The Prognostic Value of QT Dispersion in Patients With Acute Neurological Events Without Known Cardiac Disease
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- Category: Vol. 82, June 2014
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The Prognostic Value of QT Dispersion in Patients With Acute Neurological Events Without Known Cardiac Disease, NAEL SAMIR, MOHMED KHALED, WAEL SAMY and ABDELMONEM IBRAHIM
Abstract
Background: Electrocardiographic (ECG) changes are well known to occur in patients with acute neurological events but their significances remain uncertain. QT dispersion (QTD) reflects heterogeneity of myocardial repolarization, which is modulated by the central nervous system. Previous studies have shown increased QTD to be a predictor of adverse outcomes in various cardiac states.
Objective: To determine the degree of QTD and its relation to outcome in patients with acute neurological events.
Methods: We studied 40 patients admitted to our hospi-tal with acute neurological events and without known cardiac disease. Simultaneous 12-lead ECG was done within 24 hours of the onset. QTD was calculated manually as the difference between maximum and minimum QT intervals in at least 11 of 12 leads. Modified Rankin Scale (MRS) was used to assess functional status after 3months from the onset.
Results: Increased QTD in the 24h-ECG following the onset of acute neurological events (median=60, range, 20- 120msec.). QTD was higher in patients with intercerebral hem-orrhage as compared to non hemorrhagic stroke (67±16 versus 52±26msec; p=0.04). The increase in QTD was associated with lower functional outcomes on modified Rankin scale (r=0.65 and p=0.00 1) and with higher mortality (p=0.006) by 3 months follow-up. On multivariate analysis, the most independent pre-dictors of mortality were QTD (odds ratio, 1.13; 95% confi-dence interval, 1.03-1.25) and GCS (odds ratio, 0.366; 95% confidence interval, 0.177-0. 758).
Conclusion: Prolonged QTD in the first 24h of acute neu-rological events is an independent predictor of short-term func-tional outcome and mortality following hemorrhagic and non hemorrhagic strokes.