Department of Neurology, Konya Education Research Hospital, 04240, Konya, Turkey.
Department of Neurology, Selcuk University Faculty of Medicine, 04240, Konya, Turkey.
J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105206. doi: 10.1016/j.jstrokecerebrovasdis.2020.105206. Epub 2020 Aug 8.
Arterial stiffness is an independent determinant of cardiovascular and cerebrovascular risks. The relationship between the increase in arterial stiffness parameters and the severity of stroke has been shown in previous studies. We aimed to investigate the association between clinical improvement and changes in arterial stiffness parameters in patients presenting acute ischemic stroke.
A total of 107 patients were enrolled in this study. On the first and seventh day of the hospitalization, 24 h non-invasive blood pressure was monitored and arterial stiffness parameters were measured. The National Institutes of Health Stroke Scale (NIHSS) was used to determine the severity of stroke, and the Modified Rankin Scale was used to determine dependency and to evaluate functional improvements.
Arterial stiffness parameters of augmentation index (AIx@75) and pulse wave velocity (PWV) were significantly higher in patients who died during hospitalization than patients who were discharged (respectively p <0.001, p = 0.04). In the group with clinical improvement, PWV values measured on the seventh day were significantly lower than PWV values measured on the first day (p = 0.032). When the changes in PWV value measured on the first and seventh day for both groups were analyzed using mixed ANOVA test, p value were significant (p = 0.033). Multivariate binary logistic regression analyses showed that negatively change in PWV and CDBP independently predicts the clinical improvement.
Increased AIx@75 and PWV appear to be associated with higher in-hospital mortality rates in patients with acute ischemic stroke. Additionally, clinical improvement in patients with ischemic stroke is associated with a decrease in PWV .
动脉僵硬度是心血管和脑血管风险的独立决定因素。先前的研究表明，动脉僵硬度参数的增加与中风严重程度之间存在关联。我们旨在研究急性缺血性中风患者中动脉僵硬度参数的变化与临床改善之间的关系。
本研究共纳入 107 例患者。在住院的第 1 天和第 7 天，监测 24 小时无创血压并测量动脉僵硬度参数。采用国立卫生研究院卒中量表（NIHSS）评估卒中严重程度，采用改良 Rankin 量表评估依赖性和功能改善情况。
与出院患者相比，住院期间死亡的患者的动脉僵硬度参数（分别为 p<0.001，p=0.04）和脉搏波速度（PWV）明显更高。在临床改善组中，第 7 天测量的 PWV 值明显低于第 1 天测量的 PWV 值（p=0.032）。当使用混合方差分析测试分析两组第 1 天和第 7 天测量的 PWV 值的变化时，p 值具有统计学意义（p=0.033）。多变量二元逻辑回归分析显示，PWV 和 CDBP 的负向变化独立预测临床改善。
急性缺血性中风患者 AIx@75 和 PWV 的增加似乎与住院死亡率升高有关。此外，缺血性中风患者的临床改善与 PWV 的降低有关。
