Can indicators of myocardial damage predict carbon monoxide poisoning outcomes?

Kouhei Onitsuka,Shougo Urabe,Aya Okamoto,Hisashi Yamashita,Shuuichirou Sagara,Kouta Mukasa,Tomohiro Inoue,Hitoshi Koga,Kazumi Yano,Hideki Tashiro

doi:10.1186/s12873-021-00405-7

Abstract

BackgroundCarbon monoxide causes electrical, functional, and morphological changes in the heart. It is unclear, however, whether the indicators of myocardial damage can predict the patient’s prognosis after carbon monoxide poisoning. This retrospective study aimed to investigate the relationship between the carboxyhemoglobin level and electrocardiographic (ECG) changes and whether the ECG changes and troponin I levels are related to the patient’s prognosis after carbon monoxide poisoning.MethodsCarboxyhemoglobin, troponin I, and ECG parameters were measured in 70 patients with carbon monoxide poisoning. The QT and RR intervals were measured for each ECG lead in all patients, and the corrected QT interval and corrected QT dispersion were calculated.ResultsThe correlation between the maximum corrected QT interval and the carboxyhemoglobin level was significant (P = 0.0072, R2 = 0.1017), as were the relationships between QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2358) and the corrected QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2613). The multivariate logistic analysis showed that the significant predictors of sequential disability were corrected QT dispersion (P = 0.0042), and troponin I level (P = 0.0021).ConclusionsPatients’ prognosis following carbon monoxide poisoning can be predicted based on corrected QT dispersion and the troponin I level. Patients with myocardial damage should be monitored not only for their cardiovascular outcome but also for their neurological outcome and their prognosis.

Highlights

Carbon monoxide causes electrical, functional, and morphological changes in the heart
A potential clinical application of this inter-lead difference was proposed in 1990 by Day et al, who suggested that the inter-lead difference in the QT interval might provide a measure of repolarization inhomogeneity, which they called “QT dispersion” [3, 4]
(2021) 21:7 (ECG) changes and alterations of cardiac biomarkers [3, 5], it is unclear whether the indices of myocardial damage can predict the patient’s prognosis after carbon monoxide toxicity

Summary

Introduction

Functional, and morphological changes in the heart It is unclear, whether the indicators of myocardial damage can predict the patient’s prognosis after carbon monoxide poisoning. Whether the indicators of myocardial damage can predict the patient’s prognosis after carbon monoxide poisoning This retrospective study aimed to investigate the relationship between the carboxyhemoglobin level and electrocardiographic (ECG) changes and whether the ECG changes and troponin I levels are related to the patient’s prognosis after carbon monoxide poisoning. Carbon monoxide is a colorless, odorless, non-irritating gas It is produced endogenously in small amounts as a byproduct of the catabolism of heme molecules [1]. This study aimed to investigate the relationship between carboxyhemoglobin and ECG changes and whether the ECG changes and troponin I levels are related to the prognosis of patients with carbon monoxide poisoning

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Conclusion