Javaherforoosh Zadeh Fatemeh, Moadeli Mohsen, Soltanzadeh Mansoor, Janatmakan Farahzad
Associate Professor of Anesthesia, Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Assistant Professor of Anesthesia, Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Anesth Pain Med. 2017 Aug 21;7(4):e12549. doi: 10.5812/aapm.12549. eCollection 2017 Aug.
Elective open heart surgery is associated with troponin release in some cases due to myocyte necrosis.
The aim of this study was to measure cardiac troponin I (cTnI) preoperatively in elective CABG after remote ischemic preconditioning.
Twenty-eight patients were selected for elective CABG. They were randomized to receive remote ischemic preconditioning (induced by three 5-min cycles of inflation with a pneumatic tourniquet and 5-min deflation between inflation episodes as reperfusion).
Primary outcomes were cardiac troponin I levels at 6 and 24 hours after the procedure, and the secondary outcomes included creatine phosphokinase, lactate dehydrogenase, and serum creatinine levels. Hemodynamic changes were evaluated between the treatment and control groups.
Cardiac troponin I at 6 hours after preconditioning was significantly lower compared to the control group (P = 0.036), and after 24 hours, there was still a significant difference between the two groups (P < 0.05).
Remote ischemic preconditioning reduces ischemic biomarkers during coronary artery bypass graft and attenuates procedure-related cardiac troponin I release and eventually reduces cardiovascular events such as myocardial infarction, chest pain, and hemodynamic changes after cardiac surgery.
在某些情况下，择期心脏直视手术会因心肌细胞坏死导致肌钙蛋白释放。
本研究旨在测量择期冠状动脉旁路移植术（CABG）患者在远程缺血预处理后术前的心肌肌钙蛋白I（cTnI）水平。
选择28例择期行CABG的患者。将他们随机分为两组，一组接受远程缺血预处理（通过使用气动止血带进行三个5分钟的充气周期诱导，每次充气之间有5分钟的放气作为再灌注）。
主要结果是术后6小时和24小时的心肌肌钙蛋白I水平，次要结果包括肌酸磷酸激酶、乳酸脱氢酶和血清肌酐水平。评估治疗组和对照组之间的血流动力学变化。
预处理后6小时的心肌肌钙蛋白I水平与对照组相比显著降低（P = 0.036），24小时后，两组之间仍存在显著差异（P < 0.05）。
远程缺血预处理可降低冠状动脉旁路移植术中的缺血生物标志物，减轻与手术相关的心肌肌钙蛋白I释放，并最终减少心血管事件，如心肌梗死、胸痛和心脏手术后的血流动力学变化。
