Abstract |
The present study was performed to evaluate scintigraphic imaging with technetium 99m-labeled glucoheptonate and serum enzyme levels of creatine phosphokinase isoenzyme (MB-CPK) in the early diagnosis of perioperative acute myocardial infarction associated with saphenous vein bypass graft operations. Myocardial imaging was done in 27 patients (50% of whom were considered high-risk) before operation and again 5 hours after operation. Four of these patients (15%) had both electrocardiographic and serum MB-CPK evidence of acute myocardial infarction, and all 4 had developed positive postoperative scintigrams. Four other patients had only elevated serum MB-CPK, and scintigrams became positive after operation in 3 of them. In addition, serum MB-CPK 6 hours after operation was 83 +/- 21 mIU/ml (mean +/- standard error of the mean) in patients with positive postoperative scans compared with 24 +/- 5 mIU/ml in those patients with negative postoperative scintigrams (p less than 0.001). Myocardial imaging with 99mTc-glucoheptonate in the perioperative period is rapid, safe, and atraumatic. Furthermore, our results suggest that it is a sensitive method for the early diagnosis of perioperative acute myocardial infarction, and, when imaging is combined with serum MB-CPK isoenzyme analysis, the reliability of the diagnosis of acute myocardial infarction is enhanced even further. Only 1 of the patients who showed perioperative myocardial damage had acute hemodynamic compromise or obvious impairment of recovery in the immediate postoperative period, and the 30-day mortality of the total group was 4% (1 of 27).
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Authors | A J Roberts, J R Combes, J G Jacobstein, D R Alonso, M R Post, V A Subramanian, R M Abel, N Brachfeld, S A Kline, W A Gay Jr |
Journal | The Annals of thoracic surgery
(Ann Thorac Surg)
Vol. 27
Issue 1
Pg. 42-8
(Jan 1979)
ISSN: 0003-4975 [Print] Netherlands |
PMID | 313189
(Publication Type: Journal Article)
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Chemical References |
- Heptoses
- Isoenzymes
- Sugar Acids
- Technetium
- alpha-glucoheptonic acid
- Creatine Kinase
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Topics |
- Acute Disease
- Coronary Artery Bypass
(adverse effects)
- Creatine Kinase
(blood)
- Female
- Heart
(diagnostic imaging)
- Heptoses
- Humans
- Isoenzymes
(blood)
- Male
- Middle Aged
- Myocardial Infarction
(diagnosis, etiology)
- Postoperative Period
- Radionuclide Imaging
- Sugar Acids
- Technetium
- Time Factors
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