BACKGROUND: We studied the kinetic release of cardiac troponins (cTnI and cTnT) and B-type natriuretic peptides (BNP and NT-proBNP) in patients undergoing off-pump or on-pump coronary artery bypass surgery. METHODS: Twenty-five consecutive patients were prospectively enrolled. The patients were divided into three groups: beating heart (I), and cardiopulmonary bypass (CPB) with warm (II) or cold cardioplegia (III). Plasma samples were obtained before anesthesia induction until the sixth day after surgery. RESULTS AND CONCLUSIONS: The data were analyzed first for off-pump versus the CPB procedures and second for warm versus cold cardioplegia. The plasma troponin releases appeared to be significantly higher in the CPB groups in comparison to the beating heart group (P < 0.001 and P < 0.002 for cTnI and cTnT peak values, respectively). The peak of the B-type natriuretic peptide release appeared to be more delayed in the groups undergoing CPB than in the beating heart group (day 6 versus days 2 and 4 for NT-proBNP and BNP, respectively). Taken together, our results indicated that the new generation of cTnT assays seemed to be more sensitive than the cTnI assays for the diagnosis of myocardium injury. A lower increase in the cTnT values in the warm cardioplegic group indicated less damage of the myocardium than with cold cardioplegia. Our data also confirm better preservation of the myocardium with off-pump cardiac surgery than with CPB.
BACKGROUND: We studied the kinetic release of cardiac troponins (cTnI and cTnT) and B-type natriuretic peptides (BNP and NT-proBNP) in patients undergoing off-pump or on-pump coronary artery bypass surgery. METHODS: Twenty-five consecutive patients were prospectively enrolled. The patients were divided into three groups: beating heart (I), and cardiopulmonary bypass (CPB) with warm (II) or cold cardioplegia (III). Plasma samples were obtained before anesthesia induction until the sixth day after surgery. RESULTS AND CONCLUSIONS: The data were analyzed first for off-pump versus the CPB procedures and second for warm versus cold cardioplegia. The plasma troponin releases appeared to be significantly higher in the CPB groups in comparison to the beating heart group (P < 0.001 and P < 0.002 for cTnI and cTnT peak values, respectively). The peak of the B-type natriuretic peptide release appeared to be more delayed in the groups undergoing CPB than in the beating heart group (day 6 versus days 2 and 4 for NT-proBNP and BNP, respectively). Taken together, our results indicated that the new generation of cTnT assays seemed to be more sensitive than the cTnI assays for the diagnosis of myocardium injury. A lower increase in the cTnT values in the warm cardioplegic group indicated less damage of the myocardium than with cold cardioplegia. Our data also confirm better preservation of the myocardium with off-pump cardiac surgery than with CPB.
Authors: M Czerny; H Baumer; J Kilo; A Lassnigg; A Hamwi; T Vukovich; E Wolner; M Grimm Journal: Eur J Cardiothorac Surg Date: 2000-06 Impact factor: 4.191
Authors: G Godet; S Ben Ayed; M Bernard; M J Foglietti; J J Guillosson; E Kieffer; P Coriat Journal: J Cardiothorac Vasc Anesth Date: 1999-06 Impact factor: 2.628
Authors: G Godet; M Dumerat; C Baillard; S Ben Ayed; M A Bernard; M Bertrand; E Kieffer; P Coriat Journal: Acta Anaesthesiol Scand Date: 2000-05 Impact factor: 2.105
Authors: A Gobinet-Georges; N Valli; H Filliatre; M F Dubernet; O Dedeystere; L Bordenave Journal: Clin Chem Lab Med Date: 2000-06 Impact factor: 3.694
Authors: M Chello; P Mastroroberto; F Perticone; F Cirillo; E Bevacqua; S Olivito; E Covino Journal: Eur J Cardiothorac Surg Date: 2001-07 Impact factor: 4.191
Authors: F Kerbaul; F Collart; R Giorgi; C Oddoze; P J Lejeune; C Guidon; T Caus; M Bellezza; F Gouin Journal: Intensive Care Med Date: 2004-04-27 Impact factor: 17.440