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White matter hyperintensities: use of aortic arch pulse wave velocity to predict volume independent of other cardiovascular risk factors

Title: White matter hyperintensities: use of aortic arch pulse wave velocity to predict volume independent of other cardiovascular risk factors
Authors: King, Kevin S; Chen, Ke Xun; Hulsey, Keith M; McColl, Roderick W; Weiner, Myron F; Nakonezny, Paul A; Peshock, Ronald M
Source: Neuroradiology
Publisher Information: Barrow - St. Joseph's Scholarly Commons
Publication Year: 2013
Subject Terms: Aorta; Thoracic (pathology); Blacks; Brain (pathology); Cardiovascular Diseases (ethnology; pathology); Cerebrovascular Disorders (ethnology; Female; Hispanic or Latino; Humans; Least-Squares Analysis; Linear Models; Magnetic Resonance Imaging (methods); Male; Middle Aged; Nerve Fibers; Myelinated (pathology); Neuroimaging; Predictive Value of Tests; Prospective Studies; Pulse Wave Analysis; Risk Factors
Description: PURPOSE: To evaluate the relationship between pulse wave velocity (PWV) from the aortic arch and subsequent cerebral microvascular disease independent of other baseline cardiovascular risk factors among the participants in the multiethnic Dallas Heart Study. MATERIALS AND METHODS: Each subject gave written consent to participate in this HIPAA-compliant, institutional review board-approved prospective study. Aortic arch PWV was measured with phase-contrast magnetic resonance (MR) imaging in a population sample (n = 1270) drawn from the probability-based Dallas Heart Study. Seven years later, the volume of white matter hyperintensities (WMHs) was determined from brain MR images. Linear regression was conducted with aortic arch PWV, 15 other cardiovascular risk factors, and age, sex, and ethnicity included as predictors of WMH. The authors implemented a smoothly clipped absolute deviation-penalized variable selection method to evaluate an optimal predictive risk factor model. RESULTS: Aortic arch PWV helped predict WMH volume independent of the other demographic and cardiovascular risk factors (regression coefficient: 0.29; standard error: 0.06; 95% confidence interval: 0.17, 0.42; P < .0001). The optimal predictor variables of subsequent WMH volume adjusted for sex and ethnicity included aortic arch PWV, age, systolic blood pressure, hypertension treatment, and congestive heart failure. The authors estimated that a 1% increase in aortic arch PWV (in meters per second) is related to a 0.3% increase in subsequent WMH volume (in milliliters) when all other variables in the model are held constant. CONCLUSION: Aortic arch PWV measured with phase-contrast MR imaging is a highly significant independent predictor of subsequent WMH volume, with a higher standardized effect than any other cardiovascular risk factor assessed except for age. In an optimal predictive model of subsequent WMH burden, aortic arch PWV provides a distinct contribution along with systolic blood pressure, hypertension treatment, congestive heart ...
Document Type: text
Language: unknown
Relation: https://scholar.barrowneuro.org/neuroradiology/64; https://doi.org/10.1148/radiol.13121598
DOI: 10.1148/radiol.13121598
Availability: https://scholar.barrowneuro.org/neuroradiology/64; https://doi.org/10.1148/radiol.13121598
Accession Number: edsbas.7B4C7CEA
Database: BASE