title: Basilar artery diameter is an independent predictor of incident cardiovascular events.
abstract: OBJECTIVE
  Basilar arterial (BA) dolichoectasia is associated with cerebral small-vessel disease and stroke. However, the association between moderate dilation of the BA and cerebral small-vessel disease or subsequent cardiovascular events remains unclear. This study aims to clarify the factors related to BA diameter and to clarify whether the BA diameter is an independent predictor of cardiovascular events.
  
  
  RESULTS
  The study subjects comprised 493 outpatients with atherosclerotic risk factors. BA diameter, lacunar infarct, severity of deep white matter hyperintensities, and intracranial steno-occlusive lesions were assessed with MRI and magnetic resonance angiography. Then, we prospectively evaluated the association between BA diameter and cardiovascular events. The BA diameter ranged from 1.1 to 5.2 mm, and only 0.8% of the patients had dolichoectasia. Male sex, the presence of lacunar infarcts, the severity of deep white matter hyperintensities, the fetal-type variation of the circle of Willis, and intracranial steno-occlusive lesions were independently associated with BA diameter. In the mean follow-up of 6.0 years, 91 patients developed cardiovascular events. BA diameter was independently associated with total cardiovascular events after adjusting for age, sex, and conventional risk factors (hazard ratio, 1.55 per 1 mm increase in BA diameter; P=0.009).
  
  
  CONCLUSIONS
  Increased BA diameter within the normal range is related to both large-vessel disease and cerebral small-vessel disease, and it could be a new predictor of cardiovascular events.
authors: Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan. makiko.rai@gmail.com
authors: Makiko
authors: M
authors: Tanaka
authors: Manabu
authors: M
authors: Sakaguchi
authors: Kaori
authors: K
authors: Miwa
authors: Shuhei
authors: S
authors: Okazaki
authors: Shigetaka
authors: S
authors: Furukado
authors: Yoshiki
authors: Y
authors: Yagita
authors: Hideki
authors: H
authors: Mochizuki
authors: Kazuo
authors: K
authors: Kitagawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004108:Dilatation, Pathologic; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014715:Vertebrobasilar Insufficiency / Q000453:epidemiology* / Q000473:pathology*
keywords: atherosclerosis; cardiovascular diseases; cerebral small-vessel disease; magnetic resonance imaging; vertebrobasilar insufficiency