Abstract W P364: Relationships Between Endothelial Function, Biological Markers and Cerebral Small Vessel Diseasein Patients with Chronic Cerebrovascular Disease and Comorbidity

Abstract

Background and Purpose: Pathogenesis of white matter lesions is thought to be associated with endothelial dysfunction and inflammation. Ultrasound assessment of brachial artery flow mediated dilation (FMD) as a noninvasive and useful method has been recently used as an index of endothelium-dependent vasodilation. The aim of this study was to investigate the associations between endothelial function which was evaluated by FMD and the severity of white matter lesions in patients with chronic cerebrovascular disease and comorbidity. Additionally, we evaluated association between FMD and the number of circulating progenitor cells. Methods: Patients with cerebrovascular diseases history and other untypical neurological problems were enrolled in this study (n=63; 39 male, 69.8±10.0 years). Patients were classified according to periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) scores by fluid-attenuate inversion recovery image of magnetic resonance images (Fazekas gradings). Endothelial dysfunction was defined as a FMD≤4.5%. The numbers of CD34+/CD133+ cells defined as circulating progenitor cells were evaluated by flow cytometry. Results: The patients with endothelial dysfunction (n=39, 61.9%) were older (72.4±7.6 vs. 65.5±11.8, P=0.007), more frequently male (74.4% vs. 41.7%, P=0.016) and more frequently had hypertension (89.7% vs. 37.5%, P<0.001) than the patients without. FMD was negatively correlated with age, the severity of PVH and the severity of DWMH (R 2 =0.120, p=0.006, R 2 =0.280, p<0.001 and R 2 =0.234, p<0.001, respectively). In addition, FMD was positively correlated with the number of circulating progenitor cell (R 2 =0.078, p=0.034). After multivariate analysis with age, sex, presence of stroke and comorbidities, endothelial dysfunction was independently associated with the severity of PVH (standardized partial regression coefficient [β] 0.703, p=0.002), as well as DWMH (β 0.589, p=0.042). Conclusion: Endothelial dysfunction which was evaluated by FMD might be predictive for the grade of cerebral small vessel disease.