{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:53:21Z","timestamp":1793332401076,"version":"4.5.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Hemodynamic impairment of blood pressure may play a crucial role in determining the mechanisms of stroke in symptomatic intracranial atherosclerotic stenosis). We aimed to elucidate this issue and assess the impacts of modifications to blood pressure on hemodynamic impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>From the Third China National Stroke Registry III, computed fluid dynamics modeling was performed using the Newton-Krylov-Schwarz method in 339 patients with symptomatic intracranial atherosclerotic stenosis during 2015 to 2018. The major exposures were translesional systolic blood pressure (SBP) drop and poststenotic mean arterial pressure (MAP), and the major study outcomes were cortex-involved infarcts and borderzone-involved infarcts, respectively. Multivariate logistic regression models and the bootstrap resampling method were utilized, adjusting for demographics and medical histories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      In all, 184 (54.3%) cortex-involved infarcts and 70 (20.6%) borderzone-involved infarcts were identified. In multivariate logistic model, the upper quartile of SBP drop correlated with increased cortex-involved infarcts (odds ratio, 1.92 [95% CI, 1.03\u20133.57]; bootstrap analysis odds ratio, 2.07 [95% CI, 1.09\u20133.93]), and the lower quartile of poststenotic MAP may correlate with increased borderzone-involved infarcts (odds ratio, 2.07 [95% CI, 0.95\u20134.51]; bootstrap analysis odds ratio, 2.38 [95% CI, 1.04\u20135.45]). Restricted cubic spline analysis revealed a consistent upward trajectory of the relationship between translesional SBP drop and cortex-involved infarcts, while a downward trajectory between poststenotic MAP and borderzone-involved infarcts. SBP drop correlated with poststenotic MAP negatively (r\n                      <jats:sub>s<\/jats:sub>\n                      =\u22120.765;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). In generating hemodynamic impairment, simulating blood pressure modifications suggested that ensuring adequate blood pressure to maintain sufficient poststenotic MAP appears preferable to the reverse approach, due to the prolonged plateau period in the association between the translesional SBP drop and cortex-involved infarcts and the relatively short plateau period characterizing the correlation between poststenotic MAP and borderzone-involved infarcts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>This research elucidates the role of hemodynamic impairment of blood pressure in symptomatic intracranial atherosclerotic stenosis-related stroke mechanisms, underscoring the necessity to conduct hemodynamic assessments when managing blood pressure in symptomatic intracranial atherosclerotic stenosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.123.046051","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T05:12:45Z","timestamp":1717564365000},"page":"1798-1807","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Hemodynamic Impairment of Blood Pressure and Stroke Mechanisms in Symptomatic Intracranial Atherosclerotic Stenosis"],"prefix":"10.1161","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0942-2448","authenticated-orcid":true,"given":"Zimo","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0672-3202","authenticated-orcid":true,"given":"Jia","family":"Liu","sequence":"additional","affiliation":[{"name":"Laboratory for Engineering and Scientific Computing, Institute of Advanced Computing and Digital Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, China (J.L., B.W., Z. Cheng), Chinese Academy of Sciences, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2400-9396","authenticated-orcid":true,"given":"Anqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bokai","family":"Wu","sequence":"additional","affiliation":[{"name":"Laboratory for Engineering and Scientific Computing, Institute of Advanced Computing and Digital Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, China (J.L., B.W., Z. Cheng), Chinese Academy of Sciences, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaiheng","family":"Cheng","sequence":"additional","affiliation":[{"name":"Laboratory for Engineering and Scientific Computing, Institute of Advanced Computing and Digital Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, China (J.L., B.W., Z. Cheng), Chinese Academy of Sciences, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingyu","family":"Jiang","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"National Center for Healthcare Quality Management in Neurological Diseases (Yingyu Jiang, H.G., Yongjun Wang, Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1608-1856","authenticated-orcid":true,"given":"Hongqiu","family":"Gu","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"National Center for Healthcare Quality Management in Neurological Diseases (Yingyu Jiang, H.G., Yongjun Wang, Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0114-8157","authenticated-orcid":true,"given":"Lingling","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-3852","authenticated-orcid":true,"given":"Jinglin","family":"Mo","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7700-6054","authenticated-orcid":true,"given":"Yong","family":"Jiang","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2943-055X","authenticated-orcid":true,"given":"Liping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Radiology (L.J.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9822-5758","authenticated-orcid":true,"given":"Jing","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2725-2788","authenticated-orcid":true,"given":"Yilong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8345-5147","authenticated-orcid":true,"given":"Xingquan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-2341","authenticated-orcid":true,"given":"Yongjun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"National Center for Healthcare Quality Management in Neurological Diseases (Yingyu Jiang, H.G., Yongjun Wang, Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"Center for Excellence in Brain Science and Intelligence Technology (Yongjun Wang, Z.L.), Chinese Academy of Sciences, Shanghai, China."},{"name":"Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China (Yongjun Wang, Z.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4500-7508","authenticated-orcid":true,"given":"Haiqiang","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-5418","authenticated-orcid":true,"given":"Zixiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology (Z. Chen, A.W., L.D., J.M., L.L., J.J., Y.W., X.Z., Yilong Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases (Z. Chen, A.W., Yingyu Jiang, H.G., L.D., J.M., Yong Jiang, L.L., J.J., Yilong Wang, X.Z., Yongjun Wang, H.Q., Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"National Center for Healthcare Quality Management in Neurological Diseases (Yingyu Jiang, H.G., Yongjun Wang, Z.L.), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"Center for Excellence in Brain Science and Intelligence Technology (Yongjun Wang, Z.L.), Chinese Academy of Sciences, Shanghai, China."},{"name":"Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China (Yongjun Wang, Z.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00376-8"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.12.015"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493020974461"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2023.00185"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.032676"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.025732"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvad076"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012805"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz132"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu353"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-020-0411-7"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/15036781"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.622464"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.09.044"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000238"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2019-000242"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.24.1.35"},{"key":"e_1_3_3_19_2","first-page":"643","article-title":"A standardized method for measuring intracranial arterial stenosis.","volume":"21","author":"Samuels OB","year":"2000","unstructured":"Samuels, OB, Joseph, GJ, Lynn, MJ, Smith, HA, Chimowitz, MI. A standardized method for measuring intracranial arterial stenosis. AJNR Am J Neuroradiol. 2000;21:643\u2013646.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X16671321"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25456"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61088-0"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2011.00006"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.011147"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2011.05.004"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2016.01956"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.114.302721"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actbio.2014.09.001"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2015.203"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X18805209"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2023-002333"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308441"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.01372"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15181"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7139.1236"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989x.5.2.241"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.123.046051","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T11:56:45Z","timestamp":1748433405000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.123.046051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":36,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1161\/STROKEAHA.123.046051"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.123.046051","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2023-12-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-22","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}