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Peripheral Vascular Function in Stroke: Systematic Review and Meta-Analysis.

Bria L Bartsch,E. Hazen,Robert N Montgomery,Calvin Trieu,Amanda J Britton-Carpenter,S. Billinger

Published 2024 in Journal of applied physiology

ABSTRACT

Peripheral vascular dysfunction, measured as flow-mediated dilation (FMD), is present across all phases of stroke recovery and elevates risk for recurrent cardiovascular events. The objective of this systematic review and meta-analysis was to characterize baseline FMD in individuals post-stroke, with consideration for each phase of stroke recovery. METHODS Three databases (PubMed, CINAHL, and Embase) were searched between January 1st, 2000 and October 12th, 2023 for studies that examined baseline FMD in stroke. Three reviewers conducted abstract and full-text screening, data extraction, and quality assessment. A random effects model was used to estimate FMD across studies. Meta-regression was used to the examine impact of age and time since stroke (acute, subacute, chronic) on FMD. RESULTS Twenty-eight studies with ischemic and hemorrhagic stroke were included. Descriptive statistics for the demographics and FMD values of each study are presented. For the meta-analysis, average estimate FMD was 3.9% (95% CI: 2.5-5.3%). We report a large amount of heterogeneity (Cochrane's Q p-value <0.001, and I2 = 99.6%). Differences in average age and the time post-stroke between studies was not significantly associated with differences in FMD values. CONCLUSION Despite the large heterogeneity for FMD values across studies, our primary finding suggests that FMD remains impaired across all phases of stroke.

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