NT-proBNP in Myocarditis after a Scorpion Sting Envenomation

Sv, Sagarad; Bs, Thakur; Ss, Reddy; Rm, Joshi; Sb, Kerure

doi:10.7860/jcdr/2012/4858.2684

Cited by 11 publications

(14 citation statements)

References 20 publications

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“…Similar finding has been reported by our group [22]. In a recently reported study, newer biomarker like N terminal pro BNP estimation could predict presence of myocardial dysfunction [23].…”

Section: Internal Medicine Sectionsupporting

confidence: 78%

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Echocardiography Guided Therapy for Myocarditis after Scorpion Sting Envenomation

Sb²,

B³

et al. 2013

JCDR

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Section: Internal Medicine Sectionsupporting

confidence: 78%

“…Bosnak et al, noted that no clinically useful demographic or epidemiological data to guide decision making regarding the need for intensive care unit admission in paediatric victims [19]. Biomarkers like cTnI may be useful adjunct to clinical and echocardiographic findings [19][20][21][22][23].…”

Section: Methodsmentioning

confidence: 99%

Echocardiography Guided Therapy for Myocarditis after Scorpion Sting Envenomation

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B³

et al. 2013

JCDR

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“…The cardiac involvement observed manifests clinically mainly as a reversible acute left ventricle (LV) dysfunction of different degrees of severity, with altered global or regional mobility occurring soon after the sting, and possible progression to APE. It is accompanied by increased serum levels of cardiac markers, as well as by changes in the electrocardiogram (ECG) and echocardiogram (ECHO) readouts (3) (33) (34) (35) (36) (37) (38) (39) (40) (41) . Another characteristic of the cardiac dysfunction mediated by catecholamine concerns the ECHO, whose fi ndings do not follow the anatomic distribution of the coronary arteries.…”

Section: Complications Of Scorpion Envenomingmentioning

confidence: 99%

Clinical update on scorpion envenoming

Cupo

2015

Rev. Soc. Bras. Med. Trop.

110

126

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Scorpion stings are currently the leading cause of venom-related injury to humans in Brazil and are a signifi cant public health problem globally. Only scorpions of the Tityus genus are of medical importance in Brazil, and Tityus serrulatus is responsible for the most serious envenomations and deaths. The toxic effects of scorpion envenomation are due to a massive release of sympathetic and parasympathetic neurotransmitters; the severity is related to cardiac and hemodynamic changes, with cardiogenic shock and pulmonary edema contributing to the main causes of death. The pathophysiology of cardiac involvement has been discussed for decades and has been attributed to adrenergic discharge and a possible toxic effect of venom on the myocardium, while acute pulmonary edema may have a cardiogenic and/or non-cardiogenic origin. Currently, the clinical data point to catecholamine excess as the cause for reversible scorpion cardiomyopathy. These data include electrocardiographic changes, profi ling of cardiac enzymes and troponin I, echocardiographic data with global or regional left ventricle dysfunction, and myocardial perfusion alterations compatible with spasm in the coronary microcirculation. Furthermore, recent data on cardiac magnetic resonance imaging fi ndings, which are similar to those observed for stress-induced cardiomyopathy, have also been linked to catecholamine excess. The effi ciency of antivenom serum treatment is controversial in the literature. Our experience in Brazil is that the management of patients with systemic manifestations of scorpion stings is based on three approaches, all of which are extremely important. These include symptomatic treatment, antivenom serum, and cardiorespiratory support.

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“…Studies concerning envenomation have found that creatinine phosphatase, troponin, and NTproBNP increase after scorpion stings. 4,24,28,29 Examination of the literature concerning biochemical markers studied in scorpion envenomations indicates that troponin I levels have high sensitivity and specificity in determining scorpion stingÀrelated cardiac response. 4,30 Cupo et al 31 reported that troponin I values did not increase at first presentation in patients with cardiac dysfunction but rose subsequently, reaching maximum levels 24 to 36 h after scorpion sting.…”

Section: Discussionmentioning

confidence: 99%

Myocarditis and Early Markers of Cardiac Response Associated with Scorpion Stings in Children

Gökay

Kendir

Gullu

et al. 2018

Wilderness & Environmental Medicine

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Introduction-A clinical course ranging from mild local findings to life-threatening systemic findings may occur after scorpion stings. The purpose of this study was to identify priority markers indicating scorpion stingÀrelated cardiac involvement.Methods-Our study was performed between July 2014, and September 2015 in theÇukurova University medical faculty pediatric emergency department, in Adana, Turkey. Patients admitted with scorpion stingÀrelated cardiac involvement and a control group consisting of patients with no scorpion stingÀrelated cardiac involvement were included in the study. Troponin I at time of presentation and at 6 and 24 h, N-terminal prohormone of brain natriuretic peptide (NTproBNP), ejection fraction as determined by echocardiography at 24 h, and peak and end of T wave (Tp-e) and Tp-e/QTc ratios with echocardiography at 24 h were evaluated.Results-A patient group consisting of 7 cases of scorpion envenomationÀrelated myocarditis and a control group of 30 cases of scorpion intoxication without myocarditis findings were enrolled. Statistically significantly high glucose, white blood cell values, creatine kinase MB, troponin I, and NTproBNP values were identified in the scorpion stingÀrelated myocarditis group (P<0.05). Ejection fractions determined by echocardiography at time of presentation were significantly lower in the patients with myocarditis compared with the control group (P<0.05). A statistically significant difference was identified between Tp-e/corrected QT interval (QTc) ratios investigated in DI and V2 derivations in patient and control group echocardiograms (P<0.05).Conclusions-We think that use can be made of NTproBNP in addition to echocardiography and troponin I in the early diagnosis of scorpion stingÀrelated myocarditis and that Tp-e and Tp-e/QTc ratios identified via echocardiography can be used as early markers; however, further studies with larger numbers are needed to confirm this.

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NT-proBNP in Myocarditis after a Scorpion Sting Envenomation

Cited by 11 publications

References 20 publications

Echocardiography Guided Therapy for Myocarditis after Scorpion Sting Envenomation

Echocardiography Guided Therapy for Myocarditis after Scorpion Sting Envenomation

Clinical update on scorpion envenoming

Myocarditis and Early Markers of Cardiac Response Associated with Scorpion Stings in Children

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