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London, United Kingdom 2013 4 Small vessel stroke and white matter disease Risk factor profiles of incident lacunar infarcts in deep white matter and basal ganglia. Evi-dence for different aetiologies. The SMART-MR study R.P. Kloppenborg1, P.J. Nederkoorn2, M. Vermeulen3, Y. van der Graaf4, M.I. Geerlings5 Academic Medical Center, Amsterdam, THE NETHERLANDS1, Academic Medical Center, Amsterdam, THE NETHERLANDS2, Academic Medical Center, Amsterdam, THE NETHER-LANDS3, Julius Center for Health Sciences and Primary Care, Utrecht, THE NETHERLANDS4, Ju-lius Center for Health Sciences and Primary Care, Utrecht, THE NETHERLANDS5 Background Lacunar infarcts are commonly seen ischemic lesions in cerebral small vessel disease. Evidence sug-gests that lacunar infarcts have different aetiologies, possibly dependent on their anatomical locali-sation and vascularisation. We hypothesized that incident lacunar infarcts in different brain regions (deep white matter vs basal ganglia) would have different risk factor profiles, suggesting different underlying aetiologies. Methods Within the SMART-MR study, a prospective cohort on brain changes on MRI in patients with symp-tomatic atherosclerotic disease, 679 patients (57 ± 9 yrs) had vascular screening and 1.5 Tesla MRI at baseline and after a mean follow-up of 3.9 years. We investigated the longitudinal relation be-tween several risk factors and incidence of lacunar infarcts in the deep white matter and basal gan-glia. Results No associations were found for atrial fibrillation, body mass index, cholesterol level, and diabetes (data not shown). History of lacunar infarcts and cerebrovascular disease was associated with la-cunar infarcts in both localisations (table 1). Hyperhomocysteinemia was the only other risk factor significantly associated with infarcts in the basal ganglia, whereas hypertension and progression of WML were only significantly associated with new lacunar infarcts in the deep white matter. Al-though smoking and IMT were also significantly associated with lacunar infarcts in the deep white matter, the size of the ORs were similar to those for infarcts in the basal ganglia (table 1). After mul-tivariate analyses, progression of WML volume remained significantly associated with new lacunar infarcts in deep white matter (OR 2.3, 95% CI 1.0-5.2, p=0.051) Conclusion Risk factor profiles for new lacunar infarcts in deep white matter and basal ganglia differ, suggesting different aetiologies. The independent association between progression of WML and incident deep white matter lacunar infarcts suggest a common aetiology for these radiological abnormalities. E-Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 239 3 Small vessel stroke and white matter disease Lack of associatinon between brachial-ankle pulse wave velocity and white matter hyperinten-sities in healthy hypertensive elderly Chinese M.M. ZHANG1, B.J. XIE2, H.K.F. MAK3, R.T.F. CHEUNG4 The University of Hong Kong, Hong Kong, HONG-KONG1, The University of Hong Kong, Hong Kong, HONG-KONG2, The University of Hong Kong, Hong Kong, HONG-KONG3, The University of Hong Kong, Hong Kong, HONG-KONG4 Background: Previous studies have indicated that arterial stiffness is associated with white matter hyperintensities (WMH) in both healthy elderly population and patients with overt vascular disease. We are interested in whether brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiff-ness, has any association with WMH in healthy hypertensive elderly Chinese. Methods: 143 healthy hypertensive Chinese over 65 years old (mean age 70.9, 58% male) were recruited to receive a MRI brain scan, a structured interview and a brachial-ankle pulse wave ve-locity assessment. WMH was evaluated using Fazekas white matter scale scores. ANOVA and Chi-square tests were used to compare categorical data and continuous data, respectively. BaPWVs were grouped into quartiles and compared with WMH. Finally, a logistic regression model was used to compute the adjusted odds ratio (OR) for advanced WMH. Results: Advanced WMH was present in 36 (25.2%) subjects. Age and baPWV level were associ-ated with different grades of WMH. WMH was not associated with gender, BMI and other vascular risk factors (total cholesterol, triglycerides, HDL, smoke history, family history of stroke, HT grade, HT duration). In the highest baPWV quartile, 15 (42.9%) subjects had advanced WMH. However, after adjusting for age, gender and other arterial vascular risk factors, there is no association be-tween the highest quartile of baPWV and advanced WMH, (OR 1.479 95% confidence interval: 0.399-5.481). Conclusion: We did not find and significant association between arterial stiffness and WMH. The small sample size is a limitation. In addition, Fazekas white matter scale score may be too simple to reveal the association.


Karger_ESC London_2013
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