Department of Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan, ROC.
J Clin Neurosci. 2013 Mar;20(3):406-9. doi: 10.1016/j.jocn.2012.02.047. Epub 2012 Dec 7.
Autonomic cardiac dysfunction is a common complication after acute ischemic stroke (IS). We recruited 75 patients with acute IS with measurements of autonomic cardiac function, including heart rate variability (HRV) and associated parameters, and compared them with 81 controls. Of the 75 patients, 28 had right hemispheric infarctions (RH), 29 had left hemispheric infarctions (LH), and 18 had brainstem infarctions (BS). A comparison of HRV in all patients with stroke and in control subjects showed significant differences between IS subgroups and controls in low frequency (LF), high frequency (HF), normalized LF, normalized HF, and LF/HF ranges. A post-hoc comparison identified significant differences between patients with IS with BS infarctions and the control group in LF, HF, and LF/HF ranges. BS infarction may cause a much greater increase in sympathetic modulation and reduced vagal activity compared to RH or LH infarction. Our findings provide evidence that acute IS causes significant damage to the cardiovascular autonomic system, manifesting as abnormalities of HRV. BS stroke might correlate with a significant reduction in parasympathetic and an increase in sympathetic influence on HRV.
自主心脏功能障碍是急性缺血性脑卒中（IS）后的常见并发症。我们招募了 75 名急性 IS 患者，对其自主心脏功能进行了测量，包括心率变异性（HRV）和相关参数，并将其与 81 名对照者进行了比较。在这 75 名患者中，28 名患者为右侧半球梗死（RH），29 名患者为左侧半球梗死（LH），18 名患者为脑干梗死（BS）。对所有脑卒中患者和对照组的 HRV 进行比较后发现，在低频（LF）、高频（HF）、LF 归一化、HF 归一化和 LF/HF 范围内，IS 亚组与对照组之间存在显著差异。事后比较发现，BS 梗死患者与对照组在 LF、HF 和 LF/HF 范围内存在显著差异。与 RH 或 LH 梗死相比，BS 梗死可能导致交感神经调节增加和迷走神经活动减少。我们的研究结果表明，急性 IS 会对心血管自主神经系统造成显著损害，表现为 HRV 异常。BS 卒中可能与副交感神经的显著减少和对 HRV 的交感神经影响的增加有关。
