Document Detail


Myocardial dysfunction in subarachnoid hemorrhage: prognostication by echo cardiography and cardiac enzymes. A prospective study.
MedLine Citation:
PMID:  19812939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The myocardial dysfunction in nontraumatic sub-arachnoid hemorrhage (SAH) is not well understood. Borderline elevations of cardiac biomarkers, electrocardiographic repolarization abnormalities and systolic dysfunction have been reported but the clinical significance of these abnormalities is uncertain. METHODS: Patients without history of cardiac disease were prospectively evaluated for cardiac dysfunction. Myocardial regional wall motion and left ventricular ejection fraction (LVEF) were serially studied by transthoracic echocardiogram along with cardiac enzymes. RESULTS: The mean age of the study population was 53 years. Majority of the patients had aneurysms (N = 38). The mean LVEF was 55 +/- 15%. Eight patients had evidence of WMA, mostly global hypokinesia (63%). The mean LVEF of patients with WMA was significantly lower compared to those without WMA (p < 0.001) at day 0. Systolic function recovered in 25% of these patients. The mean value of troponin was significantly higher in those with WMA (p < 0.001) and mean GCS upon admission was significantly lower (p < 0.001). On multivariate analysis, WMA were associated with poor GCS (p < 0.01) and increased hospitalization (P < 0.01). CONCLUSIONS: WMA with systolic dysfunction occurred in 20% of patients and recovered within 3 days in 25%. Patients with evidence of WMA had a significant myocardial dysfunction, higher troponin levels and poor GCS.
Authors:
Prasad Vannemreddy; Prasanna Venkatesh; Kumar Dinesh; Pratap Reddy; Anil Nanda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  106     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2010  
Date Detail:
Created Date:  2009-10-08     Completed Date:  2010-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  151-4     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, LSUHSC-Shreveport, Shreveport, LA 71103, USA. pvanne@lsuhsc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiomyopathies* / diagnosis,  enzymology,  etiology
Creatine Kinase, MB Form / metabolism*
Echocardiography / methods*
Female
Humans
Male
Middle Aged
Myocardial Contraction / physiology
Predictive Value of Tests
Prospective Studies
Severity of Illness Index
Stroke Volume / physiology
Subarachnoid Hemorrhage / complications*
Troponin I / metabolism*
Chemical
Reg. No./Substance:
0/Troponin I; EC 2.7.3.2/Creatine Kinase, MB Form

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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