title: CSF catecholamine profile in subarachnoid hemorrhage patients with neurogenic cardiomyopathy.
abstract: BACKGROUND
  Patients experiencing apoplectic intracranial processes may develop neurogenic cardiomyopathy (NC). The purpose of this research is to determine whether cerebrospinal fluid (CSF) catecholamine levels are elevated in subarachnoid hemorrhage (SAH) patients with NC when compared to those without NC.
  
  
  METHODS
  Observational study of consecutive grades 3-5 SAH patients requiring ventriculostomy. All patients underwent CSF sampling for catecholamine levels, and transthoracic echocardiography (TTE) to assess for NC, within 48 h of SAH onset. Univariate analyses were performed to identify clinical and laboratory variables associated with NC. Clinical variables associated with NC in the univariate analysis were entered into logistic regression models along with the candidate catecholamine variables to identify predictors of NC.
  
  
  RESULTS
  The study group contained 100 patients--mean age of study subjects was 58 years, 73% were female, and 15% developed NC. NC patients were more likely to have a worse clinical grade than patients without NC (80 vs. 34%, P = 0.001). NC patients possessed greater DOPA levels (5.83 vs. 4.60 nmol/l, P = 0.044), and a trend toward greater noradrenergic activity as determined by NE/DHPG ratio (0.3799 vs. 0.2519, P = 0.073). Multivariate analysis identified worse clinical grade (OR 7.09, P = 0.005) and possibly NE levels (OR 1.005, P = 0.057) as independent predictors of NC. Bivariate analysis reinforced the findings for NE (OR 1.006, P = 0.022), and also identified DOPA levels (OR 1.001, P = 0.034) and NE/DHPG (OR 22.18, P = 0.019) as predictors of NC.
  
  
  CONCLUSIONS
  SAH patients with NC tend to have greater CSF catecholamine levels than those without NC. However, the development of NC may also be related to factors not evaluated by our study.
authors.affiliation: Cerebrovascular and Neurocritical Care Division, Thomas Jefferson Medical Center, 900 Walnut Street, Suite 200, Philadelphia, PA 19107, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Moussouttas
authors.forename: Edwin W
authors.initials: EW
authors.lastname: Lai
authors.forename: Keith
authors.initials: K
authors.lastname: Dombrowski
authors.forename: Thanh T
authors.initials: TT
authors.lastname: Huynh
authors.forename: John
authors.initials: J
authors.lastname: Khoury
authors.forename: Gilberto
authors.initials: G
authors.lastname: Carmona
authors.forename: Matthew
authors.initials: M
authors.lastname: DeCaro
authors.forename: Karel
authors.initials: K
authors.lastname: Pacak
mesh_terms: D015102:3,4-Dihydroxyphenylacetic Acid / Q000134:cerebrospinal fluid; D000368:Aged; D009202:Cardiomyopathies / Q000134:cerebrospinal fluid*; D002395:Catecholamines / Q000134:cerebrospinal fluid*; D004295:Dihydroxyphenylalanine / Q000134:cerebrospinal fluid; D004298:Dopamine / Q000134:cerebrospinal fluid; D004452:Echocardiography; D004837:Epinephrine / Q000134:cerebrospinal fluid; D005260:Female; D006321:Heart / Q000294:innervation; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000031:analogs & derivatives / Q000134:cerebrospinal fluid; D008875:Middle Aged; D009638:Norepinephrine / Q000134:cerebrospinal fluid; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid* / Q000150:complications* / Q000601:surgery; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy
chemical_list: D002395:Catecholamines; D015102:3,4-Dihydroxyphenylacetic Acid; D008734:Methoxyhydroxyphenylglycol; D004295:Dihydroxyphenylalanine; C010117:3,4-dihydroxyphenylglycol; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine