4C.08: AORTIC STIFFNESS IS AN INDEPENDENT BIOMARKER OF SUBCLINICAL BRAIN DAMAGE IN ACUTE ISCHEMIC STROKE. (June 2015)

• Record Type: Journal Article
• Authors: Gasecki, D.; Kwarciany, M.; Kowalczyk, K.; Rojek, A.; Nowicki, T.; Skrzypek-Czerko, M.; Szurowska, E.; Boutouyrie, P.; Laurent, S.; Narkiewicz, K.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000467502.75589.a8
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Ischemic stroke may be the first manifestation of cerebrovascular disease. However, subclinical organ complications of underlying arterial stiffness and hypertension may coexist and stratify outcome. The study aimed to examine measures of arterial stiffness and blood pressure (BP) on subclinical brain damage in acute ischemic stroke patients. Design and method: In a prospective study, we enrolled 132 (68, 6% males) patients with acute ischemic stroke, AIS (age 62.2 ± 12.2 years, admission National Institutes of Health Stroke Scale score 7.1 ± 6.5, mean ± SD). Carotid-femoral pulse wave velocity (CF-PWV), central augmentation index (cAIx), as well as central and peripheral BPs were measured (SphygmoCor, Omron, respectively) one week after stroke onset. The presence of brain subclinical lesions was graded on admission computed tomography scans using van Swieten criteria with any relevant cerebral small vessel disease considered as brain microvascular damage. Results: In univariate analysis, high carotid-femoral PWV (p = 0.00005), and high cAIx (p = 0.02) were significantly associated with brain microvascular damage. Age, presence of hypertension, diabetes mellitus, previous ischemic stroke, but not BP values, also predicted brain outcome. In multivariate analysis, the predictive value of carotid-femoral PWV remained significant (OR, 1.30; 95% CI, 1.04–1.62; p = 0.02). By contrast, cAIx had no significant predictive value after adjustment. Conclusions: Increased aortic stiffness is associated with brain microvascular disease in patients with acute ischemic stroke, beyond and above classical risk factors. PWV provides a useful new tool for identification of subclinical brain damage in AIS.