Deena M Nasr1, Sara Tomasini2, Abhiram Prasad3, Alejandro A Rabinstein2. 1. Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. nasr.deena@mayo.edu. 2. Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. 3. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Abstract
OBJECTIVE: To determine the clinical characteristics and outcomes of patients with neurogenic stress cardiomyopathy (NSC) among patients admitted to our neuroscience intensive care unit (NICU). METHODS: Following institutional review board approval, consecutive adult patients admitted to the NICU between 2009 and 2013 with definite and possible NSC were included. Data on patient demographics, baseline clinical information, cardiac function, and laboratory values were collected. Outcomes included length of stay, modified Rankin Scale (mRS) at discharge and long-term follow-up. Continuous variables were compared using a student's t test, and categorical variables were compared using a Chi-square test. RESULTS: Among 34 patients included in the study, the most common presenting symptom was dyspnea (17 patients, 50%). Subarachnoid hemorrhage (SAH) was the most common neurological inciting event (11 patients, 32.4%), but two-thirds of this cohort had other neurological triggers. The most common electrocardiogram changes were QT-interval prolongation (30 patients, 88.2%) and T-wave inversion (22 patients, 64.7%). The most common echocardiographic pattern was the apical variant (14 patients, 41.2%), and 26% of patients had right ventricular involvement (P = 0.03) which was a predictor of poor outcome along with inotropic support (P = 0.006). Functional outcome was poor (mRS > 3) in 53% of patients at discharge, but function improved over time in most survivors. CONCLUSIONS: NSC is most common after SAH, but can result from a wide spectrum of acute brain insults. Requirement of inotropic support was the strongest indicator of prognosis at last follow-up. Patients with NSC often have poor function at discharge but many improve over time.
OBJECTIVE: To determine the clinical characteristics and outcomes of patients with neurogenic stress cardiomyopathy (NSC) among patients admitted to our neuroscience intensive care unit (NICU). METHODS: Following institutional review board approval, consecutive adult patients admitted to the NICU between 2009 and 2013 with definite and possible NSC were included. Data on patient demographics, baseline clinical information, cardiac function, and laboratory values were collected. Outcomes included length of stay, modified Rankin Scale (mRS) at discharge and long-term follow-up. Continuous variables were compared using a student's t test, and categorical variables were compared using a Chi-square test. RESULTS: Among 34 patients included in the study, the most common presenting symptom was dyspnea (17 patients, 50%). Subarachnoid hemorrhage (SAH) was the most common neurological inciting event (11 patients, 32.4%), but two-thirds of this cohort had other neurological triggers. The most common electrocardiogram changes were QT-interval prolongation (30 patients, 88.2%) and T-wave inversion (22 patients, 64.7%). The most common echocardiographic pattern was the apical variant (14 patients, 41.2%), and 26% of patients had right ventricular involvement (P = 0.03) which was a predictor of poor outcome along with inotropic support (P = 0.006). Functional outcome was poor (mRS > 3) in 53% of patients at discharge, but function improved over time in most survivors. CONCLUSIONS:NSC is most common after SAH, but can result from a wide spectrum of acute brain insults. Requirement of inotropic support was the strongest indicator of prognosis at last follow-up. Patients with NSC often have poor function at discharge but many improve over time.
Authors: Thura T Abd; Salim Hayek; Jeh-wei Cheng; Owen B Samuels; Ilan S Wittstein; Stamatios Lerakis Journal: Int J Cardiol Date: 2014-08-06 Impact factor: 4.164
Authors: Vivien H Lee; Heidi M Connolly; Jimmy R Fulgham; Edward M Manno; Robert D Brown; Eelco F M Wijdicks Journal: J Neurosurg Date: 2006-08 Impact factor: 5.115
Authors: R Phillip Dellinger; Mitchell M Levy; Jean M Carlet; Julian Bion; Margaret M Parker; Roman Jaeschke; Konrad Reinhart; Derek C Angus; Christian Brun-Buisson; Richard Beale; Thierry Calandra; Jean-Francois Dhainaut; Herwig Gerlach; Maurene Harvey; John J Marini; John Marshall; Marco Ranieri; Graham Ramsay; Jonathan Sevransky; B Taylor Thompson; Sean Townsend; Jeffrey S Vender; Janice L Zimmerman; Jean-Louis Vincent Journal: Crit Care Med Date: 2008-01 Impact factor: 7.598
Authors: Christian Templin; Jelena R Ghadri; Johanna Diekmann; L Christian Napp; Dana R Bataiosu; Milosz Jaguszewski; Victoria L Cammann; Annahita Sarcon; Verena Geyer; Catharina A Neumann; Burkhardt Seifert; Jens Hellermann; Moritz Schwyzer; Katharina Eisenhardt; Josef Jenewein; Jennifer Franke; Hugo A Katus; Christof Burgdorf; Heribert Schunkert; Christian Moeller; Holger Thiele; Johann Bauersachs; Carsten Tschöpe; Heinz-Peter Schultheiss; Charles A Laney; Lawrence Rajan; Guido Michels; Roman Pfister; Christian Ukena; Michael Böhm; Raimund Erbel; Alessandro Cuneo; Karl-Heinz Kuck; Claudius Jacobshagen; Gerd Hasenfuss; Mahir Karakas; Wolfgang Koenig; Wolfgang Rottbauer; Samir M Said; Ruediger C Braun-Dullaeus; Florim Cuculi; Adrian Banning; Thomas A Fischer; Tuija Vasankari; K E Juhani Airaksinen; Marcin Fijalkowski; Andrzej Rynkiewicz; Maciej Pawlak; Grzegorz Opolski; Rafal Dworakowski; Philip MacCarthy; Christoph Kaiser; Stefan Osswald; Leonarda Galiuto; Filippo Crea; Wolfgang Dichtl; Wolfgang M Franz; Klaus Empen; Stephan B Felix; Clément Delmas; Olivier Lairez; Paul Erne; Jeroen J Bax; Ian Ford; Frank Ruschitzka; Abhiram Prasad; Thomas F Lüscher Journal: N Engl J Med Date: 2015-09-03 Impact factor: 91.245
Authors: Nicholas A Morris; Abhinaba Chatterjee; Oluwayemisi L Adejumo; Monica Chen; Alexander E Merkler; Santosh B Murthy; Hooman Kamel Journal: Neurocrit Care Date: 2019-02 Impact factor: 3.210
Authors: Seyyedmohammadsadeq Mirmoeeni; Amirhossein Azari Jafari; John V Lacci; Ali Seifi Journal: Neurocrit Care Date: 2022-09-22 Impact factor: 3.532
Authors: Csilla Molnár; Judit Gál; Dorottya Szántó; László Fülöp; Andrea Szegedi; Péter Siró; Endre V Nagy; Szabolcs Lengyel; János Kappelmayer; Béla Fülesdi Journal: PLoS One Date: 2022-05-26 Impact factor: 3.752
Authors: Ekaterina S Prokudina; Boris K Kurbatov; Konstantin V Zavadovsky; Alexander V Vrublevsky; Natalia V Naryzhnaya; Yuri B Lishmanov; Leonid N Maslov; Peter R Oeltgen Journal: Curr Cardiol Rev Date: 2021
Authors: Victoria L Cammann; Jan F Scheitz; Christian Templin; Jelena R Ghadri; Regina von Rennenberg; Lutz Jäncke; Christian H Nolte; Konrad A Szawan; Helena Stengl; Michael Würdinger; Matthias Endres Journal: Sci Rep Date: 2021-12-07 Impact factor: 4.379