Repolarisation disturbances in ischaemic stroke: unveiling the prognostic role of the frontal QRS-T angle

Sibel Çatalkaya, Ümmügülsüm Akpınar, Ahmet Yıldırım, Semra Çatalkaya, Selvi Öztaş

Abstract

Background: Ischaemic stroke is frequently associated with electrocardiographic (ECG) abnormalities, including repolarisation disturbances. These disturbances, often seen as prolonged QT intervals or altered T-wave morphology, reflect impaired ventricular repolarisation and have been linked to an increased risk of cardiovascular events. One specific marker, the frontal QRS-T angle (FQRS-T angle), which measures the relationship between the QRS complex and T wave, has gained attention as a potential prognostic indicator in cardiovascular diseases. However, its role in ischaemic stroke has been scarcely investigated. This study aimed to assess the prognostic value of the frontal QRS-T angle in predicting survival and cardiovascular events in patients with cryptogenic ischaemic stroke.
Methods: In this retrospective analysis, patients with confirmed cryptogenic ischaemic stroke were stratified into two groups based on a frontal QRS-T angle threshold of 90°. Clinical outcomes, including survival, cardiovascular events, recurrent stroke, and atrial fibrillation, were compared between the two groups.
Results: Patients with a frontal QRS-T angle >90° exhibited significantly higher mortality rates (26.3% vs. 6.3%, p < 0.05) and shorter survival durations (19.58 ± 1.72 months vs. 25.54 ±0.63 months, p = 0.003). The > 90° group also had a higher incidence of cardiovascular events (42.9% vs. 18.8%, p = 0.039). No significant association was found with recurrent stroke or atrial fibrillation.
Conclusion: The frontal QRS-T angle is a valuable prognostic marker for mortality and adverse events in cryptogenic ischaemic stroke patients. This simple parameter could be integrated into clinical practice to identify patients at higher risk for adverse outcomes, allowing for more targeted monitoring and management.