Abstract
Background: Blood viscosity (BV) affects blood vessel wall shear stress. Yet, temporal changes of BV in acute stroke patients and correlation with infarct growth and hemorrhagic transformation remain unclear. Method: This prospective observational study included acute ischemic stroke patients admitted within 24h of the last known well time, who gave an informed consent and had adequate blood sampling. Consecutive BV measurements (at 10Hz) were taken upon admission (1 st ), at 24h (2 nd ), and between 5-7 days post-admission. Each patient underwent initial and follow-up MRI. Outcomes were 1) infarct growth or recurrence, and 2) increased hemorrhagic transformation (HT) in follow-up MRI compared to the initial MRI. We assessed whether the ratio of the 2nd BV to the 1st BV and 3 rd BV to the 1 st BV were associated with outcomes. Results: Twenty-six patients met eligible criteria and had adequate blood sampling. BV demonstrated a decreasing trend during the admission (1 st BV: median 20.2 [IQR 14.8-23.2], 2 nd BV: 17.9 [14.8-20.2], 3 rd BV: 15.3 [12.0-22.0]). The ratios of 2 nd BV to 1 st BV and 3 rd BV to 1 st BV decreased after admission (P=0.41 and P=0.015 with Wilcoxon rank test, respectively). While the ratio of 2 nd BV to 1 st BV between patients with and without increased HT (1.28 [1.04-1.41] vs. 0.89 [0.67-1.33], p=0.67 with Wilcoxon rank test) was similar, it showed a tendency to rise in patients with infarct growth or recurrence (1.25 [0.78-1.63] vs. 0.80 [0.66-1.21], P=0.11 with Wilcoxon rank test) (Figure). The ratio of 3 rd BV to 1 st BV was higher in patients with increased HT (0.96 [0.82-1.27] vs. 0.72 [0.59-0.81], P=0.25 with Wilcoxon rank test). Conclusion: BV at the 24h post-admission appears to correlate with infarct growth or recurrence during the acute stroke period. BV was likely to persistently increase in patients with HT. Further investigations with a larger dataset are recommended to elucidate the predictive value of 24h BV in acute stroke patients.
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