Letter regarding article by Banki et al., "Acute neurocardiogenic injury after subarachnoid hemorrhage.".
نویسنده
چکیده
“Acute Neurocardiogenic Injury After Subarachnoid Hemorrhage” To the Editor: In their stimulating article, Banki et al1 showed that the left ventricular dysfunction found in a third of the patients studied with subarachnoid hemorrhage (SAH) is associated with an abnormal sympathetic innervation and a release of cardiac enzymes despite a normal myocardial perfusion. Interestingly, the neurocardiogenic injury after SAH shares some features in common with stress cardiomyopathy (SC).2 Both have high levels of plasma catecholamine associated with regional wall motion abnormalities and sympathetic regional denervation.1,3 For these striking similarities, the authors should provide more information about (a) the amount of the increase in catecholamine concentration (is this similar to that of SC?) and (b) whether the wall motion abnormalities localized in the apical region, and whether these recover in a period of a few months, as in SC? Last but not least, women more often than men are affected by SAH4 and represent the vast majority of SC.2 I wonder if the abnormalities found are instead due to a form of SC triggered by and not belonging specifically to the SAH picture. Women indeed represent 78% of this study population, and, in the settings of SAH, female gender is known to be more susceptible than male to QT prolongation and hypokalemia, all indirect signs of an important sympathetic activation.5 Disclosures None.
منابع مشابه
Letter by Yeo et al regarding article, "Time-dependent test characteristics of head CT in patients suspected of nontraumatic subarachnoid hemorrhage".
متن کامل
Acute neurocardiogenic injury after subarachnoid hemorrhage.
BACKGROUND Left ventricular (LV) systolic dysfunction has been reported in humans with subarachnoid hemorrhage (SAH), and its underlying pathophysiology remains controversial. Possible mechanisms include myocardial ischemia versus excessive catecholamine release from sympathetic nerve terminals. METHODS AND RESULTS For 38 months, echocardiography and myocardial scintigraphy with technetium se...
متن کاملNeurocardiogenic injury in subarachnoid hemorrhage: A wide spectrum of catecholamin-mediated brain-heart interactions.
BACKGROUND The purpose of this review was to summarize the up-to-date knowledge on clinical presentation and management of neurocardiogenic injury and to deliver the evidence of common pathophysiology of this broad spectrum of disorders. METHODS Medline and EmBase databases were searched to obtain original research articles and review papers using the following key words: neurocardiogenic inj...
متن کاملProspective analysis of prevalence, distribution, and rate of recovery of left ventricular systolic dysfunction in patients with subarachnoid hemorrhage.
OBJECT Subarachnoid hemorrhage (SAH) has been associated with cardiac injury and left ventricular (LV) dysfunction. The incidence and natural history of neurocardiogenic injury after SAH remains poorly understood. The objective of this study was to describe the incidence, time course, recovery rate, and segmental patterns of LV dysfunction after SAH. METHODS Echocardiography was performed thr...
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Letter by Reddy et al Regarding Article, “Cannabis Use and Outcomes in Patients With Aneurysmal Subarachnoid Hemorrhage” To the Editor: We read with great interest the article by Behrouz et al. In light of recent movements for widespread legalization of recreational marijuana, the adverse effects of cannabis remain a pressing area of research. Behrouz et al present a retrospective cohort analys...
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عنوان ژورنال:
- Circulation
دوره 113 18 شماره
صفحات -
تاریخ انتشار 2006