3 246

Cited 16 times in

Are electrocardiographic changes in patients with acute subarachnoid hemorrhage associated with Takotsubo cardiomyopathy?

 Jung J.-H.  ;  Min P.-K.  ;  Rim S.-J.  ;  Ha J.-W.  ;  Chung N.  ;  Lee K.-C. 
 CARDIOLOGY, Vol.115(2) : 98-106, 2010 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Echocardiography ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Norepinephrine/blood* ; Subarachnoid Hemorrhage/blood ; Subarachnoid Hemorrhage/diagnosis ; Subarachnoid Hemorrhage/etiology* ; Subarachnoid Hemorrhage/physiopathology ; Sympathetic Nervous System/physiopathology ; Takotsubo Cardiomyopathy/complications* ; Ventricular Dysfunction, Left*
Catecholamines ; Echocardiography ; Left ventricular dysfunction ; Subarachnoid hemorrhage ; Takotsubo cardiomyopathy
BACKGROUND: Subarachnoid hemorrhage (SAH) has been associated with electrocardiographic (ECG) changes, arrhythmias, and release of cardiac enzymes. Recently, Takotsubo cardiomyopathies, presenting typical ECG changes and left ventricular (LV) regional wall-motion abnormalities (RWMAs), have been reported and considered to be a result of high norepinephrine (NE) levels. We hypothesized that ST-T-wave changes in patients with SAH may be manifestations of Takotsubo cardiomyopathy and associated with RWMAs. METHODS: We instituted consecutive echocardiographic screening of all patients with acute aneurysmal SAH. A standard 12-lead ECG and blood samples for creatine kinase (CK) MB isoenzyme and troponin-T (Tn-T) were obtained. To evaluate sympathetic nervous activity, we obtained blood samples and urine samples for NE. RESULTS: Of 42 patients with acute aneurysmal SAH, 26 had abnormal ECG including rhythm abnormalities. Ten of 12 patients with ST-T-wave changes had severe neurologic deficits, but 1 patient had RWMAs on echocardiography. Another patient with LV dysfunction showed a normal ST-T wave. In patients with ST-T-wave changes, elevated Tn-T (8.3 vs. 3.3%), CK-MB (8.3 vs. 10.0%), plasma and urine NE (16.7 and 33.3% vs. 16.7 and 50.0%), and mortality (8.3 vs. 13.3%) were not significantly higher. All 5 deaths resulted from noncardiac causes. High plasma and urine NE levels were not related to neurologic severity or mortality. CONCLUSIONS: Although ECG abnormalities are frequently seen in SAH patients, the incidence of RWMAs is very low. Electrocardiographic manifestations in patients with SAH and Takotsubo cardiomyopathy are similar, but ECG abnormalities in patients with SAH are mostly not related to LV dysfunction.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Lee, Kyu Chang(이규창)
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Chung, Nam Sik(정남식)
Jung, Jae Hun(정재헌)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.