Heart rate variability - a potential early marker of sub-acute post-stroke infections.

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Title:	Heart rate variability - a potential early marker of sub-acute post-stroke infections.
Authors:	Günther, A., Salzmann, I., Nowack, S., Schwab, M., Surber, R., Hoyer, H., Witte, O. W., Hoyer, D.
Source:	Acta Neurologica Scandinavica. Sep2012, Vol. 126 Issue 3, p189-196. 8p. 2 Diagrams, 4 Charts, 1 Graph.
Subjects:	Heart beat, Stroke, Disease complications, Infection, Immunosuppression, Electrocardiography, C-reactive protein, Autonomic nervous system
Abstract:	Günther A, Salzmann I, Nowack S, Schwab M, Surber R, Hoyer H, Witte OW, Hoyer D. Heart rate variability - a potential early marker of sub-acute post-stroke infections. Acta Neurol Scand: 2012: 126: 189-196. © 2011 John Wiley & Sons A/S. Objective - Infection is the most relevant complication after acute ischemic stroke. Activity of the autonomic nervous system seems to control post-stroke immunodepression. We investigated heart rate variability (HRV) indices that reflect autonomic readjustments as predictors of post-stroke infection. Materials and methods - Forty-three patients with acute ischemic stroke were enrolled in a prospective study. The predictability of sub-acute infections (day 4 ± 1 after admission) was investigated in 34 patients without acute infection by means of HRV indices obtained in the acute period (48 h after admission). Results - Sub-acute infection could be predicted in patients without clinical or paraclinical (white blood cell count and C-reactive protein) signs of infection in the acute period at (i) day: increased HFnorm, reduced LFnorm and LF/HF; (ii) night: reduced LF and VLF ( P < 0.05). Conclusions - HRV indices are candidates for early markers of developing post-stroke infections, preceding routine blood samples. Thus, HRV-based early diagnosis of post-stroke infection should be investigated in more detail as it may have implications as a novel tool for timely and appropriate treatment. A corresponding continuous HRV-based risk assessment using the ECG provided by the routine stroke monitoring system would be possible without any additional burden for patients and staff. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Günther A, Salzmann I, Nowack S, Schwab M, Surber R, Hoyer H, Witte OW, Hoyer D. Heart rate variability - a potential early marker of sub-acute post-stroke infections. Acta Neurol Scand: 2012: 126: 189-196. © 2011 John Wiley & Sons A/S. Objective - Infection is the most relevant complication after acute ischemic stroke. Activity of the autonomic nervous system seems to control post-stroke immunodepression. We investigated heart rate variability (HRV) indices that reflect autonomic readjustments as predictors of post-stroke infection. Materials and methods - Forty-three patients with acute ischemic stroke were enrolled in a prospective study. The predictability of sub-acute infections (day 4 ± 1 after admission) was investigated in 34 patients without acute infection by means of HRV indices obtained in the acute period (48 h after admission). Results - Sub-acute infection could be predicted in patients without clinical or paraclinical (white blood cell count and C-reactive protein) signs of infection in the acute period at (i) day: increased HFnorm, reduced LFnorm and LF/HF; (ii) night: reduced LF and VLF ( P < 0.05). Conclusions - HRV indices are candidates for early markers of developing post-stroke infections, preceding routine blood samples. Thus, HRV-based early diagnosis of post-stroke infection should be investigated in more detail as it may have implications as a novel tool for timely and appropriate treatment. A corresponding continuous HRV-based risk assessment using the ECG provided by the routine stroke monitoring system would be possible without any additional burden for patients and staff. [ABSTRACT FROM AUTHOR]
ISSN:	00016314
DOI:	10.1111/j.1600-0404.2011.01626.x