Key result
Insular infarction was associated with significantly lower standard deviation (P=0.02) and coefficient of variation (P=0.03) of systolic blood pressure in the hyperacute phase of ischemic stroke.
Why the study?
Does the presence and location of insular infarction influence blood pressure variability in patients with acute ischemic stroke?
Observational (n=90)
Does the presence and location of insular infarction influence blood pressure variability in patients with acute ischemic stroke?
p-value: p=0.02
Insular infarction, particularly in the right anterior cortex, is associated with reduced systolic blood pressure variability in the hyperacute phase of ischemic stroke, suggesting its role in autonomic regulation.
Insular infarction may alter hyperacute BP variability assessment in stroke; leaves open its prognostic or therapeutic relevance.
Background: The aim of this study was to elucidate the influence of insular infarction on blood pressure (BP) variability and outcomes according to the region of the insular cortex affected. Methods: A total of 90 patients diagnosed with acute unilateral ischemic stroke were registered. The BP variability was calculated over 24 h after admission (hyperacute) and for 2–3 days after admission (acute). Patients were classified into groups of right and left, and then right anterior, right posterior, left anterior, and left posterior insular infarction. Results: Patients with insular infarction showed a significantly larger infarct volume, higher modified Rankin scale scores, and lower SD and coefficient of variation (CV) of systolic BP in the hyperacute phase than shown by patients without insular infarction (p < 0.01, p < 0.01, p = 0.02, and p = 0.03, respectively). The SD and CV of systolic BP in the hyperacute phase showed significant differences among the 3 groups with right insular infarction, with left insular infarction, and without insular infarction (p < 0.05 and p < 0.05, respectively). There was a tendency for the systolic BP variability to be lower in patients with right anterior insular infarction than in patients with infarcts in other areas. Conclusion: The right insular cortex, especially the anterior part, might be a hub for autonomic nervous regulation.
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Kitamura et al. (2018) conducted an observational in Acute unilateral ischemic stroke (n=90). Insular infarction vs. No insular infarction was evaluated on Blood pressure variability (SD and CV of systolic BP) in the hyperacute phase (p=0.02). Insular infarction was associated with significantly lower standard deviation (P=0.02) and coefficient of variation (P=0.03) of systolic blood pressure in the hyperacute phase of ischemic stroke.