Association of plaque enhancement on vessel wall MRI and the phosphodiesterase 4D variant with stroke recurrence in patients with symptomatic intracranial atherosclerosis

Chuanhui Xu, Jun Qin, Jinhui Yu, Yan Sun, Dongmin Hu, Gang Wu, Yang Li

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Vessel wall MRI (VW-MRI) can be used to evaluate the nature of intracranial atherosclerosis (ICAS) plaque in vivo. Phosphodiesterase 4D (PDE4D) participates in stroke development. This study aims to explore the value of VW-MRI findings and the PDE4D gene variant in predicting stroke recurrence in patients with ICAS. Methods: We prospectively recruited 324 symptomatic ICAS patients. VW-MRI was performed to determine luminal and wall changes. PDE4D gene single-nucleotide polymorphisms (SNPs)—namely, SNP32, SNP83, and SNP87—were determined by direct sequencing. The risk factors of stroke recurrence were analyzed using the multivariate Cox proportional hazards model. Results: Of the 324 subjects, 97 (29.9%) experienced recurrent ischemic stroke during the follow-up period. A total of 254 patients (78.4%) showed plaque enhancement; 87 of these patients experienced stroke recurrence. The CT/CC genotype frequencies of PDE4D83 were significantly higher in participants with recurrent stroke than in patients without stroke recurrence (p = 0.019 and p < 0.001, respectively). However, the PDE4D32 and PDE4D87 variants were not correlated with recurrent stroke. Multivariate analysis showed that plaque enhancement from VW-MRI (HR 4.52, 95% CI 2.35–8.73, p < 0.001) and the PDE4D83 variant (HR 7.43, 95% CI 1.75–31.87, p = 0.005) were independently correlated with stroke recurrence. Kaplan–Meier curves showed significant differences in stroke recurrence rates between the plaque-enhanced group and the non-enhanced group (p < 0.001) and between the PDE4D83 variant carriers and noncarriers (p = 0.002). Conclusion: Plaque enhancement on VW-MRI and the presence of the PDE4D83 variant are associated with ischemic stroke recurrence in subjects with symptomatic ICAS.

Original languageEnglish
Pages (from-to)1781-1794
Number of pages14
JournalNeuroradiology
Volume64
Issue number9
DOIs
StatePublished - Sep 2022
Externally publishedYes

Keywords

  • Atherosclerosis
  • Imaging markers
  • Phosphodiesterase 4D
  • Stroke recurrence
  • Vessel wall magnetic resonance imaging

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