Abstract | OBJECTIVES: 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.
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Authors | C F Kügler, H Funk, P Vlajic, D Platt |
Journal | Journal of the American Geriatrics Society
(J Am Geriatr Soc)
Vol. 45
Issue 4
Pg. 427-34
(Apr 1997)
ISSN: 0002-8614 [Print] United States |
PMID | 9100710
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Aged
- Carotid Stenosis
(blood, complications, physiopathology, surgery)
- Cross-Sectional Studies
- Endarterectomy, Carotid
- Endothelin-1
(blood)
- Event-Related Potentials, P300
- Female
- Follow-Up Studies
- Humans
- Intracranial Arteriosclerosis
(blood, complications, mortality, physiopathology)
- Male
- Middle Aged
- Prognosis
- Survival Analysis
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