The evaluation of a new marker of transmyocardial repolarization parameters in ischemic stroke patients; T peak-T end (T p-e), T p-e/QTc.

Abstract

The cardiovascular manifestations of acute ischemic stroke have been well known. Several electrocardiography (ECG) abnormalities have been reported in patients following acute stroke, including QT interval prolongation, ST segment deviation and T-wave changes. This study aimed to investigate the changes in transmyocardial repolarization parameters, in ischemic stroke patients. The study is a prospective, blind, and controlled clinical study. The patients without cardiac disease who received ischemic stroke diagnoses were included in the study. ECG was received from the patients in the first hour and 72h. The P, QT, T p-e, T p-e dispersion, and the T p-e/QT ratio were calculated. Moreover, fifty-five stroke patients and 35 control subjects were included to the study. All dispersion values and T p-e/QTc ratio in patients group were higher than those of control group (p<0.05 for all values). When evaluated between ECGs' on first and third days, it was found that decreasing on all dispersion values and T p-e/QTc ratio in ECGs on third day than ECGs on first day (p<0.05 for all values). QT, QTc, and T p-e dispersions values in patients who have insular lobe involvement were higher than those of patients who do not have insular lobe involvement (p<0.001 for all values). In this study, we showed that acute stroke increases that P d, QTd, QTcd and new repolarization markers T p-e and T p-e/QTc, during first 24 and 72h in acute stroke patients without cardiovascular disease compared with the control group. The physicians should be aware about ventricular dysrhythmias in patients with ischemic stroke and these patients closely observed with cardiac monitoring, especially within first 24h, and especially patients with insular lobe involvement.