Evidence for Acute Myocardial and Skeletal Muscle Injury after Serial Transthoracic Shocks in Healthy Swine
Previous serological studies have shown controversial results whether defibrillation or cardioversion can cause myocardial injury. Cardiovascular Magnetic Resonance (CMR) can be used to detect myocardial edema, hyperemia and capillary leak as features of acute myocardial injury. The aim of this stud...
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| description | Previous serological studies have shown controversial results whether defibrillation or cardioversion can cause myocardial injury. Cardiovascular Magnetic Resonance (CMR) can be used to detect myocardial edema, hyperemia and capillary leak as features of acute myocardial injury. The aim of this study was to assess for myocardial and skeletal muscle injury in swine following transthoracic shocks.
Seventeen anaesthetized swine were examined, with 11 undergoing five synchronized transthoracic shocks (200J). Myocardial and skeletal muscle injury were assessed at baseline and up to 5h post-shock employing T1 mapping, T2 mapping, early and late gadolinium enhancement. Serologic markers (cFABP, TnI, CK, and CK-MB) and myocardial tissue were assessed by standard histology methods.
In myocardial regions within the shock path, T1 and T2 were significantly increased compared to remote myocardium in the same animals. The early gadolinium enhancement ratio between the left-ventricular myocardium and the right pectoral muscle was also increased compared to control animals. After the shocks cFABP and CK were significantly elevated. After shock application, the regions identified as abnormal by CMR showed significantly increased interstitial and myocardial cell areas in histological analysis. This increased cell area suggests significant cellular and interstitial edema.
Our pilot study data indicate that serial defibrillator shocks lead to acute skeletal muscle and myocardial injury. CMR is a useful tool to detect and localize myocardial and skeletal muscle injury early after transthoracic shocks in vivo. In the future the technique could potentially be used as an additional tool for quality control such as verifying insufficient local shock application in non-responders after cardioversion or to develop safer shock forms. |
| doi_str_mv | 10.1371/journal.pone.0162245 |
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Seventeen anaesthetized swine were examined, with 11 undergoing five synchronized transthoracic shocks (200J). Myocardial and skeletal muscle injury were assessed at baseline and up to 5h post-shock employing T1 mapping, T2 mapping, early and late gadolinium enhancement. Serologic markers (cFABP, TnI, CK, and CK-MB) and myocardial tissue were assessed by standard histology methods.
In myocardial regions within the shock path, T1 and T2 were significantly increased compared to remote myocardium in the same animals. The early gadolinium enhancement ratio between the left-ventricular myocardium and the right pectoral muscle was also increased compared to control animals. After the shocks cFABP and CK were significantly elevated. After shock application, the regions identified as abnormal by CMR showed significantly increased interstitial and myocardial cell areas in histological analysis. This increased cell area suggests significant cellular and interstitial edema.
Our pilot study data indicate that serial defibrillator shocks lead to acute skeletal muscle and myocardial injury. CMR is a useful tool to detect and localize myocardial and skeletal muscle injury early after transthoracic shocks in vivo. In the future the technique could potentially be used as an additional tool for quality control such as verifying insufficient local shock application in non-responders after cardioversion or to develop safer shock forms.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0162245</identifier><identifier>PMID: 27611090</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Anesthesiology ; Animals ; Biology and Life Sciences ; Cardiac arrhythmia ; Creatine kinase ; Data processing ; Defibrillators ; Edema ; Electric Countershock - adverse effects ; Fatty acids ; Female ; Gadolinium ; Heart ; Heart Injuries - diagnostic imaging ; Heart Injuries - etiology ; Heart Injuries - pathology ; Hemodynamics ; Histology ; Hyperemia ; In vivo methods and tests ; Injuries ; Kinases ; Livestock ; Magnetic resonance ; Magnetic Resonance Imaging ; Mapping ; Medical research ; Medicine and Health Sciences ; Muscle, Skeletal - diagnostic imaging ; Muscle, Skeletal - injuries ; Muscle, Skeletal - pathology ; Muscles ; Musculoskeletal system ; Myocardium ; Myocardium - pathology ; NMR ; Nuclear magnetic resonance ; Pediatrics ; Physical Sciences ; Pilot Projects ; Proteins ; Quality control ; Rare earth metal compounds ; Shock ; Skeletal muscle ; Swine ; Ventricle</subject><ispartof>PloS one, 2016-09, Vol.11 (9), p.e0162245-e0162245</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Guensch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Guensch et al 2016 Guensch et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-e77614a9c1bfd30698c3b8888e7d2c9aab81f94c7a27f0014d12ebd4245818033</citedby><cites>FETCH-LOGICAL-c725t-e77614a9c1bfd30698c3b8888e7d2c9aab81f94c7a27f0014d12ebd4245818033</cites><orcidid>0000-0003-4127-4086</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017707/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017707/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27611090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Akar, Fadi G</contributor><creatorcontrib>Guensch, Dominik P</creatorcontrib><creatorcontrib>Yu, Janelle</creatorcontrib><creatorcontrib>Nadeshalingam, Gobinath</creatorcontrib><creatorcontrib>Fischer, Kady</creatorcontrib><creatorcontrib>Shearer, Jane</creatorcontrib><creatorcontrib>Friedrich, Matthias G</creatorcontrib><title>Evidence for Acute Myocardial and Skeletal Muscle Injury after Serial Transthoracic Shocks in Healthy Swine</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Previous serological studies have shown controversial results whether defibrillation or cardioversion can cause myocardial injury. Cardiovascular Magnetic Resonance (CMR) can be used to detect myocardial edema, hyperemia and capillary leak as features of acute myocardial injury. The aim of this study was to assess for myocardial and skeletal muscle injury in swine following transthoracic shocks.
Seventeen anaesthetized swine were examined, with 11 undergoing five synchronized transthoracic shocks (200J). Myocardial and skeletal muscle injury were assessed at baseline and up to 5h post-shock employing T1 mapping, T2 mapping, early and late gadolinium enhancement. Serologic markers (cFABP, TnI, CK, and CK-MB) and myocardial tissue were assessed by standard histology methods.
In myocardial regions within the shock path, T1 and T2 were significantly increased compared to remote myocardium in the same animals. The early gadolinium enhancement ratio between the left-ventricular myocardium and the right pectoral muscle was also increased compared to control animals. After the shocks cFABP and CK were significantly elevated. After shock application, the regions identified as abnormal by CMR showed significantly increased interstitial and myocardial cell areas in histological analysis. This increased cell area suggests significant cellular and interstitial edema.
Our pilot study data indicate that serial defibrillator shocks lead to acute skeletal muscle and myocardial injury. CMR is a useful tool to detect and localize myocardial and skeletal muscle injury early after transthoracic shocks in vivo. In the future the technique could potentially be used as an additional tool for quality control such as verifying insufficient local shock application in non-responders after cardioversion or to develop safer shock forms.</description><subject>Anesthesiology</subject><subject>Animals</subject><subject>Biology and Life Sciences</subject><subject>Cardiac arrhythmia</subject><subject>Creatine kinase</subject><subject>Data processing</subject><subject>Defibrillators</subject><subject>Edema</subject><subject>Electric Countershock - adverse effects</subject><subject>Fatty acids</subject><subject>Female</subject><subject>Gadolinium</subject><subject>Heart</subject><subject>Heart Injuries - diagnostic imaging</subject><subject>Heart Injuries - etiology</subject><subject>Heart Injuries - pathology</subject><subject>Hemodynamics</subject><subject>Histology</subject><subject>Hyperemia</subject><subject>In vivo methods and tests</subject><subject>Injuries</subject><subject>Kinases</subject><subject>Livestock</subject><subject>Magnetic resonance</subject><subject>Magnetic Resonance Imaging</subject><subject>Mapping</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Muscle, Skeletal - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guensch, Dominik P</au><au>Yu, Janelle</au><au>Nadeshalingam, Gobinath</au><au>Fischer, Kady</au><au>Shearer, Jane</au><au>Friedrich, Matthias G</au><au>Akar, Fadi G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evidence for Acute Myocardial and Skeletal Muscle Injury after Serial Transthoracic Shocks in Healthy Swine</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-09-09</date><risdate>2016</risdate><volume>11</volume><issue>9</issue><spage>e0162245</spage><epage>e0162245</epage><pages>e0162245-e0162245</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Previous serological studies have shown controversial results whether defibrillation or cardioversion can cause myocardial injury. Cardiovascular Magnetic Resonance (CMR) can be used to detect myocardial edema, hyperemia and capillary leak as features of acute myocardial injury. The aim of this study was to assess for myocardial and skeletal muscle injury in swine following transthoracic shocks.
Seventeen anaesthetized swine were examined, with 11 undergoing five synchronized transthoracic shocks (200J). Myocardial and skeletal muscle injury were assessed at baseline and up to 5h post-shock employing T1 mapping, T2 mapping, early and late gadolinium enhancement. Serologic markers (cFABP, TnI, CK, and CK-MB) and myocardial tissue were assessed by standard histology methods.
In myocardial regions within the shock path, T1 and T2 were significantly increased compared to remote myocardium in the same animals. The early gadolinium enhancement ratio between the left-ventricular myocardium and the right pectoral muscle was also increased compared to control animals. After the shocks cFABP and CK were significantly elevated. After shock application, the regions identified as abnormal by CMR showed significantly increased interstitial and myocardial cell areas in histological analysis. This increased cell area suggests significant cellular and interstitial edema.
Our pilot study data indicate that serial defibrillator shocks lead to acute skeletal muscle and myocardial injury. CMR is a useful tool to detect and localize myocardial and skeletal muscle injury early after transthoracic shocks in vivo. In the future the technique could potentially be used as an additional tool for quality control such as verifying insufficient local shock application in non-responders after cardioversion or to develop safer shock forms.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27611090</pmid><doi>10.1371/journal.pone.0162245</doi><tpages>e0162245</tpages><orcidid>https://orcid.org/0000-0003-4127-4086</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesiology Animals Biology and Life Sciences Cardiac arrhythmia Creatine kinase Data processing Defibrillators Edema Electric Countershock - adverse effects Fatty acids Female Gadolinium Heart Heart Injuries - diagnostic imaging Heart Injuries - etiology Heart Injuries - pathology Hemodynamics Histology Hyperemia In vivo methods and tests Injuries Kinases Livestock Magnetic resonance Magnetic Resonance Imaging Mapping Medical research Medicine and Health Sciences Muscle, Skeletal - diagnostic imaging Muscle, Skeletal - injuries Muscle, Skeletal - pathology Muscles Musculoskeletal system Myocardium Myocardium - pathology NMR Nuclear magnetic resonance Pediatrics Physical Sciences Pilot Projects Proteins Quality control Rare earth metal compounds Shock Skeletal muscle Swine Ventricle |
| title | Evidence for Acute Myocardial and Skeletal Muscle Injury after Serial Transthoracic Shocks in Healthy Swine |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T11%3A31%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evidence%20for%20Acute%20Myocardial%20and%20Skeletal%20Muscle%20Injury%20after%20Serial%20Transthoracic%20Shocks%20in%20Healthy%20Swine&rft.jtitle=PloS%20one&rft.au=Guensch,%20Dominik%20P&rft.date=2016-09-09&rft.volume=11&rft.issue=9&rft.spage=e0162245&rft.epage=e0162245&rft.pages=e0162245-e0162245&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0162245&rft_dat=%3Cgale_plos_%3EA470941504%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1818049139&rft_id=info:pmid/27611090&rft_galeid=A470941504&rft_doaj_id=oai_doaj_org_article_cbcf4e4ffa7c4ce3bba496c21da24722&rfr_iscdi=true |