Effects of preadmission beta-blockers on neurogenic stunned myocardium after aneurysmal subarachnoid hemorrhage: A meta- analysis

Luo, Hai; Wei-xin, Song; Jiang, Jiaming; Zhao, Jian‐Lan; Rong, Wei-lin; Li, Meihua

doi:10.1016/j.clineuro.2017.04.022

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…Intracranial aneurysm rupture is the main reason for spontaneous subarachnoid hemorrhage (SAH) [ 1 ]. Due to the high morbidity and fatality rate, as well as the possibility of rebleeding, intracranial aneurysm seriously threatens human life.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

et al. 2018

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BackgroundThe aim of this study was to retrospectively analyze the incidence of complications of intracranial complex aneurysms embolization by stent-assisted coils, and to investigate the causes of complications and corresponding treatment methods.Material/MethodsA total of 71 patients with subarachnoid hemorrhage (SAH) underwent stent-assisted coil embolization from 2015 to 2018 were enrolled in this study. Among them, 59 cases were single aneurysm, 12 cases were multiple aneurysms (11 cases with 2 aneurysms and 1 case with 3 aneurysms), for a total of 84 aneurysms. All enrolled patients received stent angioplasty except for 1 case.ResultsThere were 62 aneurysms (73.81%) treated with complete tamponade, 21 aneurysms (25.00%) treated with near-total tamponade and 1 aneurysm (1.19%) treated with partial tamponade. All aneurysms were evaluated based on GOS (Glascow outcome scale): 55 cases had GOS of 5 scores, 12 cases had GOS of 4 scores, 3 cases had GOS of 3 scores, and 1 case had GOS of 1 score. There were 67 SAH patients with good prognosis (GOS of 4–5 scores). In our study, the incidence of complications was 12.7%. Three cases experienced acute thrombosis, 2 cases experienced aneurysm rupture during embolization, and 1 case experienced postoperative focal ischemic changes with mild neurological deficits.ConclusionsStent-assisted coil embolization is safe, effective, and feasible for the treatment of intracranial ruptured aneurysms. Patients had a favorable outcome of as high as 94.4%. However, clinical skills should be improved to reduce the occurrence of complications. Prompt and timely treatment for complications of intracranial ruptured aneurysm is also of great significance.

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Section: Introductionmentioning

confidence: 99%

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

et al. 2018

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“…In this regard, there is a wealth of clinical data demonstrating that β-blockers protect the heart against catecholamine-derived injury (Lymperopoulos et al, 2013). Yet, β-blockade in SAH has yielded mixed results: while a few studies purport a beneficial, cardioprotective effect (Neil-Dwyer et al, 1985;Liang et al, 2013), most other retrospective studies find no concrete evidence that taking β-blockers prior to SAH protects against neurocardiac injury (Malik et al, 2015;Luo et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Experimental Subarachnoid Hemorrhage Drives Catecholamine-Dependent Cardiac and Peripheral Microvascular Dysfunction

et al. 2020

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“…Diagnosis and treatment of CAV has been well described in literature, but data in SAH remains scarce. Some research has been attempted in this area, in which prophylactic beta-blockers were hypothesized to reduce catecholaminergic surges in order to reduce the incidence and complications that arise from NSM, but a meta-analysis by Luo et al[ 20 ] showed no statistical benefit to this therapy. Clinical evidence is widespread for CAV and treatment modalities using nitrates and calcium-channel blockers; however, in the subset of patients complicated by SAH, there is limited data regarding acute cardioprotective strategies[ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Diffuse coronary artery vasospasm in a patient with subarachnoid hemorrhage: A case report

Grewal

Mohammad

Swamy

et al. 2020

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BACKGROUND Coronary artery vasospasm (CAV) is a reversible, transient form of vasoconstriction with clinical manifestations ranging from stable angina to acute coronary syndromes (ACS). Vasospasm of epicardial coronary arteries or associated micro-vasculature can lead to total or subtotal occlusion and has been demonstrated in nearly 50% of patients undergoing angiography for suspected ACS. The mechanism for CAV has been described in literature, but in a subgroup of patients presenting with intracranial hemorrhage, it appears to be multifactorial. These patients tend to have electrocardiographic changes, elevation of cardiac biomarkers of injury and neurogenic stress cardiomyopathy. CASE SUMMARY A 44-year-old woman presented with severe headaches and tonic-clonic seizures. She was found to have diffuse subarachnoid hemorrhage (SAH) requiring ventricular drain placement, coil embolization and induced hypertension. She subsequently developed chest pain with ST elevations in anterior precordial leads, elevated cardiac enzymes and apical ballooning with left ventricular ejection fraction of 35% on transthoracic echocardiogram. Coronary angiogram revealed severe diffuse triple vessel stenoses secondary to CAV seen distally. Subsequent cardiac MRI notable for apical non-viability and scar formation. CONCLUSION This case highlights a unique etiology of acute myocardial infarction in a patient with SAH leading to ST elevations, diffuse triple vessel CAV and apical scar.

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Effects of preadmission beta-blockers on neurogenic stunned myocardium after aneurysmal subarachnoid hemorrhage: A meta- analysis

Cited by 13 publications

References 18 publications

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Experimental Subarachnoid Hemorrhage Drives Catecholamine-Dependent Cardiac and Peripheral Microvascular Dysfunction

Diffuse coronary artery vasospasm in a patient with subarachnoid hemorrhage: A case report

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