Electrocardiographic markers of abnormal left ventricular wall motion in acute subarachnoid hemorrhage

Mayer, S.; Limandri, Giuseppe; Sherman, Deb S.; Lennihan, Laura; Fink, Matthew E.; Solomon, Rekha; DiTullio, Marco R.; Klebanoff, Louise M.; Beckford, Avis; Homma, Shunsaku

doi:10.1097/00008506-199604000-00013

Cited by 29 publications

(58 citation statements)

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“…4,12,13,28,29) We also have shown that the most frequently abnormal LV segments were the middle ventricular portions of the anterolateral, posterolateral, and inferior walls and basal portion of the anterior wall. This pattern did not correlate with coronary artery distributions, suggesting SAH-associated heart damage is a form of neurocardiogenic injury.…”

Section: Dysfunction In Sahmentioning

confidence: 69%

“…Therefore, early identification and monitoring of cardiac dysfunction is a critical issue. ECG abnormalities have been reported frequently in the course of SAH, [4][5][6][7]21,22) whereas the relation of ECG abnormalities to mortality has not been extensively studied. 4,7,22) Echocardiography is a more accurate method with which to assess cardiac function, however, little published data exist on the prognostic value of LV dysfunction observed shortly after SAH.…”

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confidence: 99%

“…ECG abnormalities have been reported frequently in the course of SAH, [4][5][6][7]21,22) whereas the relation of ECG abnormalities to mortality has not been extensively studied. 4,7,22) Echocardiography is a more accurate method with which to assess cardiac function, however, little published data exist on the prognostic value of LV dysfunction observed shortly after SAH. 12,13) The aim of the present study was to evaluate the prognostic value of global (LV ejection fraction [EF]) and segmental (regional wall motion abnormality [RWMA]) LV dysfunction, as compared with ECG abnormalities and neurological status.…”

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confidence: 99%

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Prognostic Implications of Left Ventricular Wall Motion Abnormalities Associated With Subarachnoid Hemorrhage

et al. 2008

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SUMMARYLeft ventricular (LV) dysfunction generally occurs early in the course of subarachnoid hemorrhage (SAH). We evaluated the prognostic value of electrocardiographic (ECG) abnormalities and echocardiographic LV dysfunction evaluated shortly after SAH.We prospectively enrolled 47 SAH patients (62 ± 14 years, mean ± SD) who were admitted to the neurosurgical care unit of our institute. Neurological status was rated on the day of admission. Twelve-lead ECG and 2-dimensional echocardiography were recorded 2 ± 1 day after onset of SAH. ECG abnormalities (pathological Q-wave, ST-segment deviation, T-wave inversion, and QT prolongation) were evaluated and the incidences of global (LV ejection fraction < 50%) and segmental (regional wall motion abnormality [RWMA]) LV dysfunction were measured.During a follow-up period of 44 ± 23 days, 17 (36%) patients died. ECG abnormalities, LV ejection fraction < 50%, and RWMA were observed in 62%, 11%, and 28% of patients, respectively. Univariate Cox proportional hazards regression analysis revealed that neurological status, rate-corrected QT interval, LV ejection fraction, and RWMA were significant predictors of death. After adjustment for these significant clinical variables, and age and sex, independent predictors of mortality were neurological status and RWMA.RWMA may provide significant prognostic information in patients with SAH. (Int Heart J 2008; 49: 75-85)

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Section: Dysfunction In Sahmentioning

confidence: 69%

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confidence: 99%

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confidence: 99%

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Prognostic Implications of Left Ventricular Wall Motion Abnormalities Associated With Subarachnoid Hemorrhage

et al. 2008

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“…Plasma levels of CK-MB are mildly elevated in 20%-50% of patients. 8,19 Also, echocardiography studies have demonstrated reversible abnormalities of left ventricular contraction after SAH.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Hemorrhage: Precipitating Event for a Tako‐tsubo‐like Cardiomyopathy?

Rahimi

Katayama

Mills³

2008

Clinical Cardiology

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There have been some reports in medical literature of patients with profound, reversible left‐ventricular (LV) dysfunction after sudden emotional stress. Originally, in Japan, the pattern was called tako‐tsubo cardiomyopathy. ST‐segment elevation is seen with this syndrome, and it may look like acute ST‐elevation myocardial infarction. However, it has also been well established that a subarachnoid hemorrhage can manifest with cardiac abnormalities. The authors describe a case involving a cerebral hemorrhage and a potential tako‐tsubo‐like cardiomyopathy in the same patient. In conclusion, even though the patient's presentation appears to be a tako‐tsubo syndrome, the radiographic evidence of a cerebral hemorrhage presents as a stronger etiology for the cardiac changes that occur in our patient. Copyright © 2008 Wiley Periodicals, Inc.

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“…2,3 Moreover, the authors' identification of ST-segment elevation and left ventricular dysfunction without significant epicardial coronary stenoses, termed ''neurogenic stunned myocardium,'' has previously been described. 4 The combination of anterolateral ST-segment elevation, raised cardiac biomarker levels, and transient apical and mid-left ventricle wall akinesis identified in this case is the hallmark of TC.…”

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confidence: 99%