@article{GunkelSchoetzauFluri2023,
  author    = {Gunkel, Sarah and Sch{\"o}tzau, Andreas and Fluri, Felix},
  title     = {Burden of cerebral small vessel disease and changes of diastolic blood pressure affect clinical outcome after acute ischemic stroke},
  series = {Scientific Reports},
  volume    = {13},
  journal   = {Scientific Reports},
  doi       = {10.1038/s41598-023-49502-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357669},
  year      = {2023},
  abstract  = {Elevated and low blood pressure (BP) may lead to poor functional outcome after ischemic stroke, which is conflicting. Hence, there must be another factor—such as cerebral small vessel disease (cSVD) -interacting with BP and thus, affecting outcome. Here, we investigate the relationship between BP and cSVD regarding outcome after stroke. Data of 423/503 stroke patients were prospectively analyzed. Diastolic (DBP) and systolic BP (SBP) were collected on hospital admission (BP\(_{ad}\)) and over the first 72 h (BP\(_{72h}\)). cSVD-burden was determined on MR-scans. Good functional outcome was defined as a modified Rankin Scale score ≤ 2 at hospital discharge and 12 months thereafter. cSVD was a predictor of poor outcome (OR 2.8; p < 0.001). SBPad, DBP\(_{ad}\) and SBP\(_{72h}\) were not significantly associated with outcome at any time. A significant relationship was found between DBP\(_{72h}\), (p < 0.01), cSVD (p = 0.013) and outcome at discharge. At 12 months, we found a relationship between outcome and DBP\(_{72h}\) (p = 0.018) and a statistical tendency regarding cSVD (p = 0.08). Changes in DBP72h were significantly related with outcome. There was a U-shaped relationship between DBP\(_{72h}\) and outcome at discharge. Our results suggest an individualized stroke care by either lowering or elevating DBP depending on cSVD-burden in order to influence functional outcome.},
  language  = {en}
}