title: Quantitative and temporal relation between the release of myoglobin and creatine kinase and the evolution of vectorcardiographic changes during acute myocardial infarction in man.
abstract: The relation in time and magnitude between QRS vector changes (QRS-VD), ST vectors (ST-VM), and the cumulated release of myoglobin, total creatine kinase, and creatine kinase isoenzyme MB was studied. Seventy four patients with a first myocardial infarction and a history of symptoms of up to 5 h were included. Blood samples for enzyme analysis were taken every 4-6 h for 72 h and cumulated enzyme release was calculated from a monocompartmental first order model. QRS-VD and ST-VM were determined every 10 min for 24 h by computer analysis of Frank lead vectorcardiograms. Infarct sizes were visually determined from the different enzymatic and vectorcardiographic evolution curves. Eight patients were excluded from the analysis because they had a QRS width greater than or equal to 120 ms or ill defined plateaus of the release curves. The relation between infarct sizes estimated from QRS-VD and total creatine kinase was r = 0.62; QRS-VD and myoglobin release r = 0.57; total creatine kinase and myoglobin release r = 0.72, showing that these variables are good and complementary indices for estimating myocardial infarct size. Median infarct evolution curves were computed after the individual curves were normalised to 100%. ST-VM fell rapidly during the first 7 h to 40% of the initial values. QRS-VD and myoglobin release were closely associated and completed their development on average 15 h after the onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Institute of Informatics, University of Oslo, Norway.
authors.forename: P
authors.initials: P
authors.lastname: Grøttum
authors.forename: M
authors.initials: M
authors.lastname: Sederholm
authors.forename: J K
authors.initials: JK
authors.lastname: Kjekshus
mesh_terms: D000328:Adult; D000368:Aged; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D009211:Myoglobin / Q000097:blood*; D013997:Time Factors; D014672:Vectorcardiography
chemical_list: D007527:Isoenzymes; D009211:Myoglobin; D003402:Creatine Kinase