Association between aortic atheroma and cerebral small vessel disease in patients with ischemic stroke

Tae Jin Song, Young Dae Kim, Joonsang Yoo, Jinkwon Kim, Hyuk Jae Chang, Geu Ru Hong, Chi Young Shim, Dongbeom Song, Ji Hoe Heo, Hyo Suk Nam

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Background and Purpose Cerebral small vessel disease (SVDs) are related with large artery atherosclerosis. However, the association between aortic atheroma (AA) and cerebral small vessel disease has rarely been reported. This study evaluated the relationship between presence and burden of AAs and those of SVDs in patients with acute ischemic stroke. Methods We included 737 consecutive patients who underwent transesophageal echocardiography (TEE) and brain magnetic resonance imaging (MRI) for evaluation of acute stroke. AA subtypes were classified as complex aortic plaque (CAP) and simple aortic plaque (SAP). Presence and burden of SVDs including cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), perivascular spaces (PVSs), asymptomatic lacunar infarctions (ALIs), and total SVD score, were investigated. Results AA was found by TEE in 360 (48.8%) patients including 11.6% with CAP and 37.2% with SAP. One or more types of SVDs was found in 269 (36.4%) patients. In multivariable analysis, presence of CMBs (odds ratio [OR] 4.68), high-grade WMHs (OR 3.13), high-grade PVSs (OR 3.35), and ALIs (OR 4.24) were frequent in patients with AA than those without AA. Each 1-point increase in total SVD score increased the odds of presence of CAP (OR 1.94, 95% confidence interval (CI) 1.441.85) and SAP (OR 1.54, 95% CI 1.35-1.75). Conclusions In this study, patients with AA frequently had cerebral SVDs. Larger burden of AA was associated with advanced cerebral SVDs. Our findings give an additional information for positive relationship with systemic atherosclerosis and coexisting cerebral SVDs in acute ischemic stroke patients.

Original languageEnglish
Pages (from-to)312-320
Number of pages9
JournalJournal of Stroke
Issue number3
StatePublished - Sep 2016

Bibliographical note

Funding Information:
This work was supported by a grant from the Korea Healthcare Technology Research and Development Project, Ministry for Health, Welfare, and Family Affairs, Republic of Korea (HI08C2149), a faculty research grant from Yonsei University College of Medicine for 2015 (6-2015-0158), and the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2015R1D1A1A01057934).

Publisher Copyright:
© 2016 Korean Stroke Society


  • Aortic atheroma
  • Cerebral small vessel diseases
  • White matter hyperintensity


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