Key result
Altered sleep and 48-hour heart rate variability in subacute stroke is linked to depression.
Why the study?
Cardiovascular dysautonomia increases morbidity and mortality in acute stroke, and beta-blocker management improves outcomes in acute and chronic stroke, but cardiovascular dysautonomia had not been systematically studied in subacute stroke during rehabilitation.
Cohort (n=5)
Preliminary findings suggest cardiovascular dysautonomia (measured by altered heart rate variability) is common during subacute stroke rehabilitation and correlates with depression, while prior beta-blocker use is associated with shorter hospital length of stay.
Answers are grounded in this paper and cite their sources.
May flag depression risk in stroke rehab; small cohort leaves open causal links and practice change.
Background and/or Objectives: Stroke is a major cause of disability and mortality worldwide.Evidence suggests that cardiovascular dysautonomia (CVD) in acute stroke increases morbidity and mortality, and beta-blocker (BB) management improves these outcomes.The beneficial BB effects have also been reported in chronic stroke.Yet, the CVD has not been systematically studied in subacute stroke, when rehabilitation is usually carried out.We studied the nature, evolution, and functional relevance of CVD during stroke rehabilitation.Our hypothesis was that subacute CVD is an underrecognized and undertreated cause of poor rehabilitation outcomes, high risk of secondary events, and low quality of life later after stroke.Design: Longitudinal prospective study.Setting: Hospital-based rehabilitation program.Participants: Subacute (1 week to 3 months poststroke) patients.Interventions: not applicable.Main Outcome Measures: Heart rate variability (HRV; Empatica: 48 hours, therapy, sleep), motor impairment, depression, anxiety, quality of life, secondary events, and dysautonomia questionnaire measured at admission, discharge, and 3 months post-stroke.Results: Preliminary inpatient data (n=5 at admission; 13.4-mean±SD-8.9days post-stroke; 61.0±9.5 years old; 60% female; 20% hemorrhagic stroke) showed an altered HRV in 40% of patients for 48 hours, 80% during sleep, and 60% during therapy.A significant relationship was found between 48-hour and sleep HRV and depression (p=0.005 for both).Due to a limited age range (46 to 70 years), we failed to detect age effects on HRV (p=0.5).Mild dysautonomia symptoms were present in 80% of patients (score>28.67)and showed a trend toward correlation with sleep HRV (p=0.06).A retrospective study of 222 patients on BB before stroke showed a shorter length of stay than those not on BB (19.3 vs. 21.8days, p=0.04).Data analysis is ongoing.Conclusions: These data may form the basis for future trials on CVD treatment, potentially advancing the use of early, personalized approaches to improve stroke rehabilitation outcomes and secondary prevention.
No takes yet. Share an insight, caveat, or question.
Ibish et al. (2026) conducted a cohort in Subacute stroke and cardiovascular dysautonomia (n=5). Cardiovascular dysautonomia (altered heart rate variability) was evaluated on Heart rate variability (48 hours, therapy, sleep), motor impairment, depression, anxiety, quality of life, secondary events, and dysautonomia symptoms (p=0.005). Altered 48-hour and sleep heart rate variability in subacute stroke patients was associated with depression, while pre-stroke beta-blockers reduced length of stay.
Synapse has enriched 10 related papers. Consider them for comparative context: