Studies that evaluate cardiac function in acute brain injury patients

Reference	Patient number	Study design	Group	Technique assessment	End-point	Findings	Quality of evidence
Incidence of altered cardiac function
Sandvei et al. [21]	18	P	SAH	Echography	To assess the incidence of LV dysfunction	Systolic function and SV were higher in patients than in controls Diastolic function was altered in the early phase when compared to controls	Very low
Banki et al. [14]	173	P	SAH	Echography	To assess the incidence and timecourse of LV dysfunction	15 % had low LVEF 13 % of patients had RWMA with normal LVEF Recovery of LV function observed in 66 % of patients	Low
Mayer et al. [16]	57	P	SAH	Echography	To assess the incidence of LV dysfunction	8 % of RWMA, which were associated with hypotension and PE	Low
Jung et al. [15]	42	P	SAH	Echography	To assess the incidence of LV dysfunction	Only 1/42 patients had LV dysfunction	Low
Lee et al. [85]	24	P	SAH	Echography	To assess the incidence of Tako-Tsubo cardiopathy among patients with SAH-induced LV dysfunction	8/24 patients had Tako-Tsubo pattern All patients recovered LVEF >40 %	Very low
Khush et al. [19]	225	P	SAH	Echography	To assess the incidence and predictors of SAH-induced LV dysfunction	RWMA were found in 27 % of patients Apical sparing pattern was found in 49 % of patients Younger age and anterior aneurysm position were independent predictors of this AS pattern	Low
Jacobshagen et al. [86]	200	R	CA	Echography	To assess the incidence of LV dysfunction	Significant reduction of LVEF (32 ± 6 %) on admission	Very low
Ruiz-Bailen et al. [87]	29	P	CA	Echography	To assess the incidence and timecourse of LV dysfunction	LV dysfunction occurred in 20/29 patients in the early phase after CA LVEF slowly improved among survivors	Very low
Role of cardiac function monitoring to explain the mechanisms of brain injury-related cardiopulmonary complications
Miss et al. [88]	172	P	SAH	Echography	To evaluate the correlation of LV dysfunction with the type of aneurysm therapy	No difference in the occurrence of RWMA or LV dysfunction with regard of coiling or clipping	Low
Frangiskasis et al. [57]	117	P	SAH	Echography	To evaluate the correlation of LV dysfunction with ECG abnormalities	Low LVEF associated with VA	Low
Pollick et al. [17]	13	P	SAH	Echography	To evaluate the correlation of LV dysfunction with ECG abnormalities	RWMA in 4/13 patients RWMA was associated with inverted T waves	Very low
Kono et al. [89]	12	P	SAH	Echography	To evaluate the correlation of LV dysfunction with ECG and coronary angiography abnormalities	Apical LV hypokinesia was not associated with coronary stenosis despite ST elevation on ECG	Low
Davies et al. [18]	41	P	SAH	Echography	To evaluate the correlation of LV dysfunction with ECG abnormalities	RWMA in 10 % of patients RWMA not associated with ECG alterations	Low
Bulsara et al. [13]	350	R	SAH	Echography	To evaluate the correlation of LV dysfunction with ECG abnormalities and markers of heart injury	LVEF < 40 % in 3 % of patients No association of LV dysfunction with ECG abnormalities Peak of cTnI in SAH patients was lower than matched patients with MI	Very low
Deibert et al. [90]	43	P	SAH	Echography	To assess the relationship between LV dysfunction and markers of heart injury	RWMA associated with high cTnI RWMA resolved over time in all patients	Low
Hravnak et al. [91]	125	P	SAH	Echography	To assess the relationship between LV dysfunction and markers of heart injury	High cTnI was associated with RWMA and lower LVEF Only 26 % of patients returned to normal cardiac function over time	Low
Naidech et al. [29]	253	R	SAH	Echography	To assess the relationship between LV dysfunction and markers of heart injury	High cTnI was associated with RWMA and low LVEF	Very low
Parekh et al. [30]	41	P	SAH	Echography	To assess the relationship between LV dysfunction and markers of heart injury	High cTnI was associated with low LVEF	Low
Tung et al. [31]	223	P	SAH	Echography	To assess the relationship between LV dysfunction and markers of heart injury	Low LVEF predicted high cTnI	Low
Kothavale et al. [92]	300	P	SAH	Echography	To assess the relationship between LV dysfunction and markers of heart injury	RWMA in 18 % patients RWMA associated with poor neurological status and high cTnI levels	Low
Apak et al. [93]	62	P	Stroke	Echography	To assess the relationship between LV dysfunction and markers of heart injury	Serum levels of cTnT were inversely correlated with LVEF	Low
Zaroff et al. [94]	30	P	SAH	Echography	To assess the relationship between RWMA and patterns of coronary artery disease	RWMA did not correlate with typical patterns of coronary artery disease RWMA resolved in all patients	Very low
Banki et al. [33]	42	P	SAH	Echography	To assess the relationship between LV dysfunction of myocardial perfusion and innervation	LV systolic dysfunction was associated with normal myocardial perfusion and abnormal sympathetic innervation	Low
Abdelmoneim et al. [32]	10	P	SAH	RTP-CE	To assess microvascular perfusion and echographic abnormalities after SAH	RWMA was not associated with altered myocardial perfusion	Very low
Sugimoto et al. [28]	77	R	SAH	Echography	To assess the relationship between LV dysfunction and estradiol (ES) or norepinephrine (NE)	The incidence of RWMA in the high-NE/low-ES group was significantly higher than the low-NE/high-ES group	Very low
Sugimoto et al. [27]	48	R	SAH	Echography	To assess the relationship between LV dysfunction and norepinephrine (NE) levels	Plasma NE levels were significantly higher in patients with RWMA and inversely correlated with LVEF	Very low
Tanabe et al. [22]	103	P	SAH	Echography	To assess the relationship between LV dysfunction and PE	Higher incidence of systolic or diastolic dysfunction in patients with elevated cTnI	Low
Kopelnik et al. [23]	207	P	SAH	Echography	To assess the incidence of diastolic dysfunction and its relationship with PE	Diastolic dysfunction was observed in 71 % of subjects Diastolic dysfunction was an independent predictor of PE	Low
Tung et al. [95]	57	R	SAH	Echography	To assess the relationship between LV dysfunction and elevated BNP	High BNP in patients with systolic or diastolic dysfunction	Very low
Meaudre et al. [96]	31	P	SAH	Echography	To assess the relationship between LV dysfunction and elevated BNP	No correlation between diastolic dysfunction and BNP	Very low
Naidech et al. [35]	171	P	SAH	Echography	To assess the relationship between LV dysfunction and PE	No association of LV dysfunction and PE	Low
McLaughin et al. [97]	178	R	SAH	Echography	To assess the relationship between LV systolic or diastolic dysfunction and PE	Occurrence of PE was associated with both systolic or diastolic dysfunction	Very low
Sato et al. [37]	49	P	SAH	TT	To assess variables related to the development of PE	Patients with PE had lower cardiac function than others	Low
Junttila et al. [36]	108	P	ICH	Echography	To evaluate the predictive value of echographic abnormalities for NPE	VEF < 50 % and E/A > 2 more frequent in NPE patients No predictive value of such abnormalities for NPE	Low
Kuwagata et al. [62]	8	P	TBI	Echography	To assess the effects of TH on cardiac function	TH did not affect stroke volume and diastolic function	Very low
Cardiac function monitoring findings and outcome
Yousef et al. [47]	149	P	SAH	Echography	To evaluate which hemodynamic variable was associated with DCI	No influence of LVEF or RWMA on DCI	Low
Jyotsna et al. [98]	56	P	SAH	Echography	To evaluate the prognostic value of myocardial dysfunction after SAH	LV dysfunction was associated with poor outcome	Low
Sugimoto et al. [60]	47	P	SAH	Echography	To evaluate the prognostic value of myocardial dysfunction after SAH	RWMA independent risk factor of mortality	Low
Papanikolaou et al. [99]	37	P	SAH	Echography	To evaluate the prognostic value of myocardial dysfunction after SAH	LV dysfunction associated with DCI and poor outcome	Low
Temes et al. [3]	119	P	SAH	Echography	To assess the impact of LV dysfunction on cerebral infarction and neurological outcome	LV dysfunction independent predictor of DCI but not of neurologic outcome	Low
Vannemreddy et al. [59]	42	P	SAH	Echography	To evaluate the prognostic value of myocardial dysfunction after SAH	RWMA was associated with poor GCS on admission and increased hospital stay but not with increased mortality	Low
Urbaniak et al. [63]	266	P	SAH	Echography	To evaluate the prognostic value of myocardial dysfunction after SAH	LV dysfunction not associated with outcome	Low
Yarlagadda et al. [64]	300	P	SAH	Echography	To evaluate the prognostic value of myocardial dysfunction after SAH	LVEF not associated with outcome	Low
Front et al. [100]	64	R	Stroke	Radionuclide	To evaluate the prognostic value of LVEF after stroke	Non-survivors had lowe LVEF (52 ± 18 %) than survivors (64 ± 10 %)	Very low
Chang et al. [61]	165	P	CA	Echography	To assess the LV function and its relationship with outcome	Lower LVEF associated with previous cardiac disease and epinephrine doses LVEF < 40 % had higher mortality than normal LVEF	Low
Khan et al. [101]	138	P	CA	Echography	To assess the LV function and its relationship with outcome	LVEF < 40 % had higher mortality than normal LVEF	Low

P prospective, R retrospective, SAH subarachnoid haemorrhage, TBI traumatic brain injury, TT transpulmonary thermodilution, PE pulmonary edema, CO cardiac output, PCWA pulse contour wave analysis, LVEF left ventricular ejection fraction, NPE neurogenic pulmonary edema, CV cerebral vasospasm, CI cardiac index, PE pulmonary edema, IABP intra-aortic balloon counterpulsation, LVEF low ventricular ejection fraction, cTnI troponin I, GEDVI global end-diastolic volume index, GEF global ejection fraction, DCI delayed cerebral infarction, BNP brain natriuretic peptide, SV stroke volume, ECG electrocardiogram, VA ventricular arrhythmias, NPE neurogenic pulmonary edema, RTP-CE real-time contrast echocardiography