Russian Heart Failure Journal 2009year Heart rhythm variability in patietns with acute ischemic stroke and chronic heart failure


To access this material please log in or register

Register Authorize
2009/

Heart rhythm variability in patietns with acute ischemic stroke and chronic heart failure

Samokhvalova E. V., Geraskina L. A., Foniyakin A. V.

Keywords:

DOI:

Urgency. Development of heart failure is associated with activation of the sympathetic component in the autonomic nervous system (ANS) and higher risk for arrhythmias and sudden cardiac death. Effects of the central nervous system ischemic damage on the autonomic regulation of heart in CHF remain understudied. Aim. Studying the dynamics of major parameters of heart rhythm variability (HRV) in patients with acute ischemic stroke depending on the presence and stage of CHF. Materials and methods. 95 patients (62 men and 33 women; mean age 61 ± 11 years) were evaluated in the dynamics of the acute phase of ischemic stroke. Patients with the constant form of atrial fibrillation, with an artificial heart pacemaker, receiving antiarrhythmics or β-adrenoblockers were not included in the study. HRV was studied using the 24-hour Holter ECG monitoring on day 2 and in dynamics on day 21-22 after stroke. Results. The most acute phase of ischemic stroke is associated with depression of autonomic regulation independent of the CHF presence; the deficit of autonomic regulation is most pronounced in patients with II stage CHF. In patients with CHF by the end of acute phase, pronouncement of autonomic deficit increases due to diffuse changes in the myocardium resulting in rearrangement of the intracardiac autonomic apparatus. In patients without CHF, parameters recover to the control level.
  1. Терещенко С. Н., Павликова Е. П., Мерай И. А. Место мозгового натрийуретического пептида в диагностике сердечной недостаточности. Журнал сердечная недостаточность. 2003; 4 (2):103‑104.
  2. Национальные Рекомендации ВНОК И ОССН по диагностике и лечению ХСН (второй пересмотр). Журнал Сердечная Недостаточность. 2007; 8 (1):4–41.
  3. Фонякин А. В., Суслина З. А., Гераскина Л. А. Кардиологическая диагностика при ишемическом инсульте. – С-Пб.: ИНКАРТ, 2005. – 224с.
  4. Vernino S, Brown RD Jr, Sejvar JJ et al. Cause-Specific Mortality After First Cerebral Infarction (A Population-Based Study). Stroke. 2003; 34 (8):1828–1832.
  5. Schwartz PJ, Billman GE, Stone HL. Autonomic mechanisms in ventricular fibrillation induced by myocardial ischemia during exercise in dogs with healed myocardial infarction. Circulation. 1984; 69 (4):790‑800.
  6. Nolan J, Batin P, Andrews R et al. Prospective study of heart rate variability and mortality in chronic heart failure; results of the United Kingdom Heart Failure Evaluation and Assessment of Risk Trial (UK-HEART). Circulation. 1998; 98 (15):1510–1516.
  7. La Rovere MT, Pinna GD, Hohnloser SH et al. Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials. Circulation. 2001; 103 (16):2072–2077.
  8. Odemuyiwa O, Malik M, Farrell T et al. Comparison of the predictive characteristics of heart rate variability index and left ventricular ejection fraction for all-cause mortality, arrhythmic events and sudden death after acute myocardial infarction. Am J Cardiol. 1991; 68 (5):434‑439.
  9. Malik M, Camm AJ. Heart rate variability and clinical cardiology. Br Heart J. 1994; 71 (1):3–6.
  10. Mäkikallio TH, Huikuri HV, Hintze U et al. Fractal analysis and time- and frequency-domain measures of heart rate variability as predictors of mortality in patients with heart failure. Am J Cardiol. 2001; 87 (2):178‑182.
  11. Рябыкина Г. В., Соболев А. В. Вариабельность ритма сердца. – М.: «Оверлей», 2001. – 211с.
  12. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 1996; 17 (3):354‑381.
  13. Lane RD, Wallace JD, Petrosky PP et al. Supraventricular tachycardia in patients with right hemisphere strokes. Stroke. 1992; 23 (3):362‑366.
  14. Naver HK, Blomstrand C, Wallin BG. Reduced heart rate variability after right-sided stroke. Stroke. 1996; 27 (2):247‑251.
  15. Tokgözoglu SL, Batur MK, Top uoglu MA et al. Effects of stroke localization on cardiac autonomic balance and sudden death. Stroke. 1999; 30 (7):1307–1311.
  16. Robinson TG, Dawson SL, Eames PJ et al. Cardiac baroreceptor sensitivity predicts long-term outcome after acute ischemic stroke. Stroke. 2003; 34 (3):705‑712.
  17. Christensen JN, Gustenhoff P, Korup E et al. Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomized controlled trial. BMJ. 1996; 312 (7032):677‑668.
  18. Christensen JH, Christensen MS, Dyerberg J, Schmidt EB. Heart rate variability and fatty acid content of blood cell membranes: a dose-response study with n-3 fatty acid. Am J Clin Nutr. 1999; 70 (3):331‑337.
  19. PROGRESS Collaborative Study Group. Randomised trial of perindopril based blood pressure-lowering regimen among 6108 individuals with previous stroke or transient ischaemic attack. Lancet. 2001; 358 (9287):1033–1041.
  20. Schrader J, Luders S, Kulschewski A et al. Morbidity and Mortality After Stroke, Eprosartan Compared with Nitrendipine for Secondary Prevention: principal results of a prospective randomized controlled study (MOSES). Stroke. 2005; 36 (6):1218–1226.
  21. Amarenco P, Bogousslavsky J, Callahan A 3rd et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006; 355 (6):549‑559.

To access this material please log in or register

Register Authorize
Ru En