Paper Title
ECG Changes and Echocardiographic Findings as an Independent Predictive Factor of Mortality in Patients with Acute Stroke

Abstract
Background- Various factors such as age & severity of stroke have been deemed connected with the risk of mortality in patients with acute stroke. The present study was performed with the aim of evaluating the role of ECG changes & echocardiographic findings in predicting the outcome of stroke patients. Methods- In our study total of 100 consecutive patients more than 18 years presenting with acute onset neuro-deficit were included during the study period after considering the exclusion criteria Results- All the patients were investigated with CT brain and cardiac evaluation was done with ECG & 2-D echo. Following observations were made during the study: Mean age of the study subjects was 57.8 years with 46% of the cases were over 60 years of age. Male preponderance was seen in the study group with 63% males to 37% females. Out of the total 100 cases, as per CT findings, Infraction was seen in 68% while Haemorrhagic stroke was observed in 32% cases. Prevalence of ECG and Echocardiographic abnormalities among stroke cases was 71% and 54% respectively. Prevalence of ECG abnormalities among ischemic and hemorrhagic stroke cases was 67.6% and 78.1% respectively, with no significant difference between the two types of stroke (p-0.34). Prevalence of echocardiographic abnormalities among ischemic and hemorrhagic stroke cases was 44.1% and 75% respectively, with significantly higher prevalence among hemorrhagic stroke cases (p<0.05). Out of the total 100 cases, survival rate was 78% while 22% cases died. Mortality rate was significantly higher among hemorrhagic cases as compared to ischemic cases (43.8% vs 11.8%; p<0.01).Most common ECG change was presence of abnormal U wave (53%) followed by QTC prolongation (41%), ST depression (39%) and T wave Inversion (30%) respectively. Out of all the ECG changes, ST depression was significantly associated with hemorrhagic stroke (p-0.03). Most common echocardiographic change was presence of Left ventricular Dysfunction (34%), mitral valve abnormality (14%) and aortic valve abnormality (11%) respectively. Left ventricular dysfunction and aortic valve abnormality were significantly associated with hemorrhagic stroke (p-0.03). Conclusion- statistically significant difference was found between echocardiographic findings and mortality whereas ECG changes were statistically insignificant. Keywords - Stroke, ECG, Echocardiography, Mortality