Page 75 - Cardiac abnormalities after aneurysmal subarachnoid hemorrhage

Cardiac dysfunction and cerebral perfusion in patients with aSAH
Quantitative values for cerebral blood flow (CBF) and time to peak (TTP) were obtained for each ROI. We chose CBF as a measure of cerebral perfusion and TTP to represent contrast delay. The ROI with the lowest CBF value and the ROI with the highest TTP value of the 12 ROIs was selected, as this represents the brain tissue with the lowest perfusion. In addition, we calculated the mean global CBF and TTP of all the ROIs.
CTA imaging
All admission CTAs were evaluated in consensus by two experienced radiologists (IvdS, BKV). Early vasospasm was interpreted as none to mild (<25%), moderate (25-50%) or severe (>50%) arterial narrowing that could not be attributed to atherosclerosis.4
Analyses
In patients with and without cardiac dysfunction we compared minimal CBF and maximal TTP values on CTP to compare focal perfusion deficits and mean CBF and TTP values to compare global perfusion. Differences of means with 95% confidence intervals (95%CI) were calculated.
Results 5
We included 72 aSAH patients, of whom 35 had cardiac dysfunction; 11 with both WMAs and positive troponins, 5 had WMAs but negative troponins, and 19 had positive troponins and no WMAs (Table 1). Patients with cardiac dysfunction had a worse clinical condition on admission compared to patients without cardiac dysfunction. The amount of extravasated blood on admission was comparable between patients with and without cardiac dysfunction (Table 1).
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