Endothelial Function is impaired in Patients with Different Clinical Manifestations of Severe Cerebral Small Vessel Disease: Preliminary Results of SHEF-CSVD Study

Background: Endothelial functions in patients with different clinical manifestations of cerebral small vessel disease (CSVD) have not yet been thoroughly described. Aim: The aim of the single center, prospective study being a part of SHEF-CSVD Study was to evaluate haemostatic factors and vascular reactivity reflecting endothelial function in different clinical manifestations of CSVD. Methods: 107 patients with extensive MRI features of CSVD with recent lacunars stroke (LS), vascular Parkinsonism (VaP) or vascular dementia (VaD) and 32 controls (CG) matched for age and vascular risk factors were prospectively recruited. Blood markers of endothelial dysfunction and inflammation (thrombomodulin, uric acid, homocysteine and hs CRP), brachial artery flow-mediated dilatation (FMD) test were determined. Results: Patients with CSVD compared to CG had significantly decreased FMD (6,9?0,05% vs 12,0?0,05, p<0,001); increased levels of hsCRP (0,8?0,02 vs 0,17?0,1 mg/L; p=0,03), homocysteine (15,3?8,1 vs 12,5?3,2 μmol/L; p=0,04) and thrombomodulin (5,4?1,7 vs 4,5?0,9 ng/mL, p=0,009). There was also a trend towards increased levels of uric acid in CSVD compared with CG (5,9?1,7 vs 5,4?1,1 mg/dL, p=0,08). No significant differences in analyzed factors were observed among LS, VaP and VaD patients. Conclusion: Similar impairment of the cerebral microvasculature and endothelial function is present in different manifestations of CSVD compared to vascular risk factors matched control group.