Intracranial Atherosclerotic Burden on 7T MRI Is Associated with Markers of Extracranial Atherosclerosis: The SMART-MR Study
Zwartbol, M. H. T.; Geerlings, M. I.; Ghaznawi, R.; Hendrikse, J.; van der Kolk, A. G.; UCC-SMART Study Group
(2019) American Journal of Neuroradiology, volume 40, issue 12, pp. 2016 - 2022
(Article)
Abstract
BACKGROUND AND PURPOSE: Intracranial atherosclerosis, a major risk factor for ischemic stroke, is thought to have different atherogenic mechanisms than extracranial atherosclerosis. Studies investigating their relationship in vivo are sparse and report inconsistent results. We studied the relationship between intracranial atherosclerosis and extracranial atherosclerosis in a cohort of patients with
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a history of vascular disease. MATERIALS AND METHODS: Within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART) study, cross-sectional analyses were performed in 130 patients (mean age, 68 ± 9 years) with a history of vascular disease and with assessable 7T intracranial vessel wall MR imaging data. Intracranial atherosclerosis burden was defined as the number of intracranial vessel wall lesions in the circle of Willis and its major branches. Age- and sex-adjusted unstandardized regression coefficients (b-value) were calculated with intracranial atherosclerosis burden as the dependent variable and extracranial atherosclerosis markers as independent variables. RESULTS: Ninety-six percent of patients had ≥1 vessel wall lesion, with a mean intracranial atherosclerosis burden of 8.5 ± 5.7 lesions. Significant associations were observed between higher intracranial atherosclerosis burden and carotid intima-media thickness (b 4 0.53 lesions per +0.1 mm; 95% CI, 0.1-1.0 lesions), 50%-100% carotid stenosis versus no stenosis (b 4 6.6 lesions; 95% CI, 2.3-10.9 lesions), ankle-brachial index ≤ 0.9 versus >0.9 (b 4 4.9 lesions; 95% CI, 1.7-8.0 lesions), and estimated glomerular filtration rate (b 4 -0.77 lesions per +10 mL/min; 95% CI, -1.50 to -0.03 lesions). No significant differences in intracranial atherosclerosis burden were found among different categories of vascular disease. CONCLUSIONS: Intracranial atherosclerosis was associated with various extracranial markers of atherosclerosis, not supporting a different etiology.
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Keywords: Clinical Neurology, Radiology Nuclear Medicine and imaging, Journal Article
ISSN: 0195-6108
Publisher: American Society of Neuroradiology
Note: Funding Information: Jeroen Hendrikse has received funding from the European Research Council under the European Union's Horizon 2020 Program (H2020)/European Research Council grant agreement No. 637024 (HEARTOFSTROKE) and H2020 grant agreement No. 666881, SVDs@target, and is supported by the Netherlands Organization for Scientific Research under grant No. 91712322. Funding Information: Received July 27, 2019; accepted after revision September 24. From the Department of Radiology (M.H.T.Z., R.G., J.H., A.G.v.d.K.) and Julius Center for Health Sciences and Primary Care (M.I.G., R.G.), University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands. Jeroen Hendrikse has received funding from the European Research Council under the European Union’s Horizon 2020 Program (H2020)/European Research Council grant agreement No. 637024 (HEARTOFSTROKE) and H2020 grant agreement No. 666881, SVDs@target, and is supported by the Netherlands Organization for Scientific Research under grant No. 91712322. Please address correspondence to Mirjam I. Geerlings, PhD, University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, PO Box 85500, Stratenum 6.131, 3508 GA Utrecht, the Netherlands; e-mail: m.geerlings@umcutrecht.nl Indicates open access to non-subscribers at www.ajnr.org Indicates article with supplemental on-line tables. Indicates article with supplemental on-line photo. Publisher Copyright: © 2019 American Society of Neuroradiology. All rights reserved.
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