Does the Magnitude of the Electrocardiogram QT Interval Dispersion Predict Stroke Outcome?

Lederman, Yitzchok S; Balucani, Clotilde; Steinberg, Leah; Philip, Charles; Lazar, Jason; Weedon, Jeremy; Mirchandani, Gautam; Weingast, Sarah; Viticchi, Giovanna; Falsetti, Lorenzo; Silvestrini, Mauro; Gugger, James J; Aharonoff, David; Piran, Pirouz; Adler, Zachary; Levine, Steven R.

doi:10.1016/j.jstrokecerebrovasdis.2018.09.006

Cited by 9 publications

(6 citation statements)

References 19 publications

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“…The maximum minus the minimum QT interval between the various ECG leads is called QT dispersion (QTd). QTd can be a sign of heterogeneity in the recovery of stimulation phase, and this heterogeneity can be the cause of malignant ventricular arrhythmia [3]. Cardiac autonomic neuropathy (CAN) is prevalent in diabetic (DM) patients and increases the risk of cardiac arrhythmias and events, Vasheghani et al Diabetol Metab Syndr (2020) 12:102 such as sudden death and myocardial infarction [4].…”

Section: Introductionmentioning

confidence: 99%

The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study

Vasheghani

Sarvghadi

Beyranvand

et al. 2020

Diabetol Metab Syndr

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Background Long QT interval (QT) and abnormal QT dispersion (QTd) are associated with sudden death. The relationship between cardiac autonomic neuropathy (CAN) and QT indices in type 2 diabetic patients were investigated. Methods Totally 130 diabetic subjects (mean age 50.87 ± 13.9 years) were included (70 individuals with and 60 individuals without CAN). All participants had sinus cardiac rhythm. The patients who had diseases or take drugs that cause orthostatic hypotension (OH), cardiac arrhythmia and QT prolongation were excluded. After interview and examination, standard and continuous ECG was taken in supine position with deep breathing and standing up position. CAN diagnosis was based on Ewing’s tests. QT, QT corrected (QTc), minimum QT (QT min), maximum QT (QT max) and mean ± SD of QT (QT mean) and QTd were assessed from standard ECG. QTc was calculated by Bazett’s formula from V2 lead. QTc > 440 ms in men and QTc > 460 ms in women and QTd > 80 ms were considered abnormal. Results In patients with CAN, 21.5% were symptomatic. The prevalence of abnormal QTc and QTd was 11.3% and 28.7%, respectively. There was no significant difference between the patients with or without CAN in terms of long QTc and abnormal QTd. However, the mean ± SD of QT max, QT mean and QTd was higher in the patients with CAN (P value < 0.03). The used cut points for QTc and QTd have high specificity (79% for both) and low sensitivity (30% and 37%, respectively). To use QTc and QTd as screening test for CAN in T2DM patients, the cutoff points 380 and 550 ms are suggested, respectively. Conclusion The prevalence of asymptomatic CAN was 3.7 times that of symptomatic CAN. In patients with CAN the QT max, QT mean and QTd were higher than those without CAN. There was no association between CAN and long QTc and abnormal QTd.

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Section: Introductionmentioning

confidence: 99%

The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study

Vasheghani

Sarvghadi

Beyranvand

et al. 2020

Diabetol Metab Syndr

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“…Previous studies have reported that a relationship between acute cerebrovascular disease and QT (Lederman et al, 2014;Lederman et al, 2019). Lazar et al found that a positive relationship between baseline QTd and NIHSS and modified ranking scores (Lazar et al, 2008).…”

Section: Discussionmentioning

confidence: 98%

Relation between index of cardioelectrophysiological balance and stroke severity in patients with acute ischemic stroke

Öztürk

2020

Niger J Clin Pract

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“…Meanwhile, Stead et al found no relationship between prolonged QTc and discharge mRS (18). Furthermore, a prospective cohort study provided no evidence that QTd is related to high mortality and poor functional outcomes on hospital discharge among acute IS patients (19). The US Third National Health and Nutrition Examination Survey suggested that a prolonged corrected QT interval can predict allcause mortality in the general population (20).…”

Section: Discussionmentioning

confidence: 99%

QT Interval Dispersion as a Predictor of Clinical Outcome in Acute Ischemic Stroke

et al. 2021

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Background and Purpose: QT dispersion (QTd) abnormalities are widely documented in stroke patients. This study aims to investigate the association between QTd and clinical outcomes in IS patients.Methods: IS patients registered in the Blood Pressure and Clinical Outcome in transient ischemic attack (TIA) or IS (BOSS) registry between 2012 and 2014 within 24 h of onset were analyzed. In this prospective observational study, we identified 1,522 IS cases with adequate electrocardiographic evaluations to assess QTd after the index stroke. Patients were classified into four groups based on the quartile of QTd, with the lowest group as the reference. The primary stroke outcome was defined as a modified Rankin Scale score ≥3 at 1-year. Multiple logistic regressions were utilized to investigate the association between QTd and outcome events.Results: The mean QTd across all cases was 57 ms (40–83). Functional dependency or death was documented in 214 (14.98%) cases at 1 year. After adjusting for confounders, the prevalence of death and major disability (mRS ≥ 3) showed significant differences according to the quartile of QTd, with the risk of death and major disability (mRS ≥ 3) at 1 year being significantly higher for patients in Q4 than for those in Q1 (adjusted OR = 1.626, 95% CI:1.033–2.560). However, there were no significant correlation between QTd and the event outcomes at 1 year.Conclusions: QTd was associated with poor functional outcomes at 1 year. QTd is a useful surrogate marker for adverse functional prognosis, which might help to stratify risk in patients with acute IS.

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Does the Magnitude of the Electrocardiogram QT Interval Dispersion Predict Stroke Outcome?

Cited by 9 publications

References 19 publications

The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study

The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study

Relation between index of cardioelectrophysiological balance and stroke severity in patients with acute ischemic stroke

QT Interval Dispersion as a Predictor of Clinical Outcome in Acute Ischemic Stroke

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