Age and aneurysm position predict patterns of left ventricular dysfunction after subarachnoid hemorrhage
Age and aneurysm position predict patterns of left ventricular dysfunction after subarachnoid hemorrhage
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DOI：
10.1016/j.echo.2004.08.045
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发表时间：
2005-02-01
影响因子：
6.5
通讯作者：
Zaroff, J
中科院分区：
文献类型：
--
作者：
Khush, K;Kopelnik, A;Zaroff, J
心脏损伤，包括左心室功能障碍，经常发生在蛛网膜下腔出血患者。左心室功能障碍的模式通常不遵循冠状动脉分布，可能与心肌交感神经支配有关。心肌梗死患者左心室前壁和前间隔壁功能障碍不常见，可能是一种神经介导的损伤模式。我们对225例蛛网膜下腔出血患者进行了连续超声心动图检查，并将出现局部壁运动异常的患者分为保留顶点型（as）和影响顶点型（AA）。研究的225例患者中有61例（27%）发现壁面运动异常。49%的患者有AS。年龄较小和前动脉瘤位置是这种AS模式的独立预测因素。两种壁面运动异常模式似乎都是短暂的、可逆的现象。AS模式可能代表了一种独特的神经介导的心脏损伤形式。
Cardiac injury, including left ventricular dysfunction, frequently occurs in patients with subarachnoid hemorrhage. Patterns of left ventricular dysfunction often do not follow coronary artery distributions, and may correlate with myocardial sympathetic innervation. Left ventricular dysfunction of the anterior and anteroseptal walls that spares the apex is unusual for patients with myocardial infarction and may represent a neurally mediated pattern of injury. We performed serial echocardiography on 225 patients with subarachnoid hemorrage and classified those with regional wall-motion abnormalities as following either an apex-sparing (AS) or apex-affected (AA) pattern. Wall-motion abnormalities were found in 61 of 225 patients studied (27%). The AS pattern was found in 49% of these patients. Younger age and anterior aneurysm position were independent predictors of this AS pattern. Both patterns of wall-motion abnormalities appear to be transient, reversible phenomena. The AS pattern may represent a unique form of neurally mediated cardiac injury.