Correlation between heart rate variability and early neurological deterioration and poor outcomes in patients with branch atheromatous disease
10.3760/cma.j.issn.1673-4165.2022.12.003
- VernacularTitle:心率变异性与分支动脉粥样硬化病患者的早期神经功能恶化和转归不良的相关性
- Author:
Ting ZHANG
1
;
Lingyun LIU
;
Mengfan LI
;
Bing LENG
;
Yanling GAO
;
Jinbiao ZHANG
;
Zhenguang LI
Author Information
1. 潍坊医学院，潍坊 261053
- Keywords:
Stroke;
Intracranial arteriosclerosis;
Heart rate;
Electrocardiography;
Disease progression;
Treatment outcome;
Risk factors
- From:
International Journal of Cerebrovascular Diseases
2022;30(12):897-903
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between heart rate variability (HRV) and early neurological deterioration (END) and poor outcomes in patients with branch atheromatous disease (BAD).Methods:Patients with BAD admitted to the Department of Neurology, Weihai Municipal Hospital from September 2020 to September 2022 were enrolled prospectively. END was defined as an increase of ≥2 points in the total score of the National Institutes of Health Stroke scale (NIHSS) or an increase of ≥1 in motor item score within 72 h of admission compared with the baseline. Poor outcome was defined as the score of the modified Rankin Scale >2 at 6 months after the onset. Multivariate logistic regression analysis was used to determine whether HRV parameters were the independent influencing factors of END and poor outcomes in patients with BAD. Results:A total of 117 patients with BAD were enrolled, including 76 males (65.0%), aged 64.27±6.95 years. Thirty-eight patients (32.4%) had END, and 21 (17.9%) had poor outcomes. Percentage of the number of pairs of adjacent R-R intervals differentiating by more than 50 ms (pNN50), number of adjacent R-R intervals differentiating by more than 50 ms (NN50), power in low frequency range (LF) and power in high frequency range (HF) in the END group were significantly lower than those in the non-END group, and the LF/HF ratio was significantly higher than the non-END group (all P<0.05). The standard deviation of the R-R interval (SDNN), standard deviation of the average of R-R intervals in all 5-min segments (SDANN), and HF in the poor outcome group were significantly lower than those in the good outcome group. Multivariate logistic regression analysis showed that HF (odds ratio [ OR] 0.994, 95% confidence interval [ CI] 0.991-0.998; P<0.001) was an independent protective factor of END in patients with BAD, and LF/HF ratio ( OR 1.455, 95% CI 1.056-2.005; P=0.022) was an independent risk factor for END in patients with BAD; SDANN ( OR 0.997, 95% CI 0.993-0.999; P=0.023) was an independent protective factor of good outcomes in patients with BAD. Conclusion:HF and LF/HF ratios are the independent influencing factors of END in patients with BAD, and SDANN is an independent influencing factor of the poor outcomes in patients with BAD, suggesting that autonomic dysfunction is involved in the pathophysiological mechanism of END and poor outcomes in patients with BAD.
