title: Low carotid artery wall shear stress is independently associated with brain white-matter hyperintensities and cognitive impairment in older patients.
abstract: OBJECTIVE
  Brain white-matter lesions and cognitive impairment are increasing because of the increasing number of patients aged ≥80 y. Wall shear stress (WSS) plays a pivotal role as a fluid mechanical mediator in vascular reactivity and atherosclerosis. In this study, we investigated the associations among common carotid artery (CCA) WSS, white-matter lesions, and cognitive impairment in patients aged ≥80 y
  
  
  METHODS
  We enrolled 384 patients aged ≥80 y. All subjects had CCA-WSS, brain white-matter hyperintensities (WMH), and Mini-Mental State Examination (MMSE) assessments and were divided into three groups using tertiles of mean and peak CCA-WSS.
  
  
  RESULTS
  For groups classified by the tertile of mean CCA-WSS, WMH, and WMH fraction were decreased; the MMSE score increased from low to high in the respective groups. Differences in WMH, WMH fraction, and the MMSE score were significant between any two groups (all adjusted p < 0.001). Groups classified by the tertile of peak CCA-WSS had the same pattern. Mean and peak CCA-WSS were significantly and inversely correlated with WMH (r = -0.575 and -0.570, respectively; p < 0.001) and WMH fraction (r = -0.574 and -0.569, respectively; p < 0.001) but positively correlated with the MMSE score (r = 0.390 and 0.278, respectively; p < 0.001). Multiple linear backward stepwise regression indicated the mean and peak CCA-WSS were significantly and independently associated with WMH, WMH fraction, and the MMSE score (all adjusted p < 0.001).
  
  
  CONCLUSIONS
  Carotid artery WSS was independently associated with brain white-matter lesions and cognitive impairment in patients aged ≥80 y.
authors: Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China. Electronic address: zhendongliu876@126.com.
authors: Zhendong
authors: Z
authors: Liu
authors: Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China.
authors: Yingxin
authors: Y
authors: Zhao
authors: Department of Neurology, Zhangqiu People's Hospital, Zhangqiu, Shandong, 250200, China.
authors: Xidi
authors: X
authors: Wang
authors: Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China.
authors: Hua
authors: H
authors: Zhang
authors: Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China.
authors: Yi
authors: Y
authors: Cui
authors: Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China.
authors: Yutao
authors: Y
authors: Diao
authors: Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China.
authors: Jianchao
authors: J
authors: Xiu
authors: Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China.
authors: Xiaolin
authors: X
authors: Sun
authors: Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China. Electronic address: jiangguosh@163.com.
authors: Guosheng
authors: G
authors: Jiang
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D012039:Regional Blood Flow; D012307:Risk Factors; D013314:Stress, Mechanical; D018616:Ultrasonography, Doppler, Duplex
keywords: Atherosclerosis; Cognitive function; Older patients; Wall shear stress; White matter lesions