Endogenous arterial blood pressure increase after aneurysmal subarachnoid hemorrhage

Hosmann, Arthur; Klenk, Simon; Wang, Wei-Te; Koren, Johannes; Sljivic, Samir; Reinprecht, Andrea

doi:10.1016/j.clineuro.2019.105639

Cited by 6 publications

(3 citation statements)

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“…Elevated blood pressure is a common occurrence in SAH and is linked with a higher risk of re-rupture of cerebral aneurysms and vasospasm. 25,26 Thus, we tested if blood pressure changes over the course of treatment were different between treatment groups. The median and mean blood pressure change from the first hospitalized day were greater than 0 for both treatment groups ( Figure 4B ).…”

Section: Resultsmentioning

confidence: 99%

Section: Cumulative Effects Of Tavns On Vascular Functionmentioning

confidence: 99%

“…Elevated blood pressure is a common occurrence in SAH and is linked with a higher risk of re-rupture of cerebral aneurysms and vasospasm. 33,34 In this study, patients in both treatment groups received medical treatment determined by the medical team, including vasopressors and medication for blood pressure management. We investigated whether taVNS induced any additional blood pressure changes beyond those managed by the medical team.…”

Section: Cumulative Effects Of Tavns On Vascular Functionmentioning

confidence: 99%

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The effect of transcutaneous auricular vagus nerve stimulation on cardiovascular function in subarachnoid hemorrhage patients: a safety study

Tan,

Huguenard,

Donovan

et al. 2024

Preprint

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Structured AbstractObjectiveSubarachnoid hemorrhage (SAH) is characterized by intense central inflammation, leading to substantial post-hemorrhagic complications such as vasospasm and delayed cerebral ischemia.2,6,7Given the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation (taVNS) and its ability to promote brain plasticity, taVNS has emerged as a promising therapeutic option for SAH patients.3,8,9However, the effects of taVNS on cardiovascular dynamics in critically ill patients like those with SAH have not yet been investigated. Given the association between cardiac complications and elevated risk of poor clinical outcomes after SAH, it is essential to characterize the cardiovascular effects of taVNS to ensure this approach is safe in this fragile population4. Therefore, we assessed the impact of both acute taVNS and repetitive taVNS on cardiovascular function in this study.MethodsIn this randomized clinical trial, 24 SAH patients were assigned to either a taVNS treatment or a Sham treatment group. During their stay in the intensive care unit, we monitored patient electrocardiogram (ECG) readings and vital signs. We compared long-term changes in heart rate, heart rate variability, QT interval, and blood pressure between the two groups. Additionally, we assessed the effects of acute taVNS by comparing cardiovascular metrics before, during, and after the intervention. We also explored rapidly responsive cardiovascular biomarkers in patients exhibiting clinical improvement.ResultsWe found that repetitive taVNS did not significantly alter heart rate, corrected QT interval, blood pressure, or intracranial pressure. However, taVNS increased overall heart rate variability and parasympathetic activity from 5–10 days after initial treatment, as compared to the sham treatment. Acutely, taVNS increased heart rate, blood pressure, and peripheral perfusion index without affecting the corrected QT interval, intracranial pressure, or heart rate variability. The acute post-treatment elevation in heart rate was more pronounced in patients who experienced a decrease of more than 1 point in their Modified Rankin Score at the time of discharge.ConclusionsOur study found that taVNS treatment did not induce adverse cardiovascular effects, such as bradycardia or QT prolongation, supporting its development as a safe immunomodulatory treatment approach for SAH patients. The observed acute increase in heart rate after taVNS treatment may serve as a biomarker for SAH patients who could derive greater benefit from this treatment.HighlightsTranscutaneous auricular vagus nerve stimulation (taVNS) treatment is a safe immunomodulatory treatment approach for subarachnoid hemorrhage patients.taVNS treatment did not induce adverse cardiovascular effects, such as bradycardia or QT prolongation.An acute increase in heart rate after taVNS treatment may serve as a biomarker for SAH patients who could derive greater benefit from this treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Cumulative Effects Of Tavns On Vascular Functionmentioning

confidence: 99%

Section: Cumulative Effects Of Tavns On Vascular Functionmentioning

confidence: 99%

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