Autonomic dysfunction in first ever ischemic stroke: Prevalence, predictors and short term neurovascular outcome

Sandeep, Nayani; Sreedharan, Sapna Erat; Namboodiri, Narayanan; Sarma, P. Sankara; Sylaja, PN

doi:10.1016/j.clineuro.2016.08.022

Cited by 31 publications

(39 citation statements)

References 42 publications

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“…In these studies, HRV measurement was performed in the supine position. However, other studies have investigated HRV over 24 h [15,20,26]. The results of the 24-h measurement may include those obtained in various situations such as when sleeping, awake, sitting, and walking or during other activities of daily living, but these situations may have an overlapping influence on the results.…”

Section: Discussionmentioning

confidence: 99%

“…Nayani et al [15] showed that autonomic dysfunction may lead to in- farct expansion in acute ischemic patients, but no previous studies had addressed the mechanism underlying this association between autonomic dysfunction and stroke outcomes. Generally, autonomic dysfunction may cause blood pressure fluctuations in stroke patients [17], which may alter cerebral perfusion [16].…”

Section: Discussionmentioning

confidence: 99%

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Heart Rate Variability During Early Mobilization in Patients with Acute Ischemic Stroke

et al. 2018

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Autonomic dysfunction is one of the predictors of poor outcome in patients with acute ischemic stroke. We compared the heart rate variability (HRV) during early mobilization in patients with or without neurological deterioration (ND). We enrolled 7 acute ischemic patients with ND and 14 without ND and measured their HRV in the rest and mobilization by electrocardiography. There was a significant difference in sympathetic nervous activity during mobilization between the 2 groups. However, no significant differences in blood pressure, heart rate, and parasympathetic nerve activity were observed. In patients with acute ischemic stroke, it is likely that the increase in sympathetic nervous activity during mobilization is associated with ND.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability During Early Mobilization in Patients with Acute Ischemic Stroke

et al. 2018

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“…[19][20][21][22] In our study, the abnormal BP response in the Valsalva test was frequently observed in the progression group of ALI. 2,3,[13][14][15]18 Interestingly, neurological progression during hospitalization is the only significant factor in the logistic regression analysis of 3-month outcome of ALI. These results suggest that the sympathetic ANS function may be impaired in the progression group of ALI patients.…”

Section: Re Sultsmentioning

confidence: 99%

“…[18][19][20][21] Increase in BP in late stage II and rapid overshoot of BP in stage IV of the Valsalva test over the baseline pretest level are the hallmark of normal sympathetic function ( Figure 1A). [12][13][14][15][16]23 When an individual suddenly stands up, the action of gravity makes approximately 500 mL of blood to move to the lower body. Moreover, insufficient systolic BP recovery in stage IV of the Valsalva test was more prominent in the progression group ( Figure 1B).…”

Section: Re Sultsmentioning

confidence: 99%

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Autonomic function test in progressive lacunar infarction

Park

et al. 2018

Acta Neurol Scand

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Stroke Related Brain–Heart Crosstalk: Pathophysiology, Clinical Implications, and Underlying Mechanisms

Fan,

Cao,

et al. 2024

Advanced Science

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The emergence of acute ischemic stroke (AIS) induced cardiovascular dysfunctions as a bidirectional interaction has gained paramount importance in understanding the intricate relationship between the brain and heart. Post AIS, the ensuing cardiovascular dysfunctions encompass a spectrum of complications, including heart attack, congestive heart failure, systolic or diastolic dysfunction, arrhythmias, electrocardiographic anomalies, hemodynamic instability, cardiac arrest, among others, all of which are correlated with adverse outcomes and mortality. Mounting evidence underscores the intimate crosstalk between the heart and the brain, facilitated by intricate physiological and neurohumoral complex networks. The primary pathophysiological mechanisms contributing to these severe cardiac complications involve the hypothalamic‐pituitary‐adrenal (HPA) axis, sympathetic and parasympathetic hyperactivity, immune and inflammatory responses, and gut dysbiosis, collectively shaping the stroke‐related brain–heart axis. Ongoing research endeavors are concentrated on devising strategies to prevent AIS‐induced cardiovascular dysfunctions. Notably, labetalol, nicardipine, and nitroprusside are recommended for hypertension control, while β‐blockers are employed to avert chronic remodeling and address arrhythmias. However, despite these therapeutic interventions, therapeutic targets remain elusive, necessitating further investigations into this complex challenge. This review aims to delineate the state‐of‐the‐art pathophysiological mechanisms in AIS through preclinical and clinical research, unraveling their intricate interplay within the brain–heart axis, and offering pragmatic suggestions for managing AIS‐induced cardiovascular dysfunctions.

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Autonomic dysfunction in first ever ischemic stroke: Prevalence, predictors and short term neurovascular outcome

Cited by 31 publications

References 42 publications

Heart Rate Variability During Early Mobilization in Patients with Acute Ischemic Stroke

Heart Rate Variability During Early Mobilization in Patients with Acute Ischemic Stroke

Autonomic function test in progressive lacunar infarction

Stroke Related Brain–Heart Crosstalk: Pathophysiology, Clinical Implications, and Underlying Mechanisms

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