Carbon Monoxide-Induced Cardiomyopathy

Abstract

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp diomyopathy (CMP) is not an established concept yet, and reports on its epidemiology and clinical characteristics are scarce. Therefore, clinical characteristics of CO-induced CMP and its significance need to be elucidated.Stress-induced CMP, also known as takotsubo CMP, is a type of heart failure characterized by rapid reversibility and distinctive contraction patterns in the left ventricle. 13-16 It can be triggered by emotional events, and is found predominantly in postmenopausal women. 13,15 Takotsubo CMP occurs under the condition of catecholamine excess, as in exogenous epinephrine, pheochromocytoma, and acute neurologic disorders (eg, intracranial bleeding and cerebral infarction). 17-21There are a number of common factors between CO-induced CMP and takotsubo CMP, although the clinical features are not completely identical. Here, we investigate CO-induced CMP in terms of its epidemiology, clinical characteristics, and prognosis.arbon monoxide (CO) is an odorless, colorless, and nonirritating gas. 1,2 Even a small amount of CO exposure is possibly associated with organ damage and specific toxic effects. Acute CO poisoning is a major cause of mortality and morbidity worldwide. 1,2 According to previous reports, the main mechanism of CO toxicity is ischemic hypoxia secondary to hypoxemia. 1,3,4 Specifically, the heart is the major target organ of acute CO poisoning. 3 Cardiovascular manifestations demonstrated in previous reports include arrhythmia, pulmonary edema, heart failure, and myocardial infarction. 5-10 Cardiac failure was presented in patients who experienced acute CO poisoning. Background: Previous reports demonstrated mechanisms of cardiac toxicity in acute carbon monoxide (CO) poisoning. Still, none established CO-induced cardiomyopathy (CMP) as a clinical entity. The aim of this study is to investigate CO-induced CMP in patients with acute CO poisoning in terms of its epidemiology, clinical characteristics, and prognosis.

Effects of hookah smoking on indoor air quality in homes

“…The present study demonstrates that hookah and cigarette smoke elevate indoor CO levels, but significantly more so with hookah smoke, resulting in CO levels several folds greater than the cigarette smoke and control concentrations. CO has been implicated to play a major role in a multitude of cardiovascular and airway diseases, including atherosclerosis,36 37 cardiomyopathy,38 chronic obstructive pulmonary disease,39 respiratory infections,40 asthma41 and cystic fibrosis 42. CO poisoning after hookah smoking has already been found in a number of case reports, with users presenting carboxyhaemoglobin levels 34% higher than normal after hookah use,43 44 syncope45 and confusion 46.…”

Cardiogenic Shock due to Psychosis-Induced Inverted Takotsubo Cardiomyopathy Bridged-to-Recovery with a Percutaneous Left Ventricular Assist Device

“…The leading hypothesis regarding the pathophysiology of SIC is that a catecholamine surge occurs after a stressful event, and targets beta-adrenergic receptors resulting in a negative inotropic effect. There is variation in the density and distribution of these adrenoreceptors along the ventricular myocardium based upon age, and this accounts for the localized areas of myocardial stunning [11]. This explains the predominant occurrence of the ITC pattern in younger patients, as the density of adrenoreceptors is greatest at the basal and mid-LV wall segments in younger age groups.…”

Therapeutic Aspects of Carbon Monoxide in Cardiovascular Disease

“…However, in medical practices, many clinicians are currently concentrating on reducing the morbidity and mortality of patients suffering from carbon monoxide poisoning, i.e., to reduce the toxic effects of carbon monoxide [77]. Studies regarding the complications and sequelae of CO poisoning, such as delayed neurological sequelae (DNS), permanent brain injury, and cardiovascular abnormalities in CO poisoning, are still being actively conducted [78,79]. Therefore, the application of CO to treat clinical disease might be counter-intuitive and lead to hesitancy in the application of CO as a remedy for patients.…”