Kosmas Macha (Germany)
University of Erlangen-Nuremberg Department of NeurologyAuthor Of 1 Presentation
CARDIOVASCULAR AUTONOMIC DYSFUNCTION IN PATIENTS WITH POSTERIOR CIRCULATION ISCHEMIC STROKE
- Ruihao Wang (Germany)
Abstract
Background and Aims:
Although it is well known that ischemic stroke may cause cardiovascular autonomic dysfunction, most studies focus on patients with anterior circulation stroke. In patients with posterior circulation ischemic stroke (PCIS), cardiovascular autonomic modulation has only been rarely studied. Therefore, we aimed to assess cardiovascular autonomic modulation in PCIS patients.
Methods:
In 57 patients with PCIS (12 occipital lobe, 14 thalamic, 11 cerebellar, 20 brainstem strokes) and 30 age- and gender-matched controls, we recorded RR-intervals (RRI), systolic, diastolic blood pressures (BPsys, BPdia), and respiration (RESP) at supine rest, within one week after stroke-onset. We calculated parameters reflecting total cardiac autonomic modulation [RRI-standard-deviation (RRI-SD), RRI-total-powers], mainly or exclusively sympathetic [RRI-low-frequency-powers (RRI-LF-powers) and BPsys-LF-powers] and parasympathetic cardiovascular modulation [Root-Mean-Square-of-Successive-RRI-Differences (RMSSD), RRI-high-frequency-powers (RRI-HF-powers)], sympathetic-parasympathetic balance (RRI-LF/HF-ratios), and baroreflex-sensitivity (BRS). Values were compared with one-way ANOVA or Kruskal-Wallis-Test, with post-hoc analyses. Significance was assumed for p<0.05.
Results:
In the patients of all PCIS- subgroups, values of RRI, RRI-SD, RMSSD, RRI-HF-powers, and BRS were significantly lower, while BPsys-LF-powers were higher than in the controls. In patients with ischemia in the occipital lobe, RRI-LF/HF-ratios were significant higher than in controls. Autonomic parameters did not differ between PCIS-subgroups.
Conclusions:
Within one week after PCIS-onset, patients have reduced parasympathetic and increased sympathetic cardiovascular modulation with diminished BRS. These findings are similar to our previous findings in patients after acute ischemic stroke in the middle cerebral artery territory (Hilz et al. 2011). The shift towards sympathetic predominance seems to be more pronounced in patients with occipital lobe lesions.