scholarly journals Statins and Gender-Related Difference in Endothelial Function in Cerebral Small Vessel Disease

Stroke ◽  
2009 ◽  
Vol 40 (9) ◽  
Author(s):  
Kazushi Tsuda
Keyword(s):  
Endothelial Function ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Related Difference ◽  
And Gender

scholarly journals Circulating biologic markers of endothelial dysfunction in cerebral small vessel disease: A review

2015 ◽  
Vol 36 (1) ◽  
pp. 72-94 ◽  
Author(s):  
Anna Poggesi ◽  
Marco Pasi ◽  
Francesca Pescini ◽  
Leonardo Pantoni ◽  
Domenico Inzitari
Keyword(s):  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Small Vessel Disease ◽  
Brain Magnetic Resonance Imaging ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Perivascular Spaces ◽  
Vessel Disease ◽  
Brain Changes

The term cerebral small vessel disease (SVD) refers to a group of pathologic processes with various etiologies that affect small arteries, arterioles, venules, and capillaries of the brain. Magnetic resonance imaging (MRI) correlates of SVD are lacunes, recent small subcortical infarcts, white-matter hyperintensities, enlarged perivascular spaces, microbleeds, and brain atrophy. Endothelial dysfunction is thought to have a role in the mechanisms leading to SVD-related brain changes, and the study of endothelial dysfunction has been proposed as an important step for a better comprehension of cerebral SVD. Among available methods to assess endothelial function in vivo, measurement of molecules of endothelial origin in peripheral blood is currently receiving selective attention. These molecules include products of endothelial cells that change when the endothelium is activated, as well as molecules that reflect endothelial damage and repair. This review examines the main molecular factors involved in both endothelial function and dysfunction, and the evidence linking endothelial dysfunction with cerebral SVD, and gives an overview of clinical studies that have investigated the possible association between endothelial circulating biomarkers and SVD-related brain changes.

scholarly journals Association of Aortic Compliance and Brachial Endothelial Function with Cerebral Small Vessel Disease in Type 2 Diabetes Mellitus Patients: Assessment with High-Resolution MRI

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Yan Shan ◽  
Jiang Lin ◽  
Pengju Xu ◽  
Mengsu Zeng ◽  
Huandong Lin ◽  
...  
Keyword(s):  
High Resolution ◽  
Endothelial Function ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Regression Analyses ◽  
Aortic Compliance ◽  
Vessel Disease ◽  
High Resolution Mri

Objective. To assess the possible association of aortic compliance and brachial endothelial function with cerebral small vessel disease in type 2 diabetes mellitus (DM2) patients by using 3.0 T high-resolution magnetic resonance imaging.Methods. Sixty-two clinically confirmed DM2 patients (25 women and 37 men; mean age:56.8±7.5years) were prospectively enrolled for noninvasive MR examinations of the aorta, brachial artery, and brain. Aortic arch pulse wave velocity (PWV), flow-mediated dilation (FMD) of brachial artery, lacunar brain infarcts, and periventricular and deep white matter hyperintensities (WMHs) were assessed. Pearson and Spearman correlation analysis were performed to analyze the association between PWV and FMD with clinical data and biochemical test results. Univariable logistic regression analyses were used to analyze the association between PWV and FMD with cerebral small vessel disease. Multiple logistic regression analyses were used to find out the independent predictive factors of cerebral small vessel disease.Results. Mean PWV was6.73±2.00 m/s and FMD was16.67±9.11%. After adjustment for compounding factors, PWV was found significantly associated with lacunar brain infarcts (OR = 2.00; 95% CI: 1.14–3.2;P<0.05) and FMD was significantly associated with periventricular WMHs (OR = 0.82; 95% CI: 0.71–0.95;P<0.05).Conclusions. Quantitative evaluation of aortic compliance and endothelial function by using high-resolution MRI may be potentially useful to stratify DM2 patients with risk of cerebral small vessel disease.

scholarly journals Tadalafil may improve cerebral perfusion in small-vessel occlusion stroke—a pilot study

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Joakim Ölmestig ◽  
Ida R Marlet ◽  
Rasmus H Hansen ◽  
Shazia Rehman ◽  
Rikke Steen Krawcyk ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endothelial Function ◽  
Oxygen Saturation ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Vessel Occlusion ◽  
Vessel Disease

Abstract New treatments for cerebral small-vessel disease are needed to reduce the risk of small-vessel occlusion stroke and vascular cognitive impairment. We investigated an approach targeted to the signalling molecule cyclic guanosine monophosphate, using the phosphodiesterase 5 inhibitor tadalafil, to explore if it improves cerebral blood flow and endothelial function in patients with cerebral small-vessel disease and stroke. In a randomized, double-blinded, placebo-controlled, cross-over pilot trial (NCT02801032), we included patients who had a previous (&gt;6 months) small-vessel occlusion stroke. They received a single dose of either 20 mg tadalafil or placebo on 2 separate days at least 1 week apart. We measured the following: baseline MRI for lesion load, repeated measurements of blood flow velocity in the middle cerebral artery by transcranial Doppler, blood oxygen saturation in the cortical microvasculature by near-infrared spectroscopy, peripheral endothelial response by EndoPAT and endothelial-specific blood biomarkers. Twenty patients with cerebral small-vessel disease stroke (3 women, 17 men), mean age 67.1 ± 9.6, were included. The baseline mean values ± standard deviations were as follows: blood flow velocity in the middle cerebral artery, 57.4 ± 10.8 cm/s; blood oxygen saturation in the cortical microvasculature, 67.0 ± 8.2%; systolic blood pressure, 145.8 ± 19.5 mmHg; and diastolic blood pressure, 81.3 ± 9.1 mmHg. We found that tadalafil significantly increased blood oxygen saturation in the cortical microvasculature at 180 min post-administration with a mean difference of 1.57 ± 3.02%. However, we saw no significant differences in transcranial Doppler measurements over time. Tadalafil had no effects on peripheral endothelial function assessed by EndoPAT and endothelial biomarker results conflicted. Our findings suggest that tadalafil may improve vascular parameters in patients with cerebral small-vessel disease stroke, although the effect size was small. Increased oxygenation of cerebral microvasculature during tadalafil treatment indicated improved perfusion in the cerebral microvasculature, theoretically presenting an attractive new therapeutic target in cerebral small-vessel disease. Future studies of the effect of long-term tadalafil treatment on cerebrovascular reactivity and endothelial function are needed to evaluate general microvascular changes and effects in cerebral small-vessel disease and stroke.

Abstract TP183: Cerebral Small Vessel Disease - A Population-based Cross-Ethnic Comparison between Chinese and White Elderly Individuals

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Vincent Mok ◽  
Ding Ding ◽  
Yunyun Xiong ◽  
Thanh G Phan ◽  
Winnie W Chu ◽  
...  
Keyword(s):  
Small Vessel Disease ◽  
White Matter Lesions ◽  
Population Based ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Age And Gender ◽  
Vessel Disease ◽  
Aging Study ◽  
National Comparison ◽  
And Gender

Background and Purpose: Ethnic differences have been reported between Asians and Whites in the prevalence of certain stroke subtypes. However, it is unknown if such differences exist with respect to manifestations of cerebral small vessel disease. We compared the prevalence of white matter lesions [WML], lacunes, and microbleeds between Han Chinese and White Australian individuals randomly selected from their respective populations. Methods: Magnetic resonance imaging (1.5 Tesla) was performed on participants of the Shanghai Aging Study (n=321, mean age 69±6 years) and Tasmanian Study of Cognition and Gait (n=397, mean age 72±7 years). A single expert rater recorded measures of WML, lacunes, and microbleeds. We compared lesion prevalence between age- and gender-matched subgroups from the two study population. Among all subjects (n=718), we used multivariable logistic regression to examine if ethnicity was associated with the presence of these lesions. Results: The prevalence rates of confluent WML, lacunes, and microbleeds among Chinese and Whites were 37% vs. 34% (p=0.09), 29% vs. 34% (p=0.24), and 9% vs. 11% (p=0.59), respectively. Subgroup analysis among age- and gender- matched subjects confirmed that confluent WML was more common among Chinese (38.5%) than Whites (28.4%, p=0.01). In multivariable regression, Chinese had a higher risk of confluent WML (odds ratio 1.53, 95% confidence interval 1.04-2.24, p=0.03) independent of other risk factors, but no differences were seen for lacunes and micro bleeds. Conclusion: In this population-based cross-national comparison, Chinese had a greater risk of moderate-to-severe WML than white Australians, but had a similar risk of lacunes and microbleeds.

P3-383: ENDOTHELIAL FUNCTION MAY MODIFY THE RELATIONSHIP BETWEEN BLOOD PRESSURE EXPOSURE AND CEREBRAL SMALL VESSEL DISEASE IN MIDLIFE

2006 ◽  
Vol 14 (7S_Part_23) ◽  
pp. P1241-P1241
Author(s):  
Shawn Kurian ◽  
Chaney R. Garner ◽  
Cristina Duque ◽  
Todd Parrish ◽  
James P. Higgins ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endothelial Function ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
The Relationship

scholarly journals Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

2020 ◽  
Vol 5 (2) ◽  
pp. 128-137
Author(s):  
Huimin Chen ◽  
Yuesong Pan ◽  
Lixia Zong ◽  
Jing Jing ◽  
Xia Meng ◽  
...  
Keyword(s):  
Regression Models ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Arterial Stenosis ◽  
Small Vessel ◽  
Minor Stroke ◽  
Bleeding Events ◽  
Stroke Outcomes ◽  
Vessel Disease ◽  
Increased Risk

BackgroundThe effect of cerebral small vessel disease (CSVD) and intracranial arterial stenosis (ICAS) on stroke outcomes remains unclear.MethodsData of 1045 patients with minor stroke or transient ischaemic attack (TIA) were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale (mRS) scores using ordinal logistic regression models.ResultsAmong the 1045 patients, CSVD was present in 830 cases (79.4%) and ICAS in 460 (44.0%). Patients with >1 ICAS segment showed the highest risk of new strokes (HR 2.03, 95% CI 1.15 to 3.56, p=0.01). No association between CSVD and the occurrence of new strokes was found. The presence of severe CSVD (common OR (cOR) 2.01, 95% CI 1.40 to 2.89, p<0.001) and >1 ICAS segment (cOR 2.15, 95% CI 1.57 to 2.93, p<0.001) was associated with higher mRS scores. Severe CSVD (HR 10.70, 95% CI 1.16 to 99.04, p=0.04), but not ICAS, was associated with a higher risk of bleeding events. Six-point modified CSVD score improved the predictive power for bleeding events and disability.InterpretationCSVD is associated with more disability and bleeding events, and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months. CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.Trial registration numberNCT00979589

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