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Related Experiment Videos

Transient autonomic nervous system dysfunction during hyperacute stroke.

G Orlandi1, S Fanucchi, G Strata

  • 1Department of Neurosciences, Pisa University, Italy. g.orlandi@neuro.med.unipi.it

Acta Neurologica Scandinavica
|November 18, 2000
PubMed
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First-time stroke patients often experience arrhythmia and autonomic nervous system imbalance, primarily linked to sympathetic activity, which improves within days. This highlights cardiovascular risks in the hyperacute stroke phase.

Area of Science:

  • Cardiology
  • Neurology
  • Autonomic Nervous System Research

Background:

  • Stroke is a major cause of morbidity and mortality.
  • Cardiovascular complications, including arrhythmias, are common in stroke patients.
  • The role of autonomic nervous system (ANS) dysfunction in acute stroke is increasingly recognized.

Purpose of the Study:

  • To investigate the prevalence and characteristics of cardiac arrhythmias and ANS imbalance in the hyperacute phase of first-time stroke.
  • To assess the temporal evolution of these cardiovascular changes and their relationship with stroke type and laterality.
  • To explore the potential link between ANS dysfunction and cardiovascular impairment in acute stroke.

Main Methods:

  • Prospective study of 44 first-time stroke patients within 10 hours of symptom onset.

Related Experiment Videos

  • 24-hour Holter ECG with heart rate variability spectral analysis.
  • Evaluation of arterial blood pressure and catecholamine levels (blood and urine).
  • Serial assessments at hospital admission, day 3, and day 7.

    • Main Results:

    • Arrhythmia detected in 70.5% of patients on admission, with higher prevalence in hemorrhagic stroke and right hemisphere lesions.
    • Arrhythmia persisted in 43.2% at day 3, decreasing to 6.5% by day 7.
    • Spectral analysis parameters were significantly altered in stroke patients with arrhythmia compared to controls, normalizing by day 7.
    • Arterial hypertension and elevated catecholamines decreased significantly from day 3 onwards.

    Conclusions:

    • A transient autonomic nervous system imbalance, with sympathetic overactivity, is implicated in cardiovascular impairment during the hyperacute phase of stroke.
    • Cardiac arrhythmias are a frequent early complication of stroke, showing a significant decline within a week.
    • These findings underscore the importance of monitoring cardiovascular function and autonomic status in acute stroke management.