Relationship Between QT Interval Parameters on Electrocardiography and Acute Cerebrovascular Accident: A...

Introduction Acute cerebrovascular accident (CVA) is a major cause of mortality and long-term disability worldwide. Electrocardiographic (ECG) abnormalities, particularly prolonged corrected QT interval (QTc) and QT dispersion (QTd), are frequently observed following acute stroke because of autonomic nervous system dysfunction. However, their clinical relevance in relation to functional outcome remains incompletely understood. This study aimed to compare QT interval parameters between ischemic and hemorrhagic stroke and determine the association of QTc and QTd with functional outcome. Materials and methods A hospital-based cross-sectional analytical study was conducted in the Department of General Medicine, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India, from January 2022 to December 2024. A total of 165 consecutive patients with acute CVA were enrolled, including 120 (72.7%) patients with ischemic stroke and 45 (27.3%) with hemorrhagic stroke. Standard 12-lead ECG was performed at admission to measure QT interval, QTc, QTmax, QTmin, QTd, and corrected QTd. Functional outcome was assessed using the modified Rankin Scale (mRS). Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2018; IBM Corp., Armonk, NY, USA), with a p-value <0.05 considered statistically significant. Results The mean QT interval parameters were comparable between ischemic and hemorrhagic stroke (all p > 0.05). Prolonged QTc (>0.44 s) was more common in hemorrhagic stroke, occurring in 21 (46.7%) patients, whereas QTd >0.08 s was observed in 69 (57.5%) patients with ischemic stroke and 26 (57.8%) patients with hemorrhagic stroke. Severe disability (mRS 4-5) occurred in 53 (44.2%) patients with ischemic stroke and 18 (40.0%) patients with hemorrhagic stroke. Significant associations were observed between QTc category and functional outcome (p < 0.001), as well as between QTd and functional outcome (p < 0.001) in both stroke subtypes. QTc (r = 0.435, p < 0.001) and QTd (r = 0.317, p < 0.001) demonstrated significant positive correlations with mRS scores. Conclusion QT interval abnormalities are common in patients with acute CVA. Prolonged QTc interval and increased QTd were significantly associated with poorer functional outcomes. These findings suggest that QTc and QTd may serve as simple, readily available, and non-invasive markers associated with functional outcomes in patients with acute stroke. However, prospective longitudinal studies with multivariable adjustment are required to establish their independent prognostic value.