J Korean Neurol Assoc > Volume 19(3); 2001 > Article

Journal of the Korean Neurological Association 2001;19(3): 207-212.

급성 허혈성 뇌졸중 환자의 심전도 및 혈청 심장효소의 변화

장용석, 민지원 유봉구 김광수 유경무

고신대학교 의학부 신경과학교실

"Changes of Electrocardiogram and Cardiac Enzymes in Acute Ischemic Stroke"

"Yong-Seok Jang, M.D., Ji-Won Min, M.D., Bong-Goo Yoo, M.D., Kwang-Soo Kim, M.D., Kyung-Moo Yoo, M.D."

Department of Neurology, Kosin University College of Medicine

Abstract

"Background : Cardiac arrhythmias and other cardiac dysfunctions occur in relation with acute cerebral ischemia. This study was undertaken to evaluate the sequential changes of electrocardiogram and cardiac enzymes after acute ischemic stroke, and to evaluate the incidence of cardiac arrhythmias. Methods : Forty-three patients with acute ischemic stroke were recruited for this study. Electrocardiogram and cardiac enzymes were checked at 1, 3, 5, 7, 15, and 30 days after onset. Results : Heart rates were decreased acutely after ischemic stroke and showed maximal decrease at day 3 (p<0.05). Heart rates were more significantly decreased in the right-sided lesions than the left (p<0.05) and in the supratentorial lesions than the infratentorial (p<0.05). PR intervals and durations of QRS complex were prolonged at day 3 and 5 but were not significant. The prolongation of the QTc interval was found in 21 patients (48.8%) and sus-tained QTc prolongation at day 30 were seen in 16 patients. Compared with controls, patients showed significantly higher incidence of arrhythmias (p<0.01). Creatine phosphokinase-MB (CK-MB) was significantly increased at day 5 (p<0.01) and lactic dehydrogenase (LDH) was increased at day 7 (p<0.01). Conclusions : In our study, the incidence of neurogenic cardiac abnormalities in acute ischemic stroke was higher than that of previous studies. Abnormalities peaked at days 3 and 5 were nearly similar to control levels at day 30. These periods of peak abnormalities coincided with those of increasing brain edema. Therefore, we postulate that cardiac autonomic controls are also influenced by acute brain edema. J Korean Neurol Assoc 19(3):207~212, 2001 Key Words : Cerebral infarction, Neurogenic heart disease, Electrocardiogram, Cardiac enzymes"