Alterations in left ventricular function assessed by two-dimensional speckle tracking echocardiography and the clinical utility of cardiac troponin I in survivors of high-voltage electrical injury

Abstract

The current study demonstrates that LV dysfunction after high-voltage electrical injury is uncommon, and that the serum cTnI level does not seem to be a useful diagnostic test for predicting impairment of LV contractility in patients who did not experience cardiac arrest or fatal arrhythmia.

Functional changes of the myocardium in survivors of high-voltage electrical injury

“…The data may explain why a small number of patients manifested LV dysfunction after HVEI. We previously reported preserved LV systolic function by conventional echocardiography in survivors in the short term after HVEI [8]. In this study, we confirmed and extended our previous report, demonstrating that survivors of HVEI with preserved LVEF maintain their LV systolic function not only in the short term, but also in long-term follow-up.…”

“…Previous studies demonstrated that the myocardial damage could occur after both low-voltage and high-voltage injuries [12,13]. However, evaluation of cardiac injury only on the basis of changes on ECG or CK-MB seems to be insufficient for determining the presence or the extent of myocardial injury after HVEI because of the non-specific characteristics and combined skeletal muscle damage [8]. Kerber et al showed no demonstrable abnormalities of the LV contraction and perfusion functions after high-energy transthoracic shocks.…”

“…Although the left ventricular ejection fraction (LVEF) is the current standard for measuring systolic function, a tissue Doppler image measures the strain (S) and the strain rate (SR), both of which are basic descriptors of the nature and the function of cardiac tissue and they have been applied to the assessment of LV function [7]. We have demonstrated with echocardiographic data using the S and SR that further deterioration of the LV function in survivors following HVEI with preserved LV function is uncommon [8]. However, the duration of follow-up was clearly short (seven days), and whether different results would be obtained with an examination at a long-term follow-up is unclear.…”

Chemical, Electrical, and Radiation Injuries

“…Myocardial damage and dysrhythmias are seen soon after injury, and unfortunately, troponin is not always a useful diagnostic of myocardial injury. 37,38 …”

Factors influencing clinical outcomes in children admitted to the emergency department with electrical injuries

“…Yüksek voltajlı elektrik yaralanmasına maruz kalmış olguların değerlendirildiği bir çalışmada kardiyak troponin I'nın, arrest ve ölümcül aritmi gelişmeyen olgularda, prognostik değerinin olmadığını gösterilmiştir. 19 Çalışmamızda kardiyak etkilenme açısından bakılan troponin I değerlerinin tüm hastalarda normal saptanmış olup, yakınma ve bulgusu olmayan olgularda kardiyak enzim tetkiklerinin alınmasının hasta yönetimine katkısı olmadığını düşündürmüştür.…”