scholarly journals Pulmonary Edema and Cardiac Dysfunction Following Subarachnoid Hemorrhage

2005 ◽  
Vol 32 (2) ◽  
pp. 178-185 ◽  
Author(s):  
Nancy McLaughlin ◽  
Michel W. Bojanowski ◽  
François Girard ◽  
André Denault
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cardiac Function ◽  
Pulmonary Edema ◽  
Cardiac Dysfunction ◽  
Early Onset ◽  
Chart Review ◽  
Cardiac Involvement ◽  
Ventricular Dysfunction ◽  
Retrospective Chart Review ◽  
Late Period

ABSTRACT:Background:Pulmonary edema (PE) can occur in the early or late period following subarachnoid hemorrhage (SAH). The incidence of each type of PE is unknown and the association with ventricular dysfunction, both systolic and diastolic, has not been described.Methods:Retrospective chart review of 178 consecutive patients with SAH surgically treated over a three-year period. Patients with pulmonary edema diagnosed by a radiologist were included. Early onset SAH was defined as occurring within 12 hours. Cardiac function at the time of the PE was analyzed using hemodynamic and echocardiographic criteria of systolic and diastolic dysfunction. Pulmonary edema was observed in 42 patients (28.8%) and was more often delayed (89.4%). Evidence of cardiac involvement during PE varied between 40 to 100%.Results and conclusions:Pulmonary edema occurs in 28.8% of patients after SAH, and is most commonly delayed. Cardiac dysfunction, both systolic and diastolic, is commonly observed during SAH and could contribute to the genesis of PE after SAH.

A Cohort Comparison Analysis of Fixed Pressure Ventriculoperitoneal Shunt Valves With Programmable Valves for Hydrocephalus Following Nontraumatic Subarachnoid Hemorrhage

2019 ◽  
Author(s):  
Eduardo Orrego-González ◽  
Alejandro Enriquez-Marulanda ◽  
Luis C Ascanio ◽  
Noah Jordan ◽  
Khalid A Hanafy ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Ventriculoperitoneal Shunt ◽  
Chart Review ◽  
External Ventricular Drain ◽  
Retrospective Chart Review ◽  
Comparison Analysis ◽  
Replacement Rate ◽  
Ventriculoperitoneal Shunts ◽  
Initial Hospitalization ◽  
Programmable Valves

Abstract BACKGROUND Hydrocephalus after nontraumatic subarachnoid hemorrhage (SAH) is a common sequela that may require the placement of ventriculoperitoneal shunts (VPS). Adjustable-pressure valves (APVs) are being widely used in this situation though more expensive than differential-pressure valves (DPVs). OBJECTIVE To compare outcomes between APV and DPV in SAH-induced hydrocephalus. METHODS We performed a retrospective chart review of patients with nontraumatic SAH who underwent VPS placement for the treatment of hydrocephalus after SAH, between July 2007 and December 2016. Patients were classified according to the type of valve (APV vs DPV). We evaluated factors that could predict the type of valve used, outcomes in VPS revision/replacement rate, and complications. RESULTS A total of 66 patients underwent VPS placement who were equally distributed into the 2 groups of valves. VPS failure with the need for revision/replacement occurred in 13 (19.7%) cases. Ten (30.3%) patients with DPV had a VPS failure, while 3 (9.1%) patients with an APV had a similar failure with the need for revision/replacement (P = .03). VPS placement before discharge during the initial hospitalization (P = .02) was statistically significant associated with the use of a DPV, while the reason of external ventricular drain (EVD) failure (P = .03) was associated with the use of an APV. CONCLUSION APVs had a lower rate of surgical revisions compared to DPVs. Early placement of VPS was associated with the use of a DPV. The need for EVD replacement due to EVD infection or malfunction was associated with higher rates of APV use.

Transient left bundle branch block and left ventricular dysfunction in a patient with NLRP1-associated autoinflammation with arthritis and dyskeratosis syndrome

2019 ◽  
Vol 29 (3) ◽  
pp. 435-438
Author(s):  
Mark R. Garrelfs ◽  
Esther Hoppenreijs ◽  
Ronald B. Tanke
Keyword(s):  
Left Bundle Branch Block ◽  
Cardiac Dysfunction ◽  
Cardiac Involvement ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
High Dose ◽  
Impaired Left Ventricular Function ◽  
Autoinflammatory Disorder ◽  
Bundle Branch Block ◽  
High Dose Methylprednisolone

AbstractThe NLRP1-associated autoinflammation with arthritis and dyskeratosis syndrome is a rare novel autoinflammatory disorder. Cardiac involvement has not been previously reported. We present a 12-year-old girl with NLRP1-associated autoinflammation with arthritis and dyskeratosis syndrome who was diagnosed with severely impaired left ventricular function and complete left bundle branch block during an exacerbation of the disease. Cardiac dysfunction proved to be rapidly reversible after initiation of high-dose methylprednisolone.

scholarly journals Cerebrolysin for the Treatment of Aneurysmal Subarachnoid Hemorrhage in Adults: A Retrospective Chart Review

2018 ◽  
Vol 35 (12) ◽  
pp. 2224-2235 ◽  
Author(s):  
Yung Ki Park ◽  
Hyeong-Joong Yi ◽  
Kyu-Sun Choi ◽  
Young-Jun Lee ◽  
Dong-Won Kim ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Chart Review ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Retrospective Chart Review

Advantages of Resuscitation with Balanced Hypertonic Sodium Solution in Disasters

1985 ◽  
Vol 1 (S1) ◽  
pp. 179-180
Author(s):  
Joseph M. Civetta ◽  
Charles L. Fox
Keyword(s):  
Cardiac Function ◽  
Pulmonary Edema ◽  
Clinical Experience ◽  
Surgical Procedures ◽  
Early Onset ◽  
Sodium Acetate ◽  
Wound Care ◽  
Surgical Trauma ◽  
Ringer’S Lactate ◽  
Sodium Solution

Resuscitation in disasters must be effective, prompt, safe and uncomplicated. Clinical experience in severe, extensive thermal burns in numerous clinics has shown that balanced hypertonic sodium solution (BHSS) can achieve effective resuscitation with: administration of less volume of fluid; early onset of excretion of sodium-containing urine; less generalized edema and without pulmonary edema. This experience is now being transferred to patients after trauma and major surgical procedures often complicated by peritonitis. In an ongoing study of randomly selected adults following surgical trauma, either Ringer's lactate (RL) or the BHSS (0.9% NaCl plus 100ml of one molar sodium acetate, total 1100ml yielding Na230, Cl 140, acetate 90mEq/l) was administered. All patients received daily (or more frequent) electrolyte and osmotic analyses of plasma and urine, continuous ICU monitoring of pulmonary and cardiac function, and similar wound care.

Abstract 41: Cardiomyocyte-specific Conditional Deletion of GSK-3β Leads to Cardiac Dysfunction in a High Fat Diet Induced Obesity Model

2017 ◽  
Vol 121 (suppl_1) ◽  
Author(s):  
Manisha Gupte ◽  
Samvruta Tumuluru ◽  
Anand P Singh ◽  
Prachi Umbarkar ◽  
Qinkun Zhang ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Fat Mass ◽  
Cardiac Dysfunction ◽  
High Fat Diet ◽  
Ventricular Dysfunction ◽  
Heart Weight ◽  
High Fat ◽  
Apoptotic Protein ◽  
Gsk 3Β

Introduction: Previous studies from our group have demonstrated that cardiac myocyte glycogen synthase kinase-3’s (GSK-3) are required to maintain normal cardiac physiology. Adult mice lacking both isoforms of GSK-3 (α and β) in cardiac myocytes exhibit excessive dilatative remodeling and ventricular dysfunction ultimately leading to death. While high fat diet (HFD) induced obesity is associated with increased risk of cardiovascular disease, the specific role of cardiac GSK-3α or GSK-3β in obesity-associated cardiac dysfunction is unknown. Objective: The primary goal of the present study was to investigate the role of cardiomyocyte GSK-3β in cardiac homeostasis in HFD-induced chronic obesity model. Method: Cardiomyocyte specific-GSK-3β knock out (CM-GSK-3βKO) and wild type (WT) mice were fed either a chow (11.5% calories from fat) or high-fat (60% calories from fat) for 24 weeks. Cardiac function was accessed by non-invasive transthoracic echocardiography. Results: HFD significantly increased body weight, lean and fat mass in the WT and CM-GSK-3βKO compared to chow. However, there was no difference in body weights, lean and fat mass between the two genotypes fed either a chow or HFD. Furthermore, ventricular chamber dimensions and cardiac function were comparable between the WT and CM-GSK-3βKO mice fed a chow diet. In contrast, high fat fed CM-GSK-3βKO hearts exhibit significant cardiac hypertrophy (heart weight/tibia length ratio) and ventricular dysfunction (reduced ejection fraction (EF) and fractional shortening (FS)) compared to the WT. Interestingly cardiomyocytes from HF fed CM-GSK-3βKO exhibit structural abnormalities and increased expression of pro-apoptotic protein Bax and reduced expression of Bcl-2, an anti-apoptotic protein. Conclusion: In summary, these data suggests that cardiac GSK-3β is important in the setting of HFD-induced chronic obesity to maintain cardiac function. In the absence of GSK-3β, cardiomyocytes undergo morphometric abnormalities, excessive fat infiltration and apoptosis leading to cardiac dysfunction.

scholarly journals Correction to: Cerebrolysin for the Treatment of Aneurysmal Subarachnoid Hemorrhage in Adults: A Retrospective Chart Review

2019 ◽  
Vol 36 (6) ◽  
pp. 1509-1509
Author(s):  
Yung Ki Park ◽  
Hyeong-Joong Yi ◽  
Kyu-Sun Choi ◽  
Young-Jun Lee ◽  
Dong-Won Kim ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Chart Review ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Retrospective Chart Review

Abstract 3456: Incidence of Vasospasm and Outcomes in Angiography-negative Perimesencephalic Subarachnoid Hemorrhage with and without Ventricular Extension

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Bryan J Bonder ◽  
Edwin A Vargas ◽  
Richard Jung ◽  
Jitendra Sharma ◽  
Kristine A Blackham
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Scale Score ◽  
Chart Review ◽  
Clinical Symptoms ◽  
Retrospective Chart Review ◽  
Modified Rankin Scale ◽  
Perimesencephalic Subarachnoid Hemorrhage ◽  
Fisher Grade ◽  
Increased Risk ◽  
Discharge Summaries

Background: Angiography negative perimesencephalic subarachnoid hemorrhage (SAH) is considered a relatively benign entity compared to aneurysmal SAH. However, some patients with angiography negative perimesencephalic subarachnoid hemorrhage with extension of hemorrhage beyond the perimesencephalic area are at increased risk for vasospasm. Here we present a series of 21 patients with angiography negative perimesencephalic pattern of SAH both with and without ventricular extension and describe their incidence of vasospasm and clinical outcomes. Methods: Retrospective chart review was performed among patients who underwent invasive angiography from 8/2007-6/2010. Inclusion criteria were presenting clinical symptoms typical of SAH, computed tomography (CT) evidence of perimesencephalic SAH with or without ventricular extension, no recent trauma or stroke, and cerebral angiography negative for aneurysm or arteriovenous malformation. 21 patients, 8 men and 13 women, with a mean age of 55.1 years met these criteria. The presenting CTs were examined and a modified Fisher Grade assigned. The patients’ clinical course was reviewed for incidence and treatment of vasospasm. The patients’ discharge summaries were evaluated and each patient given a modified Rankin Scale score. Results: The modified Fisher Scale score derived from the presenting CT was 1 for 29% (n=6), 2 for 5% (n=1), 3 for 19% (n=4), and 4 for 47% (n=10) of the patients. Amongst the 52% (n=11) of patients with intraventricular hemorrhage as defined by a modified Fisher Scale score of 2 or 4, 24% (n=5) developed angiographical evidence of vasospasm. 10% (n=2) of the patients required intra-arterial verapamil. 90% (n=9) of patients without intraventricular extension had good outcomes at discharge as defined by modified Rankin Scale score less than or equal to 2, while only 36% (n=4) of patients with angiography negative SAH with intraventricular extension had good outcomes. Conclusions: Although angiography negative perimesencephalic SAH is considered to have less associated morbidity and mortality than aneurysmal perimesencephalic SAH, patients with extension of hemorrhage into the ventricles are at increased risk for vasospasm and poor functional outcomes.

scholarly journals Correlation of cardiac function and cerebral perfusion in a murine model of subarachnoid hemorrhage

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Axel Neulen ◽  
Michael Molitor ◽  
Michael Kosterhon ◽  
Tobias Pantel ◽  
Elisa Holzbach ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cardiac Function ◽  
Murine Model ◽  
Cardiac Dysfunction ◽  
Cerebral Perfusion ◽  
Left Ventricular ◽  
Laser Speckle ◽  
Cerebral Hypoperfusion ◽  
Left Ventricular Ejection ◽  
Cortical Perfusion

AbstractCerebral hypoperfusion is a key factor for determining the outcome after subarachnoid hemorrhage (SAH). A subset of SAH patients develop neurogenic stress cardiomyopathy (NSC), but it is unclear to what extent cerebral hypoperfusion is influenced by cardiac dysfunction after SAH. The aims of this study were to examine the association between cardiac function and cerebral perfusion in a murine model of SAH and to identify electrocardiographic and echocardiographic signs indicative of NSC. We quantified cortical perfusion by laser SPECKLE contrast imaging, and myocardial function by serial high-frequency ultrasound imaging, for up to 7 days after experimental SAH induction in mice by endovascular filament perforation. Cortical perfusion decreased significantly whereas cardiac output and left ventricular ejection fraction increased significantly shortly post-SAH. Transient pathological ECG and echocardiographic abnormalities, indicating NSC (right bundle branch block, reduced left ventricular contractility), were observed up to 3 h post-SAH in a subset of model animals. Cerebral perfusion improved over time after SAH and correlated significantly with left ventricular end-diastolic volume at 3, 24, and 72 h. The murine SAH model is appropriate to experimentally investigate NSC. We conclude that in addition to cerebrovascular dysfunction, cardiac dysfunction may significantly influence cerebral perfusion, with LVEDV presenting a potential parameter for risk stratification.

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