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

UNLABELLED: 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.