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

• Published in: Atherosclerosis Vol. 225; no. 2; pp. 348 - 352
• Main Authors: Gąsecki, Dariusz, Rojek, Agnieszka, Kwarciany, Mariusz, Kowalczyk, Kamil, Boutouyrie, Pierre, Nyka, Walenty, Laurent, Stéphane, Narkiewicz, Krzysztof
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.12.2012; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Aorta - physiopathology; Arterial stiffness; atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; blood glucose; blood pressure; Brain Ischemia - diagnosis; Brain Ischemia - physiopathology; Brain Ischemia - rehabilitation; Cardiology. Vascular system; Cardiovascular; Disability Evaluation; Early outcome; Female; heart rate; Humans; Logistic Models; Male; Medical sciences; Middle Aged; morbidity; mortality; Multivariate Analysis; National Institutes of Health; Neurology; Odds Ratio; Patient Discharge; patients; Predictive Value of Tests; Prognosis; Prospective Studies; Pulse Wave Analysis; Pulse wave velocity; Recovery of Function; regression analysis; Risk factor; Risk Factors; Stroke; Stroke - diagnosis; Stroke - physiopathology; Stroke Rehabilitation; Time Factors; Vascular diseases and vascular malformations of the nervous system; Vascular Stiffness; Pulse wave velocity; Early outcome; Stroke; Arterial stiffness; Risk factor; Cerebral infarction; Nervous system diseases; Prognosis; Cardiovascular disease; Cerebral disorder; Vascular disease; Central nervous system disease; Atherosclerosis; Brain ischemia; Stiffness; Cerebrovascular disease
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2012.09.024

Abstract 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 ± 12.5 years, mean ± SD, National Institutes of Health stroke scale (NIHSS) scored 7.1 ± 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.