Abstract
BackgroundTo assess heart rate variability (HRV) among patients with arteriosclerotic cerebral small vessel disease (CSVD) by comparing with control subjects, and to determine whether HRV parameters were related to structural alterations in brain regions involved in autonomic regulation among CSVD patients.MethodsWe consecutively recruited subjects aged between 50 and 80 years who visited the Stroke Prevention Clinic of our hospital and have completed brain magnetic resonance imaging examination from September 1, 2018 to August 31, 2019. Polysomnography and synchronous analyses of HRV were then performed in all participants. Multivariable binary logistic regression was used to identify the relationship between HRV parameters and CSVD. Participants were invited to further undergo three-dimensional brain volume scan, and the voxel based morphometry (VBM) analysis was used to identify gray matter atrophy.ResultsAmong 109 participants enrolled in this study, 63 were assigned to the arteriosclerotic CSVD group and 46 to the control group. Lower standard deviation of normal-to-normal intervals (SDNN, OR = 0.943, 95% CI 0.903 to 0.985, P = 0.009) and higher ratio of low to high frequency power (LF/HF, OR = 4.372, 95% CI 1.033 to 18.508, P = 0.045) during the sleep period were associated with CSVD, independent of traditional cerebrovascular risk factors and sleep disordered breathing. A number of 24 CSVD patients and 21 controls further underwent three-dimensional brain volume scan and VBM analysis. Based on VBM results, SDNN during the awake time (β = 0.544, 95% CI 0.211 to 0.877, P = 0.001) and the sleep period (β = 0.532, 95% CI 0.202 to 0.862, P = 0.001) were both positively related with gray matter volume within the right inferior frontal gyrus only among CSVD patients.ConclusionsDecreased nocturnal HRV is associated with arteriosclerotic CSVD independent of traditional cerebrovascular risk factors and sleep disordered breathing. The structural atrophy of some brain regions associated with cardiac autonomic regulation sheds light on the potential relationship.Trial registrationTrial registration number: ChiCTR1800017902. Date of registration: 20 Aug 2018.
Highlights
Cerebral small vessel disease (CSVD), a major contributor to stroke and cognitive impairment, is a group of diseases that pathologically affect the small arteries, arterioles, capillaries and venules of the brain [1, 2]
The inclusion criteria for patients diagnosed with arteriosclerotic cerebral small vessel disease (CSVD) included 1) baseline magnetic resonance imaging (MRI) scan mainly showing moderate to severe white matter hyperintensities (WMH) of presumed vascular origin (Fazekas score of 2–3), with or without the presence of other MRI features of CSVD [3]; 2) one or more characteristic clinical manifestations of CSVD or no evident symptoms; and (3) consent to participate in the study
Among patients with arteriosclerotic CSVD, standard deviation of normal-to-normal intervals (SDNN) during the awake and sleep periods were both positively related with gray matter volume within the right inferior frontal gyrus
Summary
Cerebral small vessel disease (CSVD), a major contributor to stroke and cognitive impairment, is a group of diseases that pathologically affect the small arteries, arterioles, capillaries and venules of the brain [1, 2]. Heart rate variability (HRV) is considered to reflect the activity of the autonomic nervous system (ANS) [4]. Accumulating evidence has reported an association between HRV, at nighttime, and the development and presence of subclinical arteriosclerotic CSVD [7, 8]. Sleep disorders, sleep disordered breathing (SDB), were not considered as confounding factors in those studies, which are increasingly recognized as risk factors for arteriosclerotic CSVD [9, 10] and affect HRV [11, 12]. To assess heart rate variability (HRV) among patients with arteriosclerotic cerebral small vessel disease (CSVD) by comparing with control subjects, and to determine whether HRV parameters were related to structural alterations in brain regions involved in autonomic regulation among CSVD patients
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
