Foniakin A V, Geraskina L A, Shandalin V A
Klin Med (Mosk). 2012;90(6):35-8.
The aim of this prospective study was to elucidate the relationship between cardiac complications and heart rhythm variability (HRV) in 90 patients (age median 58 (53;67) years) with the sinus rhythm after ischemic stroke. 24-hr Holter monitoring 21 days after stroke was used for temporal and spectral analysis of HRV. The follow-up period lasted 23 (12; 45) months. Ten (11%) patients of this group developed acute myocardial infarction, unstable angina, acute cardiac failure or sudden cardiac death. The remaining 80 (89%) patients constituted group 2. The two groups were matched for the duration of prospective observation, sex, ischemic stroke subtype, the size and localization of brain infarction, multiplicity of focal cerebral lesions, severity of neurologic disorders (Rankin scale), the history of myocardial infarction, the presence of diabetes and chronic heart failure. Patients of group 1 were older in the end of the acute stroke period than those of group 2 (68 (61;72) and 57 (51;66) years) respectively. They, more frequently suffered CHD (stable angina) and had lower spectral characteristics of HRV (p < 0.05).
本前瞻性研究的目的是阐明90例缺血性卒中后窦性心律患者(年龄中位数58(53;67)岁)心脏并发症与心率变异性(HRV)之间的关系。在卒中后21天采用24小时动态心电图监测对HRV进行时域和频域分析。随访期持续23(12;45)个月。该组中有10例(11%)患者发生急性心肌梗死、不稳定型心绞痛、急性心力衰竭或心源性猝死。其余80例(89%)患者构成第2组。两组在前瞻性观察时间、性别、缺血性卒中亚型、脑梗死大小和部位、局灶性脑病变的多发性、神经功能障碍严重程度(Rankin量表)、心肌梗死病史、糖尿病和慢性心力衰竭的存在情况方面进行了匹配。第1组患者在急性卒中期末比第2组患者年龄更大(分别为68(61;72)岁和57(51;66)岁)。他们更常患冠心病(稳定型心绞痛),且HRV的频谱特征较低(p<0.05)。