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. 2021 Mar 18;9(1):28.
doi: 10.1186/s40560-021-00540-0.

Dynamic change of heart rate in the acute phase and clinical outcomes after intracerebral hemorrhage: a cohort study

Shoujiang You #  1 , Yupin Wang #  2 , Zian Lu #  2 , Dandan Chu  3 , Qiao Han  4 , Jiaping Xu  1 , Chun-Feng Liu  1   5 , Yongjun Cao  6   7 , Chongke Zhong  8
Affiliations

Dynamic change of heart rate in the acute phase and clinical outcomes after intracerebral hemorrhage: a cohort study

Shoujiang You et al. J Intensive Care. .

Abstract

Background: Dynamic change of heart rate in the acute phase and clinical outcomes after intracerebral hemorrhage (ICH) remains unknown. We aimed to investigate the associations of heart rate trajectories and variability with functional outcome and mortality in patients with acute ICH.

Methods: This prospective study was conducted among 332 patients with acute ICH. Latent mixture modeling was used to identify heart rate trajectories during the first 72 h of hospitalization after ICH onset. Mean and coefficient of variation of heart rate measurements were calculated. The study outcomes included unfavorable functional outcome, ordinal shift of modified Rankin Scale score, and all-cause mortality.

Results: We identified 3 distinct heart rate trajectory patterns (persistent-high, moderate-stable, and low-stable). During 3-month follow-up, 103 (31.0%) patients had unfavorable functional outcome and 46 (13.9%) patients died. In multivariable-adjusted model, compared with patients in low-stable trajectory, patients in persistent-high trajectory had the highest odds of poor functional outcome (odds ratio 15.06, 95% CI 3.67-61.78). Higher mean and coefficient of variation of heart rate were also associated with increased risk of unfavorable functional outcome (P trend < 0.05), and the corresponding odds ratios (95% CI) comparing two extreme tertiles were 4.69 (2.04-10.75) and 2.43 (1.09-5.39), respectively. Likewise, similar prognostic effects of heart rate dynamic changes on high modified Rankin Scale score and all-cause mortality were observed.

Conclusions: Persistently high heart rate and higher variability in the acute phase were associated with increased risk of unfavorable functional outcome in patients with acute ICH.

Keywords: Acute intracerebral hemorrhage; Dynamic change; Functional outcome; Heart rate; Mortality; Trajectory; Variability.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trajectories of heart rate during the acute phase of intracerebral hemorrhage
Fig. 2
Fig. 2
Distribution of modified Rankin Scale score. Patients in persistent-high trajectory: highest tertile of mean and CV had higher modified Rankin Scale score (all P < 0.001). a Trajectory of heart rate. b Mean heart rate. c CV of heart rate
Fig. 3
Fig. 3
Kaplan-Meier survival curves. Patients in persistent-high trajectory: highest tertile of mean and CV had highest cumulative incidence of 3-month mortality (all log-rank P < 0.001). a Trajectory of heart rate. b Mean heart rate. c CV of heart rate
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References

    1. Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8(4):355–369. doi: 10.1016/S1474-4422(09)70025-0. - DOI - PubMed
    1. O'Neal WT, Qureshi WT, Judd SE, Meschia JF, Howard VJ, Howard G, Soliman EZ. Heart rate and ischemic stroke: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Int J Stroke. 2015;10(8):1229–1235. doi: 10.1111/ijs.12620. - DOI - PMC - PubMed
    1. Vazir A, Claggett B, Cheng S, Skali H, Shah A, Agulair D, Ballantyne CM, Vardeny O, Solomon SD. Association of resting heart rate and temporal changes in heart rate with outcomes in participants of the Atherosclerosis Risk in Communities study. JAMA Cardiol. 2018;3(3):200–206. doi: 10.1001/jamacardio.2017.4974. - DOI - PMC - PubMed
    1. Sharashova E, Wilsgaard T, Lochen ML, Mathiesen EB, Njolstad I, Brenn T. Resting heart rate trajectories and myocardial infarction, atrial fibrillation, ischaemic stroke and death in the general population: the Tromso Study. Eur J Prevent Cardiol. 2017;24(7):748–759. doi: 10.1177/2047487316688983. - DOI - PubMed
    1. Zhang D, Wang W, Li F. Association between resting heart rate and coronary artery disease, stroke, sudden death and noncardiovascular diseases: a meta-analysis. CMAJ. 2016;188(15):E384–e392. doi: 10.1503/cmaj.160050. - DOI - PMC - PubMed

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