Speckle tracking analysis allows sensitive detection of stress cardiomyopathy in severe aneurysmal subarachnoid hemorrhage patients.
In: Intensive Care Medicine, Jg. 42 (2016-02-01), Heft 2, S. 173-182
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Purpose: Stress cardiomyopathy is a common life-threatening complication after aneurysmal subarachnoid hemorrhage (SAH). We hypothesized that left ventricular (LV) longitudinal strain alterations assessed with speckle tracking could identify early systolic function impairment. Methods: This was an observational single-center prospective pilot controlled study conducted in a neuro-intensive care unit. Forty-six patients with severe SAH with a World Federation of Neurological Surgeons grade (WFNS) ≥ III were included. Transthoracic echocardiography (TTE) was performed on day 1, day 3, and day 7 after the patient's admission. A cardiologist blinded to the patient's management analyzed the LV global longitudinal strain (GLS). The control group comprised normal subjects matched according to gender and age. Results: On day 1 median (25th-75th percentile) GLS was clearly impaired in SAH patients compared to controls [-16.7 (-18.7/-13.7) % versus -20 (-22/-19) %, p < 0.0001], whereas LVEF was preserved [65 (59-70) %]. GLS was severely impaired in patients with a WFNS score of V versus III-IV [-15.6 (-16.9/-12.3) % versus -17.8 (-20.6/-15.8) %, p = 0.008]. Seventeen (37 %) patients had a severe GLS alteration (>- 16 %). In these patients, GLS improved from day 1 [-12.4 (-14.8/-10.9) %] to last evaluation [-16.2 (-19/-14.6) %, p = 0.0007] in agreement with the natural evolution of stress cardiomyopathy. Conclusions: On the basis of LV GLS assessment, we demonstrated for the first time that myocardial alteration compatible with a stress cardiomyopathy is detectable in up to 37 % of patients with severe SAH while LVEF is preserved. GLS could be used for sensitive detection of stress cardiomyopathy. This is critical because cardiac impairment remains a major cause of morbidity and mortality after SAH. [ABSTRACT FROM AUTHOR]
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Speckle tracking analysis allows sensitive detection of stress cardiomyopathy in severe aneurysmal subarachnoid hemorrhage patients.
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Autor/in / Beteiligte Person: | Cinotti, Raphaël ; Piriou, Nicolas ; Launey, Yoann ; Tourneau, Thierry ; Lamer, Maxime ; Delater, Adrien ; Trochu, Jean-Noël ; Brisard, Laurent ; Lakhal, Karim ; Bourcier, Romain ; Desal, Hubert ; Seguin, Philippe ; Mallédant, Yannick ; Blanloeil, Yvonnick ; Feuillet, Fanny ; Asehnoune, Karim ; Rozec, Bertrand ; Le Tourneau, Thierry |
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Zeitschrift: | Intensive Care Medicine, Jg. 42 (2016-02-01), Heft 2, S. 173-182 |
Veröffentlichung: | 2016 |
Medientyp: | academicJournal |
ISSN: | 0342-4642 (print) |
DOI: | 10.1007/s00134-015-4106-5 |
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