期刊
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
卷 40, 期 3, 页码 482-487出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0271678X19893337
关键词
Brain; cerebral hemodynamics; chronic kidney disease; stroke; transcranial Doppler
资金
- NCATS NIH HHS [UL1 TR001420] Funding Source: Medline
Chronic kidney disease (CKD) independently increases the risk of stroke and small vessel disease (SVD). This study compared SVD and a transcranial Doppler (TCD)-based marker of intracranial vascular resistance (pulsatility index, PI) in post-stroke patients with and without CKD. Between January 2015 and December 2017, 118 individuals with stable eGFR (50 with CKD) had cerebral MRI and TCD within three months of a stroke. The means of bilateral PI in anterior (anterior cerebral [ACA] and middle cerebral arteries [MCA]) and posterior vessels (posterior cerebral [PCA] and vertebral arteries [VA]) were computed. CKD strongly correlated with higher distal resistance (median CKD ACA PI 1.2, IQR 1.0 to 1.35 vs. controls 0.91 IQR 0.79 to 1.1 [p < 0.0001]; median MCA PI 1.14 IQR 1.03 to 1.39 vs. controls 0.93 IQR 0.79 to 1.1 [p < 0.0001]) and MRI SVD burden (median CKD SVD 4.98 x 10(4) IQR 2.66 to 7.76 x 10(4) voxels vs. controls median SVD 6.7 x 10(3) IQR 2.4 to 24.0 x 10(3) [p < 0.0001]). In conclusion, in patients with recent stroke, CKD is an independent determinant of increased intracranial vascular resistance in both anterior and posterior cerebral circulations. MRI SVD volume is significantly associated with anterior and posterior circulation PI.
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