Non-invasive assessment of perioperative myocardial cell damage by circulating cardiac troponin T.
Open Access
- 1 May 1991
- Vol. 65 (5), 259-264
- https://doi.org/10.1136/hrt.65.5.259
Abstract
Troponin T is a unique cardiac antigen which is continuously released from infarcting myocardium. Its cardiospecificity as a marker protein might be particularly useful in assessing myocardial cell damage in patients undergoing cardiac surgery. Therefore, circulating troponin T was measured in serial blood samples from 56 patients undergoing cardiac surgery and in two control groups--22 patients undergoing minor orthopaedic surgery and 12 patients undergoing lung surgery by median sternotomy. In both control groups no troponin T could be detected, whereas activities of creatine kinase were raised in all 12 lung surgery controls and activities of the MB isoenzyme were raised in five of the 12 patients in the lung surgery group and in four of the 22 patients in the orthopaedic surgery group, respectively. All the patients undergoing coronary artery bypass grafting (n = 47) and cardiac surgery for other reasons (n = 9) had detectable concentrations of troponin T. Five patients had perioperative myocardial infarction detected as new Q waves and R wave reductions. In these five patients troponin T release persisted and serum concentrations (5.5-23 micrograms/l) reached a peak on the fourth postoperative day. In the 51 patients without perioperative myocardial infarction serum concentrations and the release kinetics of troponin T depended on the duration of cardiac arrest. In patients in whom aortic cross clamping was short troponin T increased slightly on the first postoperative days; in patients with longer periods of aortic cross clamping troponin T concentrations were higher and remained so beyond the fifth postoperative day.(ABSTRACT TRUNCATED AT 250 WORDS)Keywords
This publication has 24 references indexed in Scilit:
- Influence of reperfusion on serum concentrations of cytosolic creatine kinase and structural myosin light chains in acute myocardial infarctionThe American Journal of Cardiology, 1987
- Cardiac-specific troponin-l radioimmunoassay in the diagnosis of acute myocardial infarctionAmerican Heart Journal, 1987
- Serial determinations of serum enzymes following Aorta-Coronary bypass surgery and acute myocardial infarction.Japanese Heart Journal, 1985
- Diagnosis of acute myocardial infarction by detection of circulating cardiac myosin light chainsThe American Journal of Cardiology, 1984
- Energy metabolism and enzyme release of cultured adult rat heart muscle cells during anoxiaJournal of Molecular and Cellular Cardiology, 1984
- Optimal diagnosis in acute myocardial infarction. A cost-effectiveness study.Circulation, 1980
- Serum Enzymes with Special Reference to CK-MB Following Coronary Bypass SurgeryScandinavian Journal of Thoracic and Cardiovascular Surgery, 1979
- Significance of new Q waves after bypass grafting: Correlations between graft patency, ventriculogram, and surgical venting techniqueAmerican Heart Journal, 1978
- Myocardial consequences of coronary artery bypass graft surgery. The paradox of necrosis in areas of revascularization.Circulation, 1977
- The Importance of Identification of the Myocardial-Specific Isoenzyme of Creatine Phosphokinase (MB Form) in the Diagnosis of Acute Myocardial InfarctionCirculation, 1973