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Cortical modulation of cardiac autonomic activity in ischemic stroke patients

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Abstract

The cardiovascular system is regulated by the autonomic nervous system, under cortical modulation. Stroke can induce cardiac autonomic imbalance, therefore, causing secondary cardiovascular complications. Heart rate variability (HRV) analysis is a simple method to appraise the autonomic nervous function. The purpose of this study was to investigate the cardiac autonomic activity in patients that suffered an ischemic stroke in middle cerebral artery (MCA) territory. Using Biopac Acquisition System, we monitored ECG in rest condition and during Ewing’s tests. From these measurements, HRV parameters (using time and frequency domain analysis) were determined in 20 right MCA and 20 left MCA ischemic stroke patients, in the first 6 months after the acute event. Data were compared with 20 age- and sex-matched healthy controls. All the patients were right handed. In ischemic stroke patients, HRV parameters were significantly modified compared to controls (p < 0.05) and we found asymmetric responses to different stimulation autonomic tests between right and left hemisphere. Parameters illustrating the parasympathetic predominance in time domain (RMSSD) and frequency domain (HF) analysis were higher in left hemisphere stroke compared to right hemisphere stroke patients (p < 0.01) in resting state. From Ewing’s battery test, patients with left hemisphere ischemic stroke showed predominance of parasympathetic activity to deep breathing (p < 0.01), while HRV parameters in right hemisphere ischemic stroke patients described a reduced cardiac parasympathetic innervation (p < 0.01). Cardiac autonomic imbalance occurs more often after right hemisphere ischemic stroke. HRV study may highlight cardiac dysfunctions that increase the risk of cardiovascular complications and portends a poor long-term outcome.

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Acknowledgments

This work was supported by University of Medicine and Pharmacy “Grigore T. Popa” Iasi doctoral studies No. 2038. The support of the staff at the Department of Neurology Rehabilitation Hospital Iasi, as well as the enduring cooperation of the participants in this study is gratefully acknowledged.

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Authors and Affiliations

  1. Department of Neurology, Faculty of Medicine, University of Medicine and Pharmacy, Iasi, Romania

    Victor Constantinescu, Dan Cuciureanu, Bogdan Ignat & Cristian Dinu Popescu

  2. Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy, Iasi, Romania

    Daniela Matei & Calin Corciova

Authors
  1. Victor Constantinescu
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  2. Daniela Matei
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  3. Dan Cuciureanu
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  4. Calin Corciova
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  6. Cristian Dinu Popescu
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Correspondence to Daniela Matei.

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The authors declare that they have no conflict of interests.

Ethical standard

The study was carried out in accordance with the Helsinki Declaration.

Informed consent

The study was approved by our institutional ethics committee and all the patients gave consent in accordance with ethical principles.

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Constantinescu, V., Matei, D., Cuciureanu, D. et al. Cortical modulation of cardiac autonomic activity in ischemic stroke patients. Acta Neurol Belg 116, 473–480 (2016). https://doi.org/10.1007/s13760-016-0640-3

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  • DOI: https://doi.org/10.1007/s13760-016-0640-3

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