Clinical significance of the change of electrocardiogram and cardiac markers for myocardial damage after on-pump and off-pump coronary artery bypass grafting
- VernacularTitle:两种方法冠状动脉旁路移植术后心电图及心肌损伤标志物变化的对比和意义
- Author:
Yan ZHANG
;
Jinzhi XU
;
Xiuju WANG
- Publication Type:Journal Article
- Keywords:
Electrocardiography;
. Heat-shock proteins;
Coronary artery bypass grafting
- From:
Chinese Journal of Postgraduates of Medicine
2008;31(21):14-17
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical significance of the changes of electrocardiogram (ECG) and cardiac markers for myocardial damage after on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCABG). Method Monitoring 25 patients of OPCABG (OPCABG group) and 25 patients of CABG (CABG group) R wave amplitude of V4 and V5 on antorior electrocardiographic lead and simultaneously determining cardiac markers for myocardial damage creatine phosphokinase isoenzyme MB (CPK-MB), tropenin I (cTnI) and heat-shock protein 70 (HSPT0) on different lime. Results R wave amplitude of V4 and V5 on anterior electrocardiographic lead had no significant changes on 0, 6, 18 and 24 hours after OPCABG. On the contrary, R wave amplitude of V4 and V5 on anterior electrocardiographic lead decreased significantly on 0, 6 and 18 hours after CABG (P<0.01), and came back to preoperative values 24 hours after operation. The levels of CPK-MB and cTnI reached its peak and higher significantly for CABG than those for OPCABG on 24 hours after operation, 29.29 μg/L vs 5.98 μg/L and 6.74 μg/L vs 1.91 μg/L respectively. HSP70 increased significantly on 6 hours after operation in two groups, but median of HSP70 was higher significantly in CABG group (11044.5 pmol/L vs1702.0 pmol/L). In the first day after operation the HSP70 peak was correlated significantly with the level of CPK-MB(r=0.370, P<0.01) and cTnI (r=0.458,P<0.01). Conclusions Myocardial damage is significantly alleviated for patients of OPCABG comparing with those of CABG. The HSF70 in circulation may indicate the degree of myocardial damage.
