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Hemispheric lateralization, endothelial function, and arterial compliance in chronic post-stroke individuals: a
Jean Alex Matos Ribeiro1, Simone Garcia Oliveira1, Gabriela Nagai Ocamoto1
1Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
Insights
Individuals with right-sided strokes show poorer endothelial function and arterial compliance compared to those with left-sided strokes. This suggests a higher susceptibility to cardiovascular events in right-sided stroke patients.
Area of Science:
- Neuroscience
- Cardiovascular Science
- Cerebrovascular Health
Background:
- The brain-heart axis regulates cardiovascular function, with potential hemispheric asymmetry in neural control.
- Understanding stroke-related cardiovascular changes is crucial for patient outcomes.
- Existing research suggests potential differences in cardiovascular regulation based on stroke laterality.
Purpose of the Study:
- To investigate differences in endothelial function between individuals with left- and right-sided strokes.
- To examine disparities in arterial compliance based on stroke laterality.
- To explore the implications of stroke-induced cardiovascular changes on brain-heart axis function.
Main Methods:
- Cross-sectional exploratory study involving 30 post-stroke participants (≥6 months).
- Endothelial function assessed via ultrasound-measured brachial artery flow-mediated dilation (baFMD).
- Arterial stiffness measured using carotid-femoral pulse wave velocity (cfPWV) and central aortic pulse wave analysis (AIx, AIx@75, RM).
Main Results:
- Right-sided stroke participants exhibited significantly worse endothelial function (baFMD) compared to left-sided stroke participants.
- Higher arterial stiffness, indicated by augmentation index (AIx) and reflection magnitude (RM), was observed in right-sided stroke patients.
- These differences were statistically significant with medium effect sizes, highlighting stroke laterality's impact on cardiovascular metrics.
Conclusions:
- Right-sided strokes are associated with reduced endothelial function and arterial compliance.
- Individuals with right-sided strokes may be at increased risk for cardiovascular events.
- Findings underscore the importance of considering stroke laterality in cardiovascular risk assessment and management.
Abstract:
Purpose/Aim: Cardiovascular function is controlled and regulated by a functional brain-heart axis. Although the exact mechanism is not fully understood, several studies suggest a hemispheric asymmetry in the neural control of cardiovascular function. Thus, the purpose of this study was to examine whether endothelial function and arterial compliance differ between individuals with left- and right-sided strokes.Materials and Methods: This was a cross-sectional exploratory study. Thirty individuals more than 6 months after stroke participated in the study. The endothelial function was assessed by ultrasound-measured flow-mediated dilation of the nonparetic arm brachial artery (baFMD). The arterial stiffness was assessed by measuring carotid-femoral pulse wave velocity (cfPWV) and central aortic pulse wave analysis [augmentation index (AIx), augmentation index normalized to a heart rate of 75 bpm (AIx@75) and reflection magnitude (RM)] using applanation tonometry. Results: Participants with right-sided stroke had worse endothelial function than those with left-sided stroke. This difference (baFMD = 2.51%) was significant (p = 0.037), and it represented a medium effect size (r = 0.38). Likewise, they had higher arterial stiffness than those with left-sided stroke. This difference (AIx = 10%; RM = 7%) was significant (p = 0.011; p = 0.012), and it represented a medium effect size (r = 0.48; r = 0.47).Conclusions: Our findings suggest that individuals with right-sided stroke have reduced endothelial function and arterial compliance compared to those with left-sided stroke. These data may indicate that those with right-sided strokes are more susceptible to cardiovascular events.
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