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 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.

KEYWORDS:

• Flow-mediated dilation
• vascular endothelial function
• inflammatory markers
• acute stroke

Acknowledgements

We would like to thank Jason Gorup, Alison Boydston and Janice Sandt for their assistance with data collection and entry. We also want to thank the participants for their time and effort on the study.

Declaration of Interests

Sandra A Billinger is supported in part by Eunice Kennedy Shriver National Institute of Child Health and Human Development [grant number K01HD067318]; Jason-Flor V Sisante and Anna E Mattlage were supported in part by Eunice Kennedy Shriver National Institute of Child Health and Human Development [award number T32HD057850]; Anna E Mattlage was also supported in part by American Heart Association [award number 14PRE20040026]; Abdulfattah S Alqahtani was supported in part by funding from King Saud University; this project was supported by an Institutional Clinical and Translational Science Award, NIH/NCATS [grant number UL1TR000001]; this project was supported in part by the Kansas Intellectual and Developmental Disabilities Research Center [grant number P30 HD002528]; REACH laboratory space is supported by the Georgia Holland Endowment Fund.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National Institutes of Health.

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

American Heart AssociationNational Institutes of Health 14PRE20040026 from K01HD067318,P30 HD002528,T32HD057850,UL1TR000001.