Tags

Type your tag names separated by a space and hit enter

Cardiac troponin I as a predictor of arrhythmia and ventricular dysfunction in trauma patients with myocardial contusion.
J Trauma. 2004 Oct; 57(4):801-8; discussion 808.JT

Abstract

BACKGROUND

Myocardial contusion during blunt chest trauma is common and may lead to potentially fatal cardiac complications. Therefore, it is useful to identify a serum marker reflecting the myocardial damage that can predict risk for cardiac complications. In this study, the authors determined the strength of the association between cardiac troponin I (cTnI) levels and the risk of arrhythmia or the development of left ventricular dysfunction in a cohort of patients with blunt chest trauma.

METHODS AND RESULTS

In 187 multiply injured patients with blunt chest trauma, serial measurements of cTnI, total creatine kinase (CK), and isoenzyme of creatine kinase with muscle and brain subunits (CK-MB) were combined with sequential electrocardigraphic and echocardiographic recordings. The results showed that 63 patients (34%) had myocardial contusion, as defined by positive cTnI levels, of which 47 (25%) were symptomatic and 16 (9%) showed no abnormalities. The remaining 124 patients (66%) displaying negative CTnI levels were asymptomatic during the entire study. Severity of arrhythmia correlated directly with increase in cTnI levels. The levels of cTnI in the symptomatic group remained elevated significantly longer than the levels in the asymptomatic group. The depression of left ventricular ejection fraction was inversely correlated with the increase in cTn levels. The patients whose cTnI levels were below 1.05 microg/L at admission and during the first 6 hours afterward showed no cardiac abnormalities throughout the entire study period

CONCLUSIONS

Levels of cTnI below 1.05 microg/L in asymptomatic patients at admission and within the first 6 hours after admission rule out myocardial injury, whereas positive cTn levels above 1.05 microg/L mandate further cardiologic workup for the detection and management of myocardial injury. Furthermore, the dynamics and peak levels of pathologic cTnI levels allow estimation of arrhythmia risk and left ventricular dysfunction in trauma patients with myocardial contusion.

Authors+Show Affiliations

Rajan GP
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. gunesh.rajan@usz.ch
Zellweger R
No affiliation info available

MeSH

AdolescentAdultAge DistributionAgedArrhythmias, CardiacBiomarkersCohort StudiesFemaleHeart InjuriesHumansIncidenceInjury Severity ScoreLogistic ModelsMaleMiddle AgedMultiple TraumaPredictive Value of TestsProbabilityRetrospective StudiesRisk AssessmentSensitivity and SpecificitySex DistributionStatistics, NonparametricSurvival AnalysisTroponin IVentricular Dysfunction, LeftWounds, Nonpenetrating

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15514534

Citation

Rajan, Gunesh P., and René Zellweger. "Cardiac Troponin I as a Predictor of Arrhythmia and Ventricular Dysfunction in Trauma Patients With Myocardial Contusion." The Journal of Trauma, vol. 57, no. 4, 2004, pp. 801-8; discussion 808.
Rajan GP, Zellweger R. Cardiac troponin I as a predictor of arrhythmia and ventricular dysfunction in trauma patients with myocardial contusion. J Trauma. 2004;57(4):801-8; discussion 808.
Rajan, G. P., & Zellweger, R. (2004). Cardiac troponin I as a predictor of arrhythmia and ventricular dysfunction in trauma patients with myocardial contusion. The Journal of Trauma, 57(4), 801-8; discussion 808.
Rajan GP, Zellweger R. Cardiac Troponin I as a Predictor of Arrhythmia and Ventricular Dysfunction in Trauma Patients With Myocardial Contusion. J Trauma. 2004;57(4):801-8; discussion 808. PubMed PMID: 15514534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac troponin I as a predictor of arrhythmia and ventricular dysfunction in trauma patients with myocardial contusion. AU - Rajan,Gunesh P, AU - Zellweger,René, PY - 2004/10/30/pubmed PY - 2005/4/1/medline PY - 2004/10/30/entrez SP - 801-8; discussion 808 JF - The Journal of trauma JO - J Trauma VL - 57 IS - 4 N2 - BACKGROUND: Myocardial contusion during blunt chest trauma is common and may lead to potentially fatal cardiac complications. Therefore, it is useful to identify a serum marker reflecting the myocardial damage that can predict risk for cardiac complications. In this study, the authors determined the strength of the association between cardiac troponin I (cTnI) levels and the risk of arrhythmia or the development of left ventricular dysfunction in a cohort of patients with blunt chest trauma. METHODS AND RESULTS: In 187 multiply injured patients with blunt chest trauma, serial measurements of cTnI, total creatine kinase (CK), and isoenzyme of creatine kinase with muscle and brain subunits (CK-MB) were combined with sequential electrocardigraphic and echocardiographic recordings. The results showed that 63 patients (34%) had myocardial contusion, as defined by positive cTnI levels, of which 47 (25%) were symptomatic and 16 (9%) showed no abnormalities. The remaining 124 patients (66%) displaying negative CTnI levels were asymptomatic during the entire study. Severity of arrhythmia correlated directly with increase in cTnI levels. The levels of cTnI in the symptomatic group remained elevated significantly longer than the levels in the asymptomatic group. The depression of left ventricular ejection fraction was inversely correlated with the increase in cTn levels. The patients whose cTnI levels were below 1.05 microg/L at admission and during the first 6 hours afterward showed no cardiac abnormalities throughout the entire study period CONCLUSIONS: Levels of cTnI below 1.05 microg/L in asymptomatic patients at admission and within the first 6 hours after admission rule out myocardial injury, whereas positive cTn levels above 1.05 microg/L mandate further cardiologic workup for the detection and management of myocardial injury. Furthermore, the dynamics and peak levels of pathologic cTnI levels allow estimation of arrhythmia risk and left ventricular dysfunction in trauma patients with myocardial contusion. SN - 0022-5282 UR - https://www.unboundmedicine.com/medline/citation/15514534/Cardiac_troponin_I_as_a_predictor_of_arrhythmia_and_ventricular_dysfunction_in_trauma_patients_with_myocardial_contusion_ DB - PRIME DP - Unbound Medicine ER -