Neurogenic pulmonary edema and Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage
- 주제(키워드) Takotsubo Syndrome , Neurogenic stunned myocardium , Neurogenic complication , aneurysmal subarachnoid hemorrhage , SAH , Neurocritical care.
- 주제(DDC) 610
- 발행기관 아주대학교 일반대학원
- 지도교수 임용철
- 발행년도 2024
- 학위수여년월 2024. 2
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000033369
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Purpose Neurogenic pulmonary edema (NPE) combined with Takotsubo cardiomyopathy (TCM) is a rare condition associated with aneurysmal subarachnoid hemorrhage (aSAH). Although several mechanisms have been proposed, the pathophysiology and management strategies are not yet fully established. We aimed to determine the radiological and clinical outcomes of patients with NPE and with TCM after aSAH to propose management strategies. Methods We analyzed the data of 564 patients with aSAH recorded at a single medical center from February 2015 to July 2022. This study retrospectively investigated the incidence and demographics of SAH combined with both NPE and TCM and the clinical outcomes of the patients. Correlating factors, independently associated with NPE-TCM were also investigated. Results During the 7 years, 11 (2.0%) of 564 patients had NPE complicated with TCM after aSAH. Seven of 11(63.6%) patients had poor-grade SAH (Hunt–Hess Grade 4 to 5). Three of 11 patients had posterior circulation in the NPE-TCM group. The most prevalent treatment option was endovascular coil embolization except for one case of clip. Long-term outcomes were favorable in 6 of 11 patients, and there was one case of mortality. Age, troponin I level, and alveolar-arterial oxygen gradient were correlating factors of NPE-TCM. Conclusion Although NPE-TCM represents a rare complication associated with aSAH, achieving active resolution of underlying neurological causes through early and appropriate treatment may contribute to a favorable prognosis. Considering the limited incidence of SAH complicated with NPE-TCM, multi-center study may be needed. Key words: Takotsubo Syndrome, Neurogenic stunned myocardium, Neurogenic complication, aneurysmal subarachnoid hemorrhage, SAH, Neurocritical care.
more목차
1. Introduction 1
2. Method 2
A. Patient population 2
B. Clinical outcome 3
C. Radiological outcome 4
D. Statistical analysis 5
3. Results 5
A. Demographics 5
B. NPE-TCM with SAH 6
C. Correlating factors 6
4. Discussion 6
A. Limitations 11
5. Conclusion 12
6. Statements and Declarations 13
7. References 14
