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Prognostic Value of Echocardiography for Left Ventricular Dysfunction After Aneurysmal Subarachnoid Hemorrhage: A

Wonhee Kim1, Kyu-Sun Choi2, Taeho Lim3

  • 1Department of Emergency Medicine, College of Medicine, Hallym University, Seoul, Republic of Korea.

World Neurosurgery
|March 19, 2019
PubMed

Insights

Left ventricular dysfunction, including regional wall motion abnormalities and neurogenic cardiomyopathy, after subarachnoid hemorrhage (SAH) predicts higher in-hospital mortality. Echocardiography can identify these risks.

Area of Science:

  • Cardiology
  • Neurology
  • Critical Care Medicine

Background:

  • Cardiac dysfunction is a known complication of aneurysmal subarachnoid hemorrhage (SAH).
  • Left ventricular dysfunction can significantly impact patient outcomes following SAH.
  • Accurate prognostic markers are crucial for managing SAH patients.

Purpose of the Study:

  • To quantitatively assess the prognostic value of left ventricular dysfunction.
  • To evaluate the association between echocardiographic findings and functional outcomes/mortality in aneurysmal SAH.
  • To determine if specific echocardiographic markers predict in-hospital mortality.

Main Methods:

  • A systematic literature search was conducted on MEDLINE and EMBASE.
  • Fourteen observational studies involving 2234 patients with aneurysmal SAH were included.
  • Meta-analysis was used to evaluate echocardiographic left ventricular dysfunction markers.

Main Results:

  • Regional wall motion abnormalities (RWMA) and neurogenic cardiomyopathy (NCM) were significantly associated with increased in-hospital mortality (OR 2.37 and 2.82, respectively).
  • Decreased ejection fraction did not show a significant association with in-hospital mortality (OR 1.76).
  • Heterogeneity for decreased ejection fraction and NCM was reduced when analyzing studies with echocardiograms within 72 hours.

Conclusions:

  • Echocardiographic identification of RWMA and NCM provides valuable prognostic information for in-hospital mortality in SAH patients.
  • These findings highlight the importance of echocardiography in risk stratification after aneurysmal SAH.
  • Further research may refine the role of specific echocardiographic parameters in SAH management.
Abstract

Keywords:
EchocardiographyMeta-analysisMortalityPrognosisSubarachnoid hemorrhage

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