title: Age and aneurysm position predict patterns of left ventricular dysfunction after subarachnoid hemorrhage.
abstract: Cardiac injury, including left ventricular dysfunction, frequently occurs in patients with subarachnoid hemorrhage. Patterns of left ventricular dysfunction often do not follow coronary artery distributions, and may correlate with myocardial sympathetic innervation. Left ventricular dysfunction of the anterior and anteroseptal walls that spares the apex is unusual for patients with myocardial infarction and may represent a neurally mediated pattern of injury. We performed serial echocardiography on 225 patients with subarachnoid hemorrhage and classified those with regional wall-motion abnormalities as following either an apex-sparing (AS) or apex-affected (AA) pattern. Wall-motion abnormalities were found in 61 of 225 patients studied (27%). The AS pattern was found in 49% of these patients. Younger age and anterior aneurysm position were independent predictors of this AS pattern. Both patterns of wall-motion abnormalities appear to be transient, reversible phenomena. The AS pattern may represent a unique form of neurally mediated cardiac injury.
authors.affiliation: Division of Cardiology, Department of Radiology, University of California-San Francisco Medical Center, 505 Parnassus Avenue, San Francisco, CA 941243, USa.
authors.forename: Kiran
authors.initials: K
authors.lastname: Khush
authors.forename: Alexander
authors.initials: A
authors.lastname: Kopelnik
authors.forename: Poyee
authors.initials: P
authors.lastname: Tung
authors.forename: Nader
authors.initials: N
authors.lastname: Banki
authors.forename: Michael
authors.initials: M
authors.lastname: Dae
authors.forename: Michael
authors.initials: M
authors.lastname: Lawton
authors.forename: Wade
authors.initials: W
authors.lastname: Smith
authors.forename: Barbara
authors.initials: B
authors.lastname: Drew
authors.forename: Elyse
authors.initials: E
authors.lastname: Foster
authors.forename: Jonathan
authors.initials: J
authors.lastname: Zaroff
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013318:Stroke Volume; D013345:Subarachnoid Hemorrhage / Q000473:pathology* / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*