| Objective:1.To explore the effect of plaque characteristics combined with ideal cardiovascular health(CVH)factors on intracranial arterial ischemic stroke based on high resolution MR vessel wall imaging(HRMR-VWI),and analyze the risk factors and protective factors of ischemic stroke.2.To explore the correlation between the total ideal cardiovascular health factors score and the plaque characteristics of patients with intracranial arterial ischemic stroke.Methods:This paper retrospectively analyzed 69 patients with middle cerebral artery stenosis treated in the first hospital of Shanxi Medical University from January 2018 to November2021,of which 49 patients with high signal of middle cerebral artery supply area on diffusion-weighted imaging(DWI)were included in the infarction group,The remaining 20 patients without high signal of middle cerebral artery supply area on DWI were included in the non infarction group.All patients underwent routine skull scanning,DWI,MRA and HRMR-VWI with 3.0T magnetic resonance scanner.The plaque characteristics of the two groups were collected respectively,and the degree of plaque stenosis,plaque load were measured quantitatively,the qualitative parameters include the type of plaque remodeling,the degree of plaque enhancement and intra plaque hemorrhage.The ideal CVH data of patients were collected by unified questionnaire,such as physical activity,smoking,drinking,diet and other lifestyle;demographic data,such as gender,age,height,weight,education,etc;and past medical history data such as hypertension,diabetes,hyperlipidemia,cardiovascular disease and medication history.All patients were scored with 7 scores of ideal CVH factors.Compare whether there are differences between the two groups in the above factors,analyze the relationship between each factor and ischemic stroke,as well as the protective and risk factors of ischemic stroke.According to the ideal total CVH score,explore the relationship between the ideal total CVH score and the characteristics of intracranial arterial plaque.Results:A total of 69 patients were included in this study,including 49 in the infarction group and 20 in the non infarction group.Univariate analysis showed that the intensity of physical activity,the ideal CVH score and the degree of plaque stenosis,plaque enhancement rate and the type of plaque remodeling in the plaque characteristics of the infarction group and the non infarction group were statistically significant.The proportion of low intensity of physical activity in the infarction group was higher than that in the non infarction group(P< 0.05),the score of ideal cardiovascular factors in the infarction group was lower than that in the non infarction group(P < 0.05).Multivariate logistic regression analysis showed that moderate and severe physical activity intensity,ideal cardiovascular health index score and positive remodeling type were independent influencing factors of ischemic stroke.Compared with mild physical activity intensity,moderate and severe physical activity intensity is the protective factor of ischemic stroke,and positive remodeling is the risk factor of ischemic stroke.In the correlation analysis between the ideal cardiovascular health index score and the characteristics of intracranial arterial plaque,the ideal cardiovascular health score was negatively correlated with plaque load(r =-0.38,P< 0.05)and the degree of stenosis(r =-0.47,P< 0.05),but not with plaque enhancement rate(P > 0.05).ROC curve showed that the area under the curve(AUC =0.815)of ideal CVH score in predicting ischemic stroke was higher than that of reconstruction type(AUC = 0.673)and physical activity level(AUC = 0.730),and the predictive value of the combination of the three(AUC= 0.892)was higher than that of the three alone.Conclusion:Positive remodeling is a risk factor for ischemic stroke,and the ideal CVH score is a protective factor for ischemic stroke;plaque load,rate and plaque stenosis were negatively correlated with the ideal total CVH score;the combination of remodeling type,physical activity level and ideal CVH score is of high value in predicting ischemic stroke. |
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