Omura T, Teragaki M, Takagi M, Tani T, Nishida Y, Yamagishi H, Yanagi S, Nishikimi T, Yoshiyama M, Toda I
First Department of Internal Medicine, Osaka City University Medical School, Japan.
Jpn Circ J. 1995 Mar;59(3):154-9. doi: 10.1253/jcj.59.154.
The late troponin T (TnT) peak concentration, which is known to be independent of reperfusion of the infarcted zone in acute myocardial infarction (MI), has been suggested to be correlated with clinical estimates of cardiac function and myocardial infarct size. To refine the clinical application of the late TnT peak in infarct sizing, and to examine differences in this estimation in different infarct sites, we measured the serum concentrations of TnT and myosin light chain 1 (MLC1), and compared these values with left ventricular ejection fraction (LVEF) obtained from left ventriculography, and extent score (ES) and severity score (SS) obtained from 201Tl scintigraphy in patients with anterior and inferior myocardial infarction. The late TnT peak concentration was strongly correlated with the MLC1 peak value in patients with anterior MI (r = 0.67, p < 0.05) and in those with inferior MI (r = 0.92, p < 0.0005). Furthermore, there were strong linear correlations between the late TnT peak values and all of the clinical data (LVEF; r = -0.79, p < 0.01, ES; r = 0.75, p < 0.05, SS; r = 0.75, p < 0.05, respectively) in patients with anterior MI. However, these correlations were weak in patients with inferior MI. Similar correlations were observed between MLC1 and the clinical data. Thus, TnT and MLC1 have similar kinetics in the serum at the late phase and can be used to estimate the size of anterior infarct.
已知急性心肌梗死（MI）时晚期肌钙蛋白T（TnT）峰值浓度与梗死区域的再灌注无关，且有人提出其与心功能和心肌梗死面积的临床评估相关。为优化晚期TnT峰值在梗死面积评估中的临床应用，并研究不同梗死部位在该评估中的差异，我们测定了TnT和肌球蛋白轻链1（MLC1）的血清浓度，并将这些值与前壁和下壁心肌梗死患者左心室造影获得的左心室射血分数（LVEF）以及201Tl心肌显像获得的范围评分（ES）和严重程度评分（SS）进行比较。在前壁心肌梗死患者中，晚期TnT峰值浓度与MLC1峰值显著相关（r = 0.67，p < 0.05），在下壁心肌梗死患者中也是如此（r = 0.92，p < 0.0005）。此外，在前壁心肌梗死患者中，晚期TnT峰值与所有临床数据（LVEF；r = -0.79，p < 0.01，ES；r = 0.75，p < 0.05，SS；r = 0.75，p < 0.05）之间均存在强线性相关。然而，在下壁心肌梗死患者中这些相关性较弱。MLC1与临床数据之间也观察到类似的相关性。因此，TnT和MLC1在晚期血清中具有相似的动力学，可用于估计前壁梗死面积。
