TROPONIN – OUR EXPERIENCE IN DETERMINATION OF MYOCARDIAL ISCHEMIC DAMAGE IN POSTOPERATIVE PERIOD OF CARDIAC SURGERY IN PEDIATRIC POPULATION
Date Issued
2017
Author(s)
Lj. Kojik
Radica Muratovska-Delimitova
M. Kimovska Hristov
T. Voinovska
S. Neskova
DOI
10.1515/jpm-2017-2008
Abstract
Background: Troponin is an important biomarker for early evidence of ischemic damage to the
heart tissue after a cardiac surgery conducted in the pediatric and adult populations. Elevated
values correlate with perioperative and postoperative procedures and practices and are a
significant factor for possible later complications.
Methods: The study included 30 operated children divided into two groups, the first group of
operated children without a cardiopulmonary bypass (CPB), and the second group of operated
children with a cardiopulmonary bypass. The correlation between elevated troponin and
perioperative and postoperative parameters was monitored (duration of CPB and aortic crossclamping time, stay in the intensive care and therapy during respiratory support, during inotropic
support, the presence of renal or hepatic failure, postoperative complications).
Results: In both groups of operated children troponin was elevated. In the first group of children
operated without cardiopulmonary bypass, the average value of troponin was 9.5 ng/ml (range 6.5-
16.8 ng/l). In the second group of operated children (27 children) with cardiopulmonary bypass, the
mean value of duration was 81.5 minutes (range 18 to 296 minutes), and X-cross time (aortic crossclamping time) in the same group of children was with a mean value of 28.2 minutes (range of 0-86
min.). In the first group of children the mean value of troponin was 9.5 ng/ml and in the second
group 23.0 ng/ml. The obtained values of troponin have confirmed a highly significant correlation
with perioperative and postoperative procedures.
Conclusions: Troponin is a prognostic marker for early evidence of ischemic and necrotic changes
of cardiac infarction in the pediatric population in cardiac surgery. Elevated values in the first 24-48
hours are significantly correlated with perioperative and postoperative procedures and are an
important indicator of the extent of damage to the heart tissue. But its prognostic significance of
myocardial ischemic changes is lost in a period between 2-6 months after cardiac surgery.
heart tissue after a cardiac surgery conducted in the pediatric and adult populations. Elevated
values correlate with perioperative and postoperative procedures and practices and are a
significant factor for possible later complications.
Methods: The study included 30 operated children divided into two groups, the first group of
operated children without a cardiopulmonary bypass (CPB), and the second group of operated
children with a cardiopulmonary bypass. The correlation between elevated troponin and
perioperative and postoperative parameters was monitored (duration of CPB and aortic crossclamping time, stay in the intensive care and therapy during respiratory support, during inotropic
support, the presence of renal or hepatic failure, postoperative complications).
Results: In both groups of operated children troponin was elevated. In the first group of children
operated without cardiopulmonary bypass, the average value of troponin was 9.5 ng/ml (range 6.5-
16.8 ng/l). In the second group of operated children (27 children) with cardiopulmonary bypass, the
mean value of duration was 81.5 minutes (range 18 to 296 minutes), and X-cross time (aortic crossclamping time) in the same group of children was with a mean value of 28.2 minutes (range of 0-86
min.). In the first group of children the mean value of troponin was 9.5 ng/ml and in the second
group 23.0 ng/ml. The obtained values of troponin have confirmed a highly significant correlation
with perioperative and postoperative procedures.
Conclusions: Troponin is a prognostic marker for early evidence of ischemic and necrotic changes
of cardiac infarction in the pediatric population in cardiac surgery. Elevated values in the first 24-48
hours are significantly correlated with perioperative and postoperative procedures and are an
important indicator of the extent of damage to the heart tissue. But its prognostic significance of
myocardial ischemic changes is lost in a period between 2-6 months after cardiac surgery.