Investigating silent strokes in hypertensives: a magnetic resonance imaging study (ISSYS): rationale and protocol design

Riba‐Llena, Iolanda; Jarca, Carmen Ioana; Mundet, Xavier; Tovar, J.L.; Orfila, Francesc; López-Rueda, Antonio; Nafría, Cristina; Fernández, José Luis Fernández; Castañé, Xavier; Domingo, Mar; Álvarez-Sabín, José; Fernández-Cortiñas, Inés; Maisterra, Olga; Montaner, Joan; Delgado, Pilar

doi:10.1186/1471-2377-13-130

Cited by 42 publications

(42 citation statements)

References 28 publications

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“…24 According to them, the expected prevalence should be ≈10%. Therefore, after applying the Ene 3.0 free software (GlaxoSmithKline S.A., Spain; http://sct.…”

Section: Methodsmentioning

confidence: 99%

“…Data acquisition details have been published elsewhere. 24 SBIs were defined as in previous studies as lesions of ≥3 mm of diameter in their widest dimension, with cerebrospinal-like fluid signal characteristics in all pulse sequences, and the presence of an hyperintense rim surrounding the lesion in fluid attenuation inversion recovery sequence was also required. 22 All MRIs were assessed by 2 neuroradiologists and an experienced stroke neurologist, and disagreements were solved by consensus.…”

Section: Neuroimaging Protocolmentioning

confidence: 99%

“…24 Briefly, this study has been carried out in patients aged 50 to 70 years and diagnosed of essential hypertension who are routinely attended by general practitioners in our health area.…”

Section: Subjects Selectionmentioning

confidence: 99%

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Prevalence and Associated Factors of Silent Brain Infarcts in a Mediterranean Cohort of Hypertensives

et al. 2014

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“…24 According to them, the expected prevalence should be ≈10%. Therefore, after applying the Ene 3.0 free software (GlaxoSmithKline S.A., Spain; http://sct.…”

Section: Methodsmentioning

confidence: 99%

Section: Neuroimaging Protocolmentioning

confidence: 99%

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Prevalence and Associated Factors of Silent Brain Infarcts in a Mediterranean Cohort of Hypertensives

et al. 2014

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“…The detailed study protocol has been published elsewhere. 13 Briefly, this was a cohort study conducted in randomly selected hypertensives, aged 50 to 70 years, with no previous history of clinical stroke or dementia, and routinely attended by primary care physicians in our health area. The main objectives of this study were to determine the prevalence of several subclinical or silent brain vascular lesions and to study their determinants and relation to further stroke and dementia.…”

Section: Methods and Subjectsmentioning

confidence: 99%

“…A brain magnetic resonance imaging with an established data acquisition protocol 13 was carried out within the next month after study entry and ABPM. All examinations were performed with the same 1.5 Tesla MR (Signa HDx 1.5, General Electrics, Waukeska, WI) and included axial and sagittal T1-weighted images and axial propeller T2-weighted, fluidattenuated inversion recovery, and gradient recalled echo sequences.…”

Section: Brain Magnetic Resonance Imagingmentioning

confidence: 99%

Short-Term Blood Pressure Variability Relates to the Presence of Subclinical Brain Small Vessel Disease in Primary Hypertension

et al. 2015

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C urrent guidelines recommend the assessment of vascular risk factors, target organ damage, and blood pressure (BP) levels to guide the treatment on primary hypertension.1 Besides BP levels, other BP-related features, such as the nocturnal dipping 2 or more recently, visit-to-visit or long-term BP variability (BPV), have been independently associated with clinical cardiovascular outcomes in a recent systematic review and meta-analysis. 3 Also, the prognostic value of BPV measured with ambulatory BP monitoring (ABPM) for 24 hours (also value-to-value or short-term BPV) has been evaluated. Data on short-term BPV from 11 populations 4 suggest a positive association between measures of short-term BPV and cardiovascular death or any (fatal and nonfatal) event. Although the contribution of short-term BPV to the prediction of cardiovascular events was shown to be small (<1%), this is still a matter of debate because results from individual studies support significant contributions. 5,6 It has been also suggested that the prognostic significance of BPV on stroke risk is weaker for short-term than for longterm BPV in treated hypertension. 7 However, these data need further investigation taking into account not only between subject BPV but also within subject BPV.Moreover, several indices of short-term BPV have been related to the presence of subclinical damage in one or multiple organs, including the heart, kidney, and vessels, independently of BP levels. [8][9][10] About the brain, hypertension is a major risk factor for cerebral small vessel disease (CSVD), which is an Abstract-Blood pressure (BP) variability is associated with stroke risk, but less is known about subclinical cerebral small vessel disease (CSVD). We aimed to determine whether CSVD relates to short-term BP variability independently of BP levels and also, whether they improve CSVD discrimination beyond clinical variables and office BP levels. This was a cohort study on asymptomatic hypertensives who underwent brain magnetic resonance imaging and 24-hour ambulatory BP monitoring. Office and average 24-hour, daytime and nighttime BP levels, and several metrics of BP variability (SD, weighted SD, coefficient of variation, and average real variability [ARV]) were calculated. Definition of CSVD was based on the presence of lacunar infarcts and white matter hyperintensity grades. Multivariate analysis and integrated discrimination improvement were performed to assess whether BP variability and levels were independently associated with CSVD and improved its discrimination. Four hundred eighty-seven individuals participated (median age, 64; 47% women). CSVD was identified in 18.9%, related to age, male sex, diabetes mellitus, use of treatment, ambulatory BP monitoring-defined BP levels, and ARV of systolic BP at any period. The highest prevalence (33.7%) was found in subjects with both 24-hour BP levels and ARV elevated. BP levels at any period and ARV (24 hours and nocturnal) emerged as independent predictors of CSVD, and discrimination was incrementally improv...

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Integrative Multi-omics Analysis to Characterize Human Brain Ischemia

et al. 2021

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Stroke is a major cause of death and disability. A better comprehension of stroke pathophysiology is fundamental to reduce its dramatic outcome. The use of highthroughput unbiased omics approaches and the integration of these data might deepen the knowledge of stroke at the molecular level depicting the interaction between different molecular units. We aimed to identify protein and gene expression changes in the human brain after ischemia through an integrative approach to join the information of both omics analyses. The translational potential of our results was explored in a pilot study with blood samples from ischemic stroke patients.Proteomics and transcriptomics discovery studies were performed in human brain samples from six deceased stroke patients comparing the infarct core with the corresponding contralateral brain region, unveiling 128 proteins and 2716 genes significantly dysregulated after stroke. Integrative bioinformatics analyses joining both datasets exposed canonical pathways altered in the ischemic area, highlighting the most influential molecules. Among the molecules with the highest fold-change, 28 genes and 9 proteins were selected to be validated in five independent human brain samples using orthogonal techniques. Our results were confirmed for NCDN, RAB3C, ST4A1, DNM1L, A1AG1, A1AT, JAM3, VTDB, ANXA1, ANXA2 and IL8. Finally, circulating levels of the validated proteins were explored in ischemic stroke patients. Fluctuations of A1AG1 and A1AT, both up-regulated in the ischemic brain, were detected in blood along the first week after onset. In summary, our results expand the knowledge of ischemic stroke pathology, revealing key molecules to be further explored as biomarkers and/or therapeutic targets.

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Investigating silent strokes in hypertensives: a magnetic resonance imaging study (ISSYS): rationale and protocol design

Cited by 42 publications

References 28 publications

Prevalence and Associated Factors of Silent Brain Infarcts in a Mediterranean Cohort of Hypertensives

Prevalence and Associated Factors of Silent Brain Infarcts in a Mediterranean Cohort of Hypertensives

Short-Term Blood Pressure Variability Relates to the Presence of Subclinical Brain Small Vessel Disease in Primary Hypertension

Integrative Multi-omics Analysis to Characterize Human Brain Ischemia

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