ReviewEndocrine abnormalities and outcome of ischaemic stroke
Section snippets
Endothelins
Endothelins (ETs) are 21 amino-acid peptides produced in many different tissues. Discovered as products of the vascular endothelium 〚10〛, these peptides have now been shown to be produced in blood vessels by smooth muscle cells 〚11〛 and elsewhere by others cells in different tissues. Genes have been cloned for 3 ETs, ET-1, -2, -3 〚12〛, and for 2 ET receptor subtypes, ETA 〚13〛 and ETB 〚14〛. ETS, mainly ET-1, are potent and long-lasting vasoconstrictors, and it is generally accepted that
Arginine vasopressin
Experimental evidence indicates that arginine vasopressin (AVP), produced in the hypothalamic paraventricular and supraoptic nuclei, in addition to its primary physiological action as a water-retaining hormone, plays an important role in regulating brain volume and electrolyte homeostasis and microvascular resistance in ischaemic cerebral tissue 42, 43. These findings suggest that an alteration of hypothalamic AVP secretion in stroke patients may affect the severity and outcome of the cerebral
Hypothalamus-Pituitary Adrenocortical Axis
Increased activity of the hypothalamic-pituitary-adrenal axis (HPAA), as well as of the sympatho-adrenal system, is commonly seen in various forms of acute stress, including stroke 54, 55. Hypercortisolism per se has potentially serious side effects on many organ systems 〚54〛, and a higher mortality rate has been described in stroke patients with a higher stress response, as measured by plasma cortisol levels and cathecolamine excretion 〚55〛. Furthermore, cognitive disturbances have been
Leptin
Leptin, a recently identified circulating hormone secreted by the adipocytes as a product of the obese (OB) gene, seems to play a crucial role in the regulation of body weight in mammals 〚80〛. In humans, leptin is thought to act as a satiety hormone 〚81〛 in a feedback loop linking food ingestion, the hypothalamus, and adipocyte tissue mass 〚82〛. Although serum leptin levels vary considerably amongst individuals 〚83〛, several findings indicate that leptin secretion is mainly correlated with body
Conclusions
Endocrine abnormalities are common and often profound after stroke. The possibility that increased levels of some hormones, namely ET-1, AVP and cortisol, play an important role in aggravating the neurological deficit and outcome of stroke, deserves further investigation. The pathophysiological mechanisms involved may be several, including a direct effect on the development of neuronal cell death, constriction of collateral vessels with further reduction in regional blood flow, and development
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Comparing the effect of arginine vasopressin on ear and finger photoplethysmography
2008, Journal of Clinical AnesthesiaCitation Excerpt :There is evidence that isolated human cerebral arteries constrict when exposed to varying concentrations of AVP [7]. In addition, patients who have had a recent ischemic stroke show high plasma levels of endogenous AVP when compared with controls [8]. Because an increasing number of cardiac arrest victims receive AVP as part of resuscitation algorithms, it becomes important to develop ways to detect physiological changes related to AVP administration.
Predictive value of circulating insulin-like growth factor I levels in ischemic stroke outcome
2006, Journal of Clinical Endocrinology and MetabolismStress hyperglycemia increases short-term mortality in acute ischemic stroke patients after mechanical thrombectomy
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