Predicting the Development of Myocardial Depression in Acute Neurological Patients

  • STATUS
    Recruiting
  • End date
    Jun 30, 2023
  • participants needed
    10
  • sponsor
    Ohio State University
Updated on 5 June 2022

Summary

The purpose of this study is to assess the levels of serum catecholamines associated with myocardial depression (MD) in patients with acute neurological injury.

Description

The purpose of this study is to investigate the level of plasma catecholamines, associated with myocardial depression (MD) as noted on Transthoracic ECHO (TTE) by evidence of wall motion abnormalities (WMA) with or without drop in ejection fraction or symptomatic heart failure (HF). Takotsubo syndrome (TTS) is commonly diagnosed after the onset of HF once patients become symptomatic. The investigators intend to study whether early MD can be detected by identifying certain levels of plasma catecholamines and whether the level correlates with severity of myocardial depression. Identification of early MD changes can lead to alteration of management strategies and may help prevent worsening of HF. Highly selected patients with Subarachnoid Hemorrhage (SAH) or Acute Ischemic Stroke (AIS) requiring induced hypertension with the use of norepinephrine infusion will be recruited to enroll in this pilot study. This group of patients are expected to have high circulating catecholamines and are more likely to develop MD. Given the prevalence of TTS in females and elderly, 10 female patients >50 years admitted to the neuro ICU with diagnosis of either AIS or SAH will be enrolled. Patients with history of coronary artery disease, smoking, poorly controlled diabetes with HbA1c >8 and uncontrolled hypertension will be excluded. Patients with poor ECHO windows will also be excluded. Baseline plasma catecholamine levels, transthoracic ECHO(TTE), Troponin T, EKG and BNP will be obtained and will be followed daily through the study duration.

Details
Condition Myocardial Depression, Takotsubo Syndrome, Subarachnoid Hemorrhage, Acute Ischemic Stroke
Clinical Study IdentifierNCT03801694
SponsorOhio State University
Last Modified on5 June 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

female patients >50 years admitted to the neuro ICU with diagnosis of either acute ischemic stroke or subarachnoid hemorrhage
Only patients predicted to be on norepinephrine infusion for at least 48 hrs will be selected

Exclusion Criteria

patients with known history of heart failure will be excluded
Patients with history of coronary artery disease, smoking, poorly controlled diabetes with HbA1c >8 and uncontrolled hypertension will be excluded
Patients with poor ECHO windows will be excluded
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