Abstract 57: Alterations In Left Ventricular Function After High-voltage Electrical Injury Assessed By Two-dimensional Speckle Tracking Echocardiography
Myocardial damage after exposure to high-voltage electrical current has been reported to result in a serious and often life-threatening situation. However, because the diagnosis of myocardial injury based on ECG findings, creatinine kinase MB (CK-MB), and myocardial pyrophosphate scans is not reliable, the changes in myocardial function after high-voltage electrical injury are not identified yet. We investigated the alterations in the left ventricular function using two-dimensional speckle tracking imaging after high-voltage electrical injury. A total of 11 male patients (mean age 37±7) with non-flash high-voltage (>22,900 volts) electrical injuries were prospectively evaluated. Serial echocardiogram was obtained on days 1, 3, and 7 after admission. In addition, serum CK-MB and troponin I levels were drawn on admission and every 6 hours for the first 24 hours. All parameters of study patients were compared to age- and sex-and body mass index-matched healthy control (n=11). At admission and during follow up, there were no significant differences in left ventricular (LV) dimension, stroke volume index, cardiac output index, fractional shortening, ejection fraction, and peak strain (S) when compared to controls. In contrast to peak strain, peak systolic mitral annular velocity (Sa) and peak systolic strain rate (SR) were significantly increased and maintained throughout follow up in patient group (Table⇓). No significant correlations were found between the increase of troponin I or CK-MB levels and all parameters of LV systolic function. In conclusion, these results demonstrate that the LV myocardial change after high-electrical injury is related to an increase of regional and global LV function through increased myocardial contractility rather than myocardial depression, and indicate changes of troponin I or CK-MB levels are not associated with myocardial damage.