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

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

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



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.
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