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Published on: February 7, 2014
Decrease in Pulse Wave Velocity is Associated with Clinical Improvement in Patients with Ischemic Stroke
Ayşegül Demir1, Şerefnur Öztürk2, Ahmet Hakan Ekmekçi2
1Department of Neurology, Konya Education Research Hospital, 04240, Konya, Turkey.
Insights
Increased arterial stiffness, including augmentation index (AIx@75) and pulse wave velocity (PWV), is linked to higher mortality in acute ischemic stroke patients. A decrease in PWV indicates clinical improvement.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Arterial stiffness is a key factor in cardiovascular and cerebrovascular risks.
- Previous studies link increased arterial stiffness to stroke severity.
- The prognostic value of arterial stiffness changes in acute ischemic stroke requires further investigation.
Purpose of the Study:
- To investigate the association between clinical improvement and changes in arterial stiffness parameters in patients with acute ischemic stroke.
- To determine if arterial stiffness parameters predict in-hospital mortality and functional outcomes.
- To explore the relationship between arterial stiffness dynamics and recovery post-stroke.
Main Methods:
- 107 patients with acute ischemic stroke were enrolled.
- Non-invasive blood pressure monitoring and arterial stiffness measurements (AIx@75, PWV) were performed on days 1 and 7.
- Stroke severity (NIHSS) and functional outcomes (mRS) were assessed.
Main Results:
- Higher AIx@75 and PWV were observed in patients who died compared to those discharged (p <0.001, p=0.04).
- Patients with clinical improvement showed a significant decrease in PWV from day 1 to day 7 (p=0.032).
- Mixed ANOVA revealed significant changes in PWV over time between groups (p=0.033).
- Negative changes in PWV and central diastolic blood pressure independently predicted clinical improvement.
Conclusions:
- Elevated AIx@75 and PWV are associated with increased in-hospital mortality in acute ischemic stroke.
- A reduction in PWV correlates with clinical improvement in ischemic stroke patients.
- Arterial stiffness parameters may serve as important biomarkers for prognosis and recovery in acute ischemic stroke.
Background:
Arterial stiffness is an independent determinant of cardiovascular and cerebrovascular risks. The relationship between the increase in arterial stiffness parameters and the severity of stroke has been shown in previous studies. We aimed to investigate the association between clinical improvement and changes in arterial stiffness parameters in patients presenting acute ischemic stroke.
Methods:
A total of 107 patients were enrolled in this study. On the first and seventh day of the hospitalization, 24 h non-invasive blood pressure was monitored and arterial stiffness parameters were measured. The National Institutes of Health Stroke Scale (NIHSS) was used to determine the severity of stroke, and the Modified Rankin Scale was used to determine dependency and to evaluate functional improvements.
Results:
Arterial stiffness parameters of augmentation index (AIx@75) and pulse wave velocity (PWV) were significantly higher in patients who died during hospitalization than patients who were discharged (respectively p <0.001, p = 0.04). In the group with clinical improvement, PWV values measured on the seventh day were significantly lower than PWV values measured on the first day (p = 0.032). When the changes in PWV value measured on the first and seventh day for both groups were analyzed using mixed ANOVA test, p value were significant (p = 0.033). Multivariate binary logistic regression analyses showed that negatively change in PWV and CDBP independently predicts the clinical improvement.
Conclusions:
Increased AIx@75 and PWV appear to be associated with higher in-hospital mortality rates in patients with acute ischemic stroke. Additionally, clinical improvement in patients with ischemic stroke is associated with a decrease in PWV .
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