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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2010 Giugno;51(3):409-15
Cardiac valve surgery and myocardial damage: the role of cardiac troponin I
Karfis E. A. 1,2, Kontogiorgi P. 1, Papadopoulos G. 3, Tzimas P. 3, Seferiadis C. 4, Athanasulas C. 5, Anagnostopoulos C. E. 6, Drossos G. E. 1 ✉
1 Department of Cardiac and Thoracic Surgery, “G. Papanikolaou” General Hospital Thessaloniki, Thessaloniki, Greece;
2 Department of Cardiac Surgery, University Hospital of Ioannina, Ioannina, Greece;
3 Department of Cardiac Anesthesia, University Hospital of Ioannina, Ioannina, Greece;
4 Biochemical Laboratory, University Hospital of Ioannina, Ioannina, Greece;
5 Norwood Clinic, Bermingham, AL, USA;
6 College of Physicians and Surgeons of Columbia University, New York, NY, USA
AIM: The study investigated the release of cardiac Troponin I (cTnI) levels in heart valve surgery and in coronary artery bypass grafting (CABG). The aims of the research were 1) to evaluate the ability of cTnI to detect the myocardial damage; and 2) to demonstrate possible causative factors of the cTnI release after valve surgery.
METHODS: A prospective, single-center study. Ninety consecutive patients were operated on for different types of cardiac surgery; 45 patients underwent cardiac valve surgery – The VALVE group. 45 patients underwent CABG surgery – the CABG group. CTnI levels were measured preoperatively, on the day of operation and the 7 days postoperatively. The diagnosis of damaged myocardium classically performed through the measurement of cTnI, twelve-lead electrocardiograms (ECG) and echocardiographics according to the protocol of the study.
RESULTS: Although more elevated cTnI release was noticed in valve group early after operation, no occurrence of cardiac events was found in that group. Statistically significant occurrence of cardiac events was found in CABG group (P=0.015). No relationship was shown between the peak of cTnI and the presence of cardiac events in valve group. A statistically significant correlation was observed between cardiac events and peak cTnI in CABG group (P=0.05). Possible correlations were investigated between the peak of cTnI and perioperative parameters in both two groups.
CONCLUSION: The absence of cardiac events and the association of valve surgery with higher early release of cTnI compared to CABG suggest that the type of surgery strongly affects the induction of myocardial damage.