Correlation of angiographic estimates of myocardial infarct size and accumulated release of creatine kinase MB isoenzyme in man.

Abstract

Accumulated creatine kinase MB isoenzyme release (sigma CK-MB) during acute myocardial infarction was correlated with biplane left ventricular (LV) angiographic estimates of percent abnormally contracting segment (%ACS) and ejection fraction (EF) in 35 patients who underwent diagnostic angiography at a mean of 33 +/- 4 days post myocardial infarction (MI). Of the 35 patients, 18 had no evidence of prior MI and their sigma CK-MB showed good correlation with %ACS (r = 0.84) and with EF (r = - 0.78). An additional two patients with first (inferior) infarct secondary to stenosis of the right coronary artery proximal to the origin of the right ventricular arterial blood supply had disproportionately large sigma CK-MB, suggesting a combination of LV and RV necrosis. In the 15 patients with prior infarct, there was no significant correlation between sigma CK-MB and %ACS or EF. However, in the subgroup of patients with anterior MI, %ACS correlated with sigma CK-MB, both in patients with no prior MI (r = 0.88, N = 12) and in patients with prior MI (r = 0.69, N = 9). These independent angiographic and enzymatic data suggest that enzymatic infarct size estimates utilizing accumulated CK-MB release may be a valid and reliable clinical measure for assessing the extent of LV necrosis in the setting of acute anterior myocardial infarction. However, limitations may exists in certain cases of inferior MI, probably because of concomitant right and left ventricle necrosis.

Usefulness of Rapid Quantitative Measurement of Myoglobin and Troponin T in Early Diagnosis of Acute Myocardial Infarction

“…The maximum concentration of CK-MB is related to the grade of myocardial damage, [23][24][25][26] and the present study showed a close relationship between the maximum concentrations of M and CK-MB. The study data suggested that the maximum concentration of M, which was obtained at 6-12 h after onset, could be related to the grade of myocardial damage.…”

Ischemic Preconditioning Effect of Prodromal Angina Is Attenuated in Acute Myocardial Infarction Patients With Hypertensive Left Ventricular Hypertrophy

“…Although the accumulated release of CK and CK-MB is more accurate for estimating infarct size than peak CK and CK-MB levels, 35 we were restrained from using the former because of the lack of some measurement data after 24 h. Although large epidemiological studies have extensively used M-mode echocardiography, technical limitations exist when calculating LVM in patients with myocardial infarction, particularly in those who have a regional wall motion abnormality. However, several studies have demonstrated a strong relationship between LV hypertrophy detected by echocardiography and necropsy.…”

Estimation of acute myocardial infarct size in man by serum CK-MB measurements.

“…The SEE is about 25%, which, on average, gives a 95% confidence limit of ± 50% for the individual IS. Studies in man concerning the accuracy of estimating IS by serum CK and CK-MB measurements have shown a good correlation between accumulated serum CK and CK-MB and different indirect expressions of IS.10, [16][17][18] Whether the kinetics of CK-MB should be described as a one-or multicompartment model has been discussed. The onecompartment theory is supported by a monoexponential elimination of labeled CK in experimental dog studies,9' 29 but this is probably a simplification of a complex biologic system.…”

“…Recent studies comparing IS estimated from serum CK-MB with indirect indicators indicate that this is the case. [16][17][18] We demonstrated that the IS can be calculated just as well with only few blood samples as with serial samples,"' allowing us to examine the reliability of en-…”