The association between total SVD score and cardio-ankle vascular index

It is presumed that cerebral small vessel disease (CSVD) is affected by arteriosclerosis in large vessels. The purpose of this study was to evaluate whether the cardio-ankle vascular index (CAVI) was associated with total small vessel disease (SVD) score, which is the image score.

This retrospective study was performed at a single institution. The study included participants who were at least 50 years old and had undergone brain magnetic resonance imaging (MRI) and CAVI evaluation as preoperative examination for cardiovascular disease from April 2012 to March 2023. Patients with an ankle-brachial index (ABI) < 0.9 were excluded because of the reduced reliability of CAVI measurements. The white matter hyperintensity lesion, perivascular space enlargement, lacune, and microbleeds were evaluated on MRI and the total SVD score was calculated in accordance with previous studies. We evaluated whether CAVI was associated with this score using ANOVA, Jonckheere-Terpstra trend test, and ordinal logistic regression analysis.

This study included 1527 participants (mean age, 73.0 years ± 9.3 [SD], 1029 (67%) men). The difference in CAVI between the groups defined using the total SVD scores was significant (p < 0.01) and a significant trend was detected (p < 0.01), that is, the higher the total SVD score, the higher the CAVI in the participants. This significance was maintained even when the clinical risk factors for CSVD were adjusted (p < 0.01).

In patients with cardiovascular disease and ABI ≥ 0.9, proximal large artery stiffness is associated with CSVD.