title: Arterial stiffness and progressive neurological deficit in patients with acute deep subcortical infarction.
abstract: OBJECTIVE
  The mechanism of progressive neurological deficit (PND) in patients with ischemic stroke remains unclear. The aim of this study was to clarify whether arterial stiffness, a marker of vascular endothelial impairment and arteriosclerosis, is associated with PND in patients with acute deep subcortical infarction.
  
  
  METHODS
  We evaluated 156 consecutive first-ever ischemic stroke patients with acute deep subcortical infarction. PND was defined as an increment of ≥2 points in the National Institute of Health Stroke Scale score or an increase of ≥1 point in the limb weakness score within 7 days of stroke onset. Patients were assessed for risk factors, and infarct size was measured on initial diffusion-weighted magnetic resonance imaging. We measured brachial-ankle pulse wave velocity (baPWV) as a marker of arterial stiffness. We divided patients into 2 groups according to the presence or absence of PND to compare their clinical characteristics.
  
  
  RESULTS
  Fifty-two patients (33%) had PND, and baPWV was significantly higher in patients with than in those without PND. The baPWV cut-off value for PND was 18.24 m/s, with 90% sensitivity and 47% specificity. In multivariable logistic regression analysis, high baPWV (≥18.24 m/s; odds ratio, 8.22; 95% confidence interval, 2.55-31.9), large infarct size (≥15 mm; odds ratio, 2.76; 95% confidence interval, 1.01-7.92), and ≥3 infarct slices on serial axial diffusion-weighted imaging (odds ratio, 3.38; 95% confidence interval, 1.22-10.0) were independently associated with PND.
  
  
  CONCLUSIONS
  Arterial stiffness indicated by baPWV is independently associated with PND in patients with acute deep subcortical infarction.
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan. sajink@nifty.com
authors.forename: Naoki
authors.initials: N
authors.lastname: Saji
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Kawarai
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Shimizu
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kita
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D020520:Brain Infarction / Q000150:complications*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000209:etiology*; D012307:Risk Factors; D059289:Vascular Stiffness