Effects of age and ischemic times on biochemical evidence of myocardial injury after pediatric cardiac operations
Introduction: The vulnerability of pediatric myocardium to ischemia is poorly documented in the clinical setting. Methods: Serial measurements of serum concentrations of myoglobin, the MB isoenzyme of creatine kinase, and cardiac troponins T and I and their respective areas under the curve were obta...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 1997-04, Vol.113 (4), p.728-735 |
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| container_title | The Journal of thoracic and cardiovascular surgery |
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| creator | Taggart, D.P. Hadjinikolas, L. Hooper, J. Albert, J. Kemp, M. Hue, D. Yacoub, M. Lincoln, J.C. |
| description | Introduction: The vulnerability of pediatric myocardium to ischemia is poorly documented in the clinical setting.
Methods: Serial measurements of serum concentrations of myoglobin, the MB isoenzyme of creatine kinase, and cardiac troponins T and I and their respective areas under the curve were obtained, with particular reference to age and ischemic time, in 80 children undergoing cardiac operations. Sixteen (the control group) did not require cardiopulmonary bypass and 64 did.
Results: In the control group there were increases (
p < 0.01) in myoglobin and creatine kinase MB isoenzyme but no increase in cardiac troponin T or I; by contrast, the group treated with cardiopulmonary bypass had significant increases in all four markers but with differing temporal patterns. Younger age (especially |
| doi_str_mv | 10.1016/S0022-5223(97)70231-9 |
| format | Article |
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Methods: Serial measurements of serum concentrations of myoglobin, the MB isoenzyme of creatine kinase, and cardiac troponins T and I and their respective areas under the curve were obtained, with particular reference to age and ischemic time, in 80 children undergoing cardiac operations. Sixteen (the control group) did not require cardiopulmonary bypass and 64 did.
Results: In the control group there were increases (
p < 0.01) in myoglobin and creatine kinase MB isoenzyme but no increase in cardiac troponin T or I; by contrast, the group treated with cardiopulmonary bypass had significant increases in all four markers but with differing temporal patterns. Younger age (especially <12 months) was a highly significant explanatory variable only for the release of cardiac troponins T and I, and ischemic time was a significant explanatory variable for the release of creatine kinase MB isoenzyme, cardiac troponins T and I, but not myoglobin. In comparison with previous studies in adults, creatine kinase MB and cardiac troponin T concentrations were three times greater in children than in adults.
Conclusions: This study supports the specificity of cardiac troponins T and I as markers of myocardial injury after pediatric cardiac operations and defines the importance of age and ischemic time in determining their release. In comparison with previous data in adults, our results raise the possibility that the pediatric heart may be more vulnerable to the effects of ischemia and reperfusion. Cardiac troponins will permit comparison of new myocardial protective strategies or other potentially therapeutic myocardial interventions. (J Thorac Cardiovasc Surg 1997;113:728-35)</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/S0022-5223(97)70231-9</identifier><identifier>PMID: 9104982</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adult ; Age Factors ; Biological and medical sciences ; Biomarkers ; Cardiopulmonary Bypass - adverse effects ; Child, Preschool ; Creatine Kinase - blood ; Heart Defects, Congenital - surgery ; Humans ; Infant ; Isoenzymes ; Medical sciences ; Myocardial Ischemia - etiology ; Myocardial Ischemia - metabolism ; Myocardial Reperfusion Injury - etiology ; Myocardial Reperfusion Injury - metabolism ; Myoglobin - blood ; Reproducibility of Results ; Sensitivity and Specificity ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Time Factors ; Troponin - blood</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 1997-04, Vol.113 (4), p.728-735</ispartof><rights>1997 Mosby, Inc.</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-9965d4ca0f8eb7d17b18390ab7f50ab804fca6897694eef6ce90242e292eadc33</citedby><cites>FETCH-LOGICAL-c468t-9965d4ca0f8eb7d17b18390ab7f50ab804fca6897694eef6ce90242e292eadc33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-5223(97)70231-9$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2649142$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9104982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taggart, D.P.</creatorcontrib><creatorcontrib>Hadjinikolas, L.</creatorcontrib><creatorcontrib>Hooper, J.</creatorcontrib><creatorcontrib>Albert, J.</creatorcontrib><creatorcontrib>Kemp, M.</creatorcontrib><creatorcontrib>Hue, D.</creatorcontrib><creatorcontrib>Yacoub, M.</creatorcontrib><creatorcontrib>Lincoln, J.C.</creatorcontrib><title>Effects of age and ischemic times on biochemical evidence of myocardial injury after pediatric cardiac operations</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Introduction: The vulnerability of pediatric myocardium to ischemia is poorly documented in the clinical setting.
Methods: Serial measurements of serum concentrations of myoglobin, the MB isoenzyme of creatine kinase, and cardiac troponins T and I and their respective areas under the curve were obtained, with particular reference to age and ischemic time, in 80 children undergoing cardiac operations. Sixteen (the control group) did not require cardiopulmonary bypass and 64 did.
Results: In the control group there were increases (
p < 0.01) in myoglobin and creatine kinase MB isoenzyme but no increase in cardiac troponin T or I; by contrast, the group treated with cardiopulmonary bypass had significant increases in all four markers but with differing temporal patterns. Younger age (especially <12 months) was a highly significant explanatory variable only for the release of cardiac troponins T and I, and ischemic time was a significant explanatory variable for the release of creatine kinase MB isoenzyme, cardiac troponins T and I, but not myoglobin. In comparison with previous studies in adults, creatine kinase MB and cardiac troponin T concentrations were three times greater in children than in adults.
Conclusions: This study supports the specificity of cardiac troponins T and I as markers of myocardial injury after pediatric cardiac operations and defines the importance of age and ischemic time in determining their release. In comparison with previous data in adults, our results raise the possibility that the pediatric heart may be more vulnerable to the effects of ischemia and reperfusion. Cardiac troponins will permit comparison of new myocardial protective strategies or other potentially therapeutic myocardial interventions. (J Thorac Cardiovasc Surg 1997;113:728-35)</description><subject>Adult</subject><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Child, Preschool</subject><subject>Creatine Kinase - blood</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Humans</subject><subject>Infant</subject><subject>Isoenzymes</subject><subject>Medical sciences</subject><subject>Myocardial Ischemia - etiology</subject><subject>Myocardial Ischemia - metabolism</subject><subject>Myocardial Reperfusion Injury - etiology</subject><subject>Myocardial Reperfusion Injury - metabolism</subject><subject>Myoglobin - blood</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Time Factors</subject><subject>Troponin - blood</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUuPFCEUhYnRjO3oT5iEhfGxKAWK4rEyZjI-kklcqIk7QsFlmk49eoAe0_9eaqrTWzeQnPOdCxwQuqLkAyVUfPxJCGNNx1j7Tsv3krCWNvoJ2lCiZSNU9-cp2pyR5-hFzjtCiCRUX6ALTQnXim3Q_U0I4ErGc8D2DrCdPI7ZbWGMDpc4QnUm3Md5leyA4SF6mBwsifE4O5t8rHKcdod0xDYUSHgPVSupjlhth-c9JFviPOWX6FmwQ4ZXp_0S_f5y8-v6W3P74-v368-3jeNClUZr0XnuLAkKeump7KlqNbG9DF1dFeHBWaG0FJoDBOFAE8YZMM3Aete2l-jNOnef5vsD5GLG-jAYBjvBfMhGKs2llKKC3Qq6NOecIJh9iqNNR0OJWao2j1WbpUejpXms2uiauzodcOhH8OfUqdvqvz75NtfiQrKTi_mMMcE15Qv2dsW28W77NyYwebTDUIdSsysuU9oabiRTlfy0klBre4iQTHZx-QpfU64YP8f_XPkfODup-A</recordid><startdate>19970401</startdate><enddate>19970401</enddate><creator>Taggart, D.P.</creator><creator>Hadjinikolas, L.</creator><creator>Hooper, J.</creator><creator>Albert, J.</creator><creator>Kemp, M.</creator><creator>Hue, D.</creator><creator>Yacoub, M.</creator><creator>Lincoln, J.C.</creator><general>Mosby, Inc</general><general>AATS/WTSA</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19970401</creationdate><title>Effects of age and ischemic times on biochemical evidence of myocardial injury after pediatric cardiac operations</title><author>Taggart, D.P. ; Hadjinikolas, L. ; Hooper, J. ; Albert, J. ; Kemp, M. ; Hue, D. ; Yacoub, M. ; Lincoln, J.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-9965d4ca0f8eb7d17b18390ab7f50ab804fca6897694eef6ce90242e292eadc33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Child, Preschool</topic><topic>Creatine Kinase - blood</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Humans</topic><topic>Infant</topic><topic>Isoenzymes</topic><topic>Medical sciences</topic><topic>Myocardial Ischemia - etiology</topic><topic>Myocardial Ischemia - metabolism</topic><topic>Myocardial Reperfusion Injury - etiology</topic><topic>Myocardial Reperfusion Injury - metabolism</topic><topic>Myoglobin - blood</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Time Factors</topic><topic>Troponin - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Taggart, D.P.</creatorcontrib><creatorcontrib>Hadjinikolas, L.</creatorcontrib><creatorcontrib>Hooper, J.</creatorcontrib><creatorcontrib>Albert, J.</creatorcontrib><creatorcontrib>Kemp, M.</creatorcontrib><creatorcontrib>Hue, D.</creatorcontrib><creatorcontrib>Yacoub, M.</creatorcontrib><creatorcontrib>Lincoln, J.C.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Taggart, D.P.</au><au>Hadjinikolas, L.</au><au>Hooper, J.</au><au>Albert, J.</au><au>Kemp, M.</au><au>Hue, D.</au><au>Yacoub, M.</au><au>Lincoln, J.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of age and ischemic times on biochemical evidence of myocardial injury after pediatric cardiac operations</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>1997-04-01</date><risdate>1997</risdate><volume>113</volume><issue>4</issue><spage>728</spage><epage>735</epage><pages>728-735</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Introduction: The vulnerability of pediatric myocardium to ischemia is poorly documented in the clinical setting.
Methods: Serial measurements of serum concentrations of myoglobin, the MB isoenzyme of creatine kinase, and cardiac troponins T and I and their respective areas under the curve were obtained, with particular reference to age and ischemic time, in 80 children undergoing cardiac operations. Sixteen (the control group) did not require cardiopulmonary bypass and 64 did.
Results: In the control group there were increases (
p < 0.01) in myoglobin and creatine kinase MB isoenzyme but no increase in cardiac troponin T or I; by contrast, the group treated with cardiopulmonary bypass had significant increases in all four markers but with differing temporal patterns. Younger age (especially <12 months) was a highly significant explanatory variable only for the release of cardiac troponins T and I, and ischemic time was a significant explanatory variable for the release of creatine kinase MB isoenzyme, cardiac troponins T and I, but not myoglobin. In comparison with previous studies in adults, creatine kinase MB and cardiac troponin T concentrations were three times greater in children than in adults.
Conclusions: This study supports the specificity of cardiac troponins T and I as markers of myocardial injury after pediatric cardiac operations and defines the importance of age and ischemic time in determining their release. In comparison with previous data in adults, our results raise the possibility that the pediatric heart may be more vulnerable to the effects of ischemia and reperfusion. Cardiac troponins will permit comparison of new myocardial protective strategies or other potentially therapeutic myocardial interventions. (J Thorac Cardiovasc Surg 1997;113:728-35)</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>9104982</pmid><doi>10.1016/S0022-5223(97)70231-9</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Factors Biological and medical sciences Biomarkers Cardiopulmonary Bypass - adverse effects Child, Preschool Creatine Kinase - blood Heart Defects, Congenital - surgery Humans Infant Isoenzymes Medical sciences Myocardial Ischemia - etiology Myocardial Ischemia - metabolism Myocardial Reperfusion Injury - etiology Myocardial Reperfusion Injury - metabolism Myoglobin - blood Reproducibility of Results Sensitivity and Specificity Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Time Factors Troponin - blood |
| title | Effects of age and ischemic times on biochemical evidence of myocardial injury after pediatric cardiac operations |
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