Cardiovascular Autonomic Dysfunction in Acute Stroke

Pandian, Jeyaraj Durai; Dalton, Kaye; Scott, Justin; Read, Stephen; Henderson, Robert D.

doi:10.1111/j.1747-4949.2010.00577.x

Cited by 3 publications

(6 citation statements)

References 4 publications

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“…In the present study, we followed the patients six months after index stroke and found no change in the autonomic test parameters. However, like Xiong et al [ 10 ], our results are in discordance with the findings of Pandian et al [ 11 ] reporting predominantly changes in the sympathetic parameters.…”

Section: Discussioncontrasting

confidence: 99%

“…Xiong et al [10] also found the cardiovagal impairments to be most prevalent. Our results are also in accordance with a prospective observational cohort study by Pandian et al [11] reporting no change over time in autonomic dysfunction assessed by HUT, Valsalva maneuver or heart rate response to deep breathing one month after index (N 37).…”

Section: Autonomic Dysfunction In Stroke Patientssupporting

confidence: 93%

“…In a recent Framingham study [ 9 ], root mean successive squared difference (RMSSD) and standard deviation of successive normal beats (SDNN) was not associated with stroke risk which indicates that changes in RMSSD and SDNN do not precede stroke. Furthermore, observational studies have shown AD to be more prevalent in stroke patients compared to healthy controls independent of potential confounding covariables such as age and diabetes [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…AD assessed by conventional tests in the acute phase of stroke has been associated with progression in neurological symptoms, worse functional outcome, cardiovascular complications and increased mortality [4,[12][13][14] and AD is highly prevalent in chronic stroke patients [10]. One previous smaller study (n = 37) performed follow-up on the same stroke population including hemorrhagic stroke using conventional autonomic tests over time with recovery limited to one month [11]. Accordingly, changes in AD in stroke patients over time remain to be further resolved.…”

Section: Introductionmentioning

confidence: 99%

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Autonomic dysfunction after mild acute ischemic stroke and six months after: a prospective observational cohort study

et al. 2023

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Introduction Autonomic dysfunction is prevalent in ischemic stroke patients and associated with a worse clinical outcome. We aimed to evaluate autonomic dysfunction over time and the tolerability of the head-up tilt table test in an acute stroke setting to optimize patient care. Patients and method In a prospective observational cohort study, patients were consecutively recruited from an acute stroke unit. The patients underwent heart rate and blood pressure analysis during the Valsalva maneuver, deep breathing, active standing, and head-up tilt table test if active standing was tolerated. In addition, heart rate variability and catecholamines were measured. All tests were performed within seven days after index ischemic stroke and repeated at six months follow-up. Results The cohort was comprised of 91 acute stroke patients, mean (SD) age 66 (11) years, median (IQR) initial National Institute of Health Stroke Scale 2 (1–4) and modified Ranking Scale 2 (1–3). The head-up tilt table test revealed 7 patients (10%) with orthostatic hypotension. The examination was terminated before it was completed in 15%, but none developed neurological symptoms. In the acute state the prevalence of autonomic dysfunction varied between 10–100% depending on the test. No changes were found in presence and severity of autonomic dysfunction over time. Conclusion In this cohort study of patients with mild stroke, autonomic dysfunction was highly prevalent and persisted six months after index stroke. Head-up tilt table test may be used in patients who tolerate active standing. Autonomic dysfunction should be recognized and handled in the early phase after stroke.

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Section: Discussioncontrasting

confidence: 99%

Section: Autonomic Dysfunction In Stroke Patientssupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Autonomic dysfunction after mild acute ischemic stroke and six months after: a prospective observational cohort study

et al. 2023

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“…However, such arrhythmias and decreased SDNN were more prominent in stroke patients with lesions in the right insular cortex. [ 17 ] In a study by Pandian et al .,[ 18 ] it was reported that sympathetic changes were predominant in a cohort of mild-to-moderate stroke patients as compared to healthy controls. Several other studies suggested that autonomic cardiovascular failure was observed in stroke cases resulting from parasympathetic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Identifying autonomic nervous system dysfunction in acute cerebrovascular attack by assessments of heart rate variability and catecholamine levels

Akıl

Tamam

Akıl

et al. 2015

Journal of Neurosciences in Rural Practice

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Objective:This study aimed to evaluate changes in the autonomic nervous system caused by cerebral lesions due to acute stroke. We assessed heart rate variability and catecholamine levels in lieu of stroke lesion localization.Materials and Methods:A total of 60 stroke patients and 31 healthy controls were enrolled in the study. Plasma epinephrine and norepinephrine levels were measured on the first, third, and seventh days following the stroke event. Heart rate variability was evaluated with time-domain and frequency-domain analyses via 24-hour Holter monitor recordings.Results:On the first and third day following the stroke, norepinephrine levels were significantly higher in all patient groups as compared to controls. Epinephrine levels on the first, third and seventh days after the stroke were significantly higher in patients with lesions in the right middle cerebral artery territory than controls. In frequency-domain analysis, patients with right middle cerebral artery territory lesions had greater low frequency and low frequency to high frequency ratio values than controls. Time-domain analysis revealed significant decreases in the standard deviation from the mean for 5-minute 288 R-R intervals in patients with lesions in the right middle cerebral artery and posterior cerebral artery territory when contrasted with controls. Patients with lesions in the right middle cerebral artery territory demonstrated the highest increase in the percentage of consecutive R-R intervals differing by more than 50 ms (pNN50) as compared to the control group.Conclusion:These findings indicate that autonomic dysfunction favoring an increase in sympathetic activity occurs in acute stroke patients.

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Cerebral Hemodynamic Changes at Basilar Artery in Obstructive Sleep Apnea Syndrome after Continuous Positive Airway Pressure Treatment

Caballero

Coloma

Martín

et al. 2013

Journal of Stroke and Cerebrovascular Diseases

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Cardiovascular Autonomic Dysfunction in Acute Stroke

Cited by 3 publications

References 4 publications

Autonomic dysfunction after mild acute ischemic stroke and six months after: a prospective observational cohort study

Autonomic dysfunction after mild acute ischemic stroke and six months after: a prospective observational cohort study

Identifying autonomic nervous system dysfunction in acute cerebrovascular attack by assessments of heart rate variability and catecholamine levels

Cerebral Hemodynamic Changes at Basilar Artery in Obstructive Sleep Apnea Syndrome after Continuous Positive Airway Pressure Treatment

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