Impact of Aortic Arch Stiffness on Recurrence of Stroke in Patients With Acute Ischemic Stroke

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Background Aortic arch plaques are associated with increased risk of stroke recurrence. The atherosclerotic process also affects aortic stiffness. The purpose of the present study was to evaluate aortic arch stiffness by transesophageal echocardiography (TEE) and its effect on recurrence of stroke. Methods and Results TEE was performed in 201 patients with stroke and the aortic stiffness parameter β was measured as an expression of the elasticity of the aortic arch wall. Patients were followed during a median follow-up period of 459 days with the endpoint as stroke recurrence. There were 21 cases of stroke recurrence (10%) during the follow-up period and the stiffness parameter β was significantly higher in those cases (16.8±4.6 vs 12.5±3.3 [no recurrence], p<0.01). Cox multivariate hazard analysis revealed that stiffness parameter β was the only independent predictor for stroke recurrence (hazard ratio 1.683, p<0.01). Kaplan-Meier Survival analysis revealed that stiffness parameter β effectively risk stratified patients for stoke recurrence. Furthermore, in 3 groups based on the value of β, the 3^<rd> tertile had the highest stroke recurrent risk (relative risk 5.473, p<0.01). Conclusions The value of β in the aortic arch, assessed by TEE, may be a sensitive indicator of stroke recurrence.
社団法人日本循環器学会の論文
2008-07-20

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