Predictive value of human fatty acid binding protein for myocardial ischemia and injury in perioperative period of cardiac surgery / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the value of human fatty acid binding protein (h-FABP) in predicting myocardial ischemia and injury in the perioperative period of cardiac surgery, we observed the dynamic changes of h-FABP in perioperative period of patients underwent coronary artery bypass grafting and ventricular septal defects repairing surgery, and evaluated the relationship of h-FABP and ischemia modified albumin (IMA), CK-MB, cTnI.</p><p><b>METHODS</b>Patients underwent coronary artery bypass grafting (n=30) and ventricular septal defect repairing (n=30) surgery between February 2008 and December 2008 were included in this study. Venous blood sample was obtained at preoperative, aortic clamping, aortic unclamping of 10 min, 2 h, 6 h, 12 h, 24 h for the measurements of h-FABP, IMA, cTnI and CK-MB.</p><p><b>RESULTS</b>h-FABP and IMA changed in the same way at various examined time points, h-FABP changes also paralleled cTnI and CK-MB changes, h-FABP peaked early during myocardial ischemia and injury and returned to baseline level at 2 h post myocardial ischemia and injury. Linear correlation analysis showed that the peak value of h-FABP was positively correlated with IMA, CK-MB and cTnI in both CABG group (r = 0.948, 0.964 and 0.961, P < 0.05) and in the VSD group (r = 0.986, 0.978 and 0.957).</p><p><b>CONCLUSIONS</b>h-FABP is an early diagnostic parameter reflecting perioperative myocardial ischemia and injury in cardiac surgery. Quantitative h-FABP monitoring could predict the severity of myocardial ischemia and injury early during cardiac surgery.</p>

The postoperative treatment of heart transplantation / 中国基层医药

Objective To discuss the treatment after orthotopic heart transplantation and the experiences in deal- ing with ins complications.Methods To summarize the postoperative monitoring and management of 9 cases of patients af- ter heart transplantation.Results All 9 cases got out of hospital after recovery with better postoperative cardiac function and life quality.Among of them acute rejection appeared in 1 case earlier and 2 cases later after operation.1 case died later and 1 case had acute renal failure earlier after operation.Conclusion The effective monitoring for immunity and the scientific use of immunosuppressive agents after orthotopie heart transplantation,the active prevention and treannent of complications and its consanguineous follow-up are key factors for improving the survival rate.

Comparison of perioperative myocardial enzyme changes among congenital, rheumatic and coronary artery diseases / 中华外科杂志

<p><b>OBJECTIVE</b>To observe and compare perioperative myocardial enzyme changes in 107 patients with congenital (CHD, n = 53), rheumatic (RHD, n = 40) and coronary artery (CAD, n = 14) diseases, and to find whether different diseases can affect the release and recovery of myocardial enzymes after heart operations.</p><p><b>METHODS</b>On the day before operation and the 1st, 3rd, 5th and the 8th day after operation, the venous blood was taken to measure the release of myocardial enzymes: aspartate aminotransferase (AST), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH) and LDH-1.</p><p><b>RESULTS</b>All the enzymes measured before operation in three groups were in the normal range; their release increased abruptly on the 1st day postoperatively to 2 - 15 times of those before operation; on the 3rd day, they recovered to some degrees, and on the 8th day they recovered to normal in all groups except LDH and LDH-1 in rh and CAD groups. Because the aortic cross-clamp time (CCT) had a good positive correlation to the release of myocardial enzymes, those patients whose CCT was over 60 minutes in three groups were compared revealing that the CCT was not different between three groups (P < 0.05). The release of CK, CK-MB and AST was significantly higher in CHD60 group than those in CHD60 and CAD60 groups, they recovered afterwards; while the release of DH and LDH-1 was higher in CAD60 group than those in CAD60 and in CHD60 groups from the 1st day to the 8th day postoperatively.</p><p><b>CONCLUSIONS</b>The release of all the 5 enzymes measured before operation was in normal range in selected CHD, RHD and CAD patients. The release peak and the recovery order of all enzymes were the same in three groups. The release of CK, CK-MB and AST was higher in CHD60 group than those in RHD60 and CAD60 groups on the 1st day. The release of LDH and LDH-1 was higher in RHD60 group than those in CHD60 and CAD60 groups from the 1st day to the 8th day postoperatively. The shorter the CCT is, the less the release of myocardial enzymes. Using the release of LDH and LDH-1 to evaluate the recovery of myocardial injury after open-heart operations was recommended.</p>