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July2005 Vol.42 Issue:        2        Table of Contents
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Heart Rate Variability and QT Dispersion in Patients with Acute Stroke

Khaled Baraka1, Fahim Shaker3, Khaled Sayed1, Wail T. Soliman2, Alaa Rabiea1, Enjy Magdy
Departments of Cardiology1, Neurology2, El-Minya University, Al-Sahel Educational Hospital3

ABSTRACT

Fifty two first-stroke (infarction or hemorrhage) patients with a mean age ±SD of 58.6±6.4 years, as well as 20 control subjects with a mean age±SD of 56.1±4.4 were included in this study. All patients were subjected to full clinical evaluation, neurological assessment using Glasgow coma scale, NIH score, Barthel index & modified Rankin score, laboratory work-up, ECG, Holter, echocardiography, and brain CT scan. Results: ST-T changes were significantly higher in patients with hemorrhagic than infarction stroke. Incidence of arrhythmia was not different. Maximum QT & QTD were significantly higher in both thrombotic & hemorrhagic stroke patients than controls, and in hemorrhagic than infarction stroke patients. QTD had significant negative correlation with admission Glasgow coma scale, but significant positive correlation with NIH score on admission & at discharge and Modified Rankin scale at discharge. QTD was significantly higher in patients with severe functional impairment as evaluated by NIH score system at discharge, compared with patients with either mild or moderate functional impairment. Furthermore, we found a significant negative correlation between QTD and patient’s improvement as judged by change in the Barthel index but the correlation with the change in NIH score system did not reach statistical significance. QTD was significantly higher in patients who died during hospitalization due to stroke compared with those who survived. LF nu & LF/HF (low frequency/high frequency) ratio were significantly higher in patients with thrombotic & hemorrhagic stroke than controls. HF nu (normalized high frequency component) was significantly lower in both groups of patients compared with controls. Meanwhile, there was no significant difference between infarction and hemorrhagic stroke patients regarding heart rate variability parameters. There was no significant correlation between LF/HF ratio and any of the neurological scales either on admission or at discharge. Meanwhile, Both LF nu & LF/HF ratio correlated with patient’s improvement as judged by the change in NIH score. LF nu also correlated with the change in Barthel index. Ventricular ectopic beats (VEB)/h were significantly more frequent in patients with infarction & hemorrhagic stroke compared with controls. Furthermore, supraventricular ectopic beats (SVEB)/h were significantly more frequent in patients with infarction & hemorrhagic stroke versus controls. VEB/h & SVEB/h were significantly higher in patients with hemorrhagic than patients with infarction stroke. Conclusions: Patients with acute stroke have significant prolongation of QTD, impairment in heart rate variability & increased incidence of arrhythmia.

(Egypt J. Neurol. Psychiat. Neurosurg., 2005, 42(2): 441-451).

 





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