The relationship of pro-inflammatory markers to vascular endothelial function after acute stroke

Abstract

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. Materials and Methods Vascular endothelial function was assessed by flow-mediated dilation (FMD) in the brachial artery within 72 hours 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, −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.

Blunted cerebrovascular response is associated with elevated beta-amyloid

“…Participants first completed health history questionnaires and were classified as having low, moderate, or high cardiovascular risk according to American College of Sports Medicine criteria. 26 The laboratory room for the experimental session was dimly lit, quiet, and temperature maintained between 22 and 24 C. 27,28 External stimuli were kept to a minimum during the testing session. 29 The left MCA was used for the transcranial Doppler (TCD) ultrasound with a 2-MHz probe (RobotoC2MD, Multigon Industries) placed over the temporal window and fixed in place using a robotic TCD headpiece.…”

Serum-Based Proteomics Reveals Lipid Metabolic and Immunoregulatory Dysregulation in Cervical Artery Dissection With Stroke

“…Vascular cell adhesion molecule 1, as a proinflammatory marker, plays a crucial role in the initiation of inflammatory mechanisms soon after cerebral damage and promotes migration of immune cells across the blood-brain barrier within the cerebral parenchyma (20). Vascular cell adhesion molecule 1 has been reported to be increased early after stroke (21) and may influence peripheral mechanisms such as cell adhesion-regulated processes and may lower nitric oxide (NO) release in the vessels, thereby contributing to decreased vascular endothelial function. Furthermore, VCAM1 has also been found to be associated with impaired endothelial dependent dilation in cerebral artery vasoreactivity, early after stroke with poor prognoses (22).…”

Vascular Health is Associated with Amyloid-β in Cognitively Normal Older Adults

“…FMD is calculated as the peak increase in arterial diameter from the baseline value in response to an acute increase in blood flow (reactive hyperemia) and expressed as percent change [27,28]. We followed our previous published methods [21,27,29] and adhered to published recommendations for FMD [18]. Participants refrained from caffeinated beverages for 12 h, physical activity for 24 h, and fasted overnight.…”

“…Participants refrained from caffeinated beverages for 12 h, physical activity for 24 h, and fasted overnight. All morning medications for blood pressure were withheld [21]. All study procedures began between 7:30-9:00 am with FMD being conducted first.…”

“…FMD is used as a biomarker of vascular disease [19] and has predictive value for future cardiovascular events [20]. Our prior work has shown that individuals with high cardiovascular risk (stroke, diabetes) and associated cardiovascular risk factors (hypertension, dyslipidemia) have lower brachial artery FMD values [21][22][23] than healthy individuals (low cardiovascular risk) due to deleterious effects on vascular function. Older adults with elevated A␤ (a risk factor for AD) often have higher cardiovascular risk than those non-elevated [21,24,25].…”