Document Detail


Predictors of left ventricular regional wall motion abnormalities after subarachnoid hemorrhage.
MedLine Citation:
PMID:  16757824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Cardiac abnormalities that have been reported after subarachnoid hemorrhage (SAH) include the release of cardiac biomarkers, electrocardiographic changes, and left ventricular (LV) systolic dysfunction. The mechanisms of cardiac dysfunction after SAH remain controversial. The aim of this study was to determine the prevalence of LV regional wall motion abnormalities (RWMA) after SAH and to quantify the independent effects of specific demographic and clinical variables in predicting the development of RWMA.
METHODS: Three hundred patients hospitalized with SAH were prospectively studied with serial echocardiography. The primary outcome measure was the presence of RWMA. The predictor variables included the admission Hunt & Hess grade, age, gender, cardiac risk factors, aneurysm location, plasma catecholamine levels, cardiac troponin I (cTi) level, heart rate (HR), blood pressure, and phenylephrine dose. Univariate and multivariate logistic regression was performed with adjustment for serial measurements, reporting odds ratios (OR) and 95% confidence intervals (CI).
RESULTS: In this study, 817 echocardiograms were analysed. RWMA were detected in 18% of those studied. The prevalence of RWMA in patients with Hunt & Hess grades 3 - 5 was 35%. Among patients with a peak cTi level greater than 1.0 m g/L, 65% had RWMA. Multivariate analysis demonstrated that high Hunt & Hess grade (OR 4.22 for grade 3 - 5 versus grade 1 - 2, p = 0.046), a cTi level greater than 1.0 microg/L (OR 10.47, p = 0.001), a history of prior cocaine or amphetamine use (OR 5.50, p = 0.037), and higher HR (OR 1.34 per 10 bpm increase, p = 0.024) were predictive of RWMA.
CONCLUSIONS: RWMA were frequent after SAH. High-grade SAH, an elevation in cTi levels, a history of prior stimulant drug use, and tachycardia are independent predictors of RWMA.
Authors:
Avinash Kothavale; Nader M Banki; Alexander Kopelnik; Sirisha Yarlagadda; Michael T Lawton; Nerissa Ko; Wade S Smith; Barbara Drew; Elyse Foster; Jonathan G Zaroff
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurocritical care     Volume:  4     ISSN:  1541-6933     ISO Abbreviation:  Neurocrit Care     Publication Date:  2006  
Date Detail:
Created Date:  2006-06-07     Completed Date:  2006-09-12     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  199-205     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Risk Factors
Severity of Illness Index
Subarachnoid Hemorrhage / blood,  complications*,  therapy
Troponin I / blood
Ventricular Dysfunction, Left / blood,  etiology*,  ultrasonography
Grant Support
ID/Acronym/Agency:
1 K23 HL04054-01/HL/NHLBI NIH HHS; K23 NS044014/NS/NINDS NIH HHS; K23 NS044014-05/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Troponin I
Comments/Corrections
Comment In:
Neurocrit Care. 2006;4(3):197-8   [PMID:  16757823 ]

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


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