While HRV assessed by linear methods seems to have long-term prognostic value, complexity measures of HRV reflect the impact of the neurological state on distinct, temporary properties of heart rate dynamic. Respiratory rate during the first days of the stroke is associated with early and long-term neurological outcome and should be further investigated as a potential risk factor.
Background and Purpose-Increased aortic stiffness (measured by carotid-femoral pulse wave velocity) and central augmentation index have been shown to independently predict cardiovascular events, including stroke. We studied whether pulse wave velocity and central augmentation index predict functional outcome after ischemic stroke. Methods-In a prospective study, we enrolled 99 patients with acute ischemic stroke (age 63.7Ϯ12.4 years, admission NationalInstitutes of Health Stroke Scale score 6.6Ϯ6.6, meanϮSD). Carotid-femoral pulse wave velocity and central augmentation index (SphygmoCor) were measured 1 week after stroke onset. Functional outcome was evaluated 90 days after stroke using the modified Rankin Scale with modified Rankin Scale score of 0 to 1 considered an excellent outcome. Results-In univariate analysis, low carotid-femoral pulse wave velocity (Pϭ0.000001) and low central augmentation index (Pϭ0.028) were significantly associated with excellent stroke outcome. Age, severity of stroke, presence of previous stroke, diabetes, heart rate, and peripheral pressures also predicted stroke functional outcome. In multivariate analysis, the predictive value of carotid-femoral pulse wave velocity (Ͻ9.4 m/s) remained significant (OR, 0.21; 95% CI, 0.06 -0.79; Pϭ0.02) after adjustment for age, National Institutes of Health Stroke Scale score on admission, and presence of previous stroke. By contrast, central augmentation index had no significant predictive value after adjustment. Conclusions-This study indicates that aortic stiffness is an independent predictor of functional outcome in patients with acute ischemic stroke. (Stroke. 2012;43:543-544.)
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