Cardioembolic stroke and endothelial dysfunction in men aged between 30 and 50 years

Abstract

Introduction. Stroke in young adults is associated with high-level socioeconomic components, and patients face the lifelong effects of the vascular catastrophe. Young patients with cardioembolic stroke make up an important subgroup of ischemic stroke patients globally. A key to optimizing treatment and preventing relapses is identifying the causes and risk factors for ischemic stroke in young adults.Aim. To assess risk factors and endothelial function status in young men with cardioembolic strokeMaterial and methods. A total of 19 patients aged 30-50 years with cardioembolic stroke underwent clinical and instrumental examinations. All patients were admitted to the Yaroslavl Vascular Center before the COVID-19 pandemic. The severity of clinical symptoms and stroke were assessed using the NIHSS scales, Modified Rankin Scale, and Rivermead Mobility Index. The main risk factors for IS including the presence of high- or moderate-risk sources of cardioembolism were reviewed. All patients underwent brain neuroimaging, ultrasound imaging, electrocardiogram, echocardioscopy, and laboratory blood testing. An ultrasound guided tourniquet test was performed to assess the brachial artery endothelial vasomotor function. Results. The average age of patients with cardioembolic stroke was 43.2 ± 6.4 years. Mechanical valve prostheses (21.1%) and isolated atrial fibrillation (42.0%) are the most common sources of cardioembolism. Other commonly identified risk factors included hypertension (73.7%), dyslipidemia (42.1%), smoking (52.6%), and prior acute myocardial infarction (42.1%). The ultrasound guided tourniquet test showed normal dilation of the brachial artery in 26.3% patients, insufficient dilatation in 42.1% patients and vasoconstriction in 31.6% patients. Statistically significant associations between the main vascular risk factors, serum markers of endothelial dysfunction and ultrasound guided tourniquet test indices were identified.Conclusion. This study demonstrated a variety of risk factors for cardioembolic stroke in young men. Lifestyle modification is responsible for the occurrence of traditional risk factors in young adults.