Relationship between stroke severity and repolarization parameters in patients with acute ischemic stroke

Relationship between stroke severity and repolarization parameters in patients with acute ischemic stroke

Purpose: The aim of this study was to investigate therelationship between repolarization parameters andNational Institutes of Health Stroke Scale (NIHSS) scorein patients with acute ischemic stroke.Materials and Methods: The study comprised 97patients (males, 42; females, 55; 65 ± 16 years) with acuteischemic stroke. 17 patients were excluded. Patients weredivided into two groups based on the calculated NIHSSscore (Group 1, NIHSS score < 16; Group 2, NIHSS score≥ 16). Demographic, clinical, and laboratory data for allpatients were collected. A 12-lead resting ECG wasrecorded at admission to the neurology care unit inpatients with acute ischemic stroke and were manuallymeasured with a ruler. QTc, QTd, QTcd, Tpe, Tpe/QTparameters were measured.Results: There were no significant differences amongdemographic parameters of patients. We found that QTc,QTd, QTcd, Tpe, Tpe/QT parameters were significantlyhigher in Group 2 than Group 1 patients.Conclusion: In this study, we found that acute ischemicstroke has been shown to cause changes in repolarizationparameters. Repolarization parameters are associated withstroke severity on admission in patients with acuteischemic stroke. Increased dispersion of repolarizationparameters make independent contributions to the risk ofarrhythmic cardiac death in patients with acute ischemicstroke. We suggested that especially severe ischemic strokepatients closely using cardiac monitoring during the first24 h.

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  • 1. Rojek A, Gąsecki D, Fijalkowski M, Kowalczyk K, Kwarciany M, Wolf J et al. Left ventricular ejection fraction and aortic stiffness are independent predictors of neurologicaloutcome in acute ischemic stroke. J Hypertens. 2016;34:2441-8.
  • 2. Malik AN, Gross BA, Rosalind Lai PM, Moses ZB, Du R et al. neurogenic stress cardiomyopathy after aneurysmal subarachnoid hemorrhage. World Neurosurg. 2015;83:880-5.
  • 3. Kerro A, Woods T, Chang JJ. Neurogenic stunned myocardium in subarachnoid hemorrhage. J Crit Care. 2017:38:27-34.
  • 4. Ermis E, Demirelli S, Ceylan M et al: The evaluation of myocardial function of patients in the early stage of acute ischemic stroke by two-dimensional speckle tracking echocardiography. J Clin Ultrasound. 2016:44:305-11.
  • 5. Kim H, Yoon HJ, Park HS, Cho YK, Nam CW, Hur SH, et al. Usefulness of tissue Doppler imagingmyocardial performance index in the evaluation of diastolicdysfunction and heart failure with preserved ejection fraction. Clin Cardiol. 2011;34:494-9.
  • 6. Ozturk O, Ulgen MS, Tekes S, Ozturk U, Toprak N. Influence of the angiotensin converting enzyme i/d gene polymorphisms on right ventricular myocardial performance index in patients with a first acute anterior myocardial infarction. Circ J. 2005;69:211-5.
  • 7. Öztürk Ö, Toprak N. Akut Anteriyor miyokard infarktüslü hastalarda geliş miyokardiyal performans indeksi ile lökositoz arasındaki ilişki. Dicle Med J. 2004;2:36-41.
  • 8. Lyden P. Using the National Institutes of Health Stroke Scale: a cautionary tale. Stroke. 2017:48:513-9.
  • 9. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1-39.
  • 10. Zawadka-Kunikowska M, Slominski K, Slomko J, Tafil-Klawe M, Klawe JJ, Sokołowski L et al. Comprehensive non-nvasive cardiac and autonomic assessment in acute ischaemic strokepatients: pilot study. Minerva Cardioangiol. 2018;66:376-85.
  • 11. Vemmos K, Ntaios G, Savvari P, Vemmou AM, Koroboki E, Manios E et al: Stroke etiology and predictors of outcome in patients with heart failure and acute stroke: a 10-year follow-up study. Eur J Heart Fail. 2012;14:211-8.
  • 12. Holmström A, Fu ML, Hjalmarsson C, Bokemark L, Andersson B. Heart dysfunction in patients with acute ischemic stroke or TIA does not predict all-cause mortality at long-term follow-up. BMC Neurol. 2013;13:122.
  • 13. Ripoll JG, Blackshear JL, Díaz-Gómez JL. Acute cardiac complications in critical brain disease. Neurosurg Clin N Am. 2018;29:281-97.
  • 14. Constantinescu V, Matei D, Cuciureanu D, Corciova C, Ignat B, Popescu CD et al. Cortical modulation of cardiac autonomic activity in ischemic stroke patients. Acta Neurol Belg. 2016;116:473-80.
  • 15. Biso S, Wongrakpanich S, Agrawal A, Yadlapati S, Kishlyansky M, Figueredo V et al. a review of neurogenic stunned myocardium. Cardiovasc Psychiatry Neurol. 2017;2017:5842182.
  • 16. Mierzewska-Schmidt M, Gawecka A. Neurogenic stunned myocardium - do we consider this diagnosis in patients with acute central nervous system injury and acute heart failure? Anaesthesiol Intensive Ther. 2015:47:175-80.
  • 17. Chao CC, Wang TL, Chong CF, Lin YM, Chen CC, Tang GJ et al. Prognostic value of QT parameters in patients with acute hemorrhagic stroke: a prospective evaluation with respect to mortality and posthospitalization bed confinement. J Chin Med Assoc. 2009;72:124–32.
  • 18. Familoni OB, Odusan O, Ogun SA. The pattern and prognostic features of QT intervals and dispersion in patients with acute ischemic stroke. J Natl Med Assoc. 2006;98:1758–62.
  • 19. Castro Hevia J, Antzelevitch C, Torne´s Ba´rzaga F, Dorantes Sa´nchez M, Dortico´s Balea F, Zayas Molina R et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006;47:1828– 34.
  • 20. Oppenheimer SM, Cechetto DF, Hachinski VC. Cerebrogenic cardiac arrhythmias. Cerebral electrocardiographic influences and their role in sudden death. Arch Neurol. 1990;47:513–9.
  • 21. Afsar NA, Fak AS, Metzger J, Van Melle G, Kappenberger L, Bogousslavsky J. Acute stroke increases QT dispersion in patients without known cardiac disease. Arch Neurol. 2003;60:346–50.
  • 22. Sommargren CE. Electrocardiographic abnormalities in patients with subarachnoid hemorrhage. Am J Crit Care. 2002;11:48–56.
  • 23. Purushothaman S, Salmani D, Prarthana KG, Bandelkar SM, Varghese S. Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents. J Nat Sci Biol Med. 2014;5:434–36.
  • 24. Lazar J, Manzella S, Moonjelly J, Wirkowski E, Cohen TJ. The prognostic value of QT dispersion in patients presenting with acute neurological events. J Invasive Cardiol. 2003;15:31–5.
  • 25. Emektar E, Çorbacıoğlu ŞK, Korucu O, Ramadan S, Uzunosmanoğlu H, Kan E et al. The evaluation of a new marker of transmyocardial repolarization parameters in ischemic strokepatients; T peak-T end (T p-e), T p-e/QTc. Acta Neurol Belg. 2017;117:461- 7.
  • 26. Bonardo P, Pantiú F, Ferraro M, Chertcoff A, Bandeo L, Cejas LL et al. Impact of infarct size on blood pressure in young patients with acute stroke. J Vasc Interv Neurol. 2018;10:14-6.
  • 27. Hendrix P, Sofoluke N, Adams MD, Kunaprayoon S, Zand R, Kolinovsky AN et al. Risk factors for acute ischemic stroke caused by anterior large vessel occlusion. Stroke. 2019;50:1074-80.
  • 28. Chang A, Ricci B, Grory BM, Cutting S, Burton T, Dakay K et al. Cardiac biomarkers predict large vessel occlusion in patients with ischemic stroke. J Stroke Cerebrovasc Dis. 2019;28:1726-31.
  • 29. Lindsberg JP, Roine RO. Hyperglycaemia in acute stroke. Stroke. 2004;35:363-4.
  • 30. Ryu WS, Bae EK, Park SH, Jeong SW, Schellingerhout D, Nahrendorf M et al. Increased left ventricular filling pressure and arterial occlusion in stroke related to atrial fibrillation. J Stroke Cerebrovasc Dis. 2018;27:1275-82.
  • 31. Mostofsky E, Wellenius GA, Noheria A, Levitan EB, Burger MR, Schlaug G et al. Renal function predicts survival in patients with acute ischemic stroke.Cerebrovasc Dis. 2009;28:88-94.
Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi
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