Assessment of Vessel Wall Endothelial Function In lschaemic Cerebrovascular Stroke: Clinical, Laboratory and Imaging Studies

Abstract

Endothelial dysfunction (ED) has_ been reported to be the initial step in the atherosclerotic process and subsequently leads to the development of cerebrovascular stroke (CVS). This study was performed to determine the endothelial function in patients with CVS and relation ofvWF to the endothelial function and whether it is a predictor of stroke. We studied 50 patients with recent CVS (mean age 50± 9) and compared them to 27 age-matched controls. All patients and controls performed brachial artery Duplex to measure the endothelial function (FMD"/o), carotid artery Duplex to measure the intima-medial thickness (IMT) and a laboratory work-up (including: von willebrand factor [vWF], tissue plasminogen activator (t-PA), fibrinogen and factor VII). We found that the patient group had a significantly higher vWF level (p = 0.02), lower t-PA level (p = 0.000), lower FMD% (p = 0.000) and a higher IMT (p = 0.04). By logistic regression we found that vWF, t-PA, cholesterol levels, diastolic blood pressure and FMD% were predictors of CVS. Conclusion: ED is found in the majority of patients with CVS, also vWF is significantly elevated in these patients. The presence of ED and elevated vWF levels are significant predictors of acute CVS.