Acampa Maurizio, Romano Daniele Giuseppe, Lazzerini Pietro Enea, Leonini Sara, Guideri Francesca, Tassi Rossana, Casseri Tommaso, Bracco Sandra, Martini Giuseppe
Stroke Unit, Department of Neurological and Neurosensorial Sciences, "Santa Maria alle Scotte" General Hospital, Siena, Italy.
Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Curr Neurovasc Res. 2018;15(1):34-38. doi: 10.2174/1567202615666180326100347.
Cerebral collateral circulation is a network of arterial anastomotic channels capable of providing supplementary perfusion to brain regions in response to ischemic insults. Arterial stiffness could negatively affect collateral circulation development, by means of its effects on the structural intracerebral vasculature.
The aim of our study is to investigate a possible link between arterial stiffness and presence of collateral circulation in patients with acute ischemic stroke.
113 patients (age: 74±12 years) with acute anterior ischemic stroke underwent neuroimaging examination and 24-hour blood pressure monitoring. Arterial Stiffness Index (ASI) and Pulse Pressure (PP) were assumed as surrogate measures of arterial stiffness. Collateral circulation was evaluated by means of the collateral grading system that was scored on a scale of 0-3.
According to TOAST classification, etiology of ischemic stroke was the following: Large-Artery Atherosclerosis (LAA)(n:41), Cardioembolism (CE)(n:60), Undetermined Etiology (UE)(n:12). Logistic regression analysis showed that good predictors of poor collaterals were ASI (OR 2.78 for 0.1, 95% CI:1.19-6.50, p=0.01) and PP (OR 1.81 for 10 mmHg, 95% CI:1.01-3.22, p=0.04) in stroke from LAA.
Our results suggest that, in patients with ischemic stroke from LAA, arterial stiffness may contribute to the impairment of collateral circulation and, therefore, it could reduce the beneficial effects of acute treatments.
脑侧支循环是一个动脉吻合通道网络，能够在缺血性损伤时为脑区提供补充灌注。动脉僵硬度可通过对脑内血管结构的影响，对侧支循环的发育产生负面影响。
我们研究的目的是探讨急性缺血性脑卒中患者动脉僵硬度与侧支循环存在之间的可能联系。
113例急性前循环缺血性脑卒中患者（年龄：74±12岁）接受了神经影像学检查和24小时血压监测。动脉僵硬度指数（ASI）和脉压（PP）被用作动脉僵硬度的替代指标。通过0-3级评分的侧支分级系统评估侧支循环。
根据TOAST分类，缺血性脑卒中的病因如下：大动脉粥样硬化（LAA）（n：41）、心源性栓塞（CE）（n：60）、病因不明（UE）（n：12）。逻辑回归分析表明，在LAA所致脑卒中中，ASI（每增加0.1，OR为2.78，95%CI：1.19-6.50，p=0.01）和PP（每增加10 mmHg，OR为1.81，95%CI：1.01-3.22，p=0.04）是侧支循环不良的良好预测指标。
我们的结果表明，在LAA所致缺血性脑卒中患者中，动脉僵硬度可能导致侧支循环受损，因此，它可能会降低急性治疗的有益效果。
