2022年 · 第102卷第27期

Takotsubo cardiomyopathy (TTC) is an important complication of subarachnoid hemorrhage (SAH), which may lead to delayed surgery or endovascular treatment, which in turn affects the prognosis of patients. This prospective follow-up study was conducted to assess the prevalence, severity, influencing factors, and long-term outcome of TTC in patients with non-traumatic SAH. The study included consecutive admissions with a diagnosis of non-traumatic SAH. Initial assessment included brain CT, Hunt-Hess score, mFisher score and WFNS score, 12-lead electrocardiogram, transthoracic echocardiography (TTE), transcranial dual-function ultrasound and collection of laboratory parameters [creatine kinase (CK), creatine kinase isoenzyme (CK-MB), cardiac troponin T, N-terminal B-type natriuretic peptide precursor (NT-proBNP), and urine methoxyepinephrine and isoproterenol]. The diagnosis of TTC is based on the modified Mayo criteria. Patients with TTC are classified into mild and severe categories. Follow-up with TTE, Glasgow Outcome Scale (GOS), Barthel's and Karnofsky scores was performed on days 30 and 180.

Since 1995, the rapid advance in medical treatment modalities for patients with asymptomatic carotid stenosis, with studies showing that medical treatment alone can improve patient outcomes, raises questions about the absolute benefits of surgical intervention to prevent stroke in patients. The best management of patients with asymptomatic severe carotid stenosis is uncertain due to the lack of comparison of recent data on medical and surgical treatment. The aim of the study was to describe the long-term risk of stroke in patients with asymptomatic severe carotid stenosis who have not undergone surgical intervention in a more modern, racially and ethnically diverse community population.