Clin Chem Lab Med 2008;46(12):1726–1728  2008 by Walter de Gruyter • Berlin • New York. DOI 10.1515/CCLM.2008.341 2007/314 Article in press - uncorrected proof Short Communication Use of the biochip microarray system in detection of myocardial injury caused by radiofrequency catheter ablation Radek Pudil 1, *, Petr Par ˇı´zek 1 , Milos ˇ Tichy ´ 2,3 , Lude ˇ k Haman 1,3 , Lucie Hora ´ kova ´ 1 , Martina Ulrychova ´ 2 , Jan Voja ´c ˇek 1 and Vladimı´r Palic ˇka 2 1 First Department of Medicine, Charles University Prague, Faculty of Medicine, Hradec Kralove, Czech Republic 2 Institute of Clinical Biochemistry and Diagnostics, Charles University Prague, Faculty of Medicine, Hradec Kralove, Czech Republic 3 University of Defense Brno, Faculty of Military Health Sciences, Hradec Kralove, Czech Republic Abstract Background: In a prospective study, we measured plasma markers of myocardial damage induced by radiofrequency catheter ablation (RFA) with the pro- tein biochip microarray system. Methods: A total of 32 consecutive patients under- going RFA for atrioventricular nodal re-entry tachy- cardia (AVNRT), right atrial flutter (AFL) and atrial fibrillation (AF) were included in the study. Cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK- MB), heart-type fatty acid binding protein (hFABP) and glycogen phosphorylase BB (GPBB) were measured using biochip array technology at baseline and 24 h after the procedure. Results: Values for all markers increased 24 h after RFA (cTnI: 0.92"0.49 mg/L vs. 0.33"0.06 mg/L, p-0.001; CK-MB: 3.79"2.04 mg/L vs. 1.85"0.55 mg/L, p-0.001; hFABP: 2.82"0.95 mg/L vs. 2.00"0.95 mg/L, p-0.001; GPBB: 9.07"5.83 mg/L vs. 4.70"2.50 mg/L, p-0.001). The correlations between plasma marker levels and RFA time were cTnI: rs0.63, p-0.01; CK- MB: rs0.75, p-0.01; hFABP: rs0.55, p-0.05, GPBB: rs0.51, p-0.05; the correlation between RFA time and number of RF applications was significant (rs0.81, p-0.001). Patients with RFA due to AF or flutter had elevated cTnI, CK-MB and hFABP levels compared to patients with AVNRT (cTnI: 1.14" 0.49 mg/L vs. 0.59"0.25 mg/L, p-0.05; CK-MB: 4.46" 2.07 mg/L vs. 2.81"1.54 mg/L, p-0.05; hFABP: 3.21" 0.98 mg/L vs. 2.25"0.54 mg/L, p-0.01). Conclusions: Myocardial injury induced by RFA can be detected by cTnI, CK-MB, hFABP and GPBB. *Corresponding author: Assoc. Prof. Radek Pudil, MD, PhD, 1st Department of Medicine, Charles University Prague, Faculty of Medicine, Sokolska 581, 500 05 Hradec Kralove, Czech Republic Phone: q420-49-5833249, Fax: q420-49-5832006, E-mail: pudilradek@yahoo.com Received June 26, 2008; accepted August 13, 2008 Plasma cTnI, CK-MB and hFABP levels significantly increased in patients with AFL and AF compared to patients with AVNRT. The increase of cTnI, CK-MB and GPBB levels correlates with the total duration of RFA. Clin Chem Lab Med 2008;46:1726–8. Keywords: biochip microarray system; cardiac tropo- nin I; creatine kinase isoenzyme MB (CK-MB); glyco- gen phosphorylase isoenzyme BB; heart-type fatty acid-binding protein; myocardial injury; radiofrequen- cy catheter ablation. Radiofrequency catheter ablation (RFA) therapy has become standard therapy for a broad spectrum of car- diac arrhythmias. Current radiofrequency application incurs small myocardial damage by thermal injury (1). These lesions are considered to be small because of the low postprocedural creatine kinase (CK) levels. There are at least two reasons leading us to investi- gate myocardial injury: 1) RF treatment of some arrhythmias, e.g., atrial fibrillation (AF) or right atrial flutter (AFL), requires an increased number of RF applications, and 2) thermal inactivation of some markers, e.g., CK, caused by RF energy could lead to underestimation of the size of myocardial injury (2). Troponins (T and I) and CK isoenzyme MB (CK-MB) are the gold standards for diagnosis of myocardial injury (2, 3). Recently, heart-type fatty acid-binding protein (hFABP) and glycogen phosphorylase isoen- zyme BB (GPBB) have been evaluated as new markers of myocardial injury (4). hFABP is a novel small cyto- solic protein that is abundant in the heart, and is released into the circulation following myocardial ischemia and necrosis (5). GPBB is a key enzyme of glycogenolysis. Its degree of association with the sar- coplasmatic reticulum glycogenolysis complex depends essentially on the metabolic state of the myocardium. With the onset of tissue hypoxia, GPBB is converted from a structurally bound into a cyto- plasmatic form and released into circulation (6). The aims of the present study were: 1) to investi- gate whether measurement of cardiac markers w car- diac troponin I (cTnI), CK-MB, hFABP and GPBBx using new biochip array technology can detect even small myocardial injury in patients undergoing RFA; and 2) to evaluate if simultaneous measurement of mul- tiple cardiac markers has advantages compared to single marker strategy. A total of 32 consecutive patients (18 men and 14 women, aged 55"14 years, range 23–64) underwent RFA for symptomatic atrioventricular nodal re-entry Brought to you by | Brigham Young University Authenticated Download Date | 5/19/15 6:49 AM