22. European Stroke Conference 396 Heart and brain Interarm differences in blood pressure. Are they reproducible? M.S. Svraka1, N.H. Hornnes2, C.R.K. Kruuse3 Copenhagen University Hospital, Herlev, Herlev, DENMARK1, Copenhagen Hospital, Herlev, DENMARK2, Copenhagen University Hospital, Herlev, Herlev, DENMARK3 Background: Guidelines recommend initial bilateral assessment of blood pressure (BP), revealing a possible interarm difference (IAD). The aim of the current study was to investigate variability and reproducibility of such measured IAD in patients with stroke or TIA compared with non-stroke sub-jects. Furthermore, possible predictors of IAD were investigated. Methods: Patients with stroke or TIA (n=50) admitted to Dept.Neurology, Herlev Hospital, Uni-versity of Copenhagen during May-Sept 2012, and sex-and age- matched subjects without stroke, were included. Measurement of BP was done by Microlife WatchBP office ® device for simultane-ous measurements in both arms with a single monitor. Measurements were done twice daily with 3 repeated measurements for two consecutive days. Incidence of clinically relevant IAD (systolic IAD ≥10 mmHg and/or diastolic IAD ≥5 mmHg, and a large IAD, systolic IAD ≥20 mmHg and/or dia-stolic IAD ≥10 mmHg) was evaluated. Results: IAD was more frequent in stroke patients. At the time of the first BP measurement clinically relevant IAD was detected in 22 of 99 (22%) subjects, of whom 18 were stroke patients (p<0.05). In subsequent BP measurements, a clinically relevant difference was present in only 7 subjects. Only 2 subjects with stroke, repeatedly showed highest BP in the same arm. A large IAD was detected in 13 subjects, all patients with stroke, however of those, 7 patients showed IAD once, 4 had it twice and 2 had it three times. Diabetes was an independent predictor of a clinically relevant IAD. Conclusion: Guidelines which recommend future measurements of BP in the arm with the highest BP obtained from one or few consultations may be challenged. More and larger studies are warrant-ed to investigate whether IAD may be a predictor of unrecognized vascular disease. If such is the case significant IAD may provide a basis for further investigation of peripheral vascular disease and secondary prevention in stroke. 496 © 2013 S. Karger AG, Basel Scientific Programme 397 Heart and brain REDUCED CEREBRAL BLOOD FLOW IN THE CHRONIC HEART FAILURE PATIENTS T. Lepic1, G. Loncar2, B. Bozic3, D. Veljancic4, B. Lebovic5, Z. Krsmanovic6, M. Lepic7, R. Raicevic8 Military Medical Academy, Neurology department, Belgrade, SERBIA1, Clinical Medical Cen-ter Zvezdara, Cardiology Departmen, Belgrade, 2, Institute for Physiology and Biochemistry, Uni-versity of Belgrade, Belgrade, SERBIA3, Military Medical Academy, Neurology department, Bel-grade, SERBIA4, Military Medical Academy, Neurology department, Belgrade, SERBIA5, Military Medical Academy, Neurology department, Belgrade, SERBIA6, Military Medical Academy, Neurol-ogy department, Belgrade, SERBIA7, Military Medical Academy, Neurology department, Belgrade8 Background: Cerebral blood flow (CBF) is an important variable in cerebrovascular disorders. A noninvasive measurement of global CBF is approved with color duplex sonography of the extra cra-nial cerebral arteries. Chronic heart failure (CHF) increases the risk of stroke and dementia. One of the possible causes may be cerebral hypoperfusion in CHF patients. Therefore, we aimed to investi-gate the relationship between CBF and CHF severity. Methods: Study was performed in 76 ischemic or idiopathic dilatative cardiomyopathy patients, left ventricular ejection fraction (LVEF) <40%, with no clinical evidence of decompensation and 20 healthy volunteers. Each CHF patient was categorized according to the New NYHA criteria. All patients underwent Doppler echocardiography examination (GE Vivid 7). The LVEF was quantified using the Simpson method. CBF was estimated by a 7.0-MHz linear transducer of a computed so-nography system (Toshiba Power vision 6000). CBF volume was determined as the sum of the flow volumes of the ICA and the VA of both sides. Results: Atrial fibrillation was noted in 30%, left bundle branch block in 26%, while pacemaker was implanted in 9% of patients with CHF. History of myocardial infraction was presented in 64% of pa-tients. No differences in age, waist/hip ratio, body mass index and lipid profile were found between CHF patients and healthy subjects. CBF was calculated in 71 of 76 patients. Three patients had oc-clusion of ICA, while VA was ocluded in another two patients. Others did not have hemodynamicaly significant ICA and VA stenosis. CBF volume was decreased in CHF patients, (677 ± 170) accord-ing to control (783 ± 128). Conclusion: Our results of noninvasive sonographic measurement of CBF according to LVEF and NYHA criteria, suggest on significantly reduced CBF in CHF patients.
Karger_ESC London_2013
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