Hemorheologic factors in the postacute phase of ischemic stroke

Correlation Between Hemorheologic Parameters and Carotid Atherosclerosis in Stroke

An evaluation of the hemorheologic parameters and an ultrasonographic study of the extracranial carotid tract were performed on 48 patients, age range: sixty to seventy-five years, affected by acute stroke, 23 of whom had hypertension, while 27 were smokers. None of them was suffering from hyperli pidemia, diabetes mellitus, or symptomatic coronary heart or peripheral artery disease.

The echotomographic analysis, using B-mode real-time echotomography re vealed atherosclerotic lesions in 26 patients. The hemorheologic pattern (hema tocrit, fibrinogen, whole blood filterability, whole blood and plasma viscosity) was determined in all the patients three months after the clinical event.

Statistical analysis of the results indicates a possible link between athero sclerotic lesions of the extracranial carotid tract and age, fibrinogen levels, and whole blood filterability.

Worse Neurological State During Acute Ischemic Stroke is Associated with a Decrease in Serum Albumin Levels

High serum albumin levels during ischemic stroke (IS) decrease the risk of a poor outcome. This study aimed to determine whether serum albumin levels within the first days after IS correlate with radiological and biochemical markers of brain tissue damage. Fifty-six IS patients were enrolled into the study. Neurological examinations were based on the National Institute of Health Stroke Scale. Serum albumin levels and S100BB were evaluated using commercially available ELISA kits. The albumin decrease index (ADI) was calculated as the difference between serum albumin levels measured on days 1 and 10 of IS. All parameters were estimated on the 1st, 3rd, 5th, and 10th days of IS, and the volume of ischemic focus was measured on the 10th day. Mean serum albumin levels were decreased during acute IS. There were correlations between the ADI and mean S100BB serum levels (r = 0.36, p < 0.05), the volume of ischemic focus (r = 0.39, p < 0.05), and the patients’ neurological state when measured on day 10 of IS (r = 0.59, p < 0.001). A decrease in serum albumin levels during the acute phase of IS corresponds to a worse neurological state as a result of a large ischemic focus with intense catabolic processes.

Pentagastrin-induced hemoconcentration in healthy volunteers and patients with panic disorder: effect of pretreatment with ethinyl estradiol

Panic disorder has been associated with both an increased risk of coronary events as well as an increased risk of stroke. Hemoconcentration, with both a decrease in plasma volume and an increase in plasma viscosity, is a possible contributor to the risk of acute ischemic events. Our objectives were to demonstrate the process of hemoconcentration in response to induced panic symptoms and to assess the effect of pretreatment with ethinyl estradiol on panic-induced hemoconcentration. Fifteen male patients with panic disorder and 10 male healthy volunteers were included in a double-blind cross-over placebo-controlled design consisting of two injections of pentagastrin following randomized pretreatment with placebo and ethinyl estradiol. Plasma levels of hematocrit and hemoglobin were assessed at baseline and post-injections, and used to calculate an indirect estimation of the change in plasma volume. Pentagastrin-induced panic symptoms were associated with a mean decrease in plasma volume of 4.8% in the placebo pretreatment condition. Pretreatment with ethinyl estradiol attenuated this effect. The acute hemoconcentration observed in relation to pentagastrin-induced panic symptoms may be relevant to the increased risk of stroke and acute coronary events found in patients with panic disorder.