Kardiyovasküler Toksisite Olasılığı Bulunan Bazı İlaçlar Ile Zehirlenmelerin Beyin Natriüretik Peptid Düzeyi Ile Ilişkisi

Abstract

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.