Heart Rate Variability During Early Mobilization in Patients with Acute Ischemic Stroke

2018 ◽  
Vol 80 (1-2) ◽  
pp. 50-54 ◽  
Author(s):  
Masafumi Nozoe ◽  
Miho Yamamoto ◽  
Miki Kobayashi ◽  
Masashi Kanai ◽  
Hiroki Kubo ◽  
...  

Autonomic dysfunction is one of the predictors of poor outcome in patients with acute ischemic stroke. We compared the heart rate variability (HRV) during early mobilization in patients with or without neurological deterioration (ND). We enrolled 7 acute ischemic patients with ND and 14 without ND and measured their HRV in the rest and mobilization by electrocardiography. There was a significant difference in sympathetic nervous activity during mobilization between the 2 groups. However, no significant differences in blood pressure, heart rate, and parasympathetic nerve activity were observed. In patients with acute ischemic stroke, it is likely that the increase in sympathetic nervous activity during mobilization is associated with ND.

2009 ◽  
Vol 37 (06) ◽  
pp. 1013-1021 ◽  
Author(s):  
Seung Yeop Lee ◽  
Yong Hyeon Baek ◽  
Seong Uk Park ◽  
Sang Kwan Moon ◽  
Jung Mi Park ◽  
...  

This study is a double-blind randomized controlled trial on the effect of intradermal acupuncture on insomnia after stroke. Hospitalized stroke patients with insomnia were enrolled in the study and were randomly assigned to either a real intradermal acupuncture group (RA group) or a sham acupuncture group (SA group). The RA group received intradermal acupuncture on Shen-Men (He-7) and Nei-Kuan (EH-6) for three days, and the SA group received sham acupuncture on the same points. The effect of acupuncture on insomnia was measured using Insomnia Severity Index (ISI) and Athens Insomnia Scale (AIS) at baseline and three days after treatment. To assess the effect of acupuncture on the autonomic nervous function, the subjects' blood pressure and heart rate variability were monitored. Fifty-two subjects (27 in the RA group and 25 in the SA group) were included in the final analysis. The insomnia-related scales ISI and AIS showed greater improvement of insomnia in the RA group than in the SA group. Moreover, there is a greater reduction of the number of non-dippers and a greater decrease of the LF/HF ratio (heart rate variability) in the RA group than in the SA group. These results indicate that sympathetic hyperactivities were stabilized in the RA group. It can thus be concluded that intradermal acupuncture on Shen-Men and Nei-Kuan is a useful therapeutic method for post stroke-onset insomnia as it reduces sympathetic hyperactivities.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ivani C Trombetta ◽  
Cristiane M Nunes ◽  
Luciano F Drager ◽  
Raffael F Fraga ◽  
Maria Janieire N Alves ◽  
...  

Obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) independently increases muscular sympathetic nervous activity (MSNA). Unknown is whether OSA has an additive effect on MSNA in patients with MetS. We tested the hypothesis that: OSA would have an additive effect on MSNA in patients with MetS. In addition, we studied whether the increase in MSNA in patients with MetS is associated with alteration in arterial baroreflex sensitivity (BRS). Twenty four patients with MetS diagnosed according ATP-III were divided in two groups: MetS+OSA (n=14) and MetS (n=10). They were matched for age, body mass index, waist circumference, and metabolic profile: OSA was defined by an apnoea/hypopnoea index (AHI)>15 events/hour by polysonography. MSNA was recorded directly from the peroneal nerve using the technique of microneurography. Blood pressure (BP) was monitored on a beat-by-beat basis (Finapress) and heart rate by ECG. BRS was analyzed by spontaneous BP and heart rate fluctuations. AHI was higher (42±9 vs. 7±1 events/h, P =0.0001) and minimum oxygen saturation lower (77±2 vs. 87±1 %, P =0.001) in MetS+OSA patients. Patients MetS+OSA had higher MSNA (55±3 vs. 43±2 bursts/100 beats, P =0.01) and systolic BP (158±4 vs.144±3 mmHg, P =0.01) when compared with patients with MetS without OSA. Further analysis showed that AHI and minimum oxygen saturation have significant correlation with MSNA (r=0.65; P =0.001 and r=−0.48; P =0.017, respectively). Patients with MetS+OSA had lower BRS for increases (7.8±0.9 vs. 13.4 ± 1.4 msec/mmHg, P =0.01) and decreases (7.2±0.9 vs. 13.2 ± 2.0 msec/mmHg, P =0.03) in blood pressure than patients with MetS without OSA. MSNA significantly correlated with BRS during spontaneous increases in blood pressure (r=−0.56, P =0.01). OSA exacerbates MSNA in patients with MetS. In addition, the augmented MSNA in patients with MetS+OSA is associated with reduced BRS. These findings suggest that OSA increases the risk for cardiovascular disease in patients with MetS.


2019 ◽  
Vol 22 (1) ◽  
pp. 34-44
Author(s):  
Wan-Ling Chang ◽  
Jiunn-Tay Lee ◽  
Chi-Rong Li ◽  
Amy H. T. Davis ◽  
Chia-Chen Yang ◽  
...  

Background: Autonomic dysfunction, cognitive impairment, and psychological distress are associated with poorer prognosis in patients with acute ischemic stroke (AIS). Heart rate variability (HRV) biofeedback (BF) improves autonomic dysfunction, cognitive impairment, and psychological distress in other patient populations, but its effect in patients with AIS is still unclear. Objective: This study investigated the effects of an HRVBF intervention on autonomic function, cognitive impairment, and psychological distress in patients with AIS. Method: In this randomized, controlled, single-blind trial, patients with AIS were randomly assigned to the experimental or control group. The experimental group received four HRVBF training sessions. The control group received usual care. Repeated measures of HRV, mini-mental status examination (MMSE), and Hospital Anxiety and Depression Scales (HADS) were collected prior to and at 1 and 3 months postintervention. Results: A total of 35 patients completed the study (19 experimental, 16 control). HRV and HADS significantly improved in the experimental group ( p < .001) but not in the control group. Likewise, only the experimental group showed significant improvements in HRV, MMSE, and HADS over time ( p < .05). Conclusion: HRVBF is a promising intervention for improving autonomic function, cognitive impairment, and psychological distress in patients with AIS. More studies of HRVBF interventions are needed to further optimize the effects of HRVBF on autonomic, cognitive, and psychological function in patients with AIS.


2017 ◽  
Vol 130 (6) ◽  
pp. 652-658 ◽  
Author(s):  
Lin Wei ◽  
Wen-Bo Zhao ◽  
Huan-Wen Ye ◽  
Yan-Hua Chen ◽  
Xiao-Pei Zhang ◽  
...  

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