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终生心血管危险因素与晚年脑血流动力学的关联。

Associations of life-course cardiovascular risk factors with late-life cerebral hemodynamics.

作者信息

Dijsselhof Mathijs Bj, Holtrop Jorina, James Sarah-Naomi, Sudre Carole H, Lu Kirsty, Lorenzini Luigi, Collij Lyduine E, Scott Catherine J, Manning Emily N, Thomas David L, Richards Marcus, Hughes Alun D, Cash David M, Barkhof Frederik, Schott Jonathan M, Petr Jan, Mutsaerts Henk Jmm

机构信息

Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit, NL.

Amsterdam Neuroscience, Brain Imaging, NL.

出版信息

J Cereb Blood Flow Metab. 2025 Apr;45(4):765-778. doi: 10.1177/0271678X241301261. Epub 2024 Nov 17.

Abstract

While the associations of mid-life cardiovascular risk factors with late-life white matter lesions (WMH) and cognitive decline have been established, the role of cerebral haemodynamics is unclear. We investigated the relation of late-life (69-71 years) arterial spin labelling (ASL) MRI-derived cerebral blood flow (CBF) with life-course cardiovascular risk factors (36-71 years) and late-life white matter hyperintensity (WMH) load in 282 cognitively healthy participants (52.8% female). Late-life (69-71 years) high systolic (B = -0.15) and diastolic (B = -0.25) blood pressure, and mean arterial pressure (B = -0.25) were associated with low grey matter (GM) CBF (p < 0.03), and white matter CBF (B = -0.25; B = -0.15; B = -0.13, p < 0.03, respectively). The association between systolic blood pressure and GM CBF differed between sexes (male/female B = -0.15/0.02, p = 0.04). No associations were found with early- or mid-life cardiovascular risk factors. Furthermore, WMHs were associated with cerebral haemodynamics but not cardiovascular risk factors. These findings suggest that cerebral blood flow autoregulation is able to maintain stable global cerebral haemodynamics until later in life. Future studies are encouraged to investigate why cardiovascular risk factors have differential effects on haemodynamics and WMH, and their implications for cognitive decline.

摘要

虽然中年心血管危险因素与晚年白质病变(WMH)及认知衰退之间的关联已得到证实,但脑血流动力学的作用尚不清楚。我们在282名认知健康的参与者(52.8%为女性)中,研究了晚年(69 - 71岁)动脉自旋标记(ASL)MRI衍生的脑血流量(CBF)与生命历程心血管危险因素(36 - 71岁)及晚年白质高信号(WMH)负荷之间的关系。晚年(69 - 71岁)的高收缩压(B = -0.15)、舒张压(B = -0.25)和平均动脉压(B = -0.25)与低灰质(GM)CBF相关(p < 0.03),与白质CBF也相关(B = -0.25;B = -0.15;B = -0.13,p分别< 0.03)。收缩压与GM CBF之间的关联在性别上存在差异(男性/女性B = -0.15/0.02,p = 0.04)。未发现与早年或中年心血管危险因素有关联。此外,WMH与脑血流动力学相关,但与心血管危险因素无关。这些发现表明,脑血流量自动调节能够在生命后期之前维持稳定的全脑血流动力学。鼓励未来的研究探讨为什么心血管危险因素对血流动力学和WMH有不同影响,以及它们对认知衰退的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b719/11571377/32c3a60e4da1/10.1177_0271678X241301261-fig1.jpg

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