Effect of Heart Rate Variabilities on Outcome After Acute Intracerebral Hemorrhage: A Post Hoc Analysis of ATACH‐2

Bibliographic Details
Title: Effect of Heart Rate Variabilities on Outcome After Acute Intracerebral Hemorrhage: A Post Hoc Analysis of ATACH‐2
Authors: Kaori Miwa, Masatoshi Koga, Mayumi Fukuda‐Doi, Haruko Yamamoto, Kanata Tanaka, Sohei Yoshimura, Masafumi Ihara, Adnan I. Qureshi, Kazunori Toyoda
Source: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 16 (2021)
Publisher Information: Wiley, 2021.
Publication Year: 2021
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: heart rate, heart rate variabilities, intracerebral hemorrhage, randomized controlled trial, stroke, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: Background To explore how the clinical impact of heart rate (HR) and heart rate variabilities (HRV) during the initial 24 hours after acute intracerebral hemorrhage (ICH) contribute to worse clinical outcomes. Methods and Results In the ATACH‐2 (Antihypertensive Treatment in Intracerebral Hemorrhage 2) trial, the HR was recorded for every 15 minutes from baseline to 1 hour and hourly during the initial 24 hours post‐randomization. We calculated the following: mean, standard deviation, coefficient of variation, successive variation, and average real variability (ARV). Outcomes were hematoma expansion at 24 hours and unfavorable functional outcome, defined as modified Rankin Scale score 4 to 6 at 90 days. Of the 1000 subjects in ATACH‐2, 994 with available HR data were included in the analyses. Overall, 262 experienced hematoma expansion, and 362 had unfavorable outcomes. Increased mean HR was linearly associated with unfavorable outcome (per 10 bpm increase adjusted odds ratio [aOR], 1.31, 95% CI, 1.14–1.50) but not with hematoma expansion, while HR‐ARV was associated with hematoma expansion (aOR, 1.06, 95% CI, 1.01–1.12) and unfavorable outcome (aOR, 1.07, 95% CI, 1.01–1.3). Every 10‐bpm increase in mean HR increased the probability of unfavorable outcome by 4.3%, while every 1 increase in HR‐ARV increased the probability of hematoma expansion by 1.1% and unfavorable outcome by 1.3%. Conclusions Increased mean HR and HR‐ARV within the initial 24 hours were independently associated with unfavorable outcome in acute ICH. Moreover, HR‐ARV was associated with hematoma expansion at 24 hours. This may have future therapeutic implications to accommodate HR and HRV in acute ICH. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01176565.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2047-9980
Relation: https://doaj.org/toc/2047-9980
DOI: 10.1161/JAHA.120.020364
Access URL: https://doaj.org/article/87264ac51e7349ad8733a91f266b7d42
Accession Number: edsdoj.87264ac51e7349ad8733a91f266b7d42
Database: Directory of Open Access Journals
More Details
ISSN:20479980
DOI:10.1161/JAHA.120.020364
Published in:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Language:English