Speckle Tracking Analysis of Left Ventricular Systolic Function Following Traumatic Brain Injury: A Pilot Prospective...

Area of Science:

• Cardiology
• Neurology
• Critical Care Medicine

Background:

• Traumatic brain injury (TBI) is associated with systolic dysfunction and reduced left ventricular ejection fraction (LVEF).
• Speckle tracking echocardiography, particularly global longitudinal strain (GLS), is emerging for detecting subclinical myocardial dysfunction.
• This study investigated myocardial strain and regional patterns following moderate-severe TBI.

Purpose of the Study:

• To examine myocardial strain and regional strain patterns in patients with moderate-severe TBI.
• To assess the utility of speckle tracking for early diagnosis and monitoring of TBI-related cardiac dysfunction.

Main Methods:

• Prospective cohort study comparing 15 TBI patients (Glasgow Coma Scale ≤12) with 15 age/sex-matched controls.
• Transthoracic echocardiography performed within 24 hours and 1 week post-TBI.
• Myocardial function assessed via GLS and LVEF; impaired function defined as GLS >-16% or LVEF ≤50%.

Main Results:

• Systolic dysfunction detected in 38% of TBI patients by GLS within 24 hours, versus 17% by LVEF.
• Mean GLS was significantly impaired in TBI patients compared to controls (-16.4±3.8% vs. -20.7±1.8%, P=0.001).
• Impaired strain predominantly observed in basal and mid-ventricular segments, with no GLS improvement from day 1 to day 7.

Conclusions:

• Myocardial strain abnormalities are prevalent and persistent for at least one week post-moderate-severe TBI.
• Speckle tracking echocardiography shows promise for early detection and monitoring of systolic dysfunction following TBI.