Thyroid hormones have a pivotal role in controlling metabolic processes, cardiovascular function, and autonomic nervous system activity. Hypothyroidism, a prevalent endocrine illness marked by inadequate production of thyroid hormone, has been linked to different cardiovascular abnormalities, including alterations in heart rate variability (HRV). The study included 110 patients with hypothyroid disorder. Participants underwent clinical assessments, including thyroid function tests and HRV analysis. HRV, a measure of the variation in time intervals between heartbeats, serves as an indicator of autonomic nervous system activity and cardiovascular health. The HRV values were acquired using continuous 24-h electrocardiogram (ECG) monitoring in individuals with hypothyroidism, as well as after a treatment period of 3 months. All patients exhibited cardiovascular symptoms like palpitations or fatigue but showed no discernible cardiac pathology or other conditions associated with cardiac disease. The findings of our study demonstrate associations between hypothyroidism and alterations in heart rate variability (HRV) parameters. These results illustrate the possible influence of thyroid dysfunction on the regulation of cardiac autonomic function.

Background: Heart rate variability (HRV) is the fluctuation in the time intervals between adjacent heartbeats. HRV is a measure of neurocardiac function that is produced by dynamic autonomic nervous system (ANS) processes and is a simple measure that estimates cardiac autonomic modulation. Methods: The study included 108 patients admitted to the Coronary Intensive Care Unit with acute myocardial infarction (AMI) who did not undergo primary percutaneous transluminal coronary angioplasty (PTCA) or systemic thrombolysis and followed conservative management. All patients underwent detailed clinical, biological, and paraclinical assessments, including evaluation of HRV parameters and echocardiographic measurements. The analysis of RR variability in both time and frequency domains indicates that the negative prognosis of patients with AMI is associated with an overall imbalance in the neuro-vegetative system. The HRV parameters were acquired using continuous 24 h electrocardiogram (ECG) monitoring at a baseline, after 1 month, and 6 months. Results: Our analysis reveals correlations between alterations in HRV parameters and the increased risk of adverse events and mortality after AMI. The study found a significant improvement in HRV parameters over time, indicating better autonomic regulation post-AMI. The standard deviation of all RR intervals (SDNN) increased significantly from baseline (median 75.3 ms, IQR 48.2–100) to 1 month (median 87 ms, IQR 55.7–111) and further to 6 months (median 94.2 ms, IQR 67.6–118) (p < 0.001 for both comparisons). The root mean square of successive difference of RR (RMSSD) also showed significant increases at each time point, from baseline (median 27 ms, IQR 22–33) to 1 month (median 30.5 ms, IQR 27–38) and from 1 month to 6 months (median 35 ms, IQR 30–42) (p < 0.001 for all comparisons), indicating enhanced parasympathetic activity. Moreover, changes in HRV parameters have been associated with impaired left ventricle ejection fraction (LVEF) and global longitudinal strain (GLS), indicating a relationship between autonomic dysfunction and myocardial deformation. GLS values improved from a baseline median of −11% (IQR 5%) to −13% (IQR 4%) at 6 months (p < 0.001), reflecting better myocardial function. Conclusions: HRV parameters and cardiac performance analysis, especially using GLS, offer a solid framework for evaluating recovery and predicting adverse outcomes post-MI.

(1) Background: Pregnancy induces significant physiological adaptations with substantial impacts on the cardiovascular system. Hypertensive disorders of pregnancy (HDPs) are connected to significant risks of maternal and fetal complications, contributing significantly to morbidity and mortality across the globe. This study focuses on evaluating autonomic dysfunction by analyzing heart rate variability (HRV) and assessing cardiac performance through global longitudinal strain (GLS) using speckle tracking echocardiography, as well as examining diastolic function in pregnant women with HDP compared to healthy pregnant controls. (2) Methods: A case–control study was conducted involving pregnant women diagnosed with gestational hypertension (GH), preeclampsia (PE), or severe preeclampsia (SPE) as the case group, and healthy pregnant women as the control group. HRV was measured to evaluate autonomic function, GLS was assessed using speckle tracking echocardiography, and diastolic function was evaluated through standard echocardiographic parameters. Data were analyzed to compare cardiac performance and autonomic regulation between the HDP and control group, as well as among the different HDP subgroups. (3) Results: The HDP group exhibited significantly reduced HRV parameters compared to healthy controls, indicating notable autonomic dysfunction. Speckle tracking echocardiography revealed lower GLS among women with HDP, particularly in those with SPE, compared to the control group. Diastolic dysfunction was also present in the HDP group. (4) Conclusions: HRV and GLS are valuable non-invasive tools for detecting autonomic dysfunction and cardiac performance impairments in pregnant women with hypertensive disorders. These findings suggest that autonomic and cardiac dysfunctions are prevalent in HDP.

Background: Autonomic dysfunction is commonly encountered after acute ischemic stroke (AIS) and may influence both functional recovery and survival. Heart rate variability (HRV) provides a non-invasive measure of autonomic balance, but its temporal evolution and prognostic significance in AIS remain insufficiently evaluated. Methods: In this prospective observational study, 148 AIS patients (mean age of 65.93 ± 9.19 years) underwent HRV assessment at baseline, one month, and three months follow-up, between January 2022 and October 2024. Time and frequency domain parameters, including Standard Deviation of NN intervals (SDNN), Low-Frequency (LF) power, High-Frequency (HF) power, and LF/HF ratio, were analyzed. Functional outcome was assessed using the modified Rankin Scale (mRS), with a good outcome defined as mRS ≤ 2. Multivariable logistic regression identified independent predictors of poor outcome (mRS > 2) at each time point. Mortality was recorded at one and three months, and potential predictors were evaluated. Results: Over three months, SDNN increased by 34.84% (p < 0.001), HF power rose by 22.26% (p < 0.001), LF power decreased by 21.61% (p < 0.001), and LF/HF ratio declined by 35.41% (p < 0.001), indicating a shift toward parasympathetic predominance. Higher SDNN correlated strongly with better functional status and was an important predictor of favorable outcome at all time points (p < 0.001). Higher LF/HF ratio predicted poor outcome at baseline (p < 0.01) and three months (p < 0.001). At three months, mortality reached 12.2%, with significant predictors including coronary artery disease (CAD), heart failure (HF), chronic kidney disease (CKD), and altered HRV parameters. Conclusions: Post-stroke recovery is characterized by the progressive restoration of autonomic balance, with higher SDNN and lower LF/HF associated with improved functional recovery and survival. HRV analysis offers valuable prognostic insight and may aid in risk stratification after AIS.

Background and Objectives: Systolic blood pressure (SBP) variability has been increasingly associated with cardiovascular outcomes, including stroke. This study aimed to evaluate the association between visit-to-visit SBP variability and the risk of ischemic and hemorrhagic stroke. Materials and Methods: A prospective cohort study was conducted on a set of 208 hypertensive patients over a period of three years, from August 2021 to September 2024, at the County Emergency Hospital “Pius Brinzeu”, Timișoara. Patients included in the study were stroke-free. SBP variability was quantified as the standard deviation of SBP measurements obtained quarterly. Results: This study demonstrated that systolic blood pressure (SBP) variability serves as a robust predictor of stroke incidence, underscoring its important role in cerebrovascular risk. The study cohort had an average age of 65.3 ± 9.1 years, with 53.4% males and 46.6% females. Patients in the highest SBP variability group had a 1.21-fold increased risk (21%, p = 0.031) of ischemic stroke and a 1.73-fold increased risk (73%, p = 0.005) of hemorrhagic stroke compared to those in the lowest variability group, revealing that higher SBP variability is strongly associated with an increased risk of both ischemic and hemorrhagic strokes, with the relationship being particularly pronounced for hemorrhagic stroke. Patients exhibiting greater fluctuations in SBP experienced significantly earlier stroke events and reduced stroke-free survival. Moreover, mortality rates were notably higher among individuals with very high SBP variability, indicating its profound impact on long-term outcomes. Conclusions: Visit-to-visit SBP variability is a significant and independent predictor of both ischemic and hemorrhagic stroke, emphasizing the clinical importance of monitoring and managing blood pressure stability. Further research should explore interventions to mitigate SBP variability and its impact on cerebrovascular outcomes.

Background and Objectives: Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias in the adult population worldwide and it is frequently associated with heart failure (HF). The coexistence of these conditions increases morbidity, mortality and reduces quality of life in these patients. Therefore, it is important to delay the onset of AF in HF patients in order to avoid complications. The study aims to assess whether HF treatment influences AF onset. Materials and Methods: This retrospective observational study included 260 patients, 144 patients with heart failure treated with sodium–glucose cotransporter 2 inhibitors (SGLT2i) and 116 patients with heart failure without SGLT2i treatment (control group) hospitalized at least twice in the Cardiology Department of the “Pius Brinzeu” Emergency County Hospital between 2022 and 2024. Results: Treatment with SGLT2i was associated with a lower prevalence of atrial fibrillation in patients with heart failure. Conclusions: The study highlights the cardiovascular benefits of SGLT2 inhibitors and suggests a potential effect on the onset of AF in heart failure patients.