Τίτλος:
Impaired Arterial Elastic Properties and Endothelial Glycocalyx in Patients with Embolic Stroke of Undetermined Source
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background and Purpose ?Cardioembolism is a postulated mechanism of embolic stroke of undetermined source (ESUS). We investigated endothelial glycocalyx, aortic elastic properties, oxidative stress, and their association with left atrial (LA) function in ESUS and healthy individuals. Methods ?In 90 ESUS patients (age 50.4 ± 13.2) and 90 controls with similar risk factors, we measured: (1) perfused boundary region (PBR) of the sublingual arterial microvessels (range 5-25 μm), a marker inversely related with glycocalyx thickness, (2) pulse wave velocity (PWV), central systolic blood pressure (cSBP), and augmentation index (AIx), (3) LA volume and strain using speckle-tracking imaging, and (4) malondialdehyde (MDA) and protein carbonyls (PCs), as oxidative stress markers. Results ?Compared with controls, ESUS had higher PWV, PBR, MDA, and PC levels as well as higher LA volume and reduced reservoir LA strain (p < 0.05). PBR > 1.2 μm of microvessel ranging from 5 to 9 μm and PWV > 10.2 m/s were associated with ESUS on multivariable analysis (odds ratio: 2.374 and 5.429, p < 0.05, respectively) and increased the c-statistic of the initial model from 0.54 to 0.71. In ESUS, glycocalyx damage (increased PBR) was related with increased PWV (p < 0.01) which was linked with LA reservoir strain after controlling for age, sex, and risk factors (p = 0.03). Increased MDA and PC were related with glycocalyx damage, increased PWV (r = 0.67 and r = 0.52), AIx, cSBP, and aortic atheroma (p < 0.01). Conclusion ?Arterial function and endothelial glycocalyx are severely impaired in ESUS and are linked to LA dysfunction suggesting their contribution to ESUS pathogenesis. © 2019 Georg Thieme Verlag KG Stuttgart · New York.
Συγγραφείς:
Ikonomidis, I.
Frogoudaki, A.
Vrettou, A.-R.
Andreou, I.
Palaiodimou, L.
Katogiannis, K.
Liantinioti, C.
Vlastos, D.
Zervas, P.
Varoudi, M.
Lambadiari, V.
Triantafyllidi, H.
Pavlidis, G.
Efentakis, P.
Tsoumani, M.
Tsantes, A.E.
Parissis, J.
Revela, I.
Andreadou, I.
Tsivgoulis, G.
Περιοδικό:
Thrombosis and Haemostasis
Εκδότης:
Georg Thieme Verlag
Λέξεις-κλειδιά:
angiotensin receptor antagonist; calcium channel blocking agent; carbonyl derivative; dipeptidyl carboxypeptidase; malonaldehyde, adult; aortic elasticity; arterial stiffness; Article; augmentation index; body surface; brain ischemia; cardiac imaging; cardioembolic stroke; cardiovascular function; central systolic blood pressure; comparative study; computed tomographic angiography; computer assisted tomography; controlled study; echocardiography; echography; elasticity; electrocardiogram; embolic stroke of undetermined source; endothelial glycocalyx; female; glycocalyx; heart cycle; heart left ventricle endsystolic diameter; human; magnetic resonance angiography; major clinical study; male; microvasculature; middle aged; neuroimaging; nuclear magnetic resonance imaging; oxidative stress; pathophysiology; priority journal; prospective study; pulse wave; speckle tracking echocardiography; sublingual arterial microvessel; systolic blood pressure; transesophageal echocardiography; aorta; arterial stiffness; atherosclerosis; brain embolism; case control study; cerebrovascular accident; complication; elasticity; endothelium cell; glycocalyx; heart atrium function; heart disease; metabolism; mouth mucosa; pathology; pathophysiology; risk factor; vascularization, Adult; Aorta; Atherosclerosis; Atrial Function, Left; Case-Control Studies; Elasticity; Endothelial Cells; Female; Glycocalyx; Heart Diseases; Humans; Intracranial Embolism; Male; Microvessels; Middle Aged; Mouth Mucosa; Oxidative Stress; Prospective Studies; Risk Factors; Stroke; Vascular Stiffness
DOI:
10.1055/s-0039-1694752
