Chuanhui Xu1, Jun Qin2, Jinhui Yu1, Yan Sun1, Dongmin Hu1, Gang Wu1, Yang Li3. 1. Department of Radiology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, 1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, China. 2. Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Hongkou District, Shanghai, 200080, China. 3. Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Hongkou District, Shanghai, 200080, China. yang.li@shgh.cn.
Abstract
PURPOSE: Vessel wall MRI (VW-MRI) can be used to evaluate the nature of intracranial atherosclerosis (ICAS) plaque in vivo. Phosphodiesterase 4D (PDE4D) participates in stroke development. This study aims to explore the value of VW-MRI findings and the PDE4D gene variant in predicting stroke recurrence in patients with ICAS. METHODS: We prospectively recruited 324 symptomatic ICAS patients. VW-MRI was performed to determine luminal and wall changes. PDE4D gene single-nucleotide polymorphisms (SNPs)-namely, SNP32, SNP83, and SNP87-were determined by direct sequencing. The risk factors of stroke recurrence were analyzed using the multivariate Cox proportional hazards model. RESULTS: Of the 324 subjects, 97 (29.9%) experienced recurrent ischemic stroke during the follow-up period. A total of 254 patients (78.4%) showed plaque enhancement; 87 of these patients experienced stroke recurrence. The CT/CC genotype frequencies of PDE4D83 were significantly higher in participants with recurrent stroke than in patients without stroke recurrence (p = 0.019 and p < 0.001, respectively). However, the PDE4D32 and PDE4D87 variants were not correlated with recurrent stroke. Multivariate analysis showed that plaque enhancement from VW-MRI (HR 4.52, 95% CI 2.35-8.73, p < 0.001) and the PDE4D83 variant (HR 7.43, 95% CI 1.75-31.87, p = 0.005) were independently correlated with stroke recurrence. Kaplan-Meier curves showed significant differences in stroke recurrence rates between the plaque-enhanced group and the non-enhanced group (p < 0.001) and between the PDE4D83 variant carriers and noncarriers (p = 0.002). CONCLUSION: Plaque enhancement on VW-MRI and the presence of the PDE4D83 variant are associated with ischemic stroke recurrence in subjects with symptomatic ICAS.
PURPOSE: Vessel wall MRI (VW-MRI) can be used to evaluate the nature of intracranial atherosclerosis (ICAS) plaque in vivo. Phosphodiesterase 4D (PDE4D) participates in stroke development. This study aims to explore the value of VW-MRI findings and the PDE4D gene variant in predicting stroke recurrence in patients with ICAS. METHODS: We prospectively recruited 324 symptomatic ICAS patients. VW-MRI was performed to determine luminal and wall changes. PDE4D gene single-nucleotide polymorphisms (SNPs)-namely, SNP32, SNP83, and SNP87-were determined by direct sequencing. The risk factors of stroke recurrence were analyzed using the multivariate Cox proportional hazards model. RESULTS: Of the 324 subjects, 97 (29.9%) experienced recurrent ischemic stroke during the follow-up period. A total of 254 patients (78.4%) showed plaque enhancement; 87 of these patients experienced stroke recurrence. The CT/CC genotype frequencies of PDE4D83 were significantly higher in participants with recurrent stroke than in patients without stroke recurrence (p = 0.019 and p < 0.001, respectively). However, the PDE4D32 and PDE4D87 variants were not correlated with recurrent stroke. Multivariate analysis showed that plaque enhancement from VW-MRI (HR 4.52, 95% CI 2.35-8.73, p < 0.001) and the PDE4D83 variant (HR 7.43, 95% CI 1.75-31.87, p = 0.005) were independently correlated with stroke recurrence. Kaplan-Meier curves showed significant differences in stroke recurrence rates between the plaque-enhanced group and the non-enhanced group (p < 0.001) and between the PDE4D83 variant carriers and noncarriers (p = 0.002). CONCLUSION: Plaque enhancement on VW-MRI and the presence of the PDE4D83 variant are associated with ischemic stroke recurrence in subjects with symptomatic ICAS.
Authors: J D Schaafsma; S Rawal; J M Coutinho; J Rasheedi; D J Mikulis; C Jaigobin; F L Silver; D M Mandell Journal: AJNR Am J Neuroradiol Date: 2019-09-05 Impact factor: 3.825
Authors: Solveig Gretarsdottir; Sigurlaug Sveinbjörnsdottir; Hjörtur H Jonsson; Finnbogi Jakobsson; Elisabet Einarsdottir; Uggi Agnarsson; Dana Shkolny; Gisli Einarsson; Herdis M Gudjonsdottir; Einar M Valdimarsson; Olafur B Einarsson; Gudmundur Thorgeirsson; Radinka Hadzic; Sif Jonsdottir; Sigridur Th Reynisdottir; Sigrun M Bjarnadottir; Thorunn Gudmundsdottir; Gudrun J Gudlaugsdottir; Ramanjit Gill; Klaus Lindpaintner; Jesus Sainz; Helgi H Hannesson; Gunnar Th Sigurdsson; Michael L Frigge; Augustine Kong; Vilmundur Gudnason; Kari Stefansson; Jeffrey R Gulcher Journal: Am J Hum Genet Date: 2002-02-06 Impact factor: 11.025
Authors: C Grond-Ginsbach; M Hummel; T Wiest; S Horstmann; K Pfleger; M Hergenhahn; M Hollstein; U Mansmann; A J Grau; S Wagner Journal: J Neurol Date: 2008-05-15 Impact factor: 4.849