Key result
Elevated peak levels of hsTnT and NT-proBNP significantly correlated with poor SAH grade, abnormal ECG, and reduced ejection fraction (P=0.000) in patients with aneurysmal subarachnoid hemorrhage.
Why the study?
Acute cardiac complications commonly occur in aneurysmal subarachnoid hemorrhage patients, motivating evaluation of hsTnT and NT-proBNP for early identification of cardiac dysfunction.
Do serial measurements of hsTnT and NT-proBNP predict early myocardial dysfunction in patients with aneurysmal subarachnoid hemorrhage?
Observational (n=69)
Do serial measurements of hsTnT and NT-proBNP predict early myocardial dysfunction in patients with aneurysmal subarachnoid hemorrhage?
p-value: p=0.000
Elevated peak levels of hsTnT and NT-proBNP correlate with ECG and echocardiographic abnormalities, aiding in the early identification of myocardial injury in patients with aneurysmal subarachnoid hemorrhage.
May aid early myocardial injury detection in aneurysmal SAH; leaves open whether serial hsTnT/NT-proBNP predict dysfunction.
Background: Acute cardiac complications are commonly seen in aneurysmal subarachnoid hemorrhage (aSAH) patients and may vary from subclinical electrocardiographic abnormalities, or reduced ejection fraction on echocardiography, elevated levels of cardiac markers (cardiac troponin and Brain natriuretic peptide) to heart failure. Objective: This study was done to evaluate the role of cardiac markers (high-sensitive Troponin-T and N-terminal pro-B-type natriuretic peptide) in early identification of cardiac complications and hence dysfunction. Methods: All consecutive patients with aSAH without any previous cardiac history were included. At admission, neurological evaluation using Hunt and Hess grading (H and H grade), with electrocardiography to look for any changes, echocardiography for ejection fraction, and any wall motion abnormalities was also done. The serial serum levels of high-sensitive Troponin-T (hsTnT) and N-terminal pro B-type natriuretic peptide (NT pro-BNP) for 7 consecutive days was measured with hsTnT >0.14 ng/ml and NT pro-BNP >150 pg/mL considered elevated. Results: A total of 69 patients were included. The elevated peak level of hsTnT and NT pro-BNP was seen in 55.1% and 69.6% of patients. A positive correlation was seen between hsTnT (P = 0.033) and NT pro-BNP (P = 0.011) and poor SAH grade (H and H grade 3-5), similarly, abnormal ECG also significantly correlated with elevated peak hsTnT (P = 0.002) and NT proBNP (P = 0.000). Also, significant difference in peak hsTnT (P = 0.000) and NT-proBNP (P = 0.000) in patients with or without reduced ejection fraction (EF). Conclusion: The elevated peak levels of hsTnT and NTproBNP along with ECG and echocardiography abnormalities may help in early identification of myocardial injury, hence cardiac dysfunction.
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Sharma et al. (2022) conducted an observational in Aneurysmal subarachnoid hemorrhage (n=69). Elevated high-sensitive Troponin-T and N-terminal pro B-type natriuretic peptide vs. Normal biomarker levels was evaluated on Reduced ejection fraction, abnormal ECG, and poor SAH grade (p=0.000). Elevated peak levels of hsTnT and NT-proBNP significantly correlated with poor SAH grade, abnormal ECG, and reduced ejection fraction (P=0.000) in patients with aneurysmal subarachnoid hemorrhage.