Banki Nader M., Zaroff Jonathan G.
UCSF Medical Center, Division of Cardiology, 505 Parnassus Avenue, M1177, San Francisco, CA 94143, USA.
Curr Treat Options Cardiovasc Med. 2003 Dec;5(6):451-458. doi: 10.1007/s11936-003-0034-8.
Cardiac injury may occur following many types of brain injury, although the most widely investigated form of neurocardiogenic injury is subarachnoid hemorrhage (SAH). Echocardiography may help prognosticate and aid in the treatment of SAH if left ventricular (LV) dysfunction is suspected or if troponin levels are elevated. Cardiac catheterization, however, is not routinely recommended in SAH patients with LV dysfunction and elevated troponin. The priority should be treatment of the underlying neurological condition, even in the setting of LV dysfunction. Cardiac injury that occurs following an SAH appears to be reversible. For patients that develop brain death cardiac evaluation under optimal conditions may help increase the donor pool.
多种类型的脑损伤后都可能发生心脏损伤,不过神经心源性损伤研究最为广泛的形式是蛛网膜下腔出血(SAH)。如果怀疑存在左心室(LV)功能障碍或肌钙蛋白水平升高,超声心动图可能有助于对SAH进行预后评估并辅助治疗。然而,对于存在LV功能障碍且肌钙蛋白升高的SAH患者,并不常规推荐进行心导管检查。即使在存在LV功能障碍的情况下,首要任务也应该是治疗潜在的神经系统疾病。SAH后发生的心脏损伤似乎是可逆的。对于发生脑死亡的患者,在最佳条件下进行心脏评估可能有助于增加供体库。