Lack of indication of myocardial cell damage after myocardial ischaemia in patients with severe stable angina.
To evaluate myocardial cell damage in relation to spontaneous and exercise-induced ischaemia, release of myoglobin, creatine kinase (CK) and its isoenzyme MB (CK-MB) into the serum was estimated in 10 patients with severe stable angina. All patients had a positive exercise test, significant stenosis of one or more of the main coronary arteries and more than five ischaemic attacks per week. ST-segment monitoring was performed for 36 h. During the last 24 h of that period (period A) serial blood samples were analysed for myoglobin, CK and CK-MB using sensitive assays. Three days later (period B) the patients performed an exercise test at 0815 h, with ST-segment monitoring and blood sampling carried out as described for period A. During period A, 47 ischaemic episodes (100% silent) with a total duration of 599 min were noted in four patients. Forty-seven ischaemic episodes (94% silent) with a total duration of 804 min, were observed in seven patients during period B. Release of myoglobin, CK, and CK-MB did not increase in relation either to spontaneous or exercise-induced ischaemia. Thus even frequent and prolonged episodes of transient myocardial ischaemia (symptomatic or asymptomatic) in patients with severe stable angina pectoris does not seem to cause irreversible myocardial damage.
Nørregaard-Hansen
K
K
Department of Cardiology, Odense University Hospital, Denmark.
Egstrup
K
K
Nielsen
J R
JR
Jørgensen
P J
PJ
Petersen
P H
PH
Haghfelt
T
T
Hørder
M
M
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000503:physiopathology*; D003402:Creatine Kinase / Q000097:blood*; D004562:Electrocardiography; D005080:Exercise Test; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D007527:Isoenzymes; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology; D009211:Myoglobin / Q000097:blood*; D009336:Necrosis
D007527:Isoenzymes; D009211:Myoglobin; D003402:Creatine Kinase