ED is thought to be implicated in the pathogenesis of cerebral small vessel disease in patients with LIS while the role of arterial stiffness is less known.

Objective: The aim of this study was to assess the endothelial function (EF) and arterial stiffness in patients with LIS.

Methods: In this study, 35 patients with LIS, as defined by clinical characteristics and MRI findings were compared with 18 healthy age and gender-matched patients with similar risk factors.

EF was assessed using the brachial flow-mediated vasodilatation (FMD); in LIS group on the first day after stroke onset. Carotid stiffness index ß was calculated as follows: ln(systolic/diastolic blood pressure)/([Dmax-Dmin]/Dmin), where Dmax and Dmin are maximum and minimum common carotid lumen diameters measured by carotid ultrasound. Carotid intima-media thickness (IMT) was also measured. FMD was categorized according to ROC analysis and ED was defined as FMD ≤ 6.0%.

Results: Twenty-two (63%) LIS patients had ED on the 1st day and only three patients (17%) in the control group (p<0.05). FMD was lower in LIS group (6.1±2.5% versus 9.8±2.2% in the control group, p=0.02), while carotid stiffness was higher (10.5±2.2 versus 7.5±2.6, p=0.04). There was not significant difference in IMT between two groups (0.91±0.17 versus 0.87±0.21, p=0.4). Moderate correlation was observed between stiffness and IMT (r=0.33, p=0.01). No correlations were found between FMD and IMT, FMD and arterial stiffness.

Conclusion: The majority of patients with LIS have the impairment of the structural-and-functional properties of the arterial wall that manifest in the ED and increased stiffness.