Diastolic dysfunction tied to increased arterial stiffness in ischaemic stroke patients

One in five young and middle-aged ischaemic stroke survivors (20 percent) have been diagnosed with diastolic dysfunction in a recent study. The presence of diastolic dysfunction correlates with increased arterial stiffness independent of higher age, overweight, hypertension, night-time blood pressure (BP) reduction and left ventricular (LV) mass.

Of the 260 patients with acute ischaemic stroke, 20 percent was found to have prevalent diastolic dysfunction (13 percent with grade 1 and 7 percent grades 2–3). Those with diastolic dysfunction were older and more likely to have hypertension, overweight, increased arterial stiffness, higher LV mass and less percentage nightly reduction in mean BP (p_all<0.001).

Furthermore, multivariable logistic regression analysis revealed an association between diastolic dysfunction and increased arterial stiffness (odds ratio, 2.86, 95 percent confidence interval, 1.05–7.79; p<0.05), independent of age >45 years, overweight, hypertension, night-time BP reduction and LV mass.

In this study, the investigators analysed data from 260 patients with acute ischaemic stroke and assessed diastolic dysfunction by combining transmitral peak early floe (E), early diastolic mitral annular velocity (e′), E/e′ ratio, left atrial volume index and peak tricuspid regurgitant jet velocity, following current European guidelines.

Increased arterial stiffness was defined as carotid–femoral pulse wave velocity at least 10 m/s by applanation tonometry.

“Young and middle-aged ischaemic stroke survivors have a high prevalence of hypertension, increased arterial stiffness and abnormal left ventricular (LV) geometry, which all are associated with the presence of LV diastolic dysfunction,” the investigators noted.