Khush Kiran, Kopelnik Alexander, Tung Poyee, Banki Nader, Dae Michael, Lawton Michael, Smith Wade, Drew Barbara, Foster Elyse, Zaroff Jonathan
Division of Cardiology, Department of Radiology, University of California-San Francisco Medical Center, 505 Parnassus Avenue, San Francisco, CA 941243, USa.
J Am Soc Echocardiogr. 2005 Feb;18(2):168-74. doi: 10.1016/j.echo.2004.08.045.
Cardiac injury, including left ventricular dysfunction, frequently occurs in patients with subarachnoid hemorrhage. Patterns of left ventricular dysfunction often do not follow coronary artery distributions, and may correlate with myocardial sympathetic innervation. Left ventricular dysfunction of the anterior and anteroseptal walls that spares the apex is unusual for patients with myocardial infarction and may represent a neurally mediated pattern of injury. We performed serial echocardiography on 225 patients with subarachnoid hemorrhage and classified those with regional wall-motion abnormalities as following either an apex-sparing (AS) or apex-affected (AA) pattern. Wall-motion abnormalities were found in 61 of 225 patients studied (27%). The AS pattern was found in 49% of these patients. Younger age and anterior aneurysm position were independent predictors of this AS pattern. Both patterns of wall-motion abnormalities appear to be transient, reversible phenomena. The AS pattern may represent a unique form of neurally mediated cardiac injury.
心脏损伤，包括左心室功能障碍，在蛛网膜下腔出血患者中经常发生。左心室功能障碍的模式通常不遵循冠状动脉分布，并且可能与心肌交感神经支配有关。前壁和前间隔壁的左心室功能障碍不累及心尖，这在心肌梗死患者中并不常见，可能代表一种神经介导的损伤模式。我们对225例蛛网膜下腔出血患者进行了系列超声心动图检查，并将那些有节段性室壁运动异常的患者分为心尖保留（AS）或心尖受累（AA）模式。在225例研究患者中，有61例（27%）发现了室壁运动异常。这些患者中有49%表现为AS模式。年轻和动脉瘤位于前部是这种AS模式的独立预测因素。两种室壁运动异常模式似乎都是短暂的、可逆的现象。AS模式可能代表一种独特的神经介导的心脏损伤形式。
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