Autonomic dysfunction in different subtypes of post-acute ischemic stroke

Xiong, Li; Leung, Howan; Chen, X.Y.; Leung, W.H.; Soo, Oi Yan Yannie; Wong, Ka Sing

doi:10.1016/j.jns.2013.11.036

Cited by 41 publications

(35 citation statements)

References 29 publications

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“…In addition, OH in stroke patients was associated with falls [29]. Xiong et al [6] found that OH was significant in large but not in small vessel infarctions. OH was not prevalent in our patients with minor stroke and little disability; however, we found that symptoms of orthostatic intolerance that were associated with depression scores but not with age and characteristics of stroke.…”

Section: Discussionmentioning

confidence: 98%

“…Cardiac arrhythmias and sudden death during acute stroke are related to autonomic function imbalance [1], [2] and [3]. Non-invasive tests have suggested sympathetic hyperactivity and cardiovagal dysfunction in acute stroke [1], [2], [4], [5], [6] and [7] with diverse results when considering the influence of lateralization, site and sub-type of ischemic stroke [1], [2], [3] and [8].…”

Section: Introductionmentioning

confidence: 99%

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Autonomic symptoms in hypertensive patients with post-acute minor ischemic stroke

Idiáquez

Farias

Torres

et al. 2015

Clinical Neurology and Neurosurgery

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Autonomic symptoms in hypertensive patients with post-acute minor ischemic stroke

Idiáquez

Farias

Torres

et al. 2015

Clinical Neurology and Neurosurgery

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“…Patients with post-ischemic stroke have been shown to have prolongation of the QT interval, 32 frequent occurrence of tachycardia and bradycardia, 33 and impaired heart rate variability. 34 These manifestations are thought to be triggered by autonomic dysfunction after stroke, 34,35 which may adversely facilitate inappropriate ICD therapy. We speculate that physical activity in patients without diuretic therapy was higher than in those with diuretic therapy, thereby exaggerating the rate of sinus tachycardia as well as AF.…”

Section: Predictors Of Inappropriate Shocksmentioning

confidence: 99%

Predictors and Proarrhythmic Consequences of Inappropriate Implantable Cardioverter-Defibrillator Therapy

Tenma

Yokoshiki

Makino

et al. 2015

Circ J

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“…[123] A large of researches demonstrated that autonomic dysfunction differs according to the stroke stage,[456] ischemic location,[78] and ischemic subtype. [69] It occurs in the acute phase of ischemic stroke and even persists to 6 months afterward. [10] In patients with severe ischemic stroke, autonomic dysfunction particularly depresses the parasympathetic tone.…”

Section: Introductionmentioning

confidence: 99%

“…[10] In patients with severe ischemic stroke, autonomic dysfunction particularly depresses the parasympathetic tone. [691011] Researchers have found that autonomic function is also associated with other organ damage in stroke patients, such as carotid atherosclerosis and cardiovascular diseases. [1213] Renal function is closely linked to all-cause mortality and functional disabilities in patients with stroke.…”

Section: Introductionmentioning

confidence: 99%

Heart Rate Variability in Patients with Acute Ischemic Stroke at Different Stages of Renal Dysfunction

Wei

Zhao

et al. 2017

Chinese Medical Journal

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Background:Renal function is associated with mortality and functional disabilities in stroke patients, and impaired autonomic function is common in stroke, but little is known regarding its effects on stroke patients with renal dysfunction. This study sought to evaluate the association between autonomic function and stroke in patients with renal dysfunction.Methods:This study comprised 232 patients with acute ischemic stroke consecutively enrolled from February 2013 to November 2014 at Guangdong Provincial Hospital of Chinese Medicine in China. All patients recruited underwent laboratory evaluation and 24 h Holter electrocardiography (ECG). Autonomic function was measured based on the heart rate variability (HRV) using 24 h Holter ECG. Renal damage was assessed through the estimated glomerular filtration rate (eGFR), and stroke severity was rated according to the National Institutes of Health Stroke Scale (NIHSS). The Barthel index and modified Rankin score were also determined following admission. All the clinical covariates that could potentially affect autonomic outcome variables were adjusted with linear regression.Results:In the patients with a mild or moderate decreased eGFR, the values for the standard deviation of the averaged normal-to-normal RR interval (SDANN) index (P = 0.022), very low frequency (VLF) (P = 0.043), low frequency (LF) (P = 0.023), and ratio of low-to-high frequency power (LF/HF) (P = 0.001) were significantly lower than those in the patients with a normal eGFR. A multinomial linear regression indicated that eGFR (t = 2.47, P = 0.014), gender (t = −3.60, P < 0.001), and a history of hypertension (t = −2.65, P = 0.008) were the risk factors of LF/HF; the NIHSS score (SDANN index: t = −3.83, P < 0.001; VLF: t = −3.07, P = 0.002; LF: t = −2.79, P = 0.006) and a history of diabetes (SDANN index: t = −3.58, P < 0.001; VLF: t = −2.54, P = 0.012; LF: t = −2.87, P = 0.004) were independent factors for the SDANN index, VLF, and LF; the Oxfordshire Community Stroke Project (t = −2.38, P = 0.018) was related to the SDANN index.Conclusions:Autonomic dysfunction is aggravated with the progression of eGFR stage in patients with acute ischemic stroke; the eGFR is an independent factor of LF/HF in the adjusted models. Stroke severity and a history of diabetes are more significantly associated with HRV in patients with acute ischemic stroke at different stages of renal dysfunction.

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Autonomic dysfunction in different subtypes of post-acute ischemic stroke

Cited by 41 publications

References 29 publications

Autonomic symptoms in hypertensive patients with post-acute minor ischemic stroke

Autonomic symptoms in hypertensive patients with post-acute minor ischemic stroke

Predictors and Proarrhythmic Consequences of Inappropriate Implantable Cardioverter-Defibrillator Therapy

Heart Rate Variability in Patients with Acute Ischemic Stroke at Different Stages of Renal Dysfunction

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