Key result
Carotid angioplasty and stenting significantly increased heart rate complexity indices on scales 2-8 at 1-hour and scales 2-3 at 1-day post-treatment compared to pre-operative baseline.
Why the study?
Does unilateral primary percutaneous carotid angioplasty and stenting improve neurocardiovascular dynamics in male patients with high-grade carotid stenosis?
Observational (n=12)
Does unilateral primary percutaneous carotid angioplasty and stenting improve neurocardiovascular dynamics in male patients with high-grade carotid stenosis?
Carotid artery stenting acutely increases the complexity of neurocardiovascular dynamics, suggesting a restoration of autonomic regulatory networks.
May indicate restored autonomic dynamics after stenting; leaves open clinical benefits and requires randomized confirmation.
OBJECTIVE: Percutaneous carotid angioplasty and stenting (CAS) has been used to improve cerebral circulation and autoregulation. However, whether CAS ameliorates the autonomic regulatory dynamics remains unclear. This prospective study examines the neurocardiovascular dynamics following carotid stenting. METHODS: Thirty minutes electrocardiograms were recorded at three different time points (pre-operative, 1-h post-operative, 1-day post-operative) on twelve male patients (mean age 70.8 ± 9.6 years) receiving unilateral primary CAS. The HR data were analyzed by the conventional heart rate variability (HRV) and the multiscale entropy (MSE) methods; the former associates with autonomic activities and the latter quantifies the regulatory complexity of heart beat intervals. Loss of complexity at multiple scales has been associated with decoupled regulatory network in vivo. RESULTS: Conventional HRV indices showed no difference after CAS. Complexity indices increased significantly on scales 2-8 at 1-h and on scales 2-3 1-day post-treatment. The lower scale MSE (1-5) correlated with the frequency components of conventional HRV indices. The increased complexity could imply a restoration of the neurocardiovascular dynamics on the path to a healthier state. CONCLUSIONS: Primary CAS can induce a recovery in the neurocardiovascular regulatory dynamics in patients with high-grade carotid stenosis.
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Yuan et al. (2010) conducted an observational in High-grade carotid stenosis (n=12). Percutaneous carotid angioplasty and stenting (CAS) vs. Pre-operative baseline was evaluated on Neurocardiovascular dynamics (heart rate variability and multiscale entropy). Carotid angioplasty and stenting significantly increased heart rate complexity indices on scales 2-8 at 1-hour and scales 2-3 at 1-day post-treatment compared to pre-operative baseline.
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