Predictors of neurocardiogenic injury after subarachnoid hemorrhage.

Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Research Abstract Details 

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Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Abstract Text:

BACKGROUND AND PURPOSE: Subarachnoid hemorrhage (SAH) frequently results in myocardial necrosis with release of cardiac enzymes. Historically, this necrosis has been attributed to coronary artery disease, coronary vasospasm, or oxygen supply-demand mismatch. Experimental evidence, however, indicates that excessive release of norepinephrine from the myocardial sympathetic nerves is the most likely cause. We hypothesized that myocardial necrosis after SAH is a neurally mediated process that is dependent on the severity of neurological injury. METHODS: Consecutive patients admitted with SAH were enrolled prospectively. Predictor variables reflecting demographic (age, sex, body surface area), hemodynamic (heart rate, systolic blood pressure), treatment (phenylephrine dose), and neurological (Hunt-Hess score) factors were recorded. Serial cardiac troponin I measurements and echocardiography were performed on days 1, 3, and 6 after enrollment. Troponin level was treated as a dichotomous outcome variable. We performed univariate and multivariate analyses on the relationships between the predictor variables and troponin level. RESULTS: The study included 223 patients with an average age of 54 years. Twenty percent of the subjects had troponin I levels >1.0 microg/L (range, 0.3 to 50 microg/L). By multivariate logistic regression, a Hunt-Hess score >2, female sex, larger body surface area and left ventricular mass, lower systolic blood pressure, and higher heart rate and phenylephrine dose were independent predictors of troponin elevation. CONCLUSIONS: The degree of neurological injury as measured by the Hunt-Hess grade is a strong, independent predictor of myocardial necrosis after SAH. This finding supports the hypothesis that cardiac injury after SAH is a neurally mediated process.

Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Publishing Authors By Initials

For similar cardiovascular diseases: heart diseases: ventricular dysfunction: ventricular dysfunction, left research abstracts see: cardiovascular diseases: heart diseases: ventricular dysfunction: ventricular dysfunction, left research

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MEDLINE DATE:

Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: Stroke; a journal of cerebral circulation

VOLUME: 35

Page Numbers: 548-51

Journal Abbreviation: Stroke

ISSN: 1524-4628

DAY: 22

MONTH: 01

YEAR: 2004

Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 235266

Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Keywords Mesh Terms:

KEYWORDS: Ventricular Dysfunction, Left

MESH TERMS: physiopathology

Chemical & Substance for Abstract: Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Information

Substance Name: Epinephrine

Registry Number: 51-43-4

Grant and Affiliation Information for Predictors of neurocardiogenic injury after subarachnoid hemorrhage.

AFFILIATION: Division of Cardiology, UCSF Medical Center, USA.

Country: United States

AGENCY: United States NINDS

GRANT: K23 NS044014-05

ACRONYM: NS

MEDLINETA: Stroke

REFSOURCE: Stroke. 2004 Feb;35(2):552-3

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