Cerebrogenic Cardiac Arrhythmias

Oppenheimer, Stephen

doi:10.1001/archneur.1990.00530050029008

Cited by 286 publications

(40 citation statements)

References 87 publications

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“…We report the most significantly elevated values in patients with ICS in the territory of the RMCA with involvement of IC, SBP (t=-4.31; p<0.001), DBP (t=-3.34; p=0.002), MAP (t=-4.17; p<0.001), and HR (t=-2.51; p=0.018), respectively. These results are probably as- Our results support the key role of the right IC in the modulation of the sympathetic tone and can be explained by the evidence from the conducted electrophysiological tests for the presence of a higher percentage of sympatho-excitatory neurons in the right posterior IC (18,19,20). The results of the t-test showed a statistically significant difference in SBP in patients with mild and severe autonomic disorders, as SBP values were significantly higher in patients with severe disorders (t=-2.14; p=0.036).…”

Section: Discussionsupporting

confidence: 78%

Arterial blood pressure and heart rate response in patients with acute ischemic stroke - Correlation with the severity of cardiovascular autonomic dysfunction

Georgieva

Andonova²,

Kalevska³

et al. 2016

SSM

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Section: Discussionsupporting

confidence: 78%

Arterial blood pressure and heart rate response in patients with acute ischemic stroke - Correlation with the severity of cardiovascular autonomic dysfunction

Georgieva

Andonova²,

Kalevska³

et al. 2016

SSM

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“…31,32 Impaired cardiac BRS after acute stroke may also be associated with central autonomic cardiovascular dysautoregulation, involving both the parasympathetic 8,[33][34][35] and sympathetic nervous systems. 13,14,36,37 As with myocardial infarction, the poor prognosis associated with impaired BRS may be manifest through cardiac arrhythmias, which are a common complication of acute stroke. 13,14,36,38,39 Interestingly, Giubilei and colleagues, 40 in a small study of 10 patients, reported that the 4 Values presented as mean (SD) for normally distributed data and median (interquartile range) for non-normally distributed data.…”

Section: Discussionmentioning

confidence: 99%

“…12 Cardiac complications of acute stroke are common, may be associated with adverse prognosis, and include arrhythmias and symptoms related to concomitant ischemic heart disease. 13,14 As in acute myocardial infarction patients, impaired BRS may be important in the development of such complications. We have previously shown that increased beat-tobeat BP variability, perhaps reflecting impaired cardiac BRS, is associated with 30-day outcome; the odds ratio for a poor outcome was 1.32 (range, 1.1 to 1.7) for every 1 mm Hgincrease in mean arterial BP variability.…”

mentioning

confidence: 99%

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

Robinson¹,

Dawson²,

Eames³

et al. 2003

Stroke

205

173

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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

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“…11 To date, the mechanisms that could account for these changes have not been well understood, but a primary focus has been on increased sympathetic tone, 12 " 16 perhaps through disinhibition of hypothalamic or other autonomic regulatory centers. 16 The purpose of this study was to determine whether lesions located in the right or left hemisphere influence the nature and severity of cardiac arrhythmias in a differential manner.…”

Section: Background and Purposementioning

confidence: 99%

Supraventricular tachycardia in patients with right hemisphere strokes.

Lane

Wallace

Petrosky

et al. 1992

Stroke

113

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The physiological basis for the arrhythmias commonly observed after a stroke is not well understood. Based on evidence that the right and left cerebral hemispheres influence cardiac function in different ways, we sought to determine whether the nature and severity of cardiac arrhythmias in the context of an acute stroke vary in relation to whether the stroke is located in the left or the right hemisphere. Data were obtained from the medical records of nineteen patients with left hemisphere strokes and nineteen patients with right hemisphere strokes who had also had 24-hour electrocardiographic (Holter) recordings within 2 weeks of admission to a stroke unit. Written Holter monitor reports already on file were used for the data analysis. All four patients with supraventricular tachycardia had right hemisphere strokes (p = 0.05). There was a nonsignificant trend for left hemisphere stroke patients to have more severe ventricular arrhythmias. These data provide partial support for the hypothesis that the two cerebral hemispheres have a differential influence on the nature and severity of arrhythmias following an acute stroke. We speculate that parasympathetic tone was diminished ipsilateral to the affected hemisphere associated with a reciprocal rise in sympathetic tone on that side and recommend that a prospective study be undertaken to test this hypothesis more definitively.

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Cerebrogenic Cardiac Arrhythmias

Cited by 286 publications

References 87 publications

Arterial blood pressure and heart rate response in patients with acute ischemic stroke - Correlation with the severity of cardiovascular autonomic dysfunction

Arterial blood pressure and heart rate response in patients with acute ischemic stroke - Correlation with the severity of cardiovascular autonomic dysfunction

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

Supraventricular tachycardia in patients with right hemisphere strokes.

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