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Myocardial creatine kinase expression after left ventricular assist device support
Soon J Park1, Jianyi Zhang, Yun Ye
1Department of Surgery, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
Journal of the American College of Cardiology
|June 1, 2002
Summary
Left ventricular assist device (LVAD) support normalized creatine kinase (CK) activity and CK-M/CK-Mt expression in failing hearts. However, CK-B levels remained elevated, suggesting other factors contribute to this abnormality.
Area of Science:
- Cardiology
- Biochemistry
- Biomedical Engineering
Background:
- Heart failure reduces myocardial creatine kinase (CK) activity.
- Failing hearts exhibit altered CK isoform expression, increasing CK-B and decreasing CK-M and CK-Mt.
- The underlying mechanisms for these CK abnormalities remain unclear.
Purpose of the Study:
- To investigate if left ventricular unloading via a ventricular assist device (LVAD) can normalize CK abnormalities in human hearts.
- To determine the impact of LVAD support on total CK activity and specific CK isoforms (CK-M, CK-Mt, CK-B).
Main Methods:
- Analyzed total CK activity and CK protein isoform expression (Western blotting) in 11 end-stage cardiomyopathy patients.
- Obtained myocardial tissue from 7 patients after 4.1 months of LVAD support.
Main Results:
- LVAD implantation significantly increased total CK activity by 270% (p < 0.01).
- CK-M protein expression increased by 69% (p < 0.01) and CK-Mt by 121% (p < 0.01) post-LVAD.
- No significant change was observed in CK-B protein expression.
Conclusions:
- LVAD-induced unloading increases total CK activity and CK-M/CK-Mt expression in failing hearts.
- The persistent elevation of CK-B suggests that factors beyond increased cardiac workload contribute to its upregulation in heart failure.