Cardiac arrhythmias in subarachnoid haemorrhage

Stober, T.; Anstätt, T.; Sen, Semi; Schimrigk, К.; Jäger, H.

doi:10.1007/bf01409900

Cited by 41 publications

(14 citation statements)

References 26 publications

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“…Clinically, similar ECG changes have been reported in humans after subarachnoid haemorrhage, ischaemic infarction and intraparenchymal haemorrhage [10,15,31,35,36,41]. The lower brainstem and preganglionic sympathetic neurones are the primary units of central cardiovascular regulation [6,20,23].…”

Section: Discussionmentioning

confidence: 61%

“…The lower brainstem and preganglionic sympathetic neurones are the primary units of central cardiovascular regulation [6,20,23]. There appears to be a correlation between ECG findings and CA levels [6,25,35]. Although technical limitations in our experiments prevented the measurement of cardiac sympathetic nerve activity, we feel that the increased QT interval can be considered significant.…”

Section: Discussionmentioning

confidence: 89%

“…Although it primarily affects the CNS, there is also a diffuse involvement in peripheral symphatetic [8,14,21,23,24,28] and parasympathetic [37] ganglia. Cardinal manifestations of impairment of ANS activity in PD are cardiac arrythmias and orthostatic hypotension [1,12,21,23,28,31,32,35,38]. Patients with PD may also have defective cardiovascular control [21].…”

Section: Introductionmentioning

confidence: 99%

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Asymmetry of sympathetic activity in a rat model of Parkinson’s disease induced by 6-hydroxydopamine: haemodynamic, electrocardiographic and biochemical changes

et al. 1997

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We studied the effects of experimental hemiparkinsonism upon sympathetic function in rat. The rats were divided into three groups: a group given intact control, one given lesioning with 6-hydroxydopamine (6-OHDA), and one given sham operation. One day after apomorphine testing following lesioning of the substantia nigra (SN) with 6-OHDA, heart rate (HR), mean arterial blood pressure (MAP), and electrocardiogram (ECG) were monitored. Plasma norepinephrine (NE), epinephrine (E), and dopamine (DA) levels were measured. Thereafter, immunohistochemical examination was performed to detect the extent of 6-OHDA lesions, using the avidinbiotinylated peroxidase complex (ABC) method. There was no difference in the total number of tyrosine hydroxylase (TH)-positive cells and rotation responses between the right- and left-sided 6-OHDA-treated groups. On the other hand, injury of rats with unilateral 6-OHDA resulted in haemodynamic, electrocardiographic, and biochemical changes. A significant difference was found between the right-sided 6-OHDA-treated rats and the left-sided treated ones. The MAP increased in the group given left 6-OHDA treatment and to lesser extent in the sham-operated group. In contrast, MAP did not increase in the group given right 6-OHDA treatment and was significantly lower than values in both the intact control rats and the sham-treated rats. Also, only the group given right 6-OHDA injury showed a fall in the value of HR. The plasma NE level was significantly decreased in the group given right 6-OHDA treatment compared with all other groups (P < 0.005). Our results indicate that right-sided lesioning of the nigrostriatal DA pathway in the central nervous system (CNS) has greater sympathetic consequences than left-sided ones. These results also suggest that there is a differential effect of right-sided SN lesions on sympathetic cardiac innervation. The mechanism behind the confronting impairment of autonomic nervous system (ANS) could in this experiment be attributable to an asymmetric representation of sympathetic function in the brain. However, further studies will be needed before final conclusions can be made.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Asymmetry of sympathetic activity in a rat model of Parkinson’s disease induced by 6-hydroxydopamine: haemodynamic, electrocardiographic and biochemical changes

et al. 1997

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“…However, in our cohort, in the 11 cases of subarachnoid hemorrhage, only 36.4% were abnormal. Stober et al 13 described sinus bradycardia in 23%, multifocal ventricular ectopic beats in 54%, asystolic intervals in 27%, and atrial fibrillation in 4% of the cases with conventional electrocardiography. In the present study, sinus bradycardia, atrioventricular block, and the junctional rhythm were the only arrhythmias found (9.1% for each).…”

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confidence: 99%

Electrocardiographic abnormalities in neurological diseases

Póvoa¹,

Cavichio²,

Almeida³

et al. 2003

Arq. Bras. Cardiol.

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Original ArticleCentral nervous system disorders are known to be responsible for the onset of cardiac alterations, frequently observed in the electrocardiogram 1,2 . Although serum potassium disturbance has been suggested as an important factor in these alterations, this finding was not confirmed in several studies 3,4 . The majority of studies suggest that these ECG abnormalities result from disturbances in the autonomous system, due to neurologic disease, promoting a local excess of catecholamines, associated with enhanced adrenal production, and activation of the calcium channels, leading to an increase in cytosolic and mitochondrial calcium, as well as release of free radicals, causing contraction band necrosis and reflected in ECG alterations. Although the causes of cardiac alterations are a matter of scientific speculation, evidence exists that myocardial lesion is mediated by catecholamines, and an important left ventricle dysfunction with the liberation of cardiac enzymes, such as troponin-I, occurs in some cases 5 . The increase in intracranial pressure is also considered a factor in these alterations 6 . Data described by Goldstein 7 in a certain population demonstrated a high incidence (up to 92%) of electrocardiogram alteration in neurological disorders. This result was not observed in clinical practice. In our study, we observed a frequency of electrocardiogram alterations in pathological brain processes contrary to that observed in the literature. MethodsWe carried out a study for 6 years of 1,590 patients admitted because of neurological diseases, such as brain tumor, stroke, subarachnoid hemorrhage, subdural hemorrhage, brain aneurysm, and head injury, with ages ranging from 10 to 60 years. Patients with concomitant diseases that could lead to electrocardiogram alterations, such as systemic hypertension, cardiac valve abnormalities, coronary diseases, congenital cardiopathies, endocrine diseases, and others were excluded. Those patients who did not have a complete clinical history or an electrocardiogram performed at the time of admittance were also excluded. A cardiologist unaware of the neurological diseases and any other clinical data regarding the patient interpreted the elec-

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“…injection of minute amounts of the New World scorpion tityustoxin led to both central and cardio-respiratory manifestations (Carvalho et al, 1998). It is possible that the venom may pass through BBB via the 4th ventricle (naturally more permeable), compromising the control function exerted by cardiovascular/respiratory nuclei and the bulbar neural substrates (Stober et al, 1988). On the other hand, Mesquita et al (2003) demonstrated that peripherally-injected tityustoxin, unlike the present study, did not reproduce comparable effects to that observed after i.c.v.…”

Section: Discussionmentioning

confidence: 99%