Chest
Circulating Cardiac Troponin T in Myocardial Contusion
Section snippets
Materials and Methods
Ethical approval (CCPPRB, GH Pitié-Salpêtrière, Paris) was obtained. According to the French legislation, we were authorized not to obtain informed consent because of the emergency conditions and because care of the patient was not modified by the study and no randomization was performed.
Results
One hundred twenty-eight consecutive patients who had suffered blunt trauma were included in the study; mean age was 33±13 years (range, 18 to 71 years); 89 were male and 39 were female. The cause of trauma was a motor vehicle accident in 91 (71%) patients, a fall from a height in 35 (27%) patients, and the fall of a heavy structure in two (2%) patients. The ISS was 30±16 (range, 1 to 75) and TRISS probability of survival was 0.78±0.30 (range, 0.02 to 0.99). Head trauma occurred in 81 (63%)
Discussion
In the present study, we measured circulating cardiac troponin T in trauma patients and we observed that it was not an accurate diagnostic tool for myocardial contusion (Fig 1, Table 3). As previously reported, we also confirmed that the CK-MB and CK-MB/CK ratio have no diagnostic value in myocardial contusion.
The diagnosis of myocardial contusion is difficult since no gold standard method is presently available. In the present study, the diagnosis of myocardial contusion was retained in
ACKNOWLEDGMENT
Thanks to Boehringer Mannheim for kindly providing all facilities to perform the dosage of cardiac troponin T.
References (40)
- et al.
Clinical and radiographic indications for aortography in blunt chest trauma
J Vasc Surg
(1987) - et al.
Myocardial contusion in patients with blunt chest trauma as evaluated by thallium 201 myocardial scintigraphy
Chest
(1988) - et al.
Two-dimensional echocardiographic findings in cardiac trauma
Am J Cardiol
(1982) - et al.
Cardiac troponin I to diagnose myocardial injury [letter]
Lancet
(1993) - et al.
Improved detection of cardiac contusion with cardiac troponin I
Am Heart J
(1996) - et al.
Immediate diagnosis of acute myocardial contusion by two-dimensional echocardiography: studies in a canine model of blunt chest trauma
J Am Coll Cardiol
(1983) - et al.
Contusions myocardiques dans les traumatismes thoraciques fermés: étude prospective
Ann Fr Anesth Reanim
(1991) - et al.
Selective monitoring of patients with suspected blunt cardiac injury
Ann Thorac Surg
(1990) - et al.
Focal myocardial injury following blunt chest trauma: a comparison of indium-111 antimyosin scintigraphy with other noninvasive methods
Am Heart J
(1992) - et al.
Nonpenetrating traumatic injury of the heart
Circulation
(1958)