The association of poor outcome and mortality with low levels of hemoglobin (Hb) and
hematocrit (HcT) in patients admitted after acute Ischemic Stroke (IS) was recently demonstrated.
The mechanisms behind this still remain unclear. Our study aims to find out whether mRNA expressions
and plasma concentrations of endothelin-1 (ET-l), endothelin-2 (ET-2) and endothelin-3
(ET-3) remain different in IS sufferers with low HcT and Hb levels in comparison with those
whose HcT i Hb levels during a severe IS episode remain within the norm. The study included 60
patients treated consecutively for first-time IS. The assessment of mRNA gene expression and
plasma concentration of ET-1, ET-2, ET-3 was conducted in the first, third and seventh day following
the onset of stroke using qRT-PCR method and ELISA tests. We demonstrated that patients
whose initial HcT and Hb levels were below the norm presented a deeper neurologic deficit
on 1, 3 and 7 day following stroke with noticeable improvement no earlier than between day 3 and
7. We also found a negative correlation between the initial HcT and Hb and concentration of
plasma ET-1 on the same days. The patients whose HcT and Hb levels were within normal limits
showed a significant improvement in their neurologic condition on each consecutive day of the observation.
Reduced levels of Hb and HcT combined with an increased plasma concentration of
vasoconstrictive endothelin-1 are strongly associated with poor outcome and high mortality in
acute ischemic stroke.
Keywords: Endothelin-1, ischemic stroke, haemoglobin, hematocrit, plasma, ELISA.
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