Heart rate variability in chronic ischemic stroke: analysis during the sleep-wake cycle.

IF 1 4区 医学 Q4 NEUROSCIENCES
Arquivos de neuro-psiquiatria Pub Date : 2024-11-01 Epub Date: 2024-11-06 DOI:10.1055/s-0044-1791660
Natalia Buitrago-Ricaurte, Fatima Dumas Cintra, Jean Faber, Gisele Sampaio Silva
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引用次数: 0

Abstract

Background:  Alterations of the autonomic nervous system (ANS) in the chronic stage of ischemic stroke (IS) are not well understood. Heart rate variability (HRV) provides a noninvasive approach to assess autonomic function.

Objective:  To compare the HRV parameters during the sleep-wake cycle between patients with IS in the chronic stage and healthy subjects.

Methods:  We conducted a retrospective transversal study based on clinical records and 24-hour electrocardiogram (EKG) monitoring registries of 179 patients with a confirmed IS diagnosis and 184 age- and sex-matched healthy subjects. Circadian variation was calculated according to the variation of the total autonomic activity (VTAI) and the parasympathetic activity (VPAI) indexes. Comparisons were performed using nonparametric tests. Multivariable analyses were performed with canonical discriminant analysis (CDA) and a three-way analysis of variance (ANOVA). Statistical significance was established with a confidence level of 95%.

Results:  During waking hours, the healthy group exhibited higher variability in the time domain and frequency domain parameters: standard deviation of NN intervals (SDNN, p < 0.001) and of the average NN intervals (SDANN, p < 0.001), as well as low-frequency (LF) band (p < 0.001). During sleep, the difference was higher in the high-frequency (HF) band (p < 0.001), and lower in the low-/high-frequency ratio (LF/HF, p < 0.001). Both VPAI and VTAI showed less significant difference in IS patients (p < 0.001).

Conclusion:  There was diminished heart vagal activity among IS patients, as measured through HRV. During sleep, this is likely caused by an imbalance in the sympathetic and parasympathetic systems shifting through the sleep phases. These imbalances could persist over time in patients with IS, lasting months after the initial injury.

慢性缺血性中风的心率变异性:睡眠-觉醒周期分析。
背景:缺血性脑卒中(IS)慢性期自律神经系统(ANS)的变化尚不十分清楚。心率变异性(HRV)是评估自律神经功能的一种无创方法:比较慢性期缺血性中风(IS)患者和健康人在睡眠-觉醒周期中的心率变异参数:我们根据 179 名确诊为 IS 的患者和 184 名年龄和性别匹配的健康受试者的临床记录和 24 小时心电图(EKG)监测登记进行了一项回顾性横向研究。昼夜节律变化根据总自律神经活动(VTAI)和副交感神经活动(VPAI)指数的变化进行计算。比较采用非参数检验。采用典型判别分析(CDA)和三方差分析(ANOVA)进行多变量分析。统计显著性的置信度为 95%:通过心率变异测量,IS 患者的心脏迷走神经活动减弱。这可能是由于交感神经和副交感神经系统在睡眠阶段的不平衡造成的。这些失衡可能会在 IS 患者身上长期存在,并在初次受伤后持续数月之久。
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来源期刊
Arquivos de neuro-psiquiatria
Arquivos de neuro-psiquiatria 医学-精神病学
CiteScore
2.10
自引率
7.10%
发文量
262
审稿时长
4-8 weeks
期刊介绍: Arquivos de Neuro-Psiquiatria is the official journal of the Brazilian Academy of Neurology. The mission of the journal is to provide neurologists, specialists and researchers in Neurology and related fields with open access to original articles (clinical and translational research), editorials, reviews, historical papers, neuroimages and letters about published manuscripts. It also publishes the consensus and guidelines on Neurology, as well as educational and scientific material from the different scientific departments of the Brazilian Academy of Neurology. The ultimate goals of the journal are to contribute to advance knowledge in the areas of Neurology and Neuroscience, and to provide valuable material for training and continuing education for neurologists and other health professionals working in the area. These goals might contribute to improving care for patients with neurological diseases. We aim to be the best Neuroscience journal in Latin America within the peer review system.
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