PLASMA NOREPINEPHRINE AND EPINEPHRINE CONCENTRATIONS IN THE ACUTE-PHASE OF ISCHEMIC STROKE IN AN ELDERLY GROUP OF PATIENTS

Plasma levels of norepinephrine and epinephrine were observed in 22 patients with acute ischemic stroke within the first 24 h, on the 3rd, 5th and 7th day and compared with the recovery after the stroke. Elevated plasma norepinephrine was observed in 68% of patients. Changes from initially elevated to normal norepinephrine levels were observed only in those patients who had had a slightly elevated plasma concentration of norepinephrine on day 1. Plasma epinephrine concentrations were only slightly elevated in 27% of our patients on the 7th day and even in a smaller number of patients earlier in the course of stroke. No significant correlation was found between neurologic deficit and plasma norepinephrine. However, a correlation between neurologic deficit and plasma epinephrine (r = 0.359, p < 0.001) was found. As the elevated plasma epinephrine levels never exceeded twice the value of reference value, this correlation has in our opinion no clinical importance. It is possible that elevated plasma norepinephrine or epinephrine reflect an increase of sympathetic activity in acute stroke which may be due to the accompanying diseases (hypertension, heart failure) or stress and not the ischemic stroke itself.