Cerebral augmentation index derived from external counterpulsation predicts ischemic stroke outcome: A prospective...

Area of Science:

• Neurology
• Cardiovascular Medicine
• Medical Imaging

Background:

• Ischemic stroke affects millions globally, leading to significant disability.
• External counterpulsation (ECP) is a noninvasive method to augment blood flow.
• Cerebral blood flow augmentation during ECP in stroke patients warrants further investigation.

Purpose of the Study:

• To determine if the cerebral augmentation index (CAI) measured by transcranial Doppler (TCD) during ECP can predict functional outcomes in ischemic stroke patients.
• To evaluate the relationship between CAI and stroke severity and patient outcomes.

Main Methods:

• 200 patients with unilateral ischemic stroke within 7 days of onset were enrolled.
• Transcranial Doppler (TCD) monitored middle cerebral artery (MCA) flow velocities during ECP.
• CAI was calculated as the percentage increase in MCA flow velocity during ECP relative to baseline.

Main Results:

• 148 patients (74%) had good functional outcomes (mRS 0-2) at 3 months.
• Admission NIH Stroke Scale, history of ischemic heart disease, and CAI on both ipsilateral and contralateral sides differed significantly between outcome groups.
• Multivariate analysis identified NIH Stroke Scale, ipsilateral CAI, and contralateral CAI as independent predictors of poor functional outcomes.

Conclusions:

• Cerebral augmentation index (CAI) measured via TCD during ECP is a potential predictor of functional outcomes in acute ischemic stroke.
• CAI, assessed on either side of the cerebral infarct, may help identify patients at risk for unfavorable stroke outcomes.