Determinants of Central Sympathetic Activation in Spontaneous Primary Subarachnoid Hemorrhage

Moussouttas, Michael; Lai, Edwin W.; Khoury, John; Huynh, Thanh; Dombrowski, Keith; Pacák, Karel

doi:10.1007/s12028-012-9673-5

Cited by 30 publications

(20 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As previously described, our study showed that the severity of cardiac injury was associated with the degree of catecholamine release in the plasma of our SAH patients [26] in univariate analysis and with the severity of SAH in multivariate analysis. The evolution of echocardiographic and biological markers paralleled the evolution of plasma levels of norepinephrine and epinephrine and returned in most patients toward normal levels within a week.…”

Section: Discussionsupporting

confidence: 76%

Subarachnoid hemorrhage induces an early and reversible cardiac injury associated with catecholamine release: one-week follow-up study

et al. 2014

View full text Add to dashboard Cite

IntroductionThe occurrence of cardiac dysfunction is common after subarachnoid hemorrhage (SAH) and was hypothesized to be related to the release of endogenous catecholamines. The aim of this prospective study was to evaluate the relationship between endogenous catecholamine and cardiac dysfunction at the onset and during the first week after SAH.MethodsForty consecutive patients admitted for acute SAH without known heart disease were included. Catecholamine plasma concentrations and transthoracic echocardiography (TTE) were documented on admission, on day 1 (D1), and day 7 (D7).ResultsAt baseline, 24 patients had a World Federation of Neurosurgical Societies score (WFNS) of one or two; the remaining 16 had a WFNS between three and five. Twenty patients showed signs of cardiac dysfunction on admission, including six with left ventricle (LV) systolodiastolic dysfunction and 14 with pure LV diastolic dysfunction. On admission, norepinephrine, epinephrine, dopamine, B-type Natriuretic Peptide (BNP) and Troponin Ic (cTnI) plasmatic levels were higher in patients with the higher WFNS score and in patients with altered cardiac function (all P <0.05). Among patients with cardiac injury, heart function was restored within one week in 13 patients, while seven showed persistent LV diastolic dysfunction (P = 0.002). Plasma BNP, cTnI, and catecholamine levels exerted a decrease towards normal values between D1 and D7.ConclusionOur findings show that cardiac dysfunction seen early after SAH was associated with both a rapid and sustained endogenous catecholamine release and WFNS score. SAH-induced cardiac dysfunction was regressive over the first week and paralleled the normalization of catecholamine concentration.

show abstract

Section: Discussionsupporting

confidence: 76%

Subarachnoid hemorrhage induces an early and reversible cardiac injury associated with catecholamine release: one-week follow-up study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…However, methodological flaws such as the time point and the source of blood samples weakens the validity of this study. The second study could demonstrate a significant relationship of sympathetic activation to female gender and clinical but not to radiological bleeding severity [5]. Based on the same dataset, this group also published data about the acute central sympathetic response after aSAH which does not seem to be related to the development of cerebral VS [15].…”

Section: Discussionmentioning

confidence: 92%

“…In literature only little information is available on the relation of BP course to sympathetic activation in aSAH patients. There is only one study available which analyzed the MAP course during the first 2 days after aSAH and failed to demonstrate a correlation between sympathetic activation and MAP values [5]. However, the validity of these findings remains controversial since BP is usually treated rigorously prior to aneurysm treatment in order to reduce the risk of re-bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…The Hijdra scale represents one of the most accurate scales for the description of the amount of subarachnoid clots. Therefore, this scale seems superior compared to the four-point modified Fisher scale used in the study of Moussouttas et al [5]. In addition, VS has been determined using transcranial ultrasound sonography which is known to be inaccurate for detailed analysis of vasospasm.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies demonstrated hypertensive BP values as early as 3-4 days after aneurysm treatment [3] which might be linked to central sympathetic activation. Accordingly, further studies could demonstrate elevated catecholamine levels in cerebrospinal fluid (CSF) determined within 48 h after the initial bleeding [4,5]. However, little information is available regarding the exact time course of those BP alterations after aSAH http://dx.doi.org/10.1016/j.clineuro.2015.06.014 0303-8467/© 2015 Elsevier B.V. All rights reserved.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The spontaneous arterial blood pressure rise after aneurysmal subarachnoid hemorrhage – A biphasic phenomenon

Fontana

Scharf

Weiß

et al. 2015

Clinical Neurology and Neurosurgery

View full text Add to dashboard Cite

Interactions between the Autonomic Nervous System and the Immune System after Stroke

Zhu

Huang

et al. 2022

Comprehensive Physiology

View full text Add to dashboard Cite

Acute stroke is one of the leading causes of morbidity and mortality worldwide. Stroke-induced immune-inflammatory response occurs in the perilesion areas and the periphery. Although strokeinduced immunosuppression may alleviate brain injury, it hinders brain repair as the immuneinflammatory response plays a bidirectional role after acute stroke. Furthermore, suppression of the systemic immune-inflammatory response increases the risk of life-threatening systemic bacterial infections after acute stroke. Therefore, it is essential to explore the mechanisms that underlie the stroke-induced immune-inflammatory response. Autonomic nervous system (ANS) activation is critical for regulating the local and systemic immune-inflammatory responses and may influence the prognosis of acute stroke. We review the changes in the sympathetic and parasympathetic nervous systems and their influence on the immune-inflammatory response after stroke. Importantly, this article summarizes the mechanisms on how ANS regulates the immune-inflammatory response through neurotransmitters and their receptors in immunocytes and immune organs after stroke.To facilitate translational research, we also discuss the promising therapeutic approaches modulating the activation of the ANS or the immune-inflammatory response to promote neurologic recovery after stroke.

show abstract

Determinants of Central Sympathetic Activation in Spontaneous Primary Subarachnoid Hemorrhage

Abstract: Central sympathetic activation relates to clinical severity and female gender. No definitive associations were found for age, hemorrhage amount, or aneurysm location.

Cited by 30 publications

References 32 publications

Subarachnoid hemorrhage induces an early and reversible cardiac injury associated with catecholamine release: one-week follow-up study

Subarachnoid hemorrhage induces an early and reversible cardiac injury associated with catecholamine release: one-week follow-up study

The spontaneous arterial blood pressure rise after aneurysmal subarachnoid hemorrhage – A biphasic phenomenon

Interactions between the Autonomic Nervous System and the Immune System after Stroke

Contact Info

Product

Resources

About