Generic placeholder image

Current Neurovascular Research


ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

Research Article

The Association of LDH Expression and Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage: Possible Involvement of Cerebral Blood Perfusion

Author(s): Yingwen Wang, Shuang Tang, Xiaomin Yang, Yunchuan Cao, Xiaoguo Li, Rui Xu, Jin Yan, Zongduo Guo, Xiaochuan Sun* and Yue Wu*

Volume 20, Issue 1, 2023

Published on: 01 March, 2023

Page: [5 - 13] Pages: 9

DOI: 10.2174/1567202620666221230124832

Price: $65


Background and Purpose: Several pieces of evidence suggest that serum lactate hydrogenase (LDH) level is associated with the pathological process of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). This research aimed to investigate the associations of serum LDH level with the occurrence of DCI in aSAH patients.

Methods: A total of 122 patients diagnosed with aSAH within 72h of onset were retrospectively enrolled. The serum levels of LDH between 7:00-8:00 am on day 1, day 3 and day 7, patients’ demographics, and clinical features were collected. Computed tomography perfusion was performed within 7 days after aSAH. The occurrence of DCI was recorded during the hospitalization.

Results: Among all the enrolled patients, 43 (35.2%) developed DCI during hospitalization. Patients occurred DCI were always accompanied by more serious clinical features and found with higher serum LDH levels. LDH levels on day 3 and day 7 after onset were independently associated with the occurrence of DCI and showed high predictive value according to the receiver operating characteristic (ROC) curve. Moreover, there was a strong correlation between LDH and mean cerebral blood flow, transit time, and mean time to peak.

Conclusion: Serum LDH level on day 3 and day 7 may be a valuable, convenient, and rapid predictive indicator for the occurrence of DCI in aSAH patients.

Keywords: Aneurysmal subarachnoid hemorrhage, serum lactate dehydrogenase level, cerebral blood flow, delayed cerebral ischemia, ROC, CTP, EEG.

Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet 2017; 389(10069): 655-66.
[] [PMID: 27637674]
Neifert SN, Chapman EK, Martini ML, et al. Aneurysmal subarachnoid hemorrhage: The last decade. Transl Stroke Res 2021; 12(3): 428-46.
[] [PMID: 33078345]
Francoeur CL, Mayer SA. Management of delayed cerebral ischemia after subarachnoid hemorrhage. Crit Care 2016; 20(1): 277.
[] [PMID: 27737684]
Geraghty JR, Testai FD. Delayed cerebral ischemia after subarachnoid hemorrhage: Beyond vasospasm and towards a multifactorial pathophysiology. Curr Atheroscler Rep 2017; 19(12): 50.
[] [PMID: 29063300]
Macdonald RL. Delayed neurological deterioration after subarachnoid haemorrhage. Nat Rev Neurol 2014; 10(1): 44-58.
[] [PMID: 24323051]
Rosengart AJ, Schultheiss KE, Tolentino J, Macdonald RL. Prognostic factors for outcome in patients with aneurysmal subarachnoid hemorrhage. Stroke 2007; 38(8): 2315-21.
[] [PMID: 17569871]
Sun H, Li W, Ma J, Liu Y, You C. CT perfusion diagnoses delayed cerebral ischemia in the early stage of the time-window after aneurysmal subarachnoid hemorrhage. J Neuroradiol 2017; 44(5): 313-8.
[] [PMID: 28237366]
Chen HY, Elmer J, Zafar SF, et al. Combining transcranial doppler and EEG data to predict delayed cerebral ischemia after subarachnoid hemorrhage. neurology 2022; 98(5): e459-69.
[] [PMID: 34845057]
Saeedi M, Vahidi E, Asri S, Jahanshir A. Determining the value of cerebrospinal fluid lactate dehydrogenase level in differentiating subarachnoid hemorrhage from traumatic lumbar puncture. Arch Pathol Lab Med 2018; 142(5): 634-7.
[] [PMID: 29457737]
Youn DH, Kim Y, Kim BJ, et al. Mitochondrial dysfunction associated with autophagy and mitophagy in cerebrospinal fluid cells of patients with delayed cerebral ischemia following subarachnoid hemorrhage. Sci Rep 2021; 11(1): 16512.
[] [PMID: 34389795]
Anan M, Nagai Y, Fudaba H, Fujiki M. Lactate and lactate dehydrogenase in cistern as biomarkers of early brain injury and delayed cerebral ischemia of subarachnoid hemorrhage. J Stroke Cerebrovasc Dis 2020; 29(5): 104765.
[] [PMID: 32173227]
Podlasek SJ, McPherson RA, Threatte GA. Characterization of apparent lactate dehydrogenase isoenzyme 6: A lactate-independent dehydrogenase. Clin Chem 1984; 30(2): 266-70.
[] [PMID: 6692531]
Engstrom M, Schott U, Nordstrom CH, Romner B, Reinstrup P. Increased lactate levels impair the coagulation system--a potential contributing factor to progressive hemorrhage after traumatic brain injury. J Neurosurg Anesthesiol 2006; 18(3): 200-4.
[] [PMID: 16799348]
Engelke S, Bridgers S, Saldanha RL, Trought WS. Cerebrospinal fluid lactate dehydrogenase in neonatal intracranial hemorrhage. Am J Med Sci 1986; 291(6): 391-5.
[] [PMID: 3717196]
Zheng S, Wang H, Chen G, et al. Higher serum levels of lactate dehydrogenase before microsurgery predict poor outcome of aneurysmal subarachnoid hemorrhage. Front Neurol 2021; 12: 720574.
[] [PMID: 34456854]
Rostami E, Engquist H, Howells T, et al. Early low cerebral blood flow and high cerebral lactate: Prediction of delayed cerebral ischemia in subarachnoid hemorrhage. J Neurosurg 2018; 128(6): 1762-70.
[] [PMID: 28574309]
Chen S, Feng H, Sherchan P, et al. Controversies and evolving new mechanisms in subarachnoid hemorrhage. Prog Neurobiol 2014; 115: 64-91.
[] [PMID: 24076160]
Germans MR, Jaja BNR, de Oliviera Manoel AL, Cohen AH, Macdonald RL. Sex differences in delayed cerebral ischemia after subarachnoid hemorrhage. J Neurosurg 2018; 129(2): 458-64.
[] [PMID: 28862545]
Duan W, Pan Y, Wang C, et al. Risk factors and clinical impact of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: Analysis from the china national stroke registry. Neuroepidemiology 2018; 50(3-4): 128-36.
[] [PMID: 29529609]
Levy B, Desebbe O, Montemont C, Gibot S. Increased aerobic glycolysis through β2 stimulation is a common mechanism involved in lactate formation during shock states. Shock 2008; 30(4): 417-21.
[] [PMID: 18323749]
Kraut JA, Madias NE. Lactic acidosis. N Engl J Med 2014; 371(24): 2309-19.
[] [PMID: 25494270]
Wu Y, Lu C, Pan N, et al. Serum lactate dehydrogenase activities as systems biomarkers for 48 types of human diseases. Sci Rep 2021; 11(1): 12997.
[] [PMID: 34155288]
Aisiku IP, Chen PR, Truong H, Monsivais DR, Edlow J. Admission serum lactate predicts mortality in aneurysmal subarachnoid hemorrhage. Am J Emerg Med 2016; 34(4): 708-12.
[] [PMID: 26818152]
Li G, Miao J, Pan C, et al. Higher serum lactic dehydrogenase is associated with post-stroke depression at discharge. Clin Interv Aging 2021; 16: 2047-55.
[] [PMID: 34916787]
Ashraf A, Liaquat A, Shabbir S, et al. High level of lactate dehydrogenase and ischaemia–reperfusion injury regulate the multiple organ dysfunction in patients with COVID-19. Postgrad Med J 2022. [Epub ahead of print].
[] [PMID: 35321887]
Barrios-Arpi L, Arias Y, Lopez-Torres B, et al. In vitro neurotoxicity of flumethrin pyrethroid on sh-sy5y neuroblastoma cells: Apoptosis associated with oxidative stress. Toxics 2022; 10(3): 131.
[] [PMID: 35324756]
Cuddihy J, Wu G, Ho L, et al. Lactate dehydrogenase activity staining demonstrates time-dependent immune cell infiltration in human ex-vivo burn-injured skin. Sci Rep 2021; 11(1): 21249.
[] [PMID: 34711882]
Chu H, Huang C, Dong J, et al. Lactate dehydrogenase predicts early hematoma expansion and poor outcomes in intracerebral hemorrhage patients. Transl Stroke Res 2019; 10(6): 620-9.
[] [PMID: 30706410]
Wu Y, He Q, Wei Y, et al. The association of neutrophil-to-lymphocyte ratio and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage: Possible involvement of cerebral blood perfusion. Neuropsychiatr Dis Treat 2019; 15: 1001-7.
[] [PMID: 31118639]
Garcia-Esperon C, Bivard A, Levi C, Parsons M. Use of computed tomography perfusion for acute stroke in routine clinical practice: Complex scenarios, mimics, and artifacts. Int J Stroke 2018; 13(5): 469-72.
[] [PMID: 29543142]
Cremers CHP, van der Schaaf IC, Wensink E, et al. CT perfusion and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis. J Cereb Blood Flow Metab 2014; 34(2): 200-7.
[] [PMID: 24281744]
Malinova V, Dolatowski K, Schramm P, Moerer O, Rohde V, Mielke D. Early whole-brain CT perfusion for detection of patients at risk for delayed cerebral ischemia after subarachnoid hemorrhage. J Neurosurg 2016; 125(1): 128-36.
[] [PMID: 26684786]
Duan Y, Xu H, Li R, et al. Computed tomography perfusion deficits during the baseline period in aneurysmal subarachnoid hemorrhage are predictive of delayed cerebral ischemia. J Stroke Cerebrovasc Dis 2017; 26(1): 162-8.
[] [PMID: 27776892]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy