Emma Ormerod1, Khalid Ali2, James Cameron3, Muzaffar Malik4, Richard Lee5, Spas Getov6, Chakravarthi Rajkumar7. 1. Department of Medicine, Bristol University Hospitals NHS Trust, Bristol, United Kingdom; Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, United Kingdom. 2. Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, United Kingdom. Electronic address: khalid.ali@bsuh.nhs.uk. 3. Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, United Kingdom; Department of Medicine (Southern Clinical School), Monash Cardiovascular Research Centre, Monash University and Monash Heart, Clayton, Victoria, Australia. 4. Division of Medical Education, Postgraduate, Brighton and Sussex Medical School, .University of Brighton, United Kingdom. 5. Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, United Kingdom; NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust, United Kingdom. 6. Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, United Kingdom; Wellcome Trust Centre for Neuroimaging, Centre of Neurology, University College London, United Kingdom. 7. Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, United Kingdom.
Abstract
OBJECTIVES: Vascular compliance is emerging as a useful cardiovascular risk factor. The aim of this study was to investigate the association between arterial stiffness and stroke severity at presentation and 3 weeks. METHODS: Forty two patients with acute ischemic stroke (55% male, mean age 71 years) were recruited over 15-months. Stroke subtypes were classified into lacunar circulation infarct (LACI), partial anterior circulation infarct (PACI), and posterior circulation infarct (POCI). Arterial stiffness was measured by QKD (defined as the time interval between the appearance of the Q wave [Q] on the ECG and the arrival of the diastolic Korotkoff [K] sound over the brachial artery in diastole [D]; QKD It is measured in milliseconds) using 24-hour ambulatory blood pressure (BP) and electrocardiogram monitoring. The measured QKD values were then corrected for a heart rate of 60 bpm and a systolic BP of 100 mm Hg (QKD100-60). Stroke severity was assessed on admission and at 3 weeks using the National Institutes of Health Stroke Scale (NIHSS). RESULTS: Regression analysis for all patients showed a weak non-significant correlation between arterial stiffness and stroke severity. However, on performing subgroup analysis using Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, we found that in large-artery atherosclerosis, arterial stiffness predicted stroke severity significantly at baseline (r = .45, b = .093, P = .04), but not significant for cardio embolism or small-artery occlusion subtypes. QKD100-60 and stroke severity were not significantly associated in week 3. There was no difference in NIHSS scores at weeks 0 and 3, or in QKD100-60 between LACI, PACI, and POCI, or dipper versus non-dippers and reverse dippers. CONCLUSION: Further research is needed to explore the association between QKD and stroke severity.
OBJECTIVES: Vascular compliance is emerging as a useful cardiovascular risk factor. The aim of this study was to investigate the association between arterial stiffness and stroke severity at presentation and 3 weeks. METHODS: Forty two patients with acute ischemic stroke (55% male, mean age 71 years) were recruited over 15-months. Stroke subtypes were classified into lacunar circulation infarct (LACI), partial anterior circulation infarct (PACI), and posterior circulation infarct (POCI). Arterial stiffness was measured by QKD (defined as the time interval between the appearance of the Q wave [Q] on the ECG and the arrival of the diastolic Korotkoff [K] sound over the brachial artery in diastole [D]; QKD It is measured in milliseconds) using 24-hour ambulatory blood pressure (BP) and electrocardiogram monitoring. The measured QKD values were then corrected for a heart rate of 60 bpm and a systolic BP of 100 mm Hg (QKD100-60). Stroke severity was assessed on admission and at 3 weeks using the National Institutes of Health Stroke Scale (NIHSS). RESULTS: Regression analysis for all patients showed a weak non-significant correlation between arterial stiffness and stroke severity. However, on performing subgroup analysis using Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, we found that in large-artery atherosclerosis, arterial stiffness predicted stroke severity significantly at baseline (r = .45, b = .093, P = .04), but not significant for cardio embolism or small-artery occlusion subtypes. QKD100-60 and stroke severity were not significantly associated in week 3. There was no difference in NIHSS scores at weeks 0 and 3, or in QKD100-60 between LACI, PACI, and POCI, or dipper versus non-dippers and reverse dippers. CONCLUSION: Further research is needed to explore the association between QKD and stroke severity.