Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype

Autor(es)

Llwyd, Osian ^[1] ; Salinet, Angela S. M. ^{[1, 2]} ; Panerai, Ronney B. ^[1] ; Lam, Man Y. ^[1] ; Saeed, Nazia P. ^[1] ; Brodie, Fiona ^[1] ; Bor-Seng-Shu, Edson ^[2] ; Robinson, Thompson G. ^[1] ; Nogueira, Ricardo C. ^[2]

Afiliação do(s) autor(es)

^[1] Univ Leicester, Dept Cardiovasc Sci Cerebral Haemodynam, Ageing & Stroke Med Res Grp, Leicester, Leics - England

^[2] Univ Sao Paulo, Sch Med, Hosp Clin, Dept Neurol, Ave Doutor Arnaldo 455, BR-01246904 Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: CEREBROVASCULAR DISEASES EXTRA; v. 8, n. 2, p. 80-89, 2018.
• Citações Web of Science: 6

Resumo

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. (c) 2018 The Author(s) Published by S. Karger AG, Basel (AU)

• Processo FAPESP: 13/25953-0 - Autorregulação encefálica na fase aguda e subaguda do acidente vascular encefálico isquêmico em doentes submetidos a terapia trombolítica
• Beneficiário: Ricardo de Carvalho Nogueira
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 14/04955-8 - Avaliação longitudinal dos mecanismos de regulação do fluxo sanguíneo cerebral após o acidente vascular encefálico agudo
• Beneficiário: Angela Salomao Macedo Salinet
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado