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Document Details : Title: Does exercise-induced severe ischaemia result in elevation of plasma troponin-T level in patients with chronic coronary artery disease Author(s): AKDEMIR, Ilyas , AKSOY, Nur , AKSOY, Mehmet , DAVUTOGLU, Vedat , DINCKAL, Hakan Journal: Acta Cardiologica Volume: 57 Issue: 1 Date: February 2002 Pages: 13-18 DOI: 10.2143/AC.57.1.2005373 Abstract : Objective — It has been reported that the loss of cell membrane integrity during severe reversible ischaemia results in elevation of plasma troponin T (TnT) in unstable angina. We investigated whether TnT is released into circulation during severe ischaemia (e.g.on treadmill exercise testing) in patients with chronic coronary artery disease (CAD). Methods and results — The study comprised 54 patients who had angiographically documented CAD (22 of them had a prior history of myocardial infarction) and 18 normal subjects. All cases underwent exercise thallium (Tl)-201 SPECT myocardial perfusion imaging. Blood samples for TnT analysis were obtained for each patient at pre-exercise,immediately after and 12 hours after exercise. SPECT images were divided into 20 segments. Patients with redistribution defects &8805;5 were considered to have severe ischaemia. Sixteen patients had severe ischaemia on SPECT images. The mean TnT levels of the patients with severe ischaemia at pre-exercise, immediately after and 12 hours after exercise were 0.009±0.008, 0.012±0.009 and 0.010±0.010 ng/ml, respectively. In normal subjects the mean TnT levels were 0.012±0.009, 0.010±0.009, 0.010±0.010 ng/ml, respectively. There was no significant difference neither between the two groups nor within each group with respect to pre-exercise and post-exercise TnT results. All TnT levels were within normal limits (< 0.1 ng/dl). Additionally, when the patients were grouped according to other SPECT variables (patients with reversible defects vs. fixed defects;patients with increased lung uptake of Tl-201 vs.without lung uptake;patients with transient left ventricle dilatation vs. those without) and angiographic findings (patients with multivessel disease vs. normal subjects), there were no significant differences with respect to pre-exercise and post-exercise TnT results. Conclusion — Severe ischaemia does not result in the elevation of the plasma TnT level in patients with chronic CAD. |
