Myocardial injury and its association with venom-induced coagulopathy following Bothrops atrox snakebite envenomation.

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Tác giả: Karolaine Oliveira Bentes, Gisely Cardoso de Melo, João Marcos Bemfica Barbosa Ferreira, Wuelton Marcelo Monteiro, Jady Shayene Mota Cordeiro, Victor Irungu Mwangi, Samella Oliveira, Thiago Serrão Pinto, Maria Raimunda da Costa, Jacqueline Sachett, Marco Aurélio Sartim, José Wilson do Nascimento Corrêa

Ngôn ngữ: eng

Ký hiệu phân loại: 627.12 Rivers and streams

Thông tin xuất bản: England : Toxicon : official journal of the International Society on Toxinology , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 703524

BACKGOUND: In Brazil, the highest incidences of snakebite envenomation (SBE) occur in the Amazon region, caused mostly by Bothrops atrox. Among the effects of envenomation, cardiac alterations are not a frequent outcome but are highly linked to severe cases. OBJECTIVE: The present study investigated the serum profile of cardiac injury markers (fatty acid binding protein 3 - H-FABP3, N-terminal type B natriuretic peptide - NTproBNP, creatine kinase-MB - CPK-MB, and troponin I) following Bothrops SBEs and their association with venom-induced coagulopathy. METHODS: Plasma markers were evaluated from blood collected at admission (before antivenom - T0) and 48h after antivenom (T48) from 80 B. atrox SBE patients treated at a tertiary hospital in Manaus, Brazilian Amazon, and 20 healthy donors. RESULTS: Markers were found increased, above reference range or compared to sex- and age-matched healthy controls, including FABP3 in at least 98.7% of patients, Troponin I 12.5%, and CK-MB in 8.8%. Regarding correlations to coagulation markers, alpha 2-antiplasmin concentrations were negatively correlated with FABP3 levels (T0), whereas FDP, tissue factor, and plasma factor VII levels were positively correlated with troponin I concentrations. Moreover, the group of patients with increased troponin I levels presented significantly higher FDP concentrations, factor VII levels, and risk for systemic bleeding at T0, whereas higher D-dimer concentrations at T48. CONCLUSIONS: Our findings show that Bothrops SBE is responsible for myocardial injury, although not associated with severe outcomes, and its directly associated to venom-induced coagulopathy, indicating troponin-I and FABP3 as possible markers to screen patients for more detailed cardiac alterations.
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