Document Detail

Myocardial infarct size can be estimated from serial plasma myoglobin measurements within 4 hours of reperfusion.
MedLine Citation:
PMID:  8504496     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: An early estimation of infarct size is useful for the appropriate early treatment of patients with acute myocardial infarction. We evaluated how early and how accurately infarct size could be estimated from serial plasma myoglobin (Mb) measurements in patients with successful reperfusion. METHODS AND RESULTS: We measured plasma Mb and creatine kinase (CK) in 35 patients in whom reperfusion therapy was successfully performed. Blood samples were collected at 15-minute intervals for 2 hours after reperfusion, at 30-minute intervals for the subsequent 2 hours, and at 3-6-hour intervals until 52 hours after reperfusion. Plasma Mb was measured by a newly developed turbidimetric latex agglutination assay. Total Mb and CK release (sigma Mb, sigma CK) were calculated with a one-compartment model. The mean chord motion in the most hypokinetic 50% of the infarct-related artery territory was calculated from follow-up ventriculograms as an index of the severity of regional hypokinesis. There were significant correlations between sigma Mb and sigma CK (r = 0.89), between log sigma Mb and the severity of regional hypokinesis (r = -0.85), and between log sigma CK and the severity of regional hypokinesis (r = -0.74). The time required for the cumulative Mb release curves to reach a plateau was 64 +/- 28 minutes. An additional 53 +/- 14 minutes was required to calculate the disappearance rate constant of Mb, and 15 minutes was necessary for the assay. Therefore, the total time required for sigma Mb to be available was 132 +/- 40 minutes, significantly shorter than the time required for sigma CK, 24.3 +/- 9.1 hours (p < 0.001). The infarct size could be estimated from the sigma Mb in 34 of 35 patients within 4 hours of reperfusion. CONCLUSIONS: Infarct size can be estimated accurately 4 hours after reperfusion by calculating the sigma Mb in patients with successful reperfusion.
T Yamashita; S Abe; S Arima; K Nomoto; M Miyata; I Maruyama; H Toda; H Okino; Y Atsuchi; M Tahara
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  87     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-07-02     Completed Date:  1993-07-02     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1840-9     Citation Subset:  AIM; IM    
First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
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MeSH Terms
Clinical Enzyme Tests
Coronary Angiography
Creatine Kinase / blood
Latex Fixation Tests
Middle Aged
Myocardial Infarction / blood,  diagnosis*,  therapy
Myocardial Reperfusion / methods
Myoglobin / blood*
Time Factors
Reg. No./Substance:
0/Myoglobin; EC Kinase

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