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Endothelial function in lacunar infarction: a comparison of lacunar infarction, cerebral atherosclerosis and control

Jin-Seok Kim1, Hak-Seung Lee, Hyun-Young Park

  • 1Department of Neurology, Wonkwang University School of Medicine, Jeonbuk, South Korea.

Cerebrovascular Diseases (Basel, Switzerland)
|June 27, 2009
PubMed

Insights

Endothelial function, measured by flow-mediated dilatation (FMD), is impaired in patients with lacunar infarction, suggesting pure endothelial dysfunction. Nitrogen-mediated dilatation (NMD) showed no significant difference, indicating specific damage to the endothelium in these patients.

Area of Science:

  • Neurology
  • Vascular Biology
  • Cardiology

Background:

  • Conflicting evidence exists regarding endothelial function in lacunar infarction.
  • Risk factors may influence vascular smooth muscle, complicating assessments.
  • This study isolates endothelial function in lacunar infarction patients.

Purpose of the Study:

  • To evaluate endothelium-dependent and -independent vasodilation in lacunar infarction patients.
  • To differentiate endothelial dysfunction from other vascular effects.
  • To compare endothelial function in lacunar infarction with controls.

Main Methods:

  • Enrolled patients with lacunar infarction (clinical and MRI confirmed).
  • Used a control group of age/sex-matched hypertensive patients without stroke or vascular disease.
  • Assessed endothelial function via brachial artery flow-mediated dilatation (FMD) and nitrogen-mediated dilatation (NMD) using high-resolution ultrasound.

Main Results:

  • Flow-mediated dilatation (FMD) was significantly lower in lacunar infarction patients (6.6%) compared to controls (12.2%, p=0.000).
  • Nitrogen-mediated dilatation (NMD) showed no significant difference between groups (14.3% vs 13.8%, p=0.37).
  • FMD was similarly low in lacunar infarction patients with and without intracranial stenosis.

Conclusions:

  • Lacunar infarction is associated with impaired endothelial function, indicated by reduced FMD.
  • The similar NMD suggests specific endothelial dysfunction, not generalized vascular smooth muscle issues.
  • Endothelial dysfunction in lacunar infarction is comparable in severity to that seen in intracranial arterial stenosis.
Abstract

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