MRI phenotypes of the brain are related to future stroke and mortality in patients with manifest arterial disease: the SMART-MR study

Jaarsma-Coes, M.G.; Ghaznawi, R.; Hendrikse, J.; Slump, C.; Witkamp, T.D.; Graaf, Y. van der; Geerlings, M.I.; Bresser, J. de; Algra, A.; Grobbee, D.E.; Rutten, G.E.H.M.; Visseren, F.L.J.; Borst, G.J. de; Kappelle, L.J.; Leiner, T.; Doevendans, P.A.; Second Manifestn ARTerial Dis SMAR

doi:doi:10.1177/0271678X18818918

Persistent URL of this record https://hdl.handle.net/1887/3184071

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Medicine / Leiden University Medical Centre (LUMC)

Jaarsma-Coes, M.G.; Ghaznawi, R.; Hendrikse, J.; Slump, C.; Witkamp, T.D.; Graaf, Y. van der; ... ; Second Manifestn ARTerial Dis SMAR (2020)

MRI phenotypes of the brain are related to future stroke and mortality in patients with manifest arterial disease: the SMART-MR study

Article / Letter to editor

Neurodegenerative and neurovascular diseases lead to heterogeneous brain abnormalities. A combined analysis of these abnormalities by phenotypes of the brain might give a more accurate representation of the underlying aetiology. We aimed to identify different MRI phenotypes of the brain and assessed the risk of future stroke and mortality within these subgroups. In 1003 patients (59 +/- 10 years) from the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, different quantitative 1.5T brain MRI markers were used in a hierarchical clustering analysis to identify 11 distinct subgroups with a different distribution in brain MRI markers and cardiovascular risk factors, and a different risk of stroke (Cox regression: from no increased risk compared to the reference group with relatively few brain abnormalities to HR = 10.34; 95% CI 3.80 <-> 28.12 for the multi-burden subgroup) and mortality (from no increased risk compared to the reference group to HR = 4.00; 95...Show moreNeurodegenerative and neurovascular diseases lead to heterogeneous brain abnormalities. A combined analysis of these abnormalities by phenotypes of the brain might give a more accurate representation of the underlying aetiology. We aimed to identify different MRI phenotypes of the brain and assessed the risk of future stroke and mortality within these subgroups. In 1003 patients (59 +/- 10 years) from the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, different quantitative 1.5T brain MRI markers were used in a hierarchical clustering analysis to identify 11 distinct subgroups with a different distribution in brain MRI markers and cardiovascular risk factors, and a different risk of stroke (Cox regression: from no increased risk compared to the reference group with relatively few brain abnormalities to HR = 10.34; 95% CI 3.80 <-> 28.12 for the multi-burden subgroup) and mortality (from no increased risk compared to the reference group to HR = 4.00; 95% CI 2.50 <-> 6.40 for the multi-burden subgroup). In conclusion, within a group of patients with manifest arterial disease, we showed that different MRI phenotypes of the brain can be identified and that these were associated with different risks of future stroke and mortality. These MRI phenotypes can possibly classify individual patients and assess their risk of future stroke and mortality.Show less

Brain imaging

cluster analysis

magnetic resonance imaging

atherosclerosis

patient outcome