Michelle C Johansen1, Rebecca F Gottesman1, Brian G Kral2,3, Dhananjay Vaidya3, Lisa R Yanek3, Lewis C Becker2,3, Diane M Becker3, Paul Nyquist1,3. 1. Department of Neurology (M.C.J., R.F.G., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD. 2. Department of Medicine, Division of Cardiology (B.G.K., L.C.B.), Johns Hopkins University School of Medicine, Baltimore, MD. 3. Department of Medicine, Division of General Internal Medicine, GeneSTAR Research Program (B.G.K., D.V., L.R.Y., L.C.B., D.M.B., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD.
Abstract
Background and Purpose: We aim to determine, in healthy high-risk adults, the association between subclinical coronary artery disease and white matter hyperintensity (WMH) volume and location, independent of atherosclerotic risk factors. Methods: Seven hundred eighty-two asymptomatic first-degree relatives of index cases with early-onset coronary artery disease (<60 years old) from GeneSTAR (Genetic Study of Atherosclerosis Risk) with contemporaneous coronary computed tomography angiography and brain magnetic resonance imaging were analyzed. Multilevel mixed-effects linear regression models, accounting for family structure, evaluated the association of total WMH volume and 3 regions (deep WMH, periventricular WMH [PVWMH], or borderzone [cuff]) with markers of coronary artery disease. Separate models were created for total WMH, deep WMH, PVWMH, and cuff volumes, each, as dependent variables, across coronary computed tomography angiography variables, adjusted for covariates. Results: Mean age was 51 years ±10, with 58% women and 39% African American people. Participants with any coronary plaque had 52% larger WMH volumes than those without plaque (95% CI, 0.24–0.59). Per 1% greater coronary plaque volume, total WMH volumes were 0.07% larger (95% CI, 0.04–0.10). Every 1% higher total coronary plaque volume was associated with 5.03% larger deep WMH volume (95% CI, 4.67–5.38), 5.10% PVWMH larger volume (95% CI, 4.72–5.48), and 2.74% larger cuff volume (95% CI, 2.38–3.09) with differences in this association when comparing deep WMH to PVWMH (P interaction, 0.001) or cuff (P interaction, <0.001), respectively. Conclusions: In healthy, high-risk individuals, the presence and volume of coronary artery plaque are associated with larger WMH volumes, appearing the strongest for PVWMH. These findings in high-risk families suggest a disease relationship in 2 different vascular beds, beyond traditional risk factors, possibly due to genetic predisposition.
Background and Purpose: We aim to determine, in healthy high-risk adults, the association between subclinical coronary artery disease and white matter hyperintensity (WMH) volume and location, independent of atherosclerotic risk factors. Methods: Seven hundred eighty-two asymptomatic first-degree relatives of index cases with early-onset coronary artery disease (<60 years old) from GeneSTAR (Genetic Study of Atherosclerosis Risk) with contemporaneous coronary computed tomography angiography and brain magnetic resonance imaging were analyzed. Multilevel mixed-effects linear regression models, accounting for family structure, evaluated the association of total WMH volume and 3 regions (deep WMH, periventricular WMH [PVWMH], or borderzone [cuff]) with markers of coronary artery disease. Separate models were created for total WMH, deep WMH, PVWMH, and cuff volumes, each, as dependent variables, across coronary computed tomography angiography variables, adjusted for covariates. Results: Mean age was 51 years ±10, with 58% women and 39% African American people. Participants with any coronary plaque had 52% larger WMH volumes than those without plaque (95% CI, 0.24–0.59). Per 1% greater coronary plaque volume, total WMH volumes were 0.07% larger (95% CI, 0.04–0.10). Every 1% higher total coronary plaque volume was associated with 5.03% larger deep WMH volume (95% CI, 4.67–5.38), 5.10% PVWMH larger volume (95% CI, 4.72–5.48), and 2.74% larger cuff volume (95% CI, 2.38–3.09) with differences in this association when comparing deep WMH to PVWMH (P interaction, 0.001) or cuff (P interaction, <0.001), respectively. Conclusions: In healthy, high-risk individuals, the presence and volume of coronary artery plaque are associated with larger WMH volumes, appearing the strongest for PVWMH. These findings in high-risk families suggest a disease relationship in 2 different vascular beds, beyond traditional risk factors, possibly due to genetic predisposition.
Authors: Pierre-Louis Bazin; Jennifer L Cuzzocreo; Michael A Yassa; William Gandler; Matthew J McAuliffe; Susan S Bassett; Dzung L Pham Journal: J Neurosci Methods Date: 2007-05-29 Impact factor: 2.390
Authors: F Fazekas; R Kleinert; H Offenbacher; R Schmidt; G Kleinert; F Payer; H Radner; H Lechner Journal: Neurology Date: 1993-09 Impact factor: 9.910
Authors: Brian G Kral; Lewis C Becker; Dhananjay Vaidya; Lisa R Yanek; Rehan Qayyum; Stefan L Zimmerman; Damini Dey; Daniel S Berman; Taryn F Moy; Elliot K Fishman; Diane M Becker Journal: Circ Cardiovasc Imaging Date: 2014-02-27 Impact factor: 7.792
Authors: Alan J Thomas; John T O'Brien; Sue Davis; Clive Ballard; Robert Barber; Rajesh N Kalaria; Robert H Perry Journal: Arch Gen Psychiatry Date: 2002-09
Authors: Joanna M Wardlaw; Eric E Smith; Geert J Biessels; Charlotte Cordonnier; Franz Fazekas; Richard Frayne; Richard I Lindley; John T O'Brien; Frederik Barkhof; Oscar R Benavente; Sandra E Black; Carol Brayne; Monique Breteler; Hugues Chabriat; Charles Decarli; Frank-Erik de Leeuw; Fergus Doubal; Marco Duering; Nick C Fox; Steven Greenberg; Vladimir Hachinski; Ingo Kilimann; Vincent Mok; Robert van Oostenbrugge; Leonardo Pantoni; Oliver Speck; Blossom C M Stephan; Stefan Teipel; Anand Viswanathan; David Werring; Christopher Chen; Colin Smith; Mark van Buchem; Bo Norrving; Philip B Gorelick; Martin Dichgans Journal: Lancet Neurol Date: 2013-08 Impact factor: 44.182
Authors: Yousef Hannawi; Dhananjay Vaidya; Lisa R Yanek; Michelle C Johansen; Brian G Kral; Lewis C Becker; Diane M Becker; Paul A Nyquist Journal: J Am Heart Assoc Date: 2022-05-27 Impact factor: 6.106