title: Clinical prognostic significance of heart abnormality and heart rate variability in patients with stroke.
abstract: OBJECTIVE
  To investigate the difference of heart rate variability (HRV) and serum creatine kinase isoenzyme (CK-MB) activity between right-sided and left-sided stroke, and the relative impact of cardiac autonomic imbalance and heart abnormality on death by serum CK-MB activity and fractal dimension (FD) detection in patients with stroke.
  
  
  METHODS
  Three hundred and twenty-seven patients (mean age: 61.12 +/- 9.74 years) with an acute first-ever stroke underwent a comprehensive clinical investigation and laboratory tests, and were followed up for 1 month. Serum CK-MB activity and FD of heart rate variability were detected on the next day after admission.
  
  
  RESULTS
  During the 1 month follow-up period, 42 out of 327 (12.84%) patients had died. Among all the variables analysed, FD decreased and serum CK-MB activity increased after stroke, and decreased FD was more common in the right-sided stroke. This study also demonstrated that acute phase increased serum CK-MB activity [odds ratio (OR)=0.226, 95% CI: 0.103-0.493, p= 0.000) and decreased FD (OR=0.276, 95% CI: 0.135-0.567, p=0.000) had been linked with the risk of death.
  
  
  CONCLUSIONS
  Right-sided stroke and left-sided stroke had different influences on cardiac autonomic nerve activity. Acute phase increased serum CK-MB activity and decreased FD are well-established prognostic factors of death in patients with stroke. Assessment of FD and serum CK-MB activity may provide additional information on the risk of death in stroke patients.
authors.affiliation: Department of Neurology, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.
authors.forename: Lanying
authors.initials: L
authors.lastname: He
authors.forename: Changqing
authors.initials: C
authors.lastname: Li
authors.forename: Yong
authors.initials: Y
authors.lastname: Luo
authors.forename: Weiwei
authors.initials: W
authors.lastname: Dong
authors.forename: Hao
authors.initials: H
authors.lastname: Yang
mesh_terms: D000208:Acute Disease; D001145:Arrhythmias, Cardiac / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006330:Heart Defects, Congenital / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D006339:Heart Rate; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020521:Stroke / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D013997:Time Factors
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase