الفهرس 
Neurocardiology and relationship between Heart and BrainOnly 14 pages are availabe for public view
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Abstract
Acute cerebro-vascular events vary widely as regard to etiology, pathogenesis, and presentation. These events may induce central nervous system (CNS)-mediated electrocardiographic (ECG) abnormalities which occur in the absence of coexisting cardiac disease. CNS mediated ECG changes are of a type commonly seen in all forms of organic heart disease. Aim: To detect the ECG changes in patients with ischemic cerebro-vascular stroke without pre-existent cardiac disease to possibly define any neurological origin of these ECG changes with correlation of these findings to site, laterality and severity. Methods: It is a cross-sectional study that included 100 consecutive patients with no history of heart disease who were admitted to the neurology department in the Ain shams University Hospitals diagnosed with acute ischemic stroke confirmed by MRI taken at the time of admission. Within 48 hrs of admission all of the patients underwent a basic cardiac evaluation including a 12 lead ECG, Echocardiogram and cardiac markers (CK total/MB, Troponin). The ECGs were analyzed for Rhythm changes including arrhythmias, atrio-ventricular block and ectopic beats. Repolarization changes including changes in QT interval, ST-segment depression or elevation, T-wave abnormalities, presence of U-wave, and J wave syndromes. presence of Q waves and R wave progression. Results: Investigating ECG changes in our study sample revealed 67 patients had evident ECG changes of any type (67%), 39 patients had rhythm changes or arrhythmias (39%), 39 patients had a repolarization changes (39%), 5 patients had pathological Q waves in at least one lead, while 18 patients had more than one change category. The comparison between cases with and without ECG changes regarding stroke characteristics .also revealed no statistical significance regarding site and laterality of the lesion, suggesting evident occurrence of these ECG changes in ischemic stroke patients regardless the site of the lesion or it’s laterality, however, it has been shown that correlation of ECG changes was significantly higher in ischemic stroke patients with NIH score more than 6 in logistic regression model, P value: 0.012*. Conclusion: Ischemia-like ECG changes and arrhythmias are frequently seen in stroke patients, even in those without pre-existing history or signs of primary heart disease, which support a Neurogenic origin of these ECG abnormalities. these ECG changes appears likely more common in moderate to severe strokes than in mild strokes, and more incident in patients with pre-existing Hypertension.