Left ventricular Wall Motion and Cateecholamines with Subarachnoid Hemorrhage

  • Dr Risako Fujiwara, Reseach Reseach Institute for Brain and Blood Vessels-Akita, Japan
  • Dr Manabu Izumi, Reseach Institute for Brain and Blood Vessels-Akita, Japan
  • Dr Yukihiko Ono, Reseach Institute for Brain and Blood Vessels-Akita, Japan
  • Dr Satoshi Kibira, Kibira Medical Clinic, Japan
  • Dr Hiroshi Itoh, Department of Internal Medicine Division of Cardiovascular and Respiratory Medicine Akita University School of Me, Japan

    • Purpose: Left ventricular wall motion with subarachnoid hemorrhage (SAH) is sometimes disturbed, for example takotsubo cardiomyopathy, but wall motion has not been established clearly. This study was performed to clarify left ventricular wall motion pattern and cathecolamines with SAH.
    Method: We studied 91 patients with SAH using transthoracic echocardiography to evaluate left ventricular wall motion within 24 hour of onset SAH and followed until motion normalized, and divided 2groups, left ventricular wall motion disturbed(D) and normal(N) on admission.We checked creatine kinase(CK), other myocardial enzymes, renin, aldosterone, cathecolamines, human atrial natriuretic peptide and brain natriuretic peptide (BNP).
    Results: There were 8 patients in groupD , included 4 takotsubo pattern patients. Ejection fraction(EF) was higher and left ventricular(LV) systolic diameter was smaller and LV inflow pattern, E/A was higher in groupN than groupD (p<0.01~0.05). CK-MB, troponin T and BNP were higher in groupD than groupN (p<0.05), adrenaline was higher in groupN than groupD, other parameters ware higher in group D than groupN but not significant. Cathecolamines tend to increase with worsening SAH grade, only adrenaline was parallel with EF of group N on SAH grade,but not with that of group D. LV dysfunction were not matched with SAH grade nor serum cathecolamines .
    Conclusion: There is left ventricular wall motion disturbed with SAH, and wall motion dysfunction and neurohumoral parameters are not matched with SAH grade.