Size as an Important Determinant of Chest Blow–induced Commotio Cordis
PURPOSECommotio cordis is sudden cardiac death caused by a relatively innocent blow to the left chest wall. Adolescents account for the majority of the cases; whether this is due to the higher frequency of adolescents playing ball sports or whether there is some maturational reduction of risk is not...
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| Veröffentlicht in: | Medicine and science in sports and exercise 2018-09, Vol.50 (9), p.1767-1771 |
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| container_title | Medicine and science in sports and exercise |
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| creator | MADIAS, CHRISTOPHER MARON, BARRY J DAU, NATHAN ESTES, NATHAN A MARK BIR, CYNTHIA LINK, MARK S |
| description | PURPOSECommotio cordis is sudden cardiac death caused by a relatively innocent blow to the left chest wall. Adolescents account for the majority of the cases; whether this is due to the higher frequency of adolescents playing ball sports or whether there is some maturational reduction of risk is not known.
METHODSIn a swine model of commotio cordis, the effect of body weight/size (directly related to age) to the susceptibility of chest impact–induced ventricular fibrillation (VF) is examined.
METHODSBall impacts were delivered at escalating velocities from 48.3 to 96.9 km·h (30–60 mph) to 128 swine ranging in weight from 5 to 54 kg.
RESULTSVF occurred in 29% of impacts to the smallest animals compared with 34% in the 14- to 239-kg group, 27% in the 24- to 33.9-kg group, 30% in 34- to 43-kg group, and 15% in the 44- to 54-kg animals. The highest-weight group was associated with a significantly lower incidence of VF compared with other weights (P = 0.002). In a multivariate logistic regression analysis, controlling for repeated measures, four variables predicted VFbody weight (P = 0.0008), velocity (P < 0.0001), distance from the center of the heart, (P < 0.0001), and peak left ventricular pressure induced by the blow (P = 0.0007).
CONCLUSIONSIn this experimental model, animals weighing |
| doi_str_mv | 10.1249/MSS.0000000000001630 |
| format | Article |
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METHODSIn a swine model of commotio cordis, the effect of body weight/size (directly related to age) to the susceptibility of chest impact–induced ventricular fibrillation (VF) is examined.
METHODSBall impacts were delivered at escalating velocities from 48.3 to 96.9 km·h (30–60 mph) to 128 swine ranging in weight from 5 to 54 kg.
RESULTSVF occurred in 29% of impacts to the smallest animals compared with 34% in the 14- to 239-kg group, 27% in the 24- to 33.9-kg group, 30% in 34- to 43-kg group, and 15% in the 44- to 54-kg animals. The highest-weight group was associated with a significantly lower incidence of VF compared with other weights (P = 0.002). In a multivariate logistic regression analysis, controlling for repeated measures, four variables predicted VFbody weight (P = 0.0008), velocity (P < 0.0001), distance from the center of the heart, (P < 0.0001), and peak left ventricular pressure induced by the blow (P = 0.0007).
CONCLUSIONSIn this experimental model, animals weighing <44 kg seem to have a similar susceptibility to commotio cordis, whereas animals weighing ≥44 kg have a lower susceptibility. An increase in size of the individual, rather than reduced play of ball sports, is the likely reason for the decreased commotio cordis incidence in older individuals.</description><identifier>ISSN: 0195-9131</identifier><identifier>EISSN: 1530-0315</identifier><identifier>DOI: 10.1249/MSS.0000000000001630</identifier><identifier>PMID: 29620687</identifier><language>eng</language><publisher>United States: American College of Sports Medicine</publisher><subject>Animals ; Athletic Injuries - complications ; Body Size ; Commotio Cordis - etiology ; Disease Models, Animal ; Male ; Swine ; Thorax ; Ventricular Fibrillation - etiology ; Wounds, Nonpenetrating - complications</subject><ispartof>Medicine and science in sports and exercise, 2018-09, Vol.50 (9), p.1767-1771</ispartof><rights>2018 American College of Sports Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4020-d683ab7cd110cd2aa655c91092c54262c502b68011df508af9937127a4aefe033</citedby><cites>FETCH-LOGICAL-c4020-d683ab7cd110cd2aa655c91092c54262c502b68011df508af9937127a4aefe033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29620687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MADIAS, CHRISTOPHER</creatorcontrib><creatorcontrib>MARON, BARRY J</creatorcontrib><creatorcontrib>DAU, NATHAN</creatorcontrib><creatorcontrib>ESTES, NATHAN A MARK</creatorcontrib><creatorcontrib>BIR, CYNTHIA</creatorcontrib><creatorcontrib>LINK, MARK S</creatorcontrib><title>Size as an Important Determinant of Chest Blow–induced Commotio Cordis</title><title>Medicine and science in sports and exercise</title><addtitle>Med Sci Sports Exerc</addtitle><description>PURPOSECommotio cordis is sudden cardiac death caused by a relatively innocent blow to the left chest wall. Adolescents account for the majority of the cases; whether this is due to the higher frequency of adolescents playing ball sports or whether there is some maturational reduction of risk is not known.
METHODSIn a swine model of commotio cordis, the effect of body weight/size (directly related to age) to the susceptibility of chest impact–induced ventricular fibrillation (VF) is examined.
METHODSBall impacts were delivered at escalating velocities from 48.3 to 96.9 km·h (30–60 mph) to 128 swine ranging in weight from 5 to 54 kg.
RESULTSVF occurred in 29% of impacts to the smallest animals compared with 34% in the 14- to 239-kg group, 27% in the 24- to 33.9-kg group, 30% in 34- to 43-kg group, and 15% in the 44- to 54-kg animals. The highest-weight group was associated with a significantly lower incidence of VF compared with other weights (P = 0.002). In a multivariate logistic regression analysis, controlling for repeated measures, four variables predicted VFbody weight (P = 0.0008), velocity (P < 0.0001), distance from the center of the heart, (P < 0.0001), and peak left ventricular pressure induced by the blow (P = 0.0007).
CONCLUSIONSIn this experimental model, animals weighing <44 kg seem to have a similar susceptibility to commotio cordis, whereas animals weighing ≥44 kg have a lower susceptibility. An increase in size of the individual, rather than reduced play of ball sports, is the likely reason for the decreased commotio cordis incidence in older individuals.</description><subject>Animals</subject><subject>Athletic Injuries - complications</subject><subject>Body Size</subject><subject>Commotio Cordis - etiology</subject><subject>Disease Models, Animal</subject><subject>Male</subject><subject>Swine</subject><subject>Thorax</subject><subject>Ventricular Fibrillation - etiology</subject><subject>Wounds, Nonpenetrating - complications</subject><issn>0195-9131</issn><issn>1530-0315</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kLtOwzAUhi0EoqXwBghlZEk5x87NI4RLK4EYCrPlxo4aSOJiJ6pg4h14Q54EVy0IMeDB_ofvXPwRcowwRhrxs7vZbAy_DiYMdsgQYwYhMIx3yRCQxyFHhgNy4NyTh1LGcJ8MKE8oJFk6JJNZ9aYD6QLZBtNmaWwn2y641J22TdWusymDfKFdF1zUZvX5_lG1qi-0CnLTNKarjA9WVe6Q7JWydvpo-47I4_XVQz4Jb-9vpvn5bVhEQCFUScbkPC0UIhSKSpnEccEROC3iiCb-BjpPMkBUZQyZLDlnKdJURlKXGhgbkdNN36U1L73fSzSVK3Rdy1ab3gkKlPofA-MejTZoYY1zVpdiaatG2leBINYOhXco_jr0ZSfbCf280eqn6FuaB7INsDK19-Se636lrVhoWXeL_3t_AQWOfNM</recordid><startdate>201809</startdate><enddate>201809</enddate><creator>MADIAS, CHRISTOPHER</creator><creator>MARON, BARRY J</creator><creator>DAU, NATHAN</creator><creator>ESTES, NATHAN A MARK</creator><creator>BIR, CYNTHIA</creator><creator>LINK, MARK S</creator><general>American College of Sports Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201809</creationdate><title>Size as an Important Determinant of Chest Blow–induced Commotio Cordis</title><author>MADIAS, CHRISTOPHER ; MARON, BARRY J ; DAU, NATHAN ; ESTES, NATHAN A MARK ; BIR, CYNTHIA ; LINK, MARK S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4020-d683ab7cd110cd2aa655c91092c54262c502b68011df508af9937127a4aefe033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Animals</topic><topic>Athletic Injuries - complications</topic><topic>Body Size</topic><topic>Commotio Cordis - etiology</topic><topic>Disease Models, Animal</topic><topic>Male</topic><topic>Swine</topic><topic>Thorax</topic><topic>Ventricular Fibrillation - etiology</topic><topic>Wounds, Nonpenetrating - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MADIAS, CHRISTOPHER</creatorcontrib><creatorcontrib>MARON, BARRY J</creatorcontrib><creatorcontrib>DAU, NATHAN</creatorcontrib><creatorcontrib>ESTES, NATHAN A MARK</creatorcontrib><creatorcontrib>BIR, CYNTHIA</creatorcontrib><creatorcontrib>LINK, MARK S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medicine and science in sports and exercise</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MADIAS, CHRISTOPHER</au><au>MARON, BARRY J</au><au>DAU, NATHAN</au><au>ESTES, NATHAN A MARK</au><au>BIR, CYNTHIA</au><au>LINK, MARK S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Size as an Important Determinant of Chest Blow–induced Commotio Cordis</atitle><jtitle>Medicine and science in sports and exercise</jtitle><addtitle>Med Sci Sports Exerc</addtitle><date>2018-09</date><risdate>2018</risdate><volume>50</volume><issue>9</issue><spage>1767</spage><epage>1771</epage><pages>1767-1771</pages><issn>0195-9131</issn><eissn>1530-0315</eissn><abstract>PURPOSECommotio cordis is sudden cardiac death caused by a relatively innocent blow to the left chest wall. Adolescents account for the majority of the cases; whether this is due to the higher frequency of adolescents playing ball sports or whether there is some maturational reduction of risk is not known.
METHODSIn a swine model of commotio cordis, the effect of body weight/size (directly related to age) to the susceptibility of chest impact–induced ventricular fibrillation (VF) is examined.
METHODSBall impacts were delivered at escalating velocities from 48.3 to 96.9 km·h (30–60 mph) to 128 swine ranging in weight from 5 to 54 kg.
RESULTSVF occurred in 29% of impacts to the smallest animals compared with 34% in the 14- to 239-kg group, 27% in the 24- to 33.9-kg group, 30% in 34- to 43-kg group, and 15% in the 44- to 54-kg animals. The highest-weight group was associated with a significantly lower incidence of VF compared with other weights (P = 0.002). In a multivariate logistic regression analysis, controlling for repeated measures, four variables predicted VFbody weight (P = 0.0008), velocity (P < 0.0001), distance from the center of the heart, (P < 0.0001), and peak left ventricular pressure induced by the blow (P = 0.0007).
CONCLUSIONSIn this experimental model, animals weighing <44 kg seem to have a similar susceptibility to commotio cordis, whereas animals weighing ≥44 kg have a lower susceptibility. An increase in size of the individual, rather than reduced play of ball sports, is the likely reason for the decreased commotio cordis incidence in older individuals.</abstract><cop>United States</cop><pub>American College of Sports Medicine</pub><pmid>29620687</pmid><doi>10.1249/MSS.0000000000001630</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Journals@Ovid Ovid Autoload |
| subjects | Animals Athletic Injuries - complications Body Size Commotio Cordis - etiology Disease Models, Animal Male Swine Thorax Ventricular Fibrillation - etiology Wounds, Nonpenetrating - complications |
| title | Size as an Important Determinant of Chest Blow–induced Commotio Cordis |
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