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Updated: Aug 22, 2026
Real-time Pressure-volume Analysis of Acute Myocardial Infarction in Mice
Published on: July 2, 2018
Left ventricular function and rapid release of creatine kinase MB in acute myocardial infarction. Evidence for
Insights
Spontaneous coronary-artery recanalization after myocardial infarction is linked to faster creatine kinase MB release and improved cardiac function. This suggests reperfusion significantly impacts recovery and enzyme kinetics in heart attack patients.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Acute myocardial infarction (AMI) can lead to cardiac damage.
- Intracoronary thrombolysis is associated with creatine kinase release and ejection fraction improvement.
Purpose of the Study:
- To investigate spontaneous coronary-artery recanalization (SCAR) after AMI.
- To correlate creatine kinase MB (CK-MB) release patterns with changes in cardiac function.
Main Methods:
- Studied 52 patients with transmural myocardial infarction.
- Assessed CK-MB release kinetics (time to peak serum level).
- Utilized sequential radionuclide ventriculograms to evaluate ejection fraction (EF).
Main Results:
- Patients with rapid CK-MB release showed significant improvement in global EF (0.38 to 0.48, P < 0.001) and regional EF (0.33 to 0.43, P < 0.001).
- Slow CK-MB release correlated with no significant change in EF.
- A negative correlation (r = -0.52, P < 0.001) was found between time to peak enzyme level and EF improvement.
- Rapid release patients exhibited higher CK-MB increments, suggesting enzyme washout.
Conclusions:
- Spontaneous reperfusion is common after AMI.
- Altered enzyme release kinetics and improved ventricular function are associated with spontaneous reperfusion.
- CK-MB release patterns can indicate the extent of reperfusion and its impact on cardiac function.
Abstract:
Intracoronary thrombolysis during acute myocardial infarction in human beings is associated with rapid release of creatine kinase and improvement of the cardiac ejection fraction. To examine the phenomenon of spontaneous coronary-artery recanalization, we studied the release of creatine kinase MB and sequential radionuclide ventriculograms in 52 patients with transmural myocardial infarction. Patients were divided into two groups according to whether the release of creatine kinase MB (time from base-line to peak serum level) was rapid (n = 24) or slow (n = 28). Patients with slow release had no significant change in global or regional ejection fraction from the time of admission to discharge. However, global ejection fraction in patients with rapid release improved from 0.38 +/- 0.09 (mean +/- S.D.) to 0.48 +/- 0.08 (P less than 0.001). The regional ejection fraction of Q-wave regions also improved, from 0.33 +/- 0.11 to 0.43 +/- 0.13 (P less than 0.001). A negative correlation (r = -0.52, P less than 0.001) existed between time to peak enzyme level and degree of improvement in ejection fraction. With increasing left ventricular damage, patients with rapid release had greater increments in creatine kinase MB than comparable patients with slow release (P = 0.03), suggesting enzyme washout. These data are consistent with the idea that spontaneous reperfusion, leading to altered enzyme release and improvement in ventricular function, is not uncommon after acute myocardial infarction.
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