Carrillo ER, García GM, Martínez HL

Language: Spanish
References: 15
Page: 196-200
PDF size: 209.51 Kb.

ABSTRACT

Neuromediated stunned myocardium is a complication of subarachnoid hemorrhage. The pathophysiology of this entity is secondary to massive release of catecholamines. It´s characterized by left-ventricular dysfunction and increased levels of Troponin I, Natriuretic peptide-B, mioglobin and CPK-MB. This alterations are not related to ischemic event and induced a clinical and echocardiographic manifestations of stunned myocardium. We report a case of subarachnoid hemorrhage, coexisting with ischemic electrocardiographic changes, increased cardiac-specific necrosis biomarkers and regional wall motion abnormalities.

REFERENCES

1. Ohtsuka T, Hamada T, Kodama K, Sasaki O, Suzuki M, Hara Y et al. Neurogenic stunned myocardium. Circulation 2000;101:2122-2124.

2. Sugimoto K, Watanabe E, Yamada A, Iwase M, Sano H, Hishida H et al. Prognostic implications of left ventricular wall motion abnormalities associated with subarachnoid hemorrhage. Int Heart J 2008;49:73-83.

3. Naidech MA, Kreiter KT, Janjua N, Ostapkovich ND, Parra A, Commichau C et al. Cardiac troponin elevation, cardiovascular morbidity, and outcome after subarachnoid hemorrhage. Circulation 2005;112:2851-2856.

4. Doshi R A, Neily G. Clinicopathological study of patients following a subarachnoid hemorrhage. J Neurosurg 1980;52:295-301.

5. Sommargren CE, Zaroff JG, Banki N, Drew BJ. Electrocardiographic repolarization abnormalities in subarachnoid hemorrhage. J Electrocardiol. 2002;35(suppl):257-262.

6. Tung P, Kopelnik A, Banki N, Ong K, Ko N, Lawton MT et al. Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Stroke 2004;35:548-551.

7. Ammann P, Maggiorini M, Bertel O, Haenseler E, Joller-Jemelka HI, Oechslin E. Troponin as a risk factor for mortality in critically ill patients without acute coronary syndromes. J Am Coll Cardiol 2003;41:2004-2009.

8. Pinto RJ, Goyal V, Sharma S, Bhagwati SN. Transient myocardial dysfunction in a patient with subarachnoid haemorrhage. Int J Cardiol 1994;46:289-291.

9. Hays A, Diringer MN. Elevated troponin levels are associated with higher mortality following intracerebral hemorrhage. Neurology 2006;66:1330-1334.

10. Parekh N, Venkatesh B, Cross D, Leditschke A, Atherton J, Miles W, et al. Cardiac troponin I predicts myocardial dysfunction in aneurysmal subarachnoid hemorrhage. J Am Coll Cardiol 2000;36:1328-1335.

11. Sato K. Left ventricular asynergy and myocardical necrosis accompanied by subarachnoid hemorrhage. J Cardiol 1990;20:359-367.

12. Chung PW, Won Y, Joon KY, Sik CC, Moon KV. Initial troponin level as a predictor of prognosis in patients with Intracerebral Hemorrhage. J Korean Neurosurg Soc 2009;45:355-359.

13. Gascon P, Ley TJ, Toltzis RJ, Bonow RO. Spontaneous subarachnoid hemorrhage simulating acute transmural myocardial infarction. Am Heart J 1983;105:511-513.

14. Mayer S, Lin J, Homma S, Solomon R, Lenihan R, Sherman D, et al. Myocardial injury and left ventricular performance after subarachnoid hemorrhage. Stroke 1999;30;780-786.

15. Meaudre E, Jego C, Kenane N, Montcriol A, Boret H, Goutorbe P, et al. B-type natriuretic peptide release and left ventricular filling pressure assessed by echocardiographic study after subarachnoid hemorrhage: a prospective study in non-cardiac patients. Critical Care 2009;13:R76.