The Research Of Heart Rate Variability In Acute Cerebral Infarction Patients With Intracranial Atherosclerotic Stenosis

Objective: To investigate the changes of heart rate variability(HRV) in acutecerebral infarction(CI) patients with intracranial atherosclerotic stenosis(ICAS)，toanalysis the distribution of intracranial atherosclerotic stenosis and the risk factors.Methods: By magnetic resonance imaging（MRI），we continuously collected104eligible CI patients，according to the the MRA results，we divided the patientsinto two groups：the intracranial aherosclerotic stenosis(ICAS) named the group A（with one or more than one branch of artery stenosis）and the no cerebralatherosclerotic stenosis(NCAS) named group B，the group Awas further divided intothree teams，we named the anterior circulation artery stenosis as groupA1，posteriorcirculation as groupA2， anterior and posterior circulation artery stenosi asgroupA3，the group Awas further divided into two teams：one with multiple arterialstenosis and the other with single arterial stenosis；Meanwhile we collected40heathy subjects(control group)， The blood drawn from a vein on an empty stomachin the morning to detect numerical values of low density lipoprotein（LDL）and totalcholesterol(TC) of all patients；By dynamic electrocardiogram(DCG) to monitortime domain indexes，To analyze the correlation of intracranial atheroscleroticstenosis in acute CI patients with heart rate variability and risk factors.Results:（1）Among the104patients，group Ahad72cases (69.23%)，groupB had32cases(30.77%)，among the groupA，groupA1had36cases(50%），groupA2had8cases (11.11%)，group A3had28cases(38.89%)；the group with multiplearterial stenosis had32cases(44.44%)，with single arterial stenosis had40cases（55.56%）.（2）Comparing the group of acute CI with the control group，HRV parameterswas decreased obviously (P＜0.05)；the group A with group B，HRV parameterswas decreased obviously (P＜0.05)；Among the HRV parameters：group A3<groupA1<groupA2<group B；Comparing with multiple arterial stenosis and single arterialstenosis，the SDNN was significantly lower（P<0.05）.（3）Comparing the group of acute CI with the control group，LDL、TC were significantly higher；As LDLand TC，group Awas higher than group B（P<0.05），the multiple arterial stenosis was higher than single arterial stenosis，but had nostatistical significane（P>0.05）；comparing with groupA1、groupA2and groupA3，LDLwas higher than group B（P<0.05）；SDNN was negatively correlated with LDL（rs=-0.376，P＜0.05）。Conclusion:（1）The autonomic nerve dysfunction of acute CI patients wasapparent，the CI patients with ICAS was more apparent，It showed a decrease ofparasympathetic nervous activity and an increase of sympathetic nervous activity；the group A1、A2、A3all had a decrease of autonomic nervous activity，whileanterior and posterior circulation artery stenosis had no statistical significane；compared with multiple arterial stenosis with single arterial stenosis，the autonomicnerve dysfunction was more apparent.（2）The most common position of ICAS with CI patients is anteriorcirculation artery stenosis.（3）LDLand TC were important risk factors of ICAS，particularaly with LDLas one of the important risk factors of ICAS，LDL was closely related to the totalactivity of autonomic nervous system in CI patients with ICAS.