Aftyka Joanna, Staszewski Jacek, Dębiec Aleksander, Pogoda-Wesołowska Aleksandra, Żebrowski Jan
Faculty of Physics, Warsaw University of Technology, Koszykowa 75, 00-662 Warsaw, Poland.
Clinic of Neurology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland.
Life (Basel). 2023 Mar 23;13(4):856. doi: 10.3390/life13040856.
The aim of this study was to assess whether the heart rate variability (HRV) could predict a favorable or unfavorable stroke outcome. The endpoint was based on the National Institutes of Health Stroke Scale (NIHSS). The patient's health condition was assessed upon discharge from the hospital. An unfavorable stroke outcome was defined as death or NIHSS ≥ 9, while NIHSS < 9 meant a favorable stroke outcome. The studied group consisted of 59 patients with acute ischemic stroke AIS (mean age of 65.6 ± 13.2; 58% were females). An original and innovative non-linear measure was used to analyze HRV. It was based on symbolic dynamics consisting of comparing the "length of the longest words" in the night recording of HRV. "The length of the longest word" meant the longest sequence of identical adjacent symbols possible for a patient. An unfavorable stroke outcome occurred in 22 patients, whereas the majority of patients (37) had a favorable stroke outcome. The average hospitalization time of patients with clinical progression was 29 ± 14 days, and with favorable outcomes was 10 ± 3 days. Patients with long words (more than 150 adjacent RR intervals having the same symbol) were hospitalized no longer than 14 days and they had no clinical progression. The patients with a favorable stroke outcome were characterized by longer words. Our pilot study may be the beginning of work on the development of a non-linear, symbolic method as a predictor of prolonged hospitalization and increased risk of clinical progression in patients with AIS.
本研究的目的是评估心率变异性（HRV）是否能够预测中风的预后是良好还是不良。终点基于美国国立卫生研究院卒中量表（NIHSS）。患者出院时评估其健康状况。不良中风预后定义为死亡或NIHSS≥9，而NIHSS<9表示中风预后良好。研究组由59例急性缺血性中风（AIS）患者组成（平均年龄65.6±13.2岁；58%为女性）。采用一种原创且创新的非线性测量方法来分析HRV。它基于符号动力学，包括比较HRV夜间记录中“最长单词的长度”。“最长单词的长度”指患者可能出现的相同相邻符号的最长序列。22例患者出现不良中风预后，而大多数患者（37例）中风预后良好。临床病情进展患者的平均住院时间为29±14天，预后良好患者的平均住院时间为10±3天。单词长（超过150个相邻RR间期具有相同符号）的患者住院时间不超过14天且无临床病情进展。中风预后良好的患者其单词较长。我们的初步研究可能是开发一种非线性符号方法作为AIS患者住院时间延长和临床病情进展风险增加的预测指标的工作开端。
