Kanko Muhip, Yavuz Sadan, Duman Can, Hosten Tulay, Oner Emin, Berki Turan
Kocaeli University, Medical Faculty, Department of Cardiovascular Surgery, Kocaeli, Turkey.
J Cardiothorac Surg. 2012 Jan 5;7:3. doi: 10.1186/1749-8090-7-3.
Various types of markers have been used so far in order to reveal myocardial perfusion defect. However, these markers usually appear in the necrosis phase or in the late stage. Having been the focus of various investigations recently, ischemia-modified albumin (IMA) is helpful in establishing diagnosis in the early stages of ischemia, before necrosis develops.
30 patients that underwent only coronary bypass surgery due to ischemic heart disease within a specific period of time have been included in the study. IMA levels were studied in the preoperative, intraoperative, and postoperative periods. The albumin cobalt binding assay was used for IMA determination. Hemodynamic parameters (atrial fibrillation, the need for inotropic support, ventricular arrhythmia) of the patients in the postoperative stage were evaluated. Intraoperative measurement values (mean ± SD) of IMA (0.67677 ± 0.09985) were statistically significantly higher than those in the preoperative (0.81516 ± 0.08894) and postoperative (0.70477 ± 0.07523) measurements. Considering atrial fibrillation and need for inotropics, a parallelism was detected with the levels of IMA.
IMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases.
为了揭示心肌灌注缺损,目前已经使用了各种类型的标志物。然而,这些标志物通常出现在坏死期或晚期。缺血修饰白蛋白(IMA)最近成为各种研究的焦点,它有助于在坏死发生前的缺血早期阶段进行诊断。
本研究纳入了在特定时间段内仅因缺血性心脏病接受冠状动脉搭桥手术的30例患者。在术前、术中和术后阶段研究IMA水平。采用白蛋白钴结合试验测定IMA。评估患者术后阶段的血流动力学参数(房颤、是否需要使用正性肌力药物支持、室性心律失常)。IMA的术中测量值(平均值±标准差)为(0.67677±0.09985),在统计学上显著高于术前(0.81516±0.08894)和术后(0.70477±0.07523)测量值。考虑到房颤和对正性肌力药物的需求,发现其与IMA水平存在平行关系。
IMA是心脏缺血的早期上升标志物,能够为早期治疗提供指导。