Effect of cerebrovascular risk factors on regional cerebral blood flow.

Abstract

To prospectively investigate which cerebrovascular risk factors are related to regional cerebral blood flow (rCBF), as measured noninvasively with arterial spin-labeling (ASL) magnetic resonance (MR) imaging, in a large group of patients with symptomatic atherosclerotic disease. Ethics committee approval and informed consent were obtained. One hundred thirty consecutive patients (107 men, 23 women; mean age, 58 years +/- 10 [standard deviation]) with symptomatic atherosclerotic disease were included in the study. Cerebrovascular risk factors (body mass index, carotid artery stenosis, diabetes mellitus, hyperhomocysteinemia, hyperlipidemia, hypertension, and smoking) were assessed by means of a questionnaire and physical, ultrasonographic, and laboratory examinations. The control group consisted of 10 subjects (eight men, two women; mean age, 58 years +/- 15) without symptomatic atherosclerotic disease. rCBF measurements were performed with ASL MR imaging. The effects of the individual cerebrovascular risk factors on the rCBF were assessed by using linear regression analysis. Hypertension was significantly associated with higher rCBF (adjusted beta = 6.5 mL/min/100 g; 95% confidence interval: 1.4 mL/min/100 g, 11.7 mL/min/100 g). Hyperhomocysteinemia was significantly related to lower rCBF (adjusted beta = -7.4 mL/min/100 g; 95% confidence interval: -12.7 mL/min/100 g, -2.1 mL/min/100 g). No significant associations between rCBF and the other cerebrovascular risk factors were found. In patients with symptomatic atherosclerotic disease, hypertension is related to higher rCBF and hyperhomocysteinemia is related to lower rCBF.