Key result
Vascular clustering identifies three distinct profiles post-stroke but shows no association with functional capacity.
Why the study?
Vascular dysfunction is prevalent after stroke and contributes to elevated cardiovascular risk, but the extent of vascular heterogeneity and whether distinct vascular profiles are associated with functional performance in individuals with chronic stroke remained unclear.
Do distinct multi-domain cluster-derived vascular profiles exist in individuals with chronic stroke, and are these profiles associated with cardiorespiratory fitness or gait speed?
Cross-Sectional (n=45)
No
Do distinct multi-domain cluster-derived vascular profiles exist in individuals with chronic stroke, and are these profiles associated with cardiorespiratory fitness or gait speed?
Multi-domain vascular profiling reveals heterogeneous vascular phenotypes in chronic stroke survivors that are not fully explained by chronological age alone, highlighting the need to evaluate multiple vascular metrics rather than single measures.
Answers are grounded in this paper and cite their sources.
Vascular profiles after stroke lack ties to fitness or gait; hypothesis-generating for phenotyping and should not yet change practice.
Vascular dysfunction is prevalent after stroke and contributes to elevated cardiovascular risk; however, the extent to which vascular heterogeneity exists in this population remains unclear. This study examined whether distinct multi-domain cluster-derived vascular profiles are present in individuals with chronic stroke and whether these profiles are associated with functional performance. Vascular structure and function were assessed using flow-mediated dilation, carotid intima-media thickness, pulse wave velocity, and augmentation index, with age included in vascular clustering to account for vascular aging. Unsupervised k-means clustering was applied to identify vascular profiles. Functional performance was assessed using gait speed and predicted peak oxygen consumption (VO 2peak ) derived from a submaximal exercise test. Between-cluster differences were characterized using analysis of variance. Forty-five individuals with chronic stroke (62 ± 12 years; 29 ± 30 months post-stroke) were included. Three vascular profiles were identified (cluster 1: n = 13; cluster 2: n = 11; cluster 3: n = 21), with significant differences across clusters for all vascular measures (p < 0.01). Although age increased across clusters, vascular structure and function did not change uniformly. One profile exhibited elevated arterial wave reflection despite relatively preserved endothelial function and arterial structure, whereas another demonstrated impairment in all vascular variables. Vascular profile was not associated with predicted VO 2peak (p = 0.31) or gait speed (p = 0.65). Three exploratory cluster-derived vascular profiles emerged among participants with chronic stroke, and age did not fully account for the observed vascular heterogeneity. Multi-domain cluster-derived vascular profiling revealed heterogeneous vascular profiles in individuals with chronic stroke, providing a basis for future studies to evaluate their relevance to cardiovascular risk stratification and long-term health management. NCT05936008: https://clinicaltrials.gov/study/NCT05936008
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Bartsch et al. (2026) conducted a cross-sectional in Chronic stroke (n=45). Multi-domain cluster-derived vascular profiling (FMD, carotid IMT, PWV, AIx, and age) was evaluated on Identification of distinct multi-domain vascular profiles across FMD, carotid IMT, AIx, PWV, and age (p=<0.01). Unsupervised k-means clustering identified three distinct vascular profiles after chronic stroke (p<0.01 across measures), which were not associated with VO2peak (p=0.31) or gait speed (p=0.65).
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