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Danese A, Cappellari M, Pancheri E, Mugnai G, Micheletti N, Tomelleri G, Carletti M, Turri G, Marafioti V, Monaco S, Bonetti B, Bovi P. The dispersion of myocardial repolarization in ischemic stroke and intracranial hemorrhage. J Electrocardiol 2018; 51:691-695. [PMID: 29997015 DOI: 10.1016/j.jelectrocard.2018.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/06/2018] [Accepted: 05/16/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Markers of dispersion of myocardial repolarization have been proposed to identify the patients at higher risk of malignant arrhythmic events. The aim of the present study is to assess a possible association of the electrocardiografic (ECG) markers of the dispersion of repolarization with the type of stroke, involvement of insula, neurological severity (National Institutes of Health Stroke Scale, NIHSS score), and disability (modified Rankin Scale, mRS score) in patients with a cerebrovascular event. METHODS We conducted a retrospective analysis based on data prospectively collected from consecutive patients with a cerebrovascular event who underwent 12‑lead ECG at admission to the Verona Stroke Unit. RESULTS Of the 63 patients included in the study, 55 had ischemic stroke and 8 intracranial hemorrhage. TpTe (time between the peak and the end of the T wave) and TpTe/QTc (TpTe/corrected time between the start of the Q wave and the end of the T wave) in lead V5 were higher in intracranial hemorrhage than in ischemic stroke (p = 0.03 and p = 0.04, respectively) and QT max (the longest QT calculated in the 12 leads) was higher in patients with involvement of insula (p ≤ 0.01). A correlation was found between QTc max and NIHSS score at admission (p = 0.02), QT max and NIHSS score at discharge (p = 0.05), and QT max and mRS score at discharge (p = 0.02). CONCLUSIONS TpTe and TpTe/QTc in V5 lead were associated with intracranial hemorrhage and QT max was associated with involvement of insula. The prolongation of QT was correlated with neurological severity and disability.
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Affiliation(s)
- Alessandra Danese
- Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10 -, 37134 Verona, Italy.
| | - Manuel Cappellari
- Department of Neurosciences, Stroke Unit, Verona Hospital, Piazzale A. Stefani 1 -, 37126 Verona, Italy
| | - Elia Pancheri
- Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10 -, 37134 Verona, Italy
| | - Giacomo Mugnai
- Service of Cardiac Pacing and Electrophysiology, Division of Cardiology, Mirano Hospital, Via Mariutto 76 -, 30035 Mirano, VE, Italy
| | - Nicola Micheletti
- Department of Neurosciences, Stroke Unit, Verona Hospital, Piazzale A. Stefani 1 -, 37126 Verona, Italy
| | - Giampaolo Tomelleri
- Department of Neurosciences, Stroke Unit, Verona Hospital, Piazzale A. Stefani 1 -, 37126 Verona, Italy
| | - Monica Carletti
- Division of Cardiology, University Hospital of Verona, Piazzale L.A. Scuro 10 -, 37134 Verona, Italy
| | - Giulia Turri
- Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10 -, 37134 Verona, Italy
| | - Vincenzo Marafioti
- Division of Cardiology, University Hospital of Verona, Piazzale L.A. Scuro 10 -, 37134 Verona, Italy
| | - Salvatore Monaco
- Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10 -, 37134 Verona, Italy
| | - Bruno Bonetti
- Department of Neurosciences, Stroke Unit, Verona Hospital, Piazzale A. Stefani 1 -, 37126 Verona, Italy
| | - Paolo Bovi
- Department of Neurosciences, Stroke Unit, Verona Hospital, Piazzale A. Stefani 1 -, 37126 Verona, Italy
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