Cerebral Arterial Stiffness as A New Marker of Early Stage Atherosclerosis of The Cerebral Large Artery in Acute Stroke

• Published in: Journal of Atherosclerosis and Thrombosis 2019/09/01, Vol.26(9), pp.783-791
• Main Authors: Fu, Xian, Li, Xianliang, Xiong, Li, Li, Xuelong, Huang, Ruxun, Gao, Qingchun
• Format: Article
• Language: English
• Subjects: Ankle Brachial Index; Atherosclerosis - diagnosis; Atherosclerosis - etiology; Biomarkers - analysis; Carotid Intima-Media Thickness; Carotid–cerebral pulse wave velocity; Cerebral Arteries - pathology; Cerebral large artery; Early atherosclerosis; Female; Follow-Up Studies; Humans; Ischemic stroke; Male; Middle Aged; Original; Prognosis; Stroke - complications; Stroke - pathology; Vascular Stiffness
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.46573

Aim: Carotid–cerebral pulse wave velocity (ccPWV) reflects the segment (C-M segment) stiffness between the common carotid artery and ipsilateral middle cerebral artery. C-M segment atherosclerosis (CMSA) is regarded the most frequent cause of anterior circulation ischemic stroke. We aimed to evaluate the association of ccPWV with early stage CMSA in this study.Methods: Eighty-one acute ischemic stroke (AIS) patients with 154 C-M segments who were successfully evaluated with digital subtraction angiography, ccPWV, carotid intima–media thickness (cIMT), and brachial–ankle pulse wave velocity were enrolled into this study. Patient demographics and clinical data were retrieved from our AIS databases.Results: Multivariate analyses showed that CMSA was independently associated with higher systolic BP, ccPWV, and cIMT. ccPWV and cIMT presented good diagnostic values for evaluating early stage CMSA in the receiver operating characteristic curve analyses. The areas under the curve (AUCs) of ccPWV were significantly higher than that of cIMT (Z=2.204, P=0.007). The AUC, sensitivity, specificity, Youden index, and cutoff of ccPWV for detecting early stage CMSA were 0.815 (P＜0.001), 86%, 70.7%, 0.567, and 5.4 m/s, respectively. Furthermore, ccPWV was significantly correlated with the stenosis of CMSA at the early stage in Spearman’s correlation analyses (r=0.877, P＜0.001) and fractional polynomial plot with 95% confidence intervals.Conclusions: Cerebral arterial stiffness has the potential to be a new marker of early stage atherosclerosis of the cerebral large artery. This finding may help us prevent the occurrence of stroke and decrease the burden of society from stroke patients.