Mean stroke volume
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Understanding Mean Stroke Volume: Insights from Recent Research
Mean Stroke Volume in Pulmonary Hypertension
Importance of Stroke Volume in Pulmonary Hypertension
Stroke volume (SV) is a critical hemodynamic parameter in pulmonary hypertension (PH) as it directly reflects right ventricular function in response to its load. Unlike cardiac output, SV does not require correction for compensatory increased heart rate, making it a more accurate measure of therapeutic changes and prognostic information in PH.
Clinically Significant Changes in Stroke Volume
A study aimed to determine the minimal important difference (MID) in SV for patients with PH. Using both anchor-based and distribution-based methods, the researchers found that a change of 10 mL in SV should be considered clinically relevant. This finding is crucial for interpreting changes in SV during clinical follow-up and treatment of PH.
Brain Volume Changes After Stroke
Early Brain Volume Loss
Research on brain volume changes post-stroke indicates that significant brain volume loss occurs within the first month. A study involving patients with acute ischemic stroke found a median decrease of 6 mL in brain volume, equivalent to a 0.5% reduction. Age and deep white matter disease were associated with greater tissue loss, while the severity of the stroke did not significantly impact early tissue loss .
Predictive Factors for Brain Volume Change
The study highlighted that age and white matter hyperintensities (WMH) are significant predictors of brain volume loss. For every 10 years of age, there was an associated 5 mL increase in volume loss. Additionally, higher Fazekas scores of deep WMH correlated with greater tissue loss, emphasizing the role of white matter disease in post-stroke brain atrophy .
Mean Platelet Volume (MPV) and Stroke
MPV as a Predictor of Stroke Outcomes
Mean platelet volume (MPV) has been identified as a significant predictor of stroke outcomes. Higher MPV levels are associated with increased mortality and morbidity in stroke patients. For instance, patients with higher MPV had a significantly higher risk of death or readmission within a year post-stroke .
MPV in Acute Ischemic Stroke
In acute ischemic stroke, MPV tends to increase, particularly in more severe cases. This increase in MPV is linked to the release of larger and more reactive platelets, contributing to a thrombophilic state. Studies have shown that MPV is higher in non-lacunar strokes compared to lacunar strokes, and it continues to rise in the acute phase of the disease.
MPV and Atrial Fibrillation
MPV is also a useful marker for predicting stroke risk in patients with atrial fibrillation (AF). Higher MPV levels are associated with a greater risk of ischemic stroke in AF patients, even those with low to intermediate traditional thromboembolic risk. This suggests that MPV could be a valuable tool for stratifying stroke risk and guiding anticoagulation therapy in AF patients .
Conclusion
Stroke volume and mean platelet volume are critical parameters in understanding and managing stroke and related conditions. SV provides valuable insights into right ventricular function and therapeutic changes in pulmonary hypertension, with a 10 mL change being clinically significant. Meanwhile, MPV serves as a predictor of stroke outcomes and risk, particularly in acute ischemic stroke and atrial fibrillation, highlighting its potential role in patient stratification and treatment planning.
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