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Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study

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, t...

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Autores principales: Prunet, Bertrand, Basely, Mathieu, D’Aranda, Erwan, Cambefort, Pierre, Pons, Frédéric, Cimarelli, Sébastien, Dagain, Arnaud, Desse, Nicolas, Veyrieres, Jean-Brice, Jego, Christophe, Lacroix, Guillaume, Esnault, Pierre, Boret, Henry, Goutorbe, Philippe, Bussy, Emmanuel, Habib, Gilbert, Meaudre, Eric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230019/
https://www.ncbi.nlm.nih.gov/pubmed/24964817
http://dx.doi.org/10.1186/cc13943
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author Prunet, Bertrand
Basely, Mathieu
D’Aranda, Erwan
Cambefort, Pierre
Pons, Frédéric
Cimarelli, Sébastien
Dagain, Arnaud
Desse, Nicolas
Veyrieres, Jean-Brice
Jego, Christophe
Lacroix, Guillaume
Esnault, Pierre
Boret, Henry
Goutorbe, Philippe
Bussy, Emmanuel
Habib, Gilbert
Meaudre, Eric
author_facet Prunet, Bertrand
Basely, Mathieu
D’Aranda, Erwan
Cambefort, Pierre
Pons, Frédéric
Cimarelli, Sébastien
Dagain, Arnaud
Desse, Nicolas
Veyrieres, Jean-Brice
Jego, Christophe
Lacroix, Guillaume
Esnault, Pierre
Boret, Henry
Goutorbe, Philippe
Bussy, Emmanuel
Habib, Gilbert
Meaudre, Eric
author_sort Prunet, Bertrand
collection PubMed
description 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) F- fluorodesoxyglucose positron emission tomography ((18)F-FDGPET), (99m)Tc-tetrofosmin and (123)I-meta-iodobenzylguanidine ((123)I-mIBG) scintigraphy, respectively, assessing glucose metabolism, cardiac perfusion, and sympathetic innervation. Patients with initial abnormalities were followed monthly for two months for (18)F-FDG, and six months later for (123)I-mIBG. RESULTS: In this SAH population, acute cardiac metabolic disturbance was observed in 83% of patients (n = 25), and sympathetic innervation disturbance affected 90% (n = 27). 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 = 8) exhibited normal (123)I-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 (18)F-FDG and (123)I-mIBG uptake defect. TRIAL REGISTRATION: Clinicaltrials.gov NCT01218191. Registered 6 October 2010.
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spelling pubmed-42300192014-11-14 Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study Prunet, Bertrand Basely, Mathieu D’Aranda, Erwan Cambefort, Pierre Pons, Frédéric Cimarelli, Sébastien Dagain, Arnaud Desse, Nicolas Veyrieres, Jean-Brice Jego, Christophe Lacroix, Guillaume Esnault, Pierre Boret, Henry Goutorbe, Philippe Bussy, Emmanuel Habib, Gilbert Meaudre, Eric Crit Care Research 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) F- fluorodesoxyglucose positron emission tomography ((18)F-FDGPET), (99m)Tc-tetrofosmin and (123)I-meta-iodobenzylguanidine ((123)I-mIBG) scintigraphy, respectively, assessing glucose metabolism, cardiac perfusion, and sympathetic innervation. Patients with initial abnormalities were followed monthly for two months for (18)F-FDG, and six months later for (123)I-mIBG. RESULTS: In this SAH population, acute cardiac metabolic disturbance was observed in 83% of patients (n = 25), and sympathetic innervation disturbance affected 90% (n = 27). 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 = 8) exhibited normal (123)I-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 (18)F-FDG and (123)I-mIBG uptake defect. TRIAL REGISTRATION: Clinicaltrials.gov NCT01218191. Registered 6 October 2010. BioMed Central 2014 2014-06-25 /pmc/articles/PMC4230019/ /pubmed/24964817 http://dx.doi.org/10.1186/cc13943 Text en Copyright © 2014 Prunet et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Prunet, Bertrand
Basely, Mathieu
D’Aranda, Erwan
Cambefort, Pierre
Pons, Frédéric
Cimarelli, Sébastien
Dagain, Arnaud
Desse, Nicolas
Veyrieres, Jean-Brice
Jego, Christophe
Lacroix, Guillaume
Esnault, Pierre
Boret, Henry
Goutorbe, Philippe
Bussy, Emmanuel
Habib, Gilbert
Meaudre, Eric
Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study
title Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study
title_full Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study
title_fullStr Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study
title_full_unstemmed Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study
title_short Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study
title_sort impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230019/
https://www.ncbi.nlm.nih.gov/pubmed/24964817
http://dx.doi.org/10.1186/cc13943
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