Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis
Abstract Background Early neurological deterioration (END) occurs in individuals who had experienced acute ischemic stroke (AIS), impacting long-term functional outcomes. We aimed to investigate the association between endothelial function, measured via flow-mediated dilation (FMD), and END in patie...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12883-025-04048-0 |
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| author | Sang Hee Ha Bo Hye Yoon Bon Gook Koo Dong Hoon Shin Yeong-Bae Lee Bum Joon Kim |
| author_facet | Sang Hee Ha Bo Hye Yoon Bon Gook Koo Dong Hoon Shin Yeong-Bae Lee Bum Joon Kim |
| author_sort | Sang Hee Ha |
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| description | Abstract Background Early neurological deterioration (END) occurs in individuals who had experienced acute ischemic stroke (AIS), impacting long-term functional outcomes. We aimed to investigate the association between endothelial function, measured via flow-mediated dilation (FMD), and END in patients with AIS. Methods We retrospectively reviewed patients who had experienced AIS within 7 days of stroke onset and underwent FMD assessments during their hospitalization (%FMD = Peak diameter − baseline diameter)/baseline diameter x 100). END was defined as ≥ 2-point increase in the National Institutes of Health Stroke Scale total score or ≥ 1-point increase in the motor score within 72 h post-stroke. Through multivariate analysis, we examined factors associated with END and explored the relationship between FMD and END with considering stroke mechanisms. Results Among 1,262 patients diagnosed with AIS, 184 (14.6%) experienced END. Those with END were on average older (69 ± 13 vs. 67 ± 13 years; P = 0.033), had a higher prevalence of stroke history (21.2 vs. 12.9%; P = 0.003), and lower FMD (5.0 ± 1.8 vs. 5.4 ± 2.2%; P = 0.029). Multivariate analysis revealed that a history of stroke (adjusted odds ratio [aOR] = 1.728; 95% confidence interval [CI] 1.159–2.578; P = 0.007) and low % were independently associated with END. Subgroup analysis revealed that low %FMD was significantly associated with END within the small vessel disease (SVD) category (aOR = 0.789; 95% CI 0.679–0.920; P = 0.002). Conclusions Impaired FMD may be associated with END, particularly within the context of SVD. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-2377 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Neurology |
| spelling | doaj-art-0f5a3de7a8834ea59bf53f66b027f2662025-02-09T12:43:06ZengBMCBMC Neurology1471-23772025-02-012511710.1186/s12883-025-04048-0Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysisSang Hee Ha0Bo Hye Yoon1Bon Gook Koo2Dong Hoon Shin3Yeong-Bae Lee4Bum Joon Kim5Department of Neurology, Gil Medical Center, Gachon University College of MedicineDepartment of Neurology, Gil Medical Center, Gachon University College of MedicineDepartment of Neurology, Gil Medical Center, Gachon University College of MedicineDepartment of Neurology, Gil Medical Center, Gachon University College of MedicineDepartment of Neurology, Gil Medical Center, Gachon University College of MedicineDepartment of Neurology, Asan Medical Center, University of Ulsan College of MedicineAbstract Background Early neurological deterioration (END) occurs in individuals who had experienced acute ischemic stroke (AIS), impacting long-term functional outcomes. We aimed to investigate the association between endothelial function, measured via flow-mediated dilation (FMD), and END in patients with AIS. Methods We retrospectively reviewed patients who had experienced AIS within 7 days of stroke onset and underwent FMD assessments during their hospitalization (%FMD = Peak diameter − baseline diameter)/baseline diameter x 100). END was defined as ≥ 2-point increase in the National Institutes of Health Stroke Scale total score or ≥ 1-point increase in the motor score within 72 h post-stroke. Through multivariate analysis, we examined factors associated with END and explored the relationship between FMD and END with considering stroke mechanisms. Results Among 1,262 patients diagnosed with AIS, 184 (14.6%) experienced END. Those with END were on average older (69 ± 13 vs. 67 ± 13 years; P = 0.033), had a higher prevalence of stroke history (21.2 vs. 12.9%; P = 0.003), and lower FMD (5.0 ± 1.8 vs. 5.4 ± 2.2%; P = 0.029). Multivariate analysis revealed that a history of stroke (adjusted odds ratio [aOR] = 1.728; 95% confidence interval [CI] 1.159–2.578; P = 0.007) and low % were independently associated with END. Subgroup analysis revealed that low %FMD was significantly associated with END within the small vessel disease (SVD) category (aOR = 0.789; 95% CI 0.679–0.920; P = 0.002). Conclusions Impaired FMD may be associated with END, particularly within the context of SVD.https://doi.org/10.1186/s12883-025-04048-0Early neurological deteriorationFlow-mediated dilationAcute ischemic strokeSmall vessel disease |
| spellingShingle | Sang Hee Ha Bo Hye Yoon Bon Gook Koo Dong Hoon Shin Yeong-Bae Lee Bum Joon Kim Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis BMC Neurology Early neurological deterioration Flow-mediated dilation Acute ischemic stroke Small vessel disease |
| title | Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis |
| title_full | Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis |
| title_fullStr | Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis |
| title_full_unstemmed | Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis |
| title_short | Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis |
| title_sort | association between impaired brachial flow mediated dilation and early neurological deterioration in acute ischemic stroke a retrospective analysis |
| topic | Early neurological deterioration Flow-mediated dilation Acute ischemic stroke Small vessel disease |
| url | https://doi.org/10.1186/s12883-025-04048-0 |
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