{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T13:07:10Z","timestamp":1772716030139,"version":"3.50.1"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[1996,9]]},"abstract":"<jats:p>OBJECTIVE: Myocardial injury is an important cause of mortality and morbidity after paediatric cardiac surgery. Data obtained from studies in animals imply that juvenile myocardium is more resistant to the effects of ischaemia and reperfusion than adult myocardium but there is little confirmatory evidence in the clinical setting. DESIGN: Prospective observational study of biochemical markers of myocardial injury in a paediatric population undergoing cardiac surgery. SETTING: Tertiary referral centre for paediatric cardiac surgery. PATIENTS: Forty patients undergoing paediatric cardiac surgery of varying complexity including closure of atrial and ventricular septal defects and arterial switch for simple transposition. A control group included patients undergoing thoracotomy for closure of a patent ductus arteriosus or repair of a coarctation. INTERVENTIONS: Serial measurements of myoglobin, the MB isoenzyme of creatine kinase (CK-MB), and the highly specific markers of myocardial damage cardiac troponin T (cTnT) and I (cTnI) were made before and 1, 6, 24, and 48 to 72 hours after operation. RESULTS: There were significant increases in myoglobin and CK-MB, but not cTnT or cTnI, in the control group. There were significant increases in the four biochemical markers in all the cardiac operations but especially in the ventricular septal defect and transposition group. Increases in CK-MB and cTnT were about five times greater than those previously reported in adult patients. CONCLUSIONS: (i) Cardiac troponins are more specific markers of myocardial injury in paediatric cardiac surgery than myoglobin and CK-MB. (ii) Paediatric myocardium seems to be more vulnerable to injury during cardiac surgery than adult myocardium.<\/jats:p>","DOI":"10.1136\/hrt.76.3.214","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:46:00Z","timestamp":1190137560000},"page":"214-217","source":"Crossref","is-referenced-by-count":45,"title":["Vulnerability of paediatric myocardium to cardiac surgery."],"prefix":"10.1136","volume":"76","author":[{"given":"D. P.","family":"Taggart","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Hadjinikolas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Yap","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Hooper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Kemp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Hue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Yacoub","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. C.","family":"Lincoln","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,9,1]]},"reference":[{"key":"ref_1","first-page":"168","article-title":"Pediatric cardioplegic techniques. Sem Thorac Cardiovasc Surg","volume":"5","author":"Drinkwater, D.C.; Laks, H.","year":"1993","unstructured":"Drinkwater DC, Laks H. Pediatric cardioplegic techniques. Sem Thorac Cardiovasc Surg 1993;5:168-75."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S0022-5223(19)38365-5","article-title":"Cardioplegic protection of the child's heart","volume":"88","author":"Bull, C.; Cooper, J.; Stark, J.","year":"1984","unstructured":"Bull C, Cooper J, Stark J. Cardioplegic protection of the child's heart. J Thorac Cardiovasc Surg 1984;88:287-93.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/0002-9149(81)90079-5","article-title":"Intracardiac surgery in infants under age 3 months: incremental risk factors for hospital mortality","volume":"48","author":"Kirklin, J.K.; Blackstone, E.H.; Kirklin, J.W.; McKay, R.; Pacifico, A.D.; Bargeron, L.M.","year":"1981","unstructured":"Kirklin JK, Blackstone EH, Kirklin JW, McKay R, Pacifico AD, Bargeron LM. Intracardiac surgery in infants under age 3 months: incremental risk factors for hospital mortality. Am J Cardiol 1981;48:500-6.","journal-title":"Am J Cardiol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/S0022-5223(19)35691-0","article-title":"The effect of hypothermic ischemia on recovery of left ventricular function and preload reserve in the neonatal heart","volume":"95","author":"Bove, E.L.; Gallagher, K.P.; Drake, D.H.","year":"1988","unstructured":"Bove EL, Gallagher KP, Drake DH, et al. The effect of hypothermic ischemia on recovery of left ventricular function and preload reserve in the neonatal heart. J Thorac Cardiovasc Surg 1988;95:814-8.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"ref_5","first-page":"150","article-title":"Resistance of neonatal myocardium to injury during normothermic and hypothermic ischemic arrest and reperfusion","volume":"76","author":"Grice, W.N.; Konishi, T.; Apstein, C.S.","year":"1987","unstructured":"Grice WN, Konishi T, Apstein CS. Resistance of neonatal myocardium to injury during normothermic and hypothermic ischemic arrest and reperfusion. Circulation 1987;76 (suppl V):V-150-5.","journal-title":"Circulation"},{"key":"ref_6","first-page":"879","article-title":"Studies of myocardial protection in the immature heart. I. Enhanced tolerance of immature vs adult myocardium to global ischemia with reference to metabolic differences","volume":"100","author":"Julia, P.; Kofsky, E.R.; Buckberg, G.D.; Young, H.H.; Bugyi, H.I.","year":"1990","unstructured":"Julia P, Kofsky ER, Buckberg GD, Young HH, Bugyi HI. Studies of myocardial protection in the immature heart. I. Enhanced tolerance of immature vs adult myocardium to global ischemia with reference to metabolic differences. Y Thorac Cardiovasc Surg 1990;100:879-887.","journal-title":"Y Thorac Cardiovasc Surg"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/0009-8981(90)90217-G","article-title":"Purines, lactate and phosphate release from child and adult heart during cardioplegic arrest","volume":"192","author":"Smolenski, R.T.; Swierczynski, J.; Narkiewicz, M.; Zydowo, M.M.","year":"1990","unstructured":"Smolenski RT, Swierczynski J, Narkiewicz M, Zydowo MM. Purines, lactate and phosphate release from child and adult heart during cardioplegic arrest. Clinica Chimica Acta 1990;192:155-64.","journal-title":"Clinica Chimica Acta"},{"key":"ref_8","first-page":"50","article-title":"Biochemical markers of myocardial injury. Is MB Creatine Kinase the choice for the 1990s ?","volume":"88","author":"Adams, J.E.; Abendschein, D.R.; Jaffe, A.S.","year":"1993","unstructured":"Adams JE, Abendschein DR, Jaffe AS. Biochemical markers of myocardial injury. Is MB Creatine Kinase the choice for the 1990s ? Circulation 1993;88:50-763.","journal-title":"Circulation"},{"key":"ref_9","first-page":"779","article-title":"Clinical biochemistry in the investigation of acute chest pain and the acute abdomen","volume-title":"Clinical biochemistry-metabolic and clinical aspects","author":"Hooper, J.; Bangert, S.K.","year":"1995","unstructured":"Hooper J, Bangert SK. Clinical biochemistry in the investigation of acute chest pain and the acute abdomen. In: Marshall WJ, Bangert SK, eds. Clinical biochemistry-metabolic and clinical aspects. New York:Churchill Livingstone, 1995:779-87."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1136\/hrt.71.2.177","article-title":"Lack of cardioprotective efficacy of allopurinol in coronary artery surgery","volume":"71","author":"Taggart, D.P.; Young, V.; Hooper, J.; Kemp, M.; Walesby, R.; Magee, P.; Wright, J.E.","year":"1994","unstructured":"Taggart DP, Young V, Hooper J, Kemp M, Walesby R, Magee P, Wright JE. Lack of cardioprotective efficacy of allopurinol in coronary artery surgery. Br Heart J 1994; 71:177-81.","journal-title":"Br Heart J"},{"key":"ref_11","first-page":"136","article-title":"Intermittent ischaemic arrest and cardioplegia in coronary artery surgery: coming full circle?","volume":"72","author":"Taggart, D.P.; Bhusari, S.; Hooper, J.; Kemp, M.; Magee, P.; Wright, J.E.; Walesby, R.","year":"1994","unstructured":"Taggart DP, Bhusari S, Hooper J, Kemp M, Magee P, Wright JE, Walesby R. 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