Twenty-four-hour beta-endorphin secretory pattern in stroke patients.

Franceschini, R.; Gandolfo, Carlo; Cataldi, A.; Sette, Massimo Del; Cianciosi, P; Finocchi, Cinzia; Rolandi, E; Barreca, T

doi:10.1161/01.str.25.11.2142

Cited by 24 publications

(12 citation statements)

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“…Abnormalities in various hormonal systems, particularly in the hypothalamic-pituitary-adrenal axis with increased activity [28, 29, 30, 31], are described after early stroke. A high level of cortisol is found in patients with acute stroke compared to age- and sex-matched healthy normal controls [32, 33, 34]. About 70% of patients in this study had high and/or abnormal cortisol levels, and these patients had a statistically significantly higher SBP than patients with normal cortisol levels.…”

Section: Discussionmentioning

confidence: 70%

Salivary Cortisol, a Biological Marker of Stress, Is Positively Associated with 24-Hour Systolic Blood Pressure in Patients with Acute Ischaemic Stroke

2004

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Background/Aim: The cause of elevated blood pressure (BP) in acute stroke is unknown. Stress is often suggested as a main contributing factor. We aimed to investigate the relationship between BP and stress in patients with acute stroke. Methods: 58 patients with clinical symptoms of stroke were recruited prospectively after exclusion of haemorrhage by CT scan within 14 h and 15 min (mean) after symptom onset (range 2 h and 45 min–23 h and 40 min). The mean age of the patients was 66 years (range 39–86 years), and the mean National Institute of Health Stroke Scale score was 7 (range 1–26). BP and pulse rate were recorded by non-invasive automatic monitoring hourly for 24 h. Stress was evaluated by testing the level of salivary cortisol. Four samples of saliva were obtained at inclusion, on the evening of the inclusion day (20.00–22.00 h), on the morning of the next day (7.00–9.00 h) and on the afternoon of the inclusion day/next day (15.00–17.00 h) within 24 h after inclusion in the study. Logarithmic transformation was done for cortisol levels. Results: The 24-hour mean cortisol level (geometric mean 13.6 nmol/l) was related to 24-hour mean systolic BP [SBP; r = 0.36, p = 0.01, multivariate p = 0.02], mean night-time (22.00–6.00 h) SBP (r = 0.43, p = 0.001, multivariate p < 0.005) and mean night-time diastolic BP (r = 0.31, p = 0.02, multivariate p = 0.02). Cortisol levels at inclusion (r = 0.31, p = 0.02, multivariate p = 0.05 for 24-hour SBP) and in the evening were also statistically significantly related to the above BP variables. The morning cortisol (r = 0.28, p = 0.04, multivariate p = 0.04) was related to night-time SBP. Conclusions: Salivary cortisol was positively correlated with 24-hour SBP and night-time BP, suggesting that stress is a contributing factor for high BP in acute stroke.

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Section: Discussionmentioning

confidence: 70%

Salivary Cortisol, a Biological Marker of Stress, Is Positively Associated with 24-Hour Systolic Blood Pressure in Patients with Acute Ischaemic Stroke

2004

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“…Single measurement s-cortisol was chosen as a previous study has shown that a circadian rhythm cannot be demonstrated in acute stroke [18]. …”

Section: Methodsmentioning

confidence: 99%

Serum Cardiac Troponin I in Acute Stroke Is Related to Serum Cortisol and TNF-α

et al. 2004

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Background: Serum cardiac troponin I (cTnI) is a specific marker of myocardial injury related to in-patient fatality and cardiac injury in acute stroke. We investigated whether cTnI in acute stroke is related to serum cortisol, acute inflammatory response, and insular damage. We also investigated whether cTnI predicted outcome at 3 months. Patients and Methods: The study was based on 155 patients with CT-confirmed acute cerebral infarction and study inclusion within 24 h (50% within 12 h) of stroke onset. Blood samples were obtained on inclusion. Stroke severity was assessed by the Scandinavian Stroke Scale (SSS) and outcome was assessed by the modified Rankin Scale (mRS), death or dependency was defined as mRS ≧3 three months after stroke. Results: 35% of all patients and 63% of patients who died within 3 months were troponin positive. Tumor necrosis factor-α (TNF-α) and cortisol were independently related to detection of cTnI: TNF-α_{+100 pg/ml} OR 1.5 (CI 95% 1.1–2.2), cortisol_{+100 nmol/l} OR 1.1 (CI 95% 1.01–1.2). SSS and age were also included in this model and did not reach significance. cTnI positivity was, together with age, stroke severity and prestroke mRS, but not s-cortisol, an independent explanatory variable of outcome at 3 months (death or dependency) with OR 4.1 (CI 95% 1.1–14.5). cTnI did not relate to insular involvement. Conclusion: In this study, cortisol and TNF-α were independently related to cTnI, which was predictive of 3-month prognosis.

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“…It has also been observed that the normal circadian rhythm of cortisol is suspended during acute stroke as equal levels of cortisol were found round the clock [15].…”

Section: Introductionmentioning

confidence: 99%