Study of the difference in vasodilatation of the brachial artery between three types of cerebral infarction by the flow-mediated dilatation (FMD) method

We investigated endothelial function in 2 1 patients with ischemic stroke (mean age 63 years ; 5 with athero-thrombotic stroke, 14 with lacunar stroke. 2 with cardioembolic stroke)and 20 healthy control subjects (mean age 32 years)using the flow-mediated dilatation (FMD) method. To create a flow stimulus in the brachial artery, a sphygmomanometer cuff was placed above the brachium. The cuff was inflated to at least 30 mmHg above systolic blood pressure for 4.5 min, and then released. Using ultrasonography, we measured the degree of vasodilation of the brachial artery after deflation (%FMD). Maximum %FMD was significantly low in patients with atherothrombotic stroke (5.3±1.5%, p = 0.001)and lacunar stroke (7.6±2.1%, p = 0.01), whereas no significant decrease was observed in patients with cardioembolic stroke (8.4±1.0%, p = 0.26)compared with controls (9.7±2.7%). Among patients with lacunar stroke. %FMD was significantly lower in patients with than in those without diabetes mellitus (DM)(5.3±1.8% vs 8.8±0.6%, p = 0.005). These results indicate that patients with atherothrombotic stroke and lacunar stroke. especially those with DM, have endothelial dysfunction.