title: Correlation between serum cardiac markers and myocardial infarct size quantified by myocardial perfusion imaging in patients with hypertrophic cardiomyopathy after alcohol septal ablation.
abstract: Myocardial infarct (MI) size is a well-established prognostic marker but the association of serum markers with MI size, as measured by myocardial perfusion imaging (MPI), has not been well studied in patients with hypertrophic cardiomyopathy (HC) after alcohol septal ablation (ASA). Creatine kinase (CK), CK-MB, troponin I, and brain natriuretic peptide were measured before and at multiple points after ASA in patients with HC and were correlated with MI size measured by MPI. MPI at rest was performed in 54 patients with HC at a median of 2 days after ASA. CK, CK-MB, and troponin I increased after ASA to peak levels at 12 hours and their cumulative levels (area under the curve) showed significant correlation with size of MI by MPI (r = 0.544, 0.408, and 0.477, p <0.001, 0.003, and 0.001, respectively). The best marker was level of CK at 12 hours (r = 0.609, p <0.0001) after ASA. Brain natriuretic peptide level did not change significantly after ASA (p = 1.0) and only weakly correlated with MI size by MPI (r = 0.130, p = 0.007). In conclusion, CK, CK-MB, and troponin I measured at 12 hours, at peak, and as the area under the curve correlated well with infarct size, but CK level at 12 hours was the best marker. CK continues to be a useful marker of MI size despite the introduction of newer, more specific markers, especially when infarct onset is known with certainty as in patients with HC undergoing ASA.
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA. fadihage@uab.edu
authors.forename: Fadi G
authors.initials: FG
authors.lastname: Hage
authors.forename: Raed
authors.initials: R
authors.lastname: Aqel
authors.forename: Wael
authors.initials: W
authors.lastname: Aljaroudi
authors.forename: Jaekyeong
authors.initials: J
authors.lastname: Heo
authors.forename: Koteswara
authors.initials: K
authors.lastname: Pothineni
authors.forename: Sachin
authors.initials: S
authors.lastname: Hansalia
authors.forename: David
authors.initials: D
authors.lastname: Lawson
authors.forename: Eva
authors.initials: E
authors.lastname: Dubovsky
authors.forename: Ami E
authors.initials: AE
authors.lastname: Iskandrian
mesh_terms: D055011:Ablation Techniques; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood / Q000150:complications / Q000628:therapy*; D015331:Cohort Studies; D052279:Creatine Kinase, MB Form / Q000097:blood*; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D055414:Myocardial Perfusion Imaging; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012997:Solvents / Q000008:administration & dosage; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D012997:Solvents; D019210:Troponin I; D020097:Natriuretic Peptide, Brain; D000431:Ethanol; D052279:Creatine Kinase, MB Form