Blood metal concentrations and cardiac structure and function in total joint arthroplasty patients  

作　　者：Peter C Brennan Stephanie M Peterson Thomas J O'Byrne Mariana L Laporta Cody C Wyles Paul J Jannetto Garvan C Kane Maria Vassilaki Hilal Maradit Kremers 

机构地区：[1]Department of Orthopedic Surgery,Mayo Clinic,Rochester,MN 55905,United States [2]Department of Quantitative Health Sciences,Mayo Clinic,Rochester,MN 55905,United States [3]Department of Anesthesiology and Perioperative Medicine,Mayo Clinic,Rochester,MN 55905,United States [4]Department of Laboratory Medicine and Pathology,Mayo Clinic,Rochester,MN 55905,United States [5]Department of Cardiovascular Diseases,Mayo Clinic,Rochester,MN 55905,United States

出　　处：《World Journal of Orthopedics》2024年第8期773-782,共10页世界骨科杂志（英文版）

基　　金：Supported by The National Institutes of Health,No.R01HL147155 and No.R01AG060920.

摘　　要：BACKGROUND There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty(TJA)patients.AIM To determine the association of commonly used implant metals with echocardiographic measures in TJA patients.METHODS The study comprised 110 TJA patients who had a recent history of high chromium,cobalt or titanium concentrations.Patients underwent two-dimensional,three-dimensional,Doppler and speckle-strain transthoracic echocardiography and a blood draw to measure metal concentrations.Age and sex-adjusted linear and logistic regression models were used to examine the association of metal concentrations(exposure)with echocardiographic measures(outcome).RESULTS Higher cobalt concentrations were associated with increased left ventricular end-diastolic volume(estimate 5.09;95%CI:0.02-10.17)as well as left atrial and right ventricular dilation,particularly in men but no changes in cardiac function.Higher titanium concentrations were associated with a reduction in left ventricle global longitudinal strain(estimate 0.38;95%CI:0.70 to 0.06)and cardiac index(estimate 0.08;95%CI,-0.15 to-0.01).CONCLUSION Elevated cobalt and titanium concentrations may be associated with structural and functional cardiac changes in some patients.Longitudinal studies are warranted to better understand the systemic effects of metals in TJA patients.

关 键 词：Total joint arthroplasty METAL-ON-METAL CARDIOTOXICITY Heart failure ECHOCARDIOGRAPHY COBALT 

分 类 号：R687.4[医药卫生—骨科学]