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

eScholarship, University of California 2021-01-01

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.

Animals; Humans; Heart Diseases; Ventricular Dysfunction; Wounds and Injuries; Disease Susceptibility; Heart Function Tests; Severity of Illness Index; Complement Activation; Energy Metabolism; Disease Management; Biomarkers; TBI; burn injury; complement activation; complement system; extracellular histones; inflammation; markers of cardiac damage; multiple trauma; post-traumatic cardiomyopathy; stress-related cardiomyopathy; Injury - Trauma - (Head and Spine); Neurosciences; Clinical Research; Injury - Traumatic brain injury; Cardiovascular; Brain Disorders; Injury (total) Accidents/Adverse Effects; Heart Disease; Detection; screening and diagnosis; 4.2 Evaluation of markers and technologies; 2.1 Biological and endogenous factors; Aetiology; Injuries and accidents; Good Health and Well Being; Other Chemical Sciences; Genetics; Other Biological Sciences; Chemical Physics; article

Open access content. Open access content
public

application/pdf
International journal of molecular sciences vol 22, iss 2, E737 1422-0067

CDLER oai:escholarship.org:ark:/13030/qt5gf8q07t
qt5gf8q07t
https://escholarship.org/uc/item/5gf8q07t
https://escholarship.org/
1344354440

UC MASS DIGITIZATION
From OAIster®, provided by the OCLC Cooperative.

edsoai.on1344354440