Cardiac dysfunction in patients affected by subarachnoid haemorrhage affects in-hospital mortality: A systematic review and metanalysis.
Journal
European journal of anaesthesiology
ISSN: 1365-2346
Titre abrégé: Eur J Anaesthesiol
Pays: England
ID NLM: 8411711
Informations de publication
Date de publication:
01 06 2023
01 06 2023
Historique:
medline:
4
5
2023
pubmed:
14
4
2023
entrez:
13
4
2023
Statut:
ppublish
Résumé
Subarachnoid haemorrhage (SAH) is a life-threatening condition with associated brain damage. Moreover, SAH is associated with a massive release of catecholamines, which may promote cardiac injury and dysfunction, possibly leading to haemodynamic instability, which in turn may influence a patient's outcome. To study the prevalence of cardiac dysfunction (as assessed by echocardiography) in patients with SAH and its effect on clinical outcomes. Systematic review of observational studies. We performed a systematic search over the last 20 years on MEDLINE and EMBASE databases. Studies reporting echocardiography findings in adult patients with SAH admitted to intensive care. Primary outcomes were in-hospital mortality and poor neurological outcome according to the presence or absence of cardiac dysfunction. We included a total of 23 studies (4 retrospective) enrolling 3511 patients. The cumulative frequency of cardiac dysfunction was 21% (725 patients), reported as regional wall motion abnormality in the vast majority of studies (63%). Due to the heterogeneity of clinical outcome data reporting, a quantitative analysis was carried out only for in-hospital mortality. Cardiac dysfunction was associated with a higher in-hospital mortality [odds ratio 2.69 (1.64 to 4.41); P < 0.001; I2 = 63%]. The GRADE of evidence assessment resulted in very low certainty of evidence. About one in five patients with SAH develops cardiac dysfunction, which seems to be associated with higher in-hospital mortality. The consistency of cardiac and neurological data reporting is lacking, reducing the comparability of the studies in this field.
Sections du résumé
BACKGROUND
Subarachnoid haemorrhage (SAH) is a life-threatening condition with associated brain damage. Moreover, SAH is associated with a massive release of catecholamines, which may promote cardiac injury and dysfunction, possibly leading to haemodynamic instability, which in turn may influence a patient's outcome.
OBJECTIVES
To study the prevalence of cardiac dysfunction (as assessed by echocardiography) in patients with SAH and its effect on clinical outcomes.
DESIGN
Systematic review of observational studies.
DATA SOURCES
We performed a systematic search over the last 20 years on MEDLINE and EMBASE databases.
ELIGIBILITY CRITERIA
Studies reporting echocardiography findings in adult patients with SAH admitted to intensive care. Primary outcomes were in-hospital mortality and poor neurological outcome according to the presence or absence of cardiac dysfunction.
RESULTS
We included a total of 23 studies (4 retrospective) enrolling 3511 patients. The cumulative frequency of cardiac dysfunction was 21% (725 patients), reported as regional wall motion abnormality in the vast majority of studies (63%). Due to the heterogeneity of clinical outcome data reporting, a quantitative analysis was carried out only for in-hospital mortality. Cardiac dysfunction was associated with a higher in-hospital mortality [odds ratio 2.69 (1.64 to 4.41); P < 0.001; I2 = 63%]. The GRADE of evidence assessment resulted in very low certainty of evidence.
CONCLUSION
About one in five patients with SAH develops cardiac dysfunction, which seems to be associated with higher in-hospital mortality. The consistency of cardiac and neurological data reporting is lacking, reducing the comparability of the studies in this field.
Identifiants
pubmed: 37052065
doi: 10.1097/EJA.0000000000001829
pii: 00003643-202306000-00009
doi:
Types de publication
Systematic Review
Meta-Analysis
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
442-449Informations de copyright
Copyright © 2023 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.
Références
Lerch C, Yonekawa Y, Muroi C, et al. Specialized neurocritical care, severity grade, and outcome of patients with aneurysmal subarachnoid hemorrhage. Neurocrit Care 2006; 5:85–92.
Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet 2017; 389:655–666.
Nieuwkamp DJ, Setz LE, Algra A, et al. Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis. Lancet Neurol 2009; 8:635–642.
Bybee KA, Prasad A. Stress-related cardiomyopathy syndromes. Circulation 2008; 118:397–409.
Mrozek S, Constantin JM, Geeraerts T. Brain-lung crosstalk: Implications for neurocritical care patients. World J Crit Care Med 2015; 4:163–178.
Scheitz JF, Nolte CH, Doehner W, et al. Stroke-heart syndrome: clinical presentation and underlying mechanisms. Lancet Neurol 2018; 17:1109–1120.
Scheitz JF, Sposato LA, Schulz-Menger J, et al. Stroke-heart syndrome: recent advances and challenges. J Am Heart Assoc 2022; 11:e026528.
Lee VH, Oh JK, Mulvagh SL, Wijdicks EF. Mechanisms in neurogenic stress cardiomyopathy after aneurysmal subarachnoid hemorrhage. Neurocrit Care 2006; 5:243–249.
Mayer SA, Lin J, Homma S, et al. Myocardial injury and left ventricular performance after subarachnoid hemorrhage. Stroke 1999; 30:780–786.
Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014; 14:135.
Ahmadian A, Mizzi A, Banasiak M, et al. Cardiac manifestations of subarachnoid hemorrhage. Heart Lung Vessel 2013; 5:168–178.
Huang S, Sanfilippo F, Herpain A, et al. Systematic review and literature appraisal on methodology of conducting and reporting critical-care echocardiography studies: a report from the European Society of Intensive Care Medicine PRICES expert panel. Ann Intensive Care 2020; 10:49.
Zhang L, Wang Z, Qi S. Cardiac troponin elevation and outcome after subarachnoid hemorrhage: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis 2015; 24:2375–2384.
van der Bilt I, Hasan D, van den Brink R, et al. SEASAH (Serial Echocardiography After Subarachnoid Hemorrhage) Investigators. Cardiac dysfunction after aneurysmal subarachnoid hemorrhage: relationship with outcome. Neurology 2014; 82:351–358.
Taccone FS, Citerio G. Participants in the International Multidisciplinary Consensus Conference on Multimodality M. Advanced monitoring of systemic hemodynamics in critically ill patients with acute brain injury. Neurocrit Care 2014; 21: (Suppl 2): S38–63.
Banki NM, Kopelnik A, Dae MW, et al. Acute neurocardiogenic injury after subarachnoid hemorrhage. Circulation 2005; 112:3314–3319.
Singh T, Khan H, Gamble DT, et al. Takotsubo syndrome: pathophysiology, emerging concepts, and clinical implications. Circulation 2022; 145:1002–1019.
Messina A, Villa F, Cecconi M. Challenges in the hemodynamic management of acute nontraumatic neurological injuries. Curr Opin Crit Care 2022; 28:138–144.
Zaroff JG, Leong J, Kim H, et al. Cardiovascular predictors of long-term outcomes after nontraumatic subarachnoid hemorrhage. Neurocrit Care 2012; 17:374–381.
Crago EA, Kerr ME, Kong Y, et al. The impact of cardiac complications on outcome in the SAH population. Acta Neurol Scand 2004; 110:248–253.
Banki N, Kopelnik A, Tung P, et al. Prospective analysis of prevalence, distribution, and rate of recovery of left ventricular systolic dysfunction in patients with subarachnoid hemorrhage. J Neurosurg 2006; 105:15–20.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339:b2535.
Sanfilippo F, Huang S, Herpain A, et al. The PRICES statement: an ESICM expert consensus on methodology for conducting and reporting critical care echocardiography research studies. Intensive Care Med 2021; 47:1–13.
Slim K, Nini E, Forestier D, et al. Methodological index for nonrandomized studies (minors): development and validation of a new instrument. ANZ J Surg 2003; 73:712–716.
Luo D, Wan X, Liu J, et al. Optimally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile range. Stat Methods Med Res 2018; 27:1785–1805.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21:1539–1558.
Chalouhi N, Daou B, Okabe T, et al. Beta-blocker therapy and impact on outcome after aneurysmal subarachnoid hemorrhage: a cohort study. J Neurosurg 2016; 125:730–736.
Cinotti R, Piriou N, Launey Y, et al. Speckle tracking analysis allows sensitive detection of stress cardiomyopathy in severe aneurysmal subarachnoid hemorrhage patients. Intensive Care Med 2016; 42:173–182.
Cremers CH, van der Bilt IA, van der Schaaf IC, et al. Relationship between cardiac dysfunction and cerebral perfusion in patients with aneurysmal subarachnoid hemorrhage. Neurocrit Care 2016; 24:202–206.
Huang WJ, Chen WW, Zhang X. Comparison of cerebral-cardiac syndrome caused by nonaneurysmal or aneurysmal subarachnoid hemorrhage. Eur Rev Med Pharmacol Sci 2014; 18:3737–3742.
Jangra K, Grover VK, Bhagat H, et al. Evaluation of the effect of aneurysmal clipping on electrocardiography and echocardiographic changes in patients with subarachnoid hemorrhage: a prospective observational study. J Neurosurg Anesthesiol 2017; 29:335–340.
Junttila E, Vaara M, Koskenkari J, et al. Repolarization abnormalities in patients with subarachnoid and intracerebral hemorrhage: predisposing factors and association with outcome. Anesth Analg 2013; 116:190–197.
Jyotsna M, Prasad V, Indrani G, et al. Importance of detection of segmental wall motion abnormalities of left ventricle in nontraumatic subarachnoid hemorrhage: a prospective study. Echocardiography 2010; 27:496–500.
Kagiyama N, Sugahara M, Crago EA, et al. Neurocardiac injury assessed by strain imaging is associated with in-hospital mortality in patients with subarachnoid hemorrhage. JACC Cardiovasc Imaging 2020; 13:535–546.
Kilbourn KJ, Levy S, Staff I, et al. Clinical characteristics and outcomes of neurogenic stress cadiomyopathy in aneurysmal subarachnoid hemorrhage. Clin Neurol Neurosurg 2013; 115:909–914.
Kothavale A, Banki NM, Kopelnik A, et al. Predictors of left ventricular regional wall motion abnormalities after subarachnoid hemorrhage. Neurocritical Care 2006; 4:199–205.
Moussouttas M, Huynh TT, Khoury J, et al. Cerebrospinal fluid catecholamine levels as predictors of outcome in subarachnoid hemorrhage. Cerebrovasc Dis 2012; 33:173–181.
Papanikolaou J, Makris D, Karakitsos D, et al. Cardiac and central vascular functional alterations in the acute phase of aneurysmal subarachnoid hemorrhage. Crit Care Med 2012; 40:223–232.
Salem R, Vallee F, Depret F, et al. Subarachnoid hemorrhage induces an early and reversible cardiac injury associated with catecholamine release: one-week follow-up study. Crit Care 2014; 18:558.
Sharma AK, Singh D, Mahajan B, et al. Prospective analysis of role of hsTnT and NT-proBNP in prediction of neurogenic stress cardiomyopathy in patients with aneurysmal subarachnoid haemorrhage. Neurol India 2021; 69:944–949.
Sugimoto K, Yamada A, Inamasu J, et al. Electrocadiographic scoring helps predict left ventricular wall motion abnormality commonly observed after subarachnoid hemorrhage. J Stroke Cerebrovasc Dis 2018; 27:3148–3154.
van der Bilt IA, Hasan D, van den Brink RB, et al. SEASAH (Serial Echocardiography After Subarachnoid Hemorrhage) Investigators. Time course and risk factors for myocardial dysfunction after aneurysmal subarachnoid hemorrhage. Neurosurgery 2015; 76:700–705.
Temes RE, Tessitore E, Schmidt JM, et al. Left ventricular dysfunction and cerebral infarction from vasospasm after subarachnoid hemorrhage. Neurocrit Care 2010; 13:359–365.
Bihorac A, Ozrazgat-Baslanti T, Mahanna E, et al. Long-term outcomes for different forms of stress cardiomyopathy after surgical treatment for subarachnoid hemorrhage. Anesth Analg 2016; 122:1594–1602.
Dalla K, Bech-Hanssen O, Oras J, et al. Speckle tracking-vs conventional echocardiography for the detection of myocardial injury-a study on patients with subarachnoid haemorrhage. Acta Anaesthesiol Scand 2019; 63:365–372.
Inamasu J, Ganaha T, Nakae S, et al. Therapeutic outcomes for patients with aneurysmal subarachnoid hemorrhage complicated by Takotsubo cardiomyopathy. Acta Neurochir (Wien) 2016; 158:885–893.
Sugimoto K, Inamasu J, Kato Y, et al. Association between elevated plasma norepinephrine levels and cardiac wall motion abnormality in poor-grade subarachnoid hemorrhage patients. Neurosurg Rev 2013; 36:259–266.
Sanfilippo F, Messina A, Cecconi M, et al. Ten answers to key questions for fluid management in intensive care. Med Intensiva 2020; 12:30338–30347.
Messina A, Greco M, Cecconi M. What should I use next if clinical evaluation and echocardiographic haemodynamic assessment is not enough? Curr Opin Crit Care 2019; 25:259–265.