title: Prospective analysis of prevalence, distribution, and rate of recovery of left ventricular systolic dysfunction in patients with subarachnoid hemorrhage.
abstract: OBJECTIVE
  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 three times over a 7-day period in 173 patients with SAH. The incidence of global (ejection fraction [EF] < 50%) and segmental (any regional wall-motion abnormality [RWMA]) LV dysfunction was measured. The time course of LV dysfunction was determined by comparing the prevalence of LVEF less than 50% and RWMA at 0 to 2, 3 to 5, and 6 to 8 days after SAH. The recovery rate was defined as the proportion of patients with partial or complete normalization of function. The distribution of RWMAs among 16 LV segments was also determined. An LVEF less than 50% was found in 15% of patients, and 13% had an RWMA with a normal LVEF. There was a trend toward increased dysfunction at 0 to 2 days after SAH, compared with 3 to 8 days after SAH. Recovery of LV function was observed in 66% of patients. The most frequently abnormal LV segments were the basal and middle ventricular portions of the anteroseptal and anterior walls. The apex was rarely affected.
  
  
  CONCLUSIONS
  Left ventricular systolic dysfunction occurs frequently after SAH and usually improves over time. The observed segmental patterns of LV dysfunction often do not correlate with coronary artery distributions.
authors.affiliation: Division of Cardiology, University of California, San Francisco Medical Center, San Francisco, California, USA.
authors.forename: Nader
authors.initials: N
authors.lastname: Banki
authors.forename: Alexander
authors.initials: A
authors.lastname: Kopelnik
authors.forename: Poyee
authors.initials: P
authors.lastname: Tung
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lawton
authors.forename: Daryl
authors.initials: D
authors.lastname: Gress
authors.forename: Barbara
authors.initials: B
authors.lastname: Drew
authors.forename: Michael
authors.initials: M
authors.lastname: Dae
authors.forename: Elyse
authors.initials: E
authors.lastname: Foster
authors.forename: William
authors.initials: W
authors.lastname: Parmley
authors.forename: Jonathan
authors.initials: J
authors.lastname: Zaroff
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D013997:Time Factors; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology*