Arterial stiffness and progressive neurological deficit in patients with acute deep subcortical infarction

Abstract

Background and Purpose-The mechanism of progressive neurological deficit (PND) in patients with ischemic stroke remains unclear. The aim of this study was to clarify whether arterial stiffness, a marker of vascular endothelial impairment and arteriosclerosis, is associated with PND in patients with acute deep subcortical infarction. Methods-We evaluated 156 consecutive first-ever ischemic stroke patients with acute deep subcortical infarction. PND was defined as an increment of 2 points in the National Institute of Health Stroke Scale score or an increase of 1 point in the limb weakness score within 7 days of stroke onset. Patients were assessed for risk factors, and infarct size was measured on initial diffusion-weighted magnetic resonance imaging. We measured brachial-ankle pulse wave velocity (baPWV) as a marker of arterial stiffness. We divided patients into 2 groups according to the presence or absence of PND to compare their clinical characteristics. Results-Fifty-two patients (33%) had PND, and baPWV was significantly higher in patients with than in those without PND. The baPWV cut-off value for PND was 18.24 m/s, with 90% sensitivity and 47% specificity. In multivariable logistic regression analysis, high baPWV (18.24 m/s; odds ratio, 8.22; 95% confidence interval, 2.55-31.9), large infarct size (15 mm; odds ratio, 2.76; 95% confidence interval, 1.01-7.92), and 3 infarct slices on serial axial diffusion-weighted imaging (odds ratio, 3.38; 95% confidence interval, 1.22-10.0) were independently associated with PND. Conclusions-Arterial stiffness indicated by baPWV is independently associated with PND in patients with acute deep subcortical infarction. © 2012 American Heart Association, Inc.