| Background: Dysfunction of Automatic nervous system(ANS)is closely associated with ischemic stroke.Stroke patients often have dysfunction of ANS function,and dysfunction of autonomic neuroregulatory pathway may be associated with increased risk of stroke recurrence,leading to worse prognosis [1].Heart rate variability(HRV),as an indicator of ANS functional activity,has important reference value for evaluating mortality,recurrence risk and prognosis of stroke patients.Finding abnormal HRV and giving appropriate intervention can reduce the occurrence of stroke and improve prognosis [2-9].The clinical symptoms of ischemic pawns are mild and neurological deficits are rare,and reducing the risk of recurrence will greatly improve their prognosis.However,there are still few studies on HRV and acute ischemic pawns at present.Objective: To investigate the relationship between HRV and the risk of recurrent stroke in acute ischemic mini-stroke.Method: Retrospectively selected 110 acute ischemic mini-stroke patients confirmed by head MRI between January 2020 and June 2021 in the Neurological ward of Huaihe Hospital of Henan University were chosen as the observation group,the other 110 patients from the same period with no previous stoke history and no ischemic showed on MRI were chosen as the control group.All enrolled members Age,Gender,smoking history,drinking history,history of hypertension,Body mass index(BMI),Fasting plasma glucose(FPG),Total cholesterol(TC),Low density lipoprotein(LDL),high-density lipoprotein(HDL),Triglyceride(TG),Homocysteine(HCY),Uric acid(UA),Blood urea nitrogen(BUN),Creatinine(Cre),Creatine kinase(CK),Creatine kinase-MB(CK-MB)were recorded.Collect HRV indicators: Standard deviation of NN intervals(SDNN),Root mean square of square sum of adjacent NN interval differences(SDANN),Root mean square of successive differences(RMSSD),Percentage of adjacent normal-to-normal intervals that differed more than 50ms(PNN50),Total power(TP),Very low frequency power(VLF),low frequency power(LF),High frequency power(HF),High frequency to low frequency ratio(LF/HF),Heart rate related indicators:maximum heart rate,minimum heart rate,average heart rate.Skull MRI data were collected including Magnetic resonance imaging(MRI)and Magnetic resonance angiography(MRA).The relevant indicators of the observation group and the control group were compared to clarify the differences of relevant indicators.The observation group further analyzed the differences of indexes related to Left Middle cerebral artery(L-MCA)lesions and Right Middle cerebral artery(R-MCA)lesions according to different lesion regions.The relevant indicators of the observation group and the control group were compared to clarify the differences of relevant indicators.The observation group further analyzed the differences of related indexes between the lesions of left middle cerebral artery and right middle cerebral artery,as well as the differences of related indexes between anterior and posterior circulation lesions according to the different lesion regions.Results: 1.Analysis of related indexes between the experimental group and the control group: Univariate analysis of data from the observation group and the control group.The results showed that there were statistically significant differences in gender,age,smoking,drinking,hypertension,BMI,Cre,UA,LDL,HDL,TG,HCY,SDNN,SDANN,p NN50,TP,VLF,HF and LF/HF between the two groups(P < 0.05).Among them,male,old age,smoking,drinking,hypertension,BMI,Cre,UA,LDL,TG,HCY,LF/HF increased in the ischemic group,while HDL,SDNN,SDANN,p NN50,TP,VLF,HF and THE fastest heart rate decreased in the ischemic group.Multivariate Logistic regression analysis showed that hypertension,smoking,HCY,HDL,SDNN,p NN50,TP,VLF were significantly correlated with ischemic patients(P < 0.05).HDL,SDNN,p NN50,TP and VLF were significantly decreased in acute ischemic patients,while hypertension,smoking and HCY were significantly increased in acute ischemic patients.2.Analysis of related indexes of different stroke sites: L-MCA lesion group and R-MCA lesion group: There were no significant differences in general risk factors and related indexes of laboratory tests(P > 0.05).The comparison of HRV and heart rate related indexes showed that SDNN,SDANN and RMSSD indexes of R-MCA group were lower than those of LMCA group,while TP,VLF,LF/HF,mean heart rate and maximum heart rate indexes were higher than those of L-MCA group.The difference was statistically significant(P < 0.05).Anterior and posterior circulatory lesions: There were no significant differences in general risk factors and related indexes of laboratory tests(P > 0.05).The comparison of HRV and heart rate related indexes indicated that TP and VLF indexes of posterior circulation lesions were higher than those of anterior circulation lesions(P < 0.05),while SDNN and SDANN indexes were lower than those of anterior circulation lesions,with statistically significant differences(P < 0.05).3.Analysis of HRV and heart rate in patients with recurrent stroke and non-recurrent stroke within 6 months: The SDNN and SDANN indexes of patients with recurrent stroke within 6 months were significantly lower than those of patients without recurrent stroke(P < 0.05).Multivariate regression analysis of SDNN,LF and HF(P < 0.1)indicated that SDNN and LF were significantly decreased in recurrent stroke patients(P < 0.05).Conclusion: 1.Overall HRV in patients with acute ischemic stroke was significantly lower than that in the control group.2.The changes of HRV-related indicators were closely related to the location of stroke.The HRV decreased more significantly in the lesions of the right middle cerebral artery supplying region than that of the left middle cerebral artery,and more significantly in the lesions of the posterior circulation than that of the anterior circulation.3.Reduced HRV can be used as a factor to assess the risk of high recurrence within 6 months in patients with acute ischemic stroke. |
