Evaluation of Heart-Type Fatty-Acid–Binding Protein for Early Detection of Intraoperative Cardiac Damage | ||||
| Bulletin of Egyptian Society for Physiological Sciences | ||||
| Article 11, Volume 28, Issue 2, December 2008, Page 133-146 PDF (194.99 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/besps.2008.37051 | ||||
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| Authors | ||||
| Amira Hassouna* 1; Salwa fayez1; Emad Sarawy2; Mohamed El-Badawy2; Mohamed Othman2; Mohamed Fawzy3; Ayman Moharram3 | ||||
| 1Department of Medical Biochemistry, Faculty of Medicine Cairo University | ||||
| 2Cardiac Surgery National Heart Institute (NHI) | ||||
| 3Department of Critical Care, Faculty of Medicine Cairo University | ||||
| Abstract | ||||
| Myocardial injury occurs inpatients undergoing coronary artery bypass grafting (CABG) with and without cardiopulmonarybypass (CPB) (on-pump CABG) and (off-pump CABG) respectively. The extent of damage in both groups can be evaluated by the use of heart-type fatty-acid–binding protein (hFABP) and creatine kinase-MB (CK-MB) release. Also, cardiac surgery with the use of extra corporealcirculation (ECC) is associated with oxidative stress. The present study aims to evaluate myocardial injury and oxidative stress in these two groups, comparing between the two parameters indicating cardiac damage, also oxidative stress status was assessed by estimating serum levels of isoprostane during these major operations. Fifty adult patients of either sex were distributed to 1 of 2 groups: on-pump (n= 25), in which coronary revascularization was done with the use of CPB and moderate hypothermia; and off-pump (n=25), in which surgery was performed without the use of CPB. Twenty five healthy control subjects were also enrolled in the study. The current study showed a significant increase in the mean serum levels of h-FABP in on- pump and off pump groups compared to the control group. (133.60±49.41,58.29±16.67 and 4.33±2.97ng/ml respectively, p<0.001), and in the on-pump CABG group compared to off-pump CABG group (133.60±49.41vs 58.29±16.670ng/ml, P<0.001). The total amount of CK-MB released was significantly higher in the on-pump group compared to the off-pump and control groups (210.80 ± 32 .47 , 20.19 ± 4.22 and 13.70± 1.64 U/ml respectively, P<0.001). While there was no significant difference in the serum levels of CK-MB between both off pump and control groups (20.19 ± 4.222 and 13.70± 1.64 U/ml. There was a significant increase in the mean levels of serum isoprostane in on- pump and off pump groups compared to the control group (431.14±51.525, 329.83±24.620 and 132.34±15.57ng/ml respectively, p<0.001), and in the on-pump group compared to the off pump group (431.14±51.52 vs 329.83±24.62 ng/ml P<0.001). The lower levels of hFABP in the off-pump CABG group indicate that on-pump CABG with cardioplegic arrest causes more myocardial damage than does off-pump CABG. While normal CK- MB levels in the off –pump group indicate that this marker cannot detect the minor damage in that group, a finding which was detected by hFABP which increased significantlyin the off-pump CABG group compared to the controls. So, hFABP could be considered a better marker for early intraoperative detection of minimal cardiac damage. | ||||
| Keywords | ||||
| Coronary artery bypass grafting; on-pump CABG; off-pump CABG; hFABP; CK-MB; Oxidative Stress | ||||
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