[Clinical methods for evaluating infarct size and its anatomic correlations. A study conducted with 193 cases. II. Evaluation of infarct size by determining maximal creatine phosphokinase in serum. Enzimatico-anatomic correlations].
OBJECTIVE
To compare the infarct size calculated by the peak serum CK method with the anatomic infarct size in a population dying of acute myocardial infarction. CONCEPT AND PLACE OF THE STUDY: To use the method of peak serum CK in the assessment of infarct size, calculated by a method developed by the authors, in a population dying of acute myocardial infarction in a coronary care unit.


METHODS
193 patients who successively died with acute myocardial infarction entered the study. After establishing the exclusion criteria the anatomical infarct size was measured using the method developed by the authors of myocardial slices after fixation of the heart and by the peak CK method. The two methods were correlated using linear regression curves.


CONCLUSIONS
A global correlation between the two methods was found although wide scattered values were found. After dividing the population in several subgroups, the analysis showed that survival below 48 hours, death in left ventricular failure, inferior infarcts and reinfarction influenced negatively this correlation. The anatomical method showed its value for this kind of evaluation having always in mind its known limitations. The enzyme method looked less discriminating as peak CK, obtained by 12 h sampling will seldom reflect the peaks of CK liberation curve. As the study was applied to a population of patients dying of acute myocardial infarction its results cannot be applied without caution to a population of survivors. We anticipate that in such a population peak CK will have a better correlation with real CK peaks even with 12 hours sampling and therefore reflecting more accurately infarct size.
Perdigão
C
C
Monteiro
J
J
Andrade
A
A
Ribeiro
C
C
D001344:Autopsy; D003402:Creatine Kinase / Q000097:blood*; D006801:Humans; D009203:Myocardial Infarction / Q000201:enzymology / Q000473:pathology*; D011446:Prospective Studies
D003402:Creatine Kinase
Métodos clínicos de avaliação do tamanho do enfarte e suas correlações anatómicas. Estudo efectuado em 193 casos. II--Avaliação do tamanho do enfarte pela determinação da creatinafosfoquinase máxima no soro. Correlações enzimático-anatómicas.