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Association between Aortic Atheroma and Cerebral Small Vessel Disease in Patients with Ischemic Stroke.


ABSTRACT:

Background and purpose

Cerebral small vessel disease (SVDs) are related with large artery atherosclerosis. However, the association between aortic atheroma (AA) and cerebral small vessel disease has rarely been reported. This study evaluated the relationship between presence and burden of AAs and those of SVDs in patients with acute ischemic stroke.

Methods

We included 737 consecutive patients who underwent transesophageal echocardiography (TEE) and brain magnetic resonance imaging (MRI) for evaluation of acute stroke. AA subtypes were classified as complex aortic plaque (CAP) and simple aortic plaque (SAP). Presence and burden of SVDs including cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), perivascular spaces (PVSs), asymptomatic lacunar infarctions (ALIs), and total SVD score, were investigated.

Results

AA was found by TEE in 360 (48.8%) patients including 11.6% with CAP and 37.2% with SAP. One or more types of SVDs was found in 269 (36.4%) patients. In multivariable analysis, presence of CMBs (odds ratio [OR] 4.68), high-grade WMHs (OR 3.13), high-grade PVSs (OR 3.35), and ALIs (OR 4.24) were frequent in patients with AA than those without AA. Each 1-point increase in total SVD score increased the odds of presence of CAP (OR 1.94, 95% confidence interval (CI) 1.44-1.85) and SAP (OR 1.54, 95% CI 1.35-1.75).

Conclusions

In this study, patients with AA frequently had cerebral SVDs. Larger burden of AA was associated with advanced cerebral SVDs. Our findings give an additional information for positive relationship with systemic atherosclerosis and coexisting cerebral SVDs in acute ischemic stroke patients.

SUBMITTER: Song TJ 

PROVIDER: S-EPMC5066433 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Publications

Association between Aortic Atheroma and Cerebral Small Vessel Disease in Patients with Ischemic Stroke.

Song Tae-Jin TJ   Kim Young Dae YD   Yoo Joonsang J   Kim Jinkwon J   Chang Hyuk-Jae HJ   Hong Geu Ru GR   Shim Chi Young CY   Song Dongbeom D   Heo Ji Hoe JH   Nam Hyo Suk HS  

Journal of stroke 20160804 3


<h4>Background and purpose</h4>Cerebral small vessel disease (SVDs) are related with large artery atherosclerosis. However, the association between aortic atheroma (AA) and cerebral small vessel disease has rarely been reported. This study evaluated the relationship between presence and burden of AAs and those of SVDs in patients with acute ischemic stroke.<h4>Methods</h4>We included 737 consecutive patients who underwent transesophageal echocardiography (TEE) and brain magnetic resonance imagin  ...[more]

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