The Relationship between Serum Levels of Cardiac Enzymes and Junctional Ectopic‏ Tachycardia (JET) after Cardiac Surgery of Congenital Heart Disease

Khalilian, Mohammad Reza; Ebrahimi, Mehdi; Vahidshahi, Koroush; Ghasemi, Abdolrahim; Norouzi, Ali Reza; Emadi, Batool; Ghazavi, Mohammad; Saeidi, Seyedeh Laleh

doi:10.22038/ijp.2020.46829.3801

The Relationship between Serum Levels of Cardiac Enzymes and Junctional Ectopic‏ Tachycardia (JET) after Cardiac Surgery of Congenital Heart Disease

Authors

Mohammad Reza Khalilian ¹

Mehdi Ebrahimi ¹

Koroush Vahidshahi ¹

Abdolrahim Ghasemi ¹

Ali Reza Norouzi ¹

Batool Emadi ¹

Mohammad Ghazavi ¹

Seyedeh Laleh Saeidi ²

¹ Department of Pediatrics, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

² Master of Medical Education, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10.22038/ijp.2020.46829.3801

Abstract

Background
In this study, we aimed to survey the relationship between serum levels of cardiac enzymes and junctional ectopic‏ tachycardia (JET) after corrective surgery of congenital heart disease (CHD).
Materials and Methods: In this cohort study, 140 children with CHD who were hospitalized in intensive care unit of Shahid Modarres hospital in Tehran, Iran, were divided into case group (the JET group including 37 patients), and control group including 103 patients. These two groups were compared based on the previous studies and collected data.
Results: Based on the analysis of the area under the Receiver Operating Characteristic curve, the Creatine Kinase Myocardial Band (CK-MB) level assessment can predict the occurrence of JET after the surgery (area under the curve is 0.849, 95% confidence interval is 0.786- 0.911), and the best cut-off point for it is 95.5 to predict the occurrence of JET. So, CK-MB will diagnose the occurrence of JET with 97.3% sensitivity and 67% specificity‏. In the same analysis, the troponin level assessment can predict the occurrence of JET after the surgery (area under the curve is 0.877, 95% confidence interval is 0.821- 0.933). Accordingly, the best cut-off point for the troponin is 45 to predict the occurrence of junctional ectopic‏ tachycardia which will diagnose it with 97.3% sensitivity, and 72.8% specificity‏.
Conclusion
There is a positive correlation between the occurrence of JET after corrective surgery of CHD and an increase in the level of CK-MB and troponin enzymes. So that the level of CK-MB above 95.5 and the level of troponin above 45 might predict the occurrence of JET in these patients with high accuracy.

Keywords

Children

Cardiac surgery

Congenital heart disease

JET