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Myocardial infarct size can be estimated from serial plasma myoglobin measurements within 4 hours of reperfusion
1First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Background:
An early estimation of infarct size is useful for the appropriate early treatment of patients with acute myocardial infarction. We evaluated how early and how accurately infarct size could be estimated from serial plasma myoglobin (Mb) measurements in patients with successful reperfusion.
Methods And Results:
We measured plasma Mb and creatine kinase (CK) in 35 patients in whom reperfusion therapy was successfully performed. Blood samples were collected at 15-minute intervals for 2 hours after reperfusion, at 30-minute intervals for the subsequent 2 hours, and at 3-6-hour intervals until 52 hours after reperfusion. Plasma Mb was measured by a newly developed turbidimetric latex agglutination assay. Total Mb and CK release (sigma Mb, sigma CK) were calculated with a one-compartment model. The mean chord motion in the most hypokinetic 50% of the infarct-related artery territory was calculated from follow-up ventriculograms as an index of the severity of regional hypokinesis. There were significant correlations between sigma Mb and sigma CK (r = 0.89), between log sigma Mb and the severity of regional hypokinesis (r = -0.85), and between log sigma CK and the severity of regional hypokinesis (r = -0.74). The time required for the cumulative Mb release curves to reach a plateau was 64 +/- 28 minutes. An additional 53 +/- 14 minutes was required to calculate the disappearance rate constant of Mb, and 15 minutes was necessary for the assay. Therefore, the total time required for sigma Mb to be available was 132 +/- 40 minutes, significantly shorter than the time required for sigma CK, 24.3 +/- 9.1 hours (p < 0.001). The infarct size could be estimated from the sigma Mb in 34 of 35 patients within 4 hours of reperfusion.
Conclusions:
Infarct size can be estimated accurately 4 hours after reperfusion by calculating the sigma Mb in patients with successful reperfusion.
Insights
Early estimation of infarct size in acute myocardial infarction patients is possible using serial plasma myoglobin (Mb) measurements. This method provides accurate infarct size assessment within 4 hours after successful reperfusion therapy.
Area of Science:
- Cardiology
- Biomarker Research
- Medical Diagnostics
Background:
- Early estimation of infarct size is crucial for timely treatment of acute myocardial infarction (AMI).
- Assessing infarct size accurately and early aids in patient management and therapeutic decisions.
Purpose of the Study:
- To evaluate the early and accurate estimation of infarct size using serial plasma myoglobin (Mb) measurements.
- To compare the timing of infarct size estimation using Mb versus creatine kinase (CK).
Main Methods:
- Plasma Mb and CK levels were measured in 35 patients with successful reperfusion.
- Serial blood samples were collected at various intervals up to 52 hours post-reperfusion.
- Infarct size was estimated by calculating total Mb and CK release (sigma Mb, sigma CK) using a one-compartment model.
Main Results:
- Significant correlations were found between sigma Mb and sigma CK, and both correlated with regional hypokinesis severity.
- The total time to estimate infarct size using sigma Mb was 132 +/- 40 minutes.
- Infarct size was accurately estimated from sigma Mb in 34 of 35 patients within 4 hours post-reperfusion, significantly faster than using sigma CK.
Conclusions:
- Plasma myoglobin (Mb) allows for accurate infarct size estimation within 4 hours after reperfusion in patients with successful reperfusion.
- This rapid estimation using Mb offers a significant time advantage over traditional methods like CK measurement.