Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study
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- 作者：Bertrand Prunet (69)
Mathieu Basely (70)
Erwan D鈥橝randa (69)
Pierre Cambefort (70)
Fr茅d茅ric Pons (71)
S茅bastien Cimarelli (72)
Arnaud Dagain (73)
Nicolas Desse (73)
Jean-Brice Veyrieres (74)
Christophe Jego (71)
Guillaume Lacroix (69)
Pierre Esnault (69)
Henry Boret (69)
Philippe Goutorbe (69)
Emmanuel Bussy (70)
Gilbert Habib (75)
Eric Meaudre (69)
69. Department of Critical Care ; Service de R茅animation ; Sainte Anne Military Teaching Hospital ; Boulevard Sainte Anne ; Toulon ; 83000 ; France
70. Department of Nuclear Medicine ; Sainte Anne Military Teaching Hospital ; Boulevard Sainte Anne ; Toulon ; 83000 ; France
71. Department of Cardiology ; Sainte Anne Military Teaching Hospital ; Boulevard Sainte Anne ; Toulon ; 83000 ; France
72. Department of Nuclear Medicine ; L茅on B茅rard Cancer Institute ; 28 ; rue Laennec ; Lyon ; 69373 ; France
73. Department of Neurosurgery ; Sainte Anne Military Teaching Hospital ; Boulevard Sainte Anne ; Toulon ; 83000 ; France
74. Department of Neuroradiology ; Sainte Anne Military Teaching Hospital ; Boulevard Sainte Anne ; Toulon ; 83000 ; France
75. Department of Cardiology ; Timone Hospital and Aix-Marseille University ; 27 ; boulevard Jean Moulin ; Marseille ; 13385 ; France - 刊名：Critical Care
- 出版年：2014
- 出版时间：June 2014
- 年：2014
- 卷：18
- 期：3
- 全文大小：882 KB
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- 出版者：BioMed Central
- ISSN：1364-8535
文摘
Introduction Although aneurysmal subarachnoid hemorrhage (SAH) is often complicated by myocardial injury, whether this neurogenic cardiomyopathy is associated with the modification of cardiac metabolism is unknown. This study sought to explore, by positron emission tomography/computed tomography, the presence of altered cardiac glucose metabolism after SAH. Methods During a 16-month period, 30 SAH acute phase patients underwent myocardial 18鈥塅- fluorodesoxyglucose positron emission tomography (18F-FDGPET), 99mTc-tetrofosmin and 123I-meta-iodobenzylguanidine (123I-mIBG) scintigraphy, respectively, assessing glucose metabolism, cardiac perfusion, and sympathetic innervation. Patients with initial abnormalities were followed monthly for two months for 18F-FDG, and six months later for 123I-mIBG. Results In this SAH population, acute cardiac metabolic disturbance was observed in 83% of patients (n鈥?鈥?5), and sympathetic innervation disturbance affected 90% (n鈥?鈥?7). Myocardial perfusion was normal for all patients. The topography and extent of metabolic defects and innervation abnormalities largely overlapped. Follow-up showed rapid improvement of glucose metabolism in one or two months. Normalization of sympathetic innervation was slower; only 27% of patients (n鈥?鈥?) exhibited normal 123I-mIBG scintigraphy after six months. Presence of initial altered cardiac metabolism was not associated with more unfavorable cardiac or neurological outcomes. Conclusions These findings support the hypothesis of neurogenic myocardial stunning after SAH. In hemodynamically stable acute phase SAH patients, cardiomyopathy is characterized by diffuse and heterogeneous 18F-FDG and 123I-mIBG uptake defect. Trial registration Clinicaltrials.gov NCT01218191. Registered 6 October 2010.