Cardiac dysfunction after aneurysmal subarachnoid hemorrhage: relationship with outcome.

Area of Science:

• Neurology
• Cardiology
• Critical Care Medicine

Background:

• Aneurysmal subarachnoid hemorrhage (aSAH) can lead to cardiac complications.
• The association between cardiac abnormalities and outcomes like delayed cerebral ischemia (DCI) after aSAH requires further investigation.

Purpose of the Study:

• To determine if cardiac abnormalities following aSAH are independently associated with DCI and clinical outcomes.
• To identify specific cardiac markers that predict adverse events after aSAH.

Main Methods:

• Prospective, multicenter cohort study involving 301 patients with aSAH.
• Echocardiography, ECG, and biochemical markers for myocardial damage were assessed.
• Multivariable Poisson regression and survival analysis were used to evaluate outcomes including DCI, death, and poor clinical outcome at 3 months.

Main Results:

• Wall motion abnormalities (WMAs) were associated with increased risk of death and poor outcome (RR 1.8-2.3).
• Midventricular WMAs showed a significant association with death (RR 2.3) and poor outcome (RR 2.2).
• While ECG changes and troponin levels correlated with death, they were not independent predictors.

Conclusions:

• Echocardiographic WMAs are independent risk factors for clinical outcomes after aSAH.
• The increased risk of DCI partially explains the association between WMAs and poor outcomes.
• Further research into treatment strategies for aSAH-related cardiac abnormalities is warranted to improve patient outcomes.