Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype
Background: Acute ischaemic stroke (AIS) patients often show impaired cerebral autoregulation (CA). We tested the hypothesis that CA impairment and other alterations in cerebral haemodynamics are associated with stroke subtype and severity. Methods: AIS patients (n = 143) were amalgamated from simil...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2018-07-01
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| Series: | Cerebrovascular Diseases Extra |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/487514 |
| _version_ | 1828496484398530560 |
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| author | Osian Llwyd Angela S.M. Salinet Ronney B. Panerai Man Y. Lam Nazia P. Saeed Fiona Brodie Edson Bor-Seng-Shu Thompson G. Robinson Ricardo C. Nogueira |
| author_facet | Osian Llwyd Angela S.M. Salinet Ronney B. Panerai Man Y. Lam Nazia P. Saeed Fiona Brodie Edson Bor-Seng-Shu Thompson G. Robinson Ricardo C. Nogueira |
| author_sort | Osian Llwyd |
| collection | DOAJ |
| description | Background: Acute ischaemic stroke (AIS) patients often show impaired cerebral autoregulation (CA). We tested the hypothesis that CA impairment and other alterations in cerebral haemodynamics are associated with stroke subtype and severity. Methods: AIS patients (n = 143) were amalgamated from similar studies. Data from baseline (< 48 h stroke onset) physiological recordings (beat-to-beat blood pressure [BP], cerebral blood flow velocity (CBFV) from bilateral insonation of the middle cerebral arteries) were calculated for mean values and autoregulation index (ARI). Differences were assessed between stroke subtype (Oxfordshire Community Stroke Project [OCSP] classification) and severity (National Institutes of Health Stroke Scale [NIHSS] score < 5 and 5–25). Correlation coefficients assessed associations between NIHSS and physiological measurements. Results: Thirty-two percent of AIS patients had impaired CA (ARI < 4) in affected hemisphere (AH) that was similar between stroke subtypes and severity. CBFV in AH was comparable between stroke subtype and severity. In unaffected hemisphere (UH), differences existed in mean CBFV between lacunar and total anterior circulation OCSP subtypes (42 vs. 56 cm•s–1, p < 0.01), and mild and moderate-to-severe stroke severity (45 vs. 51 cm•s–1, p = 0.04). NIHSS was associated with peripheral (diastolic and mean arterial BP) and cerebral haemodynamic parameters (CBFV and ARI) in the UH. Conclusions: AIS patients with different OCSP subtypes and severity have homogeneity in CA capability. Cerebral haemodynamic measurements in the UH were distinguishable between stroke subtype and severity, including the association between deteriorating ARI in UH with stroke severity. More studies are needed to determine their clinical significance and to understand the determinants of CA impairment in AIS patients. |
| first_indexed | 2024-12-11T12:30:40Z |
| format | Article |
| id | doaj.art-a6c9895639b24873989d0b25f27fc112 |
| institution | Directory Open Access Journal |
| issn | 1664-5456 |
| language | English |
| last_indexed | 2024-12-11T12:30:40Z |
| publishDate | 2018-07-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Cerebrovascular Diseases Extra |
| spelling | doaj.art-a6c9895639b24873989d0b25f27fc1122022-12-22T01:07:15ZengKarger PublishersCerebrovascular Diseases Extra1664-54562018-07-0182808910.1159/000487514487514Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke SubtypeOsian LlwydAngela S.M. SalinetRonney B. PaneraiMan Y. LamNazia P. SaeedFiona BrodieEdson Bor-Seng-ShuThompson G. RobinsonRicardo C. NogueiraBackground: Acute ischaemic stroke (AIS) patients often show impaired cerebral autoregulation (CA). We tested the hypothesis that CA impairment and other alterations in cerebral haemodynamics are associated with stroke subtype and severity. Methods: AIS patients (n = 143) were amalgamated from similar studies. Data from baseline (< 48 h stroke onset) physiological recordings (beat-to-beat blood pressure [BP], cerebral blood flow velocity (CBFV) from bilateral insonation of the middle cerebral arteries) were calculated for mean values and autoregulation index (ARI). Differences were assessed between stroke subtype (Oxfordshire Community Stroke Project [OCSP] classification) and severity (National Institutes of Health Stroke Scale [NIHSS] score < 5 and 5–25). Correlation coefficients assessed associations between NIHSS and physiological measurements. Results: Thirty-two percent of AIS patients had impaired CA (ARI < 4) in affected hemisphere (AH) that was similar between stroke subtypes and severity. CBFV in AH was comparable between stroke subtype and severity. In unaffected hemisphere (UH), differences existed in mean CBFV between lacunar and total anterior circulation OCSP subtypes (42 vs. 56 cm•s–1, p < 0.01), and mild and moderate-to-severe stroke severity (45 vs. 51 cm•s–1, p = 0.04). NIHSS was associated with peripheral (diastolic and mean arterial BP) and cerebral haemodynamic parameters (CBFV and ARI) in the UH. Conclusions: AIS patients with different OCSP subtypes and severity have homogeneity in CA capability. Cerebral haemodynamic measurements in the UH were distinguishable between stroke subtype and severity, including the association between deteriorating ARI in UH with stroke severity. More studies are needed to determine their clinical significance and to understand the determinants of CA impairment in AIS patients.https://www.karger.com/Article/FullText/487514Blood flow velocityCerebral autoregulationAcute strokeStroke subtypeStroke severity |
| spellingShingle | Osian Llwyd Angela S.M. Salinet Ronney B. Panerai Man Y. Lam Nazia P. Saeed Fiona Brodie Edson Bor-Seng-Shu Thompson G. Robinson Ricardo C. Nogueira Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype Cerebrovascular Diseases Extra Blood flow velocity Cerebral autoregulation Acute stroke Stroke subtype Stroke severity |
| title | Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype |
| title_full | Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype |
| title_fullStr | Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype |
| title_full_unstemmed | Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype |
| title_short | Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype |
| title_sort | cerebral haemodynamics following acute ischaemic stroke effects of stroke severity and stroke subtype |
| topic | Blood flow velocity Cerebral autoregulation Acute stroke Stroke subtype Stroke severity |
| url | https://www.karger.com/Article/FullText/487514 |
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