Cardiac valve surgery and myocardial damage: the role of cardiac troponin I.
OBJECTIVE
The study investigated the release of cardiac Troponin I (cTnI) levels in heart valve surgery and in coronary artery bypass grafting (CABG). The aims of the research were 1) to evaluate the ability of cTnI to detect the myocardial damage; and 2) to demonstrate possible causative factors of the cTnI release after valve surgery.


METHODS
A prospective, single-center study. Ninety consecutive patients were operated on for different types of cardiac surgery; 45 patients underwent cardiac valve surgery - The VALVE group. 45 patients underwent CABG surgery - the CABG group. CTnI levels were measured preoperatively, on the day of operation and the 7 days postoperatively. The diagnosis of damaged myocardium classically performed through the measurement of cTnI, twelve-lead electrocardiograms (ECG) and echocardiographics according to the protocol of the study.


RESULTS
Although more elevated cTnI release was noticed in valve group early after operation, no occurrence of cardiac events was found in that group. Statistically significant occurrence of cardiac events was found in CABG group (P=0.015). No relationship was shown between the peak of cTnI and the presence of cardiac events in valve group. A statistically significant correlation was observed between cardiac events and peak cTnI in CABG group (P=0.05). Possible correlations were investigated between the peak of cTnI and perioperative parameters in both two groups.


CONCLUSIONS
The absence of cardiac events and the association of valve surgery with higher early release of cTnI compared to CABG suggest that the type of surgery strongly affects the induction of myocardial damage.
Department of Cardiac and Thoracic Surgery, "G. Papanikolaou" General Hospital Thessaloniki, Thessaloniki, Greece. hkarfis@yahoo.gr
E A
EA
Karfis
P
P
Kontogiorgi
G
G
Papadopoulos
P
P
Tzimas
C
C
Seferiadis
C
C
Athanasulas
C E
CE
Anagnostopoulos
G E
GE
Drossos
D000368:Aged; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006115:Greece; D006331:Heart Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*; D014463:Ultrasonography; D015854:Up-Regulation
D015415:Biomarkers; D019210:Troponin I