Amber McAteer1, Marilyn Hravnak1, Yuefang Chang2, Elizabeth A Crago1, Matthew J Gallek3, Khalil M Yousef4. 1. 1 Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. 2. 2 Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 3. 3 College of Nursing, University of Arizona, Tucson, AZ, USA. 4. 4 School of Nursing, University of Jordan, Amman, Jordan.
Abstract
INTRODUCTION: Neurocardiac injury, a type of myocardial dysfunction associated with neurological insult to the brain, occurs in 31-48% of aneurysmal subarachnoid hemorrhage (aSAH) patients. Cardiac troponin I (cTnI) is commonly used to diagnose neurocardiac injury. Brain natriuretic peptide (BNP), another cardiac marker, is more often used to evaluate degree of heart failure. The purpose of this study was to examine the relationships between BNP and (a) neurocardiac injury severity according to cTnI, (b) noninvasive continuous cardiac output (NCCO), and (c) outcomes in aSAH patients. METHOD: This descriptive longitudinal study enrolled 30 adult aSAH patients. Data collected included BNP and cTnI levels and NCCO parameters for 14 days and outcomes (modified Rankin Scale [mRS] and mortality) at discharge and 3 months. Generalized estimating equations were used to evaluate associations between BNP and cTnI, NCCO, and outcomes. RESULTS: BNP was significantly associated with cTnI. For every 1 unit increase in log BNP, cTnI increased by 0.05 ng/ml ( p = .001). Among NCCO parameters, BNP was significantly associated with thoracic fluid content ( p = .0003). On multivariable analyses, significant associations were found between BNP and poor mRS. For every 1 unit increase in log BNP, patients were 3.16 times more likely to have a poor mRS at discharge ( p = .021) and 5.40 times more likely at 3 months ( p < .0001). CONCLUSION: There were significant relationships between BNP and cTnI and poor outcomes after aSAH. BNP may have utility as a marker of neurocardiac injury and outcomes after aSAH.
INTRODUCTION:Neurocardiac injury, a type of myocardial dysfunction associated with neurological insult to the brain, occurs in 31-48% of aneurysmal subarachnoid hemorrhage (aSAH) patients. Cardiac troponin I (cTnI) is commonly used to diagnose neurocardiac injury. Brain natriuretic peptide (BNP), another cardiac marker, is more often used to evaluate degree of heart failure. The purpose of this study was to examine the relationships between BNP and (a) neurocardiac injury severity according to cTnI, (b) noninvasive continuous cardiac output (NCCO), and (c) outcomes in aSAH patients. METHOD: This descriptive longitudinal study enrolled 30 adult aSAH patients. Data collected included BNP and cTnI levels and NCCO parameters for 14 days and outcomes (modified Rankin Scale [mRS] and mortality) at discharge and 3 months. Generalized estimating equations were used to evaluate associations between BNP and cTnI, NCCO, and outcomes. RESULTS:BNP was significantly associated with cTnI. For every 1 unit increase in log BNP, cTnI increased by 0.05 ng/ml ( p = .001). Among NCCO parameters, BNP was significantly associated with thoracic fluid content ( p = .0003). On multivariable analyses, significant associations were found between BNP and poor mRS. For every 1 unit increase in log BNP, patients were 3.16 times more likely to have a poor mRS at discharge ( p = .021) and 5.40 times more likely at 3 months ( p < .0001). CONCLUSION: There were significant relationships between BNP and cTnI and poor outcomes after aSAH. BNP may have utility as a marker of neurocardiac injury and outcomes after aSAH.
Authors: Kent J Kilbourn; Gilbert Ching; David I Silverman; Louise McCullough; Robert J Brown Journal: Clin Neurol Neurosurg Date: 2014-11-04 Impact factor: 1.876
Authors: J Michael Frangiskakis; Marilyn Hravnak; Elizabeth A Crago; Masaki Tanabe; Kevin E Kip; John Gorcsan; Michael B Horowitz; Amin B Kassam; Barry London Journal: Neurocrit Care Date: 2009-01-28 Impact factor: 3.210
Authors: M Davis; E Espiner; G Richards; J Billings; I Town; A Neill; C Drennan; M Richards; J Turner; T Yandle Journal: Lancet Date: 1994-02-19 Impact factor: 79.321
Authors: Reda Salem; Fabrice Vallée; François Dépret; Jacques Callebert; Jean Pierre Saint Maurice; Philippe Marty; Joaquim Matéo; Catherine Madadaki; Emmanuel Houdart; Damien Bresson; Sebastien Froelich; Christian Stapf; Didier Payen; Alexandre Mebazaa Journal: Crit Care Date: 2014-10-30 Impact factor: 9.097
Authors: Sonia A El-Saiedi; Mona H Hafez; Yasser M Sedky; Sahar A Sharaf; Mona S Kamel; Antoine F AbdelMassih Journal: Cardiovasc Endocrinol Metab Date: 2020-11-19
Authors: Sebastien F M Chastin; Marieke De Craemer; Katrien De Cocker; Lauren Powell; Jelle Van Cauwenberg; Philippa Dall; Mark Hamer; Emmanuel Stamatakis Journal: Br J Sports Med Date: 2018-04-25 Impact factor: 13.800