Plasma endothelin-1 as screening marker for cerebral vasospasm after subarachnoid hemorrhage

Bellapart, J., Jones, Lee, Bandeshe, H. and Boots, R. (2014) Plasma endothelin-1 as screening marker for cerebral vasospasm after subarachnoid hemorrhage. Neurocritical Care, 20 1: 77-83. doi:10.1007/s12028-013-9887-1


Author Bellapart, J.
Jones, Lee
Bandeshe, H.
Boots, R.
Title Plasma endothelin-1 as screening marker for cerebral vasospasm after subarachnoid hemorrhage
Journal name Neurocritical Care   Check publisher's open access policy
ISSN 1541-6933
1556-0961
Publication date 2014-02
Year available 2013
Sub-type Article (original research)
DOI 10.1007/s12028-013-9887-1
Open Access Status
Volume 20
Issue 1
Start page 77
End page 83
Total pages 7
Place of publication Totowa, NJ, United States
Publisher Humana Press
Collection year 2014
Language eng
Formatted abstract
Background Cerebral vasospasm complicating subarachnoid hemorrhage causes ischemic stroke and worsens the neurological outcome. The potential role of endothelin-1 in vasospasm pathogenesis may provide therapeutic opportunities. A recent meta-analysis however, did not support the use of endothelin antagonists. Apart from clinical assessment, transcranial Doppler and interval angiography, there are no sensitive screening markers for evolving vasospasm. We investigate the ability of serial measurement of endothelin-1 to predict the development of vasospasm following subarachnoid hemorrhage.

Methods Endothelin-1 levels in cerebrospinal fluid and blood were measured daily in 20 patients admitted to the ICU with subarachnoid hemorrhage from days 1 to 10 following the inception bleed. In addition to clinical assessment, patients had daily transcranial Doppler. Digital subtraction angiography was performed on the suspicion of vasospasm based upon clinical or transcranial Doppler assessment. Neuron-specific enolase and SB100 were measured in blood as comparative biomarkers of neurological injury.

Results Mean plasma endothelin-1 on day 5, was 4.2 mcg/L (CI 3.1–5.8) in patients with vasospasm compared to 2.5 mcg/L (CI 1.5–4.0) in those without vasospasm (P = 0.047). There were no time-related differences in cerebrospinal fluid endothelin-1, plasma NSE, or SB100 for patients with and without vasospasm.

Conclusions In patients with subarachnoid hemorrhage and vasospasm, endothelin-1 is significantly higher in plasma than in CSF on day 5. Neither NSE nor SB100 is associated with the development of vasospasm. Measurement of serial plasma endothelin-1 concentration is a potential screening marker of vasospasm.
Keyword Cerebral vasospasm
Subarachnoid hemorrhage
Endothelin
Screening
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 7 August 2013

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
School of Medicine Publications
 
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Created: Mon, 17 Feb 2014, 22:15:41 EST by Lee Jones on behalf of School of Medicine