哪种标准生物标志物可用于评估冷冻球囊肺静脉隔离术后的心肌损伤？

Which standard biomarkers are useful for the evaluation of myocardial injury after pulmonary vein isolation with cryoballoon?

机构信息

Kerckhoff Heart Centre Department of Cardiology, Bad Nauheim, Germany.

出版信息

Kardiol Pol. 2011;69(11):1151-5.

PMID:22090225

Abstract

BACKGROUND

Many studies have used creatinine kinase (CK), myocardial bound for CK (CK-MB), and cardiac troponin I (cTnI) and T (cTnT) to evaluate myocardial cells injury after ablation. We applied measurements of the blood concentration of cardio-specific biomarkers as surrogates for the injured cell mass.

AIM

To clarify which of the standard biomarkers are useful in the evaluation and quantification of lesions produced by cryoballoon ablation (CBA) during pulmonary vein isolation.

METHODS

The CBA was performed in 33 patients with atrial fibrillation. Blood samples were obtained before CBA and one, six, and 24 h after CBA. We analysed CK, CK-MB and cTnI.

RESULTS

A significant increase of all biomarkers was observed at each hour of collection as compared to the baseline measurement. Maximum median peak levels occurred at 6 h. Pathological values of CK, CK-MB and cTnI were observed in 94%, 100% and 100% of patients, respectively. Both maximum CK and CK-MB values correlated with median temperature (p < 0.05) reached during CBA. Additionally, CK-MB correlated with total cryo-time (p < 0.03).

CONCLUSIONS

The CK-MB is the best biochemical marker for the evaluation of myocardial injury after CBA. The cTnI can be useful as an additional parameter of myocardial injury after CBA.

摘要

背景

许多研究已经使用肌酸激酶（CK）、心肌结合的 CK（CK-MB）和心脏肌钙蛋白 I（cTnI）和 T（cTnT）来评估消融后心肌细胞的损伤。我们应用血液中特定于心脏的生物标志物的浓度测量来替代损伤细胞的量。

目的

明确哪种标准生物标志物可用于评估和量化冷冻球囊消融（CBA）在肺静脉隔离过程中产生的病变。

方法

对 33 例房颤患者进行 CBA。在 CBA 前和 CBA 后 1、6 和 24 小时采集血样。我们分析了 CK、CK-MB 和 cTnI。

结果

与基线测量相比，在每个采集时间点，所有生物标志物均显著增加。最大中位数峰值出现在 6 小时。94%、100%和 100%的患者分别出现 CK、CK-MB 和 cTnI 的病理值。最大 CK 和 CK-MB 值与 CBA 过程中达到的中位数温度呈正相关（p<0.05）。此外，CK-MB 与总冷冻时间呈正相关（p<0.03）。