Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

The Association between Heart Rate Variability and 90-day Prognosis in Patients with Transient Ischemic Attack and Minor Stroke

First author：李常红

Corresponding author：王拥军

Heart rate variability transient ischemic attack stroke prognosis neurological function stroke recurrence

essential_information

  • Person in charge：李常红
  • Data Sources： CNSR-Ⅲ
  • Number of papers：CNSR-Ⅲ20190904
  • Published time：2021-05-28

2021-05-28

Published articles

Journal： Frontiers in Neurology

Publication type: Research Report

IF(IF): 4.003

PMID: 10.3389/fneur.2021.636474 Link To Pubmed Full text Download

Background And Purpose

非致残性脑血管事件，短暂性脑缺血发作(transient ischemic attack, TIA)和小卒中发生后即面临着卒中复发的高风险。所以需要建立有效的疾病预后的分层指标。在本研究中，我们旨在：1）评价传统指标的有效性；2）评价心率变异性是否可以做为TIA和小卒中患者早期神经功能恶化、3个月内的卒中复发、3个月时不良功能预后及全因死亡的有效指标。

Method

入组标准：本研究通过选取CNSR-III 数据库中，入院诊断为TIA和轻型卒中患者（NIHSS评分<=5分）。 排除标准：非TIA和轻型卒中，房颤，以及无HRV数据的患者。 收集患者人口学特征、危险因素、入院和出院时临床特点、住院期间心率变异性、三个月随访、一年随访等基本信息。 选取的指标：HRV选取SDNN，SDANN，RMSSD和pNN50. 采用多元回归分析观察HRV各指标和TIA/轻型卒中短期预后和长期预后的相关性。

Conclusion

Based on our findings, autonomic dysfunction is an adverse indicator for neurological function prognosis and stroke recurrence 90 days after TIA or minor stroke.

Main results

Compared with SDNN patients in the lowest quartile, neurological disability was significantly reduced in other quartile groups at 90 days, with significant differences (OR of group Q2 was 0.659; 95% confidence interval [CI], 0.482-0.900; p=0.0088; OR of group Q3 was 0.662; 95% CI, 0.478-0.916; p=0.0127; OR of group Q4 was 0.441; 95% CI, 0.305-0.639; p <0.0001). Compared with the lowest quartile, the recurrence rate of TIA or minor stroke in patients of the two higher quartiles (Q3 and Q4) of SDNN was significantly reduced at 90 days (HR of Q3 group was 0.732; 95% CI, 0.539-0.995; p=0.0461; HR of Q4 group was 0.528; 95% CI, 0.374-0.745; p=0.0003).