Brain-heart Interactions in Traumatic Brain Injury
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.
El-Menyar, A., Goyal, A., Latifi, R., Al-Thani, H., & Frishman, W. (2017). Brain-heart Interactions in Traumatic Brain Injury. Cardiology in Review, 25 (6), 279-288. https://doi.org/10.1097/CRD.0000000000000167