NIEWYDOLNOŚĆ SERCA I PŁUC, TRANSPLANTOLOGIA
Dynamics of the troponin I levels in the first days after heart transplantation (HTX) in the own material – a pilot study

Background : Troponin is a valuable and highly used marker for the assessment of the myocardial damage. Elevated tro­ponin levels are the result of myocardial injury irrespective of etiology.

Aim : Evaluation of dynamics of troponin I changes in the first days (since “0” to 3rd day) after heart transplantation (HTX).

Material and methods : Retrospective analysis of 42 patients aged 21 to 62 years, average age 47.4 ±12.4. Study group consisted of the

patients which hearts were harvested by two surgeons according to the identical protection scheme using CELSIOR cardioplegic solution. In all patients troponin I levels in the following days after HTX were measured.

Dynamics of troponin I changes was assessed, using the one-step immunoenzymatic test (normal values to 0.1 ng/ml) in all of the patients in the first days after HTX. The highest daily value was taken into the analysis.

Results : Average troponin I levels in the subsequent days after HTX were as follows: 21.7 ±22.1; 21.3 ±22.5; 17.6 ±20.3; 13.2 ±15.3 ng/ml. Based on ANOWA (Kruskal-Wallisa) test statistically significant troponin I levels decrease in the consecutive days after HTX (p = 0.0002) was noted. The biggest decrease was observed between days “0” and “3” and between days “1” and “3” (respectively: 54.1 and 53.7%); the smallest decreased appeared between days “0” and “1” after HTX (0.7%).

Conclusion : Immediately after HTX significantly elevated troponin I levels can be observed that could be connected with perioperative myocardial injury caused by the heart harvesting and transplantation.