Blood pressure variability, nocturnal heart rate variability and endothelial function predict recurrent cerebro-cardiovascular events following ischemic stroke - Archive ouverte HAL
Article Dans Une Revue Frontiers in Cardiovascular Medicine Année : 2023

Blood pressure variability, nocturnal heart rate variability and endothelial function predict recurrent cerebro-cardiovascular events following ischemic stroke

Irina Filchenko
  • Fonction : Auteur
Nicolas Mürner
  • Fonction : Auteur
Martijn Dekkers
  • Fonction : Auteur
Simone Duss
  • Fonction : Auteur
Anne-Kathrin Brill
  • Fonction : Auteur
Thomas Horvath
  • Fonction : Auteur
Mirjam Heldner
  • Fonction : Auteur
Emrush Rexhaj
  • Fonction : Auteur
Corrado Bernasconi
  • Fonction : Auteur
Claudio Bassetti
  • Fonction : Auteur
Markus Schmidt
  • Fonction : Auteur

Résumé

Introduction Cardiovascular parameters characterizing blood pressure (BP), heart rate (HR), endothelial function and arterial stiffness predict cerebro-cardiovascular events (CCVE) in the general population. Considering the paucity of data in stroke patients, we assessed these parameters as potential predictors of recurrent CCVE at acute stroke stroke. Patients and methods This is a secondary outcome analysis of a prospective observational longitudinal Sleep Deficiency & Stroke Outcome Study (ClinicalTrials.gov Identifier: NCT02559739). The study consecutively recruited acute ischemic stroke patients. Cardiovascular parameters (blood pressure variability [BPV], heart rate variability [HRV], endothelial function, and arterial stiffness) were assessed within the first week post-stroke. Future CCVE were recorded over a 3-year follow-up. Multivariate Cox regression analysis was used to investigate the prognostic value of 48 cardiovascular parameters regarding CCVE risk. Results Out of 447 recruited patients, 359 were included in this analysis. 20% of patients developed a future CCVE. A high variability of systolic BP ( n = 333) and nocturnal HR (non-linear parameters; n = 187) at acute stroke predicted CCVE risk after adjustment for demographic parameters, cardiovascular risk factors and mean BP or HR, respectively. Endothelial dysfunction ( n = 105) at acute stroke predicted CCVE risk after adjustment for age and sex, but not after adjustment for cardiovascular risk factors. Diurnal HR and arterial stiffness at acute stroke were not associated with CCVE risk. Conclusion High blood pressure variability, high nocturnal HRV and endothelial function contribute to the risk for future CCVE after stroke.

Dates et versions

hal-04762192 , version 1 (31-10-2024)

Identifiants

Citer

Irina Filchenko, Nicolas Mürner, Martijn Dekkers, Sebastien Baillieul, Simone Duss, et al.. Blood pressure variability, nocturnal heart rate variability and endothelial function predict recurrent cerebro-cardiovascular events following ischemic stroke. Frontiers in Cardiovascular Medicine, 2023, 10, ⟨10.3389/fcvm.2023.1288109⟩. ⟨hal-04762192⟩

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