dc.contributor.author
Scherbakov, Nadja
dc.contributor.author
Barkhudaryan, Anush
dc.contributor.author
Ebner, Nicole
dc.contributor.author
Haehling, Stephan von
dc.contributor.author
Anker, Stefan D.
dc.contributor.author
Joebges, Michael
dc.contributor.author
Doehner, Wolfram
dc.date.accessioned
2021-11-08T13:57:16Z
dc.date.available
2021-11-08T13:57:16Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/32606
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-32330
dc.description.abstract
Aims: Impaired autonomic nervous system regulation is frequently observed in patients with stroke. The aim of this prospective study was to evaluate the impact of cardiac autonomic tone on functional outcome after the early post-stroke rehabilitation.
Methods and results: One hundred and three consecutive patients (67 +/- 11 years, body mass index (BMI) 27.1 +/- 5.4 kg/m(2), 64% men) with ischaemic (84% of patients) and haemorrhagic stroke were studied. Depressed heart rate variability (HRV), as a surrogate marker of increased sympathetic tone, was defined by the standard deviation of NN intervals < 100 ms and HRV triangular index <= 20 assessed from a 24 h Holter electrocardiogram at admission to rehabilitation (23 +/- 16 days after stroke). Twenty-two per cent of patients had depressed HRV at baseline and were comparable with patients with normal HRV with regard to their functional [Barthel Index (BI), modified Rankin Scale (mRS), and Rivermead Motor Assessment (RMA)] and biochemical status. After a 4-week follow-up, 70% of patients with depressed HRV showed a cumulative functional disability, defined by mRS >= 4, BI <= 70, and RMA <= 5, in contrast to patients with normal HRV (35%,P = 0.003). Patients with depressed HRV showed a worse functional status by BI (-16%,P < 0.001), RMA (-12%,P < 0.05), and mRS (+16%,P < 0.01), compared with patients with normal HRV. Cumulative functional disability was associated with depressed HRV (odds ratio 4.25, 95% confidence interval 1.56-11.54,P < 0.005) after adjustment for age, sex, and body mass index (odds ratio 4.6, 95% confidence interval 1.42-14.97,P < 0.05).
Conclusions: The presence of autonomic cardiovascular dysregulation in patients with subacute stroke was associated with adverse functional outcome after the early post-stroke rehabilitation.
en
dc.rights.uri
https://creativecommons.org/licenses/by-nc/4.0/
dc.subject
Heart rate variability
en
dc.subject
Rehabilitation
en
dc.subject
Functional outcome
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Early rehabilitation after stroke: relationship between the heart rate variability and functional outcome
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1002/ehf2.12917
dcterms.bibliographicCitation.journaltitle
ESC Heart Failure
dcterms.bibliographicCitation.number
5
dcterms.bibliographicCitation.originalpublishername
Wiley
dcterms.bibliographicCitation.pagestart
2983
dcterms.bibliographicCitation.pageend
2991
dcterms.bibliographicCitation.volume
7
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
DEAL Wiley
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
33121218
dcterms.isPartOf.eissn
2055-5822