Influence of clinical and cerebral hemodynamics characteristics in acute ischemic stroke patients

This study investigated the relationship between clinical and hemodynamic aspects in acute ischemic stroke (AIS) patients and their impact on functional outcomes. Demographic, clinical, and hemodynamic data were collected from two clinical centers, comprising a total of 60 AIS patients and 50 control subjects. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and functional outcome was assessed using modified Rankin Scale (mRS). Data on the history of atrial fibrillation, diabetes mellitus, hypercholesteremia and systemic arterial hypertension were collected. Arterial blood pressure (ABP) and cerebral blood flow velocity were recorded and Cerebral autoregulation was evaluated using the Autoregulation Index (ARI). Significant differences were observed in mRS scores among stroke subgroups (mild, moderate and severe), with severe stroke patients displaying worse functional outcomes (mRS = 3.5 ± 2.0) compared to mild (mRS = 0.8 ± 0.6) and moderate (mRS = 2.4 ± 1.2). Hemodynamic analysis revealed lower arterial blood pressure (ABP) in controls compared to AIS groups, while ARI values were significantly lower in severe stroke patients, suggesting impaired autoregulation. Strong positive correlations were found between NIHSS and mRS scores (0.83), as well as significant correlations between NIHSS and time from onset to assessment (0.73), mRS and time from onset to assessment (0.69), and atrial fibrillation (AF) and diabetes mellitus (DM) (0.65). Functional recovery (mRS) was significantly associated with stroke severity (NIHSS) (p<0.001), with NIHSS scores predicting 71.2% of the variability in functional recovery. Hypercholesterolemia (HCL) was found to significantly influence functional recovery (p=0.02). These findings highlight the importance of stroke severity assessment in predicting functional outcomes and underscore the potential role of cerebral autoregulation and comorbidities in influencing stroke severity and recovery. Understanding the interplay between clinical and hemodynamic factors in AIS can guide personalized treatment strategies and improve stroke care. Further research is needed to elucidate the underlying hemodynamic mechanisms and explore additional predictors of functional outcomes in AIS patients.