title: Diastolic carotid artery wall shear stress is associated with cerebral infarcts and periventricular white matter lesions.
abstract: OBJECTIVE
  Low wall shear stress (WSS) is an early marker in the development of vascular lesions. The present study aims to assess the relationship between diastolic and systolic WSS in the internal carotid artery and periventricular (PWML), deep white matter lesions, and cerebral infarcts (CI).
  
  
  METHODS
  Early, mid, and late diastolic and peak systolic WSS were derived from shear rate obtained by gradient echo phase contrast magnetic resonance sequences multiplied by individually modeled viscosity. PWML, deep white matter lesions, and CI were derived from proton density (PD), T2, and fluid attenuated inversion recovery (FLAIR) MRI in 329 participants (70-82 years; PROSPER baseline). Analyses were adjusted, if appropriate, for age, gender, intracranial volume, and multiple cardiovascular risk factors.
  
  
  RESULTS
  Mid-diastolic WSS was significantly correlated with the presence of PWML (B=-10.15; P=0.006) and CI (B=-2.06; P=0.044), but not with deep white matter lesions (B=-1.30; P=0.050; adjusted for age, gender, WML, and intracranial volume). After adjustment for cardiovascular risk factors, these correlations weakened but remained significant. Systolic WSS was not correlated with any of the cerebrovascular parameters.
  
  
  CONCLUSIONS
  This study is the first to our knowledge to present a cross-sectional correlation between carotid artery WSS and cerebrovascular pathology such as PWML and CI in a large population. Furthermore, it shows that diastolic hemodynamics may be more important than systolic or mean hemodynamics. Future studies exploring vascular hemodynamic damage should focus on diastolic WSS.
authors: Department of Radiology, C3-Q, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, the Netherlands.
authors: Henri J M M
authors: HJ
authors: Mutsaerts
authors: Inge H
authors: IH
authors: Palm-Meinders
authors: Anton J M
authors: AJ
authors: de Craen
authors: Johan H C
authors: JH
authors: Reiber
authors: Gerard J
authors: GJ
authors: Blauw
authors: Mark A
authors: MA
authors: van Buchem
authors: Jeroen
authors: J
authors: van der Grond
authors: Frieke M A
authors: FM
authors: Box
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D020520:Brain Infarction / Q000473:pathology* / Q000503:physiopathology; D002339:Carotid Arteries / Q000473:pathology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013314:Stress, Mechanical