Key result
Lobar intracerebral hemorrhage was associated with a significantly lower heart rate variability complexity index (21.6) compared to basal ganglia (27.9) and thalamic (28.5) hemorrhage.
Why the study?
Does the location and severity of supratentorial intracerebral hemorrhage affect the complexity of heart rate variability?
Observational (n=143)
No
Does the location and severity of supratentorial intracerebral hemorrhage affect the complexity of heart rate variability?
Absolute Event Rate: 21.6% vs 27.9%
p-value: p=0.002
In patients with acute supratentorial intracerebral hemorrhage, larger hematoma volume and lobar location are associated with reduced heart rate variability complexity, which independently predicts worse functional outcomes at 3 months.
Lobar ICH location may signal greater autonomic impairment; leaves open whether reduced HRV complexity independently predicts 3-month outcomes.
Acute stroke commonly affects cardiac autonomic responses resulting in reduced heart rate variability (HRV). Multiscale entropy (MSE) is a novel non-linear method to quantify the complexity of HRV. This study investigated the influence of intracerebral hemorrhage (ICH) locations and intraventricular hemorrhage (IVH) on the complexity of HRV. We recruited 93 supratentorial ICH patients (male 59%, mean age 61 years), and the locations of ICH included basal ganglia (n = 40), thalamus (n = 35), and lobar (n = 18) group. Continuous one-hour electrocardiography signals were obtained from patients after admission, and the complexity index was defined as the area under the MSE curve. The complexity index was lower in lobar ICH (21.6 ± 7.9) than basal ganglia (27.9 ± 6.4) and thalamus (28.5 ± 7.2) groups. The complexity index was inversely correlated with initial stroke severity (r = -0.26), size of hematoma (r = -0.35) and ICH score (r = -0.26), especially among patients with intraventricular hemorrhage (r = -0.60, -0.60, and -0.41 respectively). A higher complexity can predict a good functional outcome (adjusted odds ratio 1.09, 95% confidence intervals 1.00-1.19) at post-stroke 3 months. In summary, more severe stroke and larger hematoma volume resulted in lower complexity of HRV. Lobar hemorrhage and IVH had great impacts on the cardiac autonomic function.
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Chen et al. (2018) conducted an observational in Acute supratentorial intracerebral hemorrhage (n=143). Lobar intracerebral hemorrhage vs. Basal ganglia and thalamic hemorrhage was evaluated on Complexity index (Area1-20) of heart rate variability (p=0.002). Lobar intracerebral hemorrhage was associated with a significantly lower heart rate variability complexity index (21.6) compared to basal ganglia (27.9) and thalamic (28.5) hemorrhage.
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