Abstract 17448: Echocardiographic Radial and Circumferential Strain Follow-up Analysis of Neurocardiac Injury in Patients With Subarachnoid Hemorrhage
Introduction: Neurocardiac injury in aneurysmal subarachnoid hemorrhage (aSAH) has been well described. Most researchers regard aSAH is accompanied by transient cardiac dysfunction, a kind of stress cardiomyopathy.
Hypothesis: The aim was to discuss the change of patients between early stage after aSAH and shortly later stage using Echocardiography.
Methods: We prospectively studied patients with aSAHbetween early stage (Day 0 to 5 after SAH) and shortly later stage (Day 5 to 12) in a patient subset (early n=130, later n=68; late study not always obtained due to patient discharge or death). Besides traditional echo parameters, we assessed speckle tracking circumferential and radialstrain (18 segments from 3 left ventricular short axis views). The time-to-peakdifference from earliest to latest activated segment was determined from each view as the radial strain time variation (RST), then calculated the mean of three views (RSTD-Mean). The time-to-peak radial strain difference (APT) between LV anterior septum and posterior wall in left ventricular short axis view at papillary muscle level were calculated.
Results: Of 66 aSAH patients had baseline and follow-up data, 18 (27%) had highly positive cardiac troponin I (cTnI) (>=0.3 ng/ml) and 48 (73%) had mildly positive or negative cTnI (<0.3 ng/ml). The improvement (later stage vs. early stage) of RSTD-Mean (36.68±7.14ms, 47.57±11.3ms vs. 4.58±1.77ms, 9.24±4.41ms) and APT (17.5±6.29ms, 32.11±12.71ms vs. 0.66±0.66ms, 3.27±3.27ms) in mildly positive or negative cTnI group were more significant than these in highly positive cTnI group (P<0.0001).
Conclusions: The improvement (later stage vs. early stage) of RSTD-Mean and APT in mildly positive or negative cTnI group were more significant than these in highly positive cTnI group. Both RSTD-Mean and APT are novel strain parameters to indicate LV regional discoordination of patients with aSAH and has promise for clinical utility.
Author Disclosures: Z. Qi: None. M. Sugahara: None. E.A. Crago: None. Y. Chang: None. T.F. Lagattuta: None. K. Yousef: None. R.M. Friedlander: None. M.T. Hravnak: None. J. Gorcsan: None.
- © 2016 by American Heart Association, Inc.