title: Plasma total homocysteine level is associated with the pulsatility index of cerebral arteries in lacunar infarction.
abstract: OBJECTIVE
  The pulsatility index (PI), measured by transcranial Doppler (TCD), is a surrogate marker for distal vascular resistance in cerebral arteries, and elevated plasma total homocysteine (tHcyt) is regarded as a cause of ischemic stroke, including lacunar infarction. We investigated the relationship between the PI of cerebral arteries and plasma tHcyt in patients with lacunar infarction.
  
  
  METHODS
  Plasma tHcyt level and TCD examination were performed in 94 patients with lacunar infarction. Mean flow velocity (MFV) and PI were assessed at the ipsilateral middle cerebral artery (MCA) and contralateral MCA, relative to the infarction, and the basilar artery (BA). Multivariate regression analysis was conducted between log-transformed tHcyt levels (logHcyt) and the PI of individual arteries.
  
  
  RESULTS
  There was a significant correlation between logHcyt and the PI in all tested arteries (ipsilateral MCA: r=0.21, p=0.03; contralateral MCA: r=0.21, p=0.04; BA: r=0.35, p=0.01). In multivariate regression analysis, this significance remained unchanged after adjusting for vascular risk factors, creatinine, hematocrit and platelet count (ipsilateral MCA: β=0.26, p=0.01; contralateral MCA: β=0.21, p=0.04; BA: β=0.39, p=0.001). There was no significant association between logHcyt and MFV of individual arteries.
  
  
  CONCLUSIONS
  A significant association between plasma tHcyt and the PI of cerebral arteries indicates that homocysteine plays a role in the increase of distal arterial resistance in lacunar infarction.
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 463-712, Korea.
authors.forename: Se-A
authors.initials: SA
authors.lastname: An
authors.forename: Han-Bin
authors.initials: HB
authors.lastname: Lee
authors.forename: Yoon
authors.initials: Y
authors.lastname: Kim
authors.forename: Jinkwon
authors.initials: J
authors.lastname: Kim
authors.forename: Hyun-Sook
authors.initials: HS
authors.lastname: Kim
authors.forename: Won-Chan
authors.initials: WC
authors.lastname: Kim
authors.forename: Ok-Joon
authors.initials: OJ
authors.lastname: Kim
authors.forename: Seung-Hun
authors.initials: SH
authors.lastname: Oh
mesh_terms: D000368:Aged; D001488:Basilar Artery / Q000000981:diagnostic imaging; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006400:Hematocrit; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D012044:Regression Analysis; D012307:Risk Factors; D059409:Stroke, Lacunar / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017585:Ultrasonography, Doppler, Transcranial; D014655:Vascular Resistance
chemical_list: D006710:Homocysteine
keywords: Homocysteine; lacunar infarction; pulsatility index