Abstract
Background:
Traumatic brain injury (TBI) is often associated with cardiac dysfunction, which is a consequence of the brain–heart cross talk. The subendocardial viability ratio (SEVR) is an estimate of myocardial perfusion. The aim of this study was to analyze changes in the SEVR in patients with severe TBI without previous cardiac diseases.
Methods:
Adult patients treated for severe TBI with a Glasgow coma score <8 were studied. Pressure waveforms were obtained by a high-fidelity tonometer in the radial artery for SEVR calculation at five time points: immediately after admission to the intensive care unit and 24, 48, 72, and 96 h after admission. SEVRs and other clinically important parameters were analyzed in patients who survived and did not survive after 28 days of treatment, as well as in patients who underwent decompressive craniectomy (DC).
Results:
A total of 64 patients (16 females and 48 males) aged 18–64 years were included. Fifty patients survived and 14 died. DC was performed in 23 patients. SEVRs decreased 24 h after admission in nonsurvivors (p < 0.05) and after 48 h in survivors (p < 0.01) and its values were significantly lower in nonsurvivors than in survivors at 24, 72, and 96 h from admission (p < 0.05). The SEVR increased following DC (p < 0.05).
Conclusions:
A decreased SEVR is observed in TBI patients. Surgical decompression increases the SEVR, indicating improvement in coronary microvascular perfusion. The results of our study seem to confirm that brain injury affects myocardium function.
Impact statement
Traumatic brain injury (TBI) is commonly associated with cardiac disorders, a consequence of the well-known brain–heart interaction. The pathophysiological mechanisms of cardiac dysfunction following TBI are still not completely elucidated. The present article documents the occurrence of disorders in the subendocardial viability ratio (SEVR), reflecting myocardial perfusion in patients treated for TBI. Importantly, changes in SEVRs have never been studied in patients with severe TBI. Impaired myocardial perfusion may be an essential risk factor for TBI-related cardiac dysfunction. However, further studies are warranted to confirm the relationship between brain trauma and heart dysfunction.
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
