Department of Gerontology, Cangzhou Central Hospital, Cangzhou, China.
Department of Neurosurgery, Cangzhou Central Hospital, Cangzhou, China.
Neurol Sci. 2021 Apr;42(4):1453-1462. doi: 10.1007/s10072-020-04682-1. Epub 2020 Aug 18.
We aimed to determine whether heart rate variability (HRV) was correlated to long-term outcome in patients who received mechanical thrombectomy (MT) under general anesthesia for emergent large vessel occlusion (ELVO).
Data from 106 patients receiving MT under general anesthesia to treat ELVO between January 1, 2017 and December 31, 2019 were collected in a multicenter chart review. Univariate analysis, Chi-square test, and bivariate logistic regression were performed to assess the correlations between preoperative risk factors such as HRV and long-term outcome (as indicated by the modified Rankin score [mRS] at 90 days after MT).
Bivariate logistic regression revealed that decreased LF/HF (low frequency/high frequency in HRV) ratio was correlated with unfavorable functional outcome as indicated by mRS ≥ 2 (odds ratio [OR], 0.650; 95% confidence interval [CI], 0.157-0.839; p = 0.018), and functionally dependent outcome as indicated by mRS ≥ 3 (OR, 0.704; 95% CI, 0.360-0.914; p = 0.021). It was also found that ELVO in the right anterior circulation was correlated with lower LF/HF ratio, as compared with ELVO in the contralateral side (p < 0.05).
Our retrospective study demonstrated that worse outcome in patients with ELVO who received MT under general anesthesia induced autonomic changes and that decreased LF/HF ratio.
本研究旨在探讨全麻下接受机械取栓术（MT）治疗的大血管闭塞（ELVO）患者的心率变异性（HRV）与长期预后的相关性。
本研究回顾性分析了 2017 年 1 月 1 日至 2019 年 12 月 31 日期间在多中心接受 MT 治疗 ELVO 的 106 例患者的数据。采用单因素分析、卡方检验和二元逻辑回归分析评估 HRV 等术前危险因素与长期预后（以 MT 后 90 天改良 Rankin 评分[mRS]表示）的相关性。
二元逻辑回归分析显示，LF/HF（HRV 中的低频/高频）比值降低与 mRS≥2 所示的不良功能结局（优势比[OR]，0.650；95%置信区间[CI]，0.157-0.839；p=0.018）和 mRS≥3 所示的功能依赖性结局（OR，0.704；95%CI，0.360-0.914；p=0.021）显著相关。此外，与对侧侧支 ELVO 相比，右侧前循环 ELVO 与较低的 LF/HF 比值相关（p<0.05）。
本回顾性研究表明，接受 MT 治疗的 ELVO 患者预后较差，可能与自主神经变化和 LF/HF 比值降低有关。
