title: Atherosclerotic Plaques in the Aortic Arch and Subclinical Cerebrovascular Disease.
abstract: Aortic arch plaque (AAP) is a risk factor for ischemic stroke, but its association with subclinical cerebrovascular disease is not established. We investigated the association between AAP and subclinical cerebrovascular disease in an elderly stroke-free community-based cohort.
  
  
  
  The CABL study (Cardiovascular Abnormalities and Brain Lesions) was designed to investigate cardiovascular predictors of silent cerebrovascular disease in the elderly. AAPs were assessed by suprasternal transthoracic echocardiography in 954 participants. Silent brain infarcts and white matter hyperintensity volume (WMHV) were assessed by brain magnetic resonance imaging. The association of AAP thickness with silent brain infarcts and WMHV was evaluated by logistic regression analysis.
  
  
  
  Mean age was 71.6±9.3 years; 63% were women. AAP was present in 658 (69%) subjects. Silent brain infarcts were detected in 138 participants (14.5%). In multivariate analysis adjusted for potential confounders, AAP thickness and large AAP (≥4 mm in thickness) were significantly associated with the upper quartile of WMHV (WMHV-Q4; odds ratio =1.17; 95% confidence interval, 1.04-1.32; P=0.009 and odds ratio =1.79; 95% confidence interval, 1.40-3.09; P=0.036, respectively), but not with silent brain infarcts (odds ratio =1.08; 95% confidence interval, 0.94-1.23; P=0.265 and odds ratio =1.46; 95% confidence interval, 0.77-2.77; P=0.251, respectively).
  
  
  
  Aortic arch atherosclerosis was associated with WMHV in a stroke-free community-based elderly cohort. This association was stronger in subjects with large plaques and independent of cardiovascular risk factors. Aortic arch assessment by transthoracic echocardiography may help identify subjects at higher risk of subclinical cerebrovascular disease, who may benefit from aggressive stroke risk factors treatment.
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Aylin
authors.initials: A
authors.lastname: Tugcu
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshita
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Charles
authors.initials: C
authors.lastname: DeCarli
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Koki
authors.initials: K
authors.lastname: Nakanishi
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Sofia
authors.initials: S
authors.lastname: Shames
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: From the Departments of Medicine (A.T., S.H., K.N., S.S., M.R.D.T.), Biostatistics (Z.J.), and Neurology and Epidemiology (M.S.V.E.), Columbia University, New York; Departments of Neurology (T.R., C.B.W., R.L.S.), Epidemiology and Public Health (T.R., C.B.W., R.L.S.), and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.). md42@Columbia.edu.
authors.forename: Marco R
authors.initials: MR
authors.lastname: Di Tullio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012307:Risk Factors
keywords: atherosclerosis; cerebrovascular diseases; silent brain infarct; stroke; white matter hyperintensity