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急性缺血性脑卒中中心肌跨壁复极参数与弥散受限区大小的相关性。

Association of trans-myocardial repolarisation parameters with size of the diffusion limitation area in acute ischaemic stroke.

机构信息

Keçiören Training and Research Hospital, Emergency Department, Keçiören Eğitim ve Araştırma Hastanesi, Acil servis, 06000 Ankara, Turkey.

Keçiören Training and Research Hospital, Department of Neurology, Keçiören Eğitim ve Araştırma Hastanesi, Ankara, Turkey.

出版信息

Neurol Neurochir Pol. 2019;53(5):363-368. doi: 10.5603/PJNNS.a2019.0041. Epub 2019 Sep 20.

Abstract

OBJECTIVES

This study aimed to evaluate the relationship between transmyocardial repolarisation parameters and the size of the diffusion limitation area measured using diffusion weighted magnetic resonance imaging (DWMRI) in patients diagnosed with ischaemic stroke without known cardiac diseases.

MATERIAL AND METHODS

The study was a prospective, observational clinical study. Patients without cardiac disease with acute ischaemic stroke were included in the study. Electrocardiography (ECG) was received from the patients. P, QT, QTc and Tp-e dispersions were calculated. All the patients had computerised brain tomography (CT) and then DWMRI carried out so as to calculate infarct areas.

RESULTS

Seventy ischaemic stroke patients and 30 control patients were included in the study. All parameters except for QTc dispersion (p = 0.88) were higher in the stroke group than in the control group (p < 0.05 for all values). The infarct area calculated with DWMRI was divided into four groups according to quartiles, and QT, QTc, P, and Tp-e dispersions of patients were evaluated. Patients were found to have a prolonged dispersion as the infarct area expanded, and this difference was statistically significant (p < 0.05 for all values).

CONCLUSIONS

When we compared the patients with ischaemic stroke who had no known cardiac disease to those in the control group we found an increase in transmyocardial repolarisation parameters. As diffusion limitation areas grew larger, QT, QTc, P, and Tp-e dispersions increased. Physicians should be aware of dysrhythmias and sudden cardiac death in acute stroke and should observe these patients, especially those with larger stroke lesions.

摘要

目的

本研究旨在评估经心肌复极参数与磁共振弥散加权成像(DWMRI)测量的弥散受限区大小之间的关系,这些患者患有缺血性脑卒中且无已知的心脏疾病。

材料和方法

本研究为前瞻性、观察性临床研究。纳入患有急性缺血性脑卒中且无心脏疾病的患者。从患者处获取心电图(ECG)。计算 P、QT、QTc 和 Tp-e 离散度。所有患者均行计算机脑 CT 检查,然后行 DWMRI 以计算梗死面积。

结果

共纳入 70 例缺血性脑卒中患者和 30 例对照组患者。与对照组相比,除 QTc 离散度(p=0.88)外,脑卒中组的所有参数均较高(所有值的 p<0.05)。根据四分位数将 DWMRI 计算的梗死面积分为四组,评估患者的 QT、QTc、P 和 Tp-e 离散度。随着梗死面积的扩大,患者的离散度延长,差异具有统计学意义(所有值的 p<0.05)。

结论

与对照组相比,我们发现患有无已知心脏疾病的缺血性脑卒中患者的经心肌复极参数增加。随着弥散受限区的增大,QT、QTc、P 和 Tp-e 离散度增加。医生应注意急性脑卒中患者的心律失常和心脏性猝死,并观察这些患者,尤其是那些具有较大卒中病灶的患者。

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