Recent advances in technology has made it possible to use proteins other than the "gold standard" creatine kinase MB fraction, such as troponin-T (Tn-T), and troponin-I (Tn-I) that are cardiospecific for the detection of minor myocardial damage. We compared blood Tn-T, Tn-I levels and the hemodynamics of the patients undergoing cardiopulmonary bypass surgery (CPB). Thirty five patients who underwent open heart surgery using CPB were included in this study. Blood Tn-T and Tn-I levels were measured by immunoassays. Based on their 12 hour Tn-T levels, the patients were divided into groups, A: Tn-T<5 (n=24), B:>5 (n=6), C:>10(n=5). Tn-T and Tn-I levels were compared with the hemodynamic data within the group. When 12 hour levels of Tn-T and Tn-I were compared in groups A and B, the levels correlated with the extent of myocardial damage. Group C had patients with known myocardial damage (atrial fibrillation-1, acute MI-2, cardiogenic shock-1). The 12 hour Tn-T and Tn-I levels are shown in the table along with the hemodynamic support data. Group C patients had more use of ventilator and inotropic supports. Group Tn-T (ng/ml) Tn-I (ng/ml) Vent.use IABP lno.Supp pre-op 12 h pre-op 12 h hrs hrs hrs A 0.6±0.2 2.7±0.6 0.4±0.2 4.6±1 15±6.7 0 12±9 B 1.0±0.2 6.7±0.8 1.1±0.4 8.5±3 32±8.0 0 16±8 C 14.2±3 41±11 3.5±1.0 28±10 85±20 14 134±40 Our results, from a small group of patients, clearly indicate that Tn-T predicts the extent of myocardial injury preoperatively more accurately, and in most cases, Tn-T and Tn-I measurements are specific and sensitive enough to determine the myocardial injury perioperatively. But high Tn-I seen in some patients perioperatively that are not supported by the need for hemodynamic support is of great concern.
|Original language||English (US)|
|Journal||Journal of Investigative Medicine|
|State||Published - Feb 1999|
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)