Continuous retrograde warm blood reperfusion reduces cardiac troponin I release after heart transplantation: a prospective randomized study.
During heart surgery, cardiac troponin I (cTn-I) measurement provides a tool to evaluate different cardioprotective techniques. To investigate myocardial protection during heart transplantation (HTx), cTn-I and creatine kinase (CK)-MB release was measured in 42 patients randomized to receving either continuous retrograde warm blood reperfusion or no reperfusion after cold cardioplegia. A significant linear correlation was found between donor heart ischemic time and peaks and the area under the curve of cTn-I and CK-MB release. In patients with an ischemic time longer than 90 min, cTn-I release was significantly lower in those receiving continuous retrograde warm cardioplegia than in controls. No significant difference was observed for CK-MB, tCK, and myoglobin. Our data suggest that the measurement of postoperative cTn-I release may provide a method to evaluate ischemic cardiac damage after HTx. When the ischemic time is longer than 90 min, warm retrograde blood cardioplegia provides better myocardial protection than no reperfusion.
Fiocchi
R
R
Cardiac Surgery and Clinical Pathology Department, Ospedali Riuniti di Bergamo, Italy. hearttranspl@cyberg.it
Vernocchi
A
A
Mammana
C
C
Iamele
L
L
Gamba
A
A
D015415:Biomarkers / Q000097:blood; D001769:Blood; D002314:Cardioplegic Solutions; D016001:Confidence Intervals; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D016027:Heart Transplantation / Q000379:methods* / Q000502:physiology; D006801:Humans; D008297:Male; D015425:Myocardial Reperfusion / Q000379:methods*; D009211:Myoglobin / Q000097:blood; D011446:Prospective Studies; D012044:Regression Analysis; D013696:Temperature; D013997:Time Factors; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D002314:Cardioplegic Solutions; D009211:Myoglobin; D019210:Troponin I; D003402:Creatine Kinase