くも膜下出血に続発した重症のNeurogenic stress cardiomyopathyの検討

Neurogenic stress cardiomyopathy（NSC）is caused by catecholamine excess and／or sympathetic nerve activation, presented as a transient cardiac wall motion abnormality. It is reported to occur in ４‐１５％ of patients suffering from subarachnoid hemorrhage（SAH）. Of particular concern, severe NSC leading to cardiac dysfunction is especially important to consider when treating SAH patients in the acute stage because it could affect the prognosis of SAH and the timing of surgery. Currently, the incidence of severe NSC and risk factors are not well characterized. In the present study, we reviewed the medical records of８５patients（２０men,６５women）who were admitted and treated for ruptured cerebral aneurysms at Tokushima University Hospital during the period from January ２０１０ to May ２０１２. NSC occurred in five patients（５．９％）, and three of those patients（３．５％）showed severe NSC with cardiac dysfunction. NSC was observed only in patients with poor SAH-grade, and those resulting in severe cardiac dysfunction were all in women. Notably, the incidence of severe NSC was particularly high in female patients with poor SAH-grades （１７．６％）. We reported the morbidity of severe NSC in patients with SAH. It is important to pay special attention to severe NSC in female patients, particular those with poor SAH-grades.