Evaluation of autonomic nervous system with heart rate turbulance in stroke patients

Cerebrovascular events are increasingly supported by clinical trials that cause cardiovascular and autonomic function changes. In our study, we evaluated the relationship of autonomic nervous system with cerebral localization in acute stroke patients by heart rate turbulence. Our retrospective file-based study included 30 acute stroke patients (age 65,2±10,6) who were hospitalized at the AKU Neurology Clinic between May 2016 and December 2017, and a 24-hour holter ECG monitoring was performed and a sufficient number of ventricular premature beats (>5) were recorded in holter ECG monitoring. The patients were admitted to the hospital within 24 hours of stroke, and patients who underwent holter ECG monitoring within the first 24 hours of stroke were included in the study. Patients with a history of diabetes mellitus, arrhythmia such as atrial fibrillation, previous stroke, hospitalization 24 hours after stroke, cardiac prosthesis valve, severe heart failure, renal and hepatic failure and patients without cranial MRI lesions identified and excluded from study. In addition, drugs known to affect cardiac rhythm are questioned and patients using these drugs were excluded from the study. As in all studies, at least 24-hour holter records were used. No significant difference was found between the groups included in the study in terms of gender, age, hypertension, hyperlipidemia and biochemical parameters. When TB and TE variables were classified as normal and abnormal, ın our study, abnormal TB and/or TE ratio was higher in patients with left hemisphere lesion with acute stroke, but no statistically significant difference was found between patients with right hemisphere and brain stem-cerebellum lesion. When the mean values were compared, there was no statistically significant difference between the patient group and healthy control group. As a result, closer follow-up and treatment can affect the prognosis positively, especially in the acute period in order to protect the stroke patients from complications such as arrhythmia and sudden death. However, long-term prospective studies are needed to evaluate autonomic nervous system after stroke, especially in the central areas which are considered to have effects on autonomic function.