The Relationship between Cardiotrophin-1 and Troponin-I in Coronary Arterial Bypass Grafting on the Beating Heart: A Prospective Study

2015 ◽  
Vol 18 (4) ◽  
pp. 146 ◽  
Author(s):  
Serhat Caliskan ◽  
Feyzullah Besli ◽  
Fatih Gungoren ◽  
Ahmet Yildirim ◽  
Mehmet Fethi Alisir ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Troponin I ◽  
Ischemia Reperfusion ◽  
Artery Bypass ◽  
White Blood Cells ◽  
Myocardial Damage ◽  
Beating Heart ◽  
Creatine Kinase Mb ◽  
Opcab Surgery ◽  
The Relationship

Objective: Cardiotrophin-1 (CT-1) is closely associated with many cardiovascular diseases, such as hypertension, myocardial infarction (MI), and heart failure, and exhibits a cardioprotective effect in ischemia-reperfusion injury. The aim of this study was to evaluate the relationship between CT-1 and Troponin-I (Tn-I) in off-pump coronary artery bypass (OPCAB) grafting on the beating heart.<br />Methods: Seventy-eight patients (mean age 60.8 ± 9.7 years, 79.5% male) undergoing elective OPCAB surgery were included in this study undertaken between July 1, 2012 and July 1, 2013 in the Department of Cardiology and Cardiac Surgery, University School of Medicine Hospital. Venous blood samples were collected 5 minutes before OPCAB surgery and 6 hours after surgery. Plasma CT-1 levels were measured using the ELISA method.<br />Results: Compared to the preoperative period, Tn-I and CT-1 values were higher in the postoperative period <br />[0.255 ng/mL (0.030-0.430) versus 0.045 ng/mL (0.005-0.090), P &lt; .001; and 33.7 pg/mL (15.8-98.5) versus 8.7 pg/mL (0.68-25.4), P &lt; .001]. There was also an elevation in white blood cells, aspartate aminotransferase, creatine kinase (CK), and creatine kinase MB (CK-MB) values, as well as a decrease in hemoglobin values (P &lt; .001). When a correlation analysis for postoperative CT-1 was performed, there was a significant positive correlation between postoperative CK, CK-MB, and Tn-I levels (r = 0.250, P &lt; .027; r = 0.270, P = .017; and r = 0.241, P &lt; .034).<br />Conclusion: CT-1 was found to be associated with Tn-I, which is used to detect myocardial damage after OPCAB surgery. CT-1 may also be used to detect myocardial damage.

Troponin I, Troponin T, or Creatine Kinase-MB to Detect Perioperative Myocardial Damage After Coronary Artery Bypass Surgery

CHEST Journal ◽  
1998 ◽  
Vol 114 (2) ◽  
pp. 482-486 ◽  
Author(s):  
Eric Bonnefoy ◽  
Sylvie Filley ◽  
Gilbert Kirkorian ◽  
Jeannine Guidollet ◽  
Ricardo Roriz ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Troponin I ◽  
Troponin T ◽  
Artery Bypass ◽  
Myocardial Damage ◽  
Creatine Kinase Mb

scholarly journals Frontal QRS-T angle as a predictive marker for myocardial damage in acute carbon monoxide poisoning

2021 ◽  
pp. 096032712110434
Author(s):  
Yusuf K Tekin ◽  
Gülaçan Tekin ◽  
Naim Nur ◽  
İlhan Korkmaz ◽  
Sefa Yurtbay
Keyword(s):  
Carbon Monoxide ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Myocardial Damage ◽  
Cardiac Troponin I ◽  
Arterial Oxygen ◽  
Co Poisoning ◽  
Arterial Blood ◽  
Creatine Kinase Mb

Introduction The present study was undertaken to investigate the prognostic value of the frontal QRS-T angle associated with adverse cardiac outcomes in patients with carbon monoxide (CO) poisoning in early stages in the emergency department. Materials and methods The data of 212 patients with CO poisoning who were admitted to the ED between January 2010 and May 2020 were retrospectively analyzed. The frontal QRS-T angle was obtained from the automatic reports of the EKG device. Results Compared to patients without myocardial damage, among patients with myocardial damage, statistically high creatinine, creatine kinase MB, cardiac troponin I, and frontal QRS-T angle values were found ( p < 0.001 for all parameters), while the saturation of arterial blood pH and arterial oxygen values were found to be lower ( p = 0.002 and p < 0.001, respectively). The frontal QRS-T angle values were correlated with creatine kinase, creatine kinase-MB, cardiac troponin I, and oxygen saturation (SpO2) in arterial blood (r = 0. 232, p = 0.001; r = 0. 253, p = < 0.001; r = 0. 389, p = < 0.001; r = −0. 198, p = 0.004, respectively). The optimum cut-off value of the frontal QRS-T angle was found to be 44.5 (area under the curve: 0.901, 95% confidence interval: 0.814–0.988, sensitivity: 87%, specificity: 84%). Conclusions The frontal QRS-T angle, a simple and inexpensive parameter that can be easily obtained from 12-lead surface electrocardiography, can be used as an early indicator in the detection of myocardial damage in patients with CO poisoning.

Troponin T as a Marker of Infarction during Coronary Bypass Surgery

2000 ◽  
Vol 8 (1) ◽  
pp. 19-23
Author(s):  
Tarek A Abdel Aziz ◽  
Mohamed A Ali ◽  
Donald G Roberts ◽  
Najib Al Khaja
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Troponin T ◽  
Artery Bypass ◽  
Myocardial Damage ◽  
Perioperative Myocardial Infarction ◽  
Creatine Kinase Mb ◽  
Group A ◽  
Electrocardiographic Changes ◽  
Group B

To evaluate serum troponin T as a marker of perioperative myocardial infarction, 50 patients undergoing coronary artery bypass grafting were divided into 2 groups. Group A (14 patients) had serum creatine kinase MB-isoenzyme levels above 100 U·L−1 and electrocardiographic changes indicative of infarction. Group B (36 patients) had creatine kinase MB levels below 100 U·L−1 and no electrocardiographic changes. Blood samples were obtained preoperatively, 6 hours after aortic declamping, and on postoperative day 1, 2, and 3. Following surgery, all patients had increased levels of troponin T and creatine kinase MB. Troponin T was significantly higher in group A compared to group B at 6 hours, day 1, and day 2 postoperatively. Creatine kinase MB levels were significantly higher in group A compared to group B at 6 hours and day 1 postoperatively. The increased levels of troponin T in patients without myocardial infarction suggest that some operative myocardial damage occurred. Patients with perioperative myocardial infarction had significantly higher levels of troponin T up to postoperative day 2, whereas creatine kinase MB levels were almost normal by day 2. This suggests that troponin T may be used up to 2 days postoperatively for detection of myocardial infarction.

Creatine kinase MB isoforms: sensitive markers of ischemic myocardial damage

1994 ◽  
Vol 40 (7) ◽  
pp. 1265-1271 ◽  
Author(s):  
M Hossein-Nia ◽  
P Kallis ◽  
P A Brown ◽  
M R Chester ◽  
J C Kaski ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Coronary Angiography ◽  
Cell Injury ◽  
Artery Bypass ◽  
Chronic Stable Angina ◽  
Myocardial Damage ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Myocardial Cell ◽  
Time To Peak ◽  
Creatine Kinase Mb

Abstract We investigated the use of creatine kinase (CK) MB isoforms as a marker of myocardial cell injury in a preliminary study of 16 patients with chronic stable angina after successful percutaneous transluminal coronary angioplasty (PTCA) and 25 patients after coronary artery bypass grafting (CABG). Three control groups were studied: apparently healthy volunteers (n = 31), patients undergoing thoracotomy (n = 10), and patients undergoing routine coronary angiography (n = 9). Patients in the PTCA group showed an association between ischemic ST segment changes lasting &gt; 3 min and a transient increase in the MB2/MB1 ratio; however, all had total CK-MB activity within normal limits. Routine coronary angiography subjects had no significant change in MB2/MB1. In the CABG patients, MB2/MB1 peaked within 1 h after the cross-clamp release and returned to baseline by 24 h postoperatively. The median time to peak MM3/MM1 and total CK-MB activity was 2 and 8 h after reperfusion, respectively, returning to baseline values by 2 and 5 days, respectively. After thoracotomy, MB2/MB1 was increased only in elderly patients (n = 5) with risk factors for ischemic heart disease; total CK-MB activity was increased in only three of these. Apparently, CK-MB isoforms can detect myocardial damage in clinical settings with less overt damage than myocardial infarction.

Effect of statin on perioperative myocardial injury in isolated valve surgery

2020 ◽  
pp. 021849232097451
Author(s):  
Atul Kaushik ◽  
Aditya Kapoor ◽  
Surendra Kumar Agarwal ◽  
Shantanu Pande ◽  
Shiridhar Kashyap ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Cardiopulmonary Bypass ◽  
Brain Natriuretic Peptide ◽  
Valve Replacement ◽  
Natriuretic Peptide ◽  
Myocardial Injury ◽  
Troponin I ◽  
Ischemia Reperfusion ◽  
Area Under The Curve ◽  
Creatine Kinase Mb

Background Statins have known pleiotropic effects that confer protection from ischemia-reperfusion injury. Because cardiopulmonary bypass is a potentially reversible ischemia-reperfusion sequence, we aimed to assess whether statin loading could help to limit myocardial injury in patients undergoing isolated heart valve replacement under cardiopulmonary bypass. Methods One hundred patients with rheumatic valvular heart disease undergoing valve replacement received either a loading dose of rosuvastatin (40 mg initiated 7 days before surgery; loaded group) or no statins (non-loaded group). Cardiac troponin I, creatine kinase MB, and brain natriuretic peptide were measured at 8, 24, and 48 hours postoperatively. The primary endpoint was the extent of perioperative myocardial injury measured by the area under the curve for each biomarker. Results Despite similar baseline levels, all biomarkers at 8, 24, and 48 h were significantly lower in the loaded group. The area under the curve of each biomarker was significantly lower in the loaded group than in the non-loaded group (troponin I: 31.43 vs. 77.21 ng·h·mL−1, creatine kinase MB 309.31 vs. 429.12 ng·h·mL−1, brain natriuretic peptide 5176.11 vs. 16119.31 pg·h·mL−1, all p < 0.001). The mean changes from baseline to peak levels were also significantly lower in the loaded group. The loaded group had a shorter hospital stay but no significant difference was seen in ventilator time, inotrope time, aortic crossclamp time, cardiopulmonary bypass time, or intensive care unit stay. Conclusion In patients undergoing valve replacement, high-dose statin loading before surgery had a favorable impact on the release kinetics of various cardiac biomarkers.

Evidence for Preconditioning by Isoflurane in Coronary Artery Bypass Graft Surgery

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Denis Belhomme ◽  
Jacqueline Peynet ◽  
Moez Louzy ◽  
Jean-Marie Launay ◽  
Masafumi Kitakaze ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Protein Kinase C ◽  
Protein Kinase ◽  
Troponin I ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Right Atrial ◽  
Volatile Anesthetic Agent ◽  
Kinase C ◽  
Creatine Kinase Mb

Background —Experimentally, isoflurane, a commonly used volatile anesthetic agent, mimics the cardioprotective effects of ischemic preconditioning via a mechanism that could involve the activation of protein kinase C. The present study was designed to assess the clinical relevance of this observation in patients undergoing elective CABG. Methods and Results —Twenty patients were included in the study. In 10 of them, preconditioning was elicited after the onset of cardiopulmonary bypass via a 5-minute exposure to isoflurane (2.5 minimum alveolar concentration), followed by a 10-minute washout before aortic cross-clamping and cardioplegic arrest. Ten case-matched control patients underwent an equivalent period (15 minutes) of prearrest isoflurane-free bypass. Outcome measurements included troponin I and creatine kinase–MB isoenzyme (until the third postoperative day) levels and the activity of ecto-5′-nucleotidase, which contributes to adenosine production and is considered to be a reporter of protein kinase C activation, as assessed in right atrial biopsy samples taken before bypass and at the end of the preconditioning protocol (or after 15 minutes of bypass in control patients). Aortic cross-clamping times did not differ between the 2 groups: 52±14 and 48±14 minutes (mean±SD) in control and isoflurane-preconditioned patients, respectively. Likewise, prebypass values of ecto-5′-nucleotidase were similar in control (3.54±0.86 nmol · mg protein −1 · min −1 ) and isoflurane-treated (2.98±1.08 nmol · mg protein −1 · min −1 ) patients. The values subsequently remained unchanged in control patients (3.62±0.94 nmol · mg protein −1 · min −1 ), whereas they significantly increased after isoflurane preconditioning (4.74±0.50 nmol · mg protein −1 · min −1 ; P <0.002 versus baseline values, P <0.004 versus time-matched values in control patients). This was paralleled by a consistently smaller release of troponin I, which yielded an area under the curve and a peak value of 204±147 ng · mL −1 · min −1 and 3.98±2.83 ng/mL, respectively, versus 284±136 ng · mL −1 · min −1 and 5.88±3.64 ng/mL, respectively, in control patients. The release of creatine kinase–MB featured a similar pattern. There were no adverse effects related to isoflurane. Conclusions —These data support a cardioprotective effect of isoflurane and, more generally, demonstrate the feasibility of pharmacologically preconditioning the human heart during cardiac surgery.

scholarly journals RNAi-Mediated Down-Regulation of CD47 Protects against Ischemia/Reperfusion-Induced Myocardial Damage via Activation of eNOS in a Rat Model

2016 ◽  
Vol 40 (5) ◽  
pp. 1163-1174 ◽  
Author(s):  
Hui-bo Wang ◽  
Jun Yang ◽  
Jia-wang Ding ◽  
Li-hua Chen ◽  
Song Li ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Nitric Oxide ◽  
Creatine Kinase ◽  
Infarct Size ◽  
Rat Model ◽  
Ischemia Reperfusion ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
Down Regulation ◽  
Creatine Kinase Mb

Background/Aims: Oxidative stress is strongly implicated in the pathogenesis of myocardial damage caused by ischemia reperfusion (I/R). Previous studies have confirmed that cardiac CD47 drives left ventricular heart failure. However, the role for CD47 in myocardial I/R injury (MIRI) has not previously been proposed. This study was designed to investigate whether down-regulation of CD47 using RNA interference (RNAi) technology can relieve inhibition of nitric oxide signaling and attenuate myocardial damage in a rat model of I/R. Methods: Male Sprague-Dawley rats (n = 40) were randomly allocated to four groups and pre-treated either with saline (Sham and I/R groups), or adenovirus expressing either control (Ad-EGFP-N) or CD47-targeting (Ad-EGFP-CD47) RNAi. After four days, the rat MIRI model was established by occluding the left anterior descending coronary artery for 30 min, followed by reperfusion for 3 h. Heart tissue was harvested and assessed by immunohistochemistry, western blot, and quantitative RT-PCR. Outcome measures included infarct size, myocardial enzyme (creatine kinase, creatine kinase-MB, and lactate dehydrogenase) levels in serum, markers of oxidative stress, and morphological changes to the myocardium. Results: Delivery of Ad-EGFP-CD47 RNAi into the myocardium remarkably decreased CD47 expression levels. Down-regulation of CD47 was significantly associated with reduced infarct size and serum levels of myocardial enzymes, increased activity of endothelial nitric oxide synthase, increased levels of nitric oxide, and decreased levels of oxidative stress. Conclusion: These data indicate that down-regulation of CD47 exerts a protective effect against MIRI, which may be attributable to attenuation of oxidative stress via activation of the eNOS/NO signaling pathway.

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