Evaluation of troponin-I as an indicator of cardiac dysfunction after thermal injury

Joseph T. Murphy, Jureta W. Horton, Gary F. Purdue, John L. Hunt

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: Biochemical serum markers commonly used to assess human cardiac injury (creatinine phosphokinase, creatine phosphokinase-MB) have been shown to have diminished specificity for detection of cardiac injury in the setting of burn-related soft-tissue and skeletal muscle injury. Laboratory studies have demonstrated that severe cutaneous thermal injury is associated with cardiac contractile dysfunction and a corresponding elevation in serum cardiac troponin-I (cTn-I) in several species. Methods: Twenty- three patients admitted to a tertiary care burn referral center were evaluated. Patients were monitored with pulmonary artery catheters, and creatinine phosphokinase, creatine phosphokinase-MB, and cTn-I levels were determined for 24 hours. Using a database, 6,722 burn patients were reviewed to determine the incidence of preexisting cardiac disease and postburn cardiac complications. Results: All patients had persistent sinus tachycardia (>115 beats per minute) without obvious electrical anomalies. All patients centrally monitored with a pulmonary artery catheter (n = 20) maintained a cardiac index of greater than 3.0 L · min-1.m-2. cTn-I was present (>0.3 ng/mL) within 3.0 hours and elevated (>0.55 ng/mL) at 24 hours for all burns of more than 18% total body surface area. Historically, although only 5% of all admissions manifest acute postburn cardiac complications, 94% of these patients presented with preexisting heart disease. Conclusion: Severe thermal injury was associated with a mild elevation in serum troponin-I; however, this did not correlate with overt cardiac morbidity or mortality. Postburn elevation of cTn-I suggested that a subtle degree of cardiac injury was present after a severe thermal injury despite hyperdynamic cardiac function during resuscitation.

Original languageEnglish (US)
Pages (from-to)700-707
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume45
Issue number4
DOIs
StatePublished - Oct 1998

Fingerprint

Troponin I
Hot Temperature
Wounds and Injuries
Preexisting Condition Coverage
Creatine Kinase
Burns
Pulmonary Artery
Heart Diseases
Creatinine
Phosphotransferases
Catheters
Biomarkers
Sinus Tachycardia
Burn Units
Body Surface Area
Tertiary Healthcare
Serum
Resuscitation
Skeletal Muscle
Referral and Consultation

Keywords

  • Cardiac dysfunction
  • Thermal injury
  • Troponin-I

ASJC Scopus subject areas

  • Surgery

Cite this

Evaluation of troponin-I as an indicator of cardiac dysfunction after thermal injury. / Murphy, Joseph T.; Horton, Jureta W.; Purdue, Gary F.; Hunt, John L.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 45, No. 4, 10.1998, p. 700-707.

Research output: Contribution to journalArticle

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