Cardiac enzymes after transmyocardial laser treatment with CO2 laser

Objectives-The aim of the present study was to examine postoperative serum levels of cardiac enzymes after transmyocardial laser treatment (TML) and t o evaluate any associations between this release, postoperative cardiac eve nts and change in ejection fraction after 3 months' follow-up. Design-Forty-nine patients with angina pectoris Canadian Cardiovascular Soc iety Angina Score Class III & IV refractory to medical therapy and untreata ble by coronary artery bypass or percutaneous transluminal angioplasty trea ted with CO2 laser were included. Inclusion criteria were age less than 75 years, left ventricular ejection fraction greater than or equal to 30% and myocardial regions with reversible ischemia, Serum levels of aspartate amin otranspherase (ASAT), alanine aminotranspherase (ALAT) and MB-isoenzymes of creatine kinase (CK-MB) were followed during the first 72 h after surgery. Ejection fractions were estimated by multiple-gated acquisition ventriculo graphy at inclusion and 3 months postoperatively, Results-A significant increase in serum markers of myocardial necrosis was observed 8h after surgery. A subsequent increase from 8 to 24 h after surge ry was associated with the presence of postoperative cardiac adverse events . An inverse correlation was found between peak level of cardiac enzymes an d change in ejection fraction from baseline to 3 months' follow-up. Conclusions-TML with CO2 laser is followed by a significant increase in ser um levels of cardiac enzymes after 8 h, Further significant increases are a ssociated with cardiac adverse events postoperatively. Peak enzyme values a re inversely correlated with change in ejection fraction from baseline to 3 months' follow-up.