关键词: 脑出血, 超声心动图, 左心室功能, 脑钠素

Abstract:

Objective The purpose of this study is to investigate the alterations of left ventricular function in patients with acute cerebral hemorrhage and the relationship between acute cerebral hemorrhage and plasma brain natreuretic peptide(BNP) by way of echocardiography and plasma BNP concentration determination and to bring to light the mechanism and to provide the basics for preventing and treating cardiac impairment caused by acute cerebral hemorrhage.Methods Thirty patients with acute cerebral hemorrhage within 24h having been diagnosed by clinical manifestations and head computed tomography were recruited.All enrolled patients had no history of heart diseases and no complications such as cardiac insufficiency and arrhythmia.And concurrently twenty sex and age matched patients with essential hypertension,and twenty-one sex and age matched healthy persons were selected as control groups.All patients and controls underwent echocardiographic investigation and at the same time blood was drawn for the quantitative determination of plasma BNP concentration.Results 1) The mean of LVEF in acute cerebral hemorrhage group was much lower than those in hypertension group and healthy control group((41.33±15.03)% vs(59.20±15.03)%,P<0.01;(41.33±15.03)% vs(67.71±8.02)%,P<0.01,respectively);There was no significant difference in the mean of LVEF between hypertension and healthy control groups(P>0.05).The mean E/A ratio in acute cerebral hemorrhage group was lower than those in hypertension group and healthy control groups.There was no significant difference in the mean E/A ratio between acute cerebral hemorrhage group and hypertension group(P>0.05),but there was significant difference between acute hemorrhage group and healthy control group(1.00±0.46 vs 1.47±0.23,P<0.01).The mean E/A ratio in hypertension group was lower than that in healthy control group, the difference was significant(1.09±0.37 vs 1.47±0.23,P<0.01).2) The plasma BNP concentration in acute cerebral hemorrhage group was higher than that in healthy control group((49.62 ng/L,(17.18～85.25)ng/L vs(1.90 ng/L,(0.15～21.50)ng/L,P<0.01).3) The correlation coefficient between volume of cerebral hemorrhage and plasma BNP concentration was 0.13(P>0.05).There was no correlation between volume of cerebral hemorrhage and all cardiac functional parameters in acute cerebral hemorrhage group(P>0.05).There was no correlation between plasma BNP concentration in acute hemorrhage group and cardiac structural and functional parameters(P>0.05).Conclusion Acute cerebral hemorrhage can cause left ventricular systolic dys function.Acute cerebral hemorrhage may cause left ventricular diastolic dys function as well.There was no correlation between the volume of cerebral hemorrhage and all cardiac functional parameters in acute cerebral hemorrhage group.The plasma BNP concentration increases after the onset of acute hemorrhage,but there was no correlation between the BNP concentration and changes in cardiac structural and functional parameters.The rise of plasma BNP concentration may be caused by the pathophysiologic mechanism of acute hemorrhage.

Key words: cerebral hemorrhage, echocardiography, left ventricular function, brain natriuretic peptide(BNP)