Yali Chen1, Huapeng Yu2, Jizheng Zhu3, Hua Zhang1, Yingxin Zhao1, Yuanli Dong4, Yi Cui5, Gary Gong6, Qiang Chai1, Yuqi Guo7, Zhendong Liu8. 1. Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China. 2. Department of Cardiology, Jinan Institute of Cardiovascular Diseases, The Fourth People's Hospital of Jinan, Jinan, Shandong, 250031, China. 3. Emergency Department, The Fourth People's Hospital of Jinan, Jinan, Shandong, 250031, China. 4. Department of Community, Lanshan District People Hospital, Linyi, Shandong, 276002, China. 5. Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China. 6. The Russel H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA. 7. Key Laboratory of Rare and Uncommon Diseases, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China. Electronic address: guoyuqiyky@126.com. 8. Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China. Electronic address: zhendongliu876@126.com.
Abstract
BACKGROUND AND AIMS: The association between carotid wall shear stress (WSS) and cerebral small vessel disease has yet to be fully elucidated. The major purpose of this study was to investigate this association in older subjects. METHODS: Common carotid artery WSS, endothelial function, white matter hyperintensities (WMH), lacunes, and microbleeds were assessed in 1396 older adults. Participants were followed-up for an average of 69.7 months. RESULTS: Mean (M) and peak (P) WSS and changes in endothelial function were independently associated with changes in WMH volume and fraction, lacune counts, and microbleed counts (all p < 0.05). The risks of new-incident Fazekas scale ≥2 [hazard ratio (HR) with 95% confidence interval (CI): 2.141 (1.469-3.119), p = 0.005 and 1.731 (1.197-2.505), p = 0.004, respectively], lacunes [HR (95% CI): 2.034 (1.369-3.022), p < 0.001 and 1.693 (1.151-2.490), p = 0.003, respectively], and microbleeds [HR (95% CI): 2.311 (1.509-3.541), p < 0.001 and 2.208 (1.299-3.751), p < 0.001, respectively] were significantly higher in the lowest quartile group than in the higher quartile group, as classified by either MWSS or PWSS, after adjustment for confounders. CONCLUSIONS: Low carotid WSS is an independent risk factor for the progression of cerebral small vessel disease in older adults.
BACKGROUND AND AIMS: The association between carotid wall shear stress (WSS) and cerebral small vessel disease has yet to be fully elucidated. The major purpose of this study was to investigate this association in older subjects. METHODS: Common carotid artery WSS, endothelial function, white matter hyperintensities (WMH), lacunes, and microbleeds were assessed in 1396 older adults. Participants were followed-up for an average of 69.7 months. RESULTS: Mean (M) and peak (P) WSS and changes in endothelial function were independently associated with changes in WMH volume and fraction, lacune counts, and microbleed counts (all p < 0.05). The risks of new-incident Fazekas scale ≥2 [hazard ratio (HR) with 95% confidence interval (CI): 2.141 (1.469-3.119), p = 0.005 and 1.731 (1.197-2.505), p = 0.004, respectively], lacunes [HR (95% CI): 2.034 (1.369-3.022), p < 0.001 and 1.693 (1.151-2.490), p = 0.003, respectively], and microbleeds [HR (95% CI): 2.311 (1.509-3.541), p < 0.001 and 2.208 (1.299-3.751), p < 0.001, respectively] were significantly higher in the lowest quartile group than in the higher quartile group, as classified by either MWSS or PWSS, after adjustment for confounders. CONCLUSIONS: Low carotid WSS is an independent risk factor for the progression of cerebral small vessel disease in older adults.