Trauma, a matter of the heart : molecular mechanism of post-traumatic cardiac dysfunction
Creators: name: Weber, Birte
name: Lackner, Ina
name: Gebhard, Florian
name: Miclau, Theodore
name: Kalbitz, Miriam
Publisher: name: Universität Ulm
Year: 2021
Subjects: subject: post-traumatic cardiomyopathy
subject: markers of cardiac damage
subject: complement system
subject: extracellular histones
subject: TBI
subject: stress-related cardiomyopathy
subject: burn injury
subject: DDC 610 / Medicine &amp; health
subject: Multiple trauma; Complications
subject: Cardiomyopathies
subject: Brain injuries, Traumatic
subject: Burns
subject: Complement activation
subject: Inflammation
subject: Trauma
subject: Schädel-Hirn-Trauma
subject: Verbrennung
subject: Komplement
subject: Entzündung
subject: Stress-Kardiomyopathie
subject: Histone

description: first_page settings Order Article Reprints Open AccessReview Trauma, a Matter of the Heart—Molecular Mechanism of Post-Traumatic Cardiac Dysfunction by Birte Weber 1, Ina Lackner 1, Florian Gebhard 1, Theodore Miclau 2 and Miriam Kalbitz 1,* 1 Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, Center of Surgery, University of Ulm, 86081 Ulm, Germany 2 Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of California, 2550 23rd Street, San Francisco, CA 94110, USA * Author to whom correspondence should be addressed. Int. J. Mol. Sci. 2021, 22(2), 737; https://doi.org/10.3390/ijms22020737 Received: 3 November 2020 / Revised: 7 January 2021 / Accepted: 9 January 2021 / Published: 13 January 2021 (This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics) Download Browse Figure Versions Notes Abstract Trauma remains a leading global cause of mortality, particularly in the young population. In the United States, approximately 30,000 patients with blunt cardiac trauma were recorded annually. Cardiac damage is a predictor for poor outcome after multiple trauma, with a poor prognosis and prolonged in-hospitalization. Systemic elevation of cardiac troponins was correlated with survival, injury severity score, and catecholamine consumption of patients after multiple trauma. The clinical features of the so-called “commotio cordis” are dysrhythmias, including ventricular fibrillation and sudden cardiac arrest as well as wall motion disorders. In trauma patients with inappropriate hypotension and inadequate response to fluid resuscitation, cardiac injury should be considered. Therefore, a combination of echocardiography (ECG) measurements, echocardiography, and systemic appearance of cardiomyocyte damage markers such as troponin appears to be an appropriate diagnostic approach to detect cardiac dysfunction after trauma. However, the mechanisms of post-traumatic cardiac dysfunction are still actively being investigated. This review aims to discuss cardiac damage following trauma, focusing on mechanisms of post-traumatic cardiac dysfunction associated with inflammation and complement activation. Herein, a causal relationship of cardiac dysfunction to traumatic brain injury, blunt chest trauma, multiple trauma, burn injury, psychosocial stress, fracture, and hemorrhagic shock are illustrated and therapeutic options are discussed.