Admission Heart Rate Variability Is Associated With Poststroke Depression in Patients With Acute Mild-Moderate Ischemic Stroke

Abstract

Background: Stroke has been shown to cause cardiac autonomic dysfunction. Depression is common complication after acute ischemic stroke (AIS). The purpose of this study was to investigate whether decreased heart rate variability (HRV) was related to poststroke depression (PSD) in patients with mild-moderate AIS. Methods: In this study, we assessed autonomic function of ischemic stroke patients within 72 h from symptom onset by fractal dimension (FD). 503 patients (mean age 65.93 ± 10.19) with mild-moderate AIS underwent FD test after admission. Depressive symptoms were assessed using 17-item Hamilton Depression Rating Scale (HDRS) at baseline (within 7 days) and 3 months. Depression were defined if HDRS >6 points. According to the data of FD, we investigated association with early-onset PSD status and 3-month PSD. Results: 59.24% (293/503) of patients had early-onset PSD status at baseline, and 38.66% (184/476) of patients had PSD at 3 months. ROC curve analysis shown that the optimal cut point of FD for early-onset PSD status and 3-month PSD were FD ≤ 1.27 and FD ≤ 1.19, respectively. In fully adjusted models, higher NIHSS [adjusted odd ratios (OR),

Heart rate variability as a predictor of stroke course, functional outcome, and medical complications: A systematic review

“…It is associated with higher mortality, poorer recovery, more pronounced cognitive deficits, and lower quality of life. Recently, He et al (2020) investigated whether decreased HRV metrics were predictors of PSD in 503 consecutive patients with AIS who underwent 15 min 12-lead ECG monitoring and were screened for depression using the Hamilton Depression Rating Scale at baseline (within 7 days) and after 3 months. The autonomic function was assessed using FD.…”

Preclinical evaluation of ZL006-05, a new antistroke drug with fast-onset antidepressant and anxiolytic effects

“…Given that only a small percentage of stroke patients arrive at the hospital within hours, PSD and PSA in the acute phase of stroke are independent predictors of poor functional outcomes. [4][5][6][7][8][9] Because of slow onset, 11 SSRIs are not suitable for the management of depression and anxiety symptoms in the acute phase of stroke. Positive allosteric modulators of GABA A Rs have been used in the management of depression and anxiety disorders.…”

“…3 Moreover, poststroke depression (PSD) and anxiety (PSA) are very common, and constitute an independent predictor of poor functional outcomes and quality of life during both the acute and chronic phases. [4][5][6][7][8][9] Unfortunately, high-quality clinical evidence shows that selective serotonin reuptake inhibitors (SSRIs), first-line options for pharmacological management of depression and anxiety disorders, do not reduce disability after stroke and cause a slightly increased risk of seizures and fractures, although they reduce the risk of future depression by about a quarter. 10 Additionally, because of slow onset, 11 SSRIs are not suitable for the management of depression and anxiety symptoms in the acute phase of stroke.…”

Effect of mean heart rate on 30-day mortality in ischemic stroke with atrial fibrillation: Data from the MIMIC-IV database

“…Numerous studies have found that heart rate was associated with the prognosis of many diseases, including coronary heart disease, myocardial infarction, heart failure, acute ischemic stroke, acute hemorrhagic stroke, and so on ( 7 , 9 , 11 , 13 , 27 – 30 ). In addition, heart rate variability is associated with the incidence and duration of poststroke depression ( 27 ). In patients with AF, the association between MHR and short-term prognosis in stroke patients has been limited.…”