Aortic stiffness and cardiac function in middle-aged women with ischemic stroke with and without migraine

Migraine increases the risk of ischemic stroke and cardiovascular disease in women, potentially due to systemic vascular dysfunction. We investigated whether migraine is associated with increased aortic stiffness and impaired cardiac function as markers of macrovascular dysfunction in middle-aged women with ischemic stroke.

This cross-sectional study included three groups of women aged 40-60 years with: (I) ischemic stroke, (II) ischemic stroke with migraine, and (III) no history of stroke or migraine. Aortic stiffness was measured by assessing aortic arch pulse wave velocity (arch PWV) using high-temporal 2D-phase contrast MRI. Cardiac function was evaluated through left ventricular measures, including stroke volume (SV), cardiac output (CO), and ejection fraction (EF), from two orthogonal cine biplane long-axis (2-/4-Chamber) acquisitions. Multivariable linear regression was used to estimate mean differences in arch PWV and left ventricular function, comparing groups 1 and 2 with group 3 as the reference.

Among 118 included women (mean age 51 years [SD 5]), (I) 44 had ischemic stroke, (II) 44 had both ischemic stroke and migraine, and (III) 30 had no stroke or migraine. In the reference group (group III), mean (SD) values were 6.97 (1.05) m/s for arch PWV, 95.91 (15.82) mL for SV, 6.73 (1.61) L/min for CO, and 64.90 (5.96)% for EF. Comparisons of groups I and II with group III showed no statistically significant mean differences in arch PWV, SV, CO, or EF. Although mean arch PWV was slightly higher in group II (7.11 [1.53] m/s), the adjusted mean difference (-0.03 m/s; 95%CI: -0.60 to 0.54 m/s) was not statistically significant. Small, non-significant reductions in SV, CO, and EF were also observed in the ischemic stroke groups compared with the reference group.

The increased risk of ischemic stroke in middle-aged women with migraine was not associated with differences in arch PWV or left ventricular function in this cohort. We did not detect evidence that macrovascular dysfunction plays a key role in linking migraine and cardiovascular risk, supporting other studies that point to a potential role for microvascular dysfunction.