MBBS, MD, DCN (London), FRCP (London), Consultant Neurologist, Al Neelain University, Faculty of Medicine, Khartoum, Sudan.
MBBS, MD Internal medicine, The National center for Neurological Science, Khartoum, Sudan.
Ethiop J Health Sci. 2022 May;32(3):549-554. doi: 10.4314/ejhs.v32i3.10.
Electrocardiographic changes and elevated serum troponin are frequent findings in acute stroke. They may reflect what is known as the neurogenic myocardial injury. The aim of this study is to determine the electrocardiographic changes and serum troponin level in acute stroke patients and to correlate these changes to the anatomical location and pathological type of the stroke.
A prospective cross-sectional study was conducted at the National Center of Neurological Science, from January to December 2019. Non-probability sampling with total coverage was considered. 50 patients with acute stroke were included in the study. Data were analyzed by using (SPSS) version 25. Standardized ECG was performed in the first hours of admission. 2 samples from each patient were obtained for serum troponin with at least 8 hours apart.
All patients had wide variants of ECG changes. But tachycardia was the most frequent one identified in 54% of patients (n=50). Half of them were found to have an anterior circulation stroke. 14% of patients (n=50) have positive troponin; ECG changes are identified in all patients who represent positive troponin 100% (7 patients). Moreover, anterior circulation stroke was recognized in all patients with a positive troponin I marker.
This study suggests that ECG abnormalities in patients with acute stroke are very common, especially tachycardia. The site of the lesion appears to play a major factor as a cause of the genesis of arrhythmia. Serum troponin elevation may play a role in diagnosing neurocardiogenic injury; nevertheless, ECG appears to be more sensitive and familial.
心电图改变和血清肌钙蛋白升高在急性脑卒中中很常见。它们可能反映了所谓的神经源性心肌损伤。本研究旨在确定急性脑卒中患者的心电图改变和血清肌钙蛋白水平，并将这些变化与脑卒中的解剖部位和病理类型相关联。
本前瞻性横断面研究于 2019 年 1 月至 12 月在国家神经病学科学中心进行。采用全概率抽样非概率抽样。共纳入 50 例急性脑卒中患者。数据采用 SPSS 25 版进行分析。入院后最初几小时内进行标准心电图检查。每个患者至少间隔 8 小时采集 2 份血清肌钙蛋白样本。
所有患者的心电图改变均有广泛的变异。但 54%的患者（n=50）存在心动过速，是最常见的心电图改变。其中一半患者为前循环脑卒中。14%的患者（n=50）肌钙蛋白阳性；所有代表肌钙蛋白阳性的患者（7 例）都有心电图改变。此外，所有肌钙蛋白 I 标志物阳性的患者均存在前循环脑卒中。
本研究表明，急性脑卒中患者的心电图异常非常常见，尤其是心动过速。病变部位似乎是心律失常发生的主要原因。血清肌钙蛋白升高可能在诊断神经心源性损伤中起作用；然而，心电图似乎更敏感和具有家族性。
