Related Experiment Videos
LDH isoenzymes and myocardial infarction in patients undergoing coronary bypass surgery: an excellent correlation
Insights
Lactate dehydrogenase (LDH) isoenzyme analysis, specifically the LDH1:LDH2 ratio reversal, effectively detects myocardial infarction after coronary bypass surgery. This biomarker aids in identifying patients with post-operative cardiac complications.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Myocardial infarction detection post-cardiac surgery is crucial.
- Established biomarkers like ECG, CPK, and SGOT have limitations.
- LDH isoenzymes offer a potential diagnostic advantage.
Purpose of the Study:
- To assess the efficacy of LDH isoenzymes in diagnosing myocardial infarction in patients following coronary bypass surgery.
- To correlate LDH isoenzyme patterns with postoperative cardiac events.
Main Methods:
- Studied 73 patients undergoing coronary bypass surgery.
- Collected pre- and postoperative data including ECG, CPK, SGOT, total LDH, and LDH isoenzymes.
- Defined myocardial necrosis by an LDH1:LDH2 ratio reversal (>1.0).
- Grouped patients based on LDH1:LDH2 ratio reversal (Group A) versus no reversal (Group B).
Main Results:
- Group A (LDH1:LDH2 reversal) showed significantly higher rates of new Q waves (78%) compared to Group B (4%).
- Arrhythmias were more frequent in Group A (70%) than Group B (14%).
- Severe congestive heart failure or shock occurred in 39% of Group A patients, none in Group B.
Conclusions:
- Reversal of the LDH1:LDH2 ratio is a valuable indicator of postoperative myocardial infarction.
- LDH isoenzyme analysis enhances the detection of myocardial injury after coronary bypass surgery.
- This method aids in identifying high-risk patients requiring closer monitoring.
Abstract:
To evaluate the efficacy of LDH isoenzymes in the detection of myocardial infarction in patients undergoing coronary bypass surgery, 73 patients were studied pre- and postoperatively by ECG, CPK, SGOT, total serum LDH, and LDH isoenzyme measurements. A reversal of the LDH1:LDH2 ratio was considered indicative of myocardial necrosis. Accordingly, the patients were separated into two groups: Group A (23 patients) who demonstrated an LDH1:LDH2 ratio exceeding 1.0 and Group B (50 patients) who failed to reveal an LDH1;LDH2 reversal. The two groups were similar in regard to preoperative evaluation and operative procedure performed. The postoperative ECG findings were significantly different. In Group A 18 of 23 patients (78 per cent) developed significant new Q waves. This occurred in only one patient in Group B. Significant arrhythmias occurred in 70 per cent of the patients in Group A as compared to 14 per cent of those patients in Group B. Severe congestive heart failure and/or clinical evidence of shock occurred in 39 per cent of Group A patients and in none in Group B. The results of our study indicate that the reversal of the LDH1:LDH2 ratio is a valuable tool for the evaluation of postoperative myocardial infarction.