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Association of electrocardiographic and echocardiographic variables with neurological outcomes after ischemic Stroke
Mikhail de Jesus1, Ankush Maheshwary2, Manish Kumar3
1Department of Cardiology, Hartford Hospital, Hartford, CT, USA.
Insights
Elevated heart rate and prolonged QTc intervals may predict poor neurological outcomes after ischemic stroke. Further research is needed to validate these electrocardiographic (ECG) findings for stroke outcome prediction.
Area of Science:
- Neurology
- Cardiology
- Medical Research
Background:
- Cardiac dysfunction frequently occurs after neurological injuries.
- Data on cardiac involvement in ischemic stroke patients is limited.
- This study investigates cardiac markers in relation to neurological outcomes post-stroke.
Purpose of the Study:
- To examine the association between electrocardiographic (ECG) and echocardiographic variables and neurological outcomes in acute ischemic stroke patients.
- To identify potential predictors of poor neurological outcomes.
Main Methods:
- Retrospective analysis of 174 acute ischemic stroke patients.
- Collected data included baseline characteristics, stroke location, NIHSS, reperfusion treatment, ECG, and echocardiographic parameters.
- Neurological outcomes assessed using the Cerebral Performance Category (CPC) scale.
Main Results:
- Older age, higher heart rate, longer QTc interval, and higher NIHSS scores were associated with poor neurological outcomes.
- Thrombolysis showed a non-significant trend towards better outcomes.
- After adjusting for age and NIHSS, heart rate and QTc interval significance was lost.
- No other ECG or echocardiographic variables correlated with neurological outcomes.
Conclusions:
- Elevated heart rate and prolonged QTc intervals may serve as potential predictors of poor neurological outcomes.
- Further studies are required to validate these findings and integrate them into clinical outcome prediction models.
Background:
Cardiac dysfunction is often seen following neurological injury. Data regarding cardiac involvement after ischemic stroke is sparse. We investigated the association of electrocardiographic (ECG) and echocardiographic variables with neurological outcomes after an acute ischemic stroke.
Methods:
We retrospectively collected baseline characteristics, stroke location, National Institute of Health Stroke Scale (NIHSS) at the time of admission, acute reperfusion treatment, ECG parameters, and echocardiographic data on 174 patients admitted with acute ischemic stroke. Outcomes of the stroke were based on cerebral performance category (CPC) with a CPC score of 1-2 indicating a good outcome and a CPC score of 3-5 indicating a poor outcome.
Results:
Older age (75.31 ± 11.89 vs. 65.16 ± 15.87, p < 0.001, OR = 1.04, 95 % CI 1.01-1.07), higher heart rate (80.63 ± 18.69 vs. 74.45 ± 17.17 bpm, p = 0.024, OR = 1.02, 95 % CI 1.00-1.05) longer QTc interval (461.69 ± 39.94 vs. 450.75 ± 35.24, p = 0.024, OR = 1.01, 95 % CI 0.99-1.02), NIHSS score (60.9 % vs. 17.8 %, p < 0.001, OR = 14.90, 95 % CI 3.83-69.5), and thrombolysis (15 % vs. 5 %, p = 0.049, OR = 0.55, 95 % CI 0.10-2.55) were associated with poor neurological outcomes. However, when adjusted for age and NIHSS, heart rate and QTc were no longer statistically significant. None of the other ECG and echocardiographic variables were associated neurological outcomes.
Conclusions:
Elevated heart rate and longer QTc intervals may potentially predict poor neurological outcomes. Further studies are needed for validation and possible integration of these variables in outcome predicting models.
