Abstract
BackgroundAcute ischaemic stroke is associated with alteration in systemic markers of vascular function. We measured forearm vascular function (using forearm flow mediated dilatation) to clarify whether recent acute ischaemic stroke/TIA is associated with impaired systemic vascular function.MethodsProspective case control study enrolling 17 patients with recent acute ischaemic stroke/TIA and 17 sex matched controls with stroke more than two years previously. Forearm vascular function was measured using flow medicated dilatation (FMD).ResultsFlow mediated dilatation was 6.0 ± 1.1% in acute stroke/TIA patients and 4.7 ± 1.0% among control subjects (p = 0.18). The mean paired difference in FMD between subjects with recent acute stroke and controls was 1.25% (95% CI -0.65, 3.14; p = 0.18). Endothelium independent dilatation was measured in six pairs of participants and was similar in acute stroke/TIA patients (22.6 ± 4.3%) and control subjects (19.1 ± 2.6%; p = 0.43).ConclusionsDespite the small size of this study, these data indicate that recent acute stroke is not necessarily associated with a clinically important reduction in FMD.
Highlights
Endothelial dysfunction, as measured by impaired brachial flow-mediated dilatation, occurs early in atherosclerosis
Endothelial dysfunction can be reversed with treatments that lower C-reactive protein and homocysteine, suggesting that systemic inflammation may mediate the observed vascular dysfunction in patients with stable cerebrovascular disease[5]
Control subjects had a history of transient ischaemic attacks (TIA) (n = 4) or total anterior (n = 2), partial anterior (n = 4), lacunar (n = 6) or posterior (n = 1) syndrome ischaemic stroke
Summary
Endothelial dysfunction, as measured by impaired brachial flow-mediated dilatation, occurs early in atherosclerosis. It is associated with subsequent intracranial small vessel disease (as manifest by small, deep, lacunar ischaemic stroke and brain imaging evidence of deep white matter infarction), and is an independent predictor of vascular events[1,2,3,4]. The endothelial marker E-selectin is elevated in acute stroke and returns to normal concentrations within 3-6 months[6]. We measured forearm vascular function (using forearm flow mediated dilatation) to clarify whether recent acute ischaemic stroke/TIA is associated with impaired systemic vascular function
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