High plasma glutamate concentrations are associated with infarct growth in acute ischemic stroke
Excitotoxic and inflammatory mechanisms have been demonstrated as mediating early neurologic deterioration (END) in patients with cerebral infarction. Here we investigate whether molecular markers associated with END are related to the volume and outcome of the diffusion weighted image (DWI) lesion...
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| Veröffentlicht in: | Neurology 2008-12, Vol.71 (23), p.1862-1868 |
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| container_title | Neurology |
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| creator | CARSTELLANOS, M SOBRINO, T PEDRAZA, S MOLDES, O PUMAR, J. M SILVA, Y SERENA, J GARCIA-GIL, M CASTILLO, J DAVALOS, A |
| description | Excitotoxic and inflammatory mechanisms have been demonstrated as mediating early neurologic deterioration (END) in patients with cerebral infarction. Here we investigate whether molecular markers associated with END are related to the volume and outcome of the diffusion weighted image (DWI) lesion in acute ischemic stroke.
MRI was performed on admission and at 72 hours in 197 patients with acute hemispheric infarction of |
| doi_str_mv | 10.1212/01.wnl.0000326064.42186.7e |
| format | Article |
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MRI was performed on admission and at 72 hours in 197 patients with acute hemispheric infarction of <12 hours' duration. DWI lesion enlargement was calculated as the absolute difference between volumes on admission and day 3 of evolution. NIH Stroke Scale was scored at the same intervals. END was defined as an increase >/=4 points within the 3 days. Glutamate, l-arginine, interleukin-6 (IL-6), and tumor necrosis factor-alpha levels were analyzed in blood samples obtained on admission.
DWI lesion growth was found in 144 (73%) patients (median increase 38 [6.5, 83.4] cm(3)) and END occurred in 58 (29.4%) patients. Baseline glutamate (r = 0.71), l-arginine (r = -0.35), and IL-6 levels (r = 0.50) showed a high and significant correlation with the DWI lesion enlargement (all p < 0.001). After adjustment for potential confounders, glutamate levels were the only molecular marker associated with DWI lesion enlargement at 72 hours (beta = 0.21; SD = 0.07; p = 0.004).
Molecular markers of early neurologic deterioration may play a role as mediators of lesion growth in cerebral ischemia. Plasma glutamate concentration is the most powerful and independent predictor biomarker of lesion enlargement in the acute phase of ischemic stroke, and so may well be useful as a signature of tissue at risk of infarction.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/01.wnl.0000326064.42186.7e</identifier><identifier>PMID: 18971451</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Arginine - blood ; Biological and medical sciences ; Cerebral Infarction - blood ; Cerebral Infarction - etiology ; Chi-Square Distribution ; Chromatography, High Pressure Liquid - methods ; Diffusion Magnetic Resonance Imaging ; Female ; Glutamic Acid - blood ; Humans ; Image Processing, Computer-Assisted ; Interleukin-6 - blood ; Linear Models ; Male ; Medical sciences ; Neurology ; Retrospective Studies ; Stroke - complications ; Time Factors ; Tumor Necrosis Factor-alpha - blood ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Neurology, 2008-12, Vol.71 (23), p.1862-1868</ispartof><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c378t-2473296be7de8909c77776c24397640d2819576121911d3a40e2aef0f575fb293</citedby><cites>FETCH-LOGICAL-c378t-2473296be7de8909c77776c24397640d2819576121911d3a40e2aef0f575fb293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20977495$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18971451$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CARSTELLANOS, M</creatorcontrib><creatorcontrib>SOBRINO, T</creatorcontrib><creatorcontrib>PEDRAZA, S</creatorcontrib><creatorcontrib>MOLDES, O</creatorcontrib><creatorcontrib>PUMAR, J. M</creatorcontrib><creatorcontrib>SILVA, Y</creatorcontrib><creatorcontrib>SERENA, J</creatorcontrib><creatorcontrib>GARCIA-GIL, M</creatorcontrib><creatorcontrib>CASTILLO, J</creatorcontrib><creatorcontrib>DAVALOS, A</creatorcontrib><title>High plasma glutamate concentrations are associated with infarct growth in acute ischemic stroke</title><title>Neurology</title><addtitle>Neurology</addtitle><description>Excitotoxic and inflammatory mechanisms have been demonstrated as mediating early neurologic deterioration (END) in patients with cerebral infarction. Here we investigate whether molecular markers associated with END are related to the volume and outcome of the diffusion weighted image (DWI) lesion in acute ischemic stroke.
MRI was performed on admission and at 72 hours in 197 patients with acute hemispheric infarction of <12 hours' duration. DWI lesion enlargement was calculated as the absolute difference between volumes on admission and day 3 of evolution. NIH Stroke Scale was scored at the same intervals. END was defined as an increase >/=4 points within the 3 days. Glutamate, l-arginine, interleukin-6 (IL-6), and tumor necrosis factor-alpha levels were analyzed in blood samples obtained on admission.
DWI lesion growth was found in 144 (73%) patients (median increase 38 [6.5, 83.4] cm(3)) and END occurred in 58 (29.4%) patients. Baseline glutamate (r = 0.71), l-arginine (r = -0.35), and IL-6 levels (r = 0.50) showed a high and significant correlation with the DWI lesion enlargement (all p < 0.001). After adjustment for potential confounders, glutamate levels were the only molecular marker associated with DWI lesion enlargement at 72 hours (beta = 0.21; SD = 0.07; p = 0.004).
Molecular markers of early neurologic deterioration may play a role as mediators of lesion growth in cerebral ischemia. Plasma glutamate concentration is the most powerful and independent predictor biomarker of lesion enlargement in the acute phase of ischemic stroke, and so may well be useful as a signature of tissue at risk of infarction.</description><subject>Arginine - blood</subject><subject>Biological and medical sciences</subject><subject>Cerebral Infarction - blood</subject><subject>Cerebral Infarction - etiology</subject><subject>Chi-Square Distribution</subject><subject>Chromatography, High Pressure Liquid - methods</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Female</subject><subject>Glutamic Acid - blood</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Interleukin-6 - blood</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neurology</subject><subject>Retrospective Studies</subject><subject>Stroke - complications</subject><subject>Time Factors</subject><subject>Tumor Necrosis Factor-alpha - blood</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcuKFDEUhoMoTs_oK0gQdFdlbpWLOxnUEQbcKLiLp1OnuqN1aZMUjW9veqaZWXo2IZzvP7efkNectVxw8Y7x9jiPLashhWZatUpwq1uDT8iGd0I3WoofT8mGMWEbaY29IJc5_2KsJo17Ti64dYarjm_Iz5u429PDCHkCuhvXAhMUpGGZA84lQYnLnCkkpJDzEmJN9vQYy57GeYAUCt2l5Xj3pRDWKo057HGKgeaSlt_4gjwbYMz48vxeke-fPn67vmluv37-cv3htgnS2NIIZaRweoumR-uYC6aGDkJJZ7RivbDcdUbX_R3nvQTFUAAObOhMN2yFk1fk7X3dQ1r-rJiLn-okOI4w47Jmr53tFLf8v-Cpj-r0qeL7ezCkJeeEgz-kOEH66znzJyM8474a4R-N8HdGeINV_OrcZd1O2D9Kz5evwJszADnAOCSYQ8wPnGDOGOU6-Q-LXJJs</recordid><startdate>20081202</startdate><enddate>20081202</enddate><creator>CARSTELLANOS, M</creator><creator>SOBRINO, T</creator><creator>PEDRAZA, S</creator><creator>MOLDES, O</creator><creator>PUMAR, J. M</creator><creator>SILVA, Y</creator><creator>SERENA, J</creator><creator>GARCIA-GIL, M</creator><creator>CASTILLO, J</creator><creator>DAVALOS, A</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>20081202</creationdate><title>High plasma glutamate concentrations are associated with infarct growth in acute ischemic stroke</title><author>CARSTELLANOS, M ; SOBRINO, T ; PEDRAZA, S ; MOLDES, O ; PUMAR, J. M ; SILVA, Y ; SERENA, J ; GARCIA-GIL, M ; CASTILLO, J ; DAVALOS, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c378t-2473296be7de8909c77776c24397640d2819576121911d3a40e2aef0f575fb293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Arginine - blood</topic><topic>Biological and medical sciences</topic><topic>Cerebral Infarction - blood</topic><topic>Cerebral Infarction - etiology</topic><topic>Chi-Square Distribution</topic><topic>Chromatography, High Pressure Liquid - methods</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Female</topic><topic>Glutamic Acid - blood</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted</topic><topic>Interleukin-6 - blood</topic><topic>Linear Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neurology</topic><topic>Retrospective Studies</topic><topic>Stroke - complications</topic><topic>Time Factors</topic><topic>Tumor Necrosis Factor-alpha - blood</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CARSTELLANOS, M</creatorcontrib><creatorcontrib>SOBRINO, T</creatorcontrib><creatorcontrib>PEDRAZA, S</creatorcontrib><creatorcontrib>MOLDES, O</creatorcontrib><creatorcontrib>PUMAR, J. M</creatorcontrib><creatorcontrib>SILVA, Y</creatorcontrib><creatorcontrib>SERENA, J</creatorcontrib><creatorcontrib>GARCIA-GIL, M</creatorcontrib><creatorcontrib>CASTILLO, J</creatorcontrib><creatorcontrib>DAVALOS, A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CARSTELLANOS, M</au><au>SOBRINO, T</au><au>PEDRAZA, S</au><au>MOLDES, O</au><au>PUMAR, J. M</au><au>SILVA, Y</au><au>SERENA, J</au><au>GARCIA-GIL, M</au><au>CASTILLO, J</au><au>DAVALOS, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High plasma glutamate concentrations are associated with infarct growth in acute ischemic stroke</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2008-12-02</date><risdate>2008</risdate><volume>71</volume><issue>23</issue><spage>1862</spage><epage>1868</epage><pages>1862-1868</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>Excitotoxic and inflammatory mechanisms have been demonstrated as mediating early neurologic deterioration (END) in patients with cerebral infarction. Here we investigate whether molecular markers associated with END are related to the volume and outcome of the diffusion weighted image (DWI) lesion in acute ischemic stroke.
MRI was performed on admission and at 72 hours in 197 patients with acute hemispheric infarction of <12 hours' duration. DWI lesion enlargement was calculated as the absolute difference between volumes on admission and day 3 of evolution. NIH Stroke Scale was scored at the same intervals. END was defined as an increase >/=4 points within the 3 days. Glutamate, l-arginine, interleukin-6 (IL-6), and tumor necrosis factor-alpha levels were analyzed in blood samples obtained on admission.
DWI lesion growth was found in 144 (73%) patients (median increase 38 [6.5, 83.4] cm(3)) and END occurred in 58 (29.4%) patients. Baseline glutamate (r = 0.71), l-arginine (r = -0.35), and IL-6 levels (r = 0.50) showed a high and significant correlation with the DWI lesion enlargement (all p < 0.001). After adjustment for potential confounders, glutamate levels were the only molecular marker associated with DWI lesion enlargement at 72 hours (beta = 0.21; SD = 0.07; p = 0.004).
Molecular markers of early neurologic deterioration may play a role as mediators of lesion growth in cerebral ischemia. Plasma glutamate concentration is the most powerful and independent predictor biomarker of lesion enlargement in the acute phase of ischemic stroke, and so may well be useful as a signature of tissue at risk of infarction.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>18971451</pmid><doi>10.1212/01.wnl.0000326064.42186.7e</doi><tpages>7</tpages></addata></record> |
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| subjects | Arginine - blood Biological and medical sciences Cerebral Infarction - blood Cerebral Infarction - etiology Chi-Square Distribution Chromatography, High Pressure Liquid - methods Diffusion Magnetic Resonance Imaging Female Glutamic Acid - blood Humans Image Processing, Computer-Assisted Interleukin-6 - blood Linear Models Male Medical sciences Neurology Retrospective Studies Stroke - complications Time Factors Tumor Necrosis Factor-alpha - blood Vascular diseases and vascular malformations of the nervous system |
| title | High plasma glutamate concentrations are associated with infarct growth in acute ischemic stroke |
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