Patients with subarachnoid hemorrhage (SAH) often exhibit cardiac abnormalities. Preliminary data from our current studies indicate that these abnormalities may be due to increases in sympathetic nervous system (SNS) activity and circulating levels of inflammatory cytokines (ICs). Our general hypothesis is that activation of the SNS and increases in ICs lead to cardiac dysfunction, reduced blood pressure, and cardiac output, ultimately increasing the risk of poor neurologic outcome after SAH.
The Specific Aims of this proposal are as follows: 1. To test the hypothesis that specific single nucleotide polymorphisms (SNPs) of the beta- and alpha-adrenergic receptors are associated with an increased risk of developing cardiac injury (release of cardiac troponin I) and dysfunction (reduced left ventricular ejection fraction) after SAH. 2. To test the hypothesis that elevated plasma levels of norepinephrine and epinephrine are associated with an increased risk of developing cardiac injury and dysfunction after SAH. 3. To test the hypothesis that specific SNPs of the genes encoding ICs are associated with an increased risk of developing cardiac injury and dysfunction after SAH. 4. To test the hypothesis that elevated levels of ICs, including tumor necrosis factor-alpha, interleukin-1, and interleukin-6, are associated with an increased risk of developing cardiac injury and dysfunction after SAH. 5. To test the hypothesis that SAH-induced cardiac dysfunction is associated with decreased systolic blood pressure and increased inpatient mortality.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21NS050551-01
Application #
6860929
Study Section
Clinical Neuroscience and Disease Study Section (CND)
Program Officer
Jacobs, Tom P
Project Start
2004-12-01
Project End
2006-11-30
Budget Start
2004-12-01
Budget End
2005-11-30
Support Year
1
Fiscal Year
2005
Total Cost
$175,172
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Taub, Pam R; Fields, Jeremy D; Wu, Alan H B et al. (2011) Elevated BNP is associated with vasospasm-independent cerebral infarction following aneurysmal subarachnoid hemorrhage. Neurocrit Care 15:13-8
Zaroff, Jonathan G; Pawlikowska, Ludmila; Miss, Jacob C et al. (2006) Adrenoceptor polymorphisms and the risk of cardiac injury and dysfunction after subarachnoid hemorrhage. Stroke 37:1680-5
Yarlagadda, Sirisha; Rajendran, Pam; Miss, Jacob C et al. (2006) Cardiovascular predictors of in-patient mortality after subarachnoid hemorrhage. Neurocrit Care 5:102-7