ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Jos G. Maessen
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fransen, E. J.
Right arrow Articles by Glatz, J. F. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fransen, E. J.
Right arrow Articles by Glatz, J. F. C.

Ann Thorac Surg 1998;65:48-53
© 1998 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Demonstration of Ischemia-Reperfusion Injury Separate From Postoperative Infarction in Coronary Artery Bypass Graft Patients

Erik J. Fransen, MSc, Jos G. Maessen, MD, PhD, Wim T. Hermens, PhD, Jan F. C. Glatz, PhD

Department of Cardiopulmonary Surgery, Academic Hospital Maastricht, Maastricht, the Netherlands,
Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands

Accepted for publication June 25, 1997.

Dr Maessen, Department of Cardiopulmonary Surgery, Academic Hospital Maastricht, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands (e-mail: jma@scpc.azm.nl).

Background. In patients undergoing coronary artery bypass grafting there are two possible causes of myocardial injury: (1) global ischemic myocardial injury during aortic cross-clamping and subsequent reperfusion, and (2) postoperative myocardial infarction. We studied the use of cardiac marker proteins to specifically and separately detect such injury.

Methods. Serum levels of enzymes (creatine kinase and creatine kinase-MB) and nonenzymatic proteins (fatty acid-binding protein and myoglobin) were measured in 8 low-risk patients undergoing coronary artery bypass grafting with cardiopulmonary bypass, 8 low-risk patients undergoing coronary artery bypass grafting without cardiopulmonary bypass, and 39 high-risk patients undergoing coronary artery bypass grafting with cardiopulmonary bypass, of whom 7 experienced a postoperative myocardial infarction.

Results. At 0.5 hours after reperfusion significantly increased plasma levels of all markers were noted in patients having the operation with cardiopulmonary bypass, but not in patients having the operation without cardiopulmonary bypass. In patients who had a postoperative myocardial infarction, a second significant increase of each marker was found, but that of fatty acid-binding protein was recorded 4 hours earlier than that of creatine kinase, creatine kinase-MB, or myoglobin.

Conclusions. Perioperative myocardial injury can be diagnosed from the release of cardiac marker proteins into plasma already at 0.5 hours after the start of reperfusion. For early assessment of postoperative myocardial infarction, fatty acid-binding protein is a more suitable plasma marker than are creatine kinase, creatine kinase-MB, or myoglobin.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1998 by The Society of Thoracic Surgeons.