The Association between Arterial Stiffness, Initial Stroke Severity, and 3-Week Outcomes in Patients with Ischemic Stroke.
The Association between Arterial Stiffness, Initial Stroke Severity, and 3-Week Outcomes in Patients with Ischemic Stroke.
复制标题
缺血性中风患者的动脉僵硬度、初始中风严重程度和 3 周结果之间的关联。
DOI：
10.1016/j.jstrokecerebrovasdis.2017.05.043
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
C. Rajkumar
中科院分区：
文献类型：
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作者：
E. Ormerod;K. Ali;J. Cameron;M. Malik;Richard H. Lee;S. Getov;C. Rajkumar
目的血管顺应性正在成为一个有用的心血管危险因素。这项研究的目的是调查动脉僵硬度和中风严重程度在出现和3周之间的关系。方法选取急性缺血性脑卒中患者42例（男性55%，平均年龄71岁），随访15个月。卒中亚型分为腔隙性循环梗死（LACI）、部分前循环梗死（PACI）和后循环梗死（POCI）。采用24小时动态血压（BP）和心电图监测，通过QKD（定义为心电图上出现Q波[Q]与舒张期肱动脉上到达Korotkoff [K]音之间的时间间隔[D]； QKD以毫秒为单位测量）测量动脉硬度。然后将测量的QKD值校正为心率60 bpm和收缩压100 mm Hg （QKD100-60）。在入院时和3周时使用美国国立卫生研究院卒中量表（NIHSS）评估卒中严重程度。结果所有患者的回归分析显示动脉僵硬度与脑卒中严重程度之间存在微弱的非显著相关性。然而，在对急性卒中治疗（TOAST）分类进行亚组分析时，我们发现在大动脉粥样硬化中，动脉硬度在基线时显著预测卒中严重程度（r= 0.45,b= 0.093，P= 0.04），但在心脏栓塞或小动脉闭塞亚型中不显著。qkd100 -60与卒中严重程度在第3周无显著相关性。第0周和第3周的NIHSS评分，LACI、PACI和POCI之间的qkd100 -60评分，以及舀水者与非舀水者和反向舀水者之间的评分均无差异。结论QKD与脑卒中严重程度的关系有待进一步研究。
ObjectivesVascular 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.MethodsForty 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).ResultsRegression 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. QKD100-60and stroke severity were not significantly associated in week 3. There was no difference in NIHSS scores at weeks 0 and 3, or in QKD100-60between LACI, PACI, and POCI, or dipper versus non-dippers and reverse dippers.ConclusionFurther research is needed to explore the association between QKD and stroke severity.