Application of mathematical modeling methods in the evaluation of severity of ischemic stroke in patients with arterial hypertension

Ryabchenko, A. Yu.; Долгов, А. М.; Денисов, Э. Н.; Kolosova, Natalia Ivanovna

doi:10.17116/jnevro201911912213

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“…Клинические исследования тов [12]. Роль нитроксидергических и эндотелинергических механизмов регуляции вазомоторной функции эндотелия сосудов в остром периоде ИИ остается недостаточно исследованной [13], что обусловливает целесообразность изучения динамики концентраций стабильных метаболитов NO и ET-1 у пациентов с различной тяжестью ИИ. Перспективным также является разработка методов математического моделирования, позволяющих прогнозировать и объективизировать тяжесть и исходы инсульта.…”

Section: Introductionunclassified

The Role of Endothelinergic and Nitroxidergic Reactions in Predicting the Functional Outcome in Patients with Ischemic Stroke of Different Severity

Tynterova,

Moiseeva,

Golubev

et al. 2023

Obŝaâ reanimatologiâ

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The aim of this study was to assess the value of nitric oxide (NO) and endothelin-1 (ET-1) serum concentrations as potential biomarkers for predicting the functional outcome in patients with acute ischemic stroke.Material and methods. A total of 37 patients diagnosed with ischemic stroke and admitted to a multidisciplinary vascular center were included in the study. The patients were divided into two groups based on the severity of neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS): Group 1 consisted of 20 patients with NIHSS scores < 15, and Group 2 consisted of 17 patients with NIHSS scores ≥15. The functional outcome was assessed using the NIHSS absolute values and the degree of disability measured by the Modified Rankin Scale (mRS) by comparing the values before and after baseline treatment. Lab evaluation included quantitative assessment of stable NO and ET-1 metabolites in patient’s serum at admission and on day 10 of hospital stay. The SPSS Statistics V23.0 for Windows software package, Python programming language, and Pandas and SciPy libraries were used for statistical data processing.Results. Group 1 patients demonstrated a statistically significant decrease in NIHSS (p=0.0013) and mRS (p <0.0001) scores, which was indicative of a favorable functional outcome. Group 2 patients showed some recovery of only neurological deficit measured by NIHSS scale (p=0.0012), changes in degree of disability by mRS were statistically insignificant. On Day10 of hospital stay, both groups showed a clinically significant increase in ET-1 content, and slight change in NO concentration. NIHSS score demonstrated a significant negative correlation with baseline ET-1 concentrations: r = - 0,82, p=0,00023— in Group 1; r = - 0,55, p=0,00075 — in Group 2. Modified RS scores showed negative correlation with NO (r = - 0,50, p= 0,00044) and ET-1 (r = - 1,0, p= 0,0074) concentrations in Group 1, and positive correlation with NO (r = 0,55, p= 0,0023) and ET-1 (r = 0,33, p= 0,04) concentrations in Group 2.Conclusion. Monitoring of NO and ET-1 serum concentrations provides valuable insights for personalized assessment of the anticipated functional outcome in patients with cerebral ischemia. Further research and the development of prognostic mathematical models are needed to validate the use of endothelial function markers as predictive indicators of patients' recovery potential during the acute phase of ischemic stroke.

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Section: Introductionunclassified