Reported Prestroke Physical Activity Is Associated with Vascular Endothelial Growth Factor Expression and Good Outcomes after Stroke

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• 作者：Elena Ló ; pez-Cancio ; MD ; PhD^* ; ^{elenacancio@gmail.com} ; Ana Clara Ricciardi ; MD^* ; Tomá ; s Sobrino ; PhD^&dagger ; ; Jordi Corté ; s^&Dagger ; ; Natalia Pé ; rez de la Ossa ; MD ; PhD^* ; Mó ; nica Millá ; n ; MD ; PhD^* ; Marí ; a Herná ; ndez-Pé ; rez ; MD ; PhD^* ; Meritxell Gomis ; MD ; PhD^* ; Laura Dorado ; MD ; PhD^* ; Lucí ; a Muñ ; oz-Narbona ; RN (Research Nurse)^* ; Francisco Campos ; PhD^&dagger ; ; Juan F. Arenillas ; MD ; PhD^§ ; ; Antoni Dá ; valos ; MD ; PhD^*
• 关键词：Functional recovery ; physical activity ; stroke ; vascular growth factors
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：26
• 期：2
• 页码：425-430
• 全文大小：382 K
• 卷排序：26

文摘

Physical activity (PhA) prior to stroke has been associated with good outcomes after the ischemic insult, but there is scarce data on the involved molecular mechanisms.MethodsWe studied consecutive acute ischemic stroke patients admitted to a single tertiary stroke center. Prestroke PhA was evaluated with the International Physical Activity Questionnaire (metabolic equivalent of minutes/week). We studied several circulating angiogenic and neurogenic factors at different time points: vascular endothelial growth factor (VEGF), granulocyte colony-stimulating factor (G-CSF), and brain-derived neurotrophic factor (BDNF) at admission, day 7, and at 3 months. We considered good functional outcome at 3 months (modified Rankin scale  ≤ 2) as primary end point, and final infarct volume as secondary outcome.ResultsWe studied 83 patients with at least 2 time point serum determinations (mean age 69.6 years, median National Institutes of Health Stroke Scale 17 at admission). Patients more physically active before stroke had a significantly higher increment of serum VEGF on the seventh day when compared to less active patients. This increment was an independent predictor of good functional outcome at 3 months and was associated with smaller infarct volume in multivariate analyses adjusted for relevant covariates. We did not find independent associations of G-CSF or BDNF levels neither with level of prestroke PhA nor with stroke outcomes.ConclusionsAlthough there are probably more molecular mechanisms by which PhA exerts its beneficial effects in stroke outcomes, our observation regarding the potential role of VEGF is plausible and in line with previous experimental studies. Further research in this field is needed.