Bekbossynova Makhabbat, Mukarov Murat, Kanabekova Perizat, Shaktybek Zhanerke, Sugralimova Madina, Batpen Arman, Kozhakhmetova Anar, Sholdanova Zhumagul, Zhanbolat Aknur
University Medical Center, Astana, Kazakhstan.
Nazarbayev University School of Medicine, Astana, Kazakhstan.
Eur J Trauma Emerg Surg. 2025 Apr 29;51(1):189. doi: 10.1007/s00068-025-02866-y.
One of the most common manifestations of cardiac injury because of trauma is myocardial contusion. Today, the blurred definition and wide range of nonspecific clinical presentations led to absence in consensus of diagnostic pathways and criteria. Currently, the marker of cardiac injury measured at clinical level is troponin and instrumental diagnostic tool is ECG. The patients with elevated troponin level after the chest trauma should be suspected to have myocardial contusion as cardiogenic shock or arrhythmia might take place as a complication. The release of DAMPs after the trauma has been observed as a part of inflammatory response to it. HMGB1 protein and histone levels were found to be elevated in patients with trauma and associated to recruit the inflammation. In this review the potential of these molecules to be used as diagnostic markers of myocardial contusion is discussed. Moreover, the obstacles for implementing DAMPS to clinical protocols and future research directions are included.
创伤导致心脏损伤最常见的表现之一是心肌挫伤。如今,定义模糊且非特异性临床表现范围广泛,导致诊断途径和标准缺乏共识。目前,临床层面测量的心脏损伤标志物是肌钙蛋白,仪器诊断工具是心电图。胸部创伤后肌钙蛋白水平升高的患者应怀疑有心肌挫伤,因为可能会发生心源性休克或心律失常等并发症。创伤后已观察到损伤相关分子模式(DAMPs)的释放,这是对创伤炎症反应的一部分。发现创伤患者中高迁移率族蛋白B1(HMGB1)蛋白和组蛋白水平升高,并与炎症反应的引发有关。在本综述中,讨论了这些分子用作心肌挫伤诊断标志物的潜力。此外,还包括将DAMPs应用于临床方案的障碍及未来研究方向。