Document Detail


Myocardial injury in infants with congenital heart disease: evaluation by creatine kinase MB isoenzyme analysis.
MedLine Citation:
PMID:  7090995     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Total creatine kinase (CK) and the myocardial isoenzyme CK MB activity were prospectively determined in 282 children hospitalized for cardiac catheterization and evaluation for suspected congenital cardiac abnormalities and compared with a hospitalized control group of children without such abnormalities. The percent CK MB and CK MB activity were abnormally elevated in symptomatic children with a large left to right shunt due either to a large ventricular septal defect (n = 22; p less than 0.001) or to complete atrioventricular canal (n = 10; p less than 0.001). Serum CK MB activity and percent CK MB were significantly related to the size of the shunt and the age of presentation with clinical symptoms of congestive heart failure in infants with a ventricular septal defect. CK MB activity was abnormally elevated in infants with symptomatic coarctation of the aorta, either with or without a ventricular septal defect (n = 15; p less than 0.001), and in infants with symptomatic aortic stenosis (n = 4; p less than 0.02). In contrast, CK MB activity was normal in asymptomatic children with coarctation of the aorta (n = 14) or aortic stenosis (n = 8) despite comparable systolic pressure gradients. CK MB activity and percent CK MB were abnormally elevated in those children with the cyanotic congenital cardiac abnormalities of either transposition of the great arteries (n = 32; p less than 0.001) or right ventricular outflow tract obstruction (n = 31; p less than 0.001). These results suggest that children with congenital cardiac abnormalities may have significant myocardial cell injury and release of CK MB that may be detected by the determination of serum CK MB activity. Cell injury may be secondary to arterial desaturation or acute pressure-volume overload, or both, as manifested by clinical symptoms of heart failure and measured hemodynamic variables.
Authors:
R J Boucek; A G Kasselberg; R C Boerth; M D Parrish; T P Graham
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  50     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1982 Jul 
Date Detail:
Created Date:  1982-08-14     Completed Date:  1982-08-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  129-35     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aortic Coarctation / enzymology
Aortic Valve Stenosis / enzymology
Child, Preschool
Creatine Kinase / blood*
Heart Defects, Congenital / enzymology*
Heart Failure / enzymology*
Heart Septal Defects, Atrial / enzymology
Heart Septal Defects, Ventricular / enzymology
Hemodynamics
Humans
Infant
Infant, Newborn
Isoenzymes
Transposition of Great Vessels / enzymology
Chemical
Reg. No./Substance:
0/Isoenzymes; EC 2.7.3.2/Creatine Kinase

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