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Myocardial Repolarization Parameters and Neutrophil-to-Lymphocyte Ratio are Associated with Cardiotoxicity in Carbon

Tuğba Atmaca Temrel1, Sedat Bilge2

  • 1Department of Emergency Medicine, University of Health Sciences, 06800, Ankara, Turkey. tugbatemrel@gmail.com.

Cardiovascular Toxicology
|December 22, 2019
PubMed

Insights

Complete blood count (CBC) bioindicators and myocardial repolarization (M-rep) parameters, including the neutrophil-to-lymphocyte ratio (NLR), show significant associations with carbon monoxide (CO) intoxication and myocardial injury (M-inj), aiding early detection.

Area of Science:

  • Cardiology
  • Toxicology
  • Emergency Medicine

Background:

  • Acute carbon monoxide (CO) intoxication is a significant cause of emergency room admissions.
  • CO intoxication can lead to cardiotoxicity and myocardial injury (M-inj).
  • Early detection of cardiotoxicity in CO intoxication is crucial for patient management.

Purpose of the Study:

  • To evaluate the clinical utility of complete blood count (CBC) bioindicators and myocardial repolarization (M-rep) parameters in assessing cardiotoxicity from acute CO intoxication.
  • To investigate the association between neutrophil-to-lymphocyte ratio (NLR) and M-rep parameters (QTc, Tp-e, Tp disp, Tp-e/QTc ratio) with CO intoxication and myocardial injury.

Main Methods:

  • Retrospective, cross-sectional, observational study of 234 patients admitted to the emergency service for acute CO intoxication.
  • Analysis of CBC bioindicators, including NLR, and M-rep parameters (QTc, Tp-e, Tp disp, Tp-e/QTc ratio).
  • Statistical comparison between CO intoxication and control groups, and between patients with and without myocardial injury.

Main Results:

  • Significantly elevated NLR, QTc, and Tp-e values were observed in the CO intoxication group compared to controls (p < 0.001).
  • The Tp-e/QTc ratio was significantly lower in the CO intoxication group (p < 0.001).
  • NLR, Tp-e, and Tp disp were significantly higher in the myocardial injury group (p < 0.001, p = 0.003, p = 0.018, respectively), with a significantly lower Tp-e/QTc ratio (p = 0.002).

Conclusions:

  • Myocardial repolarization parameters and NLR are significantly associated with acute CO intoxication and the development of myocardial injury.
  • These bioindicators can serve as valuable early warning signs for clinicians regarding myocardial injury in CO-intoxicated patients.
  • The study highlights the potential of routine blood tests and ECG-derived parameters for early cardiotoxicity assessment in CO poisoning.

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