J Stroke.
2016 Sep;18(3):312-320. 10.5853/jos.2016.00171.
Association between Aortic Atheroma and Cerebral Small Vessel Disease in Patients with Ischemic Stroke
- Affiliations
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- 1Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea.
- 2Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. hsnam@yuhs.ac
- 3Department of Neurology, Cha University College of Medicine, Seongnam, Korea.
- 4Department of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
- KMID: 2359508
- DOI: http://doi.org/10.5853/jos.2016.00171
Abstract
- BACKGROUND AND PURPOSE
Cerebral small vessel disease (SVDs) are related with large artery atherosclerosis. However, the association between aortic atheroma (AA) and cerebral small vessel disease has rarely been reported. This study evaluated the relationship between presence and burden of AAs and those of SVDs in patients with acute ischemic stroke.
METHODS
We included 737 consecutive patients who underwent transesophageal echocardiography (TEE) and brain magnetic resonance imaging (MRI) for evaluation of acute stroke. AA subtypes were classified as complex aortic plaque (CAP) and simple aortic plaque (SAP). Presence and burden of SVDs including cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), perivascular spaces (PVSs), asymptomatic lacunar infarctions (ALIs), and total SVD score, were investigated.
RESULTS
AA was found by TEE in 360 (48.8%) patients including 11.6% with CAP and 37.2% with SAP. One or more types of SVDs was found in 269 (36.4%) patients. In multivariable analysis, presence of CMBs (odds ratio [OR] 4.68), high-grade WMHs (OR 3.13), high-grade PVSs (OR 3.35), and ALIs (OR 4.24) were frequent in patients with AA than those without AA. Each 1-point increase in total SVD score increased the odds of presence of CAP (OR 1.94, 95% confidence interval (CI) 1.44-1.85) and SAP (OR 1.54, 95% CI 1.35-1.75).
CONCLUSIONS
In this study, patients with AA frequently had cerebral SVDs. Larger burden of AA was associated with advanced cerebral SVDs. Our findings give an additional information for positive relationship with systemic atherosclerosis and coexisting cerebral SVDs in acute ischemic stroke patients.
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