Abstract 15542: Aortic Arch Pulse Wave Velocity Predicts White Matter Hyperintensity Volume Independent of Other Cardiovascular Risk Factors
Background and Purpose: Increased aortic pulse wave velocity (APWV) is a risk factor for development of white matter hyperintensities on brain MRI, but it is uncertain if it has a direct causative effect or is merely associated due to shared vascular risk factors. Further, few studies have evaluated the significance of selective APWV obtained from the aortic arch. This study evaluated the predictive relationship between aortic arch APWV and the subsequent development of white matter hyperintensity (WMH) volume independent of other cardiovascular risk factors.
Methods: Aortic pulse wave velocity measurements were obtained from the aortic arch using phase contrast MRI in a large probability-based population sample (N=1,270) drawn from the Dallas Heart Study. 7 years later WMH volume was determined from 3 Tesla (3T) brain MRI. The log of APWV as well as age, gender, ethnicity and 15 cardiovascular risk factors included as predictors of the log of WMH volume in a linear regression model. We implemented a SCAD-penalized variable selection method, in the context of a linear regression model, to generate an optimal predictive risk factor model.
Results: APWV predicted WMH volume independent of the other demographic and cardiovascular risk factors (regression coefficient=0.29, SE=0.06, 95% CI = 0.17 to 0.42, p < .0001). The subset of predictor variables of subsequent WMH volume that were selected from the SCAD-penalized variable selection method adjusted for gender and race included APWV, age, systolic blood pressure, hypertension treatment, and congestive heart failure.
Conclusion: Aortic Pulse Wave Velocity measured from the aortic arch using phase contrast MRI is an independent predictor of subsequent WMH volume and emerges as the primary cardiovascular risk factor of WMH in our study after age. In an optimal predictive model, APWV provides a distinct contribution to WMH burden along with systolic blood pressure, hypertension treatment, congestive heart failure, and age.
- © 2012 by American Heart Association, Inc.