What is the clinical evidence from this study?

Study design: Observational. Population: Acute ischemic stroke in the middle cerebral artery (MCA) territory (n=48). Intervention: Infarct volume vs. Smaller infarct volumes. Primary outcome: Correlation between infarct volume and RRI-LF/HF-ratios (r=0.414, p=0.003).

What question did this study set out to answer?

This study aims to evaluate the relationship between infarct volume and cardiac autonomic modulation in patients with ischemic stroke in the middle cerebral artery territory.

May 8, 2026European Stroke Journal

Abstract Number: Esoc2026a1593 Increased Infarct Volume Is Associated With a Shift Towards Cardiac Sympathetic Predominancein Patients With Ischemic Stroke in the Middle Cerebral Artery Territory

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Key result

Larger infarct volume in acute MCA stroke correlates with greater cardiac sympathetic predominance.

r=0.414
P=0.003
n=48

Why the study?

Ischemic stroke frequently leads to cardiovascular autonomic dysfunction, but the relationship between infarct volume and cardiac autonomic modulation in acute middle cerebral artery stroke was unclear.

Is increased infarct volume associated with altered cardiac autonomic modulation in patients with acute ischemic stroke in the MCA territory?

Population

48 patients with acute ischemic stroke in the MCA territory

Comparison

Infarct volume >50ml vs smaller infarct volumes

Design

Observational study

Authors

RWRuihao WangFriedrich-Alexander-Universität Erlangen-Nürnberg SMSebastian MoellerWitten/Herdecke University AAAynur AkhundovaZentralklinik Bad Berka

Discussion

Member takes

Implication

HRV should not yet inform acute stroke management; leaves open its value for prognostication pending larger confirmatory studies.

Key Points

This study aims to evaluate the relationship between infarct volume and cardiac autonomic modulation in patients with ischemic stroke in the middle cerebral artery territory.
Monitored RR intervals, blood pressures, and respiration in 48 patients within 24 hours of stroke onset.
Calculated cardiac autonomic parameters like RRI-SD, RRI-LF, and RMSSD based on measurements taken early post-stroke.
Used magnetic resonance imaging or computed tomography to assess infarct volume.
Infarct volumes positively correlate with RRI-LF-nu-powers (correlation: 0.297, P=0.038) and RRI-LF/HF-ratios (correlation: 0.414, P=0.003).
Infarct volumes above 50ml correlate with higher sympathetic modulation measured via RRI-LF-nu-powers but lower parasympathetic activity (RRI-HF-nu-powers).

Study Design

Type

Observational (n=48)

Structured PICO

Is increased infarct volume associated with altered cardiac autonomic modulation in patients with acute ischemic stroke in the MCA territory?

Population

48 patients with acute ischemic stroke in the middle cerebral artery (MCA) territory, mean age 68±15 years, 23 men, 25 women.

Intervention

Infarct volume measurement (calculated using Ellipsoid model ABC/2 from DWI within 24 hours or CT within 48 hours upon stroke-onset)

Comparator

Smaller infarct volumes (comparison of >50ml vs smaller)

Outcome

Parameters of cardiac autonomic modulation (including RRI-LF-nu-powers, RRI-LF/HF-ratios, and RRI-HFnu-powers) at rest within 24 hours after stroke-onsetsurrogate

Main Result

Effect estimate: r=0.414

p-value: p=0.003

In patients with acute ischemic MCA stroke, larger infarct volumes are associated with a shift towards increased sympathetic and reduced parasympathetic cardiac modulation.

Cite This Study

Wang et al. (2026) conducted an observational in Acute ischemic stroke in the middle cerebral artery (MCA) territory (n=48). Infarct volume vs. Smaller infarct volumes was evaluated on Correlation between infarct volume and RRI-LF/HF-ratios (r=0.414, p=0.003). Increased infarct volume in acute ischemic MCA stroke was associated with a shift towards cardiac sympathetic predominance, including higher RRI-LF/HF-ratios (r=0.414, P=0.003).

synapsesocial.com/papers/69fd7fcdbfa21ec5bbf085b6 https://doi.org/10.1093/esj/aakag023.760

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Abstract Number: Esoc2026a1593 Increased Infarct Volume Is Associated With a Shift Towards Cardiac Sympathetic Predominancein Patients With Ischemic Stroke in the Middle Cerebral Artery Territory

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Abstract Number: Esoc2026a1593 Increased Infarct Volume Is Associated With a Shift Towards Cardiac Sympathetic Predominancein Patients With Ischemic Stroke in the Middle Cerebral Artery Territory

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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