title: Myocardial function at the early phase of traumatic brain injury: a prospective controlled study.
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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  NCT02380482.
authors: Pôle Anesthésie Réanimation, Hôpital Albert Michallon, BP 217, Centre Hospitalier Universitaire de Grenoble, CS 10217, F-38043, Grenoble, France.
authors: Adrien
authors: A
authors: Cuisinier
authors: Laboratory of Integrative Cardiovascular and Metabolic Physiology, Division of Physiology, Department of Medicine, University of Fribourg, Fribourg, Switzerland.
authors: Claire
authors: C
authors: Maufrais
authors: Pôle Anesthésie Réanimation, Hôpital Albert Michallon, BP 217, Centre Hospitalier Universitaire de Grenoble, CS 10217, F-38043, Grenoble, France.|Grenoble Institut des Neurosciences, INSERM U1216, F-38043, Grenoble, France.|Grenoble Alpes Université, F-38043, Grenoble, France.
authors: Jean-François
authors: JF
authors: Payen
authors: Avignon University, LAPEC EA4278, F-84000, Avignon, France.
authors: Stephane
authors: S
authors: Nottin
authors: Avignon University, LAPEC EA4278, F-84000, Avignon, France.
authors: Guillaume
authors: G
authors: Walther
authors: Pôle Anesthésie Réanimation, Hôpital Albert Michallon, BP 217, Centre Hospitalier Universitaire de Grenoble, CS 10217, F-38043, Grenoble, France. PBouzat@chu-grenoble.fr.|Grenoble Institut des Neurosciences, INSERM U1216, F-38043, Grenoble, France. PBouzat@chu-grenoble.fr.|Grenoble Alpes Université, F-38043, Grenoble, France. PBouzat@chu-grenoble.fr.
authors: Pierre
authors: P
authors: Bouzat
mesh_terms: D000293:Adolescent; D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016037:Single-Blind Method; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult