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Warm induction cardioplegia and reperfusion dose influence the occurrence of the post CABG TnI level

^a Department of Cardiopulmonary Bypass, Cardiovascular Institute & Fuwai Hospital, PUMC & CAMS, Beijing, China
^b Department of Pediatrics, Pediatrics Penn State College of Medicine-085, 500 University Drive, P.O. Box 850, Hershey, PA 17033-0850, USA
^c Department of Cardiac Surgery, Cardiovascular Institute & Fuwai Hospital, PUMC & CAMS, Beijing, China
^d Department of Anesthesiology, Cardiovascular Institute & Fuwai Hospital, PUMC & CAMS, Beijing, China

*Corresponding author. Tel.: +1 (717) 531-4647; fax: +1 (717) 531-0355.

E-mail address: bingyangji{at}psu.edu (B. Ji).

As a new biochemical marker cardiac troponin-I (CTnI) is a more sensitive and specific marker for detection of differences in myocardium injuries than other chemical enzymes. This study investigates the effect of warm induced and reperfusion blood cardioplegia on the release of troponin-I during the CABG. In our research, 24 three-vessel coronary artery disease (CAD) patients underwent CABG and were divided into two groups randomly: Group of warm induction and reperfusion blood cardioplegia (Group W N=12); Group of simple warm induction and no reperfusion (Group C N=12). The effect of myocardium protection of the two methods of myocardium protection were evaluated by clinical outcome, CTnI. Serial venous blood samples were obtained before and after surgery. In both groups, there were no differences in operative parameters. The level of CTnI increased from postoperative 6 h (P<0.05), reached peak in 2472 h and recovered postoperatively on 6th day in both groups. Compared with group C, the plasma concentrations of CTnI in group W were significantly lower at 6 h, 24 h and 72 h (P<0.01). The results suggest that the method of warm induction and reperfusion blood cardioplegia reduces the leakage of CTnI than group of simple warm blood cardioplegia in CABG patients.

Key Words: Myocardial protection; Troponin-I; Cardioplegia; Cardiopulmonary bypass