8. Myocardial dysfunction in polytrauma

Авторы

DOI:

https://doi.org/10.35805/BSK2024III008

Загрузки

Аннотация

Trauma remains one of the leading causes of mortality worldwide, particularly among the young population. A significant number of people die within the first 48 hours due to acute cardiovascular pathology. Cardiac injury is a significant predictor of adverse outcomes following multiple trauma, associated with poor prognosis and prolonged hospitalization. Systemic elevation of cardiac troponin levels is linked to survival, the severity of trauma, and catecholamine consumption in patients after multiple trauma. Clinical signs of the so-called "commotio cordis" include arrhythmias, such as ventricular fibrillation and sudden cardiac arrest, as well as wall motion abnormalities. In trauma patients with inadequate hypotension and a lack of adequate response to fluid therapy, the possibility of cardiac injury should be considered. Therefore, a combination of electrocardiography, echocardiography, and the systemic determination of cardiomyocyte injury markers, such as troponin, appears to be an appropriate diagnostic method for identifying cardiac dysfunction after trauma. However, the mechanisms of post-traumatic cardiac dysfunction continue to be actively studied. The aim of this review is to discuss cardiac injury following trauma, focusing on the mechanisms of post-traumatic cardiac dysfunction related to inflammation and complement activation. The review illustrates the causal relationship between cardiac dysfunction and blunt chest trauma, multiple trauma, and hemorrhagic shock.

Ключевые слова

trauma, myocardial dysfunction, immunology

Библиографические ссылки

  1. Iyengar KP, Venkatesan AS, Jain VK, Shashidhara MK, Elbana H, Botchu R. Risks in the Management of Pol-ytrauma Patients: Clinical Insights. Orthop Res Rev. 2023;15:27-38. doi:10.2147/ORR.S340532
  2. Ahmed SK, Mohammed MG, Abdul-qadir SO, et al. Road traffic acciden-tal injuries and deaths: A neglected global health issue. Health Sci Rep. May 2023;6(5):e1240. doi:10.1002/hsr2.1240
  3. Lord JM, Midwinter MJ, Chen YF, et al. The systemic immune response to trauma: an overview of patho-physiology and treatment. Lancet. Oct 18 2014;384(9952):1455-65. doi:10.1016/S0140-6736(14)60687-5
  4. Weber B, Lackner I, Gebhard F, Mi-clau T, Kalbitz M. Trauma, a Matter of the Heart-Molecular Mechanism of Post-Traumatic Cardiac Dysfunc-tion. Int J Mol Sci. Jan 13 2021;22(2) doi:10.3390/ijms22020737
  5. Silk E, Zhao H, Weng H, Ma D. The role of extracellular histone in or-gan injury. Cell Death Dis. May 25 2017;8(5):e2812. doi:10.1038/cd-dis.2017.52
  6. Yan I, Borschel CS, Neumann JT, et al. High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Fail-ure: Results From the BiomarCaRE Consortium. JACC Heart Fail. May 2020;8(5):401-411. doi:10.1016/j.jchf.2019.12.008
  7. Berge K, Lyngbakken MN, Myhre PL, et al. High-sensitivity car-diac troponin T and N-terminal pro-B-type natriuretic peptide in acute heart failure: Data from the ACE 2 study. Clin Biochem. Feb 2021;88:30-36. doi:10.1016/j.clinbio-chem.2020.11.009
  8. Zhang Q, Wang YF, Hu X, et al. Asso-ciation of serum cardiac troponin I and severity of coronary stenosis in patients with varied renal functions: a retrospective cohort study. BMJ Open. Mar 28 2022;12(3):e054722. doi:10.1136/bmjopen-2021-054722
  9. Firth C, Kaur T, Chakkera H, et al. Cardiac Troponin T and Right Ven-tricular Systolic Pressure Predict Cardiovascular and Mortality Risk in Kidney Transplant Candidates. Am J Nephrol. 2019;50(6):434-443. doi:10.1159/000503807
  10. Innocenti F, Palmieri V, Stefanone VT, et al. Comparison of Troponin I levels versus myocardial dysfunc-tion on prognosis in sepsis. Intern Emerg Med. Jan 2022;17(1):223-231. doi:10.1007/s11739-021-02701-3
  11. Packer M, Januzzi JL, Ferreira JP, et al. Concentration-dependent clin-ical and prognostic importance of high-sensitivity cardiac troponin T in heart failure and a reduced ejec-tion fraction and the influence of empagliflozin: the EMPEROR-Re-duced trial. Eur J Heart Fail. Sep 2021;23(9):1529-1538. doi:10.1002/ejhf.2256
  12. Suthahar N, Lau ES, Blaha MJ, et al. Sex-Specific Associations of Cardio-vascular Risk Factors and Biomark-ers With Incident Heart Failure. J Am Coll Cardiol. Sep 22 2020;76(12):1455-1465. doi:10.1016/j.jacc.2020.07.044
  13. Kalbitz M, Schwarz S, Weber B, et al. Cardiac Depression in Pigs af-ter Multiple Trauma - Characteri-zation of Posttraumatic Structural and Functional Alterations. Sci Rep. Dec 19 2017;7(1):17861. doi:10.1038/s41598-017-18088-1
  14. Motz BM, Baimas-George M, Barnes TE, et al. Mitigating clinical waste in the trauma intensive care unit: Limited clinical utility of cardiac troponin testing for trauma pa-tients with atrial fibrillation. Am J Surg. Jun 2020;219(6):1050-1056. doi:10.1016/j.amjsurg.2019.07.033
  15. Patel N, Pena C, Nesheiwat Z, Zafrul-lah F, Eltahawy E. Ventricular fibril-lation arrest after blunt chest trau-ma in a 33-year-old man, commotio cordis? BMC Cardiovasc Disord. Jun 3 2022;22(1):252. doi:10.1186/s12872-022-02689-4
  16. Mubayed L, Romme A, Nguyen HH. QT Prolongation After Minor Head Trauma in a Pediatric Patient. Pedi-atr Cardiol. Feb 2020;41(2):414-417. doi:10.1007/s00246-019-02213-0
  17. Saric P, Ravaee BD, Patel TR, Hoit BD. Acute severe mitral regurgita-tion after blunt chest trauma. Echo-cardiography. Feb 2018;35(2):272-274. doi:10.1111/echo.13775
  18. Driessen R, Doodeman I, Bogaard K, Reichert S. Contusio cordis, not an innocent diagnosis. BMJ Case Rep. May 8 2014;2014 doi:10.1136/bcr-2014-204139
  19. Jung H, Cho JY, Kim GJ, et al. Trau-matic severe tricuspid regurgita-tion diagnosis after the progres-sion of right ventricle function deterioration. Trauma Case Rep. Oct 2019;23:100239. doi:10.1016/j.tcr.2019.100239
  20. Dou LW, Du Z, Zhu JH, Wang TB. Changes and significance of serum troponin in trauma patients: A ret-rospective study in a level I trau-ma center. World J Emerg Med. 2022;13(1):27-31. doi:10.5847/wjem.j.1920-8642.2022.016
  21. Braun CK, Kalbitz M, Halbgebauer R, et al. Early structural changes of the heart after experimental polytrauma and hemorrhagic shock. PLoS One. 2017;12(10):e0187327. doi:10.1371/journal.pone.0187327
  22. Weber B, Mendler MR, Lackner I, et al. Tissue damage in the heart after cardiac arrest induced by asphyxia and hemorrhage in newborn pigs. Pediatr Res. Dec 2019;86(6):709-718. doi:10.1038/s41390-019-0505-6
  23. Mair J, Lindahl B, Hammarsten O, et al. How is cardiac troponin released from injured myocardi-um? Eur Heart J Acute Cardio-vasc Care. Sep 2018;7(6):553-560. doi:10.1177/2048872617748553
  24. Demonbreun AR, McNally EM. Plas-ma Membrane Repair in Health and Disease. Curr Top Mem-br. 2016;77:67-96. doi:10.1016/bs.ctm.2015.10.006
  25. Cooper ST, McNeil PL. Mem-brane Repair: Mechanisms and Pathophysiology. Physiol Rev. Oct 2015;95(4):1205-40. doi:10.1152/physrev.00037.2014
  26. Streng AS, Jacobs LH, Schwenk RW, et al. Cardiac troponin in ischemic cardiomyocytes: intracellular de-crease before onset of cell death. Exp Mol Pathol. Jun 2014;96(3):339-45. doi:10.1016/j.yexmp.2014.02.012
  27. Bangert A, Andrassy M, Muller AM, et al. Critical role of RAGE and HMGB1 in inflammatory heart dis-ease. Proc Natl Acad Sci U S A. Jan 12 2016;113(2):E155-64. doi:10.1073/pnas.1522288113
  28. Gami BN, Patel DS, Haridas N, Chau-han KP, Shah H, Trivedi A. Utility of Heart-type Fatty Acid Binding Pro-tein as a New Biochemical Marker for the Early Diagnosis of Acute Cor-onary Syndrome. J Clin Diagn Res. Jan 2015;9(1):BC22-4. doi:10.7860/JCDR/2015/11006.5451
  29. Ritter A, Lotterle L, Han J, et al. Evaluation of New Cardiac Damage Biomarkers in Polytrauma: GDF-15, HFABP and uPAR for Predicting Pa-tient Outcomes. J Clin Med. Feb 8 2024;13(4) doi:10.3390/jcm13040961
  30. Relja B, Land WG. Damage-asso-ciated molecular patterns in trau-ma. Eur J Trauma Emerg Surg. Aug 2020;46(4):751-775. doi:10.1007/s00068-019-01235-w
  31. Sloos PH, Maas MAW, Meijers JCM, et al. Anti-high-mobility group box-1 treatment strategies improve trauma-induced coagulopathy in a mouse model of trauma and shock. Br J Anaesth. Jun 2023;130(6):687-697. doi:10.1016/j.bja.2023.01.026
  32. Horst K, Hildebrand F, Pfeifer R, et al. Impact of haemorrhagic shock intensity on the dynamic of alarm-ins release in porcine poly-trau-ma animal model. Eur J Trauma Emerg Surg. Feb 2016;42(1):67-75. doi:10.1007/s00068-015-0504-1
  33. Zhang L, Liu M, Jiang H, et al. Extra-cellular high-mobility group box 1 mediates pressure overload-induced cardiac hypertrophy and heart failure. J Cell Mol Med. Mar 2016;20(3):459-70. doi:10.1111/jcmm.12743
  34. Tian Y, Charles EJ, Yan Z, et al. The myocardial infarct-exacerbating effect of cell-free DNA is mediat-ed by the high-mobility group box 1-receptor for advanced glycation end products-Toll-like receptor 9
  35. Ward PA, Grailer JJ. Acute lung injury and the role of histones. Transl Respir Med. 2014;2:1. doi:10.1186/2213-0802-2-1
  36. Karki P, Birukov KG, Birukova AA. Extracellular histones in lung dys-function: a new biomarker and therapeutic target? Pulm Circ. Oct-Dec 2020;10(4):2045894020965357. doi:10.1177/2045894020965357
  37. Kalbitz M, Amann EM, Bosch B, et al. Experimental blunt chest trau-ma-induced myocardial inflamma-tion and alteration of gap-junction protein connexin
  38. Kawai C, Kotani H, Miyao M, et al. Cir-culating Extracellular Histones Are Clinically Relevant Mediators of Mul-tiple Organ Injury. Am J Pathol. Apr 2016;186(4):829-43. doi:10.1016/j.aj-path.2015.11.025
  39. Chen R, Kang R, Tang D. The mecha-nism of HMGB1 secretion and release. Exp Mol Med. Feb 2022;54(2):91-102. doi:10.1038/s12276-022-00736-w
  40. Meng XY, Wu L, Zhou YH, et al. High mobility group box 1 might be a nov-el therapeutic target in ischemia heart disease. Int J Cardiol. Mar 1 2016;206:42-3. doi:10.1016/j.ij-card.2016.01.014
  41. Kalbitz M, Fattahi F, Herron TJ, et al. Complement Destabilizes Cardio-myocyte Function In Vivo after Poly-microbial Sepsis and In Vitro. J Im-munol. Sep 15 2016;197(6):2353-61. doi:10.4049/jimmunol.1600091
  42. Zhang X, Lu C, Gao M, et al. Toll-like receptor 4 plays a central role in cardiac dysfunction during trau-ma hemorrhage shock. Shock. Jul 2014;42(1):31-7. doi:10.1097/SHK.0000000000000155
  43. Lackner I, Weber B, Baur M, et al. Midkine Is Elevated After Multiple Trauma and Acts Directly on Human Cardiomyocytes by Altering Their Functionality and Metabolism. Front Immunol. 2019;10:1920. doi:10.3389/fimmu.2019.01920
  44. Fischer V, Kalbitz M, Muller-Graf F, et al. Influence of Menopause on In-flammatory Cytokines during Murine and Human Bone Fracture Heal-ing. Int J Mol Sci. Jul 16 2018;19(7) doi:10.3390/ijms19072070
  45. Brennan FH, Gordon R, Lao HW, et al. The Complement Receptor C5aR Controls Acute Inflamma-tion and Astrogliosis following Spi-nal Cord Injury. J Neurosci. Apr 22 2015;35(16):6517-31. doi:10.1523/JNEUROSCI.5218-14.2015
  46. Yang Z, Nicholson SE, Cancio TS, Cancio LC, Li Y. Complement as a vital nexus of the pathobiological connectome for acute respirato-ry distress syndrome: An emerging therapeutic target. Front Immunol. 2023;14:1100461. doi:10.3389/fim-mu.2023.1100461
  47. Hoth JJ, Wells JD, Jones SE, Yoza BK, McCall CE. Complement me-diates a primed inflammatory re-sponse after traumatic lung inju-ry. J Trauma Acute Care Surg. Mar 2014;76(3):601-8; discussion 608-9. doi:10.1097/TA.0000000000000129
  48. Lackner I, Weber B, Baur M, et al. Complement Activation and Organ Damage After Trauma-Differential Immune Response Based on Sur-gical Treatment Strategy. Front Im-munol. 2020;11:64. doi:10.3389/fim-mu.2020.0006449.vandenBergCW,TambourgiDV,ClarkHW,HoongSJ,SpillerOB,McGrealEP.Mechanismofneutro-phildysfunction:neutrophilserineproteasescleaveandinactivatetheC5areceptor.JImmunol.Feb152014;192(4):1787-95.doi:10.4049/jimmunol.1301920
  49. Biggins PJC, Brennan FH, Taylor SM, Woodruff TM, Ruitenberg MJ. The Al-ternative Receptor for Complement Component 5a, C5aR2, Conveys Neuroprotection in Traumatic Spinal Cord Injury. J Neurotrauma. Jun 15 2017;34(12):2075-2085. doi:10.1089/neu.2016.4701
  50. Fattahi F, Ward PA. Complement and sepsis-induced heart dysfunction. Mol Immunol. Apr 2017;84:57-64. doi:10.1016/j.molimm.2016.11.012
  51. Alkireidmi MA, Al-Abbasi FA, Me-hanna MG, Moselhy SS. Biochemical markers as diagnostic/prognostic indicators for ischemic disease. Afr
  52. Yan W, Blasius F, Wahl T, et al. Lac-tate dehydrogenase can be used for differential diagnosis to iden-tify patients with severe polytrau-ma with or without chest injury-A retrospective study. PLoS One. 2024;19(8):e0308228. doi:10.1371/journal.pone.0308228

Опубликован

2024-09-30

Выпуск

№ 3 (2024)

Раздел

Статьи