Determinants and prognostic significance of reduced heart rate variability for mortality and functional outcome after acute ischemic stroke

İmran Ceren; Eser Açıkgöz

doi:10.17944/interdiscip.1883447

Determinants and prognostic significance of reduced heart rate variability for mortality and functional outcome after acute ischemic stroke

Abstract

Objective: The study aimed to determine the predictors of reduced heart rate variability (HRV) in patients with stroke and to examine its relationship with functional outcomes and all-cause mortality. Methods:The 24-h Holter electrocardiographic recordings of patients referred to the cardiology outpatient clinic after acute ischemic stroke were retrospectively analyzed.Patients were grouped according to the standard deviation of normal-to-normal intervals (SDNN).Clinical and laboratory data, HRV parameters, and follow-up outcomes were evaluated. Results: The study included 163 patients (mean age, 66.7 ± 12.1 years). Compared with those with normal SDNN, patients with reduced SDNN had a higher heart rate, systolic and diastolic blood pressure, and modified Rankin Scale (mRS) scores. In multivariable logistic regression analysis, heart rate (OR 1.76, 95% CI 1.32–2.66, p = 0.001) and systolic blood pressure (OR 1.95, 95% CI 1.11–2.94, p = 0.01) were independent predictors of reduced SDNN. Over a median follow-up of 38 months, all-cause mortality was higher in the reduced SDNN group (22.4% vs. 10.5%, p = 0.039). Multivariable Cox analysis identified age (HR 1.063, 95% CI 1.012–1.117, p = 0.015), mRS score (HR 4.410, 95% CI 2.319–8.112, p < 0.001), and reduced SDNN (HR 1.976, 95% CI 1.112–4.121, p = 0.02) as independent predictors of all-cause mortality.Patients with reduced SDNN demonstrated a significantly decreased survival probability on Kaplan–Meier analysis (log-rank = 4.218, p = 0.004). Conclusion: Impaired HRV is associated with unfavorable functional outcomes and increased all-cause mortality in patients with ischemic stroke. The identification of autonomic dysfunction may provide additional insights into post-stroke prognosis.

Keywords

Ethical Statement

Ethical permission was obtained from the Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital Clinical Researches Ethics Committee (Date:10/07/2025, approval code: 2025-06/94, Decision No: 2025-06/94 ) and Helsinki Declaration rules were followed to conduct this study.

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Details

Primary Language

English

Subjects

Cardiology

Journal Section

Research Article

Authors

İmran Ceren ^*
0000-0003-0044-7681
Türkiye

Eser Açıkgöz
0000-0002-1775-1885
Türkiye

Publication Date

August 23, 2026

Submission Date

February 6, 2026

Acceptance Date

May 17, 2026

Published in Issue

Year 2026 Volume: 17 Number: 58

DOI

https://doi.org/10.17944/interdiscip.1883447

IZ

https://izlik.org/JA92XW38ED

Cite

RIS / Bibtex

APA

Ceren, İ., & Açıkgöz, E. (2026). Determinants and prognostic significance of reduced heart rate variability for mortality and functional outcome after acute ischemic stroke. Interdisciplinary Medical Journal, 17(58), 138-145. https://doi.org/10.17944/interdiscip.1883447

AMA

1.Ceren İ, Açıkgöz E. Determinants and prognostic significance of reduced heart rate variability for mortality and functional outcome after acute ischemic stroke. Interdiscip Med J. 2026;17(58):138-145. doi:10.17944/interdiscip.1883447

Chicago

Ceren, İmran, and Eser Açıkgöz. 2026. “Determinants and Prognostic Significance of Reduced Heart Rate Variability for Mortality and Functional Outcome After Acute Ischemic Stroke”. Interdisciplinary Medical Journal 17 (58): 138-45. https://doi.org/10.17944/interdiscip.1883447.

EndNote

Ceren İ, Açıkgöz E (August 1, 2026) Determinants and prognostic significance of reduced heart rate variability for mortality and functional outcome after acute ischemic stroke. Interdisciplinary Medical Journal 17 58 138–145.

IEEE

[1]İ. Ceren and E. Açıkgöz, “Determinants and prognostic significance of reduced heart rate variability for mortality and functional outcome after acute ischemic stroke”, Interdiscip Med J, vol. 17, no. 58, pp. 138–145, Aug. 2026, doi: 10.17944/interdiscip.1883447.

ISNAD

Ceren, İmran - Açıkgöz, Eser. “Determinants and Prognostic Significance of Reduced Heart Rate Variability for Mortality and Functional Outcome After Acute Ischemic Stroke”. Interdisciplinary Medical Journal 17/58 (August 1, 2026): 138-145. https://doi.org/10.17944/interdiscip.1883447.

JAMA

1.Ceren İ, Açıkgöz E. Determinants and prognostic significance of reduced heart rate variability for mortality and functional outcome after acute ischemic stroke. Interdiscip Med J. 2026;17:138–145.

MLA

Ceren, İmran, and Eser Açıkgöz. “Determinants and Prognostic Significance of Reduced Heart Rate Variability for Mortality and Functional Outcome After Acute Ischemic Stroke”. Interdisciplinary Medical Journal, vol. 17, no. 58, Aug. 2026, pp. 138-45, doi:10.17944/interdiscip.1883447.

Vancouver

1.İmran Ceren, Eser Açıkgöz. Determinants and prognostic significance of reduced heart rate variability for mortality and functional outcome after acute ischemic stroke. Interdiscip Med J. 2026 Aug. 1;17(58):138-45. doi:10.17944/interdiscip.1883447