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Is CK-MB isoenzyme useful for diagnosis of cardiac involvement in icteric leptospirosis?
E S Machado1, J G Feres, L A Feijó
1Serviço de Doenças Infecciosas, Universidade Federal do Rio de Janiero, Brasil.
Insights
Diagnosing cardiac involvement in icteric leptospirosis using electrocardiograms is possible. However, serum creatine phosphokinase isoenzyme (CK-MB) levels are not a specific indicator of myocardial involvement in these patients.
Area of Science:
- Infectious Diseases
- Cardiology
- Biochemistry
Background:
- Icteric leptospirosis can present with cardiac involvement, detectable via electrocardiogram abnormalities.
- Metabolic and electrolytic disturbances during acute leptospirosis can mimic cardiac changes on electrocardiograms.
- Accurate diagnosis of myocardial involvement is crucial for appropriate patient management.
Purpose of the Study:
- To evaluate the utility of serum creatine phosphokinase isoenzyme (CK-MB) determination in identifying patients with suspected cardiac involvement in icteric leptospirosis.
- To assess the specificity of CK-MB levels for myocardial damage in the context of leptospirosis.
Main Methods:
- Prospective study involving 69 patients with icteric leptospirosis.
- Assessment of cardiac involvement using electrocardiogram findings.
- Measurement of serum CK-MB levels in all participants.
Main Results:
- Elevated CK-MB levels were observed in 10 of 16 patients with cardiac involvement and 25 without (p > 0.05).
- Mean CK-MB levels were significantly higher in the group with cardiac involvement (p < 0.05).
- Despite higher mean values, CK-MB lacked specificity for myocardial involvement.
Conclusions:
- Serum CK-MB determination is not a specific biomarker for diagnosing myocardial involvement in icteric leptospirosis.
- Electrocardiogram abnormalities may indicate cardiac involvement, but confounding factors like metabolic disturbances should be considered.
- Further research may be needed to identify reliable markers for cardiac complications in leptospirosis.
Abstract:
In the absence of heart failure or cardiogenic shock, cardiac involvement diagnosis in icteric leptospirosis is possible on the basis of abnormal electrocardiograms. As metabolic and electrolytic disorders are frequently seen during acute leptospirosis infection, they may be responsible for some electrocardiograms changes. We conducted a study to assess if creatine phosphokinase isoenzyme determinations are useful in selecting patients with a high cardiac involvement suspicion. Sixty-nine patients were studied prospectively. Ten patients out of 16 with cardiac involvement and 25 without had high CK-MB levels (p > 0.05), although mean values of abnormal CK-MB levels were higher in the group with cardiac involvement (p < 0.05). Our analysis indicates that serum CK-MB determination does not provide a specific indicator of myocardial involvement in the course of icteric leptospirosis.