Arterial stiffness and functional outcome in acute ischemic stroke.
OBJECTIVE
Arterial stiffness is a common change associated with aging and can be evaluated by measuring pulse wave velocity (PWV) between sites in the arterial tree, with the stiffer artery having the higher PWV. Arterial stiffness is associated with the risk of stroke in the general population and of fatal stroke in hypertensive patients. This study is to clarify whether PWV value predicts functional outcome of acute ischemic stroke.


METHODS
ONE HUNDRED PATIENTS WERE ENROLLED WITH A DIAGNOSIS OF ACUTE ISCHEMIC STROKE AND CATEGORIZED INTO TWO GROUPS: large-artery atherosclerosis (LAAS) or small vessel disease (SVD) subtype of Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Each group was divided into two sub-groups based on the functional outcome of acute ischemic stroke, indicated by modified Rankin Scale (mRS) at discharge. Poor functional outcome group was defined as a mRS ≥ 3 at discharge. Student's t-test or Mann-Whitney U-test were used to compare maximal brachial-ankle PWV (baPWV) values.


RESULTS
Twenty-four patients whose state was inadequate to assess baPWV or mRS were excluded. There were 38 patients with good functional outcome (mRS < 3) and 38 patients with poor functional outcome (mRS ≥ 3). The baPWV values were significantly higher in patients with poor outcome (2,070.05 ± 518.37 cm/s) compared with those with good outcome (1,838.63 ± 436.65) (p = 0.039). In patients with SVD subtype, there was a significant difference of baPWV values between groups (2,163.18 ± 412.71 vs. 1,789.80 ± 421.91, p = 0.022), while there was no significant difference of baPWV among patients with LAAS subtype (2,071.76 ± 618.42 vs. 1,878.00 ± 365.35, p = 0.579).


CONCLUSIONS
Arterial stiffness indicated by baPWV is associated with the functional outcome of acute ischemic stroke. This finding suggests that measurement of baPWV predicts functional outcome in patients with stroke especially those whose TOAST classification was confirmed as SVD subtype.
Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.
Yeong-Bae
YB
Lee
Gachon University Gil Medical Center, Incheon, Korea.
Joo-Hwan
JH
Park
Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.
Eunja
E
Kim
Neuroscience Research Institute, Gachon University, Incheon, Korea.
Chang-Ki
CK
Kang
Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.
Hyeon-Mi
0000-0002-7816-9653
HM
Park
Arterial stiffness; Functional outcome; Large-artery atherosclerosis; Pulse wave velocity; Small vessel disease; Stroke