Lung Function, Arterial Blood Gases, and Carotid Intima–media Thickness as a Predictor of Cerebral Stroke

Background: Elevated risk of cardiovascular disease mortality in patients with reduced lung function had been demonstrated in several studies. Fewer studies have investigated the relation between pulmonary function, arterial blood gases, and the risk of cerebral stroke.

Aim of the Work: The present work aimed to detect the link between lung function parameters (FEV1, FVC, FEV1/FVC%, PEF and MVV), arterial blood gases parameters (pH, PaO2, PaCO2, SPO2%, and HCO3) and carotid intima media thickness (cIMT) as risk factors in cerebral stroke and non stroke patients without chronic respiratory disease.

Patients and Methods: Our study was conducted on 50 cerebral stroke and 200 non stroke patients as a control group. Lung function was assessed by forced vital capacity (FVC) maneuver. Carotid ultrasonography to measure cIMT and arterial blood gases were done.

Results: The risk for cerebral stroke of our studied patients was higher among those with elevated cIMT than patients with normal cIMT. There were high statistical significant decrease in pH, forced expiratory volume in the first second/ forced vital capacity% (FEV1/FVC%), and peak expiratory flow (PEF), and high statistical significant increase in PaCO2, HCO3, and cIMT in stroke patients compared to non stroke patients. Reduced FVC, FEV1/FVC%, MVV, and PaO2 were associated with elevated cIMT. Results of the stepwise multivariable regression model demonstrated that cIMT was directly proportional to age and FEV1 and inversely proportional to FEV1/FVC%, PaO2, FVC and maximum voluntary ventilation (MVV).

Conclusion: The risk for cerebral stroke was higher among patients with elevated cIMT. Reduced FVC, FEV1/FVC%, MVV, and PaO2 were associated with elevated cIMT. Stroke patients had reduced FEV1/FVC%), PEF, and pH than non stroke patients. These results suggest the requirement to perform pulmonary function and arterial blood gases in people without respiratory disease to screen those with impaired lung function for the presence of subclinical atherosclerosis to prevent the risk for cerebral stroke.