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Autonomic function test in progressive lacunar infarction.

S Y Ha1, K M Park1, J Park1

  • 1Department of Neurology, Haeundae-Paik Hospital, College of Medicine, Inje University, Busan, Korea.

Acta Neurologica Scandinavica
|February 23, 2018
PubMed
Summary
This summary is machine-generated.

Autonomic dysfunction, specifically abnormal blood pressure changes during the Valsalva test, is linked to neurological progression in acute lacunar infarction patients. This progression predicts poorer 3-month outcomes.

Keywords:
Valsalva testautonomic dysfunctionhead-up tilt testlacunar infarctsneurological progressionoutcome

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Area of Science:

  • Neurology
  • Cardiology
  • Autonomic Nervous System Research

Background:

  • Neurological progression is a significant challenge in managing acute lacunar infarction (ALI).
  • Autonomic dysfunction may play a role in the clinical course of ALI.

Purpose of the Study:

  • To investigate the association between autonomic dysfunction and neurological progression in patients with ALI.
  • To determine if autonomic function tests can predict neurological worsening and 3-month outcomes.

Main Methods:

  • Sixty patients with ALI underwent autonomic function tests: 30° head-up tilt test, Valsalva test, heart rate response to deep breathing, and sympathetic skin response.
  • Neurological progression was the primary endpoint; 3-month outcome was the secondary endpoint.

Main Results:

  • Increased initial National Institute of Health Stroke Scale (NIHSS), reduced admission time, decreased heart rate response during tilt test, abnormal Valsalva blood pressure response, and reduced systolic blood pressure rise in Valsalva stage IV were associated with neurological progression.
  • Abnormal Valsalva blood pressure response was a significant predictor of neurological progression in logistic regression.
  • Advanced age, higher NIHSS, modified Rankin Scale, reduced heart rate variability, reduced Valsalva systolic blood pressure rise, and neurological progression correlated with unfavorable 3-month outcomes.
  • Neurological progression significantly predicted poor 3-month outcomes.

Conclusions:

  • Abnormal blood pressure changes during the Valsalva test are associated with neurological progression in acute lacunar infarction.
  • Neurological progression following acute lacunar infarction is linked to unfavorable 3-month outcomes.