Ventricular arrhythmia risk after subarachnoid hemorrhage.
Ventricular arrhythmia risk after subarachnoid hemorrhage.
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DOI：
10.1007/s12028-009-9188-x
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发表时间：
2009
影响因子：
3.5
通讯作者：
London, Barry
中科院分区：
文献类型：
--
作者：
Frangiskakis, J. Michael;Hravnak, Marilyn;Crago, Elizabeth A.;Tanabe, Masaki;Kip, Kevin E.;Gorcsan, John, III;Horowitz, Michael B.;Kassam, Amin B.;London, Barry
蛛网膜下腔出血（SAH）后的心脏病发病率和死亡率可归因于心肌损伤、心室功能下降和室性心律失常（VA）。我们的目的是检测QTc延长、VA和SAH后生存率之间的关系。在200名患有急性动脉瘤性SAH的受试者中，评估了心电图、超声心动图和遥测。还评价了血清电解质和肌钙蛋白。38%的受试者的初始QTc（平均460 ± 45 ms）延长（≥470 ms），并在随访时下降（初始469 ± 49 ms与随访435 ± 31 ms; N = 89; P < 0.0001）。14%的受试者存在VA，52%的VA受试者的QTc ≥ 470 ms，VA受试者的初始QTc持续时间有延长的趋势（474 ± 61 vs. 457 ± 42 ms; P = 0. 084）。多因素分析显示年龄的增加是SAH后VA的显著预测因素（OR 1.3/5年; P = 0.025），增加卒中严重程度（OR 1.8; P = 0.009），心率降低（OR 0.5/10次/分; P= 0.006），以及SAH发作时未使用血管紧张素转换酶抑制剂或血管紧张素II受体拮抗剂（OR 0.10; P = 0.027）。3个月时全因死亡率为19%（25/135），VA受试者的死亡率显著高于无VA受试者（37% vs. 16%; P = 0.027）。这些数据表明，QTc间期延长和心律失常是SAH后常见的，但心律失常通常与QTc间期延长无关。此外，VA的存在确定了SAH后死亡风险更高的受试者。
Cardiac morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH) are attributable to myocardial injury, decreased ventricular function, and ventricular arrhythmia (VA). Our objective was to test the relationships between QTc prolongation, VA, and survival after SAH. In 200 subjects with acute aneurysmal SAH, electrocardiograms, echocardiograms, and telemetry were evaluated. Serum electrolytes and troponin were also evaluated. Initial QTc (mean 460 ± 45 ms) was prolonged (≥470 ms) in 38% of subjects and decreased on follow-up (469 ± 49 initial vs. 435 ± 31 ms follow-up; N = 89; P < 0.0001). VA was present in 14% of subjects, 52% of subjects with VA had QTc ≥ 470 ms, and initial QTc trended toward longer duration in subjects with VA (474 ± 61 vs. 457 ± 42 ms; P = 0.084). Multivariate analysis demonstrated significant predictors of VA after SAH were increasing age (OR 1.3/5 years; P = 0.025), increasing stroke severity (OR 1.8; P = 0.009), decreasing heart rate (OR 0.5/10 beats/min; P= 0.006), and the absence of angiotensin converting enzyme inhibitor or angiotensin II receptor antagonist use at SAH onset (OR 0.10; P = 0.027). All-cause mortality was 19% (25/135) at 3 months and subjects with VA had significantly higher mortality than those without VA (37% vs. 16%; P = 0.027). These data demonstrate that QTc prolongation and arrhythmias are frequently noted after SAH, but arrhythmias are often not associated with QTc prolongation. In addition, the presence of VA identified subjects at greater risk of mortality following their SAH.
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影响因子：
3.7
作者：
Collier, BR;Miller, SL;Gonzalez, LS
通讯作者：
Gonzalez, LS
影响因子：
1.3
作者：
Machado, C;Baga, JJ;Lehmann, MH
通讯作者：
Lehmann, MH
影响因子：
5.5
作者：
Brunet, S;Aimond, F;Nerbonne, JM
通讯作者：
Nerbonne, JM
影响因子：
4.1
作者：
Kongable, GL;Lanzino, G;Lightfoot, AL
通讯作者：
Lightfoot, AL
影响因子：
37.8
作者：
ALGRA, A;TIJSSEN, JGP;LUBSEN, J
通讯作者：
LUBSEN, J