Longitudinal dynamics of pulse wave velocity in the days after acute ischaemic stroke: prospective cohort study

Objectives Arterial stiffness as assessed by pulse wave velocity (PWV) improves the prediction of first-ever and recurring stroke and of stroke outcomes when measured in the days after stroke. Here, we investigated the longitudinal dynamics of PWV in the days after acute ischaemic stroke. Design Monocentric, prospective cohort study nested within a clinical trial registry with repeated measurement assessment of PWV. Setting Comprehensive middle European stroke centre. Participants 20 men and women that suffered stroke from November 2022 through August 2023. Primary and secondary outcome measures Change in carotid-femoral PWV was investigated by recording PWV four times between 1.2 and 9.9 days after stroke using a Vicorder device. Haemodynamic and patient-, stroke- and care-related variables were investigated as potential modifiers of PWV trajectories. Results Twenty patients aged 61.3 +/- 16.9 years (14 males) were included. There was a daily decline in PWV of -0.19 m/s (95% CI: -0.29 to -0.09; p<0.001) until approximately 8 days after stroke, corresponding to a total relative decline of -15.5% (95% CI: -22.3 to -8.1; p<0.001). Whereas higher anxiety predicted 0.11 m/s (95% CI: 0.01 to 0.20; p=0.044) slower daily decline, decline was not significantly related to baseline PWV, blood pressures, stroke severity or location, or functional status (all p>0.05). Rank-order correlation between the earliest and latest PWV measurements was 0.87 (95% CI: 0.69 to 0.95; p<0.001). Conclusions A marked decline in PWV during the first week after acute ischaemic stroke should be accounted for when interpreting PWV after recent stroke. Trial registration number The STROKE-CARD Registry was registered at ClinicalTrials.gov (NCT04582825).