Autonomic consequences of cerebral hemisphere infarction.

Barron, Stephen; Rogovski, Z; Hemli, Jeshayachu A.

doi:10.1161/01.str.25.1.113

Cited by 182 publications

(109 citation statements)

References 25 publications

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“…In other words, a stroke itself induces changes in risk factors, such as blood pressure, cholesterol, and diabetes mellitus, which then are not a true reflection of their status before the stroke. [17][18][19] Therefore, the aim of our study was to examine the role of prestroke cardiovascular risk factors in mortality after stroke. We first calculated mortality rates in people with and without stroke.…”

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confidence: 99%

Role of Prestroke Vascular Pathology in Long-Term Prognosis After Stroke

Portegies

Bos

Hofman

et al. 2016

Stroke

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Background and Purpose-Mortality after stroke remains high for years, mostly because of cardiovascular causes. Given that cardiovascular pathology plays an important role in causing the initial stroke, such prestroke pathology might also influence the prognosis after stroke. Within the population-based Rotterdam Study, we examined the proportion of deaths after stroke that are attributable to pre-existent cardiovascular risk factors before stroke (the population attributable risk). Methods-We examined 1237 patients with first-ever stroke and 4928 stroke-free participants (between 1990 and 2012), matched on age, sex, examination round, and stroke date (index date). Cardiovascular risk factors measured on ≈4 years before index date were used as determinants. Participants were continuously followed up for mortality (≈6 years) after the index date. We calculated separate and combined population attributable risk of hypertension, total cholesterol, high-density lipoprotein-cholesterol, body mass index, diabetes mellitus, smoking, transient ischemic attack, and atrial fibrillation. Results-Nine hundred and nineteen patients with stroke and 2654 stroke-free participants died. The combined population attributable risk in patients with stroke was 27% (95% confidence interval, 14%-45%) and in stroke-free participants was 19% (95% confidence interval, 12%-29%). Population attributable risks of diabetes mellitus, smoking, and atrial fibrillation were higher in patients with stroke than in the reference group because of a higher prevalence of risk factors. In addition, people with atrial fibrillation and stroke had a higher hazard ratio for death than those with only atrial fibrillation. Conclusions-One quarter of deaths after stroke could theoretically be prevented with rigorous cardiovascular prevention and treatment, but this should preferably start before stroke occurrence. In addition, research into factors explaining the remaining deaths needs to be encouraged.

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confidence: 99%

Role of Prestroke Vascular Pathology in Long-Term Prognosis After Stroke

Portegies

Bos

Hofman

et al. 2016

Stroke

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“…The aetiology of this autonomic dysfunction might be unclear, but altered autonomic balance with reduced vagal tone is known to occur following stroke. 4 The incidence of ACPO is unknown. However, 95% of cases are associated with an underlying condition, such as electrolyte imbalances, certain medication (eg anticholinergics) and recent abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

A case of refractory Ogilvie syndrome following a haemorrhagic stroke

Wanklyn

German

2013

Clinical Medicine

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“…Many studies have reported that cardiac autonomic function is impaired in patients with ischemic stroke [11,18]. It has been suggested that autonomic cardiovascular failure is associated with the impairment of parasympathetic function in patients with stroke [19].…”

Section: Discussionmentioning

confidence: 99%

Association of autonomic nervous system functions with immune response and prognosis in acute ischemic stroke patients

Çiğdem¹,

Yıldız²,

Bakıcı³

et al. 2012

CMJ

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Aim. Cerebrovascular disease is the most commonly encountered condition which causes serious mortality and morbidity in neurological practice. It has been reported that heart rate variability declines in a cerebrovasculer disease, which shows that autonomic functions are affected. Autonomic nervous system has a significant role in monitoring immune status and controlling inflammation. Similarly, there are studies reporting that immune system is affected during acute phase of cerebrovascular diseases. In the present study, our aim was to investigate the effect of autonomic nervous system on immune response and prognosis in acute ischemic cerebrovascular diseases. Method. 44 patients with middle cerebral artery infarction and 44 healthy controls were included in this study. Autonomic nervous system was evaluated using a methodology analysing the heart rate variability based on frequency. In order to evaluate the effects on immun system, serum levels of interleukin 1β, interleukin 6, tumor necrosis factor alfa and interleukin 10 were measured on the 1 st , 3 rd , 7 th and 10 th day by ELISA. Prognosis was evaluated by Rankin scale after 3 months. Results. Compared to the controls, low frequency power in normalized units (LFnu) was found to be high, high frequency power in normalized units (HFnu) was found to be low and ratio of LFnu/HFnu was found to be high in the patients group. The increase being more marked in left middle cerebral artery infarctions, interleukin-6 level were increased on the 10 th day and interleukin-10 level was decreased at all days compared to baseline in all patients. Interleukin-1β and tumor necrosis factor α levels were lower in all patients but the decrease was more pronounced in patients having left middle cerebral artery infarction. There was no difference between the Rankin scores of the patients having right and left middle cerebral artery infarction. Conclusions. Ischemic cerebrovascular disease is associated with an effect on immune system. This impaired immun response can be correlated both with a decreased parasympathetic activity and an increased sympathetic activity particularly in patients with middle cerebral artery infarctions.Keywords: Stroke, heart rate variability, interleukin-1β, interleukin-6, interleukin-10, tumor necrosis factor alfa Özet Amaç. Serebrovasküler hastalık nöroloji pratiğinde en sık karşılaşılan ve ciddi morbidite ve mortaliteye sebep olan bir durumdur. Serebrovasküler hastalıkta otonom fonksiyonlarda etkilenmeyi gösteren kalp hızı değişkenliğinde azalma olduğu bildirilmektedir. Otonom sinir sistemi immun durumun monitörize edilmesinde ve inflamasyonun kontrolünde önemli rol oynar. Benzer şekilde serebrovasküler hastalıkların akut döneminde immün sistemin de etkilendiğini gösteren çalışmalar mevcuttur. Amacımız akut iskemik serebrovasküler hastalıklarda otonom sinir sistemi fonksiyonunun immun yanıt ve prognoza etkisini araştırmaktır. Yöntem. Çalışmaya orta serebral arter infarktı olan 44 hasta ve 44 sağlıklı birey alınmıştır. Otonom sinir sistemi...

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Autonomic consequences of cerebral hemisphere infarction.

Cited by 182 publications

References 25 publications

Role of Prestroke Vascular Pathology in Long-Term Prognosis After Stroke

Role of Prestroke Vascular Pathology in Long-Term Prognosis After Stroke

A case of refractory Ogilvie syndrome following a haemorrhagic stroke

Association of autonomic nervous system functions with immune response and prognosis in acute ischemic stroke patients

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