Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs
Abstract Musculoskeletal injuries are the most common reason for surgery in severely injured patients. In addition to direct cardiac damage after physical trauma, there is rising evidence that trauma induces secondary cardiac structural and functional damage. Previous research associates hip fractur...
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Nature Portfolio
2021
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oai:doaj.org-article:334c35837aae40a493a911f8190992ea2021-12-02T17:33:00ZEarly myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs10.1038/s41598-021-86151-z2045-2322https://doaj.org/article/334c35837aae40a493a911f8190992ea2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86151-zhttps://doaj.org/toc/2045-2322Abstract Musculoskeletal injuries are the most common reason for surgery in severely injured patients. In addition to direct cardiac damage after physical trauma, there is rising evidence that trauma induces secondary cardiac structural and functional damage. Previous research associates hip fractures with the appearance of coronary heart disease: As 25% of elderly patients developed a major adverse cardiac event after hip fracture. 20 male pigs underwent femur fracture with operative stabilization via nailing (unreamed, reamed, RIA I and a new RIA II; each group n = 5). Blood samples were collected 6 h after trauma and the concentration of troponin I and heart-type fatty acid binding protein (HFABP) as biomarkers for EMD were measured. At baseline and 6 h after trauma, transesophageal ECHO (TOE) was performed; and invasive arterial and left ventricular blood pressure were measured to evaluate the cardiac function after femur fracture. A systemic elevation of troponin I and HFABP indicate an early myocardial damage after femur fracture in pigs. Furthermore, various changes in systolic (ejection fraction and cardiac output) and diastolic (left ventricular end-diastolic pressure, mitral valve deceleration time and E/A ratio) parameters illustrate the functional impairment of the heart. These findings were accompanied by the development of valvular dysfunction (pulmonary and tricuspid valve). To the best of our knowledge, we described for the first time the development of functional impairment of the heart in the context of EMD after long bone fracture in pigs. Next to troponin and HFABP elevation, alterations in the systolic and diastolic function occurred and were accompanied by pulmonary and tricuspid valvular insufficiency. Regarding EMD, none of the fracture stabilization techniques (unreamed nailing, reaming, RIA I and RIA II) was superior.Birte WeberIna LacknerTheodore MiclauJonathan StulzFlorian GebhardRoman PfeiferPaolo CinelliSascha HalvachizadehMichel TeubenHans-Christoph PapeMiriam LipiskiNikola CesarovicMiriam KalbitzNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021) |
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Medicine R Science Q |
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Medicine R Science Q Birte Weber Ina Lackner Theodore Miclau Jonathan Stulz Florian Gebhard Roman Pfeifer Paolo Cinelli Sascha Halvachizadeh Michel Teuben Hans-Christoph Pape Miriam Lipiski Nikola Cesarovic Miriam Kalbitz Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs |
| description |
Abstract Musculoskeletal injuries are the most common reason for surgery in severely injured patients. In addition to direct cardiac damage after physical trauma, there is rising evidence that trauma induces secondary cardiac structural and functional damage. Previous research associates hip fractures with the appearance of coronary heart disease: As 25% of elderly patients developed a major adverse cardiac event after hip fracture. 20 male pigs underwent femur fracture with operative stabilization via nailing (unreamed, reamed, RIA I and a new RIA II; each group n = 5). Blood samples were collected 6 h after trauma and the concentration of troponin I and heart-type fatty acid binding protein (HFABP) as biomarkers for EMD were measured. At baseline and 6 h after trauma, transesophageal ECHO (TOE) was performed; and invasive arterial and left ventricular blood pressure were measured to evaluate the cardiac function after femur fracture. A systemic elevation of troponin I and HFABP indicate an early myocardial damage after femur fracture in pigs. Furthermore, various changes in systolic (ejection fraction and cardiac output) and diastolic (left ventricular end-diastolic pressure, mitral valve deceleration time and E/A ratio) parameters illustrate the functional impairment of the heart. These findings were accompanied by the development of valvular dysfunction (pulmonary and tricuspid valve). To the best of our knowledge, we described for the first time the development of functional impairment of the heart in the context of EMD after long bone fracture in pigs. Next to troponin and HFABP elevation, alterations in the systolic and diastolic function occurred and were accompanied by pulmonary and tricuspid valvular insufficiency. Regarding EMD, none of the fracture stabilization techniques (unreamed nailing, reaming, RIA I and RIA II) was superior. |
| format |
article |
| author |
Birte Weber Ina Lackner Theodore Miclau Jonathan Stulz Florian Gebhard Roman Pfeifer Paolo Cinelli Sascha Halvachizadeh Michel Teuben Hans-Christoph Pape Miriam Lipiski Nikola Cesarovic Miriam Kalbitz |
| author_facet |
Birte Weber Ina Lackner Theodore Miclau Jonathan Stulz Florian Gebhard Roman Pfeifer Paolo Cinelli Sascha Halvachizadeh Michel Teuben Hans-Christoph Pape Miriam Lipiski Nikola Cesarovic Miriam Kalbitz |
| author_sort |
Birte Weber |
| title |
Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs |
| title_short |
Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs |
| title_full |
Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs |
| title_fullStr |
Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs |
| title_full_unstemmed |
Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs |
| title_sort |
early myocardial damage (emd) and valvular dysfunction after femur fracture in pigs |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/334c35837aae40a493a911f8190992ea |
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