Impact of Sleep-Disordered Breathing on Functional Outcomes in Ischemic Stroke A Cardiopulmonary Coupling Analysis
- Authors
- Kang, Dong Oh; Kim, Chi Kyung; Park, Yoonjee; Jang, Won Young; Kim, Woohyeun; Choi, Jah Yeon; Roh, Seung-Young; Choi, Cheol Ung; Kim, Eung Ju; Rha, Seung-Woon; Park, Chang Gyu; Seo, Hong Seog; Oh, Kyungmi; Na, Jin Oh
- Issue Date
- Jul-2020
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Keywords
- cerebral infarction; electrocardiography; follow-up; odds ratio; recovery of function; sleep; stroke
- Citation
- Stroke, v.51, no.7, pp 2188 - 2196
- Pages
- 9
- Indexed
- SCIE
SCOPUS
- Journal Title
- Stroke
- Volume
- 51
- Number
- 7
- Start Page
- 2188
- End Page
- 2196
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/49297
- DOI
- 10.1161/STROKEAHA.119.028730
- ISSN
- 0039-2499
1524-4628
- Abstract
- Background and Purpose:
Cardiopulmonary coupling (CPC) analysis is an easily assessable method to evaluate sleep-disordered breathing (SDB); however, its prognostic impact in patients with acute ischemic stroke needs to be investigated. We performed a CPC analysis using Holter monitoring at the early stage of noncardioembolic ischemic stroke to investigate the prognostic effect of SDB on functional impairment at the 3-month follow-up.
Methods:
A total 615 patients with acute noncardioembolic ischemic stroke who underwent Holter monitoring within 30 days of stroke onset were enrolled from a multicenter, prospective, all-comer cohort. CPC analysis was conducted, and SDB was defined by the presence of narrow-band coupling during sleep time. We investigated the association between SDB and functional impairment at 3 months as measured by the modified Rankin Scale.
Result:
Narrow-band coupling was present in 191 (31.1%) of 615 patients (mean age 64.5±12.6 years). The narrow-band group showed a significantly higher rate of severe functional impairment (modified Rankin Scale score >2; 45.5% versus 12.9%, P<0.001) and persistent disability (Δmodified Rankin Scale score ≤0; 53.9% versus 39.8%, P<0.001) at the 3-month follow-up. In multivariate analysis, narrow-band coupling was an independent predictor of higher risk of severe and persistent functional impairment at 3 months (odds ratio, 3.98 [95% CI, 2.34–6.78]; P<0.001; and odds ratio, 1.81 [95% CI, 1.23–2.66]; P<0.001, respectively). The results remained consistent after propensity-score matched analysis with 157 patient pairs (C-statistic=0.770).
Conclusions:
SDB assessed by CPC analysis at the early stage of ischemic stroke could predict severe and prolonged functional impairment at 3 months. CPC analysis using Holter monitoring can help predicting functional impairment in acute ischemic stroke.
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- Appears in
Collections - 2. Clinical Science > Department of Neurology > 1. Journal Articles
- 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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