Hemispheric lateralization, endothelial function, and arterial compliance in chronic post-stroke individuals: a cross-sectional exploratory study

Abstract

Purpose/Aim: Cardiovascular function is controlled and regulated by a functional brain-heart axis. Although the exact mechanism is not fully understood, several studies suggest a hemispheric asymmetry in the neural control of cardiovascular function. Thus, the purpose of this study was to examine whether endothelial function and arterial compliance differ between individuals with left- and right-sided strokes.Materials and Methods: This was a cross-sectional exploratory study. Thirty individuals more than 6 months after stroke participated in the study. The endothelial function was assessed by ultrasound-measured flow-mediated dilation of the nonparetic arm brachial artery (baFMD). The arterial stiffness was assessed by measuring carotid-femoral pulse wave velocity (cfPWV) and central aortic pulse wave analysis [augmentation index (AIx), augmentation index normalized to a heart rate of 75 bpm (AIx@75) and reflection magnitude (RM)] using applanation tonometry. Results: Participants with right-sided stroke had worse endothelial function than those with left-sided stroke. This difference (baFMD = 2.51%) was significant (p = 0.037), and it represented a medium effect size (r = 0.38). Likewise, they had higher arterial stiffness than those with left-sided stroke. This difference (AIx = 10%; RM = 7%) was significant (p = 0.011; p = 0.012), and it represented a medium effect size (r = 0.48; r = 0.47).Conclusions: Our findings suggest that individuals with right-sided stroke have reduced endothelial function and arterial compliance compared to those with left-sided stroke. These data may indicate that those with right-sided strokes are more susceptible to cardiovascular events.

Keywords:

• Endothelium
• Arterial stiffness
• Cerebrum
• Cerebral infarction
• Stroke

Acknowledgments

We would like to thank Irmandade Santa Casa de Misericórdia de São Carlos, Hospital Universitário Prof. Dr. Horácio Carlos Panepucci da Universidade Federal de São Carlos (HU-UFSCar) and Empresa Brasileira de Serviços Hospitalares (EBSERH) for their support.

Disclosure statement

The authors completed the ICJME Form for Disclosure of Potential Conflicts of Interest and reported no conflicts of interest.

Department and institution where work was performed

Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.

Ethics approval

This study was approved by the Ethics and Research Committee at the Federal University of São Carlos, Brazil (Certificate of Presentation for Ethical Appreciation [CAAE] 62417216.9.0000.5504). All patients provided informed consent before participating in this study.

Additional information

Funding

This study was funded by the Brazilian Government Funding Agencies: Coordination for the Improvement of Higher Education Personnel – CAPES (Finance Code 001), the São Paulo Research Foundation – FAPESP (funding: 2017/13655-6 and 2017/22173-5) and the National Council for Scientific and Technological Development – CNPq (funding: 442972/2014-8 and 310798/2020-5). SAB is supported in part by the KU Alzheimer’s Disease Research Center (P30AG072973). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.