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.
复制标题
DOI：
10.1186/s13054-014-0558-1
复制
发表时间：
2014-10-30
期刊：
影响因子：
--
通讯作者：
Mebazaa A
中科院分区：
文献类型：
--
作者：
Salem R;Vallée F;Dépret F;Callebert J;Maurice JP;Marty P;Matéo J;Madadaki C;Houdart E;Bresson D;Froelich S;Stapf C;Payen D;Mebazaa A
蛛网膜下腔出血（SAH）后心功能障碍的发生是常见的，并被假设与内源性儿茶酚胺的释放有关。这项前瞻性研究的目的是评估内源性儿茶酚胺与SAH发病时和术后第一周心功能障碍之间的关系。40例连续入院的急性SAH患者没有已知的心脏疾病。入院时、第1天（D1）和第7天（D7）记录儿茶酚胺血浆浓度和经胸超声心动图（TTE）。基线时，24例患者的世界神经外科学会联合会评分（WFNS）为1或2分；其余16人的WFNS在3到5之间。20例患者入院时出现心功能障碍，其中6例为左室收缩期舒张功能障碍，14例为纯左室舒张功能障碍。入院时，WFNS评分高的患者和心功能改变的患者血浆去甲肾上腺素、肾上腺素、多巴胺、b型利钠肽（BNP）和肌钙蛋白Ic （cTnI）水平较高（均P <0.05）。在心脏损伤患者中，13例患者心功能在一周内恢复，7例患者持续左室舒张功能不全（P = 0.002）。血浆BNP、cTnI和儿茶酚胺水平在D1和D7之间向正常值下降。我们的研究结果表明，SAH后早期出现的心功能障碍与内源性儿茶酚胺的快速和持续释放和WFNS评分有关。sah诱导的心功能障碍在第一周消退，并与儿茶酚胺浓度的正常化平行。
The 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. Forty 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). At 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. Our 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.
登录
查看更多内容
DOI：
10.1186/cc7891
发表时间：
2009
期刊：
Critical care (London, England)
影响因子：
--
作者：
Meaudre E;Jego C;Kenane N;Montcriol A;Boret H;Goutorbe P;Habib G;Palmier B
通讯作者：
Palmier B
影响因子：
8.3
作者：
Hravnak M;Frangiskakis JM;Crago EA;Chang Y;Tanabe M;Gorcsan J 3rd;Horowitz MB
通讯作者：
Horowitz MB
影响因子：
11.2
作者：
Menke, Jan;Larsen, Joerg;Kallenberg, Kai
通讯作者：
Kallenberg, Kai
影响因子：
120.7
作者：
Redfield, MM;Jacobsen, SJ;Rodeheffer, RJ
通讯作者：
Rodeheffer, RJ
影响因子：
2.8
作者：
Tanabe, Masaki;Crago, Elizabeth A.;Suffoletto, Matthew S.;Hravnak, Marilyn;Frangiskakis, J. Michael;Kassam, Amin B.;Horowitz, Michael B.;Gorcsan, John, III
通讯作者：
Gorcsan, John, III