University of Massachusetts Medical School Faculty Publications

Title

QTc-prolongation in posterior circulation stroke

UMMS Affiliation

Department of Neurology; Department of Medicine, Division of Cardiovascular Medicine

Date

10-1-2013

Document Type

Article

Medical Subject Headings

Adult; Aged; Cerebral Infarction; Electrocardiography; Female; Humans; Infarction, Posterior Cerebral Artery; Linear Models; Long QT Syndrome; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Recovery of Function; Registries; Risk Factors; Temporal Lobe; Vertebrobasilar Insufficiency

Disciplines

Nervous System Diseases | Neurology

Abstract

BACKGROUND AND PURPOSE: To evaluate the relationship between infarct location and QTc-prolongation in patients with posterior circulation strokes.

METHODS: Admission electrocardiograms (ECG) of 131 patients among a prospective sample of 407 consecutive adult patients in the New England Medical Center Posterior Circulation Registry were retrospectively analyzed. The QT interval (ms) was measured and corrected using Bazett's formula (QTcBazett) as well as linear regression functions (QTcLinear). QTcBazett > 440 ms and QTcLinear > /= 450 ms for men ( > /=460 ms for women) were considered prolonged. Multivariable linear and logistic regression analyses were used to identify independent predictors of the QTc.

RESULTS: Overall, 34% of patients had a prolonged QTcBazett and 7% had a prolonged QTcLinear noted on the admission ECG. There was a significant association between temporal lobe infarction and QTcBazett and QTcLinear (p < 0.001 for both) in multivariable linear regression analyses adjusting for demographics, ECG parameters, and preadmission medication use. In multivariable logistic regression analysis, temporal lobe infarction emerged as an independent predictor of prolonged QTcBazett (p = 0.009) and QTcLinear (p = 0.008), respectively. Sensitivity analyses excluding patients with transient ischemic attack yielded similar results. Exploratory analyses indicated that patients with temporal lobe infarction had worse functional 30-day outcomes in multivariable logistic regression (p = 0.022). However, there was no significant association between QTc and 30-day functional outcome.

CONCLUSIONS: QTc-prolongation is common after posterior circulation stroke and associated with temporal lobe infarction. Prospective studies are needed to confirm these preliminary findings and to examine potential long-term consequences.

Rights and Permissions

Citation: Neurocrit Care. 2013 Oct;19(2):167-75. doi: 10.1007/s12028-013-9873-7. Link to article on publisher's site

Comments

First author Nils Henninger is a doctoral student in the Millennium PhD Program (MPP) in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.

Related Resources

Link to Article in PubMed

PubMed ID

23860666