Journal
INTERNATIONAL JOURNAL OF STROKE
Volume 10, Issue 6, Pages 796-800Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1111/ijs.12573
Keywords
acute; autonomic function; baroreflex; heart rate variability; stroke
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Funding
- Vrije Universiteit Brussel
- Wetenschappelijk Fonds Willy Gepts of the Universitair Ziekenhuis Brussel
- Brussels Institute for Research and Innovation (INNOVIRIS)
- European Commission
- King Baudouin Foundation
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BackgroundAutonomic nervous system dysfunction is common after acute stroke and is associated with elevated risk of cardiac arrhythmia and mortality. Heart rate variability and baroreceptor sensitivity have been investigated as parameters of autonomic nervous system dysfunction for the prediction of stroke outcome. SummaryWe performed a systematic literature review on heart rate variability and baroreceptor sensitivity as parameters for autonomic nervous function in acute stroke. Twenty-two studies were included. Associations between heart rate variability or baroreceptor sensitivity and stroke severity, early and late complications, dependency and mortality were reported. However, interpretability of most studies and extrapolation to general stroke population are limited due to many confounding factors such as varying methodology, small sample sizes, survival selection, and exclusion of patients with frequently occurring comorbidities in stroke. Key issues, such as the effect of thrombolytic therapy on autonomic function, autonomic nervous system dysfunction in the hyperacute phase of stroke, and correlation with the risk of recurrent stroke have not been investigated. Also, nonlinear techniques have remained largely unexplored in this domain, in spite of their advantage to provide more solid evaluation in the occurrence of arrhythmia. Key messagesCardiac autonomic dysfunction, represented by reduced heart rate variability or impaired baroreceptor sensitivity, is associated with stroke severity, early and late complications, dependency, and mortality. Large-scale prospective studies applying internationally accepted standards of measures for analysis of heart rate variability and baroreceptor sensitivity are needed in patients with acute stroke.
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