Cerebro-visceral malfunctions in acute stroke patients with metabolic syndrome

Abstract

This review examines clinical and pathophysiological aspects of internal organ diseases; in particular, post-stroke heart and renal disturbances are discussed. Progression of cerebral-cardiac syndrome can be described as the emergence of ischemic and arrhythmic changes because of autonomic imbalance and catecholamine cytotoxicity in previously intact myocardium. Change in renal functional state can be explained with activation of proinflammatory cytokines, the sympathetic nervous system, and also hypothalamic-pituitary disturbances through the interaction of the nervous, endocrine, and autacoid system. The article argues for the principal role of microangiopathy as a systemic process, taking place in metabolic syndrome and resulting in polyorganic insufficiency with major dysfunction of the brain, heart and kidney. Diagnostics of microangiopathy in one of these organs can predict stroke and other vascular diseases. Refs 44. Table 1.