Heart Rate Variability and Cerebrovascular Events

Öz

Abstract

Background: Heart rate variability (HRV) is a noninvasive assessment that reflects the autonomic functions of the heart and it is known to be disrupted in many systematic diseases. In our study, we aimed to investigate the relationship between HRV and acute ischemic stroke (AIS).
Materials and Methods: 102 AIS patients and 66 healthy individuals (control group) were included in the study. AIS patients were divided into two groups as ischemic stroke (IS) (n=65) and transient ischemic attack (TIA) (n=37). A 24-hour rhythm Holter record were applied to all patients.
Results: The frequency of hypertension (60.8% vs. 33.3%, p=0.005) and diabetes mellitus (DM) (39.2% vs. 15.2%, p=0.002), and serum glucose (142.4±60.0 vs. 106.8±20.9, p=0.034) and creatinine levels (0.9±0.3 vs. 0.8±0.5, p=0.010) were significantly higher in AIS group, whereas serum high-density lipoprotein (44.7±9.7 vs. 54.6±12.9, p=0.022) and left ventricular ejection fraction (LVEF) values were lower (53.0 [25-60] vs. 58.0 [30-60], p=0.012). Also, the HRV parameters SDNN (112.2 [37-1473] vs. 134.8[37-405], p<0.001), SDNN index (44.0 [14-132] vs. 55.1 [24-145], p<0.001), triangular index (1.5 [1-36] vs. 2.0 [1-53], p<0.001), HF (22.1 [5-2023] vs. 28.0 [13-2701], p=0.014), LF 2.7 [13-2367] vs. 3.4 [4-1523], p<0.001), and VLF 676.3 [7-1795] vs. 1014 [291-1881], p<0.001) were lower in the AIS group. There was no significant difference between the TIA and IS groups in terms of basal characteristics and HRV (p>0.05, for all). In multivariable regression analysis, age (OR: 1.096, %95 CI: 1.056 – 1.136, p<0.001), LVEF (OR: 0.362, % 95CI: 0.355-0.559, p=0.006) and DM (OR: 0.860, % 95CI: 0.856-0.931, p<0.001) were independent risk factors for AIS.
Conclusion: In our study, we detected that HRV parameters were lower in patients with AIS. We also found that age, LVEF and DM were the independent risk factors for AIS.

Key words: Acute cerebrovascular disease, Heart rate, Ischemic stroke, Transient ischemic attack

Kalp Hızı Değişkenliği ve Serebrovasküler Olaylar

Öz

Amaç: Kalp hızı değişkenliği (KHD), kalbin otonomik fonksiyonlarını yansıtan noninvaziv bir değerlendirmedir ve sistemik hastalıklarda bozulduğu bilinmektedir. Çalışmamızda, KHD ile akut iskemik inme (Aİİ) arasındaki ilişkiyi araştırmayı amaçladık.
Materyal ve metod: Toplam 102 Aİİ hastası ve 66 sağlıklı birey (kontrol grubu) çalışmaya dahil edildi. Aİİ hastaları, iskemik inme (İİ) (n=65) ve geçici iskemik atak (GİA) (n=37) olarak iki gruba ayrıldı. Hasta ve kontrol gruplarına 24 saatlik ritim Holter kaydı yapıldı.
Bulgular: Aİİ grubunda hipertansiyon (%60.8’e karşın %33.3, p=0.005) ve diyabetes mellitus (DM) (%39.2’e karşın %15.2, p=0.002) sıklığı ile, serum glukoz (142.4±60.0’a karşı 106.8±20.9, p=0.034) ve kreatinin düzeyleri (0.9±0.3’e karşın 0.8±0.5, p=0.010) anlamlı olarak daha yüksekti, fakat serum yüksek dansiteli lipoprotein düzeyi (44.7±9.7’e karşın 54.6±12.9, p=0.022) ve sol ventrikül ejeksiyon fraksiyonu (SVEF) (53.0 [25-60]’a karşın 58.0 [30-60], p=0.012) daha düşüktü. Ek olarak, KHD parametrelerinden olan SDNN (112.2 [37-1473]’e karşın 134.8 [37-405], p<0.001), SDNN index (44.0 [14-132]’e karşın 55.1 [24-145], p<0.001), üçgen index (1.5 [1-36]’e karşın 2.0 [1-53], p<0.001), HF (22.1 [5-2023]’e karşın 28.0 [13-2701], p=0.014), LF (2.7 [13-2367]’e karşın 3.4 [4-1523], p<0.001) ve VLF (676.3 [7-1795]’e karşın 1014 [291-1881], p<0.001) Aİİ grubunda anlamlı olarak daha düşüktü. İİ ve GİA grupları arasında ise bazal özellikler ve KHD parametreleri açısından anlamlı bir farklılık izlenmedi (p>0.05, hepsi için). Çoklu regresyon analizlerinde, yaş (OR: 1.096, %95 GA: 1.056 – 1.136, p<0.001), SVEF (OR: 0.362, %95 GA: 0.355-0.559, p=0.006) ve DM (OR: 0.860, %95 GA: 0.856-0.931, p<0.001) inme için bağımsız bir risk faktörü olarak saptandı
Sonuç: Çalışmamızda Aİİ hastalarında KHD parametrelerinin azalmış olduğunu saptadık. Ek olarak; yaş, SVEF ve DM’nin Aİİ için bağımsız birer risk faktörü olduğunu bulduk.

Anahtar Kelimeler: Akut serebrovasküler hastalık, Kalp hızı, İskemik inme, Geçici iskemik atak

Anahtar Kelimeler

• Akut serebrovasküler hastalık
• kalp hızı değişkenliği
• iskemik inme

Kaynakça

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