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British Heart Journal logoLink to British Heart Journal
. 1980 Jun;43(6):609–616. doi: 10.1136/hrt.43.6.609

Comparison of enzymic with cineangiocardiographic estimations of myocardial infarct size.

N L Sammel, J G Stuckey, P W Brandt, R M Norris
PMCID: PMC482761  PMID: 7426141

Abstract

Comparisons were made between enzymic indices of myocardial infarct size (total creatine kinase appearance and peak enzyme activity) measured during the acute state of a first myocardial infarct in 32 male patients, and analysis of contraction abnormalities in biplane left ventricular cineangiocardiograms performed one month later. The cineangiocardiograms were analysed independently by two radiologists, each using two different methods for quantification of subjectively classified abnormalities of left ventricular wall motion. A very strong correlation was found between the two enzymic indices of infarct size and somewhat weaker correlations between assessment of contractility abnormalities made by the two radiologists using the same method, or by the same radiologist using the two different methods. Comparisons between enzymic and angiocardiographic indices for all infarcts showed correlation coefficients (r) within the range of 0.53 to 0.72. With all comparisons of enzymic with radiological indices r values were higher for anterior infarcts than for inferior infarcts, and there was a tendency for higher enzyme levels for a given degree of left ventricular damage in inferior than in anterior infarction. This may be the result of variable degrees of right ventricular damage in inferior infarction.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bleifeld W., Mathey D., Hanrath P., Buss H., Effert S. Infarct size estimated from serial serum creatine phosphokinase in relation to left ventricular hemodynamics. Circulation. 1977 Feb;55(2):303–311. doi: 10.1161/01.cir.55.2.303. [DOI] [PubMed] [Google Scholar]
  2. Brandt P. W., Partridge J. B., Wattie W. J. Coronary arteriography; method of presentation of the arteriogram report and a scoring system. Clin Radiol. 1977 Jul;28(4):361–365. doi: 10.1016/s0009-9260(77)80140-2. [DOI] [PubMed] [Google Scholar]
  3. Chaitman B. R., DeMots H., Bristow J. D., Rösch J., Rahimtoola S. H. Objective and subjective analysis of left ventricular angiograms. Circulation. 1975 Sep;52(3):420–425. doi: 10.1161/01.cir.52.3.420. [DOI] [PubMed] [Google Scholar]
  4. Gowda S. K., Gillespie T. A., Byrne J. D., Ambos H. D., Sobel B. E., Roberts R. Effects of external counterpulsation on enzymatically estimated infarct size and ventricular arrhythmia. Br Heart J. 1978 Mar;40(3):308–314. doi: 10.1136/hrt.40.3.308. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Heng M. K., Norris R. M., Singh B. N., Barratt-Boyes C. Effects of glucose and glucose-insulin-potassium on haemodynamics and enzyme release after acute myocardial infarction. Br Heart J. 1977 Jul;39(7):748–757. doi: 10.1136/hrt.39.7.748. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Heng M. K., Singh B. N., Norris R. M., John M. B., Elliot R. Relationship between epicardial ST-segment elevation and myocardial ischemic damage after experimental coronary artery occlusion in dogs. J Clin Invest. 1976 Dec;58(6):1317–1326. doi: 10.1172/JCI108587. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Herman M. V., Heinle R. A., Klein M. D., Gorlin R. Localized disorders in myocardial contraction. Asynergy and its role in congestive heart failure. N Engl J Med. 1967 Aug 3;277(5):222–232. doi: 10.1056/NEJM196708032770502. [DOI] [PubMed] [Google Scholar]
  8. Hutchins G. M., Bulkley B. H., Ridolfi R. L., Griffith L. S., Lohr F. T., Piasio M. A. Correlation of coronary arteriograms and left ventriculograms with postmortem studies. Circulation. 1977 Jul;56(1):32–37. doi: 10.1161/01.cir.56.1.32. [DOI] [PubMed] [Google Scholar]
  9. Ideker R. E., Behar V. S., Wagner G. S., Starr J. W., Starmer C. F., Lee K. L., Hackel D. B. Evaluation of asynergy as an indicator of myocardial fibrosis. Circulation. 1978 Apr;57(4):715–725. doi: 10.1161/01.cir.57.4.715. [DOI] [PubMed] [Google Scholar]
  10. Judkins M. P. Selective coronary arteriography. I. A percutaneous transfemoral technic. Radiology. 1967 Nov;89(5):815–824. doi: 10.1148/89.5.815. [DOI] [PubMed] [Google Scholar]
  11. Kjekshus J. K., Sobel B. E. Depressed myocardial creatine phosphokinase activity following experimental myocardial infarction in rabbit. Circ Res. 1970 Sep;27(3):403–414. doi: 10.1161/01.res.27.3.403. [DOI] [PubMed] [Google Scholar]
  12. Maroko P. R., Hillis L. D., Muller J. E., Tavazzi L., Heyndrickx G. R., Ray M., Chiariello M., Distante A., Askenazi J., Salerno J. Favorable effects of hyaluronidase on electrocardiographic evidence of necrosis in patients with acute myocardial infarction. N Engl J Med. 1977 Apr 21;296(16):898–903. doi: 10.1056/NEJM197704212961603. [DOI] [PubMed] [Google Scholar]
  13. Norris R. M., Clarke E. D., Sammel N. L., Smith W. M., Williams B. Protective effect of propranolol in threatened myocardial infarction. Lancet. 1978 Oct 28;2(8096):907–909. doi: 10.1016/s0140-6736(78)91628-8. [DOI] [PubMed] [Google Scholar]
  14. Norris R. M., Whitlock R. M., Barratt-Boyes C., Small C. W. Clinical measurement of myocardial infarct size. Modification of a method for the estimation of total creatine phosphokinase release after myocardial infarction. Circulation. 1975 Apr;51(4):614–620. doi: 10.1161/01.cir.51.4.614. [DOI] [PubMed] [Google Scholar]
  15. Peter T., Norris R. M., Clarke E. D., Heng M. K., Singh B. N., Williams B., Howell D. R., Ambler P. K. Reduction of enzyme levels by propranolol after acute myocardial infarction. Circulation. 1978 Jun;57(6):1091–1095. doi: 10.1161/01.cir.57.6.1091. [DOI] [PubMed] [Google Scholar]
  16. REINER L., MAZZOLENI A., RODRIGUEZ F. L., FREUDENTHAL R. R. The weight of the human heart. I. Normal cases. AMA Arch Pathol. 1959 Jul;68(1):58–73. [PubMed] [Google Scholar]
  17. Roe C. R., Cobb F. R., Starmer C. F. The relationship between enzymatic and histologic estimates of the extent of myocardial infarction in conscious dogs with permanent coronary occlusion. Circulation. 1977 Mar;55(3):438–449. doi: 10.1161/01.cir.55.3.438. [DOI] [PubMed] [Google Scholar]
  18. Rogers W. J., McDaniel H. G., Smith L. R., Mantle J. A., Russel R. O., Jr, Rackley C. E. Correlation of angiographic estimates of myocardial infarct size and accumulated release of creatine kinase MB isoenzyme in man. Circulation. 1977 Aug;56(2):199–205. doi: 10.1161/01.cir.56.2.199. [DOI] [PubMed] [Google Scholar]
  19. Rosalki S. B. An improved procedure for serum creatine phosphokinase determination. J Lab Clin Med. 1967 Apr;69(4):696–705. [PubMed] [Google Scholar]
  20. Sharpe D. N., Botvinick E. H., Shames D. M., Schiller N. B., Massie B. M., Chatterjee K., Parmley W. W. The noninvasive diagnosis of right ventricular infarction. Circulation. 1978 Mar;57(3):483–490. doi: 10.1161/01.cir.57.3.483. [DOI] [PubMed] [Google Scholar]
  21. Shell W. E., Kjekshus J. K., Sobel B. E. Quantitative assessment of the extent of myocardial infarction in the conscious dog by means of analysis of serial changes in serum creatine phosphokinase activity. J Clin Invest. 1971 Dec;50(12):2614–2625. doi: 10.1172/JCI106762. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Shell W. E., Lavelle J. F., Covell J. W., Sobel B. E. Early estimation of myocardial damage in conscious dogs and patients with evolving acute myocardial infarction. J Clin Invest. 1973 Oct;52(10):2579–2590. doi: 10.1172/JCI107450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Shell W. E., Sobel B. E. Protection of jeopardized ischemic myocardium by reduction of ventricular afterload. N Engl J Med. 1974 Sep 5;291(10):481–486. doi: 10.1056/NEJM197409052911001. [DOI] [PubMed] [Google Scholar]
  24. Slutsky A. S. Individualized values for the disappearance rate parameter (Kd) in the enzymatic estimation of infarct size. A critique. Circulation. 1977 Oct;56(4 Pt 1):545–547. doi: 10.1161/01.cir.56.4.545. [DOI] [PubMed] [Google Scholar]
  25. Sobel B. E., Bresnahan G. F., Shell W. E., Yoder R. D. Estimation of infarct size in man and its relation to prognosis. Circulation. 1972 Oct;46(4):640–648. doi: 10.1161/01.cir.46.4.640. [DOI] [PubMed] [Google Scholar]
  26. Sobel B. E., Markham J., Karlsberg R. P., Roberts R. The nature of disappearance of creatine kinase from the circulation and its influence on enzymatic estimation of infarct size. Circ Res. 1977 Dec;41(6):836–844. doi: 10.1161/01.res.41.6.836. [DOI] [PubMed] [Google Scholar]
  27. Vatner S. F., Baig H., Manders W. T., Maroko P. R. Effects of coronary artery reperfusion on myocardial infarct size calculated from creatine kinase. J Clin Invest. 1978 Apr;61(4):1048–1056. doi: 10.1172/JCI109004. [DOI] [PMC free article] [PubMed] [Google Scholar]

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