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Published on: April 23, 2021
The Relationship Between ADAMTS13 Activity and Overall Cerebral Small Vessel Disease Burden: A Cross-Sectional Study
Wenbo Sun1, Yufan Luo1, Shufan Zhang1
1Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Insights
Lower ADAMTS13 activity and higher von Willebrand factor levels are linked to white matter hyperintensity and subcortical infarction in cerebral small vessel disease (CSVD). ADAMTS13 activity is also negatively correlated with overall CSVD burden.
Area of Science:
- Neurology
- Vascular Biology
- Biochemistry
Background:
- Cerebral small vessel disease (CSVD) is a significant cause of stroke and cognitive impairment.
- Von Willebrand factor (VWF) and ADAMTS13 play critical roles in hemostasis and vascular health.
- The relationship between VWF, ADAMTS13, and specific neuroimaging markers of CSVD requires further elucidation.
Purpose of the Study:
- To investigate the association between plasma VWF levels, ADAMTS13 activity, and neuroimaging features of CSVD.
- To determine the relationship between VWF, ADAMTS13, and the overall burden of CSVD.
- To explore the role of VWF and ADAMTS13 in the pathogenesis of CSVD markers like white matter hyperintensity, subcortical infarction, and cerebral microbleeds.
Main Methods:
- A cohort of 296 patients with CSVD was recruited between 2016 and 2020.
- Plasma VWF levels and ADAMTS13 activity were measured for all participants.
- Logistic regression models were used to assess the association between VWF, ADAMTS13, and CSVD severity, including specific neuroimaging markers and overall CSVD score.
Main Results:
- Lower ADAMTS13 activity and higher VWF levels were independently associated with white matter hyperintensity (WMH) and subcortical infarction (SI).
- No significant association was found between VWF/ADAMTS13 levels and cerebral microbleeds (CMB).
- ADAMTS13 activity was independently and negatively correlated with the overall CSVD burden after adjusting for relevant clinical factors.
Conclusions:
- Reduced ADAMTS13 activity is associated with specific CSVD markers, including WMH and SI, but not CMB.
- VWF levels and ADAMTS13 activity are independently related to key features of CSVD.
- ADAMTS13 activity may play a crucial role in the progression and overall burden of cerebral small vessel disease.
Abstract:
Objectives: This study aimed to investigate the association between plasma von Willebrand factor (VWF) level, ADAMTS13 activity, and neuroimaging features of cerebral small vessel disease (CSVD), including the CSVD neuroimaging markers and the overall CSVD burden. Methods: CSVD patients admitted to our hospital from 2016 to 2020 were recruited. Plasma VWF level and ADAMTS13 activity were measured. The overall effect of CSVD on the brain was described as a validated CSVD score. We evaluated the association between VWF levels, ADAMTS13 activity, and the increasing severity of CSVD score by the logistic regression model. Results: We enrolled 296 patients into this study. The mean age of the sample was 69.0 years (SD 7.0). The mean VWF level was 1.31 IU/mL, and the ADAMTS13 activity was 88.01 (SD 10.57). In multivariate regression analysis, lower ADAMTS13 activity and higher VWF level was related to white matter hyperintensity (WMH) [β = -7.31; 95% confidence interval (CI) (-9.40, -4.93); p<0.01; β = 0.17; 95% confidence interval (0.11, 0.23); p<0.01], subcortical infarction (SI) [(β = -9.22; 95% CI (-11.37, -7.06); p<0.01); β = 0.21; 95% confidence interval (0.15, 0.27); p<0.01] independently, but not cerebral microbleed (CMB) [(β = -2.3; 95% CI (-4.95, 0.05); p = 0.22); β = 0.02; 95% confidence interval (-0.05, 0.08); p = 0.63]. Furthermore, ADAMTS13 activity was independently negatively correlated with the overall CSVD burden (odd ratio = 21.33; 95% CI (17.46, 54.60); p < 0.01) after adjustment for age, history of hypertension, and current smoking. Conclusions: Reducing ADAMTS13 activity change is related to white matter hyperintensity, subcortical infarction, but not with cerebral microhemorrhage. In addition, ADAMTS13 may have played an essential role in the progression of CSVD.
