Pulse wave velocity is associated with early clinical outcome after ischemic stroke.
OBJECTIVE
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.
Dept. of Neurology of Adults, Medical University of Gdańsk, Poland. dgasecki@gumed.edu.pl
Dariusz
D
Gąsecki
Agnieszka
A
Rojek
Mariusz
M
Kwarciany
Kamil
K
Kowalczyk
Pierre
P
Boutouyrie
Walenty
W
Nyka
Stéphane
S
Laurent
Krzysztof
K
Narkiewicz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D020127:Recovery of Function; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D059289:Vascular Stiffness