scholarly journals Effect of Staged Preconditioning on Biochemical Markers in the Patients Undergoing Coronary Artery Bypass Grafting

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Alireza Mohammadzadeh ◽  
Naser Jafari ◽  
Behzad Babapoursaatlou ◽  
Hossein Doustkami ◽  
Adallat Hosseinian ◽  
...  
Keyword(s):  
Biochemical Markers ◽  
Myocardial Injury ◽  
Creatine Phosphokinase ◽  
Troponin T ◽  
Artery Bypass ◽  
Serum Levels ◽  
Target Organ ◽  
Control Group ◽  
Target Organs ◽  
Two Stages

The present study has investigated the effectiveness of staged-preconditioning, in both remote and target organs. After IP the myocardial release of the biochemical markers including, creatine phosphokinase (CPK), cardiac creatine kinase (CK-MB), cardiac troponin T (cTnT) and lactate dehydrogenase (LDH) were evaluated in patients who underwent CABG, with and without staged-preconditioning. Sixty-one patients entered the study; there were 32 patients in the staged-preconditioning group and 29 patients in the control group. All patients underwent on-pump CABG using cardiopulmonary bypass (CPB) techniques. In the staged-preconditioning group, patients underwent two stages of IP on remote (upper limb) and target organs. Each stage of preconditioning was carried out by 3 cycles of ischemia and then reperfusion. Serum levels of biochemical markers were immediately measured postoperatively at 24, 48 and 72 h. Serum CK-MB, CPK and LDH levels were significantly lower in the staged-preconditioning group than in the control group. The CK-MB release in the staged-preconditioning patients reduced by 51% in comparison with controls over 72 h after CABG. These results suggest that myocardial injury was attenuated by the effect of three rounds of both remote and target organ IP.

Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery

2015 ◽  
Vol 18 (4) ◽  
pp. 171 ◽  
Author(s):  
Tolga Demir ◽  
Mehmet Umit Ergenoglu ◽  
Hale Bolgi Demir ◽  
Nursen Tanrikulu ◽  
Mazlum Sahin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Myocardial Protection ◽  
Troponin T ◽  
Artery Bypass ◽  
Control Group ◽  
Study Group ◽  
Cabg Surgery ◽  
Anti Inflammatory ◽  
Pump Coronary Artery Bypass

<strong>Background</strong>: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB).<br /><strong>Methods</strong>: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time. <br /><strong>Results</strong>: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P &lt; .001; T3: <br />P &lt; .001; T4: P &lt; .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group <br />(P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001).<br /><strong>Conclusions</strong>: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.<br /><br />

scholarly journals Effects of peak time of myocardial injury biomarkers on mid-term outcomes of patients undergoing OPCABG

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Hu ◽  
Fei Gao ◽  
Mengwei Lv ◽  
Ban Liu ◽  
Yu Shi ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Cox Regression ◽  
Troponin T ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Peak Time ◽  
Clinical Trial Registry ◽  
Ventricular Ejection Fraction ◽  
The Impact

Abstract Background With the development of cardiac surgery techniques, myocardial injury is gradually reduced, but cannot be completely avoided. Myocardial injury biomarkers (MIBs) can quickly and specifically reflect the degree of myocardial injury. Due to various reasons, there is no consensus on the specific values of MIBs in evaluating postoperative prognosis. This retrospective study was aimed to investigate the impact of MIBs on the mid-term prognosis of patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods Totally 564 patients undergoing OPCABG with normal courses were included. Cardiac troponin T (cTnT) and creatine kinase myocardial band (CK-MB) were assessed within 48 h before operation and at 6, 12, 24, 48, 72, 96 and 120 h after operation. Patients were grouped by peak values and peak time courses of MIBs. The profile of MIBs and clinical variables as well as their correlations with mid-term prognosis were analyzed by univariable and multivariable Cox regression models. Result Continuous assessment showed that MIBs increased first (12 h after surgery) and then decreased. The peak cTnT and peak CK-MB occurred within 24 h after operation in 76.8% and 67.7% of the patients respectively. No significant correlation was found between CK-MB and mid-term mortality. Delayed cTnT peak (peak cTnT elevated after 24 h after operation) was correlated with lower creatinine clearance rate (69.36 ± 21.67 vs. 82.18 ± 25.17 ml/min/1.73 m2), body mass index (24.35 ± 2.58 vs. 25.27 ± 3.26 kg/m2), less arterial grafts (1.24 ± 0.77 vs. 1.45 ± 0.86), higher EuroSCORE II (2.22 ± 1.12 vs.1.72 ± 0.91) and mid-term mortality (26.5 vs.7.9%). Age (HR: 1.067, CI: 1.006–1.133), left ventricular ejection fraction (HR: 0.950, CI: 0.910–0.993), New York Heart Association score (HR: 1.839, CI: 1.159–2.917), total venous grafting (HR: 2.833, CI: 1.054–7.614) and cTnT peak occurrence within 24 h (HR: 0.362, CI: 0.196–0.668) were independent predictors of mid-term mortality. Conclusion cTnT is a better indicator than CK-MB. The peak value and peak occurrence of cTnT are related to mid-term mortality in patients undergoing OPCABG, and the peak phases have stronger predictive ability. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000033850. Registered 14 June 2020, http://www.chictr.org.cn/edit.aspx?pid=55162&htm=4.

Leucocyte-depleted cardioplegia does not reduce reperfusion injury in hypothermic coronary artery bypass surgery

Perfusion ◽  
1999 ◽  
Vol 14 (5) ◽  
pp. 371-377 ◽  
Author(s):  
P G Browning ◽  
M Pullan ◽  
M Jackson ◽  
A Rashid
Keyword(s):  
Oxidative Stress ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Myocardial Injury ◽  
Bypass Surgery ◽  
Troponin T ◽  
Artery Bypass ◽  
Oxidized Glutathione ◽  
Patient Groups

This study investigated the effects of leucocyte-depleted cardioplegia on postreperfusion oxidative stress and myocardial injury in elective hypothermic coronary artery bypass surgery. Forty patients were randomized to receive either cardioplegia with leucocytes depleted by an in-line Pall BC1B filter, or blood cardioplegia without leucocyte depletion. Transmyocardial oxidative stress was assessed by oxidized glutathione measurements in samples taken simultaneously from the coronary sinus and aortic root, and myocardial injury by postoperative CKMB and troponin-T measurements. The BC1B filters reduced numbers of cardioplegia leucocytes by a mean of 90.7%. Both patient groups demonstrated significant increases ( p < 0.001) in transcardiac oxidized glutathione gradients after crossclamp release. No significant differences were found between the groups for postreperfusion oxidized glutathione gradients, postoperative levels of CKMB or troponin-T, or in the frequency of perioperative and postoperative complications. These results suggest that leucocyte-depleted cardioplegia does not significantly improve myocardial protection in patients undergoing elective coronary artery bypass surgery.

scholarly journals Functional dynamics of myocardial injury biomarkers production during acute isoprenaline treatment in rats

2021 ◽  
Vol 72 (2) ◽  
pp. 11-18
Author(s):  
Nina Gatarić ◽  
Ana Ilić ◽  
Dušan Todorović ◽  
Slavica Mutavdžin ◽  
Jovana Jakovljević-Uzelac ◽  
...  
Keyword(s):  
Experimental Model ◽  
Myocardial Injury ◽  
Saline Solution ◽  
Troponin T ◽  
Significant Rise ◽  
Control Group ◽  
Activity Levels ◽  
St Segment Elevation ◽  
Therapeutic Modalities ◽  
Male Wistar Rats

Introduction: Isoprenaline or isoproterenol (1-(3,4-dihydroxyphenyl)-2-isopropylaminoethanolhydrochloride; ISO), a synthetic b-adrenergic agonist, can be used to establish myocardial ischemia, cardiotoxicity, necrosis and/or an experimental model of infarction in rats. Aim: Determination of the dynamics of myocardial injury biomarkers production of aspartate transaminase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and high-sensitive troponin T (hsTnT), with changes on electrocardiogram (ECG) parameters during the subcutaneous aplication of ISO in male Wistar rats. Material and methods: All animals (n = 23) were divided into two groups: control group (n = 11) treated with a saline solution, during two consecutive days (0,2 ml/kg b.m. daily, sc); and the ISO group (n = 12) treated with isoprenaline, during two consecutive days (85 mg/kg b.m. daily, sc). Blood was drawn from the rat tail vein in both groups, in order to determine serum activity levels of myocardial injury biomarkers, and an ECG (n = 6) was registered prior to the application, as well as 48h following the first dose of of saline solution or isoprenaline. Results: In comparison to the control group, in which no significant enzyme activities elevation (p > 0.05) nor ECG changes were registered, ISO group presented a significant rise of two clinically significant biomarkers of acute myocardial injury/myocardial infarction (AMI), CK (p = 0.05) and hsTnT (p < 0.01), as well as an ST segment elevation, with a patognomonic ECG change. Conclusion: Obtained results support previous studies, proving that isoprenaline represents an adequate experimental model for myocardial injury/AMI induction, and a "golden standard" for evaluating potential cardioprotective effects of pharmacological and non-pharmacological therapeutic modalities, with the ultimate goal of lowering the degree of lesions and improving post-infarction myocardium function.

Early Prognostic Value of High-Sensitivity Troponin T after Coronary Artery Bypass Grafting

2018 ◽  
Vol 67 (06) ◽  
pp. 467-474 ◽  
Author(s):  
Mauricio Nassau Machado ◽  
Fernando Bruetto Rodrigues ◽  
Ingrid Hellen Grigolo ◽  
Amália Tieco Rocha Sabbag ◽  
Osvaldo Lourenço Silva ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Myocardial Injury ◽  
Troponin T ◽  
Artery Bypass ◽  
High Sensitivity ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
High Sensitivity Troponin T

Abstract Background Periprocedural myocardial injury after coronary artery bypass grafting (CABG) may affect the patient's prognosis and may be due to a different set of factors beyond the atherosclerotic plaque instability. Considering the challenges in the diagnosis of myocardial injury after CABG, the aim of this study was to determine the association between postoperative early elevation of high-sensitivity troponin T (hsTnT) and all-cause 30-day mortality after CABG. Methods We enrolled 600 consecutive patients who underwent CABG. The hsTnT value was measured immediately before surgery and in the morning of the first postoperative day. Results The baseline hsTnT was 13 ng/L (7–26 ng/L) and 273 patients (45.7%) had baseline hsTnT above the 99th percentile/upper reference limit (URL) (14 ng/L). The median for hsTnT at first postoperative day was 235 ng/L (152–425 ng/L). We calculated the postoperative hsTnT ratio to URL for each patient, representing the number of times exceeding the URL (hsTnT value divided by 14 ng/L). The multivariate analysis by Cox proportional hazard model revealed that age (years) (hazard ratio [HR] = 1.13, 95% confidence interval [CI]: 1.07–1.20; p < 0.001) and postoperative hsTnT ratio to URL (per 10-fold increase) (HR = 1.06, 95% CI: 1.04–1.08; p < 0.001) were independent predictors of all-cause 30-day mortality after CABG. Conclusion In our series, age and higher postoperative hsTnT levels were independent and reliable predictors of all-cause 30-day mortality after CABG.

scholarly journals Potential Use of Pregnancy-associated Plasma Protein-A and IMA as Biomarkers for the Early Stage of COVID-19

2021 ◽  
Author(s):  
Belén G Sánchez ◽  
Jose M Gasalla ◽  
Manuel Sanchez-Chapado ◽  
Alicia Bort ◽  
Ines Diaz-Laviada
Keyword(s):  
Plasma Protein ◽  
Roc Curve ◽  
Troponin T ◽  
Early Stage ◽  
Acute Infection ◽  
Protein A ◽  
Serum Levels ◽  
Early Infection ◽  
Control Group ◽  
Serum Samples

Abstract BackgroundThis study has been undertaken with the urgent need for exploring reliable biomarkers for early infection of SARS-CoV-2. We performed a retrospective study analyzing the serum levels of the cardiovascular biomarkers N-terminal pro-B natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), Ischemia Modified Albumin (IMA) and pregnancy associated plasma protein A (PAPP-A), in 84 patients with COVID-19. MethodsPatients were divided in three groups according to their RT-qPCR and IgG values in acute infection (n=35), early infection (n=25) or control subjects (n=24). Levels of biomarkers were analyzed in patient’s serum samples by commercially available ELISA kits.ResultsMultivariate analysis and Receiver Operating Characteristic (ROC) curve showed that IMA and PAPP-A, had an excellent discrimination value for the early stage of COVID-19. Serum levels of IMA in early SARS-CoV-2 infected patients were significantly higher than in the control group with an area under the ROC curve (AUC) value of 0.94 (95% confidence interval (CI): 0.881- 0.999). Likewise, the serum level of PAPP-A was significantly higher in patients with early infection than in controls [AUC = 0.801 (95% CI: 0.673–0.929)]. The combined use of IMA and PAPP-A enhanced the sensitivity for total SARS-CoV-2 infected patients to 93%. ConclusionsThese results suggest that the levels of PAPP-A and IMA might be used as efficient biomarkers for the early stage of COVID-19 with high sensitivity and specificity. Importantly, when monitoring pregnancy and cardiovascular diseases by PAPP-A or IMA levels, an infection by SARS-CoV-2 should be discarded for proper interpretation of the results.

scholarly journals Comparison of protective effects of carvedilol and α-tocopherol on doxorubicin-induced cardiotoxocity

2019 ◽  
Vol 8 (9) ◽  
pp. 1944
Author(s):  
Khalida Ajmal ◽  
Mohammad Ajmal ◽  
Ayesha Afzal ◽  
Saima . ◽  
Uzma Naeem ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Early Stage ◽  
Serum Levels ◽  
Serum Biomarkers ◽  
Control Group ◽  
Protective Effects ◽  
Single Intravenous Injection ◽  
Childhood Malignancies ◽  
Concurrent Use ◽  
Cardioprotective Effects

Background: Doxorubicin, an effective anticancer drug used to treat multiple solid tumours and childhood malignancies since many decades but its cardiac adverse effects limits its use in full therapeutic dose. The mechanism involved in cardiotoxicity is apoptosis of cardiomyocytes due to reactive oxidative stress. The study was conducted to compare the cardioprotective effects of carvedilol and α-Tocopherol and to detect myocardial injury at early stage.Methods: Cardiotoxicity was produced in a group of rabbits by single intravenous injection of doxorubicin; control group was treated with normal saline only. Third and fourth groups were pretreated with carvedilol 30 mg/kg bodyweight and α-Tocopherol 200 mg/kg bodyweight respectively for ten days before injection of doxorubicin.Results: Doxorubicin produced marked cardiotoxicity represented by raised levels of serum biomarkers (cTnI, LDH and CK-MB) and severe necrosis of cardiomyocytes on microscopic examination. Carvedilol and α-tocopherol pretreatment resulted in decreased serum levels of biomarkers and improved the histological picture of heart tissue.Conclusions: The outcome of doxorubicin chemotherapy can be made successful with the concurrent use of carvedilol or α-tocopherol. Although carvedilol has more pronounced cardioprotective effects perhaps due to its antioxidant activity in addition to antiapoptotic, antiproliferative and anti-inflammatory effects. Furthermore the quantitative cTnI estimation for detection of cardiotoxicity at early stage can lead to significant economic impact in management of cancer.

scholarly journals Remote Ischemic Preconditioning on New Onset Post-Cardiac Surgery Atrial Fibrillation: A Single-Centre Prospective Clinical Study

2019 ◽  
pp. 1-6
Author(s):  
Aidonidis Isaac ◽  
Aidonidis Isaac ◽  
Befani Christina ◽  
Dipla Konstantina ◽  
Hatziefthimiou Apostolia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Preconditioning ◽  
Troponin T ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Group Analysis ◽  
P Wave ◽  
Remote Ischemic Preconditioning ◽  
Control Group ◽  
Prospective Clinical Study

Background: Remote ischemic preconditioning (RIPC) has been shown to reduce myocardial ischemiareperfusion injury. However, its efficacy in preventing postoperative atrial fibrillation (POAF) remains unsettled. Methods: A total of 97 eligible patients were prospectively randomized to receive either RIPC or shamRIPC (control) prior to coronary artery bypass graft (CABG) surgery. RIPC was performed by applying 3 alternating cycles of a 5-min upper limb ischemia and reperfusion using a blood-pressure cuff. The primary endpoint was the incidence of POAF. Secondary endpoints included cardiac troponin T (cTnT) and H2O2 serum concentration after revascularization, and P-wave duration (PWD) on a 12-lead electrocardiogram. Results: Twelve out of 49 RIPC patients (24.5%) and 18/48 of control patients (37.5%) developed POAF (p=0.165, χ2-test). H2O2 levels were significantly increased 30 min after revascularization in both groups compared to pre-clamping values (8.8±6 vs 25.5±2 and 8.5±5 vs 39±15.5 µM/L in the RIPC and control group, respectively; P<.001, within-group analysis). However, mean differences of H2O2 levels after reperfusion were lower in RIPC patients than in controls (P<.05). cTnT concentrations though increased between 6 and 12 h after operation in both groups, they began to fall later only in the RIPC group. PWD became shorter in RIPC treated patients but not in controls when measured postoperatively (82±13 vs 75±11 ms, P<.01). Conclusion: RIPC did not significantly reduce the incidence of POAF despite decreases in cTnT/H2O2 levels and PWD, indicating that not the extent of myocardial injury but the injury itself triggers the electrophysiologic mechanisms underlying the development of this arrhythmia.

scholarly journals Effect of different exercises on effective factors involved in reverse cholesterol transfer in patients with coronary artery bypass surgery

2021 ◽  
pp. 58-74
Keyword(s):  
Resistance Training ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Aerobic Training ◽  
Artery Bypass ◽  
Training Group ◽  
Serum Levels ◽  
Control Group ◽  
Apo B ◽  
Training Groups

Background: The present study aimed to compare the effect of different exercises on effective factors involved in reverse cholesterol transfer in patients with coronary artery bypass surgery (CABG). Materials and Methods: A number of 45 patients with CABGwere assigned to three groups: control (n=12), aerobic exercise (n=15), and resistance training (n=18). Three aerobic and resistance training sessions were performed per week for eight weeks. Anthropometric variables, expression of ABCG4 gen, as well as the serum levels of Apo-A and Apo-B, were measured before and after the training period. Data were analyzed using repeated measures of ANOVA. A p-value less than 0.05 was considered statistically significant. Results: Aerobic and resistance training significantly increased the expression of ABCG4 gene, compared to those in the control group (P=0.001); nonetheless, there was no significant difference between the two training groups (P= 0.021). Significant differences were observed in serum levels of Apo-A and Apo-B in both aerobic and resistance training groups, compared to those obtained in the control group (P=0.001). However, the difference between aerobic and resistance training groups was significant for Apo-A (P= 0.001), but not for Apo-B (P=1.000). Moreover, the ratio of Apo-A to Apo-B was significantly different for the resistance training group, compared to that in the control group (P= 0.001); nevertheless, it was not significant for the aerobic training group (P=1.000). Conclusion: As evidenced by the results of this study, resistance training improves cholesterol reverse transport regulators more than aerobic training; therefore, resistance training is recommended to regulate reverse cholesterol transfer.

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