title: High plasma levels of endothelin-1 and atrial natriuretic peptide in patients with acute ischemic stroke.
abstract: The plasma levels of endothelin-1 (ET-1) and atrial natriuretic peptide (ANP) have been measured in 37 patients with acute ischemic stroke, on admission and 3 and 7 days thereafter. The plasma ET-1 levels at the onset of symptoms were about two-fold those observed in age-matched normal volunteers (3.5 +/- 2.26 v 1.54 +/- 0.9 pg/mL, respectively; P < .001). These levels remained significantly elevated during the 7-day study period. The neurologic deficit was assessed daily by Mathew's modified scale (MS). A significant correlation was found between neurologic status on admission and ET-1 plasma values; patients with worse neurologic status (MS < 45 points) had higher ET-1 plasma values than those with better neurologic status (MS > 45 points) (5.4 +/- 2.34 v 3.05 +/- 2.04 pg/mL, respectively, P < .05). The plasma ET-1 values did not correlate either with the site of the infarction or with its primary cause (cardioembolic, lacunar, or atherothrombotic). No significant differences were seen in plasma ET-1 concentrations between patients who eventually died and those who survived the acute event. The plasma ANP were about 18-fold higher in ischemic stroke patients on admission than in controls at admission (110.9 +/- 29.5 v 5.84 +/- 3.96 pg/mL, respectively, P < .01). These values remained significantly elevated on days 3 and 7. There was no correlation between the ANP plasma values and the neurologic status, the site or mechanism of the stroke, or the plasma ET-1 levels. In conclusion, ischemic stroke is associated with marked acute and long-duration increases of ET-1 and ANP.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Hospital Universitario San Carlos, Madrid, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Estrada
authors.forename: M J
authors.initials: MJ
authors.lastname: Téllez
authors.forename: J
authors.initials: J
authors.lastname: Moya
authors.forename: R
authors.initials: R
authors.lastname: Fernández-Durango
authors.forename: J
authors.initials: J
authors.lastname: Egido
authors.forename: A F
authors.initials: AF
authors.lastname: Fernández Cruz
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood*; D002545:Brain Ischemia / Q000097:blood* / Q000503:physiopathology; D002544:Cerebral Infarction / Q000097:blood; D002561:Cerebrovascular Disorders / Q000097:blood* / Q000503:physiopathology; D016232:Endothelins / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination
chemical_list: D016232:Endothelins; D009320:Atrial Natriuretic Factor