Deneysel Künt Toraks Travması Modelinde Kardiyak Kontüzyonun Saptanmasında Serum Kardiyak Miyozin Bağlayıcı Protein C (cMyBP-C) Düzeylerinin Değeri

Yıl 2025, Cilt: 6 Sayı: 3, 200 - 208, 28.09.2025

Aysegül Bayır , Hasan Kara , Bahadir Öztürk , Nejat Ünlükal , Muhammed Eseroğlu , Abdullah Akkuş , Fatih Akbuğa , Fatih İkiz

https://doi.org/10.47482/acmr.1647937

Öz

Giriş: Bu çalışmanın amacı, künt torasik travma modelinde kardiyak hasarı göstermede bir belirteç olarak Kardiyak Miyozin Bağlayıcı Protein C'nin kullanılabilirliğini araştırmaktır.
Yöntemler: Travma gruplarına bilateral künt torasik travma sağlandı (düşük enerjili travma grubuna 3,31 joule, orta enerjili travma grubuna 6,62 joule, yüksek enerjili travma grubuna 9,93 joule). Deneklerden cMyBP-C seviyelerini incelemek için 0., 12. ve 24. saatlerde kan örnekleri alındı. Deneyin sonunda (24. saat), histopatolojik inceleme için deneklerden akciğer dokuları alındı.
Sonuçlar: Travma gruplarının 24. saatteki ortalama cMyBP-C seviyeleri, kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksekti (p=0,02). Düşük enerjili travma grubunun 24. saatindeki, orta enerjili travma grubunun 0. saatindeki ve yüksek enerjili travma grubunun 12. ve 24. saatlerindeki ortalama cMyBP-C düzeyleri kontrol grubundan anlamlı derecede yüksekti (sırasıyla p=0,004, 0,007, 0,02, 0,03). İkili korelasyon analizinde 0. ve 24. saatlerdeki kontüzyon düzeyleri ile travma gruplarının cMyBP-C düzeyleri arasında anlamlı pozitif korelasyon bulundu (sırasıyla Spearman's ρ= 0,396, p=0,04, Spearman's ρ= 0,473, p=0,01). 24. saat cMyBP-C değerlerinin (ng/ml) duyarlılığının ve özgüllüğünün 11.150 kesme değerinde %83,3 olduğu belirlendi. Sonuç: cMyBP-C, künt torasik travmaya bağlı kardiyak hasarı ve derecesini değerlendirmede tanısal bir belirteç olarak kullanılabilir.

Anahtar Kelimeler

Kardiyak Myozin Bağlayıcı Protein C, , miyokardiyal hasar , biyobelirteçler , göğüs travması

Proje Numarası

21401109

The Value of Serum Cardiac Myosin Binding Protein C (cMyBP-C) Levels in Detecting Cardiac Contusion in an Experimental Blunt Thoracic Trauma Model

Öz

Background: The aim of this study is to investigate the usability of Cardiac Myosin Binding Protein C (cMyBP-C) as a marker in demonstrating cardiac damage in the blunt thoracic trauma model.
Methods: It was provided in the trauma groups bilateral blunt thoracic trauma (3.31 joules to the low-energy trauma group, 6.62 joules to the medium-energy trauma group, 9.93 jouls to the high-energy trauma group). Blood samples were taken 0th, 12th and 24th hours to examine cMyBP-C levels from the subjects. At the end of the experiment (24th hour), lung tissues were taken from the subjects for histopathological examination.
Results: The mean cMyBP-C levels of the trauma groups at the 24th hour were statistically significantly higher than the control group (p=0.02). The mean cMyBP-C levels at the 24th hour of the low-energy trauma group, the 0th hour of the medium-energy trauma group, and the 12th and 24th hours of the high-energy trauma group were significantly higher than the control group (p=0.004, 0.007, 0.02, 0.03 respectively). A significant positive correlation was found in the bilateral correlation analysis between the contusion levels at 0th and 24th hours and cMyBP-C levels of the trauma groups (Spearman’s ρ= 0.396, p=0.04, spearman’s ρ= 0.473, p=0.01, respectively) . It was determined that the 24th hour cMyBP-C values (ng/ml)
the sensitivity and specificity was 83.3% at the cut-off value of 11,150.
Conclusion: cMyBP-C levels increase in cardiac contusion due to blunt thoracic trauma. However, more comprehensive experimental and clinical studies are required for the use of cMyBP-C as a biomarker in the diagnosis of cardiac contusion due to blunt thoracic trauma.

Anahtar Kelimeler

Cardiac Myosin Binding Protein C , myocardial injury , biomarkers , chest trauma

Etik Beyan

Ethics committee permission was obtained from Selçuk University Experimental Medicine Research and Application Center Animal Experiments Local Ethics Committee with the date of 26.03.2021 and decision number 2021-28.

Destekleyen Kurum

Selçuk University Scientific Research Projects Coordinatorship supported this study with project number 21401109.

Proje Numarası

21401109

Kaynakça

• Nair L, Winkle B, Senanayake E. Managing blunt cardiac injury. J Cardiothorac Surg. 2023;18(1):71. Singh S, Heard M, Pester JM, Angus LD. Blunt Cardiac Injury. [Updated 2022 Oct 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532267/
• Mistry RN, Moore JE. Management of blunt thoracic trauma. BJA Educ. 2022;22(11):432-9.
• El-Andari R, O’Brien D, Bozso SJ, Nagendran J. Blunt cardiac trauma: a narrative review. Mediastinum. 2021;25;5:28.
• Kuster DW, Cardenas-Ospina A, Miller L, Liebetrau C, Troidl C, Nef HM, et al. Release kinetics of circulating cardiac myosin binding protein-C following cardiac injury. Am J Physiol Heart Circ Physiol. 2014:15;306(4):H547-56.
• Bansal MK, Maraj S, Chewaproug D, Amanullah A. Myocardial contusion injury: redefining the diagnostic algorithm. Emerg Med J. 2005;22(7):465-9.
• Sağlam Gürmen E, Tulay CM. Attention: Cardiac contusion. Ulus Travma Acil Cerrahi Derg. 2022;28(5):634-40.
• Gautam PL, Luthra N, Kaur M, Singh J, Wander GS, Tandon R, et al. Evaluation of Myocardial Injury using Standard Diagnostic Tools and Tissue Doppler Imaging in Blunt Trauma Chest. J Clin Diagn Res. 2017;11(6):OC33-OC36.
• Shoar S, Hosseini FS, Naderan M, Khavandi S, Tabibzadeh E, Khavandi S, et al. Cardiac injury following blunt chest trauma: diagnosis, management, and uncertainty. Int J Burns Trauma. 2021;11(2):80-9.
• Alborzi Z, Zangouri V, Paydar S, Ghahramani Z, Shafa M, Ziaeian B, et al. Diagnosing Myocardial Contusion after Blunt Chest Trauma. J Tehran Heart Cent. 2016;11(2):49-54.
• Kyriazidis IP, Jakob DA, Vargas JAH, Franco OH, Degiannis E, Dorn P, et al. Accuracy of diagnostic tests in cardiac injury after blunt chest trauma: a systematic review and meta-analysis. World J Emerg Surg. 2023;18(1):36.
• Scagliola R, Seitun S, Balbi M. Cardiac contusions in the acute care setting: Historical background, evaluation and management. Am J Emerg Med. 2022;61:152-7.
• Chen XJ, Zhang W, Bian ZP, Wang ZM, Zhang J, Wu HF, et al. Cardiac Myosin-Binding Protein C Release Profile After Cardiac Surgery in Intensive Care Unit. Ann Thorac Surg. 2019;108(4):1195-1201.
• Kozhuharov N, Wussler D, Kaier T, et al. Cardiac myosin-binding protein C in the diagnosis and risk stratification of acute heart failure. Eur J Heart Fail. 2021;23(5):716-25.
• Anand A, Chin C, Shah ASV, Kwiecinski J, Vesey A, Cowell J, et al. Cardiac myosin-binding protein C is a novel marker of myocardial injury and fibrosis in aortic stenosis. Heart. 2018;104(13):1101-8.
• Kaier TE, Stengaard C, Marjot J, Sørensen JT, Alaour B, Stavropoulou-Tatla S, et al. Cardiac Myosin-Binding Protein C to Diagnose Acute Myocardial Infarction in the Pre-Hospital Setting. J Am Heart Assoc. 2019 Aug 6;8(15):e013152.