Correlation of CPK-MB and LVEF with Pulmonary Edema in Cases with Scorpion Sting
Background: To study correlation between rise in CPK-MB and Fall in Left Ventricular Ejection Fraction (LVEF) with Pulmonary Edema in cases with Scorpion Sting.
Methods: Design: Randomised Controlled Trial, Subjects: 126 patients with scorpion sting. All the patients enrolled in the study were monitored clinically in ICU and investigated for markers of myocardial injury by S.CPK-MB and 2D Echocardiography for LVEF at admission. Results: in our study patients with left ventricular ejection fraction less than 40% had higher than normal value of serum CPK-MB (120.28 ± 88.76 IU/L), but the value of this cardiac enzyme was comparatively higher (155.1 ± 65.94) in those with normal left ventricular output. The cases with ejection fraction between 40-60% demonstrated the lowest values of CPK-MB (94.25 ± 94.25). It was observed that mean serum CPK-MB level was higher (130.4 ± 104.6 IU/L) in cases with pulmonary edema than in those without edema (113.3 ± 68.1 IU/L); however, this difference was statistically insignificant (p>0.20). Our second indicator of myocardial injury left ventricular ejection fraction was significantly lower (33 ± 14%) in cases with pulmonary edema when compared to those without edema (54 ± 11%), p-value being <0.01.
Conclusions: There is no direct relationship in CPK-MB level and fall in LVEF, meaning thereby there are other physiological factors affecting LVEF rather than only direct myocardial injury. Pulmonary Edema is mainly due to fall in LVEF. LVEF is a better indicator of the severity of myocardial injury than CPK-MB and can help in guiding the treatment.
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