Impact of aortic stiffness on ischemic stroke in elderly patients

Kenichi Sugioka, Takeshi Hozumi, Robert R. Sciacca, Yumiko Miyake, Inna Titova, Gabrielle Gaspard, Ralph L Sacco, Shunichi Homma, Marco R. Di Tullio

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background and Purpose - Large atherosclerotic plaques in the aortic arch detected by transesophageal echocardiography (TEE) are associated with increased risk of ischemic stroke in the elderly. The atherosclerotic process also affects aortic distensibility, which can also be assessed by TEE. The purpose of this study was to evaluate the possible association of aortic stiffness by TEE with ischemic stroke in elderly patients. Methods - We performed TEE in 40 consecutive elderly patients aged ≥ 55 years with acute ischemic stroke and in 42 consecutive control subjects aged ≥ 55 years. Aortic stiffness index β, which has been used in the literature to express the stiffness of the aortic wall, was calculated as follows: β=ln (systolic blood pressure/diastolic blood pressure)/([Dmax-Dmin]/Dmin), where ln is natural logarithm, Dmax is maximum aortic lumen diameter, and Dmax is minimum aortic lumen diameter by TEE. The association of index β with ischemic stroke was evaluated by logistic regression analysis after adjustment for potential confounders, including thickness of aortic arch plaques. Results - Index β was significantly greater in stroke patients than in controls (9.7±5.0 versus 5.3±3.5; P<0.0001). When aortic plaque thickness and other stroke risk factors were entered in multivariate analysis, index β was found to be independently associated with ischemic stroke (odds ratio, 1.28 per unit increase; 95% CI, 1.10 to 1.52). Conclusions - Aortic stiffness by TEE is associated with ischemic stroke, independent of thickness of aortic arch plaques and other stroke risk factors. This suggests that aortic stiffness by TEE may add prognostic information when assessing the risk of ischemic stroke in the elderly.

Original languageEnglish
Pages (from-to)2077-2081
Number of pages5
JournalStroke
Volume33
Issue number8
DOIs
StatePublished - Aug 14 2002
Externally publishedYes

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Vascular Stiffness
Transesophageal Echocardiography
Stroke
Thoracic Aorta
Blood Pressure
Atherosclerotic Plaques
Multivariate Analysis
Logistic Models
Odds Ratio
Regression Analysis

Keywords

  • Aorta
  • Cerebrovascular disorders
  • Echocardiography, transesophageal
  • Stroke, ischemic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Sugioka, K., Hozumi, T., Sciacca, R. R., Miyake, Y., Titova, I., Gaspard, G., ... Di Tullio, M. R. (2002). Impact of aortic stiffness on ischemic stroke in elderly patients. Stroke, 33(8), 2077-2081. https://doi.org/10.1161/01.STR.0000021410.83049.32

Impact of aortic stiffness on ischemic stroke in elderly patients. / Sugioka, Kenichi; Hozumi, Takeshi; Sciacca, Robert R.; Miyake, Yumiko; Titova, Inna; Gaspard, Gabrielle; Sacco, Ralph L; Homma, Shunichi; Di Tullio, Marco R.

In: Stroke, Vol. 33, No. 8, 14.08.2002, p. 2077-2081.

Research output: Contribution to journalArticle

Sugioka, K, Hozumi, T, Sciacca, RR, Miyake, Y, Titova, I, Gaspard, G, Sacco, RL, Homma, S & Di Tullio, MR 2002, 'Impact of aortic stiffness on ischemic stroke in elderly patients', Stroke, vol. 33, no. 8, pp. 2077-2081. https://doi.org/10.1161/01.STR.0000021410.83049.32
Sugioka K, Hozumi T, Sciacca RR, Miyake Y, Titova I, Gaspard G et al. Impact of aortic stiffness on ischemic stroke in elderly patients. Stroke. 2002 Aug 14;33(8):2077-2081. https://doi.org/10.1161/01.STR.0000021410.83049.32
Sugioka, Kenichi ; Hozumi, Takeshi ; Sciacca, Robert R. ; Miyake, Yumiko ; Titova, Inna ; Gaspard, Gabrielle ; Sacco, Ralph L ; Homma, Shunichi ; Di Tullio, Marco R. / Impact of aortic stiffness on ischemic stroke in elderly patients. In: Stroke. 2002 ; Vol. 33, No. 8. pp. 2077-2081.
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abstract = "Background and Purpose - Large atherosclerotic plaques in the aortic arch detected by transesophageal echocardiography (TEE) are associated with increased risk of ischemic stroke in the elderly. The atherosclerotic process also affects aortic distensibility, which can also be assessed by TEE. The purpose of this study was to evaluate the possible association of aortic stiffness by TEE with ischemic stroke in elderly patients. Methods - We performed TEE in 40 consecutive elderly patients aged ≥ 55 years with acute ischemic stroke and in 42 consecutive control subjects aged ≥ 55 years. Aortic stiffness index β, which has been used in the literature to express the stiffness of the aortic wall, was calculated as follows: β=ln (systolic blood pressure/diastolic blood pressure)/([Dmax-Dmin]/Dmin), where ln is natural logarithm, Dmax is maximum aortic lumen diameter, and Dmax is minimum aortic lumen diameter by TEE. The association of index β with ischemic stroke was evaluated by logistic regression analysis after adjustment for potential confounders, including thickness of aortic arch plaques. Results - Index β was significantly greater in stroke patients than in controls (9.7±5.0 versus 5.3±3.5; P<0.0001). When aortic plaque thickness and other stroke risk factors were entered in multivariate analysis, index β was found to be independently associated with ischemic stroke (odds ratio, 1.28 per unit increase; 95{\%} CI, 1.10 to 1.52). Conclusions - Aortic stiffness by TEE is associated with ischemic stroke, independent of thickness of aortic arch plaques and other stroke risk factors. This suggests that aortic stiffness by TEE may add prognostic information when assessing the risk of ischemic stroke in the elderly.",
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AU - Sugioka, Kenichi

AU - Hozumi, Takeshi

AU - Sciacca, Robert R.

AU - Miyake, Yumiko

AU - Titova, Inna

AU - Gaspard, Gabrielle

AU - Sacco, Ralph L

AU - Homma, Shunichi

AU - Di Tullio, Marco R.

PY - 2002/8/14

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N2 - Background and Purpose - Large atherosclerotic plaques in the aortic arch detected by transesophageal echocardiography (TEE) are associated with increased risk of ischemic stroke in the elderly. The atherosclerotic process also affects aortic distensibility, which can also be assessed by TEE. The purpose of this study was to evaluate the possible association of aortic stiffness by TEE with ischemic stroke in elderly patients. Methods - We performed TEE in 40 consecutive elderly patients aged ≥ 55 years with acute ischemic stroke and in 42 consecutive control subjects aged ≥ 55 years. Aortic stiffness index β, which has been used in the literature to express the stiffness of the aortic wall, was calculated as follows: β=ln (systolic blood pressure/diastolic blood pressure)/([Dmax-Dmin]/Dmin), where ln is natural logarithm, Dmax is maximum aortic lumen diameter, and Dmax is minimum aortic lumen diameter by TEE. The association of index β with ischemic stroke was evaluated by logistic regression analysis after adjustment for potential confounders, including thickness of aortic arch plaques. Results - Index β was significantly greater in stroke patients than in controls (9.7±5.0 versus 5.3±3.5; P<0.0001). When aortic plaque thickness and other stroke risk factors were entered in multivariate analysis, index β was found to be independently associated with ischemic stroke (odds ratio, 1.28 per unit increase; 95% CI, 1.10 to 1.52). Conclusions - Aortic stiffness by TEE is associated with ischemic stroke, independent of thickness of aortic arch plaques and other stroke risk factors. This suggests that aortic stiffness by TEE may add prognostic information when assessing the risk of ischemic stroke in the elderly.

AB - Background and Purpose - Large atherosclerotic plaques in the aortic arch detected by transesophageal echocardiography (TEE) are associated with increased risk of ischemic stroke in the elderly. The atherosclerotic process also affects aortic distensibility, which can also be assessed by TEE. The purpose of this study was to evaluate the possible association of aortic stiffness by TEE with ischemic stroke in elderly patients. Methods - We performed TEE in 40 consecutive elderly patients aged ≥ 55 years with acute ischemic stroke and in 42 consecutive control subjects aged ≥ 55 years. Aortic stiffness index β, which has been used in the literature to express the stiffness of the aortic wall, was calculated as follows: β=ln (systolic blood pressure/diastolic blood pressure)/([Dmax-Dmin]/Dmin), where ln is natural logarithm, Dmax is maximum aortic lumen diameter, and Dmax is minimum aortic lumen diameter by TEE. The association of index β with ischemic stroke was evaluated by logistic regression analysis after adjustment for potential confounders, including thickness of aortic arch plaques. Results - Index β was significantly greater in stroke patients than in controls (9.7±5.0 versus 5.3±3.5; P<0.0001). When aortic plaque thickness and other stroke risk factors were entered in multivariate analysis, index β was found to be independently associated with ischemic stroke (odds ratio, 1.28 per unit increase; 95% CI, 1.10 to 1.52). Conclusions - Aortic stiffness by TEE is associated with ischemic stroke, independent of thickness of aortic arch plaques and other stroke risk factors. This suggests that aortic stiffness by TEE may add prognostic information when assessing the risk of ischemic stroke in the elderly.

KW - Aorta

KW - Cerebrovascular disorders

KW - Echocardiography, transesophageal

KW - Stroke, ischemic

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