Cardiac Autonomic Responsiveness Analysis Of Acute Ischemic Stroke Patients Based On Holter Data

ObjectiveUsing Phase-rectified signal averaging technique(PRSA),this study intends to check the effects of acute ischemic stroke on autonomic nervous system,especially on the parasympathetic nervous system.MethodsThis study enrolled patients with acute cerebral infarction,who were admitted in the department of neurology in Shanghai sixth people’s East hospital from 2016/01/01 to 2017/12/31.Those at high risk of ischemic stroke were enrolled at the same time as the control group.The detailed clinical data were collected and recorded from both groups.All subjects underwent 24-hour Holter examination within 3 days after admission.Using PRSA to analyze the Holter data to get several cardiac autonomic responsiveness markers,such as DC,AC,etc.We use SPSS.20 to compare autonomic nervous activity between different age groups,in relation to hypertension and diabetes.We also check the cardiac autonomic responsiveness markers between ischemic stroke patients and the control group,also by specific ischemic infarction,different subtypes of ischemic stroke.ResultsAge is negatively correlated with DC,AC and SDNN(P<0.05).Hypertension and diabetes can lead to the decrease of DC and AC,while SDNN is not statistically influenced.The values of DC,AC,SDNN and pNN50 in acute ischemic stroke patients are significantly lower than those of control group(P<0.05).However,ischemic infarction localization and subtypes of ischemic stroke have no effects on autonomic nervous markers(P>0.05).Similarly,taking hypertension drugs such as ARB and Calcium-ion antagonists has no statistical significance.ConclusionRisk factors for ischemic stroke such as hypertension,diabetes,old-age are all associated with decreased parasympathetic activity.The accident of stroke independently influences autonomic nervous system,leading to reduced parasympathetic as well as sympathetic activity.Left cerebral infarction has a reduced DC compared with that of right cerebral infarction,but with no statistical significance.This study reports no effects of ischemic infarction localization and subtypes in ischemic stroke on autonomic nervous system.