Study On The Relationship Between Carotid-temporal Pulse Wave Velocity And Ischemic Stroke Induced By Large Atherosclerosis

【Background & Objective】Pulse wave is the pressure on the peripheral blood vessel wall formed by each pulse of the heart along the blood flow.It rises and falls periodically with systolic and diastolic periods.The velocity of this pressure wave is called pulse wave velocity(PWV),which is the ratio of distance to time.PWV is used to measure the function of arterial elasticity,as well as a sensitive index to reflect the degree of early atherosclerosis.According to the different parts in measurement,it can be divided into carotid-femoral pulse wave velocity(cfPWV)and brachial-ankle pulse wave velocity(baPWV)and so on.cfPWV has been widely studied in clinic,and it is regarded as the gold standard of arterial stiffness by the European Association of Hypertensive Heart Diseases.This study explored the association between carotid-temporal pulse velocity(ctPWV)and cerebral infarction to verify whether ctPWV can be used as a risk assessment index for atherosclerotic ischemic stroke.【Methods】This is a cross-sectional study,enrolled patients with acute ischemic stroke caused by large artery atherosclerotic disease(LAAD)and non-stroke patients as the control group in the Department of Neurology of Shanghai General Hospital from March 2018 to October 2018.The baseline data of demography and risk factors were collected.The difference of ctPWV between ischemic side and non-ischemic side in stroke patients,left and right side in non-stroke patients,and mean value of ctPWV between stroke and non-stroke patients were compared.Independent risk factors for ischemic stroke were selected by binary logistic regression.The critical value of ischemic stroke risk assessment was determined by the area under the receiver operating characteristic curves(AUROC),and the risk factors affecting ctPWV were determined by bivariate correlation analysis and stepwise logistic regression.【Results】In this study,28 patients with acute ischemic stroke and 19 patients without stroke were enrolled.There was no significant difference of ctPWV between ischemic side and non-ischemic side in patients with acute ischemic stroke(8.70±3.36 vs 9.18±3.00,P=0.749).There was no significant difference of ctPWV between left and right side of non-stroke patients(5.58±1.40 vs 6.64±1.83,P=0.092).The mean value of ctPWV in stroke group was higher than that in non-stroke group(8.59±2.98、5.70±1.10 P=0.000).Bivariate logistic regression showed that there was an independent relationship between ctPWV and ischemic stroke.The value of ctPWV could be used to predict the risk of cerebral infarction.The critical value of ROC curve was 5.75,the area under the curve was 0.846,the sensitivity was 92.86,and the specificity was 63.16.Stepwise multivariate logistic regression analysis showed that free fatty acids had an independent effect on the value of ctPWV.【Conclusion】There was significant difference in ctPWV between ischemic stroke and nonstroke patients,and ctPWV is associated with stroke caused by large artery atherosclerotic disease.