Endothelin-1 levels in plasma and cerebrospinal fluid of patients with cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
BACKGROUND
Plasma and cerebrospinal fluid (CSF) concentrations of endothelin-1 (ET-1) were measured in patients with subarachnoid hemorrhage (SAH) after aneurysmal rupture and compared with levels of ET-1 in volunteers. We analyze the relationship between levels of ET-1 in both CSF and plasma with the risk of developing cerebral vasospasm (CVS).


METHODS
Cerebrospinal fluid and blood samples were collected from 30 selected patients after SAH and from 10 healthy volunteers who were used as control. All samples were stored at -70 degrees C and the levels of ET-1 in CSF and blood were measured by using enzyme-linked immunosorbent assay and Western blot. All patients were submitted to angiography to confirm vasospasm.


RESULTS
From the 30 patients admitted at different days of SAH, 18 (60%) developed clinical CVS and 10 (33%) presented angiographic CVS. The levels of ET-1 in the CSF were significantly higher (P = .0001) in patients (1.618 +/- 1.05 fmol/mL) than in controls (0.365 +/- 0.328 fmol/mL). There was statistical difference (P < .05) in CSF levels of ET-1 between each group of the Hunt-Hess scale and controls. The mean plasma concentration of ET-1 was similar (P > .05) in the control group (1.531 +/- 0.753 fmol/mL) and in patients with SAH (1.920 +/- 1.15 fmol/mL).


CONCLUSIONS
These findings indicate that a significant rise in ET-1 levels in the CSF, but not in the plasma, occurs in patients who develop CVS after SAH. Our observation suggests that ET-1 might be involved in the pathogenesis of SAH-associated CVS.
Kessler
Iruena Moraes
IM
Neurosurgical Service, Medical School, University of Brasilia, 71680-070 Brasília-DF, Brazil.
Pacheco
Yolanda Galindo
YG
Lozzi
Silene Paulino
SP
de Araújo
Antônio Santos
AS
Onishi
Franz Jooji
FJ
de Mello
Paulo Andrade
PA
D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology; D019332:Endothelin-1 / Q000097:blood* / Q000134:cerebrospinal fluid*; D006801:Humans; D011237:Predictive Value of Tests; D012016:Reference Values; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D013346:Subarachnoid Space / Q000473:pathology / Q000503:physiopathology; D015854:Up-Regulation / Q000502:physiology; D020301:Vasospasm, Intracranial / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000503:physiopathology
D019332:Endothelin-1