1. Cardiac Dysfunction After Neurologic Injury: What Do We Know and Where Are We Going?
- Author
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Krishnamoorthy V, Mackensen GB, Gibbons EF, and Vavilala MS
- Subjects
- Brain Death metabolism, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic metabolism, Cardiomyopathies etiology, Cardiomyopathies metabolism, Catecholamines metabolism, Central Nervous System Infections complications, Central Nervous System Infections metabolism, Epilepsy complications, Epilepsy metabolism, Heart Diseases metabolism, Humans, Myocardial Stunning etiology, Myocardial Stunning metabolism, Nervous System Diseases metabolism, Stroke complications, Stroke metabolism, Subarachnoid Hemorrhage, Takotsubo Cardiomyopathy etiology, Takotsubo Cardiomyopathy metabolism, Heart Diseases etiology, Nervous System Diseases complications
- Abstract
Recent literature has implicated severe neurologic injuries, such as aneurysmal subarachnoid hemorrhage, as a cause of cardiac dysfunction, impaired hemodynamic function, and poor outcomes. Mechanistic links between the brain and the heart have been explored in detail over the past several decades, and catecholamine excess, neuroendocrine dysfunction, and unchecked inflammation all likely contribute to the pathophysiologic process. Although cardiac dysfunction has also been described in other disease paradigms, including septic shock and thermal injury, there is likely a common underlying pathophysiology. In this review, we will examine the pathophysiology of cardiac dysfunction after neurologic injury, discuss the evidence surrounding cardiac dysfunction after different neurologic injuries, and suggest future research goals to gain knowledge and improve outcomes in this patient population., (Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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