Abstract：
BACKGROUND: We aimed to clarify the predictive value of cerebral small-vessel disease and intracranial large artery disease (LAD) observed in magnetic resonance imaging of the brain and magnetic resonance angiography on future vascular events and cognitive impairment.
RESULTS: Data were derived from a Japanese cohort with evidence of cerebral vessel disease on magnetic resonance imaging. This study included 862 participants who underwent magnetic resonance angiography after excluding patients with a modified Rankin Scale score >1 and Mini-Mental State Examination score <24. We evaluated small-vessel disease such as white matter hyperintensities and lacunes in magnetic resonance imaging and LAD with magnetic resonance angiography. Outcomes were incident stroke, dementia, acute coronary syndrome, and all-cause death. Over a median follow-up period of 4.5 years, 54 incident stroke, 39 cases of dementia, and 27 cases of acute coronary syndrome were documented. Both small-vessel disease (white matter hyperintensities and lacunes) and LAD were associated with stroke; however, only white matter hyperintensities were related to dementia. In contrast, only LAD was associated with acute coronary syndrome. Among the 357 patients with no prior history of stroke, coronary or peripheral artery disease, or atrial fibrillation, white matter hyperintensities emerged as the sole predictor of future stroke and dementia, while LAD was the sole predictor of acute coronary syndrome.
CONCLUSIONS: Among cerebral vessels, small-vessel disease could underlie the cognitive impairment while LAD was associated with coronary artery disease as atherosclerotic vessel disease.
RESULTS: Data were derived from a Japanese cohort with evidence of cerebral vessel disease on magnetic resonance imaging. This study included 862 participants who underwent magnetic resonance angiography after excluding patients with a modified Rankin Scale score >1 and Mini-Mental State Examination score <24. We evaluated small-vessel disease such as white matter hyperintensities and lacunes in magnetic resonance imaging and LAD with magnetic resonance angiography. Outcomes were incident stroke, dementia, acute coronary syndrome, and all-cause death. Over a median follow-up period of 4.5 years, 54 incident stroke, 39 cases of dementia, and 27 cases of acute coronary syndrome were documented. Both small-vessel disease (white matter hyperintensities and lacunes) and LAD were associated with stroke; however, only white matter hyperintensities were related to dementia. In contrast, only LAD was associated with acute coronary syndrome. Among the 357 patients with no prior history of stroke, coronary or peripheral artery disease, or atrial fibrillation, white matter hyperintensities emerged as the sole predictor of future stroke and dementia, while LAD was the sole predictor of acute coronary syndrome.
CONCLUSIONS: Among cerebral vessels, small-vessel disease could underlie the cognitive impairment while LAD was associated with coronary artery disease as atherosclerotic vessel disease.
摘要：
背景：我们的目的是阐明脑磁共振成像和磁共振血管造影术中观察到的脑小血管疾病和颅内大动脉疾病（LAD）对未来血管事件和认知障碍的预测价值。
结果：数据来自一个日本队列，磁共振成像显示有脑血管疾病的证据。这项研究包括862名参与者，他们在排除改良的Rankin量表评分>1和迷你精神状态检查评分<24的患者后接受了磁共振血管造影术。我们在磁共振成像和磁共振血管造影术中评估了小血管疾病，例如白质高强度和腔隙。结果是中风，痴呆症,急性冠脉综合征,和全因死亡。在4.5年的中位随访期内，54中风事件，39例痴呆，并记录了27例急性冠脉综合征。小血管疾病（白质高信号和空洞）和LAD均与卒中相关；然而，只有白质高信号与痴呆有关.相比之下,只有LAD与急性冠脉综合征相关.在357名没有中风史的患者中，冠状动脉或外周动脉疾病，或者心房颤动,白质高强度成为未来中风和痴呆的唯一预测因子，而LAD是急性冠脉综合征的唯一预测因子。
结论：在脑血管中，小血管疾病可能是认知障碍的基础,而LAD与冠状动脉疾病如动脉粥样硬化血管疾病相关.
结果：数据来自一个日本队列，磁共振成像显示有脑血管疾病的证据。这项研究包括862名参与者，他们在排除改良的Rankin量表评分>1和迷你精神状态检查评分<24的患者后接受了磁共振血管造影术。我们在磁共振成像和磁共振血管造影术中评估了小血管疾病，例如白质高强度和腔隙。结果是中风，痴呆症,急性冠脉综合征,和全因死亡。在4.5年的中位随访期内，54中风事件，39例痴呆，并记录了27例急性冠脉综合征。小血管疾病（白质高信号和空洞）和LAD均与卒中相关；然而，只有白质高信号与痴呆有关.相比之下,只有LAD与急性冠脉综合征相关.在357名没有中风史的患者中，冠状动脉或外周动脉疾病，或者心房颤动,白质高强度成为未来中风和痴呆的唯一预测因子，而LAD是急性冠脉综合征的唯一预测因子。
结论：在脑血管中，小血管疾病可能是认知障碍的基础,而LAD与冠状动脉疾病如动脉粥样硬化血管疾病相关.
