Postischemia myocardial injury in coronary artery bypass patients (PP6).
OBJECTIVE
To investigate the reperfusion injury of the myocardium in patients undergoing elective coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB), we monitored the blood levels of troponin I (TNI), white blood cells, oxygen radicals, malondialdehyde, and myeloperoxidase seeking to define the relationship between the CABG-induced systemic inflammation and myocardial injury.


METHODS
We selected 10 patients undergoing primary CABG with CPB at moderate hypothermia and cardioplegic arrest concomitant with intermittent warm blood cardioplegia. We compared all data with their own baseline values to study the reperfusion injury. After release of the aortic clamp, blood was drawn from the coronary sinus, via a catheter placed through the right atrium. We measured plasma levels of inflammatory mediators, such as malondialdehyde, myeloperoxidase, oxygen radicals, and the myocardium injury parameter of TNI.


RESULTS
Patients showed no difference concerning aortic clamp time. TNI increased significantly at 1, 15, and 30 minutes after the onset of reperfusion. Blood levels of white blood cells, oxygen radicals, malondialdehyde, and myeloperoxidase also increased significantly with reperfusion time.


CONCLUSIONS
Reperfusion of ischemic myocardium induced increased TNI, which may be related to the systemic inflammatory responses induced by ischemia and reperfusion of the myocardium among patients undergoing elective coronary bypass surgery.
Huang
W H
WH
Department of Medicine, Weigong Memorial Hospital, Miouli, County, Taiwan.
Lee
J F
JF
Wang
D
D
Gou
W H
WH
Chang
C Y
CY
Wei
J
J
D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D007700:Kinetics; D007958:Leukocyte Count; D008315:Malondialdehyde / Q000097:blood*; D017202:Myocardial Ischemia / Q000209:etiology* / Q000473:pathology; D015428:Myocardial Reperfusion Injury / Q000453:epidemiology*; D009195:Peroxidase / Q000097:blood*; D019210:Troponin I / Q000097:blood
D019210:Troponin I; D008315:Malondialdehyde; D009195:Peroxidase