Heart Rate Variability and Recurrent Stroke and Myocardial Infarction in Patients With Acute Mild to Moderate Stroke
Objectives: In patients with acute ischemic stroke, reduced heart rate variability (HRV) may indicate poor outcome. We tested whether HRV in the acute phase of stroke is associated with higher rates of mortality, recurrent stroke, myocardial infarction (MI) or functional outcome.Materials and Method...
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| Format: | Article |
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.772674/full |
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| author | Regina von Rennenberg Regina von Rennenberg Regina von Rennenberg Thomas Krause Juliane Herm Juliane Herm Simon Hellwig Simon Hellwig Jan F. Scheitz Jan F. Scheitz Jan F. Scheitz Matthias Endres Matthias Endres Matthias Endres Matthias Endres Karl Georg Haeusler Christian H. Nolte Christian H. Nolte Christian H. Nolte Christian H. Nolte |
| author_facet | Regina von Rennenberg Regina von Rennenberg Regina von Rennenberg Thomas Krause Juliane Herm Juliane Herm Simon Hellwig Simon Hellwig Jan F. Scheitz Jan F. Scheitz Jan F. Scheitz Matthias Endres Matthias Endres Matthias Endres Matthias Endres Karl Georg Haeusler Christian H. Nolte Christian H. Nolte Christian H. Nolte Christian H. Nolte |
| author_sort | Regina von Rennenberg |
| collection | DOAJ |
| description | Objectives: In patients with acute ischemic stroke, reduced heart rate variability (HRV) may indicate poor outcome. We tested whether HRV in the acute phase of stroke is associated with higher rates of mortality, recurrent stroke, myocardial infarction (MI) or functional outcome.Materials and Methods: Patients with acute mild to moderate ischemic stroke without known atrial fibrillation were prospectively enrolled to the investigator-initiated Heart and Brain interfaces in Acute Ischemic Stroke (HEBRAS) study (NCT 02142413). HRV parameters were assessed during the in-hospital stay using a 10-min section of each patient's ECG recording at day- and nighttime, calculating time and frequency domain HRV parameters. Frequency of a combined endpoint of recurrent stroke, MI or death of any cause and the respective individual events were assessed 12 months after the index stroke. Patients' functional outcome was measured by the modified Rankin Scale (mRS) at 12 months.Results: We included 308 patients (37% female, median NIHSS = 2 on admission, median age 69 years). Complete follow-up was achieved in 286/308 (93%) patients. At 12 months, 32 (9.5%), 5 (1.7%) and 13 (3.7%) patients had suffered a recurrent stroke, MI or death, respectively. After adjustment for age, sex, stroke severity and vascular risk factors, there was no significant association between HRV and recurrent stroke, MI, death or the combined endpoint. We did not find a significant impact of HRV on a mRS ≥ 2 12 months after the index stroke.Conclusion: HRV did not predict recurrent vascular events in patients with acute mild to moderate ischemic stroke. |
| first_indexed | 2024-12-22T00:25:16Z |
| format | Article |
| id | doaj.art-57316907d1624a67828527411e9c5a90 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-22T00:25:16Z |
| publishDate | 2021-12-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-57316907d1624a67828527411e9c5a902022-12-21T18:45:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-12-011210.3389/fneur.2021.772674772674Heart Rate Variability and Recurrent Stroke and Myocardial Infarction in Patients With Acute Mild to Moderate StrokeRegina von Rennenberg0Regina von Rennenberg1Regina von Rennenberg2Thomas Krause3Juliane Herm4Juliane Herm5Simon Hellwig6Simon Hellwig7Jan F. Scheitz8Jan F. Scheitz9Jan F. Scheitz10Matthias Endres11Matthias Endres12Matthias Endres13Matthias Endres14Karl Georg Haeusler15Christian H. Nolte16Christian H. Nolte17Christian H. Nolte18Christian H. Nolte19Klinik und Hochschulambulanz für Neurologie, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité – Universitätsmedizin Berlin, Berlin, GermanyGerman Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), Berlin, GermanyDepartment of Neurology, Jüdisches Krankenhaus Berlin, Berlin, GermanyKlinik und Hochschulambulanz für Neurologie, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité – Universitätsmedizin Berlin, Berlin, GermanyKlinik und Hochschulambulanz für Neurologie, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité – Universitätsmedizin Berlin, Berlin, GermanyKlinik und Hochschulambulanz für Neurologie, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité – Universitätsmedizin Berlin, Berlin, GermanyGerman Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Berlin, GermanyKlinik und Hochschulambulanz für Neurologie, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité – Universitätsmedizin Berlin, Berlin, GermanyGerman Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), Berlin, GermanyGerman Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Berlin, GermanyDepartment of Neurology, Universitätsklinikum Würzburg, Würzburg, GermanyKlinik und Hochschulambulanz für Neurologie, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, GermanyCenter for Stroke Research Berlin (CSB), Charité – Universitätsmedizin Berlin, Berlin, GermanyGerman Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), Berlin, GermanyGerman Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Berlin, GermanyObjectives: In patients with acute ischemic stroke, reduced heart rate variability (HRV) may indicate poor outcome. We tested whether HRV in the acute phase of stroke is associated with higher rates of mortality, recurrent stroke, myocardial infarction (MI) or functional outcome.Materials and Methods: Patients with acute mild to moderate ischemic stroke without known atrial fibrillation were prospectively enrolled to the investigator-initiated Heart and Brain interfaces in Acute Ischemic Stroke (HEBRAS) study (NCT 02142413). HRV parameters were assessed during the in-hospital stay using a 10-min section of each patient's ECG recording at day- and nighttime, calculating time and frequency domain HRV parameters. Frequency of a combined endpoint of recurrent stroke, MI or death of any cause and the respective individual events were assessed 12 months after the index stroke. Patients' functional outcome was measured by the modified Rankin Scale (mRS) at 12 months.Results: We included 308 patients (37% female, median NIHSS = 2 on admission, median age 69 years). Complete follow-up was achieved in 286/308 (93%) patients. At 12 months, 32 (9.5%), 5 (1.7%) and 13 (3.7%) patients had suffered a recurrent stroke, MI or death, respectively. After adjustment for age, sex, stroke severity and vascular risk factors, there was no significant association between HRV and recurrent stroke, MI, death or the combined endpoint. We did not find a significant impact of HRV on a mRS ≥ 2 12 months after the index stroke.Conclusion: HRV did not predict recurrent vascular events in patients with acute mild to moderate ischemic stroke.https://www.frontiersin.org/articles/10.3389/fneur.2021.772674/fullstrokeheart rate variabilityfunctional outcomecardiovascular eventsheart and brain interaction |
| spellingShingle | Regina von Rennenberg Regina von Rennenberg Regina von Rennenberg Thomas Krause Juliane Herm Juliane Herm Simon Hellwig Simon Hellwig Jan F. Scheitz Jan F. Scheitz Jan F. Scheitz Matthias Endres Matthias Endres Matthias Endres Matthias Endres Karl Georg Haeusler Christian H. Nolte Christian H. Nolte Christian H. Nolte Christian H. Nolte Heart Rate Variability and Recurrent Stroke and Myocardial Infarction in Patients With Acute Mild to Moderate Stroke Frontiers in Neurology stroke heart rate variability functional outcome cardiovascular events heart and brain interaction |
| title | Heart Rate Variability and Recurrent Stroke and Myocardial Infarction in Patients With Acute Mild to Moderate Stroke |
| title_full | Heart Rate Variability and Recurrent Stroke and Myocardial Infarction in Patients With Acute Mild to Moderate Stroke |
| title_fullStr | Heart Rate Variability and Recurrent Stroke and Myocardial Infarction in Patients With Acute Mild to Moderate Stroke |
| title_full_unstemmed | Heart Rate Variability and Recurrent Stroke and Myocardial Infarction in Patients With Acute Mild to Moderate Stroke |
| title_short | Heart Rate Variability and Recurrent Stroke and Myocardial Infarction in Patients With Acute Mild to Moderate Stroke |
| title_sort | heart rate variability and recurrent stroke and myocardial infarction in patients with acute mild to moderate stroke |
| topic | stroke heart rate variability functional outcome cardiovascular events heart and brain interaction |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.772674/full |
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