Arterial Stiffness and Functional Outcome in Acute Ischemic Stroke

Abstract

ObjectiveArterial stiffness is a common change associated with aging and can be evaluated by measuring pulse wave velocity (PWV) between sites in the arterial tree, with the stiffer artery having the higher PWV. Arterial stiffness is associated with the risk of stroke in the general population and of fatal stroke in hypertensive patients. This study is to clarify whether PWV value predicts functional outcome of acute ischemic stroke.MethodsOne hundred patients were enrolled with a diagnosis of acute ischemic stroke and categorized into two groups: large-artery atherosclerosis (LAAS) or small vessel disease (SVD) subtype of Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Each group was divided into two sub-groups based on the functional outcome of acute ischemic stroke, indicated by modified Rankin Scale (mRS) at discharge. Poor functional outcome group was defined as a mRS ≥ 3 at discharge. Student's t-test or Mann-Whitney U-test were used to compare maximal brachial-ankle PWV (baPWV) values.ResultsTwenty-four patients whose state was inadequate to assess baPWV or mRS were excluded. There were 38 patients with good functional outcome (mRS < 3) and 38 patients with poor functional outcome (mRS ≥ 3). The baPWV values were significantly higher in patients with poor outcome (2,070.05 ± 518.37 cm/s) compared with those with good outcome (1,838.63 ± 436.65) (p = 0.039). In patients with SVD subtype, there was a significant difference of baPWV values between groups (2,163.18 ± 412.71 vs. 1,789.80 ± 421.91, p = 0.022), while there was no significant difference of baPWV among patients with LAAS subtype (2,071.76 ± 618.42 vs. 1,878.00 ± 365.35, p = 0.579).ConclusionsArterial stiffness indicated by baPWV is associated with the functional outcome of acute ischemic stroke. This finding suggests that measurement of baPWV predicts functional outcome in patients with stroke especially those whose TOAST classification was confirmed as SVD subtype.

Distinct proteomic profiles in monozygotic twins discordant for ischaemic stroke

“…Increased plasma concentrations of fibulin 1 are predictive of cardiovascular mortality in type 2 diabetes [18], and a recent study found that common polymorphisms in the FBLN1 gene predict aortic stiffness in young healthy subjects [33]. Aortic stiffness is an important independent risk factor for IS, suggesting the potential usefulness of fibulin 1 as a biomarker [34].…”

Plasma soluble vascular adhesion protein-1 concentration correlates with arterial stiffness: A cross-sectional study

“…In this study, baPWV, rather than carotid-femoral PWV (cfPWV) which represents the gold standard among the PWV parameters and reflects the stiffness of central artery, was used to assess arterial stiffness. However, recent studies showed that baPWV was significantly and positively associated with cfPWV, and that both PWV values were similarly associated with cardiovascular risk factors and clinical events (Lee et al, 2014). In addition, PWV and the augmentation index (AI) are the 2 major non-invasive methods of assessing arterial stiffness.…”

Blood–Brain Barrier Disruption, Vascular Impairment, and Ischemia/Reperfusion Damage in Diabetic Stroke

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“…60 Arterial stiffness is a commonly encountered complication of DM, which is also associated with poor functional outcome after stroke. 61 DM-induced oxidative stress and inflammatory responses in turn accelerate atherosclerosis. 62 Impaired vasodilation leads to prolonged CBF decrease, which can trigger neuronal cell death.…”