Cardiac wall motion abnormality after bleeding from vertebral artery aneurysms

Inamasu, Joji; Hayashi, Takuro; Oheda, Motoki; Yamashiro, Kei; Tateyama, Shinichiro; Kogame, Hirotaka; Yamada, Yoshihiko; Sugimoto, Keiko; Watanabe, Eiichi; Kato, Yōkō; Hirose, Yuichi

doi:10.1007/s10286-014-0256-8

Cited by 4 publications

(6 citation statements)

References 16 publications

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“…Similar to previous investigations, no connection was demonstrated between NC and age [ 11 , 12 ], gender [ 12 , 27 ] or aneurysm location [ 12 , 20 ]. Conversely, our investigation confirms prior reports that NC is related to clinical severity [ 11 , 12 , 28 , 29 ] and, importantly, demonstrates that this association may be mediated by neuronal NE transmission. This conclusion is based on the logistic regression findings which reveal the prominence of NE level over H/H grade as an independent predictor of NC.…”

Section: Discussionsupporting

confidence: 92%

“…This conclusion is based on the logistic regression findings which reveal the prominence of NE level over H/H grade as an independent predictor of NC. Findings provide parsimony between various investigations identifying clinical grade as a/the principle determinant of central catecholaminergic activation [ 6 ], investigations implicating (nor)adrenergic function in the production of NC [ 7 , 16 , 17 ], and investigations identifying clinical severity as a major determinant of NC among patients with SAH [ 11 , 12 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 95%

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Plasma Catecholamine Profile of Subarachnoid Hemorrhage Patients with Neurogenic Cardiomyopathy

Moussouttas

Mearns²,

Walters

et al. 2015

Cerebrovasc Dis Extra

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Purpose: To investigate the connection between sympathetic function and neurogenic cardiomyopathy (NC), and to determine whether NC is mediated primarily by circulating adrenal epinephrine (EPI) or neuronally transmitted norepinephrine (NE), following subarachnoid hemorrhage (SAH). Methods: This is a prospective observational investigation of consecutive severe-grade SAH patients. All participants had transthoracic echocardiography and serological assays for catecholamine levels - dopamine (DA), NE and EPI - within 48 h of hemorrhage onset. Clinical and serological independent predictors of NC were determined using multivariate logistic regression analyses, and the accuracy of predictors was assessed by receiver operating characteristic (ROC) curves. Multivariate linear regression analyses were used to evaluate correlations among the catecholamines. Results: The investigation included a total of 94 subjects: the mean age was 55 years, 81% were female and 57% were Caucasian. NC was identified in approximately 10% (9/94) of cases. Univariate analyses revealed associations between NC and worse clinical severity (p = 0.019), plasma DA (p = 0.018) and NE levels (p = 0.024). Plasma NE correlated with DA levels (ρ = 0.206, p = 0.046) and EPI levels (ρ = 0.392, p < 0.001), but was predicted only by plasma EPI in bivariate [parameter estimate (PE) = 1.95, p < 0.001] and multivariate (PE = 1.89, p < 0.001) linear regression models. Multivariate logistic regression analyses consistently demonstrated the predictive value of clinical grade for NC (p < 0.05 for all analyses) except in models incorporating plasma NE, where NC was independently predicted by NE level (OR 1.25, 95% CI 1.01-1.55) over clinical grade (OR 4.19, 95% CI 0.874-20.1). ROC curves similarly revealed the greater accuracy of plasma NE [area under the curve (AUC) 0.727, 95% CI 0.56-0.90, p = 0.02] over clinical grade (AUC 0.704, 95% CI 0.55-0.86, p = 0.05) for identifying the presence or absence of NC. Conclusions: Following SAH, the development of NC is primarily related to elevated plasma NE levels. Findings implicate a predominantly neurogenic process mediated by neuronal NE (and not adrenal EPI), but cannot exclude synergy between the catecholamines.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Plasma Catecholamine Profile of Subarachnoid Hemorrhage Patients with Neurogenic Cardiomyopathy

Moussouttas

Mearns²,

Walters

et al. 2015

Cerebrovasc Dis Extra

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“…The frequency was close to that of various physiological functions in the human body, such as the resting respiratory rate (∼0.2 Hz), resting heart rate (∼1 Hz), and autonomic processes (such as body temperature regulation, fluid balance, and basal metabolism). However, at this frequency, high-intensity events also occur, such as the growth of hematomas, cerebral edema, or tumors. , At a frequency of 0.1 Hz, a large amount of energy was dissipated into the microstructure, which was damaged. Within this frequency range, the medulla oblongata under a pulse electric field exhibited a more significant elastic and viscous response than those without an electric field.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Effects of Pulsed Electrical Stimulation on the Mechanical Behavior and Microstructure of Medulla Oblongata Tissues

Li,

Zong,

Zhao

et al. 2024

ACS Biomater. Sci. Eng.

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The development of remote surgery hinges on comprehending the mechanical properties of the tissue at the surgical site. Understanding the mechanical behavior of the medulla oblongata tissue is instrumental for precisely determining the remote surgery implementation site. Additionally, exploring this tissue’s response under electric fields can inform the creation of electrical stimulation therapy regimens. This could potentially reduce the extent of medulla oblongata tissue damage from mechanical compression. Various types of pulsed electric fields were integrated into a custom-built indentation device for this study. Experimental findings suggested that applying pulsed electric fields amplified the shear modulus of the medulla oblongata tissue. In the electric field, the elasticity and viscosity of the tissue increased. The most significant influence was noted from the low-frequency pulsed electric field, while the burst pulsed electric field had a minimal impact. At the microstructural scale, the application of an electric field led to the concentration of myelin in areas distant from the surface layer in the medulla oblongata, and the orderly structure of proteoglycans became disordered. The alterations observed in the myelin and proteoglycans under an electric field were considered to be the fundamental causes of the changes in the mechanical behavior of the medulla oblongata tissue. Moreover, cell polarization and extracellular matrix cavitation were observed, with transmission electron microscopy results pointing to laminar separation within the myelin at the ultrastructure scale. This study thoroughly explored the impact of electric field application on the mechanical behavior and microstructure of the medulla oblongata tissue, delving into the underlying mechanisms. This investigation delved into the changes and mechanisms in the mechanical behavior and microstructure of medulla oblongata tissue under the influence of electric fields. Furthermore, this study could serve as a reference for the development of electrical stimulation regimens in the central nervous system. The acquired mechanical behavior data could provide valuable baseline information to aid in the evolution of remote surgery techniques involving the medulla oblongata tissue.

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“…Frequently concomitant neurogenic pulmonary edema [ Table 2 ] may also be explained by the overactivation of the medullary vasomotor nuclei. [ 11 ] NSM by itself may also be causally associated with neurogenic pulmonary edema. [ 11 ] Considering the fact that the great majority of pediatric patients with hydrocephalus do not develop NSM, however, other factors, such as genetic susceptibility, may also be involved in its pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…[ 11 ] NSM by itself may also be causally associated with neurogenic pulmonary edema. [ 11 ] Considering the fact that the great majority of pediatric patients with hydrocephalus do not develop NSM, however, other factors, such as genetic susceptibility, may also be involved in its pathogenesis. [ 1 ] Development of pulmonary edema may have been merely a result of intra-/post-operative fluid mismanagement: According to a recent literature review, the majority of cases summarized developed NSM in the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

Neurogenic stunned myocardium associated with pediatric brain tumor may not be catecholamine-induced

et al. 2015

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A rare case of pediatric neurogenic stunned myocardium (NSM) associated with a brain tumor is reported. A previously healthy 6-year-old boy presented with coma, and imaging studies revealed a brain tumor. On hospitalization day 3, he developed NSM and neurogenic pulmonary edema necessitating intensive cardiopulmonary support. Although blood marker levels of cardiac injury were elevated, his plasma and urinary norepinephrine levels were within normal limits. His cardiorespiratory functions markedly improved by hospitalization day 8. This case report may be one of the first to document plasma and urinary catecholamine levels in pediatric NSM. While solid conclusion cannot be drawn based on experience from a single case, these results suggest that pediatric NSM may not be catecholamine-induced.

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Cardiac wall motion abnormality after bleeding from vertebral artery aneurysms

Cited by 4 publications

References 16 publications

Plasma Catecholamine Profile of Subarachnoid Hemorrhage Patients with Neurogenic Cardiomyopathy

Plasma Catecholamine Profile of Subarachnoid Hemorrhage Patients with Neurogenic Cardiomyopathy

Evaluating the Effects of Pulsed Electrical Stimulation on the Mechanical Behavior and Microstructure of Medulla Oblongata Tissues

Neurogenic stunned myocardium associated with pediatric brain tumor may not be catecholamine-induced

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