Abstract Details

Title Use of a Non-invasive Central Arterial Pressure Waveform Analysis Device in Stroke Patients – A Feasibility Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-008

Objective This study was conducted to determine the feasibility of a non-invasive device to measure arterial stiffness indices and comparison to standard cuff sphygmomanometery.

Background Hypertension is a risk factor for acute ischemic stroke (AIS). Accurate blood pressure assessment is key to prevention. Arterial pressure varies over the cardiac cycle. Only brachial pressures are routinely measured; brachial systolic pressure can be up to 40 mmHg higher than the aorta. New evidence suggests arterial stiffness indices such as augmentation index (AI) may be markers of vascular risk.

Design/Methods This feasibility study was conducted at a single comprehensive stroke center. The primary objective was to determine the feasibility of utilizing the device to measure brachial and atrial blood pressure, aortic pulse wave velocity (APWV), aortic pulse pressure (APP), and calculate AI over three study visits over 24-44 weeks from the index stroke. Secondary objectives were comparison of device measurements to standard cuff sphygmomanometry and determination if improvements in brachial blood pressure, central blood pressure, and arterial stiffness occurred.

Results 30 patients were enrolled. 29 patients completed the first visit; 14 patients completed all visits. Initial APWV (mean 8.71m/s ± 2.4), APP (mean 43.45 mm Hg ± 14.0), and AI (mean 16.86 ± 14.2) were measured in all 29 patients. Brachial systolic readings between the device (mean 143.3mm Hg ± 20.5) were similar to standard cuff (mean 142.4 mm Hg ± 17.4) but differed from device atrial systolic readings (mean 128.1 mmHg±16.2). Of patients who completed all visits, six had improvement in AI (mean -13.40 ± 5.2) and six had worsening (mean 13.20 ± 12).

Conclusions

Non-invasive device to obtain various pressure indices is feasible with good concordance to standard cuff sphygmomanomatry. High variability and no improvement in arterial stiffness indices were noted. Larger scale studies are needed to determine reliability and relationships between indices and stroke outcomes.

Authors/Disclosures
Kasim Qureshi, MD (Henry Ford Hospital) PRESENTER	Dr. Qureshi has nothing to disclose.
Quinton Quagliano	No disclosure on file
Taylor R. Anderson, MD (Trinity Health Muskegon)	Dr. Anderson has nothing to disclose.
Tracy J. Koehler	Tracy J. Koehler has nothing to disclose.
Muhammad Farooq, MD (Neuroscience Program,Saint Mary'S Health)	Dr. Farooq has nothing to disclose.
Philip B. Gorelick, MD, MPH, FAAN	Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AstraZeneca. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AMGEN. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. Dr. Gorelick has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Thorek Memorial Hospital. Dr. Gorelick has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Thorek Memorial Hospital.

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