Association of Cerebral Arterial Stiffness with Initial Severity in Acute Ischemic Stroke

AIM: To evaluate the association between cerebral arterial stiffness, measured using carotid-cerebral pulse wave velocity (ccPWV), and the initial severity estimated by the National Institutes of Health Stroke Scale (NIHSS) after acute ischemic stroke (AIS). METHODS: We prospectively studied 402 consecutive patients with first-ever acute cerebral infarction who underwent brain multimodal magnetic resonance, ccPWV, echocardiography, and carotid ultrasonography during the admission period. Their stroke subtypes were classified using the Trial of Org 10172 in Acute Stroke Treatment classification. Severe initial stroke severity was defined as an NIHSS score ＞6 on admission. RESULTS: We observed that 168 (41.79%) patients had severe initial stroke severity. A multivariate logistic regression analysis revealed that ccPWV [as a continuous variable; odds ratios (OR) (95% confidence intervals (CI)): 1.36 (1.08-1.72); P=0.010] and ccPWV ＞6.87 m/s [OR (95% CI): 8.13 (3.06-21.58); P＜0.001], calculated from the receiver-operating characteristic curve, remained independent determinants of severe initial stroke severity in three models. Furthermore, we observed that ccPWV significantly correlated with the NIHSS score, and the value of ccPWV was most strongly correlated with the NIHSS score (r=0.82, P＜0.001) in subjects with small vessel occlusion (SVO) among all stroke subtypes. CONCLUSIONS: Cerebral arterial stiffness was independently associated with initial severity in AIS patients, and may be more strongly correlated with the initial SVO severity than those of other subtypes.