The Role of Troponin in Blunt Cardiac Injury After Multiple Trauma in Humans

Kalbitz, Miriam; Preßmar, Jochen; Stecher, Johanna; Weber, Birte; Weiß, Manfred; Schwarz, Stephan; Miltner, E.; Gebhard, Florian; Huber‐Lang, Markus

doi:10.1007/s00268-016-3650-7

Cited by 35 publications

(34 citation statements)

References 33 publications

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“…However, no data are available on any of these effects on the cardiac OT/OTR system. Txt not only causes ALI but is also frequently associated with myocardial injury [ 29 , 30 ]. Therefore, we chose to investigate OTR expression in heart tissue from the most severely affected groups from the aforementioned previous study [ 7 ] that included a modulation of the H 2 S system.…”

Section: Introductionmentioning

confidence: 99%

Interaction of the hydrogen sulfide system with the oxytocin system in the injured mouse heart

Merz

Lukaschewski

Wigger

et al. 2018

ICMx

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BackgroundBoth the hydrogen sulfide/cystathionine-γ-lyase (H2S/CSE) and oxytocin/oxytocin receptor (OT/OTR) systems have been reported to be cardioprotective. H2S can stimulate OT release, thereby affecting blood volume and pressure regulation. Systemic hyper-inflammation after blunt chest trauma is enhanced in cigarette smoke (CS)-exposed CSE−/− mice compared to wildtype (WT). CS increases myometrial OTR expression, but to this point, no data are available on the effects CS exposure on the cardiac OT/OTR system. Since a contusion of the thorax (Txt) can cause myocardial injury, the aim of this post hoc study was to investigate the effects of CSE−/− and exogenous administration of GYY4137 (a slow release H2S releasing compound) on OTR expression in the heart, after acute on chronic disease, of CS exposed mice undergoing Txt.MethodsThis study is a post hoc analysis of material obtained in wild type (WT) homozygous CSE−/− mice after 2-3 weeks of CS exposure and subsequent anesthesia, blast wave-induced TxT, and surgical instrumentation for mechanical ventilation (MV) and hemodynamic monitoring. CSE−/− animals received a 50 μg/g GYY4137-bolus after TxT. After 4h of MV, animals were exsanguinated and organs were harvested. The heart was cut transversally, formalin-fixed, and paraffin-embedded. Immunohistochemistry for OTR, arginine-vasopressin-receptor (AVPR), and vascular endothelial growth factor (VEGF) was performed with naïve animals as native controls.ResultsCSE−/− was associated with hypertension and lower blood glucose levels, partially and significantly restored by GYY4137 treatment, respectively. Myocardial OTR expression was reduced upon injury, and this was aggravated in CSE−/−. Exogenous H2S administration restored myocardial protein expression to WT levels.ConclusionsThis study suggests that cardiac CSE regulates cardiac OTR expression, and this effect might play a role in the regulation of cardiovascular function.

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Section: Introductionmentioning

confidence: 99%

Interaction of the hydrogen sulfide system with the oxytocin system in the injured mouse heart

Merz

Lukaschewski

Wigger

et al. 2018

ICMx

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“…A high serum level of cardiac troponin I (cTnI) as a specific marker of cardiac damage has recently been demonstrated as an independent risk factor for the outcome of patients, admitted after severe trauma [ 8 ]. Furthermore, high-mobility group box 1 (HMGB1), which functions as a damage-associated molecular pattern (DAMP) and is actively secreted as a danger response signal by a variety of cells [ 9 ], has recently been proposed to contribute to inflammation-mediated cardiac dysfunction via toll-like receptor 4 interaction [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Early structural changes of the heart after experimental polytrauma and hemorrhagic shock

et al. 2017

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Evidence is emerging that systemic inflammation after trauma drives structural and functional impairment of cardiomyocytes and leads to cardiac dysfunction, thus worsening the outcome of polytrauma patients. This study investigates the structural and molecular changes in heart tissue 4 h after multiple injuries with additional hemorrhagic shock using a clinically relevant rodent model of polytrauma. We determined mediators of systemic inflammation (keratinocyte chemoattractant, macrophage chemotactic protein 1), activated complement component C3a and cardiac troponin I in plasma and assessed histological specimen of the mouse heart via standard histomorphology and immunohistochemistry for cellular and subcellular damage and ongoing apoptosis. Further we investigated spatial and quantitative changes of connexin 43 by immunohistochemistry and western blotting. Our results show significantly increased plasma levels of both keratinocyte chemoattractant and cardiac troponin I 4 h after polytrauma and 2 h after induction of hypovolemia. Although we could not detect any morphological changes, immunohistochemical evaluation showed increased level of tissue high-mobility group box 1, which is both a damage-associated molecule and actively released as a danger response signal. Additionally, there was marked lateralization of the cardiac gap-junction protein connexin 43 following combined polytrauma and hemorrhagic shock. These results demonstrate a molecular manifestation of remote injury of cardiac muscle cells in the early phase after polytrauma and hemorrhagic shock with marked disruption of the cardiac gap junction. This disruption of an important component of the electrical conduction system of the heart may lead to arrhythmia and consequently to cardiac dysfunction.

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“…There are no definitive diagnostic criteria, but various combinations of clinical picture, ECG, troponin, or cardiac imaging were used to define BCI. Therefore, the incidence of BCI in patients with BTT varies from 3% to 56% (65-67). The release of troponin reflecting myocardial cell injury is believed to be because of mechanical transmission of force through the chest wall (68).…”

Section: Cardiac Contusionmentioning

confidence: 99%

Turkish Society of Cardiology Consensus Paper onThe Rational Use of Cardiac Troponins in Daily Practice

Okyay

Sadıç²,

Şahinarslan³

et al. 2019

Anatol J Cardiol

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The Role of Troponin in Blunt Cardiac Injury After Multiple Trauma in Humans

Abstract: Macroscopic heart injury was 20 times more frequent in non-survivors than in survivors. Serum troponin levels correlated with mortality after multiple injury and therefore may represent a valuable prognostic marker in trauma patients.

Cited by 35 publications

References 33 publications

Interaction of the hydrogen sulfide system with the oxytocin system in the injured mouse heart

Interaction of the hydrogen sulfide system with the oxytocin system in the injured mouse heart

Early structural changes of the heart after experimental polytrauma and hemorrhagic shock

Turkish Society of Cardiology Consensus Paper onThe Rational Use of Cardiac Troponins in Daily Practice

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