A sensitivity analysis of enzymatic estimation of infarct size.

SHELL AND COWORKERS present a compartmental mathematical model representing a biological system (acute myocardial infarction) in which CPK appears in the blood and is eventually degraded. From this model they developed a method for estimation of the size of a volume of infarcted myocardium.'-3 This method would seem ideally suited for estimating the acute effect of an intervention on infarct size, and several investigators have proposed doing so.4-8 Up to this time, the literature on enzymatic estimation of infarct size has emphasized the situations in which it should be useful. However, there is little discussion of the potential limitation of this method. Therefore, we thought it would be useful to review the original work of Shell and to determine if any limitations existed, with particular emphasis on the sensitivity of infarct size estimation to the observed variations in model parameters.