Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation

• Published in: Human & experimental toxicology Vol. 37; no. 6; pp. 580 - 586
• Main Authors: Chakroun-Walha, O, Karray, R, Jerbi, M, Ben Rebeh, A, Jammeli, C, Bahloul, M, Ammar, R, Chabchoub, I, Bouaziz, M, Nasri, A, Rekik, N
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.06.2018; Sage Publications Ltd
• Subjects: Adolescent; Adult; Biomarkers; Biomarkers - blood; Calcium-binding protein; Child; Correlation analysis; Echocardiography; EKG; Electrocardiography; Emergency medical services; Emergency Service, Hospital - statistics & numerical data; Female; Heart diseases; Humans; Male; Medical diagnosis; Middle Aged; Myocarditis; Myocarditis - blood; Myocarditis - diagnosis; Patients; Retrospective Studies; Scorpion Stings - blood; Sex ratio; Troponin; Troponin - blood; Venom; Ventricle; Ventricular Dysfunction, Left - blood; Ventricular Dysfunction, Left - diagnosis; Young Adult; electrocardiogram; troponin; emergency department; myocarditis; Scorpion envenomation
• ISSN: 0960-3271; 1477-0903
• DOI: 10.1177/0960327117722822

Context: Cardiac dysfunction is one of the most serious consequences of scorpion envenomation. The best tool to evaluate cardiac function is echocardiography, but it is not available at all emergency departments. Many studies aimed to describe biological predictive factors of cardiac dysfunction in scorpion envenomation. Troponin is one of these biomarkers but its correlation with myocarditis is not well established. The aim of this study was to evaluate correlation between troponin levels and cardiac dysfunction in moderate scorpion envenomation. Methods: A retrospective monocentric study including patients admitted in the emergency department for moderate scorpion envenomation with troponin measurement during their early management. On arrival, an electrocardiogram and a chest X-ray were realized for all patients. Results: We enrolled 132 patients with a mean age at 31.3 ± 24.4 years and a 1.35 sex-ratio. All patients had moderate systemic manifestations. There were 28 patients with clinical manifestations of cardiac dysfunction without life-threatening troubles (21.2%). Troponin was undetectable in 69 patients (56%). The mean value of troponin level (pg/ml) was higher in patients with clinical manifestations of left ventricular dysfunction (1.80 ± 3.8 vs. 0.11 ± 0.5; p = 0.02). Troponin levels were significantly higher in patients with positive T wave on electrocardiogram. Conclusion: In patients with moderate scorpion envenomation with positive T wave, high values of troponin suggest the presence of cardiac dysfunction.