Abstract T MP18: Physical Activity Prior to Stroke May Exert Neurorestorative Effects by Increasing Vascular Endothelial Growth Factor Expression after Acute Ischemic Stroke
Objective: Previous studies by our group have found an independent association between pre-stroke physical activity (PhA) and good functional outcome in a cohort of patients with a cerebral large vessel occlusion. In this study our aim was to evaluate the possible molecular mechanisms by which PhA exerts its neurorestorative effect by studying angiogenic and neurogenic growth factors at different timepoints after stroke onset.
Methods: We included 159 consecutive previously independent patients with an acute stroke due to MCA or TICA occlusion within the first 8 hours from stroke onset. Pre-stroke PhA was evaluated with the international physical activity questionnaire (IPAQ) and subjects were classified into 2 groups: low and high level of pre-stroke PhA. We measured serum levels of Vascular Endothelial Grow Factor (VEGF), Granulocyte Colony-Stimulating Factor (G-CSF) and Brain-Derived Neurotrophic Factor (BDNF) at admission, day 7, and 3 months. We considered good functional outcome at 3 months (mRS ≤ 2) as primary endpoint.
Results: Mean age was 68 and median NIHSS 17. Serum levels of VEGF, G-CSF and BDNF at admission were similar among patients with good (46.5%) and poor (53.5%) functional outcome, However, VEGF and G-CSF serum levels were significantly higher at 7 days and 3 months (p<0.05) in those patients who showed good functional outcome, emerging as independent predictors of good outcome in adjusted logistic regression analyses. When we studied the temporal profile of biomarkers in the different groups of pre-stroke PhA, we observed that those more physically active before stroke had a significantly higher increment of VEGF at day 7 compared to those with low PhA level. In a logistic regression model adjusted for age, sex, baseline NIHSS, reperfusion therapies administered, VEGF increment at day 7 and level of PhA previous to stroke, both VEGF increment and high level of pre-stroke PhA emerged as independent predictors of good functional outcome with and OR 7.7 and 33 respectively, p<0.05.
Conclusion: Beneficial effect of pre-stroke PhA in stroke outcomes may be mediated by increasing the expression of VEGF in the first days after stroke, triggering angiogenesis processes.
Author Disclosures: E. Lopez-Cancio: None. T. Sobrino: None. F. Campos: None. A. Ricciardi: None. N. Pérez de la Ossa: None. M. Hernández-Pérez: None. M. Gomis: None. L. Dorado: None. J.F. Arenillas: None. A. Dávalos: None.
- © 2014 by American Heart Association, Inc.