Autonomic Disturbances in Acute Cerebrovascular Disease / 神经科学通报·英文版

Autonomic disturbances often occur in patients with acute cerebrovascular disease due to damage of the central autonomic network. We summarize the structures of the central autonomic network and the clinical tests used to evaluate the functions of the autonomic nervous system. We review the clinical and experimental findings as well as management strategies of post-stroke autonomic disturbances including electrocardiographic changes, cardiac arrhythmias, myocardial damage, thermoregulatory dysfunction, gastrointestinal dysfunction, urinary incontinence, sexual disorders, and hyperglycemia. The occurrence of autonomic disturbances has been associated with poor outcomes in stroke patients. Autonomic nervous system modulation appears to be an emerging therapeutic strategy for stroke management in addition to treatments for sensorimotor dysfunction.

Study of Heart Rate Variability in Hypertensive Subjects.

Introduction: Hypertension represents a multifactorial disease of blood pressure (BP) regulation with persistently elevated systolic and/or diastolic BP over 140/90mmHg. 90% cases of hypertension have to be assigned as essential hypertension. Research has proven that patients with essential hypertension, especially at an early stage without any medication, display autonomic disturbance in the form of increase in sympathetic and a reduction in parasympathetic activity of the ANS. The heart rate variability analysis is a powerful tool in assessment of the cardiac autonomic nerve function. It is non-invasive, an accurate, reliable, reproducible, yet simple to measure and to process and It is indicative of neuro-cardiac fitness and overall health. Objective – The aim of the present study was to (1) measure Heart rate variability (HRV) in Essential Hypertension (2) effect of different drugs on Heart rate variability in hypertension among hypertensive subjects. Materials and Methods: This study was conducted On 100 Hypertension subjects & 100 Normal subjects after obtaining informed written consent by use of Heart rate variability Analysis System Variowin-HR Medical System. Results: The mean values of Very low frequency (VLF), Low frequency (LF), High frequency (HF), Normalized High Frequency (HF (nu) & all time domain parameters were found to be reduced significantly in hypertensive subjects as compared to control subjects. The mean values of LF (nu), LF / HF ratio were significantly high in hypertensive subjects as compared to control subjects. Conclusion: observations in our study demonstrate that hypertensive subjects had markedly reduced heart rate variability (HRV) in comparison with normal subjects which indicate cardiac autonomic disturbances in hypertension subjects in causation of essential hypertension.

Assessment of Autonomic Disturbance by 24-hour Heart Rate Variability in Patients with Liver Cirrhosis / 대한내과학회지

OBJECTIVE: Heart rate variability(HRV) is helpful to diagnosis autonomic disturbance and sympathetic-parasympathetic imbalance in patients with myocardial infarction and diabetes mellitus. Patients with liver cirrhosis demonstrate reduced blood pressure despite increased heart rate and increased cardiac output, indicating a fall in peripheral vascular resistance. Autonomic disturbance may contribute to this phenomenon. The aim of the present study is to evaluate the degree of autonomic disturbance and the circadian rhythm of autonomic nervous system by estimating HRV with 24 hour-Holter recorder, METHODS: 24 hour-HRV with Del Mar Avionics 563 Holter recorder and cardiovascular reflex tests were carried out on 32 patients with liver cirrhosis and 20 control subjects. We evaluated the presence of autonomic disturbance, and assessed quantitatively the autonomic disturbance. RESULTS: 1) Among cardiovascular reflex tests, Valsalva test, standing test and deep breathing test were showed a significantly decreased response in liver cirrhosis compared with control groups. 2) The standard deviation of 24hours average R-R intervals were showed a significantly decrease in liver cirrhosis than control groups(P<0.0001). The HRV of low frequency(LF. P<.D.001), high frequency(HF, P<0.0001) and total power spectral density (P<0.0001) in liver cirrhosis were statistically lower than control. 3) The LF/HF ratio of patients with liver cirrhosis was showed higher than control at night CONCLUSION: Non-invasive assessment of 24 hour-HRV has a few advantages in the diagnosis and degree of autonomic disturbance, evaluation of diurnal variation of autonomic tone.