BIOMAT Database Logo BIOMAT Database Logo

Cardiac Troponin T to evaluate myocardial protection via intermittent cold blood or continuous warm blood cardioplegia in coronary artery bypass grafting. 1998

E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Department of Medical Pathology, University of Parma, Italy.

BACKGROUND The aim of our study was to evaluate the efficacy of myocardial protection during coronary artery bypass grafting (CABG) in cold blood intermittent (CBIC) and warm continuous blood cardioplegia (WCBC). To assess myocardial necrosis, Troponin T, a structural protein belonging to the troponin complex, was measured. Troponin T is released in the blood stream 4 hours after myocardial damage, and it does not cross-react with the isomeric form of the skeletal muscle. METHODS Our study involved 20 consecutive patients, scheduled for isolated CABG. They were divided into two groups: the first group (10 patients; 8 m, 2 f) underwent surgery with the use of CBIC, the second group (10 patients; 9 m, 1 f) with WCBC. The serum levels of cardiac Troponin T (cTn-T) were all <0.2 microg/l before operation. RESULTS In the CBIC the mean cTn-T peaked on the 1st day after CABG, in the WCBC group the first peak occurred in the 2nd hour after arrival in the intensive care unit, and the second peak occurred on the 4th day postoperatively. The mean serum cTn-T was lower in the WCBC vs CBIC group from the 1st to the 5th day postoperatively, with a statistical difference on the 1st day (p<0.05). In the CBIC group either the cTn-T peak values (r=0.77; p<0.02) or area under the concentration curve of cTn-T release (r=0.85; p<0.004), were directly correlated with the aortic cross-clamping time. This was not demonstrated in the WCBC. CPK and CK-MB peaked in both groups 6 hours after arrival in the intensive care unit and on the 1st day postoperatively, with higher values at 6 hours in the WCBC group (p<0.05). The CK-MB/CPK ratio was significantly lower in the WCBC group at the six hours (p<0.05). CONCLUSIONS The results of this preliminary study suggest that fewer necrosis markers are released during CABG in the WCBC group; in the CBIC group the release of cTn-T whether measured by peak serum level or by area under the curve, shows a statistically significant correlation with cross-clamping time. Warm blood cardioplegia is safe and supplies adequate myocardial protection during CABG; the more prolonged cross-clamping is, the more myocardial protection is afforded by WCBC.

UI MeSH Term Description Entries
D007527 Isoenzymes Structurally related forms of an enzyme. Each isoenzyme has the same mechanism and classification, but differs in its chemical, physical, or immunological characteristics. Alloenzyme,Allozyme,Isoenzyme,Isozyme,Isozymes,Alloenzymes,Allozymes
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009206 Myocardium The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow. Muscle, Cardiac,Muscle, Heart,Cardiac Muscle,Myocardia,Cardiac Muscles,Heart Muscle,Heart Muscles,Muscles, Cardiac,Muscles, Heart
D002314 Cardioplegic Solutions Solutions which, upon administration, will temporarily arrest cardiac activity. They are used in the performance of heart surgery. Cardioplegic Solution,Solution, Cardioplegic,Solutions, Cardioplegic
D003080 Cold Temperature An absence of warmth or heat or a temperature notably below an accustomed norm. Cold,Cold Temperatures,Temperature, Cold,Temperatures, Cold
D003402 Creatine Kinase A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. Creatine Phosphokinase,ADP Phosphocreatine Phosphotransferase,ATP Creatine Phosphotransferase,Macro-Creatine Kinase,Creatine Phosphotransferase, ATP,Kinase, Creatine,Macro Creatine Kinase,Phosphocreatine Phosphotransferase, ADP,Phosphokinase, Creatine,Phosphotransferase, ADP Phosphocreatine,Phosphotransferase, ATP Creatine
D004797 Enzyme-Linked Immunosorbent Assay An immunoassay utilizing an antibody labeled with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. ELISA,Assay, Enzyme-Linked Immunosorbent,Assays, Enzyme-Linked Immunosorbent,Enzyme Linked Immunosorbent Assay,Enzyme-Linked Immunosorbent Assays,Immunosorbent Assay, Enzyme-Linked,Immunosorbent Assays, Enzyme-Linked
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

Related Publications

E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Warm blood cardioplegia versus cold crystalloid cardioplegia for myocardial protection during coronary artery bypass grafting surgery.
December 2018, Cell death discovery,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Cold blood cardioplegia or intermittent cross-clamping in coronary artery bypass grafting?
August 1998, The Annals of thoracic surgery,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Warm or cold continuous blood cardioplegia provides similar myocardial protection.
August 1999, The Annals of thoracic surgery,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
[Coronary artery bypass grafting using retrograde continuous cold blood cardioplegia].
February 1992, Kyobu geka. The Japanese journal of thoracic surgery,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
[Clinical appraisal of myocardial protection for coronary artery bypass grafting--efficacy of retrograde continuous cold blood cardioplegia].
March 1992, [Zasshi] [Journal]. Nihon Kyobu Geka Gakkai,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Assessment of continuous cold blood cardioplegia in coronary artery bypass grafting.
March 1997, The Annals of thoracic surgery,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Interrupted warm blood cardioplegia for coronary artery bypass grafting.
January 1995, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Myocardial protective effect of warm blood, tepid blood, and cold crystalloid cardioplegia in coronary artery bypass grafting surgery.
December 2005, Croatian medical journal,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Retrograde continuous warm blood cardioplegia reduces oxidative stress during coronary artery bypass grafting.
February 2002, Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia,
E Astorri, and P Fiorina, and C Grattagliano, and D Medici, and S Pinelli, and D Albertini, and S Pincolini, and G Barboso, and R Albertini
Randomized trial comparing intermittent antegrade warm blood cardioplegia with multidose cold blood cardioplegia for coronary artery bypass.
January 1996, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery,
Copied contents to your clipboard!