Prevalence and Implications of Diastolic Dysfunction After Subarachnoid Hemorrhage

Abstract

Diastolic dysfunction is common after SAH. It is associated with history of hypertension and older age and may explain the development of pulmonary edema in many SAH patients.

Neurocardiogenic injury in subarachnoid hemorrhage: A wide spectrum of catecholamin-mediated brain-heart interactions

“…Consistent with the paper of Kopelnik et al [37], 28% of patients had regional wall motion score more than 1 on at least 1 study day, suggesting RWMA [4]. In addition, 15% of patients were characterized by impaired global systolic function (LVEF < 50%).…”

“…Never theless, prevalence of diastolic dysfunction reached 71% of all SAH subjects (impaired relaxation, pseudonormal, restrictive pattern) and was associated with older age and history of hypertension [37]. As proven by Kopelnik et al [37], diastolic dysfunction predisposed patients to pulmonary edema, while systolic dysfunction was considerably less frequent in this clinical scenario.…”

“…The release of natriuretic peptides was previously shown to correlate with LV wall stress and diastolic dysfunction encountered in chronic heart failure, but in the setting of SAH BNP did not correlate with LV filling pressure [36]. Never theless, prevalence of diastolic dysfunction reached 71% of all SAH subjects (impaired relaxation, pseudonormal, restrictive pattern) and was associated with older age and history of hypertension [37]. As proven by Kopelnik et al [37], diastolic dysfunction predisposed patients to pulmonary edema, while systolic dysfunction was considerably less frequent in this clinical scenario.…”

Cerebral Vasospasm and Concurrent Left Ventricular Outflow Tract Obstruction: Requirement for Modification of Hyperdynamic Therapy Regimen

“…SAH is frequently associated with changes in cardiac physiology, including left ventricular diastolic dysfunction, electrocardiac aberrancies, and in rare cases takotsubo cardiomyopathy [9,10]. Following administration of inotropic agents for HHH therapy, a small proportion of patients fail to respond due to underlying or induced left ventricular outflow tract (LVOT) obstruction.…”

Left ventricular myocardial function during the acute phase of a subarachnoid haemorrhage

“…The most common abnormalities (prolonged QT-interval, ST-T changes, pathological T-waves, and U-waves) have been shown to occur in 27 to 100% of patients (1,2). Echocardiographic studies have shown abnormal left ventricular (LV) wall motion (13Á27%), which seems to be reversible (3Á7), and diastolic dysfunction (71%) (8). Others have reported myocardial necrosis measured by CK-MB and troponin I and T (3,7,9), and subendocardial necrosis and haemorrhages have been described at autopsy (10).…”