Wierzbicki Karol, Bochenek Maciej, Kędziora Anna, Sojecki Krzysztof, Ciołczyk-Wierzbicka Dorota, Węgrzyn Piotr, Drwiła Rafał, Kapelak Bogusław, Milaniak Irena, Sadowski Jerzy
Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, John Paul II Hospital, Krakow, Poland.
Chair of Medical Biochemistry, Jagiellonian University, Medical College, Krakow, Poland.
Kardiochir Torakochirurgia Pol. 2014 Sep;11(3):289-93. doi: 10.5114/kitp.2014.45679. Epub 2014 Sep 28.
Plasma troponin I (TnI) concentration is a well-established and widely-used marker of myocardial damage.
To determine the correlation between TnI concentration measured within the first 4 days following heart transplantation (HTX) and clinical course, with consideration of hemodynamic performance.
The retrospective study included 54 patients (12-62 years) who underwent HTX. TnI levels were assessed over the first 4 post-operative days. Hemodynamic parameters were assessed daily at Swan-Ganz catheterization and echocardiography. The number of required inotropic drugs was also analyzed.
There is a strong and positive correlation between the mean TnI levels and the mean number of required inotropic drugs (r = 0.51, p = 0.00), and also mean central venous pressure (CVP) (r = 0.33, p = 0.015). A weak trend towards a positive correlation between the mean values of pulmonary capillary wedge pressure (PCWP) and the mean plasma TnI levels was observed. There was no correlation between mean TnI levels and mean values of ejection fraction (EF) and cardiac output (CO). Detailed analysis showed a statistically significant correlation between TnI levels on days 3 and 4 after HTX and PCWP on the preceding days (r = 0.32, p = 0.04; r = 0.46, p = 0.006 respectively). Furthermore, a strong, inverse correlation between TnI levels on day 3 and CO on day 4 following HTX was observed (r = -0.44, p = 0.03).
Plasma TnI could be a useful marker for assessing the hemodynamic function after HTX.
血浆肌钙蛋白I（TnI）浓度是一种公认的、广泛应用的心肌损伤标志物。
确定心脏移植（HTX）后4天内测得的TnI浓度与临床病程之间的相关性，并考虑血流动力学表现。
这项回顾性研究纳入了54例接受HTX的患者（年龄12 - 62岁）。在术后的前4天评估TnI水平。每天通过Swan - Ganz导管插入术和超声心动图评估血流动力学参数。还分析了所需的血管活性药物数量。
平均TnI水平与所需血管活性药物的平均数量之间存在强正相关（r = 0.51，p = 0.00），与平均中心静脉压（CVP）也存在强正相关（r = 0.33，p = 0.015）。观察到肺毛细血管楔压（PCWP）的平均值与平均血浆TnI水平之间有微弱的正相关趋势。平均TnI水平与射血分数（EF）和心输出量（CO）的平均值之间无相关性。详细分析显示，HTX后第3天和第4天的TnI水平与前几天的PCWP之间存在统计学显著相关性（分别为r = 0.32，p = 0.04；r = 0.46，p = 0.006）。此外，观察到HTX后第3天的TnI水平与第4天的CO之间存在强负相关（r = -0.44，p = 0.03）。
血浆TnI可能是评估HTX后血流动力学功能的有用标志物。
