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Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction

Trauma remains a leading global cause of mortality, particularly in the young population. In the United States, approximately 30,000 patients with blunt cardiac trauma were recorded annually. Cardiac damage is a predictor for poor outcome after multiple trauma, with a poor prognosis and prolonged in...

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Detalles Bibliográficos
Autores principales: Weber, Birte, Lackner, Ina, Gebhard, Florian, Miclau, Theodore, Kalbitz, Miriam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828409/
https://www.ncbi.nlm.nih.gov/pubmed/33450984
http://dx.doi.org/10.3390/ijms22020737
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author Weber, Birte
Lackner, Ina
Gebhard, Florian
Miclau, Theodore
Kalbitz, Miriam
author_facet Weber, Birte
Lackner, Ina
Gebhard, Florian
Miclau, Theodore
Kalbitz, Miriam
author_sort Weber, Birte
collection PubMed
description Trauma remains a leading global cause of mortality, particularly in the young population. In the United States, approximately 30,000 patients with blunt cardiac trauma were recorded annually. Cardiac damage is a predictor for poor outcome after multiple trauma, with a poor prognosis and prolonged in-hospitalization. Systemic elevation of cardiac troponins was correlated with survival, injury severity score, and catecholamine consumption of patients after multiple trauma. The clinical features of the so-called “commotio cordis” are dysrhythmias, including ventricular fibrillation and sudden cardiac arrest as well as wall motion disorders. In trauma patients with inappropriate hypotension and inadequate response to fluid resuscitation, cardiac injury should be considered. Therefore, a combination of echocardiography (ECG) measurements, echocardiography, and systemic appearance of cardiomyocyte damage markers such as troponin appears to be an appropriate diagnostic approach to detect cardiac dysfunction after trauma. However, the mechanisms of post-traumatic cardiac dysfunction are still actively being investigated. This review aims to discuss cardiac damage following trauma, focusing on mechanisms of post-traumatic cardiac dysfunction associated with inflammation and complement activation. Herein, a causal relationship of cardiac dysfunction to traumatic brain injury, blunt chest trauma, multiple trauma, burn injury, psychosocial stress, fracture, and hemorrhagic shock are illustrated and therapeutic options are discussed.
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spelling pubmed-78284092021-01-25 Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction Weber, Birte Lackner, Ina Gebhard, Florian Miclau, Theodore Kalbitz, Miriam Int J Mol Sci Review Trauma remains a leading global cause of mortality, particularly in the young population. In the United States, approximately 30,000 patients with blunt cardiac trauma were recorded annually. Cardiac damage is a predictor for poor outcome after multiple trauma, with a poor prognosis and prolonged in-hospitalization. Systemic elevation of cardiac troponins was correlated with survival, injury severity score, and catecholamine consumption of patients after multiple trauma. The clinical features of the so-called “commotio cordis” are dysrhythmias, including ventricular fibrillation and sudden cardiac arrest as well as wall motion disorders. In trauma patients with inappropriate hypotension and inadequate response to fluid resuscitation, cardiac injury should be considered. Therefore, a combination of echocardiography (ECG) measurements, echocardiography, and systemic appearance of cardiomyocyte damage markers such as troponin appears to be an appropriate diagnostic approach to detect cardiac dysfunction after trauma. However, the mechanisms of post-traumatic cardiac dysfunction are still actively being investigated. This review aims to discuss cardiac damage following trauma, focusing on mechanisms of post-traumatic cardiac dysfunction associated with inflammation and complement activation. Herein, a causal relationship of cardiac dysfunction to traumatic brain injury, blunt chest trauma, multiple trauma, burn injury, psychosocial stress, fracture, and hemorrhagic shock are illustrated and therapeutic options are discussed. MDPI 2021-01-13 /pmc/articles/PMC7828409/ /pubmed/33450984 http://dx.doi.org/10.3390/ijms22020737 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Weber, Birte
Lackner, Ina
Gebhard, Florian
Miclau, Theodore
Kalbitz, Miriam
Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction
title Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction
title_full Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction
title_fullStr Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction
title_full_unstemmed Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction
title_short Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction
title_sort trauma, a matter of the heart—molecular mechanism of post-traumatic cardiac dysfunction
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828409/
https://www.ncbi.nlm.nih.gov/pubmed/33450984
http://dx.doi.org/10.3390/ijms22020737
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