NYMC Faculty Publications

Brain-heart Interactions in Traumatic Brain Injury

DOI

10.1097/CRD.0000000000000167

Journal Title

Cardiology in Review

First Page

279

Last Page

288

Document Type

Article

Publication Date

November 2017

Department

Surgery

Second Department

Medicine

Keywords

Adrenergic beta-Antagonists therapeutic use, Brain physiopathology, traumatic brain injuries complications, traumatic brain injuries 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, Peptide Fragments blood, Troponin blood

Disciplines

Medicine and Health Sciences

Abstract

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.

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