Horie M, Yasue H, Omote S, Takizawa A, Nagao M, Nishida S, Kubota J
Am J Cardiol. 1986 Jan 1;57(1):76-81. doi: 10.1016/0002-9149(86)90955-0.
The relations of several creatine kinase (CK) variables to angiographic left ventricular ejection fraction and abnormally contracting segments in the chronic phase were examined in 2 groups of patients with a first anterior acute myocardial infarction. In group A (n = 22), emergency coronary angiography was performed and nonsurgical early reperfusion was attempted. Such an early revascularization, which was considered partially present in group B (n = 16), which received conventional therapy, shifted the CK time-activity curve to the left and altered its relation to angiographic cardiac function. At similar levels of peak CK, myocardial damage was significantly smaller in patients with successful thrombolysis than in those with unsuccessful reperfusion and conventional therapy (p less than 0.01). In patients whose infarct was considered to be moderate according to peak CK (1,000 to 3,000 U/liter), there was significant correlation between time to peak CK and left ventricular ejection fraction or percent abnormally contracting segments irrespective of their group. The results suggest that one should take into account rapid washout and shorter time to peak CK when estimating enzymatic infarct size in humans. The multivariate analysis of cardiac function with peak CK and time to peak CK resulted in a closer correlation in all patients. Such a correction in the time to peak CK may be a clinically useful approach for better interpretation of infarct size.
在两组首次发生前壁急性心肌梗死的患者中，研究了几个肌酸激酶（CK）变量与慢性期血管造影左心室射血分数及异常收缩节段的关系。A组（n = 22）患者接受了急诊冠状动脉造影并尝试进行非手术早期再灌注。这种早期血管重建在接受传统治疗的B组（n = 16）中部分存在，它使CK时间 - 活性曲线左移并改变了其与血管造影心脏功能的关系。在CK峰值水平相似时，溶栓成功患者的心肌损伤明显小于再灌注失败及接受传统治疗的患者（p < 0.01）。根据CK峰值（1000至3000 U/升）判断梗死为中度的患者，无论其所属组别，CK达峰时间与左心室射血分数或异常收缩节段百分比之间均存在显著相关性。结果表明，在评估人类酶学梗死大小时，应考虑到快速清除和CK达峰时间较短的情况。对心脏功能与CK峰值及CK达峰时间进行多变量分析，在所有患者中得出了更密切的相关性。CK达峰时间的这种校正可能是一种临床上有用的方法，有助于更好地解释梗死大小。
