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The following is a summary of “Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis,” published in the February 2025 issue of BMC Neurology by Ha et al. 

Early neurological deterioration (END) in acute ischemic stroke (AIS) affects long-term outcomes and is linked to endothelial dysfunction and flow-mediated dilation (FMD). 

Researchers conducted a retrospective study to investigate the association between endothelial function, measured via FMD, and END in patients with AIS.  

They retrospectively reviewed patients who experienced AIS within 7 days of stroke onset and underwent FMD assessments during hospitalization (%FMD = (Peak diameter − baseline diameter) / baseline diameter × 100). END was defined as a ≥2-point increase in the National Institutes of Health Stroke Scale total score or a ≥1-point increase in the motor score within 72 hours post-stroke. Multivariate analysis was performed to examine factors associated with END and explore the relationship between FMD and END, considering stroke mechanisms. 

The results showed that among 1,262 patients with AIS, 184 (14.6%) experienced END. Patients with END were older (69 ± 13 vs. 67 ± 13 years; P = 0.033), had a higher stroke history prevalence (21.2 vs. 12.9%; P = 0.003), and lower FMD (5.0 ± 1.8 vs. 5.4 ± 2.2%; P = 0.029). Multivariate analysis showed that stroke history (aOR = 1.728; 95% CI 1.159–2.578; P = 0.007) and low %FMD were independently associated with END. Subgroup analysis revealed low %FMD was significantly associated with END in the small vessel disease category (aOR = 0.789; 95% CI 0.679–0.920; P = 0.002). 

Investigators found that impaired FMD was associated with END, especially in patients with small vessel disease (SVD).  

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04048-0