Influence of Atorvastatin Treatment on
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            -Arginine Cerebrovascular Reactivity and Flow-Mediated Dilatation in Patients With Lacunar Infarctions

Oblak, Janja Pretnar; Šabovič, Mišo; Šebeštjen, Miran; Pogačnik, Tomaž; Zaletel, Marjan

doi:10.1161/01.str.0000239659.99112.fb

Cited by 76 publications

(82 citation statements)

References 21 publications

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“…Recently, a new study made by Pretnar-Oblak et al showed that atorvastatin had improved endothelial functions not only on peripheral arterial system but also on central nervous [14]. The results of our study have shown that treatment with 10 mg atorvastatin daily for a six week period resulted in a statisticaly significant improvement of flow mediated and nitroglycerin induced dilatation in type 2 diabetic patients with average lipid levels.…”

Section: Discussionsupporting

confidence: 61%

Short Term Effects of Atorvastatin on Endothelial Functions and Oxidized LDL Levels in Patients with Type 2 Diabetes

et al. 2008

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Abstract. Objective: This study was designed in order to investigate the short term effects of atorvastatin on endothelial function and oxidized LDL (oxLDL) levels and to evaluate the association of endothelial dysfunction to oxLDL levels and inflammatory markers in type 2 diabetic patients. Material and Methods: Thirty type 2 diabetic and 11 healthy subjects with LDL levels between 100-160 mg/dl. without a history of cardiovascular event were included in the study. Both groups were matched with respect to age, gender, body mass indices and lipid levels. Flow-mediated dilatation (endothelium dependent, FMD) and nitroglycerine-induced dilatation (endothelium independent, NID) were measured in the brachial artery using high-resolution ultrasound in all participants and carotid artery intima media thickness (IMT) were also evaluated. OxLDL levels, lipid parameters, blood glucose, C-peptide, HbA1c and inflammatory markers including C-reactive protein (CRP), fibrinogen, erythrocyte sedimentation rate (ESR) were studied. Type 2 diabetic patients received 10 mg. Atorvastatin for 6 weeks and FMD and NID were reevaluated and oxLDL levels and inflammatory markers remeasured. Results: Basal FMD, NID, IMT and oxLDL levels besides inflammatory markers were not significantly different between patients and controls. No correlation was found between inflammatory markers and FMD and NID. Only IMT correlated with fibrinogen levels obtained before treatment. In non-diabetics, IMT also correlated with oxLDL levels (p: 0.013). FMD and NID significantly improved after atorvastatin therapy ((7.62 ± 7.6 vs. 12.65 ± 7.8, p<0.001 and 18.22 ± 9.57 vs. 21.43 ± 9.6, p: 0.007, respectively). Atorvastatin significantly reduced oxLDL levels (57.85 ± 10.33 vs. 44.36 ± 6.34, p<0.001). Conclusion: Atorvastatin improves endothelial functions and reduces oxLDL levels in type 2 diabetics with average lipid levels in the short term and may have beneficial effects in the prevention of early atherosclerotic changes.

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Section: Discussionsupporting

confidence: 61%

Short Term Effects of Atorvastatin on Endothelial Functions and Oxidized LDL Levels in Patients with Type 2 Diabetes

et al. 2008

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“…Most papers excluded patients with carotid stenosis (except 1 30 ), 5 excluded cardiogenic sources of emboli, 32,33,36,38,41 and 3 excluded middle cerebral artery (MCA) stenosis 35,39,40 from the lacunar stroke group.…”

Section: Characteristics Of Included Patients and Control Subjectsmentioning

confidence: 99%

“…30,32,39,40,42 Three studies recruited age-and risk-factor matched control subjects (with longstanding hypertension and hypercholesterolemia in 2 32,34 ; with hypertension only in 1 43 ). Five papers compared patients with lacunar ischemic stroke with patients with cortical ischemic stroke, 35,37,38,42,44 confirming the infarct subtype with CT or MRI.…”

Section: Characteristics Of Included Patients and Control Subjectsmentioning

confidence: 99%

A Systematic Review of Dynamic Cerebral and Peripheral Endothelial Function in Lacunar Stroke Versus Controls

Stevenson

Doubal

Shuler

et al. 2010

Stroke

104

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Background and Purpose-The etiology of cerebral small vessel disease is unknown. An association with endothelial dysfunction has been suggested. We systematically assessed all relevant studies of dynamic endothelial function in patients with lacunar stroke as a marker of small vessel disease. Methods-We searched for studies of cerebral or peripheral vascular reactivity in patients with lacunar or cortical (ie, large artery atheromatous) ischemic stroke or nonstroke control subjects. We calculated standardized mean difference (SMD) in vascular reactivityϮ95% CIs between small vessel disease and control groups. Results-Sixteen publications (974 patients) were included. In lacunar stroke, cerebrovascular reactivity (nϭ534) was reduced compared with age-matched normal (SMD Ϫ0.94, 95% CI Ϫ1.17 to Ϫ0.70), but not ageϩrisk factor-matched control subjects (SMD 0.08, 95% CI Ϫ0.36 to 0.53) or cortical strokes (SMD Ϫ0.29, 95% CI Ϫ0.69 to 0.11); forearm flow-mediated dilatation (nϭ401) was reduced compared with age-matched normal control subjects (SMD Ϫ1.04, 95% CI Ϫ1.33 to Ϫ0.75) and ageϩrisk factor-matched control subjects (SMD Ϫ0.94, 95% CI Ϫ1.26 to Ϫ0.61), but not cortical strokes (SMD Ϫ0.23, 95% CI Ϫ0.55 to 0.08). Conclusions-Endothelial dysfunction is present in patients with lacunar stroke but may simply reflect exposure to vascular risk factors and having a stroke, because a similar degree of dysfunction is found in cortical (large artery atheromatous) stroke. Current data do not confirm that endothelial dysfunction is specific to small vessel stroke. Future studies should include control subjects with nonlacunar stroke. (Stroke. 2010;41:e434-e442.)

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“…Treatment with Atorvastatin has shown an improvement of FMD values in patients with lacunar infarcts and patients with risk factors but without stroke [25]. One study showed than endothelial nitric oxide synthase gene is a modifier of the cerebral response to ischemia [26] and in obese patients the endothelial function is related with thrombolysis [27].…”

Section: Discussionmentioning

confidence: 99%

Endothelial Function In Stroke Subtypes Using EndoPAT Technology.

Caballero

Espuela

Portilla-Cuenca

et al. 2015

JNRT

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:Background : Endothelial function is characterized by the vasodilator capacity of blood vessel smooth muscle cells mediated by nitric oxide. Some studies have shown an inverse association between the endothelial function and the carotid intima-media thickness (IMT). The relationship between endothelial dysfunction and stroke based on several studies has shown that is altered in all stroke subtypes especially lacunar strokes. Methods :We aimed to investigate endothelial function by EndoPAT device in relation to stroke subtypes.We investigate too the correlations between endothelial function and IMT and we study possible interactions with age, sex, traditional risk factors and severity of stroke. Subsequent patients with acute ischemic stroke were enrolled. They were divided according with the etiological mechanism of stroke (TOAST classification).Endothelial function was assessed with finger plethysmography by the EndoPAT device that gave Reactive Hyperemia Index (RHI) and Augmentation Index (AI).Results : Patients with a cardioembolic stroke had a RHI higher than atherotrombotic or lacunar stroke.There was a negative correlation between RHI and IMT and positive between AI and age. Conclusions:The endothelial function is different between stroke subtypes with higher values of RHI in the cardioembolic respect to lacunar or atherotrombotic. The RHI is correlated with the atherosclerosis by the negative relationship with the IMT. The AI that shows the rigidity in the arteries increased with the age.

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Influence of Atorvastatin Treatment on l -Arginine Cerebrovascular Reactivity and Flow-Mediated Dilatation in Patients With Lacunar Infarctions

Cited by 76 publications

References 21 publications

Short Term Effects of Atorvastatin on Endothelial Functions and Oxidized LDL Levels in Patients with Type 2 Diabetes

Short Term Effects of Atorvastatin on Endothelial Functions and Oxidized LDL Levels in Patients with Type 2 Diabetes

A Systematic Review of Dynamic Cerebral and Peripheral Endothelial Function in Lacunar Stroke Versus Controls

Endothelial Function In Stroke Subtypes Using EndoPAT Technology.

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