Age and aneurysm position predict patterns of left ventricular dysfunction after subarachnoid hemorrhage - 21/08/11
Résumé |
Cardiac injury, including left ventricular dysfunction, frequently occurs in patients with subarachnoid hemorrhage. Patterns of left ventricular dysfunction often do not follow coronary artery distributions, and may correlate with myocardial sympathetic innervation. Left ventricular dysfunction of the anterior and anteroseptal walls that spares the apex is unusual for patients with myocardial infarction and may represent a neurally mediated pattern of injury. We performed serial echocardiography on 225 patients with subarachnoid hemorrage and classified those with regional wall-motion abnormalities as following either an apex-sparing (AS) or apex-affected (AA) pattern. Wall-motion abnormalities were found in 61 of 225 patients studied (27%). The AS pattern was found in 49% of these patients. Younger age and anterior aneurysm position were independent predictors of this AS pattern. Both patterns of wall-motion abnormalities appear to be transient, reversible phenomena. The AS pattern may represent a unique form of neurally mediated cardiac injury.
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Supported by National Institutes of Health/National Heart, Lung, and Blood Institute 1 K23 HL04054-01 (principal investigator: Dr Zaroff) and a gift from The Pritzker Cousins Foundation, John A. Pritzker, Director. These agencies had no direct role in the study design, data collection, analysis, interpretation, manuscript preparation, or the decision to submit the manuscript for publication. |
Vol 18 - N° 2
P. 168-174 - février 2005 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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