title: Autonomic dysfunction in ischemic stroke with carotid stenosis.
abstract: OBJECTIVE
  Impaired autonomic function is common in acute ischemic stroke. Previous limited studies have suggested that atherosclerosis may affect the distensibility of the carotid sinus and then impair the cardiovascular autonomic function. This study sought to investigate cardiovascular autonomic function in patients with ischemic stroke with carotid stenosis.
  
  
  METHODS
  Eighty-five patients with ischemic stroke (58 ones without carotid stenosis and 27 ones with carotid stenosis, average 6 months after stroke onset) and 37 elderly controls were recruited. All performed Ewing's battery autonomic function tests.
  
  
  RESULTS
  From Ewing's battery of autonomic function tests, atypical, definite, or severe autonomic dysfunction was identified in 69.0% patients without carotid stenosis and 88.9% with carotid stenosis, with significant difference between the two groups, and the prevalence of autonomic dysfunction in both groups was higher than that in controls (21.6%). Patients with carotid stenosis showed impairment of all parasympathetic tests (all P < 0.05) and one of the sympathetic tests [Mean fall in systolic blood pressure (BP) on standing: P = 0.051], and those without carotid stenosis only showed impairment in two parasympathetic tests (Valsalva ratio: P = 0.014; heart rate response to deep breathing: P < 0.001) in comparison with controls. Patients with carotid stenosis had significantly more impairment than those without carotid stenosis in some autonomic parameters (Valsalva ratio: P < 0.05; mean fall in systolic BP on standing: P < 0.05).
  
  
  CONCLUSIONS
  Cardiovascular autonomic function is impaired in patients with ischemic stroke, but patients with carotid stenosis show more severely impaired parasympathetic and sympathetic functions.
authors.affiliation: Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: L
authors.initials: L
authors.lastname: Xiong
authors.forename: H W
authors.initials: HW
authors.lastname: Leung
authors.forename: X Y
authors.initials: XY
authors.lastname: Chen
authors.forename: J H
authors.initials: JH
authors.lastname: Han
authors.forename: W H
authors.initials: WH
authors.lastname: Leung
authors.forename: O Y
authors.initials: OY
authors.lastname: Soo
authors.forename: Y L
authors.initials: YL
authors.lastname: Lau
authors.forename: K S
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology*; D002545:Brain Ischemia / Q000150:complications; D002320:Cardiovascular Physiological Phenomena; D016893:Carotid Stenosis / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D020521:Stroke / Q000150:complications*