The elevation of different myocardial biomarkers on admission is associated with disease features and different outcomes in aneurysmal subarachnoid hemorrhage

Chen, Yuqi; Cai, Chengzhi; Jiang, Fei; Luo, Shuhong; You, Chao

doi:10.1038/s41598-022-20650-5

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…Additionally, brain and systemic inflammation, impairment of the neurovascular unit leading to increased blood-brain barrier permeability, microthrombosis of small vessels, and cortical depolarization are implicated. Autonomic dysfunction and inflammatory response not only manifest within the intracranial space but also affect other organs, including the cardiovascular system [41][42][43]. Cardiovascular complications symptomatic of disruption in the brain-heart axis are not the decisive factor for the final outcome but are independently associated with an elevated risk of DCI, cerebral infarction, and unfavourable outcome [7,11,44].…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal Fluid and Serum Biomarker Insights in Aneurysmal Subarachnoid Haemorrhage: Navigating the Brain–Heart Interrelationship for Improved Patient Outcomes

Burzyńska,

Uryga,

Załuski

et al. 2023

Biomedicines

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The pathophysiological mechanisms underlying severe cardiac dysfunction after aneurysmal subarachnoid haemorrhage (aSAH) remain poorly understood. In the present study, we focused on two categories of contributing factors describing the brain–heart relationship. The first group includes brain-specific cerebrospinal fluid (CSF) and serum biomarkers, as well as cardiac-specific biomarkers. The secondary category encompasses parameters associated with cerebral autoregulation and the autonomic nervous system. A group of 15 aSAH patients were included in the analysis. Severe cardiac complications were diagnosed in seven (47%) of patients. In the whole population, a significant correlation was observed between CSF S100 calcium-binding protein B (S100B) and brain natriuretic peptide (BNP) (rS = 0.62; p = 0.040). Additionally, we identified a significant correlation between CSF neuron-specific enolase (NSE) with cardiac troponin I (rS = 0.57; p = 0.025) and BNP (rS = 0.66; p = 0.029), as well as between CSF tau protein and BNP (rS = 0.78; p = 0.039). Patients experiencing severe cardiac complications exhibited notably higher levels of serum tau protein at day 1 (0.21 ± 0.23 [ng/mL]) compared to those without severe cardiac complications (0.03 ± 0.04 [ng/mL]); p = 0.009. Impaired cerebral autoregulation was noted in patients both with and without severe cardiac complications. Elevated serum NSE at day 1 was related to impaired cerebral autoregulation (rS = 0.90; p = 0.037). On the first day, a substantial, reciprocal correlation between heart rate variability low-to-high frequency ratio (HRV LF/HF) and both GFAP (rS = −0.83; p = 0.004) and S100B (rS = −0.83; p = 0.004) was observed. Cardiac and brain-specific biomarkers hold the potential to assist clinicians in providing timely insights into cardiac complications, and therefore they contribute to the prognosis of outcomes.

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