Heart Rate Variability Parameter Changes in Patients With Acute Ischemic Stroke Undergoing Intravenous Thrombolysis
Background Autonomic dysfunction has been revealed in patients with acute ischemic stroke and is associated with poor prognosis. However, autonomic nervous system function assessed by heart rate variability (HRV) and its relationship with clinical outcomes in patients undergoing intravenous thrombol...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.028778 |
| _version_ | 1797810181282725888 |
|---|---|
| author | Yang Qu Ying‐Ying Sun Reziya Abuduxukuer Xiang‐Kun Si Peng Zhang Jia‐Xin Ren Yu‐Li Fu Ke‐Jia Zhang Jia Liu Pan‐Deng Zhang Hang Jin Yi Yang Zhen‐Ni Guo |
| author_facet | Yang Qu Ying‐Ying Sun Reziya Abuduxukuer Xiang‐Kun Si Peng Zhang Jia‐Xin Ren Yu‐Li Fu Ke‐Jia Zhang Jia Liu Pan‐Deng Zhang Hang Jin Yi Yang Zhen‐Ni Guo |
| author_sort | Yang Qu |
| collection | DOAJ |
| description | Background Autonomic dysfunction has been revealed in patients with acute ischemic stroke and is associated with poor prognosis. However, autonomic nervous system function assessed by heart rate variability (HRV) and its relationship with clinical outcomes in patients undergoing intravenous thrombolysis (IVT) remain unknown. Methods and Results Patients who did and did not undergo IVT between September 2016 and August 2021 were prospectively and consecutively recruited. HRV values were measured at 1 to 3 and 7 to 10 days after stroke to assess autonomic nervous system function. A modified Rankin scale score ≥2 at 90 days was defined as an unfavorable outcome. Finally, the analysis included 466 patients; 224 underwent IVT (48.1%), and 242 did not (51.9%). Linear regression showed a positive correlation of IVT with parasympathetic activation‐related HRV parameters at 1 to 3 days (high frequency: β=0.213, P=0.002) and with both sympathetic (low frequency: β=0.152, P=0.015) and parasympathetic activation‐related HRV parameters (high frequency: β=0.153, P=0.036) at 7 to 10 days after stroke. Logistic regression showed HRV values and autonomic function within 1 to 3 and 7 to 10 days after stroke were independently associated with 3‐month unfavorable outcomes after adjusting for confounders in patients who underwent IVT (all P<0.05). Furthermore, addition of HRV parameters to conventional risk factors significantly improved risk‐predictive ability of 3‐month outcome (the area under the receiver operating characteristic curve significantly improved from 0.784 [0.723–0.846] to 0.855 [0.805–0.906], P=0.002). Conclusions IVT positively affected HRV and autonomic nervous system activity, and autonomic function assessed by HRV in acute stroke phase was independently associated with unfavorable outcomes in patients undergoing IVT. |
| first_indexed | 2024-03-13T07:04:22Z |
| format | Article |
| id | doaj.art-53ce40caf7734f169644702f0a32b1ea |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-13T07:04:22Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-53ce40caf7734f169644702f0a32b1ea2023-06-06T12:15:47ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-06-01121110.1161/JAHA.122.028778Heart Rate Variability Parameter Changes in Patients With Acute Ischemic Stroke Undergoing Intravenous ThrombolysisYang Qu0Ying‐Ying Sun1Reziya Abuduxukuer2Xiang‐Kun Si3Peng Zhang4Jia‐Xin Ren5Yu‐Li Fu6Ke‐Jia Zhang7Jia Liu8Pan‐Deng Zhang9Hang Jin10Yi Yang11Zhen‐Ni Guo12Stroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaLaboratory for Engineering and Scientific Computing Institute of Advanced Computing and Digital Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences Shenzhen ChinaLaboratory for Engineering and Scientific Computing Institute of Advanced Computing and Digital Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences Shenzhen ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaStroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun ChinaBackground Autonomic dysfunction has been revealed in patients with acute ischemic stroke and is associated with poor prognosis. However, autonomic nervous system function assessed by heart rate variability (HRV) and its relationship with clinical outcomes in patients undergoing intravenous thrombolysis (IVT) remain unknown. Methods and Results Patients who did and did not undergo IVT between September 2016 and August 2021 were prospectively and consecutively recruited. HRV values were measured at 1 to 3 and 7 to 10 days after stroke to assess autonomic nervous system function. A modified Rankin scale score ≥2 at 90 days was defined as an unfavorable outcome. Finally, the analysis included 466 patients; 224 underwent IVT (48.1%), and 242 did not (51.9%). Linear regression showed a positive correlation of IVT with parasympathetic activation‐related HRV parameters at 1 to 3 days (high frequency: β=0.213, P=0.002) and with both sympathetic (low frequency: β=0.152, P=0.015) and parasympathetic activation‐related HRV parameters (high frequency: β=0.153, P=0.036) at 7 to 10 days after stroke. Logistic regression showed HRV values and autonomic function within 1 to 3 and 7 to 10 days after stroke were independently associated with 3‐month unfavorable outcomes after adjusting for confounders in patients who underwent IVT (all P<0.05). Furthermore, addition of HRV parameters to conventional risk factors significantly improved risk‐predictive ability of 3‐month outcome (the area under the receiver operating characteristic curve significantly improved from 0.784 [0.723–0.846] to 0.855 [0.805–0.906], P=0.002). Conclusions IVT positively affected HRV and autonomic nervous system activity, and autonomic function assessed by HRV in acute stroke phase was independently associated with unfavorable outcomes in patients undergoing IVT.https://www.ahajournals.org/doi/10.1161/JAHA.122.028778acute ischemic strokeautonomic functionautonomic nervous systemheart rate variabilityintravenous thrombolysisnomogram |
| spellingShingle | Yang Qu Ying‐Ying Sun Reziya Abuduxukuer Xiang‐Kun Si Peng Zhang Jia‐Xin Ren Yu‐Li Fu Ke‐Jia Zhang Jia Liu Pan‐Deng Zhang Hang Jin Yi Yang Zhen‐Ni Guo Heart Rate Variability Parameter Changes in Patients With Acute Ischemic Stroke Undergoing Intravenous Thrombolysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute ischemic stroke autonomic function autonomic nervous system heart rate variability intravenous thrombolysis nomogram |
| title | Heart Rate Variability Parameter Changes in Patients With Acute Ischemic Stroke Undergoing Intravenous Thrombolysis |
| title_full | Heart Rate Variability Parameter Changes in Patients With Acute Ischemic Stroke Undergoing Intravenous Thrombolysis |
| title_fullStr | Heart Rate Variability Parameter Changes in Patients With Acute Ischemic Stroke Undergoing Intravenous Thrombolysis |
| title_full_unstemmed | Heart Rate Variability Parameter Changes in Patients With Acute Ischemic Stroke Undergoing Intravenous Thrombolysis |
| title_short | Heart Rate Variability Parameter Changes in Patients With Acute Ischemic Stroke Undergoing Intravenous Thrombolysis |
| title_sort | heart rate variability parameter changes in patients with acute ischemic stroke undergoing intravenous thrombolysis |
| topic | acute ischemic stroke autonomic function autonomic nervous system heart rate variability intravenous thrombolysis nomogram |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.028778 |
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