Kardiyovasküler Toksisite Olasılığı Bulunan Bazı İlaçlar Ile Zehirlenmelerin Beyin Natriüretik Peptid Düzeyi Ile Ilişkisi
Özet
Nowadays, referrals to emergency departments due to intoxication
remains to be important in terms of mortality and morbidity. Among these
intoxications, cases with cardiac involvement should be closely monitored. Brain
Natriuretic Peptide (BNP) is considered as a sensitive marker of cardiac dysfunction
at recent years and, measurement of BNP levels provides considerable information
about cardiac functions in a short time. In the present study, it is aimed to evaluate
the relationship between plasma BNP level and severity of intoxication in order to
identify cardiac dysfunction caused by intoxication with cardiotoxic agents. 44
patients included in the study, 20 (45.4%) of them were male, 24 (54.5%) of them
were women. 35 patients (79.5%) with TSA, 5 patients (11.4%) with ß blocker and 4
patients (9.1%) with calcium channel blocker intoxications were admitted to the
emergency department. When patients with BNP levels above or below of cut-off
value were compared, it was found that hypotension rate was significantly higher and
need for intensive care unit admission was significantly greater in patients with high
BNP levels. When patients were considered regarding their ECG, no statistically
significant relationship was found between BNP level and PR or QTc interval.
However, a significant prolongation was detected in QRS interval in patients with
high BNP levels, which is an indicator of ventricle contraction. As a conclusion, in
cardiotoxic drugs intoxication, hypotension and widening in QRS on ECG were
found in patients with high plasma BNP levels. In addition, intensive care unit
admission ratio was found higher in patients with BNP level was above cut-off value.
Regarding all these data, measurement of plasma BNP level could be used as a
marker of cardiac involvement in patients intoxicated with cardiotoxic drugs.