3.6 AORTIC STIFFNESS IS RELATED TO CEREBRAL LESION GROWTH IN PATIENTS WITH ACUTE ISCHEMIC STROKE

Abstract

Objective: Cerebral lesion growth in acute ischemic stroke leads to secondary neurological deterioration and poor outcome. Whether cSBP and arterial stiffness are related to the early brain infarct growth in patients after ischemic stroke is unknown. Design and Methods: We enrolled 65 patients (43 males, age 62.9 ± 12.2 years, mean ± SD) with acute ischemic stroke (NIHSS at admission 6.0 ± 4.6 points). Carotid-femoral pulse wave velocity (CF-PWV), central systolic blood pressure (cSBP) and central augmentation index (cAIx) were measured (Sphygmocor®) within few (5 ± 2) days after stroke onset. Serial brain MRI were analysed. Cerebral lesion growth was assessed on diffusion-weighted imaging (DWI) by comparing baseline and follow-up scans. Marked cerebral lesion growth was determined as the highest tertile in a standardized measure of DWI lesion volume increase, and compared with the lowest tertile used as the reference group. Data were analysed with multivariate logistic regression. Results: CF-PWV was higher in patients with marked cerebral lesion growth than that in patients of the reference group (10.9 ± 3.1 vs. 9.1 ± 1.9 m/s, P = 0.035). By contrast, cAIx, as well as none of central and peripheral BP-derived parameters were significantly associated with cerebral lesion growth in univariate analysis. In multivariable regression logistic model, CF-PWV predicted cerebral lesion growth with an odds ratio of 1.43 [1.00–2.04], independently of age, and peripheral pulse pressure. Conclusions: Increased aortic stiffness is independently associated with cerebral lesion growth in patients with acute ischemic stroke. Its deleterious effect is more important than that of BP.