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

Hromádka, Milan; Seidlerová, Jitka; Rohan, Vladimír; Baxa, Jan; Šedivý, J.; Rajdl, Daniel; Ulč, Ivan; Ševčík, Petr; Polívka, Jiří; Rokyta, R

doi:10.1016/j.jstrokecerebrovasdis.2016.08.005

Cited by 17 publications

(9 citation statements)

References 37 publications

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“…The possible explanations underlying prolonged QTc include electrolyte disturbances, myocardial ischemia, etc. For healthy, cardiac amyloidosis and some other diseases, QTc interval has been suggested to be associated with adverse outcomes 20‐23 . Consistent with previous results, our study demonstrated that prolonged QTc interval was independently associated with overall mortality, even after adjusting for age, gender, creatinine, and PR interval.…”

Section: Discussionsupporting

confidence: 91%

Electrocardiographic parameters and prognosis of renal light chain amyloidosis

Wang

Lan

et al. 2020

Clinical Cardiology

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Background: Cardiac involvement frequently occurs in patients with renal light chain (AL) amyloidosis, which predisposes these patients to heart failure, arrhythmia, or infarction with poor prognosis. Hypothesis: Twelve-lead electrocardiogram (ECG) parameters may be associated with prognosis in renal AL amyloidosis. Methods: A retrospective single-center cohort study was performed. Biopsy-proven renal AL amyloidosis patients from January 2014 to December 2018 at the First Affiliated Hospital of Xi'an Jiaotong University were enrolled. The baseline demographic information, laboratory tests, 12-lead ECG parameters at the time of diagnosis were obtained from medical records. The endpoint was defined as the time to all-cause death from baseline for all deceased patients and time to censor date (June 2019) for all other patients. Univariate and multivariate Cox proportional hazard models were conducted to identify the relationship between ECG parameters and all-cause mortality. Results: A total of 69 patients with a mean age of 61.5 ± 11.4 years were enrolled in this study. The median PR interval and QTc interval were 160 (140, 186) and 417 ± 42 ms. The mean follow-up duration was 15.9 ± 13.8 months. Multivariate Cox regression analysis showed that regardless of adjustment for age, gender and serum creatinine, PR interval (HR 1.022, 95% CI: 1.007-1.038, P = .005), and QTc interval (HR 1.012, 95% CI: 1.004-1.021, P = .004) were independently associated with all-cause mortality. Conclusions: PR interval and QTc interval were independently associated with allcause mortality in renal AL amyloidosis patients. ECG parameters may provide prognostic potential of renal AL amyloidosis patients and promote the management of patients with renal AL amyloidosis.

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Section: Discussionsupporting

confidence: 91%

Electrocardiographic parameters and prognosis of renal light chain amyloidosis

Wang

Lan

et al. 2020

Clinical Cardiology

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“…A prospective study of 93 hemorrhagic stroke patients found that a higher QT max had a positive relationship to bed confinement and Barthel index of 28 days (17). The same result was found in a observational case control study which showed prolonged corrected QT interval (QTc) in acute IS patients 48 h after the index stroke correlated with admission NIHSS and discharge mRS scores (12). Meanwhile, Stead et al found no relationship between prolonged QTc and discharge mRS (18).…”

Section: Discussionmentioning

confidence: 78%

“…The major autonomic dysfunctions caused by ischemic stroke (IS) include a loss of heart rate variability and various ECG changes, particularly QT dispersion (QTd), which is an expression of cardiac repolarization abnormalities (7). Several studies have confirmed the association between acute cerebrovascular events and QTd (8)(9)(10)(11)(12). In patients admitted to hospital for acute cerebrovascular diseases, QTd may reflect neurologic injury as well as the underlying heart disease.…”

Section: Introductionmentioning

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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“…3A). The prognostic value of the QTc interval has been suggested in healthy populations and those with cardiovascular diseases 11–15 . From our results, prolonged QTc interval remained independently associated with overall mortality, even after adjusting for revised Mayo stage, LV GLS, and other variables.…”

Section: Discussionmentioning

confidence: 99%

Associations of Electrocardiographic Parameters with Left Ventricular Longitudinal Strain and Prognosis in Cardiac Light Chain Amyloidosis

Kim

Lee

Choi

et al. 2019

Sci Rep

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A 12-lead ECG is a simple and less costly measure to assess cardiac amyloidosis and may reflect the infiltrative nature of cardiac amyloidosis and have prognostic value for predicting overall survival in patients with cardiac AL amyloidosis. Therefore, we investigated the associations of surface ECG parameters with left ventricular (LV) global longitudinal strain (GLS) and prognosis in patients with cardiac AL amyloidosis. We performed a multi-center, retrospective analysis of 102 biopsy-proven cardiac AL amyloidosis patients. Baseline studies included 12-lead surface ECG and echocardiography, with two-dimensional strain analysis performed within one month of diagnosis. From the Kaplan-Meier survival analysis, patients with prolonged QTc (≥483 msec) had significantly poorer survival. ECG scores were assigned according to presence of prolonged QTc (≥483 msec) and abnormal QRS axis, and the study participants were divided into three groups according to ECG score. Mean absolute value of LV GLS and regional LV longitudinal strain (LS) differed significantly among the three groups and decreased in a stepwise manner as ECG score increased. Log NT-proBNP increased in a stepwise manner as ECG score increased. Prolonged QTc (≥483 msec) and abnormal QRS axis showed significant incremental values in addition to the revised Mayo stage. The presence of prolonged QTc (≥483 msec) and abnormal QRS axis showed significant incremental values for overall mortality rates. In addition, ECG scores consisting of presence of prolonged QTc (≥483 msec), and abnormal QRS axis showed good association with longitudinal LV dysfunction and NT-proBNP. ECG finding may provide prognostic additional information regarding prognosis of AL amyloidosis with cardiac involvement.

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

Cited by 17 publications

References 37 publications

Electrocardiographic parameters and prognosis of renal light chain amyloidosis

Electrocardiographic parameters and prognosis of renal light chain amyloidosis

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

Associations of Electrocardiographic Parameters with Left Ventricular Longitudinal Strain and Prognosis in Cardiac Light Chain Amyloidosis

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