LONG-TERM CARDIOVASCULAR OUTCOMES AFTER SEVERE BURN INJURY

Background
Severe burn injury (BI) leads to hypermetabolic response which can persist for several years and cause many late complications including cardiovascular (CV) disease. The aim of this study was to assess the CV outcomes of the patients with severe BI two years after their hospital discharge.

Methods
In this prospective cohort study, we included adult patients with burns >30 % of total body surface area (TBSA), which were followed up during discharge, one year and two years after discharge. The controls included laboratory tests and cardiac magnetic resonance imaging (MRI). Furthermore, a cardiac MRI was performed in a control group which consisted of healthy volunteers.

Results
We enrolled 16 patients in this study. The average age was 44.2 ± 12.7 years old; the burnt area was 47% ± 14,7% TBSA. The most common CV adverse events during acute hospitalization were signs of heart failure and arterial hypertension which was observed in 6 patients (both 37.5%), followed by arrhythmia which developed in 3 patients (18.8%), 1 patient required cardiopulmonary resuscitation due to circulatory arrest.
Laboratory results showed significant difference in NT-proBNP levels comparing discharge and second follow-up (82.6 ± 61.4 ng/l vs 60.1 ± 94.7 ng/l p=0.033).
Cardiac MRI showed no difference in ejection fraction (EF). The only significantly different MRI parameter was the left ventricular end-diastolic volume index (LVEDVI) which was lower comparing the second follow-up to health controls (59.2 ± 15.5 ml/m2vs 75.4 ± 16.0 ml/m2, p=0.046).

Conclusion
The preliminary data show that patients after severe BI develop increased myocardial wall stress, presented by higher levels of NT-proBNP two years after the BI. Combining this finding with the decrease of the LVEDVI, we assume that BI leads to its decreased compliance resulting in heart failure with preserved EF.