P3715Impact of sleep-disordered breathing on short-term functional outcomes in ischemic stroke patients: a cardiopulmonary coupling analysis using holter-monitoring

Autor:	Dong Oh Kang, Yun-Kwon Park, Ja Yeon Choi, Chi Kyung Kim, Woohyeun Kim, C U Choi, Won Young Jang, Junhong Na
Rok vydání:	2019
Předmět:	medicine.medical_specialty Cardiopulmonary coupling business.industry Internal medicine Ischemic stroke Sleep disordered breathing medicine Cardiology Cardiology and Cardiovascular Medicine business Holter monitoring Term (time)
Zdroj:	European Heart Journal. 40
ISSN:	1522-9645 0195-668X
DOI:	10.1093/eurheartj/ehz745.0569
Popis:	Background Sleep-disordered breathing (SDB) assessed by conventional polysomnography is reported to have close association with worsened clinical outcomes in patients with ischemic stroke. The cardiopulmonary coupling (CPC) analysis using Holter-monitoring is an easily assessable method to evaluate SDB. However, its prognostic impact needs to be investigated. Purpose The present study investigated the prognostic impact of SDB defined by CPC analysis using Holter-monitoring at early stage of ischemic stroke on the functional disability at 3-month follow-up. Methods Total 692 patients with acute ischemic stroke who underwent Holter-monitoring were enrolled. The CPC analysis was conducted and SDB was defined as the presence of narrow-band (NB) coupling during sleep time. We investigated the association between SDB and functional disability at 3-month measured by modified Rankin scale (mRS). Result The NB coupling was present in 216 (31.2%) of 692 patients with mean age of 64.2±12.8 years. The NB group showed significantly higher proportion of severe functional disability (mRS ≥3; 45.3% vs. 12.3%, p Parameters of functional disability Overall population (n=692) PSM population (n=350) no NB (n=476) NB (n=216) OR (95% CI) p-value no NB (n=175) NB (n=175) OR (95% CI) p-value Initial NIHSS ≥5 89 (18.6) 81 (37.5) 0.999 Discharge mRS ≥3 146 (30.6) 126 (58.3) Functional disabilities after 3-month Conclusion SDB assessed by CPC analysis at early phase of ischemic stroke was able to predict both greater and persistent functional disability at 3-month. The CPC analysis using Holter-monitoring is a useful modality for predicting functional disabilities in acute ischemic stroke.
Databáze:	OpenAIRE
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