title: Brachial-ankle pulse wave velocity is associated with both acute and chronic cerebral small vessel disease.
abstract: OBJECTIVE
  The aim of this study was to determine the association of brachial-ankle pulse wave velocity (baPWV) with both acute and chronic cerebral small vessel disease (SVD).
  
  
  METHODS
  We identified 1282 consecutive patients with acute ischemic stroke or transient ischemic attack. Neuroimaging correlates of chronic lacunes, white matter hyperintensity (WMH), and cerebral microbleed (CMB) were assessed using MR images. Combined SVD score was defined as the number of presence of SVD markers including chronic lacunes, WMH, deep CMB, and acute lacunar infarction. The association between baPWV and SVD was tested using linear and logistic regression analyses.
  
  
  RESULTS
  Mean age of patients was 68 (± 12) years. Chronic lacunes were found in 675 patients (53%), WMH in 970 patients (77%), and deep CMB in 349 patients (30%). Among the 1145 patients with ischemic stroke, 292 patients (26%) were classified as having acute SVD. On multivariate analysis, a 1-SD increase in baPWV was associated with chronic lacunes [odds ratio, 1.24; 95% CI, 1.07-1.44; p < 0.01], WMH (1.38; 1.13-1.71; p < 0.01), deep CMB (1.29; 1.11-1.51; p < 0.01), acute SVD (1.19; 1.01-1.40; p = 0.04), combined SVD score >1 (1.27; 1.06-1.53; p = 0.01), and combined SVD score >2 (1.40; 1.19-1.65; p < 0.01).
  
  
  CONCLUSIONS
  baPWV is associated with both acute and chronic SVD. Our findings suggest that arterial stiffness is linked to the pathogenesis of SVD. Also, baPWV could be used as a biomarker of SVD. In future trials, it should be tested whether arterial stiffness can be a therapeutic target for SVD.
authors.affiliation: Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea.
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, South Korea. Electronic address: kwangyeol.park@gmail.com.
authors.forename: Kwang-Yeol
authors.initials: KY
authors.lastname: Park
authors.affiliation: Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea.
authors.forename: Pil-Wook
authors.initials: PW
authors.lastname: Chung
authors.affiliation: Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, South Korea.
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea.
authors.forename: Heui-Soo
authors.initials: HS
authors.lastname: Moon
authors.affiliation: Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, South Korea.
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Youn
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index / Q000379:methods*; D001783:Blood Flow Velocity / Q000502:physiology*; D059345:Cerebral Small Vessel Diseases / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D063177:Pulse Wave Analysis / Q000379:methods*; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology*
keywords: Brachial-ankle pulse wave velocity; Cerebral microbleed; Cerebral small vessel disease; Lacunes; White matter hyperintensity