The relationship of pro-inflammatory markers to vascular endothelial function after acute stroke.
Purpose/Aim: Data from chronic stroke studies have reported reduced blood flow and vascular endothelial function in the stroke-affected limb. It is unclear whether these differences are present early after stroke. First, we investigated whether vascular endothelial function in the stroke-affected limb would be different from healthy adults. Second, we examined whether between-limb differences in vascular endothelial function existed in the stroke-affected arm compared to the non-affected arm. Last, we tested whether reduced vascular endothelial function was related to pro-inflammatory markers that are present early after stroke.


METHODS
Vascular endothelial function was assessed by flow-mediated dilation (FMD) in the brachial artery within 72 h post-stroke. All participants withheld medications from midnight until after the procedure. Ultrasound scans and blood draws for pro-inflammatory markers occurred on the same day between 7:30 am and 9:00 am.


RESULTS
People with acute stroke had significantly lower FMD (4.2% ± 4.6%) than control participants (8.5% ± 5.2%, p = 0.037). Stroke participants had between-limb differences in FMD (4.2% ± 4.6% stroke-affected vs. 5.3% ± 4.4% non-affected, p = 0.02), whereas, the control participants did not. Of the pro-inflammatory markers, only vascular cell adhesion molecule-1(VCAM-1) had a significant relationship to FMD (stroke-affected limb, r = -0.62, p = 0.03; non-affected limb, r = -0.75, p = 0.005), but not tumor necrosis factor alpha nor interleukin-6.


CONCLUSIONS
Vascular endothelial function is reduced starting in the early stage of stroke recovery. People with higher levels of VCAM-1 had a lower FMD response.
a 1 Department of Physical Therapy and Rehabilitation Science.
Sandra A
SA
Billinger
a 1 Department of Physical Therapy and Rehabilitation Science.
Jason-Flor V
JV
Sisante
a 1 Department of Physical Therapy and Rehabilitation Science.
Anna E
AE
Mattlage
a 1 Department of Physical Therapy and Rehabilitation Science.
Abdulfattah S
AS
Alqahtani
b 2 Department of Neurology.|c 3 Department of Radiology , University of Kansas Medical Center , Kansas City , KS , USA.
Michael G
MG
Abraham
b 2 Department of Neurology.|d 4 University of Kansas Hospital , Kansas City , KS , USA.
Marilyn M
MM
Rymer
e 5 Department of Neurosurgery , University of Kansas Medical Center , Kansas City , KS , USA.
Paul J
PJ
Camarata
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001916:Brachial Artery / Q000378:metabolism*; D016022:Case-Control Studies; D003583:Cytokinins / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D051437:Renal Insufficiency / Q000209:etiology; D020521:Stroke / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism*
D003583:Cytokinins; D019010:Vascular Cell Adhesion Molecule-1
Flow-mediated dilation; acute stroke; inflammatory markers; vascular endothelial function