Correlation between clinical severity and extent of autonomic cardiovascular impairment in the acute phase of subarachnoid hemorrhage
Borutta M, Gerner ST, Möser P, Hölter P, Engelhorn T, Dörfler A, Huttner HB, Schwab S, Kuramatsu J, Köhn J (2022)
Publication Type: Journal article
Publication year: 2022
Journal
DOI: 10.1007/s00415-022-11220-w
Abstract
Background and aim: To assess associations between clinical severity and possible dysfunction of autonomic cardiovascular modulation within the acute phase after spontaneous subarachnoid hemorrhage (SAH). Methods: In this prospective observational study, in 51 patients with spontaneous SAH, Hunt-and-Hess scores (H&H) were assessed and cardiovascular autonomic modulation was monitored within 24 h after SAH-onset. From 5 min time-series of R–R-intervals (RRI) and blood-pressure (BP) recordings, we calculated autonomic parameters including time-domain [RRI-coefficient-of-variation (RRI-CV) and square-root-of-the-mean-squared-differences-of-successive-RRIs (RMSSD)] and frequency-domain parameters [low- and high-frequency-powers of RRI- and BP-modulation (RRI-LF-, RRI-HF-, SBP-LF-powers) and RRI-total-powers]. Data were compared to those of 20 healthy volunteers. Results: RRI- and BP-values did not differ between groups. Yet, parameters of sympathetic (RRI-LF-powers 141.0 (18.9–402.4) ms2 vs 442.3 (246.8–921.2) ms2, p = 0.001) and total autonomic modulation (RRI-CV 2.4 (1.2–3.7) ms2 vs 3.7 (3.1–5.3) ms2, p = 0.001) were significantly lower in patients than in controls. Subgroup analyses (patients with H&H < 3 vs H&H ≥ 3) and Spearman-rank-correlations revealed increasing loss of sympathetic (RRI-LF-powers 338.6 (179.7–710.4) ms2 vs 72.1 (10.1–175.9) ms2, p = 0.001, rho = − 0.524) and total autonomic modulation (RRI-CV 3.5 (2.3–5.4) ms2 vs 1.6 (1.0–2.8) ms2, p < 0.001, rho = − 0.519) with higher H&H-scores. Multiple-logistic-regression underlined the significant influence of H&H-scores on sympathetic (RRI-LF-powers, p = 0.033) and total autonomic modulation (RRI-CV, p = 0.040) compared to possible confounders (e.g., age, intubation). Conclusion: Within the acute phase, spontaneous SAH induces a decrease in sympathetic and total autonomic cardiovascular modulation. Higher H&H-scores were associated with increasing autonomic dysfunction and may therefore augment the risk of cardiovascular complications and poor clinical outcome.
Authors with CRIS profile
Matthias Borutta
Medizinische Fakultät
Philip Möser
Department of Neurology
Philip Hölter
Department of Neuroradiology
Tobias Martin Engelhorn
Department of Neuroradiology
Arnd Dörfler
Department of Neuroradiology
Stefan Schwab
Lehrstuhl für Neurologie
Joji Kuramatsu
Medizinische Fakultät
Julia Köhn
Medizinische Fakultät
Involved external institutions
Germany (DE)How to cite
APA:
Borutta, M., Gerner, S.T., Möser, P., Hölter, P., Engelhorn, T., Dörfler, A.,... Köhn, J. (2022). Correlation between clinical severity and extent of autonomic cardiovascular impairment in the acute phase of subarachnoid hemorrhage. Journal of Neurology. https://doi.org/10.1007/s00415-022-11220-w
MLA:
Borutta, Matthias, et al. "Correlation between clinical severity and extent of autonomic cardiovascular impairment in the acute phase of subarachnoid hemorrhage." Journal of Neurology (2022).
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