BACKGROUND Acute ischaemic stroke (AIS) patients often show impaired cerebral autoregulation (CA). We tested the hypothesis that CA impairment and other alterations in cerebral haemodynamics are associated with stroke subtype and severity. METHODS AIS patients (n = 143) were amalgamated from similar studies. Data from baseline (< 48 h stroke onset) physiological recordings (beat-to-beat blood pressure [BP], cerebral blood flow velocity (CBFV) from bilateral insonation of the middle cerebral arteries) were calculated for mean values and autoregulation index (ARI). Differences were assessed between stroke subtype (Oxfordshire Community Stroke Project [OCSP] classification) and severity (National Institutes of Health Stroke Scale [NIHSS] score < 5 and 5-25). Correlation coefficients assessed associations between NIHSS and physiological measurements. RESULTS Thirty-two percent of AIS patients had impaired CA (ARI < 4) in affected hemisphere (AH) that was similar between stroke subtypes and severity. CBFV in AH was comparable between stroke subtype and severity. In unaffected hemisphere (UH), differences existed in mean CBFV between lacunar and total anterior circulation OCSP subtypes (42 vs. 56 cm•s-1, p < 0.01), and mild and moderate-to-severe stroke severity (45 vs. 51 cm•s-1, p = 0.04). NIHSS was associated with peripheral (diastolic and mean arterial BP) and cerebral haemodynamic parameters (CBFV and ARI) in the UH. CONCLUSIONS AIS patients with different OCSP subtypes and severity have homogeneity in CA capability. Cerebral haemodynamic measurements in the UH were distinguishable between stroke subtype and severity, including the association between deteriorating ARI in UH with stroke severity. More studies are needed to determine their clinical significance and to understand the determinants of CA impairment in AIS patients.

中文翻译：

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急性缺血性中风后的脑血流动力学：中风严重度和中风亚型的影响。

背景技术急性缺血性中风（AIS）患者经常显示出脑自动调节（CA）受损。我们检验了以下假设：CA损伤和脑血流动力学的其他改变与中风亚型和严重程度有关。方法将AIS患者（143例）从类似研究中合并。计算出基线（卒中发作<48小时）的生理记录数据（搏动血压[BP]，大脑中动脉双侧声速的脑血流速度（CBFV））的平均值和自动调节指数（ARI） ）。评估卒中亚型（牛津郡社区卒中项目[OCSP]分类）和严重程度（美国国立卫生研究院卒中量表[NIHSS]得分<5和5-25）之间的差异。相关系数评估了NIHSS与生理测量之间的关联。结果有32％的AIS患者在受影响的半球（AH）中CA受损（ARI <4），这在卒中亚型和严重程度之间相似。AH中的CBFV在卒中亚型和严重程度之间具有可比性。在未受影响的半球（UH）中，腔隙性和全前循环OCSP亚型之间的平均CBFV存在差异（42 vs. 56 cm•s-1，p <0.01），轻度和中度至重度卒中严重程度（45 vs. 51 cm•s-1，p = 0.04）。NIHSS与UH中的外周血（舒张压和平均动脉血压）和脑血流动力学参数（CBFV和ARI）相关。结论具有不同OCSP亚型和严重程度的AIS患者在CA能力方面具有同质性。UH的脑血流动力学测量值可区分卒中亚型和严重程度，包括UH中ARI恶化与卒中严重程度之间的关系。需要更多的研究来确定其临床意义并了解AIS患者CA损伤的决定因素。