Incidence and Clinical Course of Left Ventricular Systolic Dysfunction in Patients with Carbon Monoxide Poisoning.
10.4070/kcj.2016.46.5.665
- Author:
Jae Hwan LEE
1
;
Hyun Sook KIM
;
Jae Hyeong PARK
;
Min Su KIM
;
Byung Joo SUN
;
Seung RYU
;
Song Soo KIM
;
Seon Ah JIN
;
Jun Hyung KIM
;
Si Wan CHOI
;
Jin Ok JEONG
;
In Sun KWON
;
In Whan SEONG
Author Information
1. Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea. jaehpark@cnu.ac.kr
- Publication Type:Original Article
- Keywords:
Carbon monoxide;
Poisoning;
Left ventricular dysfunction
- MeSH:
Anoxia;
Carbon Monoxide Poisoning*;
Carbon Monoxide*;
Carbon*;
Cohort Studies;
Coronary Stenosis;
Echocardiography;
Electrocardiography;
Emergency Service, Hospital;
Follow-Up Studies;
Heart Rate;
Humans;
Incidence*;
Lactic Acid;
Male;
Multivariate Analysis;
Poisoning;
Pulmonary Edema;
Sensitivity and Specificity;
Thorax;
Troponin I;
Ventricular Dysfunction, Left
- From:Korean Circulation Journal
2016;46(5):665-671
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Carbon monoxide (CO) poisoning can cause tissue hypoxia and left ventricular systolic dysfunction (LVSD) requiring intensive medical management. Our objectives were to find incidence and clinical course of LVSD CO intoxicated patients and make a clinical scoring to predict LVSD. SUBJECTS AND METHODS: We included all consecutive patients with CO exposure in the emergency room. LVSD was defined by LVEF <50% assessed by echocardiography. We compared their clinical, chemical, radiological and electrocardiographic patterns according to the presence of LVSD. RESULTS: From May 2009 to June 2015, we included a total of 81 patients (48 men, 47±19 years old) with CO exposure in this cohort. LVSD was found in about 25 patients (31%). Nine had regional wall motion abnormality. Follow up echocardiographic examinations were available in 21 patients. Of them, 18 patients showed complete recovery in about 3 days (mean 2.8±1.7 days). Of 3 patients without recovery, 2 had significant coronary artery stenosis. LVSD was significantly associated with initial heart rate (>100/min), pulmonary edema on chest X-ray, serum NT pro-BNP (>100 pg/mL), troponin-I (>0.1 ng/mL) and lactic acid (>4.0 mg/dL) after a univariate analysis. Combining these into a clinical score, according to their beta score after a multivariate analysis (rage=0-16), allowed prediction of LVSD with a sensitivity of 84% and specificity of 91% (reference ≥8, area under the curve=0.952, p<0.001) CONCLUSION: About 31% showed LVSD in patients with CO poisoning, and most of them (86%, 18 of 21 patients) recovered within 3 days. Patients with a higher clinical score (≥8) might have LVSD.
