Importance of detection of segmental wall motion abnormalities of left ventricle in nontraumatic subarachnoid hemorrhage: a prospective study.

Object: To find out the incidence and importance of segmental wall motion abnormalities (SWMAs) of the left ventricle in noncoronary artery disease (CAD) and nontraumatic subarachnoid hemorrhage (SAH) patients.

Methods: Nontraumatic SAH patients were evaluated with two-dimensional echocardiogram in addition to detailed clinical and investigative data. In echocardiogram, LV was evaluated as a 16-segment approach and its function was noted. Cerebral angiogram was performed in all the patients. Repeat echocardiograms were performed on day 10 and 6 weeks later.

Results: In 56 nontraumatic SAH patients, the average age was 45.8 + or - 9.1 years. Among them 16 were females. Clinical grade was 3-5 in 26 (46.43%) patients and 24 (42.86%) patients had aneurysms. Echocardiogram was normal in 33 patients and in 23 (41.07%) patients there were left ventricular (LV) abnormalities. LV SWMA was present in 15 patients (65.22%) and global hypokinesia in 8 patients (34.78 %). In the SWMA group, preservation of apical function relative to the base was observed in 13 patients. The repeat echocardiogram on day 10 in SWMA group showed normalization of LV abnormalities in 14 patients and one patient died due to rebleed. In global hypokinesia group, four patients recovered and four died. Significant associations were observed between SWMA and presence of aneurysm (P < 0.05) and LV function (P < 0.001), mortality correlated with LV function (P < 0.001) and clinical grade (P < 0.02).

Conclusion: Transient SWMA can occur due to aneurysmal SAH itself and when associated with LV dysfunction, it had a higher mortality. (Echocardiography 2010;27:496-500).