Silent Brain Infarction and Subcortical White Matter Lesions Increase the Risk of Stroke and Mortality: A Prospective Cohort Study

Bokura, Hirokazu; Kobayashi, Shotai; Yamaguchi, Shûhei; Iijima, Kenichi; Nagai, Atsushi; Toyoda, Genya; Oguro, Hiroaki; Takahashi, Kazuo

doi:10.1016/j.jstrokecerebrovasdis.2005.11.001

Cited by 163 publications

(163 citation statements)

References 27 publications

Supporting

Mentioning

152

Contrasting

Unclassified

Order By: Relevance

“…4,7,14 SBI was defined as a focal lesion of at least 3 mm in diameter, with hyperintensity on T2WI and hypointensity on FLAIR. [5][6][7]14 WMHs were defined as an irregular periventricular hyperintensity (Fazekas grade X3) and/ or early confluent or confluent separate deep white-matter hyperintense lesions (Fazekas grade X2) on T2WI and FLAIR, based on the rating scales of ischemic tissue damage due to arteriosclerosis. 5,7,14,31,32 Carotid ultrasonography Far wall common carotid artery intima-media thickness (CCAIMT) was measured using images acquired by high-resolution B-mode ultrasonography with a 7.5-MHz linear array transducer.…”

Section: Mri Assessmentmentioning

confidence: 99%

Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

et al. 2012

View full text Add to dashboard Cite

It is still unclear whether silent brain infarct (SBI) and white-matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) scans are associated with cardio-ankle vascular index (CAVI), a novel parameter of arterial stiffness. We studied 220 consecutive patients (mean age, 69 years) without a history of stroke or transient ischemic attack. Patients were assessed for the presence of SBI, WMHs and risk factors. Arterial stiffness was evaluated using CAVI. Patients were categorized into one of two groups according to the presence or absence of SBI and WMHs, and clinical characteristics were compared between the two groups. CAVI was significantly higher in patients with SBI or in patients with WMHs than in those without those respective findings. The CAVI cutoff values for detection of SBI and WMHs were 9.2 and 8.9, respectively. On multivariable analyses, CAVI, a one point increase in CAVI: odds ratio (OR), 1.25; 95% confidence interval (CI), 1.01-1.56; CAVIX9.2: OR, 2.34; 95% CI, 1.16-5.02, was independently associated with SBI, however, CAVI was not independently associated with WMHs. Patients with CAVI X9.2 had higher OR for the presence of both SBI and WMHs (OR, 2.57; 95% CI, 1.15-5.98) when compared with patients with CAVI o9.2 after adjustment for age and sex. SBI is independently associated with arterial stiffness indicated by CAVI.

show abstract

Section: Mri Assessmentmentioning

confidence: 99%

Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Small vessel disease (SVD) is an incidental but frequent finding on brain scans of elderly individuals (Vermeer et al 2003;resonance tomography (MRI) by the brain imaging markers white matter lesions (WML) and lacunar infarcts (LI). While brain MRI has become a frequently used diagnostic tool, also in population-based epidemiologic studies, only few studies have examined the impact of structural brain changes on survival in elderly populations (Briley et al 2000;Bokura et al 2006;Kuller et al 2007;Ikram et al 2009;Staff et al 2010;Olesen et al 2011;Conijn et al 2011). In these studies, global vascular brain lesions and brain atrophy were associated with an increased risk of mortality in the elderly.…”

Section: Introductionmentioning

confidence: 99%

Structural brain changes and all-cause mortality in the elderly population—the mediating role of inflammation

Hanning

Roesler

Peters

et al. 2016

AGE

View full text Add to dashboard Cite

While MRI brain changes have been related to mortality during ageing, the role of inflammation in this relationship remains poorly understood. Hence, this study aimed to investigate the impact of MRI changes on all-cause mortality and the mediating role of cytokines. All-cause mortality was evaluated in 268 community dwelling elderly (age 65-83 years) in the MEMO study (Memory and Morbidity in Augsburg elderly). MRI markers of brain atrophy and cerebral small vessel disease (SVD), C-reactive protein (CRP) and a panel of cytokines in serum were assessed. Cox proportional hazard models were used to estimate the association of MRI changes with survival over 9 years. Regression models were used to assess the hypothesis that inflammation is mediating the relationship between MRI-brain changes and mortality. In total, 77 (29 %) deaths occurred during a mean follow up of 9 years. After adjusting for confounders, the degree of global cortical atrophy and the level of the cytokines CRP, TNF-α and IL-8 were of higher significance in study participants who had died at follow-up in comparison to survivors. In Cox proportional hazard models, higher degrees of global cortical atrophy (HR 1.56, p = 0.003) and regional atrophy of the temporal lobe (HR 1.38, p = 0.011) were associated with a significantly increased risk of mortality. Mediation analyses revealed a partial mediation by IL-6 and IL-8 of the effects of global cortical atrophy on mortality. Global cortical brain atrophy is a significant indicator of survival in the elderly. Our study supports a possible role for inflammation in the atrophy pathogenesis. If replicated in other samples, IL-6 and IL-8 level assessment may improve risk prognosis for mortality.

show abstract

“…In most cases, the SCI is found to be in the form of a lacunar infarction, the most common form of subcortical infarction, defined by Fisher as a small, deep cerebral infarction caused by occlusion of small penetrating cerebral artery (6). The presence of SCI, independent of cardiovascular risk factors, has been shown to more than double the risk of subsequent stroke in both population-and hospital-based cohort studies (7)(8)(9). Although the predictive value of SCI for incident stroke has been established, routine magnetic resonance imaging (MRI) screening of neurologically asymptomatic people is not cost effective.…”

Section: Introductionmentioning

confidence: 99%

Relation of Carotid Intima-Media Thickness and Silent Cerebral Infarction to Cardiovascular Events and All-Cause Mortality in Chronic Hemodialysis Patients

et al. 2012

View full text Add to dashboard Cite

Objective Silent cerebral infarction (SCI) and increased carotid intima-media thickness (IMT) have been found to be associated with future stroke in the general population. We investigated whether a combination of SCI and increased IMT is a predictor of cardiovascular events and all-cause mortality in chronic hemodialysis (HD) patients. Methods We performed a retrospective cohort study of 70 HD patients who had one or more risk factors for atherosclerosis but no history of cardiovascular disease. We performed cranial magnetic resonance imaging (MRI) and measured carotid IMT at baseline, and then evaluated the risks of cardiovascular events and all-cause mortality by using Cox proportional hazards models. The Kaplan-Meier method and a log-rank test were used to compare event-free survival.Results SCI was present in 25 patients (35.7%) at baseline. During an average follow-up of 46.3±14.3 months (range: 19 to 56 months), 15 patients (21.4%) died and 16 (22.9%) experienced a new cardiovascular event. The presence of SCI in combination with increased carotid IMT at baseline was independently associated with cardiovascular events and all-cause mortality after adjustment for age, sex, duration of dialysis, and traditional vascular risk factors. Conclusion SCI, similar to carotid IMT, is an independent predictor of cardiovascular events and all-cause mortality in chronic HD patients.

show abstract

Silent Brain Infarction and Subcortical White Matter Lesions Increase the Risk of Stroke and Mortality: A Prospective Cohort Study

Cited by 163 publications

References 27 publications

Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

Structural brain changes and all-cause mortality in the elderly population—the mediating role of inflammation

Relation of Carotid Intima-Media Thickness and Silent Cerebral Infarction to Cardiovascular Events and All-Cause Mortality in Chronic Hemodialysis Patients

Contact Info

Product

Resources

About