Inversion of T Waves on Admission is Associated with Mortality in Spontaneous Intracerebral Hemorrhage.
Action Potentials
Aged
Arrhythmias, Cardiac
/ diagnosis
Cerebral Hemorrhage
/ diagnosis
Electrocardiography
Female
Heart Conduction System
/ physiopathology
Heart Rate
Humans
Male
Middle Aged
Patient Admission
Predictive Value of Tests
Prevalence
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
Intracerebral hemorrhage
Mortality
Neurocritical care
TWI
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
23
02
2021
revised:
16
03
2021
accepted:
22
03
2021
pubmed:
12
4
2021
medline:
1
6
2021
entrez:
11
4
2021
Statut:
ppublish
Résumé
Cardiac dysfunction directly caused by spontaneous intracerebral hemorrhage (ICH) is a poorly understood phenomenon, and its impact on outcome is still uncertain. The aim of this study is to investigate the relationship between electrocardiographic (EKG) abnormalities and mortality in ICH. This is a retrospective study analyzing EKG patterns on admission in patients admitted with ICH at a tertiary care center over an eight-year period. For each patient, demographics, medical history, clinical presentation, EKG on admission and during hospitalization, and head CT at presentation were reviewed. Mortality was noted. A total of 301 ICH patients were included in the study. The most prevalent EKG abnormalities were QTc prolongation in 56% of patients (n = 168) followed by inversion of T waves (TWI) in 37% of patients (n = 110). QTc prolongation was associated with ganglionic location (p = 0.03) and intraventricular hemorrhage (IVH) (p = 0.01), TWIs were associated with ganglionic location (p = 0.02), and PR prolongation was associated with IVH (p = 0.01), while QRS prolongation was associated with lobar location (p < 0.01). Volume of ICH, hemispheric laterality, and involvement of insular cortex were not correlated with specific EKG patterns. In a logistic regression model, after correcting for ICH severity and prior cardiac history, presence of TWI was independently associated with mortality (OR: 3.04, CI:1.6-5.8, p < 0.01). Adding TWI to ICH score improved its prognostic accuracy (AUC 0.81, p = 0.04). Disappearance of TWI during hospitalization did not translate into improvement of survival (p = 0.5). Presence of TWI on admission is an independent and unmodifiable factor associated with mortality in ICH. Further research is needed to elucidate the pathophysiologic mechanisms underlying electrocardiographic changes after primary intracerebral hemorrhage.
Identifiants
pubmed: 33839377
pii: S1052-3057(21)00179-8
doi: 10.1016/j.jstrokecerebrovasdis.2021.105776
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105776Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.