Echocardiographic and clinical patterns in patients with acute carbon monoxide poisoning without cardiovascular and other chronic diseases.

Introduction: Severe carbon monoxide may impact the circulatory system, potentially leading to myocardial injury. This study aimed to assess left ventricular function via echocardiography in patients with acute carbon monoxide poisoning who were otherwise healthy.

Methods: We conducted an observational, single-centre study involving consecutive patients hospitalized with carbon monoxide poisoning.

Results: In a study of 112 consecutive patients with acute carbon monoxide poisoning, we identified a subset of 46 patients with moderate to severe poisoning. Among them, myocardial injury (defined by a peak high-sensitivity troponin T concentration >14.0 ng/L) was observed in 17 of 46 (36.9%) patients, forming the myocardial injury group. The remaining 29 patients formed the non-myocardial injury group. The echocardiographic assessment revealed no significant difference (P = 0.06) between the mean (±SD) left ventricular ejection fraction in the myocardial injury group (59.8 ± 5.4%), compared to the mean (±SD) in the non-myocardial injury group (62.9 ± 5.5%). However, the mean (±SD) left ventricular global longitudinal strain was significantly higher (P = 0.008) in the myocardial injury group (-20.1 ± 1.8%) compared to the non-myocardial injury group (-22.1 ± 2.4%). Patients in the myocardial injury group also exhibited significantly higher (P <0.001) mean heart rates (108.9 beats/min) compared to the non-myocardial injury group (87.6 beats/min). In addition, the mean plasma lactate concentration was significantly higher (P <0.001) in the myocardial injury group (1.95 mmol/L) compared to the non-myocardial injury group (1.2 mmol/L). There were no fatalities in either group.

Discussion: Healthy patients with carbon monoxide poisoning who have myocardial injury may show minor changes in echocardiography in contrast to patients with co-morbidities.

Conclusions: In patients with moderate to severe carbon monoxide poisoning, without concurrent chronic diseases, left ventricular global longitudinal strain was significantly lower in those with myocardial injury. However, these findings are based on a small cohort, necessitating further research.