Complexity of Heart Rate Variability Can Predict Stroke-In-Evolution in Acute Ischemic Stroke Patients

About one-third of acute stroke patients may experience stroke-in-evolution, which is often associated with a worse outcome. Recently, we showed that multiscale entropy (MSE), a non-linear method for analysis of heart rate variability (HRV), is an early outcome predictor in non-atrial fibrillation (...

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Bibliographic Details
Published in:Scientific reports 2015-12, Vol.5 (1), p.17552-17552, Article 17552
Main Authors: Chen, Chih-Hao, Huang, Pei-Wen, Tang, Sung-Chun, Shieh, Jiann-Shing, Lai, Dar-Ming, Wu, An-Yu, Jeng, Jiann-Shing
Format: Article
Language:English
Subjects:
631/114/1314
692/617/375/534
Acute Disease
Aged
Aged, 80 and over
Brain Ischemia - physiopathology
Cardiac arrhythmia
EKG
Entropy
Female
Fibrillation
Heart Rate
Humanities and Social Sciences
Humans
Intensive Care Units
Ischemia
Male
Middle Aged
multidisciplinary
Predictive Value of Tests
Science
Stroke
Stroke - physiopathology
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Summary:About one-third of acute stroke patients may experience stroke-in-evolution, which is often associated with a worse outcome. Recently, we showed that multiscale entropy (MSE), a non-linear method for analysis of heart rate variability (HRV), is an early outcome predictor in non-atrial fibrillation (non-AF) stroke patients. We aimed to further investigate MSE as a predictor of SIE. We included 90 non-AF ischemic stroke patients admitted to the intensive care unit (ICU). Nineteen (21.1%) patients met the criteria of SIE, which was defined as an increase in the National Institutes of Health Stroke Scale score of ≥2 points within 3 days of admission. The MSE of HRV was analyzed from 1-hour continuous ECG signals during the first 24 hours of admission. The complexity index was defined as the area under the MSE curve. Compared with patients without SIE, those with SIE had a significantly lower complexity index value (21.3 ± 8.5 vs 26.5 ± 7.7, P  = 0.012). After adjustment for clinical variables, patients with higher complexity index values were significantly less likely to have SIE (odds ratio = 0.897, 95% confidence interval 0.818–0.983, P  = 0.020). In summary, early assessment of HRV by MSE can be a potential predictor of SIE in ICU-admitted non-AF ischemic stroke patients.
ISSN:2045-2322
2045-2322
DOI:10.1038/srep17552