title: Heart rate variability - a potential early marker of sub-acute post-stroke infections.
abstract: OBJECTIVE
  Infection is the most relevant complication after acute ischemic stroke. Activity of the autonomic nervous system seems to control post-stroke immunodepression. We investigated heart rate variability (HRV) indices that reflect autonomic readjustments as predictors of post-stroke infection.
  
  
  METHODS
  Forty-three patients with acute ischemic stroke were enrolled in a prospective study. The predictability of sub-acute infections (day 4 ± 1 after admission) was investigated in 34 patients without acute infection by means of HRV indices obtained in the acute period (48 h after admission).
  
  
  RESULTS
  Sub-acute infection could be predicted in patients without clinical or paraclinical (white blood cell count and C-reactive protein) signs of infection in the acute period at (i) day: increased HFnorm, reduced LFnorm and LF/HF; (ii) night: reduced LF and VLF (P < 0.05).
  
  
  CONCLUSIONS
  HRV indices are candidates for early markers of developing post-stroke infections, preceding routine blood samples. Thus, HRV-based early diagnosis of post-stroke infection should be investigated in more detail as it may have implications as a novel tool for timely and appropriate treatment. A corresponding continuous HRV-based risk assessment using the ECG provided by the routine stroke monitoring system would be possible without any additional burden for patients and staff.
authors: Hans Berger Department of Neurology, Jena University Hospital, Germany.
authors: A
authors: A
authors: Günther
authors: I
authors: I
authors: Salzmann
authors: S
authors: S
authors: Nowack
authors: M
authors: M
authors: Schwab
authors: R
authors: R
authors: Surber
authors: H
authors: H
authors: Hoyer
authors: O W
authors: OW
authors: Witte
authors: D
authors: D
authors: Hoyer
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001786:Blood Glucose; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007239:Infections / Q000175:diagnosis* / Q000209:etiology*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D020521:Stroke / Q000150:complications*
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein