TY - JOUR
T1 - Diastolic carotid artery wall shear stress is associated with cerebral infarcts and periventricular white matter lesions
AU - Mutsaerts, Henri J.M.M.
AU - Palm-Meinders, Inge H.
AU - De Craen, Anton J.M.
AU - Reiber, Johan H.C.
AU - Blauw, Gerard J.
AU - Van Buchem, Mark A.
AU - Van Der Grond, Jeroen
AU - Box, Frieke M.A.
PY - 2011/12/1
Y1 - 2011/12/1
N2 - 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). 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. 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. 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. 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.
AB - 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). 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. 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. 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. 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.
KW - Carotid artery
KW - Cerebral infarct
KW - Hemodynamics
KW - Wall shear stress
KW - White matter lesions
UR - http://www.scopus.com/inward/record.url?scp=84856232976&partnerID=8YFLogxK
U2 - https://doi.org/10.1161/STROKEAHA.111.614453
DO - https://doi.org/10.1161/STROKEAHA.111.614453
M3 - Article
C2 - 21903967
SN - 0039-2499
VL - 42
SP - 3497
EP - 3501
JO - Stroke
JF - Stroke
IS - 12
ER -