心臓のトロポニン値上昇,心血管疾患,および下arachnoid出血後の結果
Andrew M Naidech1, Kurt T Kreiter, Nazli Janjua
1Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Circulation
|November 4, 2005
まとめ
サバラクノイド出血 (SAH) の後の心臓トロポニンI (cTI) の上昇は一般的であり,神経原性心筋損傷に関連しています. 高いCTIレベルは,心肺疾患のリスクの増加と,退院時のより悪い結果と相関しています.
科学分野:
- 心臓病学 心臓病学
- 神経学 神経学とは
- クリティカルケア・メディシン
背景:
- 心臓トロポニンI (cTI) の放出は,下頭下出血 (SAH) の後に頻繁に行われ,神経原性心筋損傷を示唆する.
- これらのcTI上昇の予後的意義はよく定義されていません.
研究 の 目的:
- サバラクノイド出血後の心臓のトロポニンI値上昇の臨床的影響と予後的意義を調査する.
主な方法:
- シリアルCTI測定は,心臓損傷の臨床的またはECGの徴候を有する253人のSAH患者に実施されました.
- 病院でのイベントと3ヶ月のアウトカム (修正されたランキンスケール) を前向きに記録しました.
- ピークのcTIレベルは,さまざまな臨床およびエコーカルディオグラフィックパラメータに関連して分析されました.
主要な成果:
- cTI上昇の入院予測要因には,臨床グレードが低い,心室内出血,意識喪失が含まれていました.
- ピークのCTIレベルは,左心室機能不全,肺腫,低血圧,遅延性脳不全のリスクの増加と関連していました.
- 増加したCTIは,入院中の死亡または重度の障害を予測した (調整されたOR,1.4 per quintile; P=0.02).
結論:
- SAH後の心臓トロポニンIの上昇は,心肺合併症のより高いリスクと関連しています.
- また,CTIの上昇は,遅延性脳缺血および退院時の機能的アウトカムが悪化することとも関連しています.
関連する概念動画
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
1.2K
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
1.2K
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
765
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
765
01:30Acute Coronary Syndrome I: Introduction
2.1K
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
2.1K
01:30Acute Coronary Syndrome III: Diagnostic Studies
495
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
495
01:17Hemorrhagic Stroke l: Introduction
20
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
20
01:29Hemorrhagic Stroke ll: Pathophysiology
30
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
30