Impaired baroreflex sensitivity and increased systolic blood pressure variability in chronic post-ischemic stroke

Abstract

OBJECTIVES:Acute post-stroke patients present cardiovascular autonomic dysfunction, which manifests as lower heart rate variability and impaired baroreflex sensitivity. However, few studies performed to date have evaluated cardiovascular autonomic function in chronic post-stroke patients. The aim of this study was to evaluate cardiovascular autonomic modulation in chronic post-ischemic stroke patients.METHODS:The seventeen enrolled subjects were divided into a stroke group (SG, n=10, 5±1 years after stroke) and a control group (CG, n=7). Non-invasive curves for blood pressure were continuously recorded (Finometer®) for 15 minutes while the subject was in a supine position. Heart rate variability and blood pressure variability were analyzed in the time and frequency domains.RESULTS:No differences were observed in systolic and diastolic pressure and heart rate between post-stroke patients and healthy individuals. The SG group had lower indexes for heart rate variability in the time domain (standard deviation of normal to normal R-R intervals, SDNN; variance of normal to normal R-R intervals, VarNN; and root mean square differences of successive R-R intervals, RMSSD) and a lower high-frequency band for heart rate variability than was observed in the CG. Systolic blood pressure variability and the low-frequency band for systolic pressure were higher in post-stroke patients, while the alpha index was lower in the SG than in the CG.CONCLUSION:After ischemic stroke, affected patients present chronically reduced heart rate variability, impaired cardiac vagal modulation, increased systolic blood pressure variability and higher sympathetic vascular modulation along with impaired baroreflex sensitivity, which can increase the risk of cardiovascular events, despite adequate blood pressure control.

Dynamic Resistance Training Improves Cardiac Autonomic Modulation and Oxidative Stress Parameters in Chronic Stroke Survivors: A Randomized Controlled Trial

“…In addition to the neuromuscular alterations, marked oxidative stress, impairment in blood pressure control mechanisms (e.g., baroreflex sensitivity), and severe autonomic dysfunction, characterized by an elevated sympathetic activity, combined with a reduced or unchanged parasympathetic activity [5–7] might also been observed in stroke survivors and collaborated to genesis of cardiovascular complications (e.g., hypertension and myocardial infarction) in this population [8].…”

Cardiovascular system parameters in participants of Arctic expeditions

“…The most popular is the Finometer instrument system that allows accurate BP measurements with an "adjustment" to the results of auscultatory measurements on the other upper arm. This system is very useful in clinical practice [10] but, due to its technical characteristics, it cannot be used in expeditions. Similar technical approaches (with the same disadvantages) are implemented in the Task Force Monitor instrument complex that is also used in clinical practice [11,12].…”

The Relationship Between Rhythm Variability and the Structural and Functional State of the Heart in Patients with Cerebral Atherosclerosis

“…Так, у пациентов, перенесших ИИ и в ПП, и в ЛП, триангулярный индекс практически в 2 раза был ниже, чем у пациентов с ЦА. Прогностическая значимость триангулярного индекса подтверждена во многих исследованиях [13,15,17]. Например, в исследовании Т. Griррs и соавторов (1991) установлена прогностически неблагоприятная величина триангулярного индекса -25 ед.…”

“…Кондратюк Виталий евгеньевич -Национальный медицинский университет имени А.А. Богомольца, 01601, г. Киев, бульвар Т. Шевченко, 13 егорова мария Сергеевна -ГУ «Институт эндокринологии и обмена веществ имени В.П. Комиссаренко НАМН Украины», 04114, г. Киев, ул.…”