Brain-Heart Interactions in Traumatic Brain Injury

• Published in: Cardiology in review Vol. 25; no. 6; p. 279
• Main Authors: El-Menyar, Ayman, Goyal, Abhishek, Latifi, Rifat, Al-Thani, Hassan, Frishman, William
• Format: Journal Article
• Language: English
• Published: United States 01.11.2017
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Brain - physiopathology; Brain Injuries, Traumatic - complications; Brain Injuries, Traumatic - physiopathology; Cardiovascular Diseases - blood; Cardiovascular Diseases - drug therapy; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; Creatine Kinase, MB Form - blood; Electrocardiography; Heart - physiopathology; Hemodynamics; Humans; Myocardial Stunning - blood; Myocardial Stunning - drug therapy; Myocardial Stunning - etiology; Myocardial Stunning - physiopathology; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Troponin - blood
• ISSN: 1538-4683
• DOI: 10.1097/crd.0000000000000167

The cardiovascular manifestations associated with nontraumatic head disorders are commonly known. Similar manifestations have been reported in patients with traumatic brain injury (TBI); however, the underlying mechanisms and impact on the patient's clinical outcomes are not well explored. The neurocardiac axis theory and neurogenic stunned myocardium phenomenon could partly explain the brain-heart link and interactions and can thus pave the way to a better understanding and management of TBI. Several observational retrospective studies have shown a promising role for beta-adrenergic blockers in patients with TBI in reducing the overall TBI-related mortality. However, several questions remain to be answered in clinical randomized-controlled trials, including population selection, beta blocker type, dosage, timing, and duration of therapy, while maintaining the optimal mean arterial pressure and cerebral perfusion pressure in patients with TBI.