BACKGROUND AND AIMS We explored the association between the total small vessel disease score obtained from baseline magnetic resonance imaging and subsequent cerebro-cardiovascular events in neurologically healthy Japanese adults. METHODS The presence of small vessel disease features, including lacunae, cerebral microbleeds, white matter changes, and basal ganglia perivascular spaces on magnetic resonance imaging, was summed to obtain a "total small vessel disease score" (range, 0-4). After excluding participants with previous stroke or ischemic heart disease, intracranial artery stenosis (≥50%), or cerebral aneurysm (≥4 mm), a total of 1349 participants (mean age, 57.7 years; range, 22.8-85.0 years; 46.9% male) were classified into three groups by total small vessel disease score: 0 (n = 984), 1 (n = 269), and ≥2 (n = 96). Cerebro-cardiovascular events (i.e., any stroke, transient ischemic attack, ischemic heart disease, acute heart failure, and aortic dissection) were defined as the primary end point. The hazard ratio (HR) of events during follow-up was calculated using Cox proportional hazards modeling with adjustments for age, sex, hypertension, diabetes mellitus, and smoking. Cumulative event-free rates were estimated using the Kaplan-Meier method. RESULTS During follow-up (mean, 6.7 years), 35 cerebro-cardiovascular (16 cerebrovascular) events were identified. Higher small vessel disease score was associated with increased risk of cerebro-cardiovascular events (HR per unit increase, 2.17; 95% confidence interval, 1.36-3.46; P = 0.001). Events were more frequent among participants with higher score (P < 0.001, log-rank test). CONCLUSIONS This study offered additional evidence for the clinical relevance of total small vessel disease score, suggesting the score as a promising tool to predict the risk of subsequent vascular events even in healthy populations.

中文翻译：

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健康成人的总小血管疾病评分和脑心血管事件：鹿岛扫描研究。

背景和目的 我们探讨了从基线磁共振成像获得的总小血管疾病评分与神经系统健康日本成人随后的脑心血管事件之间的关联。方法 将磁共振成像上存在的小血管疾病特征，包括腔隙、脑微出血、白质改变和基底节血管周围间隙相加，以获得“总小血管疾病评分”（范围，0-4）。排除既往中风或缺血性心脏病、颅内动脉狭窄（≥50%）或脑动脉瘤（≥4 mm）的参与者后，共有 1349 名参与者（平均年龄，57.7 岁；范围，22.8-85.0 岁；46.9%）男性）根据总小血管疾病评分分为三组：0（n = 984）、1（n = 269）和≥2（n = 96）。脑心血管事件（即任何中风、短暂性脑缺血发作、缺血性心脏病、急性心力衰竭和主动脉夹层）被定义为主要终点。随访期间事件的风险比 (HR) 使用 Cox 比例风险模型计算，并调整了年龄、性别、高血压、糖尿病和吸烟。使用 Kaplan-Meier 方法估计累积无事件率。结果 在随访期间（平均 6.7 年），确定了 35 次脑-心血管（16 次脑血管）事件。较高的小血管疾病评分与脑心血管事件风险增加相关（每单位增加的 HR，2.17；95% 置信区间，1.36-3.46；P = 0.001）。事件在得分较高的参与者中更频繁（P < 0.001，对数秩检验）。