Related Experiment Video

Updated: Aug 24, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Beating versus arrested heart coronary revascularization: evaluation by cardiac troponin I release

Kifah Alwan1, Pierre-Emmanuel Falcoz, Jihad Alwan

  • 1Department of Thoracic and Cardiovascular Surgery, Centre Hospitalier du Nord, Jdeidet, Zgharta, Lebanon.

The Annals of Thoracic Surgery
|June 3, 2004
PubMed

Insights

Off-pump coronary artery bypass graft surgery results in less myocardial injury than traditional arrested heart surgery. Beating heart revascularization shows significantly lower cardiac troponin I release, indicating reduced heart damage.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Biomarkers
  • Myocardial Protection

Background:

  • Prospective randomized study comparing two coronary artery bypass graft techniques.
  • Evaluation of myocardial injury using cardiac troponin I release.

Purpose of the Study:

  • To compare myocardial injury between beating heart revascularization and arrested heart revascularization.
  • To assess cardiac troponin I release as a marker for myocardial damage in first-time elective coronary artery bypass graft patients.

Main Methods:

  • Seventy patients were randomized into beating heart or arrested heart revascularization groups.
  • Serial cardiac troponin I measurements were taken at multiple time points post-procedure.
  • Analysis of covariance with repeated measures was used to analyze troponin I levels.

Main Results:

  • The arrested heart group exhibited significantly higher total cardiac troponin I release (8.25 ± 6.16 microg) compared to the beating heart group (3.18 ± 4.75 microg).
  • Elevated cardiac troponin I concentrations were consistently observed in the arrested heart group at 6, 9, 12, and 24 hours post-procedure (p < 0.0001).

Conclusions:

  • Beating heart revascularization leads to less myocardial damage than conventional coronary artery bypass graft with cardioplegic arrest.
  • Off-pump myocardial revascularization is associated with reduced cardiac troponin I release, suggesting improved myocardial protection.
Abstract

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...