naa a22 4500 510800319 CHVBK 20180411083352.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s12028-012-9804-z doi (NATIONALLICENCE)springer-10.1007/s12028-012-9804-z Cardiovascular Protection to Improve Clinical Outcomes After Subarachnoid Hemorrhage: Is There a Proven role? [Elektronische Daten] [Toshimasa Okabe, Mitul Kanzaria, Fred Rincon, Walter Kraft] Cardiac abnormalities seen in patients with subarachnoid hemorrhage (SAH) are considered to be a neurally mediated process rather than a manifestation of coronary artery disease. In patients with SAH, myocardial injury evidenced by troponin elevation appears to predict short and long-term outcomes independently of other conventional risk. Although incidence of electrocardiographic changes, arrhythmias and left ventricular systolic dysfunction do not independently predict the outcomes, monitoring these changes and optimizing hemodynamic status in high-grade SAH is crucial to ensure adequate cerebral perfusion and arterial oxygenation. Novel interventions that go beyond blood pressure control, prevention of re-bleeding, and aneurysm obliteration should target early physiologic derangements seen in the acute phase of SAH. The early resuscitation phase in SAH represents the greatest opportunity for impacting clinical outcome and is thus the most promising window of opportunity to demonstrate a benefit when investigating novel therapeutic strategies related to protection and modulation of cardiovascular function. Specific measures, such as the early use of beta-adrenergic antagonists, to prevent these cardiac abnormalities and ameliorate its impact on morbidity and mortality are yet to be established. Springer Science+Business Media New York, 2012 Subarachnoid hemorrhage nationallicence Cardiac arrhythmias nationallicence Myocardial diseases nationallicence Troponin nationallicence Beta-adrenergic blockers nationallicence Hydroxymethylglutaryl-CoA reductase inhibitors nationallicence Perioperative care nationallicence Okabe Toshimasa Division of Cardiology, Department of Medicine, Thomas Jefferson University, 925 Chestnut Street, Mezzanine, 19107, Philadelphia, PA, USA aut Kanzaria Mitul Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA aut Rincon Fred Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA aut Kraft Walter Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA aut Neurocritical Care Humana Press Inc 18/2(2013-04-01), 271-284 1541-6933 18:2<271 2013 18 12028 https://doi.org/10.1007/s12028-012-9804-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9804-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Okabe Toshimasa Division of Cardiology, Department of Medicine, Thomas Jefferson University, 925 Chestnut Street, Mezzanine, 19107, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Kanzaria Mitul Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Rincon Fred Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Kraft Walter Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/2(2013-04-01), 271-284 1541-6933 18:2<271 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer