Diastolic carotid artery wall shear stress is associated with cerebral infarcts and periventricular white matter lesions

Mutsaerts, H.J.M.M. et al. (2011) Diastolic carotid artery wall shear stress is associated with cerebral infarcts and periventricular white matter lesions. Stroke, 42(12), pp. 3497-3501. (doi: 10.1161/STROKEAHA.111.614453)

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<p>Background and Purpose — Low wall shear stress (WSS) is an early marker in the development of vascular lesions. The present study aims to assess the relationship between diastolic and systolic WSS in the internal carotid artery and periventricular (PWML), deep white matter lesions, and cerebral infarcts (CI).</p> <p>Methods — Early, mid, and late diastolic and peak systolic WSS were derived from shear rate obtained by gradient echo phase contrast magnetic resonance sequences multiplied by individually modeled viscosity.</p> <p>PWML, deep white matter lesions, and CI were derived from proton density (PD), T2, and fluid attenuated inversion recovery (FLAIR) MRI in 329 participants (70–82 years; PROSPER baseline). Analyses were adjusted, if appropriate, for age, gender, intracranial volume, and multiple cardiovascular risk factors.</p> <p>Results — Mid-diastolic WSS was significantly correlated with the presence of PWML (B=−10.15; P=0.006) and CI (B=−2.06; P=0.044), but not with deep white matter lesions (B=−1.30; P=0.050; adjusted for age, gender, WML, and intracranial volume). After adjustment for cardiovascular risk factors, these correlations weakened but remained significant. Systolic WSS was not correlated with any of the cerebrovascular parameters.</p> <p>Conclusions — This study is the first to our knowledge to present a cross-sectional correlation between carotid artery WSS and cerebrovascular pathology such as PWML and CI in a large population. Furthermore, it shows that diastolic hemodynamics may be more important than systolic or mean hemodynamics. Future studies exploring vascular hemodynamic damage should focus on diastolic WSS.</p>

Item Type:Articles
Additional Information:Group Author(s): PROSPER Study Group - James Shepherd, Stuart Cobbe, Ian Ford, Allan Gaw, Peter Macfarlane, Chris Packard, David Stott
Glasgow Author(s) Enlighten ID:Macfarlane, Professor Peter and Shepherd, Prof James and Gaw, Dr Allan and Stott J, Professor David and Ford, Professor Ian and Packard, Professor Chris and Cobbe, Professor Stuart
Authors: Mutsaerts, H.J.M.M., Palm-Meinders, I.H., de Craen, A.J.M., Reiber, J.H.C., Blauw, G.J., van Buchem, M.A., van der Grond, J., Box, F.M.A., Shepherd, J., Cobbe, S.M., Ford, I., Gaw, A., Macfarlane, P.W., Packard, C.J., and Stott, D.J.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Stroke

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