本课题组首次基于横断面研究报道可诊室使用的无创力学指标踝间血压差是脑卒中患病的独立标志，但缺少多时间点的两者之间因果关系推断及潜在机制研究。由于力学因素对心血管系统病理生理过程的作用最直接和明显，且生物流体力学对颅内动脉粥样硬化性斑块易损性的影响是缺血性脑卒中预防领域常被忽视却很重要的问题，本项目将在长程（8年）随访队列的基础上，建立并验证基于踝间血压差纵向轨迹的缺血性脑卒中风险预测模型及危险分层工具；通过多模态及高分辨率核磁影像揭示踝间血压差多时间点特定变化谱的颅内动脉重塑、病变血管分布、斑块易损性等特点，进一步融合影像学和3D流-固耦合模型等计算流体力学技术，从机械负荷角度对踝间血压差纵向轨迹致缺血性脑卒中发病的颅内动脉血流场进行生物流体力学解释、阐明二者因果关系的机制，最终验证踝间血压差纵向轨迹亦是颅内动脉斑块稳定性下降的预警因子。通过有机的医工融合研究为缺血性脑卒中防治提供新途径。

To the best knowledge, our group reported for the first-time that non-invasive mechanical indicator of interankle systolic blood pressure difference was related with prevalent stroke independent of hypertension which is the strongest predictor of stroke based on a cross-sectional study, but their causal relationship inference across multiple time points and the underlying mechanism is still lack of systematic population follow-up study. It is the most direct and obvious effect of mechanical factors on the pathophysiology of cardiovascular system. However, the impact of biofluid mechanics on the vulnerability of atherosclerotic plaque is a problem that is often overlooked but of great importance in the field of ischemic stroke prediction. Here, in order to verify the causal relationship between the longitudinal trajectories of interankle systolic blood pressure difference with the incidence of ischemic stroke, the project will build on the long-term follow-up (8 years) cohort to establish an ischemic stroke risk prediction model and risk stratification tools based on interankle systolic blood pressure difference, and to use multi-modal and high-resolution magnetic resonance imaging to provide the different features of intracranial arterial remodeling, vascular lesion distribution, plaque vulnerability characteristics in the difference modes of longitudinal trajectories of interankle systolic blood pressure. Furthermore, we intent to uncover the biomechanical mechanism of the intracranial arterial blood flow field of ischemic stroke incident caused by the longitudinal trajectories of interankle systolic blood pressure from the point of mechanical load. Finally, we would reveal that longitudinal trajectories of interankle systolic blood pressure could be a warning sign of intracranial arterial plaque vulnerability. In short, our work will illustrate the power of interankle systolic blood pressure in the prediction of ischemic stroke, and the results will provide a new approach for the prevention and treatment of ischemic stroke from the perspective of medical and engineering joint.