Heart Rate Variability in Patients of Recurrent Stroke as Compared to Patients of First-Ever Stroke

Background- Cardiac autonomic neuropathy (CAN) is a common complication in stroke patients; both in acute and chronic phase. Multiple studies have found impaired cardiovagal or parasympathetic function in stroke patients which may result in cardiac arrhythmias and sudden death. Autonomic dysfunction increases cardiovascular risk in patients of first-ever stroke, but to the best of our knowledge very few studies have investigated if this risk is further increased in patients of recurrent stroke.Aim- To assess and compare, the cardiovascular autonomic functions via heart rate variability (HRV), and therefore, the cardiovascular risk, in patients of recurrent stroke and patients of first – ever stroke.Methods- 30 recurrent stroke patients and 30 first – ever stroke patients were recruited for this study. Heart Rate Variability (HRV) was used to assess cardiovascular autonomic function.Results - Time domain parameters- SDNN (p=0.011), rMSSD (p=0.031) and pNN50 (p=0.041) and frequency domain parameters - LF power (p=0.011), HF power (p=0.026), TP (p=0.022) were significantly reduced in recurrent stroke patients as compared to with a single stroke event.Conclusion- Our preliminary study shows that parasympathetic function is significantly reduced in patients with recurrent stroke than in patients with a single stroke event. This may indicate an increased risk of adverse cardiovascular events and cardiac mortality in patients of recurrent stroke.Key words: Cardiac Autonomic neuropathy, HRV, Stroke, recurrent stroke.