Arterial Stiffness Is Associated With Basal Ganglia Enlarged Perivascular Spaces and Cerebral Small Vessel Disease Load.

We assessed whether the load of cerebral small vessel disease (cSVD) and its individual markers, including lacunes, white matter hyperintensities, microbleeds, and enlarged perivascular spaces (EPVS), are associated with arterial stiffness. We evaluated cSVD markers in a cohort of 782 hypertensive individuals without history of stroke or dementia. The load of the disease was calculated using an ordinal scale ranging from 0 to 4 (1 point was given for each of the 4 markers examined). The arterial stiffness was tested by measuring the carotid-femoral pulse wave velocity with an oscillometric automatic device. The mean age of the participants (49.6% women) was 62.7±5.4 years, and the mean systolic/diastolic blood pressure was 142.9/77.3 mm Hg (55.5% of the participants had poor blood pressure control). We found 7.2% cases with lacunes, 6.4% with microbleeds, 6.7% with extensive white matter hyperintensities, 24.5% with extensive basal ganglia EPVS, and 40.1% with extensive EPVS in the centrum semiovale. Regarding the cSVD load, 19.7% of the participants scored 1, 6.5% scored 2, and 1.4% scored ≥3. The median carotid-femoral pulse wave velocity was 10.5 m/s (interquartile range, 9.2-11.9) and was associated with lacunes (odds ratio per carotid-femoral pulse wave velocity SD increase, 1.51; 95% confidence interval, 1.13-2.03), extensive basal ganglia EPVS (odds ratio, 1.39; 95% confidence interval, 1.16-1.67), and cSVD load (common odds ratio, 1.42; 95% confidence interval, 1.19-1.68). We found that, in a cohort of hypertensive individuals, the arterial stiffness is associated with the total load of the cSVD, especially with lacunes and basal ganglia EPVS.

Riba-Llena I ，Jiménez-Balado J ，Castañé X ，Girona A ，López-Rueda A ，Mundet X ，Jarca CI ，Álvarez-Sabin J ，Montaner J ，Delgado P ... -  《-》

The Relationship Between Chronic Obstructive Pulmonary Disease and Cerebral Small Vessel Disease Assessed by Magnetic Resonance Imaging: A Case-Control Study from a Single Center in Beijing, China.

Qin W ，Yin J ，Yang L ，Yang S ，Li Y ，Li X ，Hu W ... -  《MEDICAL SCIENCE MONITOR》

Assessment of enlarged perivascular spaces and their relation to target organ damage and mild cognitive impairment in patients with hypertension.

Enlarged perivascular spaces (EPVS) have been recently considered a feature of cerebral small vessel disease. They have been related to aging, hypertension and dementia but their relationship with hypertension related variables (i.e. target organ damage, treatment compliance) and mild cognitive impairment (MCI) is not fully elucidated. Our aims were to investigate the relation between basal ganglia (BG) and centrum semiovale (CSO) EPVS with vascular risk factors, hypertension related variables and MCI. In all, 733 hypertensive individuals free of stroke and dementia from the Investigating Silent Strokes in Hypertensives, a magnetic resonance imaging Study (ISSYS) underwent brain magnetic resonance imaging and cognitive testing to diagnose MCI or normal cognitive aging. The numbers of participants presenting high grade (>10) EPVS at the BG and CSO were 23.3% and 40.0%, respectively. After controlling for vascular risk factors, high grade BG EPVS were associated with age (odds ratio 1.68; 95% confidence interval 1.37, 2.06), poor antihypertensive compliance (1.49; 1.03, 2.14) and the presence of microalbuminuria (1.95; 1.16, 3.28), whereas in the CSO only age (1.38; 1.18, 1.63) and male sex were associated with EPVS (1.73; 1. 24, 2.42). MCI was diagnosed in 9.3% of the participants and it was predicted by EPVS in the BG (1.87; 1.03, 3.39) but not in the CSO. This last association was greatly attenuated after correction for lacunes and white matter hyperintensities. Basal ganglia EPVS are associated with the presence of microalbuminuria and poor adherence to antihypertensive drugs. The BG EPVS relation with MCI is not independent of the presence of other cerebral small vessel disease markers.

Riba-Llena I ，Nafría C ，Mundet X ，López-Rueda A ，Fernández-Cortiñas I ，Jarca CI ，Jiménez-Balado J ，Domingo M ，Tovar JL ，Orfila F ，Pujadas F ，Álvarez-Sabín J ，Maisterra O ，Montaner J ，Delgado P ... -  《-》

Chronic Kidney Disease as Risk Factor for Enlarged Perivascular Spaces in Patients With Stroke and Relation to Racial Group.

Penton AA ，Lau H ，Babikian VL ，Shulman J ，Cervantes-Arslanian A ，Gangadhara S ，Greer D ，Aparicio HJ ，Romero JR ... -  《-》

Microalbuminuria and the Combination of MRI Markers of Cerebral Small Vessel Disease.

Kidney function has been related to the presence of individual markers of cerebral small vessel disease (CSVD), as lacunes, white matter hyperintensities (WMH) or microbleeds. We aimed at studying the relationship of kidney dysfunction with the combination of several markers of CSVD. Subjects are those included in the ISSYS cohort (Investigating Silent Strokes in hypertensives: a magnetic resonance imaging study). A scale ranging from 0 to 4 points was applied based on the presence (one point each) of lacunes, deep microbleeds, moderate to extensive basal ganglia enlarged perivascular spaces (EPVS), and periventricular or deep WMH. We determined the creatinine-based glomerular filtration rate and the urinary albumin-to-creatinine ratio (UACR) as markers of kidney function and studied their association with the scale of CSVD in univariate and ordinal logistic regression analyses. Among the 975 patients included, 28.2% presented one or more CSVD markers, being the most prevalent marker (either alone or in combination) basal ganglia EPVS. The UACR was elevated at increasing the scores of the CSVD scale and remained as independent predictor of the combination of markers (common OR per natural log unit increase in UACR: 1.23, 1.07-1.41) after controlling per age, gender, cardiovascular risk, antihypertensive treatment and hypertension duration. In contrast, no associations were found between the CSVD scores and the creatinine-based estimated glomerular filtration rate. A significant proportion of stroke-free hypertensives present at least one imaging marker of CSVD. UACR but not creatinine-based glomerular filtration rate is associated with the combination of markers of CSVD.

Vilar-Bergua A ，Riba-Llena I ，Ramos N ，Mundet X ，Espinel E ，López-Rueda A ，Ostos E ，Seron D ，Montaner J ，Delgado P ... -  《-》