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

Résumé : 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. 20 consecutive adult patients with severe TBI were matched according to age and gender with 20 control patients. Control group included adult patients undergoing general anesthesia for 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. Primary endpoint was left ventricle ejection fraction (LVEF) measured by the Simpson’s method. Secondary endpoints included diastolic function and 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 systolic function were also similar between the two groups. Regarding diastolic function, isovolumic relaxation time was significantly higher in the TBI cohort (125s [84-178] versus 107s [83-141] p=0.04), suggesting subclinical diastolic dysfunction. Using STE, we observed a trend toward higher strains in the TBI group but only apical circumferential strain and basal rotation reached statistical significance. STE-derived parameters of diastolic function tended to be lower in TBI patients. Conclusions: No systematic myocardial depression was found in a cohort of severe TBI patients. STE rather revealed correct adaptation of left systolic function, while diastolic function slightly impaired.
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Human health and pathology. 2016
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https://dumas.ccsd.cnrs.fr/dumas-01347959
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Soumis le : vendredi 22 juillet 2016 - 09:21:25
Dernière modification le : vendredi 28 septembre 2018 - 18:54:51

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  • HAL Id : dumas-01347959, version 1

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Adrien Cuisinier. Myocardial function at the early phase of traumatic brain injury : a prospective controlled study. Human health and pathology. 2016. 〈dumas-01347959〉

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