VEGETATIVE RELATIONS IN PATIENTS WITH DIFFERENT FORMS OF DISTURBANCES OF CEREBRAL CIRCULATIONIN THE MOST ACUTE PERIOD
Objective: to determine the distinguishing features of the ANS state as the first link of the stress-realizing system in patients with various forms of acute disturbances of cerebral circulation (passing infringements of cerebral circulation and stroke) in the most acute period. Methods. 51 patients with transient ischemic attack (TIA), 25 with cerebral hypertensive crisis (CHC), 71 with lacunar stroke (LS), and 10 volunteers were examined. Besides the standard examinations, the heart rate variability (HRV) parameters, including the standard deviation of consecutive RR intervals (SDNN), percentage of the number of pairs of consecutive RR-intervals differing by more than 50 ms during the recording period (pNN50), mode of intervals RR (Mo), amplitude of the mode (AMO) were tested in all the patients. On the basis of the above parameters the stress index, the reactivity coefficient, the vegetative equilibrium index (IER) and the vegetative index of the rhythm (VIR) were calculated. The correlation, linear, and nonlinear regression analysis of the HRV parameters was performed. Results. A negative effect of the sympathetic tone (AMO, r=0.42, p=0.006) and a favorable effect of the parasympathetic tone of the ANS on severity of clinical manifestations in TIA (ΔX, r=0.66, p=0.026) were determined. The patients with CHC found an inverse relation: (AMo; r=-0.48; p=0.026) and (r=0.55, p=0.009). The group with stroke revealed a negative effect of growing parasympathycotonya after the end of the first decade (pNN50, r=-0.72, p=0.028). In the group of patients with rapid recovery of the neurological deficit (CHC, TIA, LI) there was a negative AMO / Mo dependence. The patients with all variants of stroke detected a positive relation of ΔX / Mo. In the isolation of a group of young patients with stroke, certain patterns were confirmed, and the positive ratio (ΔX / Mo) at the end of the treatment preserved only in patients with a large site of stroke affection. Conclusion. The key difference of the vegetative status of the patients with TIA from the stroke group is predominance of activity of the sympathetic ANS segment with an increase of parasympathycotonya in exercise. The stroke patients irrespective of the size showed an increase in activity of the parasympathetic link of the ANS in response to an increase in the humoral effect.