Pulse wave velocity is associated with early clinical outcome after ischemic stroke

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• 作者：Dariusz G?secki^a ; ^{dgasecki@gumed.edu.pl} ; Agnieszka Rojek^b ; Mariusz Kwarciany^a ; Kamil Kowalczyk^a ; Pierre Boutouyrie^c ; Walenty Nyka^a ; Sté ; phane Laurent^c ; Krzysztof Narkiewicz^b
• 关键词：Stroke ; Arterial stiffness ; Pulse wave velocity ; Risk factor ; Early outcome
• 刊名：Atherosclerosis
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：225
• 期：2
• 页码：348-352
• 全文大小：142 K

文摘

Background and purposes

Pulse wave analysis (PWV), a marker of aortic stiffness, has independent predictive value for cardiovascular morbidity and mortality in both healthy and high-risk populations, especially fatal stroke, and for long-term functional stroke prognosis. Whether arterial stiffness and wave reflection are related to stroke in-hospital short-term outcome has never been demonstrated.

Methods

In a prospective study, we enrolled 134 patients with acute ischemic stroke, aged 63.4?¡À?12.5 years, mean?¡À?SD, National Institutes of Health stroke scale (NIHSS) scored 7.1?¡À?6.5 at admission. Carotid-femoral (CF) PWV and central augmentation index (cAIx) were measured (SphygmoCor) one week after stroke onset. At hospital discharge, favorable outcome was defined as a 4 or more point improvement from baseline NIHSS or NIHSS of 0-1. Data were analyzed with logistic regression.

Results

In univariate analysis, low CF-PWV (P?=?0.000,001), but not cAIx, was significantly associated with early favorable outcome. In multivariate analysis, CF-PWV?>?9.0?m/s remained significantly associated with favorable early outcome after adjustment for age, NIHSS and blood glucose level on admission, as well as heart rate, systolic and mean blood pressure, measured at day 7 (OR?=?0.17 [95 % CI, 0.05-0.60];P?=?0.006).

Conclusions

In ischemic stroke, low aortic stiffness (CF-PWV) is associated with early favorable outcome, independently of other known prognostic factors.