ATVB：基底动脉血管直径增加或为心血管事件预测因子

　　日本一项研究表明，在正常范围内的基底动脉血管直径增加与大血管疾病和脑小血管疾病相关，且这可能为心血管事件新的预测因子。相关论文5月9日在线发表于《动脉粥样硬化、血栓形成和血管生物学》（ATVB）。

　　研究入选了493例存在动脉粥样硬化性危险因子的出院患者。利用磁共振显像（MRI）和磁共振血管造影评估基底动脉血管直径、腔隙性梗死、深部脑白质高信号的严重度以及颅内血管狭窄至闭塞病变。然后前瞻性评估磁共振与心血管事件的相关性。

　　结果显示，入选患者的基底动脉血管直径范围从1.1 —5.2 mm不等，且仅有0.8%的患者存在延长扩张。男性、腔隙性脑梗死的出现、深部脑白质高信号的严重度、Willis环胎儿型变异和颅内血管狭窄至闭塞病变与基底动脉血管直径独立相关。平均随访6年时，91例患者发生了心血管事件。校正年龄、性别和传统危险因素后总体心血管事件仍与基底动脉血管直径独立相关（P=0.009）。

与心血管相关的拓展阅读：

• JAMA：戒烟与心血管疾病风险降低有关
• ICSLE：狼疮患者的心血管风险
• NEJM述评：阿奇霉素和其他抗菌药的心血管风险
• NEJM：阿奇霉素与心血管原因死亡风险增加无关
• Europace：成功的导管消融可减少CHA2DS2-VASc评分≥1分房颤患者的心血管事件发生 更多信息请点击：有关心血管更多资讯

Basilar Artery Diameter Is an Independent Predictor of Incident Cardiovascular Events
Objective
Basilar arterial (BA) dolichoectasia is associated with cerebral small-vessel disease and stroke. However, the association between moderate dilation of the BA and cerebral small-vessel disease or subsequent cardiovascular events remains unclear. This study aims to clarify the factors related to BA diameter and to clarify whether the BA diameter is an independent predictor of cardiovascular events.
Approach and Results
The study subjects comprised 493 outpatients with atherosclerotic risk factors. BA diameter, lacunar infarct, severity of deep white matter hyperintensities, and intracranial steno-occlusive lesions were assessed with MRI and magnetic resonance angiography. Then, we prospectively evaluated the association between BA diameter and cardiovascular events. The BA diameter ranged from 1.1 to 5.2 mm, and only 0.8% of the patients had dolichoectasia. Male sex, the presence of lacunar infarcts, the severity of deep white matter hyperintensities, the fetal-type variation of the circle of Willis, and intracranial steno-occlusive lesions were independently associated with BA diameter. In the mean follow-up of 6.0 years, 91 patients developed cardiovascular events. BA diameter was independently associated with total cardiovascular events after adjusting for age, sex, and conventional risk factors (hazard ratio, 1.55 per 1 mm increase in BA diameter; P=0.009).
Conclusions
Increased BA diameter within the normal range is related to both large-vessel disease and cerebral small-vessel disease, and it could be a new predictor of cardiovascular events.