title: Risk Factors for Lacunar Strokes with Visible Cerebral Lesions on Computed Tomography Scan.
abstract: BACKGROUND
  The aim of this study was the detection of risk factors for lacunar strokes with visible lesions on computed tomography (CT) scan, considering in particular clinical characteristics, echocardiographic parameters, and carotid-femoral pulse wave velocity (PWV, a marker of large-artery stiffness). Lacunar strokes with very small or nonvisible lesions may have different risk factors.
  
  
  METHODS
  We examined 106 patients (mean age 66.9 ± 12.3 years, 60 men), including 55 patients with clinically lacunar stroke associated with deep ischemic lesions of .3-1.5 cm on brain CT scan, and 51 control patients with cortical ischemic stroke, with lesions of 2.5-10.0 cm.
  
  
  RESULTS
  In multiple logistic regression, with respect to cortical strokes, the following variables were independently associated with lacunar strokes: tricuspid regurgitation velocity (inverse relationship, odds ratio [OR] .13, 95% confidence interval [CI] .04-.43, P = .0007, cutoff at 228 cm/s), mean systolic blood pressure (SBP) (OR 3.98, 95% CI 2.78-7.79, P = .008, cutoff at 145 mmHg), ever-smoker status (OR 2.68, 95% CI 1.06-6.80, P = .04), and atrial fibrillation (inverse relationship, OR .11, 95% CI .01-1.00, P = .0496). In univariate analysis, the patients with lacunar stroke also had a lower prevalence of mitral regurgitation. There were no differences between the 2 groups in relation to diabetes, cholesterol, left ventricular mass and dimensions, and PWV.
  
  
  CONCLUSIONS
  The patients with lacunar strokes with visible cerebral lesions on CT scan, compared with the patients with cortical infarct, had a lower tricuspid regurgitation velocity, a higher mean SBP, a greater prevalence of ever-smokers, and a lower prevalence of atrial fibrillation.
authors.affiliation: Stroke Unit, Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Electronic address: antonio.muscari@unibo.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Muscari
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Conte
authors.affiliation: Stroke Unit, Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Degli Esposti
authors.affiliation: Diagnostic and Interventional Neuroradiology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Faccioli
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Falcone
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Besar
authors.initials: B
authors.lastname: Kolce
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Marabini
authors.affiliation: Stroke Unit, Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Giovanni M
authors.initials: GM
authors.lastname: Puddu
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Rosticci
authors.affiliation: Diagnostic and Interventional Neuroradiology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Spinardi
authors.affiliation: Stroke Unit, Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Veronesi
authors.affiliation: Stroke Unit, Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Borghi
authors.affiliation: Stroke Unit, Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Zoli
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology; D001794:Blood Pressure; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D063177:Pulse Wave Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D059409:Stroke, Lacunar / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D059289:Vascular Stiffness
keywords: Blood pressure; brain CT scan; echocardiogram; lacunar stroke; pulse wave velocity; risk factors; tricuspid regurgitation