title: QTc-prolongation in posterior circulation stroke.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurology, UMass Medical School, 55 Lake Ave, North, Worcester, MA, 01655, USA, nils.henninger@umassmed.edu.
authors.forename: Nils
authors.initials: N
authors.lastname: Henninger
authors.forename: Diogo C
authors.initials: DC
authors.lastname: Haussen
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kakouros
authors.forename: Magdy
authors.initials: M
authors.lastname: Selim
authors.forename: D Eric
authors.initials: DE
authors.lastname: Searls
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kumar
authors.forename: Gottfried
authors.initials: G
authors.lastname: Schlaug
authors.forename: Louis R
authors.initials: LR
authors.lastname: Caplan
mesh_terms: D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D020762:Infarction, Posterior Cerebral Artery / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D016014:Linear Models; D008133:Long QT Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012042:Registries; D012307:Risk Factors; D013702:Temporal Lobe / Q000098:blood supply*; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology