Baroreceptor Sensitivity as an Independent Predictor for Functional Outcomes in Acute Ischemic Stroke

Area of Science:

• Neurology
• Cardiology
• Autonomic Neuroscience

Background:

• Post-stroke autonomic dysfunction impacts long-term prognosis.
• Reduced baroreceptor sensitivity (BRS) is a marker of autonomic dysfunction.
• The independent predictive value of BRS for functional recovery after stroke needs further clarification.

Purpose of the Study:

• To determine the independent prognostic value of acute-phase BRS for 12-month functional outcomes in first-ever ischemic stroke patients.
• To assess the association between BRS levels and functional recovery metrics.

Main Methods:

• Prospective, single-center, observational cohort study of 292 first-ever ischemic stroke patients.
• Baroreceptor sensitivity (BRS) measured within 7 days of stroke onset using the sequence method.
• Patients categorized into low-BRS and high-BRS groups; outcomes assessed using modified Rankin Scale (mRS) and Barthel Index (BI) at 12 months.
• Statistical analysis included inverse probability of treatment weighting (IPTW) and logistic regression.

Main Results:

• Low BRS was an independent predictor of poor 12-month functional outcomes after adjusting for confounders.
• Patients with low BRS had significantly higher adjusted odds of unfavorable outcomes (mRS 3-6) and moderate-to-severe dependency (BI ≤ 90).
• Adjusted odds ratios were 2.06 for unfavorable mRS and 3.13 for low BI in the low-BRS group.

Conclusions:

• Reduced BRS in the acute phase of ischemic stroke is independently associated with adverse functional outcomes at 12 months.
• BRS assessment in the acute phase may serve as a valuable tool for early risk stratification in stroke patients.
• Further validation in external cohorts and standardization of protocols are recommended for clinical implementation.