Differential risk factor profile and neuroimaging markers of small vessel disease between lacunar ischemic stroke and deep intracerebral hemorrhage.

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-05-23 eCollection Date: 2024-01-01 DOI:10.1177/17562864241253901

Yajun Cheng, Maria Del C Valdés Hernández, Mangmang Xu, Shuting Zhang, Xiaohua Pan, Baoqiang An, Joanna M Wardlaw, Ming Liu, Bo Wu

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引用次数: 0

Abstract

Background: Lacunar ischemic stroke (LIS) and deep intracerebral hemorrhage (dICH) are two stroke phenotypes of deep perforator arteriopathy. It is unclear what factors predispose individuals with deep perforator arteriopathy to either ischemic or hemorrhagic events.

Objectives: We aimed to investigate risk factors and neuroimaging features of small vessel disease (SVD) associated with LIS versus dICH in a cross-sectional study.

Methods: We included patients with clinically presenting, magnetic resonance imaging-confirmed LIS or dICH from two tertiary hospitals between 2010 and 2021. We recorded vascular risk factors and SVD markers, including lacunes, white matter hyperintensities (WMH), perivascular spaces (PVS), and cerebral microbleeds (CMB). Logistic regression modeling was used to determine the association between vascular risk factors, SVD markers, and stroke phenotype. We further created WMH probability maps to compare WMH distribution between LIS and dICH.

Results: A total of 834 patients with LIS (mean age 61.7 ± 12.1 years) and 405 with dICH (57.7 ± 13.2 years) were included. Hypertension was equally frequent between LIS and dICH (72.3% versus 74.8%, p = 0.349). Diabetes mellitus, hyperlipidemia, smoking, and prior ischemic stroke were more associated with LIS [odds ratio (OR) (95% confidence interval (CI)), 0.35 (0.25-0.48), 0.32 (0.22-0.44), 0.31 (0.22-0.44), and 0.38 (0.18-0.75)]. Alcohol intake and prior ICH were more associated with dICH [OR (95% CI), 2.34 (1.68-3.28), 2.53 (1.31-4.92)]. Lacunes were more prevalent in LIS [OR (95% CI) 0.23 (0.11-0.43)], while moderate-to-severe basal-ganglia PVS and CMB were more prevalent in dICH [OR (95% CI) 2.63 (1.35-5.27), 4.95 (2.71-9.42)]. WMH burden and spatial distribution did not differ between groups.

Conclusion: The microangiopathy underlying LIS and dICH reflects distinct risk profiles and SVD features, hence possibly SVD subtype susceptibility. Prospective studies with careful phenotyping and genetics are needed to clarify the mechanisms underlying this difference.

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腔隙性缺血性中风与深部脑内出血之间小血管病变的风险因素概况和神经影像学标志物的差异。

背景：腔隙性缺血性卒中（LIS）和深部脑内出血（dICH）是深部穿孔动脉病变的两种卒中表型。目前尚不清楚哪些因素会导致深穿孔动脉病变患者发生缺血性或出血性事件：我们旨在通过一项横断面研究调查与 LIS 和 dICH 相关的小血管疾病（SVD）的风险因素和神经影像学特征：我们纳入了 2010 年至 2021 年间两家三甲医院临床表现、磁共振成像证实为 LIS 或 dICH 的患者。我们记录了血管风险因素和SVD标记物，包括裂隙、白质高密度（WMH）、血管周围间隙（PVS）和脑微出血（CMB）。我们使用逻辑回归模型来确定血管风险因素、SVD 标志物和卒中表型之间的关联。我们进一步绘制了WMH概率图，以比较LIS和dICH的WMH分布：结果：共纳入了 834 名 LIS 患者（平均年龄为 61.7 ± 12.1 岁）和 405 名 dICH 患者（57.7 ± 13.2 岁）。高血压在 LIS 和 dICH 患者中的发生率相同（72.3% 对 74.8%，P = 0.349）。糖尿病、高脂血症、吸烟和既往缺血性卒中与 LIS 的相关性更高[几率比（OR）（95% 置信区间（CI））分别为 0.35（0.25-0.48）、0.32（0.22-0.44）、0.31（0.22-0.44）和 0.38（0.18-0.75）]。酒精摄入和既往 ICH 与 dICH 的相关性更高[OR（95% CI），2.34（1.68-3.28），2.53（1.31-4.92）]。LIS患者中漆黑一团的发生率更高[OR（95% CI）为0.23（0.11-0.43）]，而dICH患者中度至重度基底神经节PVS和CMB的发生率更高[OR（95% CI）为2.63（1.35-5.27），4.95（2.71-9.42）]。各组间的WMH负荷和空间分布无差异：结论：LIS和dICH背后的微血管病变反映了不同的风险特征和SVD特征，因此可能是SVD亚型易感性。需要进行仔细的表型分析和遗传学前瞻性研究，以阐明这种差异的内在机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.