Akademik Veri Yönetim Sistemi
7th Eurasian Congress on Emergency Medicine& 17th Turkish Congress on Emergency Medicine, Antalya, Türkiye, 25 Kasım 2021, ss.247
OBJECTIVE: Ischemic stroke is a disease that has strong relations with cardiac arrhythmias, mainly atrial
fibrillation (AF). There are many studies on ECG parameters that might help stratify risk factors better. One of
them is the time to T wave’s peak amplitude to its end (Tp-e) and the ratio of corrected QT interval (Tp-e/QTc
ratio). Current literature suggests that these parameters which show transmural repolarization are linked to cardiac
arrhythmias. Our study aimed to investigate Tp-e intervals and Tp-e/QTc ratios of stroke patients and whether
these parameters could predict patients’ mortalities and morbidity scales.
MATERIAL and METHODS: Information about patients in six months who were hospitalized from Emergency
Department to Neurology Department (both ward and ICU) with the diagnosis of ischemic stroke were gathered
from hospital database with their ECGs on their specific admission retrospectively. Patients with known or newly
diagnosed AF were excluded. Remaining ECGs’ Tp-e intervals and Tp-e/QTc ratios were calculated manually by
an Emergency Medicine specialist. Modified Rankin Score (mRs) was used to determine patients’ morbidity and
3 or higher scores were accepted as ‘dependent’.
RESULT: A total of 190 patients were included in the study. 55.8% of the patients were male. Median age was
70.0 [IQR: 61.0-77.8]. While 17 patients (8.9%) were treated with alteplase, 26 patients (13.7%) got endovascular
intervention. Twenty-four patients were admitted to the ICU and 166 patients were admitted to the ward. Fifteen
patients died in hospital in their follow up and the rest could be discharged with a modified Rankin score ranging
between 0 and 5. There was no statistically significant relationship found between Tp-e interval and ward/ICU
hospitalization, dependency, and mortality (p=0.516, p=0.436 and p=0.864 respectively). Also, Tp-e/QTc ratio
was found not to be related to ward/ICU hospitalization, dependency, and mortality (p=0.290, p=0.431 and
p=0.765 respectively)
CONCLUSION: New studies show that there might be a relation between Tp-e interval and Tp-e/QTc ratio and
various conditions such as benign paroxysmal positional vertigo, sickle cell anemia and COVID-19. While larger
studies on the topic are needed, our study’s findings suggest that there is no link to these relatively new ECG
parameters in terms of morbidity, mortality, or clinical predictability in stroke patients.
Keywords: Electrocardiography, Tp-e, QTc, Stroke