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The Relationship Between Endothelin‐1, Event‐Related P300 Potentials, and Prognosis in Cerebral Arteriosclerosis
Author(s) -
Kügler Christian F.A.,
Funk H.,
Vlajic P.,
Platt D.
Publication year - 1997
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1997.tb05166.x
Subject(s) - medicine , cardiology , stenosis , carotid endarterectomy , arteriosclerosis , blood pressure , endothelin 1 , surgery , receptor
OBJECTIVES: To search for a potential role of endothelin‐1 (ET‐1), a potent vasoconstrictor and presumably neurotoxic 21‐amino acid peptide, for dysfunction of brain signal processing and cerebrovascular morbidity in nondemented patients with cerebral arteriosclerosis. DESIGN: Cross‐sectional study with longitudinal follow‐up. SETTING: University‐affiliated teaching hospital. PARTICIPANTS: A total of 106 nondemented patients with significant stenosis of either the internal carotid (cAD, cases; n = 63, mean age ± SD, 62 ± 7 years) or peripheral arteries (pAD, disease controls; n = 43, 60 ± 11 years) were investigated before carotid endarterectomy and bypass surgery, respectively. After a mean follow‐up of about 19 months, cerebrovascular morbidity of the cAD and pAD patients was evaluated by phone. MEASUREMENTS: Brain signal processing functions by event‐related visual P300 potentials; cerebrovascular events by a structured telephone interview; the extent of arteriosclerosis by venous ET‐1 concentration. RESULTS: Venous ET‐1 levels were elevated in both cAD and pAD patient groups, but to the same degree. In these patients, ET‐1 concentration was correlated slightly with diastolic blood pressure ( r = .334, P = .0326, stepwise regression). Only in cAD patients with ET‐1 levels above the 75th percentile were P300 latencies markedly prolonged compared with their lower ET‐1 level counterparts. Furthermore, the P300 latencies of the cAD patients, but not of the pAD patients, correlated positively with venous ET‐1 concentration and inversely with pack years of smoking ( r = .728, P = .0002; stepwise regression). In contrast to base‐line P300 abnormalities and classical risk factors (e.g., hypertension), high ET‐1 levels predicted an increased cerebrovascular morbidity of cAD, but not of pAD, patients ( P = .0044; Mantel‐Cox test). CONCLUSIONS: In nondemented patients with cerebral arteriosclerosis, endothelin‐1 is associated with P300 abnormalities reflecting subclinical dysfunction of brain signal processing. In the long‐term, high venous ET‐1 levels also appear to predict a higher cerebrovascular morbidity of cAD patients even after carotid endarterectomy.