Comparison of cerebral-cardiac syndrome caused by nonaneurysmal or aneurysmal subarachnoid hemorrhage

摘要

OBJECTIVE: To investigate the difference between myocardial injuries caused by nonaneurysmal subarachnoid hemorrhage (SAH) or aneurysmal SAH. PATIENTS AND METHODS: A total of 92 inpatients with SAH at early stage (within 48h), who were treated in our hospital from 2008 to 2014 were enrolled in this study. Differences in cerebral-cardiac syndrome seen in perimesencephalic subarachnoid hemorrhage (PMSAH), non-perimesencephalic subarachnoid hemorrhage (n-PMSAH), and aneurysmal subarachnoid hemorrhage (aSAH) were recorded based Hunt-Hess scores, electrocardiogram/echocardiography findings, and serum myocardial enzymes. RESULTS: The Hunt-Hess grade was relatively lower in the PMSAH group (mainly at grades I and II) than in aSAH group and n-PMSAH group. The ECG score was significantly lower in the PMSAH Group than in the aSAH or n-PMSAH Group. In the PMSAH group, the left ventricular function was normal; in contrast, the left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left ventricular wall thickness, and left ventricular ejection fraction showed certain abnormalities in the aSAH group and n-PMSAH group. The myocardial enzymes remarkably increased only in the aSAH group. CONCLUSIONS: In PMSAH patients, the lower Hunt-Hess grade, milder ECG abnormalities, less changes in cardiac enzymes and echocardiography are associated with better prognosis. The clinical course and myocardial injuries are poorer in n-PMSAH patients when compared with the PMSAH patients but better than aSAH patients.