Leistungsfähigkeit der Troponinbestimmung in der kardialen Diagnostik

The central aim of cardiac surgery is to preserve myocardial function during the perioperative period whilst operating on the heart. Different strategies have evolved to protect the heart during an obligatory ischaemic insult which have resulted in safer surgery and acceptable myocardial function in the post-operative period [1]. It is likely that all cardiac operations cause some degree of cardiac injury but until the development of the newer markers of myocardial damage such as troponin-T, troponin-I and CK-MB isoforms, the assessment of injury was difficult to define [2]. With the use of these novel markers the assessment of pre, peri and post-operative injury has been more precise. These new markers of myocardial injury also allow comparisons of different strategies of myocardial protection [3,4]. In the field of cardiac transplantation there is the potential for myocardial damage in the donor organ prior to transplantation (pre-operative), during the “obligatory” ischaemic time between procurement and reperfusion in the recipient (peri-operative) and during the rejection process in the post-operative period. The role of newer markers of myocardial injury has been explored in each of these settings in patients undergoing transplantation at St. George’s Hospital and the results of these studies form the basis of this chapter.

Jon R. Anderson

Papers

The Assessment of Myocardial Damage in Heart Transplantation