Plasma adrenomedullin and carotid atherosclerosis in atherothrombotic ischemic stroke.
OBJECTIVE
Adrenomedullin is known to exert anti-atherosclerotic actions by inhibiting proliferation and migration of smooth muscle cells in vitro. Here we examine the relationship between the plasma concentration of adrenomedullin and ultrasonographic characteristics of carotid arteries both in ischemic stroke and in the absence of cerebrovascular disease.


METHODS
We studied 61 patients with atherothrombotic ischemic stroke in the chronic phase and 50 patients without any cerebrovascular disease. Intima-media thickness and vascular lumen diameters were evaluated by carotid ultrasonography. Plasma mature-adrenomedullin was determined by radioimmunoassay.


RESULTS
Plasma mature-adrenomedullin in the patients with atherothrombotic ischemic stroke in the chronic phase (2.01 +/- 0.58 fmol/ml) was significantly higher than that in the patients without any cerebrovascular disease (1.24 +/- 0.18 fmol/ml, P < 0.001). With multiple regression analysis, plasma mature-adrenomedullin was found to be predicted by: stroke status (atherothrombotic ischemic stroke versus no cerebrovascular disease), diabetes status (yes/no), left ventricular ejection fraction, internal carotid artery intima-media thickness, and common carotid artery pressure strain elastic modulus (R = 0.79; F5,105 = 85.39, P < 0.0001).


CONCLUSIONS
Plasma mature-adrenomedullin showed significantly positive associations with carotid atherosclerosis and atherothrombotic ischemic stroke, independent of systolic blood pressure.
Hosomi
Naohisa
N
Second Department of Internal Medicine, Kagawa University School of Medicine, Kagawa, Osaka Neurosurgical Hospital, Kagawa, Japan. naohisa@med.kagawa-u.ac.jp
Ohyama
Hideo
H
Takahashi
Tsutomu
T
Shinomiya
Kaori
K
Naya
Takayuki
T
Ban
Camelia R
CR
Osaka
Kunihiko
K
Kohno
Masakazu
M
Koziol
James A
JA
D053607:Adrenomedullin; D000368:Aged; D001794:Blood Pressure; D002545:Brain Ischemia / Q000150:complications*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000150:complications*; D002341:Carotid Artery Thrombosis / Q000150:complications*; D017536:Carotid Artery, Common / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002908:Chronic Disease; D003925:Diabetic Angiopathies / Q000150:complications; D004548:Elasticity; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood*; D013314:Stress, Mechanical; D020521:Stroke / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology*; D013318:Stroke Volume; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography
D010455:Peptides; D053607:Adrenomedullin