Association of electrocardiographic and echocardiographic variables with neurological outcomes after ischemic Stroke

Cardiac dysfunction is often seen with neurological injury. Data regarding cardiac involvement following ischemic stroke is sparse. We investigated the association of electrocardiographic (ECG) and echocardiographic variables with neurological outcomes after an acute ischemic stroke. We retrospectively collected baseline characteristics, stroke location, National Institute of Health Stroke Scale (NIHSS) at the time of admission, acute reperfusion treatment, ECG parameters, and echocardiographic data on 174 patients admitted with acute ischemic stroke. Outcomes of the stroke were based on cerebral performance category (CPC) with a CPC score of 1–2 indicating a good outcome and a CPC score of 3–5 indicating a poor outcome. Older age (75.31 ± 11.89 vs. 65.16 ± 15.87, p < 0.001, OR = 1.04, 95 % CI 1.01–1.07), higher heart rate (80.63 ± 18.69 vs. 74.45 ± 17.17 bpm, p = 0.024, OR = 1.02, 95 % CI 1.00–1.05) longer QTc interval (461.69 ± 39.94 vs. 450.75 ± 35.24, p = 0.024, OR = 1.01, 95 % CI 0.99–1.02), NIHSS score (60.9 % vs. 17.8 %, p < 0.001, OR = 14.90, 95 % CI 3.83–69.5), and thrombolysis (15 % vs. 5 %, p = 0.049, OR = 0.55, 95 % CI 0.10–2.55) were associated with poor neurological outcomes. Adjusting for age and NIHSS, heart rate and QTc lost significance. None of the ECG and echocardiographic variables independently predicted neurological outcomes. Elevated heart rate and longer QTc intervals potentially predict poor neurological outcomes, likely due to sympathetic activation in parallel to severity of neurological damage. Further studies are needed for validation and possible integration of these variables in outcome predicting models.