Evaluating the values of blood troponin T in relation to the values of cardiac ejection fraction in patients suffering sub-arachnoid hemorrhage due to ruptured cerebral aneurysms
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KeywordsEjection Fraction Cardiomyopathy Cardiac Function Cerebral Aneurysm Cerebral Angiography
To evaluate the values of blood troponin T (T-T) in relation to the values of cardiac ejection fraction (EF) in patients suffering sub-arachnoid hemorrhage (SAH) due to ruptured cerebral aneurysms (RCA).
Patients and methods
The present study was approved by the local ethical committee and informed consent was obtained from all patients and/or their relatives. During 1 April to 30 November, 10 patients were transferred to Kanemaru Hospital under suspicion of SAH: they complained of sudden headache and/or showed disturbed consciousness. The diagnosis for RCA with SAH was obtained by checking the views from cranial computed tomography (CT) and cerebral angiography. We also examined blood samples to evaluate the blood T-T and also their cardiac function using an echocardiogram machine (Sonos 4500; Philips). To compare, we divided the patients into the two groups in relation to the results of blood T-T: patients who showed negative results (N-G) and patients who showed positive results (P-G), respectively. Cardiac functions were evaluated using the values of cardiac EF. T-T was measured using the kit Trop-T sensitive (Roche). These values were obtained from blood samples drawn from patients after more than 4 hours since the onset of the SAH attack. Data were expressed as means (± SD). Statistical analysis was performed using Statview software and P < 0.05 was thought statistically significant.
In two patients, paired values could not be obtained and we removed them from the study. Eventually, eight patients were enrolled. Two female patients of all the eight patients showed positive results in T-T and the other six patients (two male and four female) showed negative results. The age was 70 (12.6) years with the range of 43–80 in N-G and was 80.5 (0.7) years with the range 80–81 in P-G, respectively. In N-G, the EF value was 73.1% (6.2) with the range of 64–81, and in P-G was 39.5% (7.8) with the range of 34–46, respectively. There was a significant difference in the cardiac EF values between the two groups (P = 0.0003). However, no patient with normal cardiac function showed a positive value of T-T. In addition, patients with disturbed cardiac EF values less than 55% showed positive results in the T-T test. The patients in P-G also showed giant negative T waves in their electrical cardiogram.
Catecholamine-induced cardiomyopathy can occur in several kinds of diseases, one of which is SAH. It can induce disturbed cardiac function. Many patients with SAH due to RCA need surgical procedures, such as neck clipping. However, we also need to obtain correct information about their general conditions including the state of cardiac functions. Evaluations with measuring cardiac EF and blood T-T could give us good information to understand cardiac conditions. The information might also help surgeons and anesthesiologists to decide when the surgical procedures should be done or not. We can obtain the values of blood T-T easily without special equipment and a talented technique.
Some patients who suffered SAH due to RCA showed disturbed cardiac dysfunctions. In assessing them, we recommend measuring blood troponin T as an adjunctive method.