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238 Scientific Programme 22. European Stroke Conference © 2013 S. Karger AG, Basel 2 Small vessel stroke and white matter disease Regional Low Cerebral Blood Flow Predicts White Matter Hyperintensity Development at 18 Months in Patients with TIA and Minor Stroke. M.L. Bernbaum1, B. Menon2, E. E. Smith3, M. Goyal4, R. Frayne5, S.B. Coutts6 University of Calgary, Calgary, CANADA1, University of Calgary, Calgary, CANADA2, Univer-sity of Calgary, Calgary, CANADA3, University of Calgary, Calgary, CANADA4, University of Cal-gary, Calgary, CANADA5, University of Calgary, Calgary, CANADA6 Background: White matter hyperintensities (WMH) are thought to be markers of underlying small vessel damage. Understanding the role of cerebral blood flow (CBF) in the formation of WMH will allow us to determine if hypoperfusion is a critical determinant of WMH development. The purpose of this study was to determine if normal appearing white matter with reduced blood flow predicts WMH on follow-up. Methods: Minor stroke and TIA patients who had MR imaging including perfusion at baseline and 18 months were included. Imaging was co-registered. New WMH at 18 months were identified by comparing follow-up with baseline FLAIR. Regions of interest (ROI) were placed on FLAIR imag-es in 3 groups: Group 1: WMH on baseline and follow-up, Group 2: new WMH on follow-up, and Group 3: normal appearing white matter at both time points. Mean CBF was measured in each ROI using Olea Sphere software. A paired t-test was used to report differences in “within patient” mean CBF. Data was analyzed using ANOVA and mixed effects regression modeling. Results: 33 patients were evaluated. Mean age 62+/-12 years, 78% male and 9% diabetic. Mean CBF was different in the 3 groups using ANOVA, taking into account clustering of data within pa-tient (p<0.0001). This difference in “within patient” mean CBF was noted between Group 1 and 3 (16.97 vs. 21.01, p<0.0001) and between Group 2 and 3 (17. 11 vs. 21.01, p< 0.0001). There was no difference in mean CBF between Group 1 and 2 (16.95 vs. 17.11, p=0.71). A mixed effects regres-sion model shows an interaction between Group and presence of diabetes; the nature of interaction being such that there is a significant difference between Group 3 vs. Group 1 + 2 only in patients with diabetes. Conclusion: Regions of white matter that develop WMH on follow-up imaging at 18 months have low baseline CBF values. Future studies aiming to improve cerebral perfusion in normal appearing white matter might provide a target for arresting the development of WMH. 1 Small vessel stroke and white matter disease Cerebrovascular reactivity and endothelial function are impaired in post lacunar stroke pa-tients. J. Staszewski1, R. Piusinska-Macoch2, E. Skrobowska3, A. Stepien4 Military Institute of Medicine, Warsaw, POLAND1, Military Institute of Medicine, Warsaw, PO-LAND2, Military Institute of Medicine, Warsaw, POLAND3, Military Institute of Medicine, Warsaw, POLAND4 Background. Cerebrovascular reactivity (CVR) impairment, platelet and endothelial function in post lacunar stroke period have not been thoroughly described. Aim. The aim of the single center, prospective study was to evaluate CVR, hemostatic factors in post lacunar ischemic stroke (LIS) patients. Methods. The CVR of the middle cerebral artery (MCA) expressed as the vasomotor reac-tivity reserve (VMRr), pulsatility and resistance indices (PI, RI) were measured by TCD ultrasonog-raphy in both MCAs. Markers of endothelial and platelet dysfunction, brachial artery flow-mediated dilatation (FMD) test have been determined. All tests have been performed 2 months following LIS. Levels of blood markers were adjusted for age, gender, and vascular risk factors. 28 LIS patients and 26 age and sex matched controls (CG) were recruited as a part of SHEF-CSVD Study. Results. The mean age (69 years in LIS, 68 in CG, p>0.05) and comorbidities were similar in both groups. Com-pared with CG, patients with LIS had significantly decreased VMRr (74% vs 48%, p<0,001), FMD (13% vs 5%, p<0,001) and had increased thrombomodulin (4412 pg/ml vs 5780 pg/ml, p=0,03), IL-1 (0,13 pg/ml vs 0,37 pg/ml, p<0,05) and hsCRP (0,24 vs 0,48, p<0,05), respectively. Other fac-tors studied (PI, RI, sP-selectin, sICAM, PF-4, β-thromboglobulin) did not differ among groups. Conclusion. Impairment of the cerebral microvasculature and endothelial function is present in post lacunar stroke patients. E-Poster Terminal 3


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