| Acute left ventricular dysfunction of severe scorpion envenomation is related to myocardial perfusion disturbance. | |
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MedLine Citation:
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PMID: 16828898 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Scorpion envenomation (SE) may present severe cardiac dysfunction with acute pulmonary edema and cardiogenic shock. The pathophysiology of this acute heart failure is still controversial. We aimed at assessing the contribution of the myocardial ischemia to the left ventricular dysfunction in SE by using 99mTc-Sestamibi myocardial perfusion scintigraphy (MPS). METHODS: Twelve children (7 males, 1-12 years old) presenting severe Tityus serrulatus envenomation were prospectively submitted to MPS within 72 h (acute) and 15 days (follow-up) after the event. MPS images were interpreted using a visual semi-quantitative uptake score (0 = normal, 4 = absent). Echocardiography was used for the assessment of left ventricular (LV) ejection fraction (EF) and regional wall motion (WM) by using a semi-quantitative score (0 = normal, 4 = akinesia). A 16-segment LV model was used. RESULTS: Initial echocardiography showed marked WM abnormalities with a mean score of 31.4+/-13.9, and a reduced EF (36+/-16%). All patients exhibited myocardial perfusion (MP) defects. The mean MP uptake score was 14.6+/-7.8. A significant topographic association between MP and WM changes was obtained (p<0.0001, Fischer exact test). A positive correlation was obtained between the summed WM and MP scores (R=0.68, p=0.016). Follow-up evaluation showed a significant improvement of LVEF (65+/-10%) and WM score (3.9+/-4.2), parallel to the normalization of MP. CONCLUSIONS: These observations strongly support the participation of transitory myocardial ischemia in the mechanism of the acute cardiac dysfunction caused by severe scorpion envenoming. Micro vascular spasm related to the catecholamine over stimulation may be the pathophysiologic link triggering the myocardial perfusion disturbance in this syndrome. |
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Authors:
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Palmira Cupo; Alexandre B Figueiredo; Antonio P Filho; Antonio O Pintya; Gerson A Tavares Júnior; Fábio Caligaris; José A Marin-Neto; Sylvia E Hering; Marcus V Simões |
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Publication Detail:
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Type: Journal Article Date: 2006-07-10 |
Journal Detail:
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Title: International journal of cardiology Volume: 116 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-02-16 Completed Date: 2007-04-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 98-106 Citation Subset: IM |
Affiliation:
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Pediatrics Division, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. pcupo@fmrp.usp.br |
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Arachnidism / complications* Child Child, Preschool Female Humans Infant Male Myocardial Ischemia / chemically induced*, radionuclide imaging Prospective Studies Pulmonary Edema / chemically induced, therapy Scorpion Venoms / poisoning* Treatment Outcome Ventricular Dysfunction, Left / chemically induced*, physiopathology*, therapy, ultrasonography |
| Chemical | |
Reg. No./Substance:
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0/Scorpion Venoms |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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