Introduction: Acute stroke commonly affects cardiac autonomic responses. Our recent study showed that lower complexity of heart rate variability (HRV), assessed by multiscale entropy (MSE), is associated with worse outcome in acute stroke patients.
Hypothesis: The study aimed to further investigate the impact of stroke locations on various HRV parameters in patients with non-surgical supratentorial intracerebral hemorrhage (ICH), and their correlations with stroke severity, and outcome.
Methods: Continuous one-hour ECG signals were obtained from ICH patients within 48 hours after admission and controls. The complexity index was defined as the area under the MSE curve from scale 1 to 20. Stroke severity was assessed by NIHSS. A favorable outcome was defined as modified Rankin scale ≤2 at 3 months after stroke.
Results: A total of 93 supratentorial ICH patients (male 59.1%, mean age 61.1 years), including basal ganglia (n=40), thalamic (n=35), and lobar ICH (n=18), were recruited during 2012 and 2014. The HRV complexity index was lower in ICH patients than that in controls (26.9 ± 7.4 vs 33.6 ± 3.7, P<0.001). Lobar ICH had significantly lower complexity index than basal ganglia and thalamic ICH (21.6 ± 7.9 vs. 27.9 ± 6.4 & 28.5 ± 7.2, P<0.01, Figure). Complexity index was negatively associated with NIHSS score (= -0.25, P=0.02). Forty patients (43%) had a favorable outcome. Complexity index independently predicted outcome (OR 1.09, 95%CI 1.00 - 1.19, P=0.039), though the effects did not exist in ICH location.
Conclusions: The HRV complexity was related to stroke severity and function outcome in patients with supratentorial ICH, and lobar ICH had the lowest complexity of HRV.