This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Force, T. Articles by Parisi, A. F. Search for Related Content PubMed PubMed Citation Articles by Force, T. Articles by Parisi, A. F.

Circulation, Vol 72, 781-789, Copyright © 1985 by American Heart Association

ARTICLES

Non-Q wave perioperative myocardial infarction: assessment of the incidence and severity of regional dysfunction with quantitative two- dimensional echocardiography

T Force, AJ Kemper, P Bloomfield, DE Tow, SF Khuri, M Josa and AF Parisi

Since the widespread use of hypothermic potassium cardioplegia began, marked reductions in perioperative mortality and the rate of Q wave- associated myocardial infarctions have been noted. No study to date has evaluated whether there has been an equally dramatic improvement in the incidence of postoperative myocardial infarctions unassociated with Q wave development. We used a previously validated quantitative two- dimensional echocardiographic analytic algorithm to determine the incidence and severity of regional wall motion abnormalities (RWMAs) and first-pass radionuclide ventriculography to assess deterioration in global left ventricular function in the four following groups of patients (total n = 65): (1) those with peak postoperative creatine kinase (CK)-MB levels equal to or less than the mean value for patients undergoing coronary artery bypass surgery at our institution (n = 10), (2) those with CK-MB levels between the mean and 1 SD above the mean (n = 10), (3) those with peak CK-MB levels higher than 1 SD above the mean (n = 25), and (4) those with new pathologic Q waves on the postoperative electrocardiogram (n = 20). All patients had electrocardiograms without pathologic Q waves and normal wall motion and ejection fraction by contrast ventriculography before surgery. The incidence of postoperative RWMA by two-dimensional echocardiography for groups 1 through 4 was 0%, 20%, 55%, and 89%, respectively. Percent of abnormal left ventricular segments, wall motion scores, and the deterioration in left ventricular ejection fraction as assessed by radionuclide ventriculography were similar for patients with new RWMAs whether or not new Q waves developed (p = NS for all).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				F. Capuano, C. Simon, A. Roscitano, G. Sclafani, E. Tonelli, and R. Sinatra Cardiac Troponin I Concentrations During On-Pump Coronary Artery Surgery Asian Cardiovasc Thorac Ann, December 1, 2007; 15(6): 502 - 506. [Abstract] [Full Text] [PDF]

				K. Klatte, B. R. Chaitman, P. Theroux, J. A. Gavard, K. Stocke, S. Boyce, C. Bartels, B. Keller, A. Jessel, and for the GUARDIAN Investigators Increased mortality after coronary artery bypass graft surgery is associated with increased levels of postoperative creatine kinase-myocardial band isoenzyme release: Results from the GUARDIAN trial J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1070 - 1077. [Abstract] [Full Text] [PDF]

				J. C. K. Fitch, S. Rollins, L. Matis, B. Alford, S. Aranki, C. D. Collard, M. Dewar, J. Elefteriades, R. Hines, G. Kopf, et al. Pharmacology and Biological Efficacy of a Recombinant, Humanized, Single-Chain Antibody C5 Complement Inhibitor in Patients Undergoing Coronary Artery Bypass Graft Surgery With Cardiopulmonary Bypass Circulation, December 21, 1999; 100(25): 2499 - 2506. [Abstract] [Full Text] [PDF]

				J.-L. Fellahi, P. Leger, E. Philippe, M. Arthaud, B. Riou, I. Gandjbakhch, and P. Coriat Pericardial Cardiac Troponin I Release After Coronary Artery Bypass Grafting Anesth. Analg., October 1, 1999; 89(4): 829 - 829. [Abstract] [Full Text] [PDF]

				G. Babatasi, M. Massetti, P. Nataf, S. Fradin, D. Agostini, G. Grollier, J.-L. Gerard, and A. Khayat Minimally invasive coronary surgery: surgical considerations and assessment of cardiac troponin I Eur. J. Cardiothorac. Surg., October 1, 1998; 14(suppl_1): S82 - S87. [Abstract] [Full Text] [PDF]

				J. E. Adams, G. A. Sicard, B. T. Allen, K. H. Bridwell, L. G. Lenke, V. G. Davila-Roman, G. S. Bodor, J. H. Ladenson, and A. S. Jaffe Diagnosis of Perioperative Myocardial Infarction with Measurement of Cardiac Troponin I N. Engl. J. Med., March 10, 1994; 330(10): 670 - 674. [Abstract] [Full Text]