# Mechanisms and Clinical Impact of Myocardial Injury Following Traumatic Brain Injury

> **NIH NIH K23** · DUKE UNIVERSITY · 2020 · $188,881

## Abstract

PROJECT SUMMARY/ABSTRACT
Traumatic brain injury (TBI) is a major public health concern, affecting more than 1.7 million individuals annually
in the United States. Hypotension after severe TBI results in cerebral hypoperfusion and poor clinical outcomes.
Approximately 50% of severe TBI patients are treated for hypotension and maintenance of cerebral perfusion;
this may be due to unrecognized myocardial injury and cardiac dysfunction. My prior research has demonstrated
that: 22% of patients with moderate-severe TBI have early cardiac dysfunction, patients with TBI and cardiac
dysfunction exhibit signs of sympathetic activation, and patients with TBI and cardiac dysfunction experience
hypotension and cerebral hypoperfusion. Sympathetic activation is implicated in cardiac dysfunction and
hypotension after TBI, but mechanistic data is limited. The central hypothesis of the current proposal is that
severe TBI causes myocardial injury through activation of the sympathetic nervous system, and this results in
systolic cardiac dysfunction, reduced cardiac output, hypotension, decreased cerebral perfusion, and poor
neurologic outcomes. We propose 3 Specific Aims in patients with severe TBI: 1) Determine the effect of severe
TBI on autonomic nervous system function, 2) Determine if autonomic dysfunction contributes to myocardial
injury after severe TBI, and 3) Examine the impact of myocardial injury on echocardiographic, hemodynamic,
and clinical outcomes after severe TBI. Results of this study, as well as completion of a rigorous career
development plan, will lead to a larger trial that examines the impact of reduction of sympathetic nervous system
activation on myocardial injury and neurologic outcomes after severe TBI. The long-term goal of my work is to
personalize hemodynamic management and improve clinical outcomes after severe TBI.

## Key facts

- **NIH application ID:** 10011895
- **Project number:** 5K23NS109274-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Vijay Krishnamoorthy
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $188,881
- **Award type:** 5
- **Project period:** 2019-09-15 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10011895

## Citation

> US National Institutes of Health, RePORTER application 10011895, Mechanisms and Clinical Impact of Myocardial Injury Following Traumatic Brain Injury (5K23NS109274-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10011895. Licensed CC0.

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