Relationship between augmentation index and acute ischemic stroke subtype

J Clin Neurosci. 2014 Jul;21(7):1220-4. doi: 10.1016/j.jocn.2013.10.032. Epub 2014 Jan 30.

Abstract

The aim of the present study was to explore the relationship between augmentation index (AIx) and vascular risk factors according to stroke subtypes. Patients were eligible for this study if they experienced their first ischemic stroke within the preceding 7 days and were 45 years of age or older. AIx was measured by applanation tonometry (SphygmoCor, AtCor Medical, Sydney, Australia) and ischemic stroke was classified according to the Trial of Org 10172 in the Acute Stroke Treatment (TOAST) classification system. A total of 189 patients were enrolled. The most frequent stroke subtype was lacune (76, 40.2%), followed by stroke of undetermined etiology, negative work-up (SUDn) (59, 31.2%), large artery atherosclerosis (LAA) (31, 16.4%), and cardioembolism (23, 12.2%). While there were no significant differences among the groups for hemodynamic indices, AIx at 75 beats per minute (AIx@75) was higher in lacune subtype (29.6%) than SUDn (28.4%), LAA (26.6%), and cardioembolism (24.8%) (p=0.064). The AIx@75 was significantly related to age (r=0.189), sex (r=0.252), peripheral systolic blood pressure (SBP) (r=0.189), peripheral diastolic blood pressure (DBP) (r=0.191), and peripheral mean arterial pressure (MAP) (r=0.327). Multiple linear regression analysis revealed that age, sex, peripheral SBP, peripheral DBP and peripheral MAP were significant (p<0.002). This study showed that arterial stiffness is increased in acute lacunar infarction. Considering the pathogenesis of lacunar infarction and the potential interconnected causes of arterial stiffness, our findings indicate that increased arterial stiffness in acute lacunar infarction may be related to the pathogenesis of lacunar infarction.

Keywords: Arterial stiffness; Augmentation index; Ischemic stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Blood Pressure
  • Echocardiography
  • Female
  • Hemodynamics
  • Humans
  • Ischemic Attack, Transient / classification
  • Ischemic Attack, Transient / diagnosis
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Risk Factors
  • Severity of Illness Index*
  • Stroke / classification*
  • Stroke / diagnosis*
  • Time Factors
  • Tomography, X-Ray Computed