Brain-Heart Interactions in Traumatic Brain Injury

作者：El Menyar Ayman^*; Goyal Abhishek; Latifi Rifat; Al Thani Hassan; Frishman William

来源：Cardiology in Review, 2017, 25(6): 279-288.

DOI：10.1097/CRD.0000000000000167

• trauma
• brain injury
• myocardial dysfunction
• troponins
• biomarkers
• neurocardiac axis
• neurogenic stunned myocardium
• beta adrenergic blockers
• catecholamines

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.

• 出版日期2017-12