Heart rate variability and functional outcome in ischemic stroke

Graff, Beata; Gąsecki, Dariusz; Rojek, Agnieszka; Boutouyrie, Pierre; Nyka, Walenty M.; Laurent, Stéphane; Narkiewicz, Krzysztof

doi:10.1097/hjh.0b013e328361e48b

Cited by 74 publications

(61 citation statements)

References 43 publications

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“…First, our study provides reference values for men and women in a large sample of participants, once all potential confounding was addressed. Participants were removed from analysis if they presented with hypertension (Schroeder et al, 2003), diabetes (May & Arildsen, 2011), coronary heart disease and myocardial infarction (Buccelletti et al, 2009), obesity (Karason, Molgaard, Wikstrand, & Sjostrom, 1999), kidney disease (Furuland, Linde, Englund, & Wikstrom, 2008), and stroke (Graff et al, 2013). Participants on medications including angiotensin-converting enzyme inhibitors, antiarrhythmics, beta blockers, diuretics and sympathetic agonists (Felber et al, 2006), and antidepressants (Kemp et al, 2010(Kemp et al, , 2014 were also excluded from the present analysis.…”

Section: Discussionmentioning

confidence: 99%

Reference values for short‐term resting‐state heart rate variability in healthy adults: Results from the Brazilian Longitudinal Study of Adult Health—ELSA‐Brasil study

et al. 2018

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Heart rate variability (HRV) is a psychophysiological phenomenon with broad implications, providing an accessible index of vagal function, underpinning psychological constructs, including the capacity for social engagement and emotion regulation, and may predict future morbidity and mortality. However, the lack of reference values for short-term HRV indices for participants of both sexes across the age spectrum is a limiting factor. This was the objective of the present study. Resting electrocardiographic records were obtained from 13,214 participants (both sexes, 35-74 years), and HRV indices in time and frequency domains (mean ± SD) were determined from 5-min records. Results were based on a subsample of 2,874 nonmedicated, healthy participants stratified by sex across 10-year age groupings. Men showed lower heart rate (HR, 64 ± 8 bpm vs. 68 ± 8 bpm, p < .05) and normalized high frequency (HF; 39.4 ± 18.0 normalized units [n.u.] vs. 50.4 ± 18.5 n.u., p < .05) than women, and higher N-N variance (2,214 ± 1,890 ms vs. 1,883 ± 1,635 ms , p < .05), standard deviation of all N-N intervals (SDNN; 43.7 ± 17.3 ms vs. 40.3 ± 15.8 ms, p < .05) and LF/HF (2.30 ± 2.68 vs. 1.33 ± 1.82, p < .05). HR and HF (n.u.) were also higher in younger than older women. LF/HF was lower in women than men. Percentile curves showed almost all HRV indices decreasing with aging. The availability of short-term, resting-state HRV reference values in a large sample of healthy and nonmedicated participants from 35-74 years will provide a valuable tool for researchers, clinicians, and those in the quantified-self community.

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Section: Discussionmentioning

confidence: 99%

Reference values for short‐term resting‐state heart rate variability in healthy adults: Results from the Brazilian Longitudinal Study of Adult Health—ELSA‐Brasil study

et al. 2018

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“…Recently, one study compared several non-linear parameters including approximate, sample and fuzzy entropies and conventional linear parameters of HRV in patients with acute stroke 15. It concluded that entropy values were more like to reflect early neurological status (eg, NIHSS score) within 7 days after stroke rather than long-term prognosis.…”

Section: Discussionmentioning

confidence: 99%

Complexity of heart rate variability predicts outcome in intensive care unit admitted patients with acute stroke

Tang

Jen

Lin

et al. 2014

J Neurol Neurosurg Psychiatry

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“…Finally, adult neurology has long sought to deploy HRV monitoring as a means to predict the deleterious effects of stroke (Graff et al . ). While this remains a work in progress, findings so far indicate the potential of HRV monitoring to identify patients at risk of adverse early neurological outcomes and of a second stroke over years of follow‐up (Graff et al .…”

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confidence: 97%

“…While this remains a work in progress, findings so far indicate the potential of HRV monitoring to identify patients at risk of adverse early neurological outcomes and of a second stroke over years of follow‐up (Graff et al . ; Bodapati et al . ).…”

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confidence: 99%

Saving the brain one heartbeat at a time

Frasch

2018

The Journal of Physiology

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In an article in this issue of The Journal of Physiology, Yamaguchi et al. (2018) set out to demonstrate the time course of changes in several widely used heart rate variability (HRV) measures during an exposure to a hypoxic-ischaemic (HI) insult using fetal sheep as a model.Although this study was conducted in a fetal model, the findings may well be useful as a surrogate for the neonate with HI encephalopathy that needs timely diagnosis for effective treatment. This information is difficult to obtain from neonatal models of HI injury due to anaesthetic confounding or from human studies where there are the confounding challenges of the treatment paradox and the lack of non-cooled controls. The team demonstrated a complex temporal profile of three linear time-domain (also referred to as statistical) HRV measures, standard deviation of the normalnormal interval (SDNN), square root of the mean squared differences of n successive RR intervals (root mean square of the successive differences; RMSSD) and skewness, during the evolving HI brain injury. SDNN and RMSSD represent the true beat-to-beat HRV measures widely deployed throughout HRV studies in all ages. In addition, and to account for the current practice of the ultrasound-based fetal heart rate monitoring, the long-term variation (LTV) and short-term variation (STV) metrics were also computed. These two metrics, unique to fetal monitoring, are not true beat-to-beat HRV measures, but, rather, even in the case of STV, derived from an average over roughly 12 fetal heart beats (3.75 s or 1/16th min epoch). Two groups were studied: mild HI, known to be associated with only selective subcortical neuronal injury, and severe HI, associated with a pattern of diffuse white matter injury and severe subcortical neuro-nal injury seen in preterm babies. A complete umbilical cord occlusion (UCO) lasting 15 min triggered the mild HI, while a severe HI was triggered by 25 min of complete UCO. For the entire first 6 h after the UCO insult, the RMSSD measure of HRV showed no suppression, but rather an increase in the severe HI group compared to both the mild HI group and the controls.

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Heart rate variability and functional outcome in ischemic stroke

Cited by 74 publications

References 43 publications

Reference values for short‐term resting‐state heart rate variability in healthy adults: Results from the Brazilian Longitudinal Study of Adult Health—ELSA‐Brasil study

Reference values for short‐term resting‐state heart rate variability in healthy adults: Results from the Brazilian Longitudinal Study of Adult Health—ELSA‐Brasil study

Complexity of heart rate variability predicts outcome in intensive care unit admitted patients with acute stroke

Saving the brain one heartbeat at a time

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