Effect of essential hypertension on QTc dispersion in patients with intracerebral haemorrhage

To investigate the effects of essential hypertension on QTc dispersion (QTcd) in patients with intracerebral haematoma (ICH). Materials and methods: This prospective study included adult patients presenting with acute ICH within the first 24 h of ictus to the Emergency Department (ED). On admission, following the first clinical assessment of patients, a complete 12-lead ECG and non-contrast computed tomography (CT) were obtained from each patient. Then, the patients were divided into 2 subgroups according to the presence of hypertension history. The patient groups were compared to each other as well as the control group for QTcd. Results: The study groups consisted of 47 hypertensive (group 1) without evidence of left ventricular hypertrophy and 30 non-hypertensive patients (group 2). Forthy two subjects served as control. While in the hypertensive patient group mean QTcd was 49.36 ± 20 ms, in the non-hypertensive group, it was 48.00 ± 19 ms (P > 0.05). Conclusion: In the present study, although QTcd was higher in the group 1 compared to group 2, this difference was not statistically significant. Thus, systemic hypertension does not seem to have a great effect on post-stroke QTcd in ICH patients.

Effect of essential hypertension on QTc dispersion in patients with intracerebral haemorrhage

To investigate the effects of essential hypertension on QTc dispersion (QTcd) in patients with intracerebral haematoma (ICH). Materials and methods: This prospective study included adult patients presenting with acute ICH within the first 24 h of ictus to the Emergency Department (ED). On admission, following the first clinical assessment of patients, a complete 12-lead ECG and non-contrast computed tomography (CT) were obtained from each patient. Then, the patients were divided into 2 subgroups according to the presence of hypertension history. The patient groups were compared to each other as well as the control group for QTcd. Results: The study groups consisted of 47 hypertensive (group 1) without evidence of left ventricular hypertrophy and 30 non-hypertensive patients (group 2). Forthy two subjects served as control. While in the hypertensive patient group mean QTcd was 49.36 ± 20 ms, in the non-hypertensive group, it was 48.00 ± 19 ms (P > 0.05). Conclusion: In the present study, although QTcd was higher in the group 1 compared to group 2, this difference was not statistically significant. Thus, systemic hypertension does not seem to have a great effect on post-stroke QTcd in ICH patients.

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  • Christensen H, Boysen G, Christensen AF, Johannesen HH. Insular lesions, ECG abnormalities, and outcome in acute stroke. J Neurol Neurosurg Psychiatry 2005; 76:269-271.
  • Ko NU, Zaroff JG. Cardiac manifestations of acute neurological lesions. In: Aminoff MJ (ed.). Neurology and general medicine. New York: Churchill Livingstone, 2008:185-200.
  • Hirashima Y, Takashima S, Matsumura N, Kurimoto M, Origasa H, Endo S. Right sylvian fissure subarachnoid hemorrhage has electrocardiographic consequences. Stroke 2001; 32: 2278–2281.
  • Eckardt M, Gerlach L, Welter FL. Prolongation of the frequency-corrected QT Dispersion following cerebral strokes with involvement of the insula of Reil. Eur Neurol 1999; 42:190- 193.
  • Fukui S, Otani N, Tsuzuki N, Nawashiro H, Shima K. Laterality of ruptured aneurysm has no influence on QT Prolongation after subarachnoid hemorrhage. Stroke. 2002; 33:1167.
  • Robinson TG, Dawson SL, Eames PJ, Panerai RB, Potter JF. Cardiac baroreceptor sensitivity predicts long-term outcome after acute ischemic stroke. Stroke 2003;34:705-712.
  • Robinson T, James M, Youde J, Panerai R, Potter J. Cardiac baroreceptor sensitivity is impaired after acute stroke. Stroke. 1997; 28: 1671–1676.
  • Sander D, Klingelhofer J. Changes of circadian blood pressure patterns after hemodynamic and thromboembolic brain infarction. Stroke 1994; 25: 1730–1737.
  • Sander D, Klingelhofer J. Changes of circadian blood pressure patterns and cardiovascular parameters indicate lateralization of sympathetic activation following hemispheric brain infarction. J Neurol 1995:242:313–318.
  • Bassi A, Colivicchi F, Santini, M, Caltagirone C.Cardiac autonomic dysfunction and functional outcome after ischaemic stroke. Eur J Neurol 2007; 14: 917-922.
  • Butcher KS, Cechetto DF: Insular lesion evokes autonomic effects of stroke in normotensive and hypertensive rats. Stroke 1995;26:459-465.
  • Dawber TF, Meaders GF, Moore FE. Epidemiologic approaches to heart disease: The Framingham Study. Am J Public Health 1951; 41: 279 – 286.
  • Nakayasu K, Nakaya Y, Oki Y, Nomura M, Ito S. Long-term follow-up in japanese public office workers of the influence of blood pressure on ECG changes. Circ J 2004; 68:563-567.
  • Chakko S, Mulintapang RF, Huikuri HV, Kessler KM, Materson BJ, Myerburg RJ. Alterations in heart rate variability and its circadian rhythm in hypertensive patients with left ventricular hypertrophy free of coronary artery disease. Am Heart J. 1993;126:1364-1372.
  • Perkiomaki JS, Ikaheimo MJ, Pikkujamsa SM, Rantala A, Lilja M, Kesaniemi YA, Huikuri HV. Dispersion of the QT Interval and autonomic modulation of heart rate in hypertensive men with and without left ventricular hypertrophy. Hypertension 1996;28:16-21.
  • Ketch T, Biaggioni I, Robertson RM, Robertson D. Four faces of baroreflex failure hypertensive crisis, volatile hypertension, orthostatic tachycardia, and malignant vagotonia. Circulation 2002; 105:2518.
  • Chapleau MW, Hajduczok G, Abboud FM. Paracrine role of prostanoids in activation of arterial baroreceptors: an overview. Clin Exp Hypertens A 1991;13:817-24. Review. Hirschl M, Kundi M, Blazek G. Five year follow-up of patients after thromboendarterectomy of the internal carotid artery: relevance of baroreceptor sensitivity. Stroke 1996; 27: 1167– 1172.
  • Sen S, Stober T, Burger L, Anstatt T, Rettig G. Recurrent torsade de pointes type ventricular tachycardia in intracranial hemorrhage. Intensive Care Med 1984; 10:263-264.
  • Chao CL, Chen WJ, Wu CC, Lee YT. Torsade de pointes and T- wave alternans in a patient with brainstem hemorrhage. Int J Cardiol 1995;51:199-201.
  • Calder K. QTc dispersion in intracerebral hemorrhage. Am J Emerg Med 2005; 23:98.
  • Biller J, Love BB, Scheneck MJ. İschemic cerebrovascular disease. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds.). Neurology in clinical practice. Butterworth and Heinemann; Philadelphia 2008:1165-1223.
  • Gebel JM, Sila CA, Sloan MA, Granger CB, Weisenberger JP, Green CL, Topol EJ, Mahaffey KW. Comparison of the ABC/2 estimation technique to computer-assisted volumetric analysis of intraparenchymal and subdural hematomas complicating the GUSTO-1 trial. Stroke 1998; 29:1799-1801.
  • Schamroth L. The 12 lead electrocardiogram. Cambridge, Mass: Blackwell scientific publications 1989; 26-29.
  • Chen A, Kusumoto FM. QT Dispersion: Much ado about something? Chest 2004; 125:1974-1977.
  • Afsar N, Fak AS, Metzger JT, Melle GV, Kappenberger L, Bogouslavsky J. Acute stroke increases QT dispersion in patients without known cardiac diseases. Arch Neurol 2003; 60:346-350.
  • Smith KE, Hachinski VC, Gibson CJ, et al. Changes in plasma catecholamine levels after insula damage in experimental stroke. Brain Research 1986;375:182–185.
  • Tatschl C, Stöllberger C, Matz K, Yilmaz N, Eckhardt R, Nowotny M, Dachenhausen A, Brainin M. Insular involvement is associated with QT prolongation: ECG abnormalities in patients with acute stroke. Cerebrovasc Dis 2006;21:47-53.
  • Oppenheimer SM, Cechetto DF, Hachinski VC. Cerebrogenic cardiac arrhythmias. Cerebral electrocardiographic influences and their role in sudden death. Arch Neurol 1990; 47; 513-519.
  • Colivicchi F, Bassi A, Santini M, Caltagirone C. Cardiac autonomic derangement and arrhythmias in right-sided stroke with insular involvement. Stroke 2004;35:2094-2098.
  • Oppenheimer S. Cerebrogenic cardiac arrhythmias: Cortical lateralization and clinical significance Clin Auton Res 2006;16:6–11.
  • Oppenheimer SM, Zhang ZH, Boekholdt M. Electrical stimulation of the right posterior insular cortex increases cardiac sympathetic tone in the rat. Soc Neurosci Abstracts 1998;24:1134. 42. Zhang Z, Rashba S, Oppenheimer S. Insular cortex lesions alter baroreceptor sensitivity in the urethane-anesthetized rat. Brain Res 1998; 813: 73–81.
  • Hilz M, Dutsch M, Perrine K, Nelson P, Rauhat U, Devinsky O. Hemispheric influence on autonomic modulation and baroreflex sensitivity. Ann Neurol 2001; 49: 575–584.
  • Korpelainen J, Sotaniemi K, Makikallio A, Huikuri H, Myllyla V. Dynamic behavior of heart rate in ischemic stroke. Stroke 1999; 30: 1008–1013.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Comparison of quality of life in hepatitis B virus carriers versus chronic hepatitis B virus carriers versus the normal population

Tansu YAMAZHAN, Işıkgöz Meltem TAŞBAKAN, Özkören Şebnem ÇALIK, Önen Özen SERTÖZ, Hüsnü PULLUKÇU, Oğuz Reşat SİPAHİ

The comprehensive evaluation of latent tuberculosis infection in health care workers and of patients with active tuberculosis using TST, ELISA, and ELISPOT methods

Hülya ŞİMŞEK, Kurtuluş AKSU, Mustafa ERTEK, Sibel Meryem ALPAR, Ayşegül GÖZALAN, İsmail CEYHAN, Salih CESUR, Funda AKSU

Investigation of premenstrual syndrome and contributing factors among university students*

Nülüfer ERBİL, Ayşenur KARACA, Tülay KIRIŞ

Peritoneal dialysis-related peritonitis: an analysis of risk factors in Northeast Anatolia*

Mustafa KELEŞ, Ramazan ÇETİNKAYA, Abdullah UYANIK, Hamit ACEMOĞLU, Fatma EROĞLU, M. Hamidullah UYANIK

Peritoneal dialysis-related peritonitis: An analysis of risk factors in Northeast Anatolia

Mustafa KELEŞ, Ramazan ÇETİNKAYA, Fatma EROĞLU, Hamit ACEMOĞLU, M. Hamidullah UYANIK, Abdullah UYANIK

Caustic esophageal injury decreases the number of interstitial cells of Cajal in the rat esophagus

Tutku SOYER, Turan KANMAZ, Murat ÇAKMAK, Pınar ATASOY, Salih SOMUNCU, Şebnem AYVA

Correlation between increased urinary serotonin levels and coronary artery disease in cigarette smoking patients

Ayşenur YEĞİN, Emine NAMIDURU, Yakup MERMERDAŞ, Necat YILMAZ, Esin EREN

Absence of vancomycin-resistant enterococci (VRE) despite the presence of risk factors: A survey of rectal carriage of VRE

Ali Murat ÇELİK, Sami KINIKLI, Ali Pekcan DEMİRÖZ, Selcan ARSLAN, Zeliha Koçak TUFAN, Ferah ERGİN, Hasan IRMAK, Salih CESUR, Cemal BULUT

A novel hand-held device for the measurement of ocular alignment

Uğur E. ALTIPARMAK, Esra KARABULUT, Earic R. ERGENBERGER

Underestimated role of alcohol at skin disinfection: lipid dissolving property when used in association with conventional antiseptic agents

Alp YENTÜR, İsmet TOPÇU, Ruşen IŞIK, Süheyla SÜRÜCÜOĞLU, Kenan DEĞERLİ