Rogers W J, McDaniel H G, Smith L R, Mantle J A, Russel R O, Rackley C E
Circulation. 1977 Aug;56(2):199-205. doi: 10.1161/01.cir.56.2.199.
Accumulated creatine kinase MB isoenzyme release (sigma CK-MB) during acute myocardial infarction was correlated with biplane left ventricular (LV) angiographic estimates of percent abnormally contracting segment (%ACS) and ejection fraction (EF) in 35 patients who underwent diagnostic angiography at a mean of 33 +/- 4 days post myocardial infarction (MI). Of the 35 patients, 18 had no evidence of prior MI and their sigma CK-MB showed good correlation with %ACS (r = 0.84) and with EF (r = - 0.78). An additional two patients with first (inferior) infarct secondary to stenosis of the right coronary artery proximal to the origin of the right ventricular arterial blood supply had disproportionately large sigma CK-MB, suggesting a combination of LV and RV necrosis. In the 15 patients with prior infarct, there was no significant correlation between sigma CK-MB and %ACS or EF. However, in the subgroup of patients with anterior MI, %ACS correlated with sigma CK-MB, both in patients with no prior MI (r = 0.88, N = 12) and in patients with prior MI (r = 0.69, N = 9). These independent angiographic and enzymatic data suggest that enzymatic infarct size estimates utilizing accumulated CK-MB release may be a valid and reliable clinical measure for assessing the extent of LV necrosis in the setting of acute anterior myocardial infarction. However, limitations may exists in certain cases of inferior MI, probably because of concomitant right and left ventricle necrosis.
在35例急性心肌梗死后平均33±4天接受诊断性血管造影的患者中，急性心肌梗死期间累积的肌酸激酶MB同工酶释放量（sigma CK-MB）与双平面左心室（LV）血管造影对异常收缩节段百分比（%ACS）和射血分数（EF）的估计值相关。在这35例患者中，18例无既往心肌梗死证据，其sigma CK-MB与%ACS（r = 0.84）和EF（r = - 0.78）显示出良好的相关性。另外2例因右冠状动脉近端狭窄继发首次（下壁）梗死，且梗死位于右心室动脉血供起源处近端，其sigma CK-MB不成比例地升高，提示左心室和右心室均有坏死。在15例有既往梗死的患者中，sigma CK-MB与%ACS或EF之间无显著相关性。然而，在前壁心肌梗死患者亚组中，%ACS与sigma CK-MB相关，在无既往心肌梗死的患者中（r = 0.88，N = 12）以及有既往心肌梗死的患者中（r = 0.69，N = 9）均如此。这些独立的血管造影和酶学数据表明，利用累积CK-MB释放量估计酶学梗死面积可能是评估急性前壁心肌梗死时左心室坏死程度的一种有效且可靠的临床方法。然而，在下壁心肌梗死的某些情况下可能存在局限性，可能是因为合并了右心室和左心室坏死。
