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Lv B, Ran Y, Lv J, Lou X, Tian C. Individualized interpretation for the clinical significance of fluid-attenuated inversion recovery vessel hyperintensity in ischemic stroke and transient ischemic attack: A systematic narrative review. Eur J Radiol 2023; 166:111010. [PMID: 37523872 DOI: 10.1016/j.ejrad.2023.111010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/09/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
Fluid-attenuated inversion recovery (FLAIR) vessel hyperintensity(FVH)refers to the hyperintensity corresponding to the arteries in the subarachnoid space. It is caused by critically slowed blood flow and is commonly encountered in patients with large artery steno-occlusions. Quite a few studies have focused on the clinical significance of FLAIR vessel hyperintensity in terms of its relationship to the prognosis of transient ischemic attack (TIA), baseline severity or infarction volume, early neurological deterioration or infarction growth, and functional outcomes in acute ischemic stroke (AIS). However, inconsistent or conflicting findings were common in these studies and caused confusion in the clinical decision-making process guided by this imaging marker. Through reviewing the available studies on the etiologic mechanism of FVH and investigating findings on its clinical significance in AIS and TIA, this review aims to elucidate the key factors for interpreting the clinical significance of FVH individually.
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Affiliation(s)
- Bin Lv
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No.28, Fuxing Road, Beijing 100853, China
| | - Ye Ran
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No.28, Fuxing Road, Beijing 100853, China
| | - Jinhao Lv
- Department of Radiology, The First Medical Center, Chinese PLA General Hospital, No.28, Fuxing Road, Beijing 100853, China
| | - Xin Lou
- Department of Radiology, The First Medical Center, Chinese PLA General Hospital, No.28, Fuxing Road, Beijing 100853, China.
| | - Chenglin Tian
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, No.28, Fuxing Road, Beijing 100853, China.
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2
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Wang T, Dong S, Zhang M, Yu C, Xue M, Chen A. Effect of Solitaire FR Stent Thrombectomy Combined with the Suction Thrombus on the Clinical Effect and Prognosis of Acute Middle Cerebral Artery Occlusion. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:9227790. [PMID: 35942370 PMCID: PMC9356800 DOI: 10.1155/2022/9227790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
To determine the curative effect and prognosis of Solitaire FR stent thrombectomy integrated with the suction thrombus on the treatment of acute middle cerebral artery occlusion (AMCAO). Based on the treatment, patients suffering from AMCAO were separated into the Solitaire FR group (Solitaire FR stent + suction thrombus) and suction group (suction thrombus). Modified thrombolysis in cerebral infarction grading, National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale score, and safety performance were compared between the two groups. The operation time in the suction group was obviously shorter than the Solitaire FR group (P < 0.05). Significant differences were observed in the NIHSS scores 1 week and 4 weeks after the operation between the Solitaire FR group and the suction group (P < 0.05). The NIHSS scores 1 week and 4 weeks after operation were significantly lower than those before operation (P < 0.05). NIHSS scores 1 week after operation did not show obvious difference (P > 0.05). The Solitaire FR group showed obvious lower NIHSS scores than the suction group 4 weeks after surgery (P < 0.05). Statistically obvious difference in cerebral infarction grading of modified thrombolysis between the Solitaire FR group and the suction group were observed (P < 0.05). The recanalization rate of the Solitaire FR group was obviously higher than the suction group (P < 0.05). The difference in the monthly modified Rankin Scale score was obvious (P < 0.05). The good prognosis rate of the Solitaire FR group was obviously higher than the suction group (P < 0.05). No obvious differences in the incidence of internal bleeding, reocclusion, and 3-month postoperative mortality were observed (P > 0.05). These results showed that the treatment of the Solitaire FR stent + suction thrombus in AMCAO patients has a good thrombus recanalization rate and is helpful in improving the prognosis and safety performance.
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Affiliation(s)
- Tao Wang
- Department of Neurology, The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan 232007, Anhui, China
- School of Medicine, Anhui University of Science and Technology, Huainan 232001, Anhui, China
| | - Shuyang Dong
- Department of Neurology, The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan 232007, Anhui, China
| | - Mei Zhang
- Department of Neurology, The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan 232007, Anhui, China
| | - Chuangqing Yu
- Department of Neurology, The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan 232007, Anhui, China
| | - Min Xue
- Department of Neurology, The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan 232007, Anhui, China
| | - Anran Chen
- School of Medicine, Anhui University of Science and Technology, Huainan 232001, Anhui, China
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3
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Zeng L, Chen J, Liao H, Wang Q, Xie M, Wu W. Fluid-Attenuated Inversion Recovery Vascular Hyperintensity in Cerebrovascular Disease: A Review for Radiologists and Clinicians. Front Aging Neurosci 2022; 13:790626. [PMID: 34975459 PMCID: PMC8716740 DOI: 10.3389/fnagi.2021.790626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/26/2021] [Indexed: 11/18/2022] Open
Abstract
Neuroradiological methods play important roles in neurology, especially in cerebrovascular diseases. Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) is frequently encountered in patients with acute ischemic stroke and significant intracranial arterial stenosis or occlusion. The mechanisms underlying this phenomenon and the clinical implications of FVH have been a matter of debate. FVH is associated with large-vessel occlusion or severe stenosis, as well as impaired hemodynamics. Possible explanations suggested for its appearance include stationary blood and slow antegrade or retrograde filling of the leptomeningeal collateral circulation. However, the prognostic value of the presence of FVH has been controversial. FVH can also be observed in patients with transient ischemic attack (TIA), which may have different pathomechanisms. Its presence can help clinicians to identify patients who have a higher risk of stroke after TIA. In this review article, we aim to describe the mechanism and influencing factors of FVH, as well as its clinical significance in patients with cerebrovascular disease.
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Affiliation(s)
- Lichuan Zeng
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jinxin Chen
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huaqiang Liao
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qu Wang
- Department of Ultrasound, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mingguo Xie
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenbin Wu
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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4
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Miryala A, Javali M, Mehta A, Pradeep R, Acharya P, Srinivasa R. Study of Short Latency Somatosensory and Brain Stem Auditory Evoked Potentials Patients with Acute Ischemic Stroke Involving Middle Cerebral Artery Territory. J Neurosci Rural Pract 2021; 12:478-482. [PMID: 34295101 PMCID: PMC8289523 DOI: 10.1055/s-0041-1727558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background
The precise timings of evoked potentials in evaluating the functional outcome of stroke have remained indistinct. Few studies in the Indian context have studied the outcome of early prognosis of stroke utilizing evoked potentials.
Objective
The aim of this study was to determine somatosensory evoked potentials (SSEPs) and brain stem auditory evoked potentials (BAEPs), their timing and abnormalities in acute ischemic stroke involving the middle cerebral artery (MCA) territory and to correlate SSEP and BAEP with the functional outcome (National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS) and Barthel’s index) at 3 months.
Methods
MCA territory involved acute ischemic stroke patients (
n
= 30) presenting consecutively to the hospital within 3 days of symptoms onset were included. Details about clinical symptoms, neurological examination, treatment, NIHSS score, mRS scores were collected at the time of admission. All patients underwent imaging of the brain and were subjected to SSEP and BAEP on two occasions, first at 1 to 3 days and second at 4 to 7 days from the onset of stroke. At 3 months of follow-up, NIHSS, mRS, and Barthel’s index were recorded.
Results
P37 and N20 amplitude had a strong negative correlation (at 1–3 and 4–7 days) with NIHSS at admission, NIHSS at 3 months, mRS at admission, and mRS at 3 months and a significant positive correlation with Barthel’s index (
p
< 0.0001). BAEP wave V had a negative correlation (at 1–3 and 4–7 days) with NIHSS at admission, NIHSS at 3 months, mRS at admission, and mRS at 3 months and a positive correlation with Barthel’s index (
p
< 0.0001).
Conclusion
SSEP abnormalities recorded on days 4 to 7 from onset of stroke are more significant than those recorded within 1 to 3 days of onset of stroke; hence, the timing of 4 to 7 days after stroke onset can be considered as better for predicting functional outcome.
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Affiliation(s)
- Abhishek Miryala
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - R Pradeep
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Purushottam Acharya
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
| | - Rangasetty Srinivasa
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, Karnataka, India
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Zhou Z, Malavera A, Yoshimura S, Delcourt C, Mair G, Al-Shahi Salman R, Demchuk AM, Wardlaw JM, Lindley RI, Anderson CS. Clinical prognosis of FLAIR hyperintense arteries in ischaemic stroke patients: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2020; 91:475-482. [PMID: 32217786 DOI: 10.1136/jnnp-2019-322625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/18/2020] [Accepted: 03/09/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We performed a systematic review and meta-analysis to determine the association of fluid-attenuated inversion recovery (FLAIR) hyperintense arteries (FLAIR-HAs) on brain MRI and prognosis after acute ischaemic stroke (AIS). METHODS We searched Medline, Embase and Cochrane Central Register of Controlled Trials for studies reporting clinical or imaging outcomes with presence of FLAIR-HAs after AIS. Two researchers independently assessed eligibility of retrieved studies and extracted data, including from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Outcomes were unfavourable functional outcome (primary, modified Rankin scale scores 3-6 or 2-6), death, intermediate clinical and imaging outcomes. We performed subgroup analyses by treatment or types of FLAIR-HAs defined by location (at proximal/distal middle cerebral artery (MCA), within/beyond diffusion-weighted imaging (DWI) lesion) or extent. RESULTS We included 36 cohort studies (33 prospectively collected) involving 3577 patients. FLAIR-HAs were not associated with functional outcome overall (pooled risk ratio 0.87, 95% CI 0.71 to 1.06), but were significantly associated with better outcome in those receiving endovascular therapy (0.56, 95% CI 0.41 to 0.75). Contrary to FLAIR-HAs at proximal MCA or within DWI lesions, FLAIR-HAs beyond DWI lesions were associated with better outcome (0.67, 95% CI 0.57 to 0.79). FLAIR-HAs favoured recanalisation (1.21, 95% CI 1.06 to 1.38) with increased risk of intracerebral haemorrhage (2.07, 95% CI 1.37 to 3.13) and early neurological deterioration (1.93, 95% CI 1.30 to 2.85). CONCLUSIONS FLAIR-HAs were not associated with functional outcome overall but were associated with outcome after endovascular therapy for AIS. FLAIR-HAs were also associated with early recanalisation or haemorrhagic complications, and early neurologic deterioration. PROSPERO REGISTRATION NUMBER CRD42019131168.
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Affiliation(s)
- Zien Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China .,The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Alejandra Malavera
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sohei Yoshimura
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Candice Delcourt
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Grant Mair
- Division of Neuroimaging Science, Edinburgh Imaging and Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Andrew M Demchuk
- Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Joanna M Wardlaw
- Division of Neuroimaging Science, Edinburgh Imaging and Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Richard I Lindley
- The George Institute for Global Health and University of Sydney, Sydney, New South Wales, Australia
| | - Craig S Anderson
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, New South Wales, Australia.,The George Institute China at Peking University Health Science Center, Beijing, PR China
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6
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Seleverstov O, North K, Simakova M, Bisen S, Bickenbach A, Bursac Z, Dopico AM, Bukiya AN. Temporal Requirement for the Protective Effect of Dietary Cholesterol against Alcohol-Induced Vasoconstriction. JOURNAL OF DRUG AND ALCOHOL RESEARCH 2020; 9:236103. [PMID: 33537157 PMCID: PMC7853201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Moderate-to-heavy episodic alcohol drinking resulting in 30-80 mM of ethanol in blood constricts cerebral arteries and constitutes a risk factor for cerebrovascular disease. Alcohol-induced constriction of cerebral arteries in vivo and ex vivo has been shown to be blunted by dietary cholesterol (CLR) in a rat model of a high-CLR diet. Such protection has been proposed to arise from the high-CLR diet-driven increase in blood CLR levels and accompanying buildup of CLR within the cerebral artery smooth muscle. Here we used a rat model of high-CLR feeding in vivo and pressurized cerebral arteries ex vivo to examine whether the degree and time-course of alcohol-induced constriction are related to blood CLR levels. We demonstrate that subjecting young (3 weeks-old, 50 g) male Sprague-Dawley rats to a high- CLR feeding up to 41 weeks, resulted in an age-dependent increase in total blood CLR levels, when compared to those of age-matched rats on isocaloric (control) chow. This increase was paralleled by a high-CLR diet-driven elevation of blood low-density lipoproteins whereas high-density lipoprotein levels matched those of age-matched, chow-fed controls. Alcohol-induced constriction was only blunted by high-CLR dietary intake when high-CLR chow was taken for up to 8-12 and 18-23 weeks. However, alcohol-constriciton was not blunted when high-CLR chow intake lasted for longer times, such as 28-32 and 38-41 weeks. Thus, alcohol-induced constriction of rat middle cerebral arteries did not critically depend on the total blood CLR levels. Alcohol-induced constriction seemed unrelated to the natural, progressive elevation of the total blood CLR level in control- or high-CLR-fed animals over time. Thus, neither the exogenously nor endogenously driven increases in blood CLR could predict cerebral artery susceptibility to alcohol-induced constriction. However, we identified a temporal requirement for the protective effect of dietary CLR against alcohol, that could be governed by the young age of the high- CLR chow recipients (3 weeks of age) and/or the short duration of high-CLR chow feeding lasting for up to 23 weeks.
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Affiliation(s)
- Olga Seleverstov
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Kelsey North
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Maria Simakova
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Shivantika Bisen
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Alexandra Bickenbach
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Zoran Bursac
- Department of Biostatistics, Stempel College, Florida International University, Miami, Florida, United States of America
| | - Alex M. Dopico
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Anna N. Bukiya
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States of America,Address Correspondence to Anna N. Bukiya,
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7
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Zhu LH, Zhang ZP, Wang FN, Cheng QH, Guo G. Diffusion kurtosis imaging of microstructural changes in brain tissue affected by acute ischemic stroke in different locations. Neural Regen Res 2019; 14:272-279. [PMID: 30531010 PMCID: PMC6301161 DOI: 10.4103/1673-5374.244791] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The location of an acute ischemic stroke is associated with its prognosis. The widely used Gaussian model-based parameter, apparent diffusion coefficient (ADC), cannot reveal microstructural changes in different locations or the degree of infarction. This prospective observational study was reviewed and approved by the Institutional Review Board of Xiamen Second Hospital, China (approval No. 2014002). Diffusion kurtosis imaging (DKI) was used to detect 199 lesions in 156 patients with acute ischemic stroke (61 males and 95 females), mean age 63.15 ± 12.34 years. A total of 199 lesions were located in the periventricular white matter (n = 52), corpus callosum (n = 14), cerebellum (n = 29), basal ganglia and thalamus (n = 21), brainstem (n = 21) and gray-white matter junctions (n = 62). Percentage changes of apparent diffusion coefficient (ΔADC) and DKI-derived indices (fractional anisotropy [ΔFA], mean diffusivity [ΔMD], axial diffusivity [ΔDa], radial diffusivity ΔDr, mean kurtosis [ΔMK], axial kurtosis [ΔKa], and radial kurtosis [ΔKr]) of each lesion were computed relative to the normal contralateral region. The results showed that (1) there was no significant difference in ΔADC, ΔMD, ΔDa or ΔDr among almost all locations. (2) There was significant difference in ΔMK among almost all locations (except basal ganglia and thalamus vs. brain stem; basal ganglia and thalamus vs. gray-white matter junctions; and brainstem vs. gray-white matter junctions. (3) The degree of change in diffusional kurtosis in descending order was as follows: corpus callosum > periventricular white matter > brainstem > gray-white matter junctions > basal ganglia and thalamus > cerebellum. In conclusion, DKI could reveal the differences in microstructure changes among various locations affected by acute ischemic stroke, and performed better than diffusivity among all groups.
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Affiliation(s)
- Liu-Hong Zhu
- Department of Radiology, Xiamen Second Hospital; Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, Fujian Province, China
| | | | - Fu-Nan Wang
- Department of Radiology, Xiamen Second Hospital, Xiamen, Fujian Province, China
| | - Qi-Hua Cheng
- Department of Radiology, Xiamen Second Hospital, Xiamen, Fujian Province, China
| | - Gang Guo
- Department of Radiology, Xiamen Second Hospital, Xiamen, Fujian Province, China
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8
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Yuan LY, He ZY, Li L, Wang YZ. Association of G-protein coupled purinergic receptor P2Y2 with ischemic stroke in a Han Chinese population of North China. Neural Regen Res 2018; 14:506-512. [PMID: 30539820 PMCID: PMC6334602 DOI: 10.4103/1673-5374.245472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The G-protein-coupled purinergic receptor P2Y2 (P2RY2) plays an important role in the mechanism of atherosclerosis, which is relevant to ischemic stroke. This retrospective case-control study aimed to assess the relationship between P2RY2 gene polymorphisms and ischemic stroke risk in the northern Han Chinese population. In this study, clinical data and peripheral blood specimens were collected from 378 ischemic stroke patients and 344 controls. The ischemic stroke participants were recruited from the First Affiliated Hospital of China Medical University and the First Affiliated Hospital of Liaoning Medical University. The controls were recruited from the Health Check Center at the First Affiliated Hospital of China Medical University. Ischemic stroke patients were divided into two subgroups according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification: large-artery atherosclerosis (n = 178) and small-artery occlusion (n = 200) strokes. All subjects were genotyped for three single nucleotide polymorphisms (rs4944831, rs1783596, and rs4944832) in the P2RY2 gene using peripheral venous blood samples. The distribution of the dominant rs4944832 phenotype (GG vs. GA+AA) differed significantly between small-artery occlusion patients and control subjects (odds ratio (OR) = 1.720, 95% confidence interval (CI): 1.203–2.458, P < 0.01). Multivariable logistic regression analysis revealed that the GG genotype of rs4944832 was significantly more prevalent in small-artery occlusion patients than in control subjects (OR = 1.807, 95% CI: 1.215–2.687, P < 0.01). The overall distribution of the haplotype established by rs4944831-rs1783596-rs4944832 was significantly different between ischemic stroke patients and controls (P < 0.01). In ischemic stroke patients, the frequency of the G-C-G haplotype was significantly higher than in control subjects (P = 0.028), whereas the frequency of the T-C-A haplotype was lower than in control subjects (P = 0.047). These results indicate that the G-C-G haplotype of P2RY2 is a susceptibility haplotype for ischemic stroke. In addition, the GG genotype of rs4944832 may be associated with the development of small-artery occlusion in the northern Han Chinese population. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of China Medical University on February 20, 2012 (No. 2012-38-1) and the First Affiliated Hospital of Liaoning Medical University, China, on March 1, 2013 (No. 2013-03-1). All participants gave their informed consent. This trial was registered with the ISRCTN Registry (ISRCTN11439124) on October 24, 2018. Protocol version (1.0).
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Affiliation(s)
- Li-Ying Yuan
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Zhi-Yi He
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Lei Li
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yan-Zhe Wang
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
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