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Cardiac Autonomic Derangement Is Associated with Worse Neurological Outcome in the Very Early Phases of Ischemic Stroke

Background: Acute ischemic stroke (AIS) is associated with autonomic dysfunction. We evaluated the prognostic value of heart rate variability (HRV) and the role of stroke localization and reperfusion treatment (RT) on autonomic control. Methods: Patients with AIS and sinus rhythm were enrolled in th...

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Autores principales: Tobaldini, Eleonora, Sacco, Roberto M., Serafino, Serena, Tassi, Michele, Gallone, Gianluca, Solbiati, Monica, Costantino, Giorgio, Montano, Nicola, Torgano, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616397/
https://www.ncbi.nlm.nih.gov/pubmed/31208012
http://dx.doi.org/10.3390/jcm8060852
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author Tobaldini, Eleonora
Sacco, Roberto M.
Serafino, Serena
Tassi, Michele
Gallone, Gianluca
Solbiati, Monica
Costantino, Giorgio
Montano, Nicola
Torgano, Giuseppe
author_facet Tobaldini, Eleonora
Sacco, Roberto M.
Serafino, Serena
Tassi, Michele
Gallone, Gianluca
Solbiati, Monica
Costantino, Giorgio
Montano, Nicola
Torgano, Giuseppe
author_sort Tobaldini, Eleonora
collection PubMed
description Background: Acute ischemic stroke (AIS) is associated with autonomic dysfunction. We evaluated the prognostic value of heart rate variability (HRV) and the role of stroke localization and reperfusion treatment (RT) on autonomic control. Methods: Patients with AIS and sinus rhythm were enrolled in the emergency department. Autonomic parameters were recorded at the onset and after a potential RT. Neurological deficit was assessed using the National Institute of Health Stroke Scale (NIHSS) at the onset and residual disability with modified Rankin Scale (mRS) at 3 months. Two analyses were used to assess HRV. Low frequency (LF) and high frequency (HF) are, respectively, markers of sympathetic and respiratory vagal modulation in spectral analysis. Symbolic analysis provides pattern with no variation (0V%) as an index of sympathetic modulation and pattern with two like variations (2LV%) and pattern with two unlike variations (2UV%) as markers of vagal modulation. Results: We enrolled 41 patients. Twenty-seven underwent RT. A prevalent parasympathetic modulation was found in patients with NIHSS ≥14. The group with mRS 3–6 exhibited a higher 2UV% and lower 0V%. Right-sided strokes were associated with a higher respiratory vagal control. RT had no effects on HRV parameters. Conclusions: In the very early phases of AIS, a decreased 0V% and an increased 2UV% may reflect a loss of sympathetic oscillation, predicting a poorer 3 month-outcome.
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spelling pubmed-66163972019-07-18 Cardiac Autonomic Derangement Is Associated with Worse Neurological Outcome in the Very Early Phases of Ischemic Stroke Tobaldini, Eleonora Sacco, Roberto M. Serafino, Serena Tassi, Michele Gallone, Gianluca Solbiati, Monica Costantino, Giorgio Montano, Nicola Torgano, Giuseppe J Clin Med Article Background: Acute ischemic stroke (AIS) is associated with autonomic dysfunction. We evaluated the prognostic value of heart rate variability (HRV) and the role of stroke localization and reperfusion treatment (RT) on autonomic control. Methods: Patients with AIS and sinus rhythm were enrolled in the emergency department. Autonomic parameters were recorded at the onset and after a potential RT. Neurological deficit was assessed using the National Institute of Health Stroke Scale (NIHSS) at the onset and residual disability with modified Rankin Scale (mRS) at 3 months. Two analyses were used to assess HRV. Low frequency (LF) and high frequency (HF) are, respectively, markers of sympathetic and respiratory vagal modulation in spectral analysis. Symbolic analysis provides pattern with no variation (0V%) as an index of sympathetic modulation and pattern with two like variations (2LV%) and pattern with two unlike variations (2UV%) as markers of vagal modulation. Results: We enrolled 41 patients. Twenty-seven underwent RT. A prevalent parasympathetic modulation was found in patients with NIHSS ≥14. The group with mRS 3–6 exhibited a higher 2UV% and lower 0V%. Right-sided strokes were associated with a higher respiratory vagal control. RT had no effects on HRV parameters. Conclusions: In the very early phases of AIS, a decreased 0V% and an increased 2UV% may reflect a loss of sympathetic oscillation, predicting a poorer 3 month-outcome. MDPI 2019-06-14 /pmc/articles/PMC6616397/ /pubmed/31208012 http://dx.doi.org/10.3390/jcm8060852 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tobaldini, Eleonora
Sacco, Roberto M.
Serafino, Serena
Tassi, Michele
Gallone, Gianluca
Solbiati, Monica
Costantino, Giorgio
Montano, Nicola
Torgano, Giuseppe
Cardiac Autonomic Derangement Is Associated with Worse Neurological Outcome in the Very Early Phases of Ischemic Stroke
title Cardiac Autonomic Derangement Is Associated with Worse Neurological Outcome in the Very Early Phases of Ischemic Stroke
title_full Cardiac Autonomic Derangement Is Associated with Worse Neurological Outcome in the Very Early Phases of Ischemic Stroke
title_fullStr Cardiac Autonomic Derangement Is Associated with Worse Neurological Outcome in the Very Early Phases of Ischemic Stroke
title_full_unstemmed Cardiac Autonomic Derangement Is Associated with Worse Neurological Outcome in the Very Early Phases of Ischemic Stroke
title_short Cardiac Autonomic Derangement Is Associated with Worse Neurological Outcome in the Very Early Phases of Ischemic Stroke
title_sort cardiac autonomic derangement is associated with worse neurological outcome in the very early phases of ischemic stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616397/
https://www.ncbi.nlm.nih.gov/pubmed/31208012
http://dx.doi.org/10.3390/jcm8060852
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