Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.

To investigate whether acute liver failure (ALF) leads to secondary acute myocardial injury, 100 ALF patients that were retrospectively identified in a single center based on ICD 10 codes and 8 rats from an experimental study that died early after bile duct ligation (BDL) were examined. Creatine kin...

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Autores principales:	Moritz Uhlig, Marc Hein, Moriz A Habigt, René H Tolba, Till Braunschweig, Marius J Helmedag, Uwe Klinge, Alexander Koch, Christian Trautwein, Mare Mechelinck
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d8b8f4270f9c41118c876f97a5fe48bf
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spelling	oai:doaj.org-article:d8b8f4270f9c41118c876f97a5fe48bf2021-12-02T20:19:21ZAcute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.1932-620310.1371/journal.pone.0256790https://doaj.org/article/d8b8f4270f9c41118c876f97a5fe48bf2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256790https://doaj.org/toc/1932-6203To investigate whether acute liver failure (ALF) leads to secondary acute myocardial injury, 100 ALF patients that were retrospectively identified in a single center based on ICD 10 codes and 8 rats from an experimental study that died early after bile duct ligation (BDL) were examined. Creatine kinase (CK), creatine kinase-MB isoenzyme (CKMB) and cardiac troponin-I (cTnI) were analyzed as markers of myocardial injury. For histological analysis, hematoxylin-eosin (HE), elastic Van Gieson (EVG), CD41 and myeloperoxidase were used to stain rat hearts. Major adverse cardiac events (MACEs) were a critical factor for mortality (p = 0.037) in human ALF. Deceased patients exhibited higher levels of CKMB than survivors (p = 0.023). CKMB was a predictor of mortality in ALF (p = 0.013). Animals that died early after BDL exhibited increased cTnI, CKMB, tumor necrosis factor α (TNFα) and interleukin-6 (IL-6) levels compared to controls (cTnI: p = 0.011, CKMB: p = 0.008, TNFα: p = 0.003, IL-6: p = 0.006). These animals showed perivascular lesions and wavy fibers, microthrombi and neutrophilic infiltration in the heart. MACEs are decisive for mortality in human ALF, and elevated CKMB values indicate that this might be due to structural myocardial damage. Accordingly, CKMB was found to have predictive value for mortality in ALF. The results are substantiated by data from a rat BDL model demonstrating diffuse myocardial injury.Moritz UhligMarc HeinMoriz A HabigtRené H TolbaTill BraunschweigMarius J HelmedagUwe KlingeAlexander KochChristian TrautweinMare MechelinckPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0256790 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Moritz Uhlig Marc Hein Moriz A Habigt René H Tolba Till Braunschweig Marius J Helmedag Uwe Klinge Alexander Koch Christian Trautwein Mare Mechelinck Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.
description	To investigate whether acute liver failure (ALF) leads to secondary acute myocardial injury, 100 ALF patients that were retrospectively identified in a single center based on ICD 10 codes and 8 rats from an experimental study that died early after bile duct ligation (BDL) were examined. Creatine kinase (CK), creatine kinase-MB isoenzyme (CKMB) and cardiac troponin-I (cTnI) were analyzed as markers of myocardial injury. For histological analysis, hematoxylin-eosin (HE), elastic Van Gieson (EVG), CD41 and myeloperoxidase were used to stain rat hearts. Major adverse cardiac events (MACEs) were a critical factor for mortality (p = 0.037) in human ALF. Deceased patients exhibited higher levels of CKMB than survivors (p = 0.023). CKMB was a predictor of mortality in ALF (p = 0.013). Animals that died early after BDL exhibited increased cTnI, CKMB, tumor necrosis factor α (TNFα) and interleukin-6 (IL-6) levels compared to controls (cTnI: p = 0.011, CKMB: p = 0.008, TNFα: p = 0.003, IL-6: p = 0.006). These animals showed perivascular lesions and wavy fibers, microthrombi and neutrophilic infiltration in the heart. MACEs are decisive for mortality in human ALF, and elevated CKMB values indicate that this might be due to structural myocardial damage. Accordingly, CKMB was found to have predictive value for mortality in ALF. The results are substantiated by data from a rat BDL model demonstrating diffuse myocardial injury.
format	article
author	Moritz Uhlig Marc Hein Moriz A Habigt René H Tolba Till Braunschweig Marius J Helmedag Uwe Klinge Alexander Koch Christian Trautwein Mare Mechelinck
author_facet	Moritz Uhlig Marc Hein Moriz A Habigt René H Tolba Till Braunschweig Marius J Helmedag Uwe Klinge Alexander Koch Christian Trautwein Mare Mechelinck
author_sort	Moritz Uhlig
title	Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.
title_short	Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.
title_full	Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.
title_fullStr	Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.
title_full_unstemmed	Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.
title_sort	acute myocardial injury secondary to severe acute liver failure: a retrospective analysis supported by animal data.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/d8b8f4270f9c41118c876f97a5fe48bf
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Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data.

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