Key result
Ischemic stroke survivors had lower pulse arrival time during standing compared to controls (248 vs 270 ms, p < 0.05), indicating higher arterial stiffness and impaired HRV-PRV agreement.
Why the study?
PRV has been used as a surrogate for HRV to monitor autonomic reflex mainly in young, healthy individuals, but its validity in ischemic stroke survivors was unknown.
Is pulse rate variability a reliable surrogate for heart rate variability in monitoring autonomic reflex in ischemic stroke survivors?
Observational
Is pulse rate variability a reliable surrogate for heart rate variability in monitoring autonomic reflex in ischemic stroke survivors?
Absolute Event Rate: 248% vs 270%
p-value: p=< 0.05
Pulse rate variability may not be a reliable surrogate for heart rate variability when monitoring autonomic cardiovascular control during standing in ischemic stroke survivors.
PRV may not surrogate HRV reliably in stroke survivors; leaves open validation before ambulatory use.
Autonomic reflex ascertains cardiovascular homeostasis during standing. Impaired autonomic reflex could lead to dizziness and falls while standing; this is prevalent in stroke survivors. Pulse rate variability (PRV) has been utilized in the literature in lieu of heart rate variability (HRV) for ambulatory and portable monitoring of autonomic reflex predominantly in young, healthy individuals. Here, we compared the PRV with gold standard HRV for monitoring autonomic reflex in ischemic stroke survivors. Continuous blood pressure and electrocardiography were acquired from ischemic stroke survivors (64 ± 1 years) and age-matched controls (65 ± 2 years) during a 10-minute sit-to-stand test. Beat-by-beat heart period (represented by RR and peak-to-peak (PP) intervals), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse arrival time (PAT), an indicator of arterial stiffness, were derived. Time and frequency domain HRV (from RR intervals) and PRV (from PP intervals) metrics were extracted. PAT was lower (248 ± 7 ms vs. 270 ± 8 ms, p < 0.05) suggesting higher arterial stiffness in stroke survivors compared to controls during standing. Further, compared to controls, the agreement between HRV and PRV was impaired in stroke survivors while standing. The study outcomes suggest that caution should be exercised when considering PRV as a surrogate of HRV for monitoring autonomic cardiovascular control while standing in stroke survivors.
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Verma et al. (2019) conducted an observational in Ischemic stroke. Ischemic stroke vs. Age-matched controls was evaluated on Pulse arrival time (PAT) during standing (p=< 0.05). Ischemic stroke survivors had lower pulse arrival time during standing compared to controls (248 vs 270 ms, p < 0.05), indicating higher arterial stiffness and impaired HRV-PRV agreement.
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