Acute increase of complexity in the neurocardiovascular dynamics following carotid stenting

• Published in: Acta neurologica Scandinavica Vol. 123; no. 3; pp. 187 - 192
• Main Authors: Yuan, H.-K., Lin, C., Tsai, P.-H., Chang, F.-C., Lin, K.-P., Hu, H.-H., Su, M.-C., Lo, M.-T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2011; Blackwell
• Subjects: Acute Disease; Aged; Aged, 80 and over; angioplasty & stenting; Angioplasty - methods; Biological and medical sciences; carotid stenosis; Carotid Stenosis - diagnosis; Carotid Stenosis - physiopathology; Carotid Stenosis - therapy; cerebral hemodynamics; complexity; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; Heart Rate - physiology; heart rate variability; Humans; Male; Medical sciences; Middle Aged; Neurologic Examination - methods; Neurology; Pilot Projects; Prospective Studies; Stents; Stroke - diagnosis; Stroke - physiopathology; Stroke - therapy; Carotid stenosis; angioplasty & stenting; complexity; Nervous system diseases; AMP; Acute; Central nervous system; Cardiovascular disease; Artery; Cerebral disorder; Encephalon; Arterial disease; Vascular disease; Heart rate; Dynamics; heart rate variability; Blood vessel; Carotid; Central nervous system disease; Circulatory system; Hemodynamics; Cerebrovascular disease; cerebral hemodynamics
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/j.1600-0404.2010.01384.x

Yuan H‐K, Lin C, Tsai P‐H, Chang F‐C, Lin K‐P, Hu H‐H, Su M‐C, Lo M‐T. Acute increase of complexity in the neurocardiovascular dynamics following carotid stenting. 
Acta Neurol Scand: 2011: 123: 187–192.
© 2010 John Wiley & Sons A/S. Objective –  Percutaneous carotid angioplasty and stenting (CAS) has been used to improve cerebral circulation and autoregulation. However, whether CAS ameliorates the autonomic regulatory dynamics remains unclear. This prospective study examines the neurocardiovascular dynamics following carotid stenting. Methods –  Thirty minutes electrocardiograms were recorded at three different time points (pre‐operative, 1‐h post‐operative, 1‐day post‐operative) on twelve male patients (mean age 70.8 ± 9.6 years) receiving unilateral primary CAS. The HR data were analyzed by the conventional heart rate variability (HRV) and the multiscale entropy (MSE) methods; the former associates with autonomic activities and the latter quantifies the regulatory complexity of heart beat intervals. Loss of complexity at multiple scales has been associated with decoupled regulatory network in vivo. Results –  Conventional HRV indices showed no difference after CAS. Complexity indices increased significantly on scales 2–8 at 1‐h and on scales 2–3 1‐day post‐treatment. The lower scale MSE (1–5) correlated with the frequency components of conventional HRV indices. The increased complexity could imply a restoration of the neurocardiovascular dynamics on the path to a healthier state. Conclusions –  Primary CAS can induce a recovery in the neurocardiovascular regulatory dynamics in patients with high‐grade carotid stenosis.