Cardiac Baroreceptor Sensitivity Predicts Long-Term Outcome After Acute Ischemic Stroke

Abstract

Background and Purpose-The baroreceptor reflex arc is important in the short-term regulation of the cardiovascular system, and small studies have reported impaired cardiac baroreceptor sensitivity (BRS) after acute stroke. However, the prognostic significance of impaired BRS is uncertain. Methods-One hundred twenty-four patients underwent simultaneous ECG and noninvasive beat-to-beat blood pressure (BP) monitoring within 72 hours of neuroradiologically confirmed acute ischemic stroke. Cardiac BRS was assessed from the combined ␣-index by means of power spectral analysis techniques. Baseline data for acute stroke patients were compared with those of a control group matched for age, sex, and casual BP. Patients were followed up for a median of 1508 days (range, 9 to 2656 days), and outcome was compared between patients with and without impaired BRS. Results-Median

Altered blood pressure responses of carotid endarterectomy in patients with contralateral carotid artery lesion

“…[6,16,[18][19][20][21] Furthermore, several studies have defined preoperative neurological deficits as independent predictors of hypertension following CEA. [5,6,22] Hypertension is common following ischemic stroke; however, target values of the arterial pressure following stroke still remain a matter of debate. [23] Increased perioperative arterial pressure lability may be also observed in patients who have recently had TIA.…”

Speeding stroke recovery?

“…Both elevations in blood pressure and heart rate are associated with poor outcome after stroke, 32 33 as is impaired baroreceptor sensitivity, with increased cardiac events and arrhythmias. 34 Despite this, the relationship between drug induced haemodynamic changes and outcome remains unclear. Experimental data supporting the use of amphetamine, where no tendency to harm has been demonstrated, have involved healthy volunteers.…”

Autonomic control of blood circulation in patients undergoing elective carotid endarterectomy

“…Diminished BRS impedes adequate modulation of baroreceptor activity, resulting in increased BPV. Consequently, low BRS has been associated with less favorable prognosis and long-term mortality after myocardial infarction and ischemic stroke [9][10][11] . ICAS is associated with a significantly higher risk of ipsilateral stroke 12 .…”