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2006 | 1 | 2 | 148-157
Tytuł artykułu

Abnormal ECG patterns during the acute phase of subarachnoid hemorrhage in patients without previous heart disease

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Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Subarachnoid hemorrhage (SAH) occurs primarily during early to mid-adulthood; approximately 30% of individuals with SAH die within 2 weeks, and mortality is 30% to 45%. SAH happens suddenly, without patients being aware of previous heart abnormalities. Here, we performed a pilot single cohort (historical) study to examine the hypothesis that early abnormal electrocardiographic (ECG) changes may reveal unknown but “silent” heart pathologies in SAH patients without previous heart disease (PHD). Data were collected retrospectively on 56 consecutive patients during the acute phase of SAH (29 men, 27 women; mean age 49.0 ± 6.2 years) with different degrees of neurologic deficit (Hunt-Hess scale assessment) in a 2-year period single-cohort study. Repolarization abnormalities were most frequent (p<0.05) and were independent of a history of PHD, although it corresponded to a higher risk for such abnormalities (odds ratio OR=3.21; CI95%=1.01–10.22). ECG changes in patients without PHD were similar to those in PHD patients, confirming the hypothesis that SAH is associated with previously “silent” heart pathology. The increased frequency of ECG changes in PHD patients and their high incidence in no-PHD patients suggested a neurogenic form of myocardial dysfunction following SAH. Notably, repolarization changes were more frequent in patients with less severe deficit (p<0.05), whereas rhythm and conductive abnormalities were more frequent in patients with more severe neurologic deficit.
Wydawca

Czasopismo
Rocznik
Tom
1
Numer
2
Strony
148-157
Opis fizyczny
Daty
wydano
2006-06-01
online
2006-06-01
Twórcy
  • Department of Cardiology, Medical University, 4000, Plovdiv, Bulgaria
  • Stroke Unit, Department of Neurology, Medical University, 4000, Plovdiv, Bulgaria
  • Stroke Unit, Department of Neurology, Medical University, 4000, Plovdiv, Bulgaria
  • Stroke Unit, Department of Neurology, Medical University, 4000, Plovdiv, Bulgaria
  • Information Services Section, Medical University Hospital ‘St. George’, 4000, Plovdiv, Bulgaria
Bibliografia
  • [1] C.E. Sommargren: “Electrocardiographic abnormalities in patients with subarchnoid hemorrhage”, Am. J. Crit. Care., Vol. 11(1), (2002), pp. 48–56.
  • [2] S. Homma and C. Grahame-Clarke: “Myocardial Damage in Patients With Subarachnoid Hemorrhage”, Stroke, Vol. 35, (2004), p. 552. http://dx.doi.org/10.1161/01.STR.0000117566.64450.DD[Crossref]
  • [3] J.J. De Oliviera and S.R. Silva: “Signs of myocardial ischemia associated with subarachnoid hemorrhage”, Arq. Bras. Cardiol., Vol. 67(6), (1996), pp. 403–406.
  • [4] C.E. Sommargren, J.C. Zaroff, N. Banki and B.J. Drew: “Electrocardiographic repolarization abnormalities in subarachnoid hemorrhage”, J. Electrocardiol., Vol. 35, (2002), pp. 257–262. http://dx.doi.org/10.1054/jelc.2002.37187[Crossref]
  • [5] J.G. Zaroff, G. Rordorf, J.B. Newell, C.S. Ogilvy and J.R. Levinson: “Cardiac outcome in patients with subarachnoid hemorrhage and electrocardiographic abnormalities”, Neurosurgery, Vol. 44(1), (1999), pp. 34–39. http://dx.doi.org/10.1097/00006123-199901000-00013[Crossref]
  • [6] J.M. Calvo-Romero, R. Fernandez De Soria-Pantoja, J.D. Arrebola-Garcia and M. Gil-Cubero: “Electrocardiographic abnormalities in subarachnoid hemorrhage”, Rev. Neurol., Vol. 32(6), (2001), pp. 536–537.
  • [7] P. Tung, A. Kopelnik, N. Banki, K. Ong, N. Ko, M.T. Lawton et al.: “Predictors of neurocardiogenic injury after subarachnoid hemorrhage”, Stroke, Vol. 35(2), (2004), pp. 548–551. http://dx.doi.org/10.1161/01.STR.0000114874.96688.54[Crossref]
  • [8] G. Khechinashvili and K. Asplund: “Electrocardiographic changes in patients with acute stroke: a systematic review”, Cerebrovasc. Dis., Vol. 14(2), (2002), pp. 67–76. http://dx.doi.org/10.1159/000064733[Crossref]
  • [9] A.A. Kothavale, N.M. Banki, A. Kopelnik et al.: “Predictors of left ventricular dysfunction after subarachnoid hemorrhage”, J. Am. Soc. Echocardiogr., Vol. 15, (2003), p. 530.
  • [10] J.L. Fleiss: Statistical Methods for Rates and Proportions, 2nd ed., John Wiley & Sons, 1981, pp. 23–24, 29–30.
  • [11] D. Cooke, A.H. Craven and G.M. Clarke: Basic Statistical Computing, 2nd ed., Edward Arnold, 1990, pp. 84–85.
  • [12] K.J. Rothman Modern Epidemiology, Little brown and Company, 1986, pp. 131–176.
  • [13] E. Kawahara, S. Ikeda, Y. Miyahara and S. Kohno: “Role of autonomic nervous disfunction in electrocardiographic abnormalities and cardiac injury in patients with acute subarachnoid hemorrhage”, Circ. J., 67(9), (2003), pp. 753–756. http://dx.doi.org/10.1253/circj.67.753[Crossref]
  • [14] C.S. Macmillan, I.S. Grant and P.J. Andrews: “Pulmonary and cardiac sequelae of subarachnoid hemorrhage: time for active management?”, Intensive Care Med., 28(8), (2002), pp. 1012–1023. http://dx.doi.org/10.1007/s00134-002-1382-7[Crossref]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_s11536-006-0018-7
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