Background: Cerebral microbleeds (CMB) are now receiving considerable attention for their association with stroke recurrence and white matter lesions (WML). Pulse wave velocity (PWV), which is a measure of arterial stiffness, was found to be one of the predictors of cardiovascular disease and stroke in a large population-based study. The current study set out to investigate the association between CMB and arterial stiffness. Methods: Subjects included 255 patients with strokes, such as cerebral infarctions or transient ischemic attacks, who were enrolled at Korea University Stroke Registry, Ansan arm, between October 2005 and May 2007, and underwent MRI and PWV. CMB, stroke lesion, stroke subtype and WML were coded by researchers blind to clinical details. Arterial stiffness was assessed by measuring brachial-ankle PWV (baPWV). Results: CMB were observed in 57 patients (22.4%), and were most frequently seen in the basal ganglia, followed by the cerebral cortex. The baPWV was significantly higher in patients with CMBs compared to those without (p < 0.01). After adjustment for demographics, vascular risk factors and hemodynamic parameters, baPWV proved to be significantly associated with CMB using a logistic regression test (odds ratio 1.119, 95% CI 1.013–1.237). Conclusions: PWV had an independent association with CMB in patients with stroke. These findings suggest that arterial stiffness may be pathophysiologically associated with CMB.

1.
Lakatta EG: Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises. III. Cellular and molecular clues to heart and arterial aging. Circulation 2003;107:490–497.
2.
Laurent S, Boutouyrie P: Recent advances in arterial stiffness and wave reflection in human hypertension. Hypertension 2007;49:1202–1206.
3.
Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, Asmar R, Reneman RS, Hoeks AP, Breteler MM, Witteman JC: Arterial stiffness and risk of coronary heart disease and stroke: The Rotterdam Study. Circulation 2006;113:657–663.
4.
Hirata K, Kawakami M, O’Rourke MF: Pulse wave analysis and pulse wave velocity: a review of blood pressure interpretation 100 years after Korotkov. Circ J 2006;70:1231–1239.
5.
O’Rourke MF, Safar ME: Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension 2005;46:200–204.
6.
Fazekas F, Kleinert R, Roob G, Kleinert G, Kapeller P, Schmidt R, Hartung HP: Histopathologic analysis of foci of signal loss on gradient-echo T2*-weighted MR images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy-related microbleeds. AJNR Am J Neuroradiol 1999;20:637–642.
7.
Cordonnier C, Al-Shahi Salman R, Wardlaw J: Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting. Brain 2007;130:1988–2003.
8.
Lee SH, Bae HJ, Kwon SJ, Kim H, Kim YH, Yoon BW, Roh JK: Cerebral microbleeds are regionally associated with intracerebral hemorrhage. Neurology 2004;62:72–76.
9.
Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE 3rd: Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment. Stroke 1993;24:35–41.
10.
Kim M, Bae HJ, Lee J, Kang L, Lee S, Kim S, Lee JE, Lee KM, Yoon BW, Kwon O, Koo JS, Kim BK: APOE ε2/ε4 polymorphism and cerebral microbleeds on gradient-echo MRI. Neurology 2005;65:1474–1475.
11.
Kim S, Jeong J: Vaskor MRI Protocol. Seoul, Vaskor, 2006.
12.
Munakata M, Ito N, Nunokawa T, Yoshinaga K: Utility of automated brachial ankle pulse wave velocity measurements in hypertensive patients. Am J Hypertens 2003;16:653–657.
13.
Sugawara J, Hayashi K, Yokoi T, Cortez-Cooper MY, DeVan AE, Anton MA, Tanaka H: Brachial-ankle pulse wave velocity: an index of central arterial stiffness? J Hum Hypertens 2005;19:401–406.
14.
Kato H, Izumiyama M, Izumiyama K, Takahashi A, Itoyama Y: Silent cerebral microbleeds on T2*-weighted MRI: correlation with stroke subtype, stroke recurrence, and leukoaraiosis. Stroke 2002;33:1536–1540.
15.
Kinoshita T, Okudera T, Tamura H, Ogawa T, Hatazawa J: Assessment of lacunar hemorrhage associated with hypertensive stroke by echo-planar gradient-echo T2*-weighted MRI. Stroke 2000;31:1646–1650.
16.
Kwa VI, Franke CL, Verbeeten B Jr, Stam J: Silent intracerebral microhemorrhages in patients with ischemic stroke. Amsterdam Vascular Medicine Group. Ann Neurol 1998;44:372–377.
17.
Tsushima Y, Tanizaki Y, Aoki J, Endo K: MR detection of microhemorrhages in neurologically healthy adults. Neuroradiology 2002;44:31–36.
18.
Zieman SJ, Melenovsky V, Kass DA: Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol 2005;25:932–943.
19.
Wardlaw JM, Lewis SC, Keir SL, Dennis MS, Shenkin S: Cerebral microbleeds are associated with lacunar stroke defined clinically and radiologically, independently of white matter lesions. Stroke 2006;37:2633–2636.
20.
Fisher CM: Lacunes: small, deep cerebral infarcts. Neurology 1965;15:774–784.
21.
van Swieten JC, van den Hout JH, van Ketel BA, Hijdra A, Wokke JH, van Gijn J: Periventricular lesions in the white matter on magnetic resonance imaging in the elderly: a morphometric correlation with arteriolosclerosis and dilated perivascular spaces. Brain 1991;114:761–774.
22.
Inzitari D: Leukoaraiosis: an independent risk factor for stroke? Stroke 2003;34:2067–2071.
23.
Naka H, Nomura E, Wakabayashi S, Kajikawa H, Kohriyama T, Mimori Y, Nakamura S, Matsumoto M: Frequency of asymptomatic microbleeds on T2*-weighted MR images of patients with recurrent stroke: association with combination of stroke subtypes and leukoaraiosis. AJNR Am J Neuroradiol 2004;25:714–719.
24.
Lee SH, Park JM, Kwon SJ, Kim H, Kim YH, Roh JK, Yoon BW: Left ventricular hypertrophy is associated with cerebral microbleeds in hypertensive patients. Neurology 2004;63:16–21.
25.
Gosse P, Jullien V, Jarnier P, Lemetayer P, Clementy J: Reduction in arterial distensibility in hypertensive patients as evaluated by ambulatory measurement of the QKD interval is correlated with concentric remodeling of the left ventricle. Am J Hypertens 1999;12:1252–1255.
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