PMID- 30932017
OWN - NLM
STAT- MEDLINE
DCOM- 20200908
LR  - 20210416
IS  - 1348-4214 (Electronic)
IS  - 0916-9636 (Print)
IS  - 0916-9636 (Linking)
VI  - 42
IP  - 7
DP  - 2019 Jul
TI  - Brain arterial dilatation modifies the association between extracranial pulsatile 
      hemodynamics and brain perivascular spaces: the Northern Manhattan Study.
PG  - 1019-1028
LID - 10.1038/s41440-019-0255-1 [doi]
AB  - Pulsatile hemodynamics are associated with brain small perivascular spaces 
      (SPVS). It is unknown whether the stiffness of intermediary arteries connecting 
      the aorta and brain modifies this association. Participants from the Northern 
      Manhattan Study were assessed for SPVS (defined as </=3 mm T1 voids) and white 
      matter hyperintensity volume (WMH) using MRI. Middle (MCA) and anterior cerebral 
      arterial (ACA) diameters (measured on time-of-flight MRA) and CCA strain 
      (assessed by ultrasound) were used as surrogates of stiffness. Brachial and 
      aortic pulse pressure (PP) and aortic augmentation index (Aix, assessed by 
      applanation tonometry) were used as markers of pulsatility. We tested whether 
      stiffness in intermediary arteries modifies the association between extracranial 
      pulsatility with SPVS and WMH. We found that among 941 participants (mean age 
      71 +/- 9 years, 60% women, 66% Hispanic), the right MCA/ACA diameter was associated 
      with right anterior SPVS (B = 0.177, P = 0.002). Brachial PP was associated with 
      right anterior SPVS (B = 0.003, P = 0.02), and the effect size was bigger with 
      right MCA/ACA diameter in the upper tertile (P = 0.001 for the interaction). The 
      association between right CCA strain and ipsilateral SPVS was modified by MCA/ACA 
      diameter, with the largest effect size in those with ipsilateral MCA/ACA diameter 
      in the upper tertile (P = 0.001 for the interaction). Similar dose-effects and 
      statistical interactions were replicated using aortic AIx or aortic PP. We found 
      no evidence of effect modification between pulsatile measures and WMH by 
      stiffness measures. In summary, pulsatile hemodynamics relate to brain SPVS, and 
      the association is the strongest among individuals with dilated brain arteries.
FAU - Gutierrez, Jose
AU  - Gutierrez J
AD  - Department of Neurology, Columbia University Medical Center, New York, NY, USA. 
      jg3233@cumc.columbia.edu.
FAU - DiTullio, Marco
AU  - DiTullio M
AD  - Department of Cardiology, Columbia University Medical Center, New York, NY, USA.
FAU - K Cheung, Ying Kuen
AU  - K Cheung YK
AD  - Division of Biostatistics, Columbia University Medical Center, New York, NY, USA.
FAU - Alperin, Noam
AU  - Alperin N
AD  - Department of Radiology, University of Miami School of Medicine, Miami, FL, USA.
FAU - Bagci, Ahmet
AU  - Bagci A
AD  - Department of Radiology, University of Miami School of Medicine, Miami, FL, USA.
FAU - L Sacco, Ralph
AU  - L Sacco R
AD  - Department of Neurology, University of Miami School of Medicine, Miami, FL, USA.
FAU - B Wright, Clinton
AU  - B Wright C
AD  - National Institute of Neurological Disorders and Stroke, National Institutes of 
      Health, Bethesda, MD, USA.
FAU - Sv Elkind, Mitchell
AU  - Sv Elkind M
AD  - Department of Neurology, Columbia University Medical Center, New York, NY, USA.
AD  - Department of Epidemiology, Columbia University Medical Center, New York, NY, 
      USA.
FAU - Rundek, Tatjana
AU  - Rundek T
AD  - Department of Neurology, University of Miami School of Medicine, Miami, FL, USA.
LA  - eng
GR  - R37 NS029993/NS/NINDS NIH HHS/United States
GR  - R01 AG057709/AG/NIA NIH HHS/United States
GR  - R01 NS029993/NS/NINDS NIH HHS/United States
GR  - K24 NS062737/NS/NINDS NIH HHS/United States
GR  - R01 AG066162/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20190401
PL  - England
TA  - Hypertens Res
JT  - Hypertension research : official journal of the Japanese Society of Hypertension
JID - 9307690
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Arteries/diagnostic imaging/*physiology
MH  - Blood Pressure/physiology
MH  - Brain/diagnostic imaging
MH  - Cerebrovascular Circulation/*physiology
MH  - Female
MH  - Glymphatic System/diagnostic imaging/*physiology
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Pulsatile Flow/physiology
MH  - Vascular Stiffness/*physiology
MH  - Vasodilation/*physiology
PMC - PMC6913094
MID - NIHMS1061666
OTO - NOTNLM
OT  - Brain arterial dilatation
OT  - Dolichoectasia
OT  - Perivascular spaces
OT  - Pulse pressure.
OT  - Stiffness
COIS- CONFLICT OF INTEREST: Jose Gutierrez, MD, MPH : Dr Gutierrez receives 
      compensation for serving as an expert witness in medical litigation. Noam 
      Alperin, PhD: Shareholder in Alperin Noninvasive Diagnostics, Inc Clinton B 
      Wright, MD, MS: Dr. Wright receives royalties from UpToDate.com for two chapters 
      on vascular dementia. Mitchell SV Elkind, MD, MS: Dr. Elkind receives 
      compensation for providing consultative services for Biotelemetry/Cardionet, 
      BMS-Pfizer Partnership, Boehringer-Ingelheim, and Sanofi-Regeneron Partnership; 
      receives compensation for serving as an expert witness in litigation for 
      BMS-Sanofi (Plavix), Merck/Organon (Nuvaring), and Hi-Tech Pharmaceuticals 
      (dimethylamylamine); serves on the National, Founders Affiliate, and New York 
      City chapter boards of the American Heart Association/American Stroke 
      Association; and receives royalties from UptoDate for chapters related to stroke. 
      No other author report conflict of interests rlated to this work.
EDAT- 2019/04/02 06:00
MHDA- 2020/09/09 06:00
PMCR- 2020/07/01
CRDT- 2019/04/02 06:00
PHST- 2018/10/01 00:00 [received]
PHST- 2019/01/10 00:00 [accepted]
PHST- 2018/12/11 00:00 [revised]
PHST- 2019/04/02 06:00 [pubmed]
PHST- 2020/09/09 06:00 [medline]
PHST- 2019/04/02 06:00 [entrez]
PHST- 2020/07/01 00:00 [pmc-release]
AID - 10.1038/s41440-019-0255-1 [pii]
AID - 10.1038/s41440-019-0255-1 [doi]
PST - ppublish
SO  - Hypertens Res. 2019 Jul;42(7):1019-1028. doi: 10.1038/s41440-019-0255-1. Epub 
      2019 Apr 1.