B-type natriuretic peptide release and left ventricular filling pressure assessed by echocardiographic study after subarachnoid hemorrhage: a prospective study in non-cardiac patients

• DOI: 10.1186/cc7891
• Publication Date: 2009-05-20T08:14:12Z
• Authors: Eric Meaudre; Christophe Jego; Nadia Kenane; Ambroise Montcriol; Henry Boret; Philippe Goutorbe; Gilbert Habib; Bruno Palmier
• Keywords: Brain natriuretic peptide

Abstract Introduction Serum B-type natriuretic peptide (BNP) is frequently elevated after subarachnoid hemorrhage (SAH), but whether this high BNP level related to transient elevation of left ventricular filling pressure (LVFP) unknown. However, in patients with preexistent cardiac pathologies, it impossible differentiate between caused by chronic abnormalities and acute neurocardiac injury. Methods All adult SAH admitted our intensive care unit were eligible. Patients excluded for the following reasons: admission >48 hours aneurysm rupture, pre-existing hypertension, or disease. Levels troponin Ic measured daily 7 days. Echocardiography was performed a blinded cardiologist on days 1, 2, 7. Doppler signals from mitral inflow, tissue Doppler, color M-mode–derived flow propagation velocity (FPV) obtained assess echo-estimated LVFP. Results During 3-year period, sixty-six consecutive admitted. Thirty one studied. The >100 ng/L 25 (80%) during first 3 days, peak day 2 (median, 126 ng/L) followed gradual decrease (median variation 1 7, 70%). had an ejection fraction >50%. Early transmitral velocity/tissue annular early diastolic low: 5.4 (± 1.5) 5.8 1.2) 5.1 0.9) velocity/FPV also 1.27 0.4), 1.25 0.3), 1.1 0.2) respectively. Cardiac levels ranged 0 3.67 μg/L correlated ( r = 0.63, P < 0.01). Conclusions rises gradually over two return normal within week SAH. Its release associated myocardial necrosis, unrelated LVFP assessed echocardiography.