Correlation Analysis Between Heart Rate Variability And Imaging Features In Patients With Ischemic Cerebral Small Vessel Disease

Background and ObjectiveCerebral small vessel diseases(CSVD)is a common cerebrovascular disease in clinic,accounting for about 25% of ischemic stroke,which not only increase the risk of stroke,but also is closely related to poor prognosis of stroke,decreased cognitive ability,movement and gait disorders,depression,dysuria and so on.CSVD is the main cause of disability and decreased independent living ability of the elderly.The lacune and white matter hyperintensity(WMH)are the most common ischemic manifestations of cranial Magnetic Resonance Imaging(MRI),which is considered to be the symbolic MRI features of CSVD and is common in the elderly.This study aims to analysis the relationship between the heart rate variability(HRV)measured by 24 hours dynamic electrocardiogram and ischemic CSVD imaging characteristics(WMH,lacunes),and to investigate the correlation between the autonomic nerve function with CSVD,hoping to provide theoretical support for the study of pathogenesis of CSVD as well as the early detection and intervention of CSVD.MethodsA total of 248 patients with CSVD admitted to the Department of Neurology of the Second Affiliated Hospital of Zhengzhou University from January 2018 to December 2020 were selected.All patients underwent 24-hour dynamic electrocardiogram,clinical biochemical indicators and cranial magnetic resonance examination,and general baseline data and clinical examination data of the patients were collected.According to Fazekas score,patients could be divided into no or mild WMH group(0-2 points),moderate WMH group(3-4 points)and severe WMH group(5-6 points).The differences in general information and HRV parameters between the three groups were compared.According to the number of lacunes,the patients were divided into multiple group(two or more lacunes)and non-multiple group(no or one lacune),and the differences in general data and HRV parameters between the two groups were compared.Results1.Correlation analysis between WMH and HRV parameters: There was no statistical difference in gender,age,hypertension history,diabetes history,smoking and drinking history,blood lipid,Hcy among patients with no or mild group,moderate group and severe group(P> 0.05).SDNNindex and PNN50 in severe group were significantly lower than those in no or mild group and moderate group,RMSSD in mild group was significantly higher than that in moderate and severe group,LF and HF in severe group was significantly lower than that in no or mild group,the difference was statistically significant(P< 0.05).There was no significant difference in other HRV parameters between the three groups(P> 0.05).Spearman correlation analysis between the severity of WMH and HRV parameters showed that the severity of WMH was negatively correlated with SDNNindex(rs=-0.232,P<0.001),RMSSD(rs=-0.243,P<0.001),PNN50(rs=-0.167,P=0.008),LF(rs=-0.147,P=0.021)and HF(rs=-0.151,P=0.018).The factors with significant difference in univariate analysis(P<0.05)were included in the ordered logistic regression analysis.The results showed that RMSSD and the severity of WMH were independently correlated after adjusting for age,sex,hypertension history,diabetes history,smoking and drinking history(OR=0.988;95%CI:0.978~0.998;P=0.015).2.Correlation analysis between lacune and HRV parameters: There was no significant difference in HRV parameters and general data between multiple group patients and non-multiple group patients(P>0.05).Conclusions1.The decrease of HRV is independently related to the severity of WMH.2.There was no correlation between HRV and imaging lacune.