Assessing autonomic nervous function by heart rate variability and heart rate turbulence in patients with acute ischemic stroke

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Candemir M. , Önder H.

Annals Of Indian Academy Of Neurology, vol.23, no.5, pp.608-615, 2020 (Journal Indexed in SCI Expanded)

  • Publication Type: Article / Article
  • Volume: 23 Issue: 5
  • Publication Date: 2020
  • Doi Number: 10.4103/aian.aian_647_19
  • Title of Journal : Annals Of Indian Academy Of Neurology
  • Page Numbers: pp.608-615


Background: Acute ischemic stroke (AIS) induces adverse effects on the

cardiovascular system by affecting the autonomic nervous system (ANS).

Objectives: This study aimed to determine whether the parameters of heart

rate variability (HRV) and heart rate turbulence (HRT) differed in patients

with AIS as compared to that in the control group. Furthermore, we aimed to

determine the differences in the involvement of the ANS between right and

left hemisphere (LH) strokes. Methods: A total of 148 [74 right hemispheres

(RH) and 74 left hemispheres] patients with AIS and 80 control subjects were

included in the study. The Holter device was used to obtain

elcctrocardiogram readings for over 20 h from all patients. Results of HRV

and HRT parameters [Tonset (TO) and Tslope (TS)] were acquired through an automatic analysis of the program. Results: All HRV parameters were

found to be low in patients with AIS (P < 0.05, for all parameters). TO and

TS were disrupted in 99 patients with AIS (66.8%) and in 15 control subjects

(18.7%) (HRT–1 and HRT–2 groups, P = <0.001). HRV parameters were

detected to be similar in patients, irrespective of the left or right infarct. TO

and TS were normal in 31 patients (41.9%) with left hemisphere localization

and in only 18 patients (24.3%) with right hemisphere localization.

Conclusions: Combined evaluation of HRV and HRT parameters may

provide important information regarding the alterations in the ANS in

patients with AIS. The utility of HRT in the determination of ANS alterations

in patients with AIS should be investigated in larger future prospective