Autonomic Dysfunction Predicts Clinical Outcomes After Acute Ischemic Stroke

Xiong, Li; Tian, Ge; Leung, Howan; Soo, Yannie; Chen, Xiangyan; Ip, Vincent; Mok, Vincent; Chu, Winnie C.W.; Wong, Ka Sing; Leung, Thomas

doi:10.1161/strokeaha.117.019312

Cited by 68 publications

(52 citation statements)

References 14 publications

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“…It has been reported that impaired autonomic function, characterized by a predominance of sympathetic activity, is also associated with ND in patients with acute ischemic stroke [13][14][15][16] as predominance of sympathetic activity may alter cerebral perfusion or induce secondary brain injury [17,18]. Based on these results, we assume that autonomic nervous abnormalities accompanying EM may be involved in the development of ND in patients with acute ischemic stroke.…”

Section: Introductionmentioning

confidence: 54%

“…A previous study reported that autonomic dysfunction is one of the predictors of worse functional outcome in patients with acute ischemic stroke [13][14][15][16]. 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.…”

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]. Xiong et al [16] showed how these processes may lead to ND in such patients.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, autonomic dysfunction may cause blood pressure fluctuations in stroke patients [17], which may alter cerebral perfusion [16]. Xiong et al [16] showed how these processes may lead to ND in such patients. In this study, we only measured the variation in blood pressure; therefore, we were unable to confirm these mechanisms.…”

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: Introductionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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“…Xiong and colleagues have attempted to help answer this question in their recent paper published in the December 4, 2017 issue of Stroke [6]. The authors recruited 150 adult patients who were admitted for mild acute ischemic stroke (NIHSS 4-10).…”

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confidence: 99%

Autonomic dysfunction predicts poor outcome in stroke: Updates on recent autonomic research

Miglis

Muppidi

2018

Clin Auton Res

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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 Predicts Clinical Outcomes After Acute Ischemic Stroke

Abstract: Autonomic dysfunction gauged by Ewing battery predicts poor functional outcome after acute ischemic stroke.

Cited by 68 publications

References 14 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 dysfunction predicts poor outcome in stroke: Updates on recent autonomic research

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

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