Cytokines and troponin-I in cardiac dysfunction after coronary artery grafting with cardiopulmonary bypass.
OBJECTIVE
The association between cytokines and troponin-I with cardiac function after cardiac surgery with cardiopulmonary bypass remains a topic of continued investigation.


METHODS
Serial measurements, within 24h following surgery, of tumor necrosis factor-alpha, its soluble receptors, and troponin-I were performed in patients with normal ejection fraction undergoing coronary artery bypass grafting. Ejection fraction was measured by radioisotopic ventriculography preoperatively, at 24h and at day 7 postoperatively.


RESULTS
Of 19 patients studied (59+/-8.5 years), 10 (group 1) showed no changes in ejection fraction, 53+/-8% to 55+/-7%, and 9 (group 2) had a decrease in ejection fraction, 60+/-11% to 47+/-11% (p=0.015) before and 24h after coronary artery bypass grafting, respectively. All immunological variables, except tumor necrosis factor-alpha soluble receptor I at 3h postoperation (5.5+/- 0.5 in group 1 versus 5.9+/-0.2 pg/ml in group 2; p=0.048), were similar between groups. Postoperative troponin-I had an inverse correlation with ejection fraction at 24h (r= -0.44).


CONCLUSIONS
Inflammatory activity, assessed based on tumor necrosis factor-alpha and its receptors, appears to play a minor role in cardiac dysfunction after cardiac surgery. Troponin I levels are inversely associated with early postoperative ejection fraction.
Savaris
N
N
Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, 90035-003, Brazil.
Polanczyk
C
C
Clausell
N
N
D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood*; D005112:Extracorporeal Circulation / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D013318:Stroke Volume; D019210:Troponin I / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D018754:Ventricular Dysfunction / Q000097:blood / Q000175:diagnosis
D015415:Biomarkers; D016207:Cytokines; D018124:Receptors, Tumor Necrosis Factor; D019210:Troponin I; D014409:Tumor Necrosis Factor-alpha