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<p>Background. An exponential law for chaotic cardiac dynamics,<br />found previously, allows the quantification of the differences<br />between normal cardiac dynamics and those with acute<br />diseases, as well as the cardiac dynamics of the evolution<br />between these states.</p><p><br />Objective. To confirm the clinical applicability of the developed<br />methodology through the mathematical law for cardiac<br />dynamics in dynamics with arrhythmias.</p><p><br />Materials and methods. 60 Holter electrocardiograms were<br />analyzed, 10 corresponded to normal subjects, and 50 to subjects with different arrhythmias. For each Holter, an attractor was performed, and its fractal dimension and spatial occupancy were measured. A mathematical evaluation was applied in order to differentiate normal dynamics from pathological ones. Sensitivity, specificity and the Kappa coefficient were calculated.</p><p><br />Results. The mathematical evaluation differentiated occupation spaces, normal dynamics, acute illness dynamics, and evolution between these states. The sensitivity and specificity values were 100%, and the Kappa coefficient was 1.</p><p>Conclusions. The clinical applicability of the methodology<br />for cases with arrhythmia was shown. It is also applicable for<br />the detection of changes in dynamics that are not classified<br />clinically as pathological.</p>

Introduction: Glycemic variability (GV) has been associated with worse prognosis in critically ill patients. We sought to evaluate the potential association between GV indices and clinical outcomes in acute stroke patients. Methods: Consecutive diabetic and nondiabetic, acute ischemic or hemorrhagic stroke patients underwent regular, standard-of-care finger-prick measurements and continuous glucose monitoring (CGM) for up to 96 h. Thirteen GV indices were obtained from CGM data. Clinical outcomes during hospitalization and follow-up period (90 days) were recorded. Hypoglycemic episodes disclosed by CGM but missed by finger-prick measurements were also documented. Results: A total of 62 acute stroke patients [48 ischemic and 14 hemorrhagic, median NIHSS score: 9 (IQR: 3–16) points, mean age: 65 ± 10 years, women: 47%, nondiabetic: 79%] were enrolled. GV expressed by higher mean absolute glucose (MAG) values was associated with a lower likelihood of neurological improvement during hospitalization before and after adjusting for potential confounders (OR: 0.135, 95% CI: 0.024–0.751, p = 0.022). There was no association of GV indices with 3-month clinical outcomes. During CGM recording, 32 hypoglycemic episodes were detected in 17 nondiabetic patients. None of these episodes were identified by the periodic blood glucose measurements and therefore they were not treated. Conclusions: Greater GV of acute stroke patients may be related to lower odds of neurological improvement during hospitalization. No association was disclosed between GV indices and 3-month clinical outcomes.

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