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Heart rate variability – a potential early marker of sub‐acute post‐stroke infections
Author(s) -
Günther A.,
Salzmann I.,
Nowack S.,
Schwab M.,
Surber R.,
Hoyer H.,
Witte O. W.,
Hoyer D.
Publication year - 2012
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2011.01626.x
Subject(s) - medicine , stroke (engine) , acute stroke , heart rate variability , white blood cell , complication , prospective cohort study , cardiology , heart rate , blood pressure , mechanical engineering , tissue plasminogen activator , engineering
Günther A, Salzmann I, Nowack S, Schwab M, Surber R, Hoyer H, Witte OW, Hoyer D. Heart rate variability – a potential early marker of sub‐acute post‐stroke infections.
Acta Neurol Scand: 2012: 126: 189–196.
© 2011 John Wiley & Sons A/S. Objective – Infection is the most relevant complication after acute ischemic stroke. Activity of the autonomic nervous system seems to control post‐stroke immunodepression. We investigated heart rate variability (HRV) indices that reflect autonomic readjustments as predictors of post‐stroke infection. Materials and methods – Forty‐three patients with acute ischemic stroke were enrolled in a prospective study. The predictability of sub‐acute infections (day 4 ± 1 after admission) was investigated in 34 patients without acute infection by means of HRV indices obtained in the acute period (48 h after admission). Results – Sub‐acute infection could be predicted in patients without clinical or paraclinical (white blood cell count and C‐reactive protein) signs of infection in the acute period at (i) day: increased HFnorm, reduced LFnorm and LF/HF; (ii) night: reduced LF and VLF ( P < 0.05). Conclusions – HRV indices are candidates for early markers of developing post‐stroke infections, preceding routine blood samples. Thus, HRV‐based early diagnosis of post‐stroke infection should be investigated in more detail as it may have implications as a novel tool for timely and appropriate treatment. A corresponding continuous HRV‐based risk assessment using the ECG provided by the routine stroke monitoring system would be possible without any additional burden for patients and staff.