RESUMO
OBJECTIVE: This study aimed to evaluate changes in the autonomic nervous system caused by cerebral lesions due to acute stroke. We assessed heart rate variability and catecholamine levels in lieu of stroke lesion localization. MATERIALS AND METHODS: A total of 60 stroke patients and 31 healthy controls were enrolled in the study. Plasma epinephrine and norepinephrine levels were measured on the first, third, and seventh days following the stroke event. Heart rate variability was evaluated with time-domain and frequency-domain analyses via 24-hour Holter monitor recordings. RESULTS: On the first and third day following the stroke, norepinephrine levels were significantly higher in all patient groups as compared to controls. Epinephrine levels on the first, third and seventh days after the stroke were significantly higher in patients with lesions in the right middle cerebral artery territory than controls. In frequency-domain analysis, patients with right middle cerebral artery territory lesions had greater low frequency and low frequency to high frequency ratio values than controls. Time-domain analysis revealed significant decreases in the standard deviation from the mean for 5-minute 288 R-R intervals in patients with lesions in the right middle cerebral artery and posterior cerebral artery territory when contrasted with controls. Patients with lesions in the right middle cerebral artery territory demonstrated the highest increase in the percentage of consecutive R-R intervals differing by more than 50 ms (pNN50) as compared to the control group. CONCLUSION: These findings indicate that autonomic dysfunction favoring an increase in sympathetic activity occurs in acute stroke patients.
RESUMO
A total of 100 hospitalized stroke patients and 30 healthy controls were included in a study aiming to determine the predictive role of ApoE genotype polymorphism for stroke outcome in the Turkish population. The most frequent ApoE genotype was epsilon3/3 reflecting Asian population polymorphic distribution. ApoE polymorphism in the Eastern Turkish population was found to be independent of stroke type, OSCP subtypes of infarction, localization of hemorrhage, severity of carotid artery stenosis, and resultant stroke outcome. Distinct polymorphic results in populations from nearby regions suggest a multifactorial pathogenesis and presence of very complex genetic factors in the development of stroke and stroke outcome.
Assuntos
Apolipoproteínas E/genética , Dano Encefálico Crônico/genética , Acidente Vascular Cerebral/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Dano Encefálico Crônico/etiologia , Estudos de Casos e Controles , Comorbidade , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , Hipertensão/epidemiologia , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Prognóstico , Estudos Prospectivos , Recuperação de Função Fisiológica , Fatores de Risco , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/epidemiologia , Resultado do Tratamento , Turquia/epidemiologia , Adulto JovemRESUMO
The purpose of the present study was to investigate the predictive role of apolipoprotein E genotypes for stroke-related risk factors in the Turkish population. Among 100 stroke patients and 30 healthy subjects included in the study, most frequent Apo E genotype was epsilon3/3, compatible with polymorphic distribution of Asian population. VLDL and triglyceride levels in epsilon2/4(+) subjects were higher than in epsilon2/4(-) patients. HDL and homocysteine levels were higher in epsilon4/4 (+) subjects than in epsilon4/4 (-) stroke patients. These results suggest that ApoE polymorphism in this population was not associated with any other demographic or clinical variables except for lipid profiles and homocysteine levels.
Assuntos
Apolipoproteínas E/genética , Lipoproteínas VLDL/sangue , Acidente Vascular Cerebral/genética , Triglicerídeos/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/complicações , Estudos de Casos e Controles , Feminino , Humanos , Hemorragias Intracranianas/complicações , Hemorragias Intracranianas/genética , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético/genética , Isoformas de Proteínas/genética , Valores de Referência , Fatores de Risco , Fatores Sexuais , Estatísticas não Paramétricas , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/complicaçõesRESUMO
OBJECTIVE: The aim of this study was to determine the prevalence of post-stroke dementia (PSD) and its possible clinical and sociodemographic risk factors 3 months after the index stroke episode. METHODS: Among 147 patients who were hospitalized in the inpatient neurology clinic of Dicle University Faculty of Medicine with a diagnosis of stroke, 106 that met the inclusion criteria were included in the study 3 months after the index stroke. All patients underwent a detailed systemic and neurological examination, as well as a clinical interview in an effort to determine the sociodemographic features, and both vascular and non-vascular risk factors of stroke. Routine laboratory examinations and cranial imaging (computed tomography [CT] or magnetic resonance imaging [MRI]) were also conducted. The functional, clinical, and cognitive status of the patients were evaluated at the time of hospitalization and 3 months later with the Barthel Index, NIH Stroke Scale (NIHSS), and Mini Mental State Examination (MMSE), respectively. RESULTS: Of the 106 patients included in the study, 32 (30.2%) were diagnosed with PSD. Multivariate analyses revealed that increased age, presence of atrial fibrillation, multiple brain lesions, and cognitive and functional status during hospitalization predicted the development of PSD in this group of patients. CONCLUSION: The results corroborate previous findings that PSD is a common complication of stroke. Early recognition and treatment of PSD risk factors will definitely diminish the burden of stroke on society and help to improve patient quality of life.
