N-terminal pro-B-type natriuretic peptide as a marker of blunt cardiac contusion in trauma.
Cardiac contusion is usually caused by blunt chest trauma and, although it is potentially a life-threatening condition, the diagnosis of a myocardial contusion is difficult because of non-specific symptoms and the lack of an ideal test to detect myocardial damage. Cardiac enzymes, such as creatine kinase (CK), creatine kinase MB fraction (CK-MB), cardiac troponin I (cTn-I), and cardiac troponin T (cTn-T) were used in previous studies to demonstrate the blunt cardiac contusion (BCC). Each of these diagnostic tests alone is not effective for diagnosis of BCC. The aim of this study was to investigate the serum heart-type fatty acid binding protein (h-FABP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), CK, CK-MB, and cTn-I levels as a marker of BCC in blunt chest trauma in rats. The eighteen Wistar albino rats were randomly allocated to two groups; group I (control) (n=8) and group II (blunt chest trauma) (n=10). Isolated BCC was induced by the method described by Raghavendran et al. (2005). All rats were observed in their cages and blood samples were collected after five hours of trauma for the analysis of serum h-FABP, NT-pro BNP, CK, CK-MB, and cTn-I levels. The mean serum NT-pro BNP was significantly different between group I and II (10.3 ± 2.10 ng/L versus 15.4 ± 3.68 ng/L, respectively; P=0.0001). NT-pro BNP level >13 ng/ml had a sensitivity of 87.5%, a specificity of 70%, a positive predictive value of 70%, and a negative predictive value of 87.5% for predicting blunt chest trauma (area under curve was 0.794 and P=0.037). There was no significant difference between two groups in serum h-FABP, CK, CK-MB and c Tn-I levels. A relation between NT-Pro BNP and BCC was shown in this study. Serum NT-proBNP levels significantly increased with BCC after 5 hours of the blunt chest trauma. The use of NT-proBNP as an adjunct to other diagnostic tests, such as troponins, electrocardiography (ECG), chest x-ray and echocardiogram may be beneficial for diagnosis of BCC.
Department of Emergency Medicine, Bakirkoy Dr. SadiKonuk Training and Research Hospital Istanbul, Turkey.
Halil
H
Dogan
Department of Emergency Medicine, Yeditepe University Hospital Istanbul, Turkey.
Sezgin
S
Sarikaya
Department of Biochemistry, Bakirkoy Dr. SadiKonuk Training and Research Hospital Istanbul, Turkey.
Sebnem Tekin
ST
Neijmann
Bagcilar Training and Research Hospital, Emergency Medicine Istanbul Turkey.
Emin
E
Uysal
Department of Emergency Medicine, Inonu University Hospital Malatya, Turkey.
Neslihan
N
Yucel
Istanbul University, Health Sciences Faculty Istanbul, Turkey.
Dogac Niyazi
DN
Ozucelik
Department of Internal Medicine, Bakirkoy Dr. SadiKonuk Training and Research Hospital Istanbul, Turkey.
Yıldız
Y
Okuturlar
Bagcilar Training and Research Hospital, Emergency Medicine Istanbul Turkey.
Suleyman
S
Solak
Department of Biochemistry, Bakirkoy Dr. SadiKonuk Training and Research Hospital Istanbul, Turkey.
Nurten
N
Sever
Department of Emergency Medicine, Bakirkoy Dr. SadiKonuk Training and Research Hospital Istanbul, Turkey.
Cem
C
Ayan
D000818:Animals; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D003288:Contusions / Q000097:blood* / Q000175:diagnosis; D052279:Creatine Kinase, MB Form / Q000097:blood; D004195:Disease Models, Animal; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D006335:Heart Injuries / Q000097:blood* / Q000175:diagnosis; D009206:Myocardium / Q000378:metabolism*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D017208:Rats, Wistar; D013997:Time Factors; D019210:Troponin I / Q000097:blood; D015854:Up-Regulation
D015415:Biomarkers; C509948:FABP3 protein, rat; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D052279:Creatine Kinase, MB Form
NT-Pro BNP; blunt cardiac contusion; blunt chest trauma; emergency medicine; h-FABP; trauma