TY - JOUR
T1 - Low carotid endothelial shear stress associated with cerebral small vessel disease in an older population
T2 - A subgroup analysis of a population-based prospective cohort study
AU - Chen, Yali
AU - Yu, Huapeng
AU - Zhu, Jizheng
AU - Zhang, Hua
AU - Zhao, Yingxin
AU - Dong, Yuanli
AU - Cui, Yi
AU - Gong, Gary
AU - Chai, Qiang
AU - Guo, Yuqi
AU - Liu, Zhendong
N1 - Publisher Copyright:
© 2019 The Authors
PY - 2019/9
Y1 - 2019/9
N2 - Background and aims: The association between carotid wall shear stress (WSS) and cerebral small vessel disease has yet to be fully elucidated. The major purpose of this study was to investigate this association in older subjects. Methods: Common carotid artery WSS, endothelial function, white matter hyperintensities (WMH), lacunes, and microbleeds were assessed in 1396 older adults. Participants were followed-up for an average of 69.7 months. Results: Mean (M) and peak (P) WSS and changes in endothelial function were independently associated with changes in WMH volume and fraction, lacune counts, and microbleed counts (all p < 0.05). The risks of new-incident Fazekas scale ≥2 [hazard ratio (HR) with 95% confidence interval (CI): 2.141 (1.469–3.119), p = 0.005 and 1.731 (1.197–2.505), p = 0.004, respectively], lacunes [HR (95% CI): 2.034 (1.369–3.022), p < 0.001 and 1.693 (1.151–2.490), p = 0.003, respectively], and microbleeds [HR (95% CI): 2.311 (1.509–3.541), p < 0.001 and 2.208 (1.299–3.751), p < 0.001, respectively] were significantly higher in the lowest quartile group than in the higher quartile group, as classified by either MWSS or PWSS, after adjustment for confounders. Conclusions: Low carotid WSS is an independent risk factor for the progression of cerebral small vessel disease in older adults.
AB - Background and aims: The association between carotid wall shear stress (WSS) and cerebral small vessel disease has yet to be fully elucidated. The major purpose of this study was to investigate this association in older subjects. Methods: Common carotid artery WSS, endothelial function, white matter hyperintensities (WMH), lacunes, and microbleeds were assessed in 1396 older adults. Participants were followed-up for an average of 69.7 months. Results: Mean (M) and peak (P) WSS and changes in endothelial function were independently associated with changes in WMH volume and fraction, lacune counts, and microbleed counts (all p < 0.05). The risks of new-incident Fazekas scale ≥2 [hazard ratio (HR) with 95% confidence interval (CI): 2.141 (1.469–3.119), p = 0.005 and 1.731 (1.197–2.505), p = 0.004, respectively], lacunes [HR (95% CI): 2.034 (1.369–3.022), p < 0.001 and 1.693 (1.151–2.490), p = 0.003, respectively], and microbleeds [HR (95% CI): 2.311 (1.509–3.541), p < 0.001 and 2.208 (1.299–3.751), p < 0.001, respectively] were significantly higher in the lowest quartile group than in the higher quartile group, as classified by either MWSS or PWSS, after adjustment for confounders. Conclusions: Low carotid WSS is an independent risk factor for the progression of cerebral small vessel disease in older adults.
KW - Cerebral small vessel disease
KW - Endothelial function
KW - Hemodynamic
KW - Shear stress
UR - http://www.scopus.com/inward/record.url?scp=85068922167&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068922167&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2019.07.006
DO - 10.1016/j.atherosclerosis.2019.07.006
M3 - Article
C2 - 31323461
AN - SCOPUS:85068922167
SN - 0021-9150
VL - 288
SP - 42
EP - 50
JO - Atherosclerosis
JF - Atherosclerosis
ER -