Perioperative catecholamine changes in cardiac risk patients.
BACKGROUND
It has previously been found that in cardiac risk patients undergoing non-cardiac surgery post-operative cardiac complications are correlated with high post-operative serum levels of troponin T (TNT) and troponin I (TNI). We investigated whether perioperative changes in the release of free (fCAs) and conjugated catecholamines (cCAs) correlate with the increased serum level of TN (TN upward arrow).


METHODS
Plasma levels of CAs were determined in 28 patients at risk for or with definite coronary artery disease. Blood sampling was performed in the morning on the day before surgery, on the day of surgery before induction of anaesthesia and until the fifth post-operative day for measurement of CAs by high-performance liquid chromatography.


RESULTS
The plasma concentrations of free and conjugated noradrenaline (fNA and cNA) as well as of free and conjugated adrenaline (fA and cA) were increased significantly in TN upward arrow patients post-operatively. The plasma levels of free as well as of conjugated NA and A in TN upward arrow patients were significantly higher than in TN0 patients over the whole post-operative period.


CONCLUSIONS
This study demonstrates that increased post-operative release of fNA and fA as well as of cNA and cA correlates with high post-operative serum levels of troponins in cardiac risk patients undergoing non-cardiac surgery.
Sametz
W
W
Department of Biomedical Research, University of Graz, Austria. wolfgang.sametz@kfunigraz.ac.at
Metzler
H
H
Gries
M
M
Porta
S
S
Sadjak
A
A
Supanz
S
S
Juan
H
H
D000368:Aged; D000787:Angina Pectoris; D015906:Angioplasty, Balloon, Coronary; D001794:Blood Pressure; D002395:Catecholamines / Q000097:blood*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology*; D004298:Dopamine / Q000097:blood; D017558:Elective Surgical Procedures; D004837:Epinephrine / Q000097:blood; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006333:Heart Failure; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D009638:Norepinephrine / Q000097:blood; D011184:Postoperative Period; D012307:Risk Factors
D002395:Catecholamines; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine