title: Association between Aortic Atheroma and Cerebral Small Vessel Disease in Patients with Ischemic Stroke.
abstract: OBJECTIVE
  Cerebral small vessel disease (SVDs) are related with large artery atherosclerosis. However, the association between aortic atheroma (AA) and cerebral small vessel disease has rarely been reported. This study evaluated the relationship between presence and burden of AAs and those of SVDs in patients with acute ischemic stroke.
  
  
  METHODS
  We included 737 consecutive patients who underwent transesophageal echocardiography (TEE) and brain magnetic resonance imaging (MRI) for evaluation of acute stroke. AA subtypes were classified as complex aortic plaque (CAP) and simple aortic plaque (SAP). Presence and burden of SVDs including cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), perivascular spaces (PVSs), asymptomatic lacunar infarctions (ALIs), and total SVD score, were investigated.
  
  
  RESULTS
  AA was found by TEE in 360 (48.8%) patients including 11.6% with CAP and 37.2% with SAP. One or more types of SVDs was found in 269 (36.4%) patients. In multivariable analysis, presence of CMBs (odds ratio [OR] 4.68), high-grade WMHs (OR 3.13), high-grade PVSs (OR 3.35), and ALIs (OR 4.24) were frequent in patients with AA than those without AA. Each 1-point increase in total SVD score increased the odds of presence of CAP (OR 1.94, 95% confidence interval (CI) 1.44-1.85) and SAP (OR 1.54, 95% CI 1.35-1.75).
  
  
  CONCLUSIONS
  In this study, patients with AA frequently had cerebral SVDs. Larger burden of AA was associated with advanced cerebral SVDs. Our findings give an additional information for positive relationship with systemic atherosclerosis and coexisting cerebral SVDs in acute ischemic stroke patients.
authors.affiliation: Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea.|Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Song
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kim
authors.affiliation: Department of Neurology, Cha University College of Medicine, Seongnam, Korea.
authors.forename: Joonsang
authors.initials: J
authors.lastname: Yoo
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.|Department of Neurology, Cha University College of Medicine, Seongnam, Korea.
authors.forename: Jinkwon
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
authors.affiliation: Department of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Geu Ru
authors.initials: GR
authors.lastname: Hong
authors.affiliation: Department of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dongbeom
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyo Suk
authors.initials: HS
authors.lastname: Nam
keywords: Aortic atheroma; Cerebral small vessel diseases; White matter hyperintensity