title: Association between the severity of cerebral small vessel disease, pulsatility of cerebral arteries, and brachial ankle pulse wave velocity in patients with lacunar infarction.
abstract: OBJECTIVE
  Stiff arteries cause high pulse pressure and flow to be transmitted to distal organs during systole, damaging the cerebral microvasculatures. We investigated the association between the severity of cerebral small vessel disease (CSVD), the pulsatility of cerebral arteries, and the stiffness of large arteries in patients with lacunar infarction (LI).
  
  
  METHODS
  Subjects included 120 patients with LIs, who underwent MRI, transcranial Doppler ultrasonography, and brachial ankle pulse wave velocity (BaPWV). We compared the severity of CSVD, the pulsatile index (PI) of both middle cerebral arteries (MCAs), and BaPWV.
  
  
  RESULTS
  Patients with higher BaPWV were more likely to have multiple LIs and more severe white matter lesions, and tended to have higher age, systolic blood pressure, pulse pressure, heart rate, and the PI of MCAs. The PI of MCAs significantly correlated with BaPWV (with PI: r = 0.441, p < 0.001) and age (with PI: r = 0.538, p < 0.001). Multiple linear regression analysis indicated that aging (β = 0.008, p < 0.001) and BaPWV (β = 0.001, p = 0.007) were independent determinants of the PI of MCAs after adjustment for sex, pulse pressure, hypertension, and diabetes.
  
  
  CONCLUSIONS
  These findings suggest that systemic arterial stiffness may be associated with the severity of CSVD and pulsatility of cerebral arteries.
authors.affiliation: Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea. circo@lycos.co.kr
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Jae-Hyeong
authors.initials: JH
authors.lastname: Choi
authors.forename: Jung-Soo
authors.initials: JS
authors.lastname: Moon
authors.forename: Hyun-Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Cha
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000842:Ankle / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001917:Brachial Plexus / Q000503:physiopathology*; D020520:Brain Infarction / Q000209:etiology*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D011673:Pulsatile Flow / Q000502:physiology*; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017585:Ultrasonography, Doppler, Transcranial