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Subarachnoid haemorrhage and acute heart injury
Insights
Elevated creatine kinase (CK) MB isoenzyme in subarachnoid hemorrhage patients may indicate cardiac injury. This study found CK-MB in 41% of patients, often preceding ECG changes and mortality.
Area of Science:
- Biochemistry
- Neurology
- Cardiology
Background:
- Subarachnoid hemorrhage (SAH) can lead to cardiac complications.
- Creatine kinase (CK) isoenzymes, including CK-MB, are potential biomarkers for cardiac injury.
Purpose of the Study:
- To investigate the presence and significance of CK isoenzymes, particularly CK-MB, in patients with subarachnoid hemorrhage.
- To explore the potential conversion of other CK isoenzymes to CK-MB in vitro.
Main Methods:
- Serum samples from 17 SAH patients were analyzed for CK isoenzyme activity.
- Electrocardiogram (ECG) changes were monitored.
- In vitro experiments assessed CK isoenzyme conversion under specific conditions.
Main Results:
- Seven (41%) of 17 SAH patients exhibited CK-MB activity, peaking around 16 hours post-symptom onset.
- Five of these patients (71%) showed pathological ECG changes indicative of acute cardiac injury.
- Four of the five non-survivors had both CK-MB and CK-BB isoenzymes.
- No conversion of CK-MM or CK-BB to CK-MB was observed in vitro.
Conclusions:
- CK-MB elevation in SAH patients is associated with cardiac injury and poorer outcomes.
- The observed CK-MB is unlikely to result from in vitro conversion of other isoenzymes.
Abstract:
Seven (41%) out of 17 subarachnoid haemorrhage patients had MB isoenzyme of creatine kinase (CK) in the serum. The peak activity of MB was observed about 16 h after the onset of neurological symptoms. Of the patients with MB activity, five (71%) had pathological ECG changes suggesting acute cardiac injury. Of the patients examined, five died, and four of these had both CK-MB and CK-BB isoenzymes in the serum. In a preliminary study a test was made whether MM and BB were converted to MB in 48 h at 4 degrees C or 20 degrees C in a saline solution containing mercaptoethanol and bovine serum albumin. Such conversion was not observed. Human brain tissue extract obtained at autopsy was used in the study.