Changes of circadian blood pressure patterns and cardiovascular parameters indicate lateralization of sympathetic activation following hemispheric brain infarction.

Abstract:

:The effects of left- and right-sided hemispheric brain infarction on variability in circadian blood pressure and cardiovascular measures were investigated in 35 patients to test for asymmetry of the sympathetic consequences of stroke. No significant differences regarding age, size of infarction or extent and frequency of damage to the insular cortex could be detected between the two groups. Patients with right-sided infarction showed a significantly reduced circadian blood pressure variability [diastolic: -1% (95% CI -4 to 1) vs -6% (-9 to -2); P < 0.05] and a higher frequency of nocturnal blood pressure increase (47% vs 35%; P < 0.05) as compared with patients with left-sided infarction. Right-sided infarction was also associated with higher serum noradrenaline concentrations [546 pg/ml (95% CI 415-677) vs 405 pg/ml (266-544); P < 0.05], and ECG more frequently showed QT prolongation (53% vs 35%; P < 0.05) and cardiac arrhythmias (67% vs 20%; P < 0.005). However, irrespective of the hemisphere damaged, patients with insular infarction showed the most pronounced changes of these parameters. In addition, two patients with right-sided strokes (13%) involving the insula, but none with a left-sided infarction, developed myocardial infarction. These findings suggest lateralization of sympathetic activation with right-sided dominance for sympathetic effects following hemispheric stroke.

journal_name

J Neurol

journal_title

Journal of neurology

authors

Sander D,Klingelhöfer J

doi

10.1007/BF00878874

subject

Has Abstract

pub_date

1995-05-01 00:00:00

pages

313-8

issue

5

eissn

0340-5354

issn

1432-1459

journal_volume

242

pub_type

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