TREATMENT OF PATIENTS WITH TRANSIENT IMPAIRMENT OF THE CEREBRAL CIRCULATION

The study involved 83 patients with passing infringements of brain blood circulation (PIBBC), among which  are 55 patients with a transient ischemic attack and 28 patients with a cerebral hypertensive crisis, 13 volunteers. On the 1st  and 10th day after PIBBC for patients and once for volunteers the state of heart rate variability with the indices: a standard  deviation of consecutive RR-intervals (SDNN), ms; percentage of pairs of consecutive RR-intervals differing by more than 50  ms during the recording period (pNN50), %; a mode (Mo), s; a mode amplitude (AMO), %; a range of ΔX, s were determined.  To determine a vegetative tone, a stress index (IN) was calculated. The second stroke or ischemic events were detected by  means of telephone interviews over the period of 3 months. In the group with the use of addition cholinomimetic therapy on the first day of hospitalization, a higher SDNN value was in comparison with the control group (р = 0.048); in the comparison  group (р = 0.003), SDNN exceeded 75 % of the interquartile range of normal values   (25–36 ms). After the 10-day course of  treatment, changes in SDNN were not observed in the both groups, and in the main group SDNN remained above the control  indices (р = 0.016). During therapy this group showed a tendency to decrease IN1/2 with significantly lower values   compared  in the control group (р = 0.009) and in the comparison group (р = 0.008). The unfavorable prognosis of acute ischemic events  in the PIBBC group with the use of parasympathomimetic therapy was determined during a 3-month period as a greater percentage of recurrent ischemic events.  Based on the data obtained, SDNN is proposed for use as a predictive parameter for the personification of the appointment of cholinomimetic therapy.

 passing infringements of brain blood circulation,  transient ischemic attack,  cerebral hypertensive crisis,   parasympathomimetic treatment

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