Key result
Elevated high-sensitive cardiac troponin I (>0.04 ng/mL), found in 30.3% of acute ischemic stroke patients, was associated with significantly higher LF/HF values compared to normal troponin levels.
Why the study?
Neurogenic myocardial stunning is linked to autonomic dysregulation, and heart rate variability may help understand autonomic dysfunction mechanisms in acute ischemic stroke.
Is elevated troponin associated with altered heart rate variability in patients with acute ischemic stroke?
Observational (n=66)
Is elevated troponin associated with altered heart rate variability in patients with acute ischemic stroke?
Neurogenic myocardial damage in ischemic stroke, indicated by elevated troponin, is associated with sympathetic overactivity as measured by heart rate variability.
May signal sympathetic overactivity in troponin-positive stroke; hypothesis-generating for HRV monitoring, needs prospective validation.
Objective: Neurogenic myocardial stunning is a type of stress-induced cardiomyopathy thought to be a result of dysregulation of the autonomic nervous system. Heart rate variability (HRV) analysis is a potential method for understanding the underlying mechanisms of autonomic dysfunction in ischemic stroke. The aim of the study was to investigate HRV in stroke patients in accordance with troponin levels. Patients and Methods: Sixty-six patients (mean age 65 ± 13 years; 39 male) presenting with acute ischemic stroke were consecutively included. High-sensitive cardiac troponin I (hs-cTnI) levels were accepted as elevated when> 0.04 ng/mL. All patients underwent ambulatory electrocardiographic (ECG) monitoring within the first seven days to obtain time-domain and frequency-domain measures of HRV. Results: Twenty patients (30.3 %) had elevated hs-cTnI. Patients with high troponin levels had significantly lower left ventricular ejection fraction (LVEF), higher ST-segment-T wave changes, and higher N terminal pro-brain natriuretic peptide (NT-proBNP) levels. Low-frequency/high-frequency (LF/HF) value was significantly higher in the troponin-positive group, but other ambulatory ECG monitoring parameters such as SDNN, SDANN, RMSSD, and pNN50 were similar among patients. Conclusion: Neurogenic myocardial damage presenting with high troponin levels can be seen in ischemic stroke patients and may be associated with sympathetic overactivity.
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İleri et al. (2023) conducted an observational in acute ischemic stroke (n=66). Elevated high-sensitive cardiac troponin I (> 0.04 ng/mL) vs. Normal high-sensitive cardiac troponin I (≤ 0.04 ng/mL) was evaluated on Heart rate variability (time-domain and frequency-domain measures). Elevated high-sensitive cardiac troponin I (>0.04 ng/mL), found in 30.3% of acute ischemic stroke patients, was associated with significantly higher LF/HF values compared to normal troponin levels.
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