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Randomized Controlled Trial
. 2016 Oct 28;24(1):129.
doi: 10.1186/s13049-016-0323-3.

Myocardial function at the early phase of traumatic brain injury: a prospective controlled study

Adrien Cuisinier  1 , Claire Maufrais  2 , Jean-François Payen  1   3   4 , Stephane Nottin  5 , Guillaume Walther  5 , Pierre Bouzat  6   7   8
Affiliations
Randomized Controlled Trial

Myocardial function at the early phase of traumatic brain injury: a prospective controlled study

Adrien Cuisinier et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: The concept of brain-heart interaction has been described in several brain injuries. Traumatic brain injury (TBI) may also lead to cardiac dysfunction but evidences are mainly based upon experimental and clinical retrospective studies.

Methods: We conducted a prospective case-control study in a level I trauma center. Twenty consecutive adult patients with severe TBI were matched according to age and gender with 20 control patients. The control group included adult patients undergoing a general anesthesia for a peripheral trauma surgery. Conventional and Speckle Tracking Echocardiography (STE) was performed within the first 24 post-traumatic hours in the TBI group and PRE/PER-operative in the control group. The primary endpoint was the left ventricle ejection fraction (LVEF) measured by the Simpson's method. Secondary endpoints included the diastolic function and the STE analysis.

Results: We found similar LVEF between the TBI group and the PER-operative control group (61 % [56-76]) vs. 62 % [52-70]). LV morphological parameters and the systolic function were also similar between the two groups. Regarding the diastolic function, the isovolumic relaxation time was significantly higher in the TBI cohort (125 s [84-178] versus 107 s [83-141], p = 0.04), suggesting a subclinical diastolic dysfunction. Using STE parameters, we observed a trend toward higher strains in the TBI group but only the apical circumferential strain and the basal rotation reached statistical significance. STE-derived parameters of the diastolic function tended to be lower in TBI patients.

Discussion: No systematic myocardial depression was found in a cohort of severe TBI patients.

Conclusions: STE revealed a correct adaptation of the left systolic function, while the diastolic function slightly impaired.

Trial registration: NCT02380482.

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Figures

Fig. 1
Fig. 1
Left ventricle ejection fraction (LVEF) in patients with traumatic brain injury (TBI, n = 20 patients) and in control patients (n = 20 patients) obtained by conventional cardiac ultrasonography using the Simpson’s method. Echocardiography was performed within the first post-traumatic 24 h in the TBI group and under general anesthesia/mechanical ventilation in the control group. Values are median and extreme
See this image and copyright information in PMC

References

    1. Mertes PM, Bruder N, Audibert G. Cardiac complications of acute brain injury. Ann Fr Anesth Reanim. 2012;31(6):91–6. doi: 10.1016/j.annfar.2012.04.011. - DOI - PubMed
    1. Moussouttas M, Lai EW, Khoury J, Huynh TT, Dombrowski K, Pacak K. Determinants of central sympathetic activation in spontaneous primary subarachnoid hemorrhage. Neurocrit Care. 2012;16(3):381–8. doi: 10.1007/s12028-012-9673-5. - DOI - PubMed
    1. Oppenheimer SM, Hachinski VC. The cardiac consequences of stroke. Neurol Clin. 1992;10(1):167–76. - PubMed
    1. Arbabi S, Campion EM, Hemmila MR, Barker M, Dimo M, Ahrns KS, et al. Beta-blocker use is associated with improved outcomes in adult trauma patients. J Trauma. 2007;62(1):56–61. doi: 10.1097/TA.0b013e31802d972b. - DOI - PubMed
    1. Kolin A, Norris JW. Myocardial damage from acute cerebral lesions. Stroke. 1984;15(6):990–3. doi: 10.1161/01.STR.15.6.990. - DOI - PubMed

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