The assesment of autonomic nervous system in acute serebrovasculer disorders with heart rate variability and catecholamine levels

In clinical studies, it has been seen that the cerebralvascular events has a big effect on cardiovascular and autonomic functions. In this study, We have used heart rate valuabilty analysis based on frequency and time compared with the plasma catecholamine levels to show the relation of parasympathetic and sympathetic autonom nervous system activities with cerebral stroke fieldIn this study, 60 patients with acute stroke hospitalzed in the neurology department at Dicle University Medical Faculty and 31 healty control subjects has been examined. The patients with diabetes mellitus, atrial fibrillation, chronic kidney disease, liver failure, chronic stroke, applied to hospital after 24 hours passed from acute stroke, advanced cardiac failure and the patient whose MRI doesn?t give any clue for cerebral lesion was excluded. In addition, the patiens treated with anti anginal and antiarrhythmic drugs was also excluded. With the help of the time domain SDANN, SDNN, Pnn50, RMSSD and frequency domain LF, HF, VLF, LF/HF parameters measured from holter, we have analysed HRV for 60 patients with acute stroke and 31 control group. At 1. 3. 7. days of acute stroke, the concentration of plasma norepinephrine and epinephrine has been measured by using high performance liquid chromatography (HPLC) method. SPSS (Statistical Package for Social Sciences) 11,5 PC program has been used in statistical analysis.At first and third days of acute stroke, the concentration of plasma norepinephrine in patients with right and left cerebral hemispheric stroke has significanty increased in comparison to control subjects (p<0.05). High HRV diffrence for patients with acute stroke has been occured in patint with right hemisphere stroke. The SDANN parameter in patints with acute stroke has significanty decreased in comporirison to control subjects (p=0.01). In 5 minutes recording frequency domain, the values at VLF and LF for patients with right hemisphere and brainstem-cerebellum stroke has significanty increased in comparison to control subjects (p<0.05). While the epinephrine and norepinephrine values for patients with acute stroke have given negative correlation with Barthel and Canadian stroke scale values, SDANN parameter has given positive correlation. Since the LF/HF values indicating sempatovagal balance and plasma catecholamine level, for patients with right hemisphere stroke increased. The sympathetic function indicating hemispheric lateralization in autonomic control pronounced and sustained up-regulation. As a result, evaluation of autonomic nervous system after acute stroke requires long-time and prospective studies.