Open AccessMyoglobin or enzymes for a rapid evaluation of infarction diagnosis?
Author(s) -
Mezger V.A.,
Kahles H.,
Stellwaag M.,
Spieckermann P. G.
Publication year - 1980
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960030316
Subject(s) - myoglobin , malate dehydrogenase , lactate dehydrogenase , medicine , creatine kinase , enzyme , perfusion , anaerobic exercise , myocardial infarction , infarction , cardiology , biochemistry , endocrinology , physiology , biology
Abstract Recently published clinical studies on patients with acute myocardial infarction (AMI) have documented that radioimmunologically determined serum peak concentrations of myoglobin (Mb) precede enzyme peak values. It has, therefore, been concluded that Mb (molecular weight 17,600) is liberated earlier from damaged myocardium than, for example, creatine kinase (CK, molecular weight 80,000). As rapid diagnosis is essential in the management of patients suffering from AMI, we have studied the liberation of cardiac enzymes and Mb using a nonrecirculating perfusion system. The release of malate dehydrogenase (MDH), lactate dehydrogenase (LDH), CK, and Mb from isolated guinea pig heart preparations was induced by anaerobic coronary perfusion at a constant flow rate. Thirty minutes after onset of anoxia there was a simultaneous increase in MDH, LDH, and Mb release. Maximum levels were reached between 120 and 180 min. The release curves for enzymes and Mb were approximately parallel. Close correlations exist between LDH/MDH (r = 0.94), CK/MDH (r = 0.98), LDH/Mb (r = 0.89), and MDH/Mb (r = 0.91). Based on these results and on calculations related to invasion and elimination kinetics, we suggest that the early peak of serum Mb in patients with AMI does not reflect a prior Mb release but depends on the more rapid rate of elimination of Mb from serum in comparison to enzymes.