title: Endothelium-dependent vasodilation is related to the occurrence of cortical brain infarcts at MR imaging: The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.
abstract: BACKGROUND
  Infarcts in the brain can be divided into larger cortical and smaller deep lacunar infarcts. The pathogenesis differs between these two types of infarctions.
  
  
  OBJECTIVE
  This study aims to investigate the relationship between measures of endothelium-dependent vasodilation (EDV) and occurrence of cortical and lacunar infarcts in a population-based sample.
  
  
  METHODS
  In the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS) study, 1016 subjects aged 70 were evaluated by the invasive forearm technique with acetylcholine (EDV) and brachial artery ultrasound to assess flow-mediated vasodilation (FMD). Six to seven years later MRI of the brain was performed, and the prevalence of cortical and lacunar infarcts was visually assessed in 407 randomly selected subjects.
  
  
  RESULTS
  Lacunar infarcts were found in 22% and cortical infarcts in 5·9% of the subjects. EDV and FMD were both significantly related to the occurrence of cortical, but not lacunar infarcts. In a model adjusting for gender, waist circumference, body mass index, fasting blood glucose, systolic and diastolic blood pressure, HDL and LDL cholesterol, serum triglycerides, smoking, antihypertensive treatment and statin use, both EDV and FMD were independent predictors of cortical infarcts (P = 0·035 and P = 0·008, respectively).
  
  
  CONCLUSIONS
  Endothelium-dependent vasodilation in both forearm resistance vessels and the brachial artery was related to the occurrence of cortical, but not lacunar, infarcts at MRI in a population-based sample independently of traditional risk factors.
authors: Department of Medical Sciences, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
authors: Lars
authors: L
authors: Lind
authors: Department of Radiology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
authors: Ruta
authors: R
authors: Nylander
authors: Department of Radiology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
authors: Lars
authors: L
authors: Johansson
authors: Department of Radiology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
authors: Joel
authors: J
authors: Kullberg
authors: Department of Radiology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
authors: Håkan
authors: H
authors: Ahlström
authors: Department of Radiology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
authors: Elna-Marie
authors: EM
authors: Larsson
mesh_terms: D000109:Acetylcholine / Q000008:administration & dosage; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012039:Regional Blood Flow; D012307:Risk Factors; D059409:Stroke, Lacunar / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D013548:Sweden; D014463:Ultrasonography; D014655:Vascular Resistance; D014664:Vasodilation; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D000109:Acetylcholine
keywords: brain; brain infarcts; endothelium; magnetic resonance imaging; vasodilation