Patterns of cardiac dysfunction after carbon monoxide poisoning

被引:0
作者
Villela, Miguel Alvarez [1 ,2 ]
Wever-Pinzon, Omar [2 ]
Parikh, Mona [1 ]
Deru, Kayla [1 ]
Muhlestein, Joseph B. [3 ,4 ]
Anderson, Jeffrey L. [3 ,4 ]
Weaver, Lindell K. [1 ,4 ]
机构
[1] Intermt Med Ctr, Hyperbar Med Div, Murray, UT 84107 USA
[2] Univ Utah, Sch Med, Div Cardiovasc Med, Salt Lake City, UT 84112 USA
[3] Intermt Med Ctr, Intermt Heart Inst, Murray, UT USA
[4] Univ Utah, Sch Med, Salt Lake City, UT USA
关键词
carbon monoxide; cardiac injury; cardiac MRI; delayed; CARDIOVASCULAR-MAGNETIC-RESONANCE; LONG-TERM MORTALITY; VENTRICULAR EJECTION FRACTION; HYPERBARIC-OXYGEN; MYOCARDIAL INJURY; HEART-FAILURE; MODERATE; EPIDEMIOLOGY; CARDIOLOGY; COMMITTEE;
D O I
暂无
中图分类号
Q17 [水生生物学];
学科分类号
071004 ;
摘要
Objective: To describe the structural sequelae of carbon monoxide (CO) poisoning on the heart assessed using stress cardiac MRI (CMR). CO poisoning is common. While acute cardiac injury is frequent among survivors, the mid- and long-term effects of CO on the myocardium are unclear. Methods: CMR studies performed between the years 2005 and 2014 for a primary diagnosis of CO poisoning at a tertiary care center were reviewed by an experienced cardiologist. Variables of interest were compared between patients with normal and abnormal studies to identify factors associated with cardiac dysfunction. Results: Eighty-eight patients underwent stress CMR, age 34 years (range 11-70); 49% were male, 74 had acute poisoning and 14 had chronic poisoning (CO exposure for longer than 24 hours). Time from CO poisoning to imaging was 24 months (1day-120 months). Patients were stratified into four categories, which included those with acute poisoning imaged: <= 12 months; 12-60 months; >60 months from the event; and those with chronic poisoning. Overall, 26 studies (30%) were abnormal. The most common findings were: left ventricular systolic dysfunction in 14 patients, right ventricular systolic dysfunction in nine, and LV dilatation in six. Abnormalities were mild in most cases and were equally prevalent in all four patient categories. Dyspnea at the time of follow-up was more frequent among those with abnormal studies. Conclusions: Mild alterations in ventricular structure and function are frequent in survivors of CO poisoning. Myocardial scarring is rare, suggesting that acute hypoxic injury may not fully explain these abnormalities.
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页码:477 / 485
页数:9
相关论文
共 30 条
[1]  
Anderson J., 2007, The Open General and Internal Medicine Journal, V1, P6
[2]   Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance - Are they interchangeable? [J].
Bellenger, NG ;
Burgess, MI ;
Ray, SG ;
Lahiri, A ;
Coats, AJS ;
Cleland, JGF ;
Pennell, DJ .
EUROPEAN HEART JOURNAL, 2000, 21 (16) :1387-1396
[3]   RECOVERY OF ENERGY-METABOLISM IN RAT-BRAIN AFTER CARBON-MONOXIDE HYPOXIA [J].
BROWN, SD ;
PIANTADOSI, CA .
JOURNAL OF CLINICAL INVESTIGATION, 1992, 89 (02) :666-672
[4]   EPIDEMIOLOGY OF IDIOPATHIC DILATED AND HYPERTROPHIC CARDIOMYOPATHY - A POPULATION-BASED STUDY IN OLMSTED COUNTY, MINNESOTA, 1975-1984 [J].
CODD, MB ;
SUGRUE, DD ;
GERSH, BJ ;
MELTON, LJ .
CIRCULATION, 1989, 80 (03) :564-572
[5]  
Douglas CG, 1912, J PHYSIOL-LONDON, V44, P275
[6]   Recording acute poisoning deaths [J].
Flanagan, RJ ;
Rooney, C .
FORENSIC SCIENCE INTERNATIONAL, 2002, 128 (1-2) :3-19
[7]   Acute myocardial injury from carbon monoxide poisoning by cardiac magnetic resonance imaging [J].
George, Bennet ;
Ruiz-Rodriguez, Ernesto ;
Campbell, Charles L. ;
Leung, Steve W. ;
Sorrell, Vincent L. .
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, 2014, 15 (04) :466-466
[8]   Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease [J].
Hamon, Michele ;
Fau, Georges ;
Nee, Guillaume ;
Ehtisham, Javed ;
Morello, Remy ;
Hamon, Martial .
JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE, 2010, 12
[9]  
Hampson NB, 2007, UNDERSEA HYPERBAR M, V34, P163
[10]   Increased long-term mortality among survivors of acute carbon monoxide poisoning [J].
Hampson, Neil B. ;
Rudd, Rose Anne ;
Hauff, Niels M. .
CRITICAL CARE MEDICINE, 2009, 37 (06) :1941-1947