Cerebral and Extracerebral Vasoreactivity in Patients With Different Clinical Manifestations of Cerebral Small‐Vessel Disease: Data From the Significance of Hemodynamic and Hemostatic Factors in the Course of Different Manifestations of Cerebral Small‐Vessel Disease Study

• Published in: Journal of ultrasound in medicine 2019-04, Vol.38 (4), p.975-987
• Main Authors: Staszewski, Jacek, Skrobowska, Ewa, Piusińska‐Macoch, Renata, Brodacki, Bogdan, Stępień, Adam
• Format: Article
• Language: English
• Subjects: brachial artery flow‐mediated dilatation; cerebral small vessel disease; cerebrovascular reactivity; endothelial dysfunction; vascular ultrasound; vasomotor reactivity reserve
• ISSN: 0278-4297; 1550-9613
• DOI: 10.1002/jum.14782

Objectives Endothelial dysfunction has been implicated in the pathogenesis of cerebral small‐vessel disease (SVD). Little is known about the relationship between SVD and measures of endothelium‐dependent vasodilatation and cerebral vasomotor reactivity. The aim of this study was to evaluate cerebral and extracerebral endothelial dysfunction in patients with different manifestations of SVD and to assess the relationship between endothelial dysfunction and radiologic markers of SVD. Methods The vasomotor reactivity reserve (VMRr), breath‐holding index (BHI) of the middle cerebral arteries, and brachial artery flow‐mediated dilatation (FMD) were measured with ultrasound techniques in 90 patients (30 in each group) older than 60 years with extensive white matter lesions (Fazekas grade ≥ 2) with a history of lacunar stroke, vascular dementia, or parkinsonism and 30 individuals with normal magnetic resonance imaging findings (control group). All groups were matched for age, sex, hypertension, and diabetes. Results The mean age ± SD (71.8 ± 3.4 versus 71.7 ± 3.4 years), sex distribution, and prevalence of the main vascular risk factors were similar in the SVD and control groups. The VMRr (56.6% ± 18.3% versus 77.1% ± 16.9%), BHI (0.8 ± 0.3 versus 1.1 ± 0.4), and FMD (5.8% ± 4 versus 12.1% ± 5.2%) were severely impaired in the SVD groups compared to the control group (P