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001-es BibID:BIBFORM102086
035-os BibID:(cikkazonosító)e0268525 (WOS)000835048800009 (Scopus)85130851932
Első szerző:Molnár Csilla (aneszteziológus)
Cím:Takotsubo cardiomyopathy in patients suffering from acute non-traumatic subarachnoid hemorrhage : A single center follow-up study / Molnár Csilla, Gál Judit, Szántó Dorottya, Fülöp László, Szegedi Andrea, Siró Péter, Nagy V. Endre, Lengyel Szabolcs, Kappelmayer János, Fülesdi Bela
Dátum:2022
ISSN:1932-6203
Megjegyzések:Background Takotsubo cardiomyopathy (TTC) is an important complication of subarachnoid hemorrhage (SAH), that may delay surgical or endovascular treatment and may influence patient outcome. This prospective follow-up study intended to collect data on the prevalence, severity, influencing factors and long-term outcome of TTC in patients suffering from non-traumatic SAH. Methods Consecutive patients admitted with the diagnosis of non-traumatic SAH were included. Intitial assessment consisted of cranial CT, Hunt-Hess, Fisher and WFNS scoring, 12-lead ECG, transthoracic echocardiography (TTE), transcranial duplex sonography and collecting laboratory parameters (CK, CK-MB, cardiac troponin T, NT-proBNP and urine metanephrine and normetanephrine). Diagnosis of TTC was based on modified Mayo criteria. TTC patients were dichotomized to mild and severe forms. Follow-up of TTE, Glasgow Outcome Scale assessment, Barthel's and Karnofsky scoring occurred on days 30 and 180. Results One hundred thirty six patients were included. The incidence of TTC in the entire cohort was 28.7%; of them, 20.6% and 8.1% were mild and severe, respectively. TTC was more frequent in females (30/39; 77%) than in males (9/39; 23%) and was more severe. The occurrence of TTC was related to mFisher scores and WFNS scores. Although the severity of TTC was related to mFisher score, Hunt-Hess score, WFNS score and GCS, multivariate analysis showed the strongest relationship with mFisher scores. Ejection fraction differences between groups were present on day 30, but disappeared by day 180, whereas wall motion score index was still higher in the severe TTC group at day 180. By the end of the follow-up period (180 days), 70 (74.5%) patients survived in the non-TTC, 22 (81.5%) in the mild TTC and 3 (27%) in the severe TTC group (n = 11) (p = 0.002). At day 180, GOS, Barthel, and Karnofsky outcome scores were higher in patients in the control (non-TTC) and the mild TTC groups than in the severe TTC group. Conclusions Takotsubo cardiomyopathy is a frequent finding in patients with SAH, and severe TTC may be present in 8% of SAH cases. The severity of TTC may be an independent predictor of mortality and outcome at 6 months after disease onset. Therefore, a regular follow-up of ECG and TTE abnormalities is warranted in patients with subrachnoid hemorrhage for early detection of TTC.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Plos One. - 17 : 5 (2022), p. 1-20. -
További szerzők:Gál Judit (1977-) (aneszteziológiai és ITO szakorvos) Szántó Dorottya (1991-) (aneszteziológus, intenzív terápiás szakorvos) Fülöp László (1976-) (kardiológus) Szegedi Andrea (kardiológus) Siró Péter (1973-) (neurológus, aneszteziológus, intenzív terápiás szakorvos) Nagy Endre V. (1957-) (belgyógyász, endokrinológus) Lengyel Szabolcs (1981-) (belgyógyász) Kappelmayer János (1960-) (laboratóriumi szakorvos) Fülesdi Béla (1961-) (aneszteziológus)
Pályázati támogatás:Nemzeti Agykutatási Projekt
Egyéb
Internet cím:DOI
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001-es BibID:BIBFORM120447
035-os BibID:(Scopus)85190128657 (WoS)001201644800001
Első szerző:Szántó Dorottya (aneszteziológus, intenzív terápiás szakorvos)
Cím:Correlation of Inflammatory Parameters with the Development of Cerebral Vasospasm, Takotsubo Cardiomyopathy, and Functional Outcome after Spontaneous Subarachnoid Hemorrhage / Dorottya Szántó, Péter Luterán, Nikolett Kóti, Péter Siró, Éva Simon, Zsuzsa Jakab, Judit Gál, János Kappelmayer, Béla Fülesdi, Csilla Molnár
Dátum:2024
ISSN:2077-0383
Megjegyzések:Background: The present work aimed to determine whether a relationship exists between inflammatory parameters and the development of vasospasm (VS) and Takotsubo cardiomyopathy (TTC), as well as clinical outcome, in patients suffering from spontaneous subarachnoid hemorrhage (SAH). Methods: In this study, the authors processed the prospectively collected laboratory and clinical data of spontaneous SAH patients admitted to the neurointensive care unit between March 2015 and October 2023. The highest values of neutrophils (NEUpeak), monocytes (MONOpeak), neutrophil-to-lymphocyte ratio (NLRpeak), and CRP (CRPpeak) during the initial 7 days were correlated with the occurrence of VS and TTC, and with the outcome measures at day 30 after onset. Results: Data were collected from 175 SAH patients. Based on ROC analysis, for the development of VS, MONOpeak was the most accurate indicator (AUC: 0.619, optimal cut-off: 1.45 G/L). TTC with severe left ventricular dysfunction (ejection fraction < 40%) was indicated most sensitively by NEUpeak (ROC: 0.763, optimal cut-off: 12.34 G/L). Both for GOS and Barthel Index at day 30, CRPpeak was the best predictor for the outcome (GOS: ROC: 0.846, optimal cut-off: 78.33 mg/L and Barthel Index: ROC: 0.819, optimal cut-off: 78.33 mg/L). Conclusions: Laboratory parameters referring to inflammation during the initial 7 days after SAH correlate with the development of VS and TTC, and thus may predict functional outcome.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
subarachnoid hemorrhage
vasospasm
delayed cerebral ischemia
Takotsubo cardiomyopathy
systemic inflammatory response
Megjelenés:Journal of Clinical Medicine. - 13 : 7 (2024), p. 1-12. -
További szerzők:Luterán Péter (1991-) (aneszteziológus) Kóti Nikolett (1998-) (orvostanhallgató) Siró Péter (1973-) (neurológus, aneszteziológus, intenzív terápiás szakorvos) Simon Éva (1963-) (aneszteziológus) Jakab Zsuzsa (1982-) (aneszteziológus) Gál Judit (1977-) (aneszteziológiai és ITO szakorvos) Kappelmayer János (1960-) (laboratóriumi szakorvos) Fülesdi Béla (1961-) (aneszteziológus) Molnár Csilla (1962-) (aneszteziológus)
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