Left ventricular systolic dysfunction (LVEF < 50%) occurred in 15% of patients after subarachnoid hemorrhage, with recovery of LV function observed in 66% of patients.
Observational (n=173)
What is the incidence, time course, recovery rate, and segmental pattern of left ventricular dysfunction in patients with subarachnoid hemorrhage?
Left ventricular systolic dysfunction occurs frequently after subarachnoid hemorrhage, typically affects basal and mid anteroseptal/anterior walls, and usually improves over time.
OBJECT: 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.
Banki et al. (2006) conducted an observational in subarachnoid hemorrhage (n=173). Left ventricular systolic dysfunction (LVEF < 50%) occurred in 15% of patients after subarachnoid hemorrhage, with recovery of LV function observed in 66% of patients.