Discordant and Worse Reactivity of Peripheral Microvasculature in Acute Ischemic Stroke Patients

Impaired opisthenar microvessel area (OMA) has been associated with adverse cardiac outcomes in acute myocardial infarction (AMI) patients. Here, we compared the characteristics of OMA of ischemic stroke (AIS) patients, National Institutes of Health Stroke Scale (NIHSS) positive, AIS recurrence, and AMI patients.

OMA was investigated using optical coherence tomography (OCT) in AIS patients with mild or no neurological deficit (MND, NND) and recurrence or recurrence-free (RG, RFG). The characteristics of microvessel were compared to those of AMI patients. Brachial-ankle pulse wave velocity (baPWV) was also measured with Omron Instrument.

Compared to controls (Con), OMA, total and average vessel length (TVL, AVL) were smaller but End points (EPs) were greater in AIS at room temperature (RT). Both heat and cold stimulation (HS and CS) increased vessel length and area. However, significantly increased EPs and Lacunarity were observed at CS in AIS patients. As for the effect of neurological deficiency, OMA, TVL, and AVL were smaller, and EPs were markedly increased in MND with CS. OMA and TVL were smaller in the RG group at RT, but CS or HS did not change microvascular characteristics. Between AIS and AMI patients, baPWV was significantly greater in AIS, microvessel area and length were comparable between the two groups, and EPs were significantly increased in AIS. Furthermore, baPWV showed a positive correlation with OMA in CON, a negative correlation in AMI, but no correlation in AIS.

Greater EPs and lacunarity of microvasculature are indicative of discordancy in AIS patients. Disrupted macrovascular-microvascular association in AIS suggests distinctive pathology to those of AMI.