McGregor C G, MacLeod M D, Muir A L, Smith A F, Hannan W J, Miller H C
Br Heart J. 1984 Jun;51(6):612-7. doi: 10.1136/hrt.51.6.612.
Fifty consecutive patients, 25 undergoing aortic valve replacement and 25 mitral valve replacement, were studied by serial electrocardiography, preoperative and postoperative technetium-99m pyrophosphate radionuclide scanning, and serial measurement of enzymes (creatine kinase, aspartate aminotransferase, urea stable lactic dehydrogenase) and the MB isoenzyme of creatine kinase to define the incidence of preoperative myocardial infarction and to identify the most appropriate diagnostic techniques. The use of myocardial scanning and measurement of peak enzyme activity proved to be accurate indicators of myocardial infarction, but the electrocardiogram was of limited value. The measurement of creatine kinase MB isoenzyme had no diagnostic advantage over that of the other enzymes. There were two deaths in the series, one due to acute pancreatitis after aortic valve replacement and the other due to myocardial injury after mitral valve replacement. There were four non-fatal myocardial infarctions after aortic valve replacement, giving an incidence of 16%, and none after mitral valve replacement, giving an incidence of 4%.
对连续50例患者进行了研究，其中25例行主动脉瓣置换术，25例行二尖瓣置换术。通过系列心电图检查、术前和术后的锝-99m焦磷酸盐放射性核素扫描，以及系列酶（肌酸激酶、天冬氨酸转氨酶、尿素稳定乳酸脱氢酶）和肌酸激酶MB同工酶测定，以确定术前心肌梗死的发生率，并确定最合适的诊断技术。心肌扫描和酶活性峰值测定被证明是心肌梗死的准确指标，但心电图价值有限。肌酸激酶MB同工酶测定与其他酶相比没有诊断优势。该系列中有2例死亡，1例死于主动脉瓣置换术后急性胰腺炎，另1例死于二尖瓣置换术后心肌损伤。主动脉瓣置换术后有4例非致命性心肌梗死，发生率为16%，二尖瓣置换术后无心肌梗死发生，发生率为0%。
