Cardiac enzyme changes in myxedema coma.

Abstract A 74-year-old man with myxedema and hypothermia had increased activities in plasma of creatine kinase (CK; EC 2.7.3.2), aspartate aminotransferase (AST; EC 2.6.1.1), and lactate dehydrogenase (LD; EC 1.1.1.27) and increased proportions of CK-MB (up to 20% of total CK) and LD1 isoenzymes, but no clinical or investigational evidence of associated myocardial infarction. This case illustrates that plasma enzyme activity and isoenzyme profiles in such clinical settings should be interpreted with caution, because increases in CK-MB and LD1 may relate to myxedema coma or hypothermia (or both) rather than to myocardial infarction.

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Local myotoxicity of ketamine hydrochloride in the marmoset

Laboratory Animals ◽

10.1258/002367787780740725 ◽

1987 ◽

Vol 21 (1) ◽

pp. 60-67 ◽

Cited By ~ 28

Author(s):

C. W. Davy ◽

P. N. Trennery ◽

J. G. Edmunds ◽

J. F. B. Altman ◽

D. A. Eichler

Keyword(s):

Creatine Kinase ◽

Lactate Dehydrogenase ◽

Physical Properties ◽

Aspartate Aminotransferase ◽

Solution Ph ◽

Histopathological Findings ◽

Plasma Enzyme ◽

Routine Blood ◽

Ketamine Hydrochloride ◽

Injection Procedure

An investigation of raised plasma aspartate aminotransferase (AST) in marmosets after intramuscular ketamine injection suggested a local myotoxicity. This was confirmed by a range of histopathological findings from myofibrillar striation loss to necrosis. In addition to the elevations in AST levels, creatine kinase and the lactate dehydrogenase-5 isoenzyme levels were elevated. It was further demonstrated that, although the physical properties of the injectable solution (pH, osmolality) and to a lesser extent the injection procedure itself caused slight changes in plasma enzyme levels, the ketamine was predominantly responsible for the lesion. No hepatic interactions were seen. This effect should be taken into consideration when this anaesthetic is used in the marmoset if the primary objectives of the experiment entail routine blood analyses.

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Effect of Various Diluents on the Activity of Several Enzymes Present in Serum

Clinical Chemistry ◽

10.1093/clinchem/19.9.1079 ◽

1973 ◽

Vol 19 (9) ◽

pp. 1079-1080

Author(s):

Ted W Fendley ◽

Jane M Hochholzer ◽

Christopher S Frings

Keyword(s):

Alkaline Phosphatase ◽

Creatine Kinase ◽

Enzyme Activity ◽

Lactate Dehydrogenase ◽

Confidence Level ◽

Aspartate Aminotransferase ◽

Nacl Solution ◽

Manual Method ◽

Accuracy And Precision ◽

Significant Difference

Abstract We have evaluated the effect of diluting serum with water or NaCl solution (8.5 or 9.0 g/liter) before assaying by a manual method for creatine kinase (EC 2.7.3.2), alkaline phosphatase (EC 3.1.3.1), lactate dehydrogenase (EC 1.1.1.27), and aspartate aminotransferase (EC 2.6.1.1) activity. The t test and the F test show no significant difference in the accuracy and precision of the assays at the 95% confidence level when 100 different samples were compared for each enzyme activity after use of the three diluents.

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Activities of some enzymes in serum after therapy with intracoronary streptokinase in acute myocardial infarction.

Clinical Chemistry ◽

10.1093/clinchem/30.5.731 ◽

1984 ◽

Vol 30 (5) ◽

pp. 731-734 ◽

Cited By ~ 18

Author(s):

T C Kwong ◽

P G Fitzpatrick ◽

R L Rothbard

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Lactate Dehydrogenase ◽

Aspartate Aminotransferase ◽

Maximum Rate ◽

Intracoronary Streptokinase ◽

Rate Of Increase ◽

The Mean

Abstract Enzyme kinetics for creatine kinase (CK), CK-MB, aspartate aminotransferase (AST), and lactate dehydrogenase (LD) in serum were followed in 14 patients who had suffered acute myocardial infarction and who were given intracoronary streptokinase shortly (mean 4.9 h, SD 2.6 h) after onset of symptoms. In the 10 patients for whom thrombolysis was successful, CK activity peaked earlier (12.8 vs 21.6 h) and at higher values (3548 vs 2436 U/L) than in the four patients for whom the treatment was unsuccessful. The mean maximum rate of increase in CK was threefold greater in the former group (574 vs 169 U/L per hour), but the total amount of CK released into the circulation and the fractional disappearance rates were similar for both groups. The profiles for AST and CK-MB for successfully treated patients closely resembled those for CK. LD, however, peaked significantly later than CK (25.7 vs 12.8 h). Early peaking of CK or CK-MB after nonsurgical reperfusion can be potentially useful as a noninvasive in vitro index to the success of therapy of myocardial infarction with thrombolytic agents.

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Hypothermic myxedema coma erroneously diagnosed as myocardial infarction because of increased creatine kinase MB.

Clinical Chemistry ◽

10.1093/clinchem/33.6.1083 ◽

1987 ◽

Vol 33 (6) ◽

pp. 1083-1084 ◽

Cited By ~ 8

Author(s):

P A Nee ◽

A C Scane ◽

P H Lavelle ◽

I W Fellows ◽

P G Hill

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Lactate Dehydrogenase ◽

Myxedema Coma ◽

Creatine Kinase Mb

Abstract As is well recognized, activities of creatine kinase (CK, EC 2.7.3.2) and lactate dehydrogenase (EC 1.1.1.27) in plasma may be substantially increased in hypothyroidism. We emphasize here that an increase and decrease in CK-MB isoenzyme, characteristic of acute myocardial infarction, can occur in hypothermic myxedema coma without myocardial infarction.

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Serum enzymes and isoenzymes in the diagnosis and differential diagnosis of myocardial ischemia and necrosis.

Clinical Chemistry ◽

10.1093/clinchem/26.9.1241 ◽

1980 ◽

Vol 26 (9) ◽

pp. 1241-1250 ◽

Cited By ~ 127

Author(s):

J A Lott ◽

J M Stang

Keyword(s):

Myocardial Infarction ◽

Skeletal Muscle ◽

Acute Myocardial Infarction ◽

Pulmonary Embolism ◽

Creatine Kinase ◽

Lactate Dehydrogenase ◽

Aspartate Aminotransferase ◽

Acute Injury ◽

Enzyme Analysis ◽

Dehydrogenase Isoenzyme

Abstract Diagnosis of injury to the myocardium is facilitated by information on the activities of creatine kinase (EC 2.7.3.2) MB isoenzyme (CK-MB) and lactate dehydrogenase (EC 1.1.1.27) isoenzyme 1 in serum, thee isoenzymes being present in higher activities in the myocardium than in other tissues or in normal serum. The temporal relationships of these isoenzymes, total creatine kinase, total lactate dehydrogenase, and aspartate aminotransferase (EC 2.6.1.1) are highly sensitive and specific for acute injury to the heart, particularly acute myocardial infarction. Chronic heart diseases, electric cardioversion for heart rhythm disturbances, coronary catheterization, and exercise usually do not produce increases of CK-MB, although abnormal aspartate aminotransferase, creatine kinase, lactate dehydrogenase, and lactate dehydrogenase isoenzyme 1 activities are seen in some individuals. Many other causes of increased activities of these enzymes and isoenzymes in serum are unrelated to injury to the heart. Because CK-MB is present in the skeletal muscle in low activities, substantial injury to skeletal muscle can increase CK-MB activities in the blood to abnormal values. Pulmonary embolism can mimic myocardial infarction in its clinical presentation. In patients with an accurately known time of onset of symptoms and serial enzyme analysis every 12 h during the first 48 h, acute myocardial infarction can be distinguished from pulmonary embolism by determinations of creatine kinase, CK-MB, aspartate aminotransferase, and lactate dehydrogenase isoenzyme 1 in serum.

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Production and certification of secondary enzyme reference materials (ERMs). Part 1: Preparation of the sera and some of their properties.

Clinical Chemistry ◽

10.1093/clinchem/32.10.1901 ◽

1986 ◽

Vol 32 (10) ◽

pp. 1901-1905 ◽

Cited By ~ 6

Author(s):

J C Koedam ◽

G M Steentjes ◽

S Buitenhuis ◽

E Schmidt ◽

R Klauke

Keyword(s):

Creatine Kinase ◽

Lactate Dehydrogenase ◽

Reference Material ◽

Human Serum ◽

Dehydrogenase Activity ◽

Aspartate Aminotransferase ◽

Alanine Aminotransferase ◽

Glutamate Dehydrogenase Activity ◽

The Stability ◽

Clinical Enzymology

Abstract We produced three batches of a human-serum-based enzyme reference material (ERM) enriched with human aspartate aminotransferase (EC 2.6.1.1), alanine aminotransferase (EC 2.6.1.2), creatine kinase (EC 2.7.3.2), and lactate dehydrogenase (EC 1.1.1.27). The added enzymes were not exhaustively purified; thus the final ERMs contained some enzymes as contaminants, of which only glutamate dehydrogenase activity might interfere. The stability during storage and after reconstitution was good. The commutability of the four enzymes in the three ERM batches was also good, except when German or Scandinavian methods for aminotransferases were involved. The temperature-conversion factors for the ERMs were equivalent to those for patients' sera. Reactivation after reconstitution was complete within 5 min and was independent of the temperature of the reconstitution fluid. We believe that these secondary ERMs will aid in the transfer of accuracy between well-defined reference methods and daily working methods so that clinical enzymology results will become more comparable from laboratory to laboratory.

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ASSOCIATION OF SERUM LACTATE LEVELS WITH CREATINE KINASE – MB AND LACTATE DEHYDROGENASE IN PATIENTS WITH MYOCARDIAL INFARCTION

10.36106/ijsr/4608142 ◽

2021 ◽

pp. 73-75

Author(s):

Mallaiyan Manonmani ◽

Meiyappan Kavitha

Keyword(s):

Myocardial Infarction ◽

Creatine Kinase ◽

Lactate Dehydrogenase ◽

Serum Lactate ◽

Serum Creatine Kinase ◽

Hemodynamic Management ◽

Diagnosis And Prognosis ◽

Creatine Kinase Mb ◽

Enzymatic Markers ◽

Lactate Levels

Objectives: Myocardial infarction is the most common form of coronary heart disease, the commonest cause of worldwide mortality. The present biochemical markers take atleast 6 hours for elevation following an episode of myocardial infarction. There is a need for sensitive marker for early diagnosis and prognosis. Lactate, the end product of anaerobic glycolysis is found to be elevated in many critical illnesses. Thus the study was undertaken to assess the levels of serum lactate in patients with myocardial infarction and to correlate it with the frequently used enzymatic markers for the diagnosis of myocardial infarction, i.e creatine kinase – MB and lactate dehydrogenase Methods: Fifty age and sex matched controls and fty cases of myocardial infarction were included in the study. Serum creatine kinase – MB, lactate dehydrogenase and lactate were estimated in these subjects. Results:The serum lactate levels were signicantly higher among cases when compared to controls. The serum lactate levels positively correlated with serum creatine kinase – MB among cases but not with lactate dehydrogenase. Conclusions: We conclude that serum lactate is altered in patients with myocardial infarction and may be considered as a prognostic risk factor in these patients. Further studies are needed to nd the cut-off value of serum lactate for assistance in the hemodynamic management of these patients.

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Improved column method for separating lactate dehydrogenase isoenzymes 1 and 2.

Clinical Chemistry ◽

10.1093/clinchem/24.3.480 ◽

1978 ◽

Vol 24 (3) ◽

pp. 480-482 ◽

Cited By ~ 9

Author(s):

D W Mercer

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Heart Disease ◽

Lactate Dehydrogenase ◽

Sodium Chloride ◽

Lactate Dehydrogenase Activity ◽

Column Method ◽

Creatine Kinase Mb ◽

Lactate Dehydrogenase Isoenzymes

Abstract Lactate dehydrogenase (LD) isoenzymes 1 and 2 in human serum were separated on a column of diethylaminoethyl-Sephadex. Samples layered on mini-columns were eluted with buffered sodium chloride (100, 150, and 200 mmol/liter). Lactate dehydrogenase activity in column effluents was measured by the Wacker method, and their isoenzyme content was evaluated by electrophoresis on polyacrylamide gel. Results for column-fractionated LD-1 and LD-2 were expressed in two ways: LD-1/LD-2 ratios and total LD-1 + LD-2 activities. The former is a more specific indicator of myocardial infarction than the latter. Sera from 10 patients with acute myocardial infarction (increased creatine kinease isoenzyme MB activity) exhibited ratios in the range of 0.92 to 1.56, ratios for 10 patients without heart disease (normal creatine kinase MB) ranged from 0.33 to 0.69.

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Analysis of enzyme activity and the level of malondialdehyde in the saliva of children with gingivitis

Vojnosanitetski pregled ◽

10.2298/vsp0911892t ◽

2009 ◽

Vol 66 (11) ◽

pp. 892-896

Author(s):

Olivera Trickovic-Janjic ◽

Tatjana Cvetkovic ◽

Mirjana Apostolovic ◽

Draginja Kojovic ◽

Ljiljana Kostadinovic ◽

...

Keyword(s):

Enzyme Activity ◽

Lactate Dehydrogenase ◽

Aspartate Aminotransferase ◽

Alanine Aminotransferase ◽

Study Groups ◽

Functional Condition ◽

Gamma Glutamyl Transferase ◽

Gamma Glutamyl ◽

Severe Inflammation ◽

Glutamyl Transferase

Introduction/Aim. By analyzing activity of some of the enzymes normally present in the saliva and the level of malondialdehyde in gingivitis, it is possible to estimate the functional condition of parodontium, and the examined parameters can be considered as biochemical markers of its functional condition. The aim of this paper was to examine activity of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, lactate dehydrogenase and the level of malondialdehyde in the saliva of children affected with gingivitis, as well as the values of the mentioned parameters in relation to the level of the inflammation of gingiva. Methods. The research included 120 children at the age of 12.2 with permanent dentition. L?e and Silness gingival index was used to estimate the condition of gingiva, based on which the children were classified into four groups: the children with healthy gingiva (the control groups), the children with mild, moderate and severe inflammation of gingiva (the study group). Enzymes of the saliva were determined by the use of original tests and measured by the autoanalyser (Bio Systems A25, Spain). A modified method with tiobarbituric acid was used to determine malondialdehyde in nonstimulated mixed saliva. Results. The results of the examined enzyme activity and the level of malondialdehyde in the saliva of the study groups showed statistically considerably higher values for the level of malondialdehyde (p < 0.001), for the activity of aspartate aminotransferase and gamma glutamyl transferase (p < 0.01), as well as for alanine aminotransferase (p < 0.05) in comparison with the control group, whereas the activity of lactate dehydrogenase did not show a statistically significant increase. In relation to the level of the inflammation of gingiva, the results of the examination of the enzyme activity in the study groups showed statistically significantly higher values in the group with severe inflammation in comparison with those with mild, as well as the moderate inflammatory, except for the gamma glutamyl transferase, and in the group with moderate inflammation compared to that with the mild one, except for alanine aminotransferase. The results of the examination of the level of malondialdehyde in the saliva of the study groups did not show a statistically significantly increase in relation to the level of the inflammation of gingiva. Conclusion. There is a higher level of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase and lactate dehydrogenase enzyme activity together with the higher level of malondialdehyde in the saliva of children with gingivitis in comparison with the activity of the same enzymes and the level of malondialdehyde in the saliva of children without gingivitis. The activity of the examined enzymes in the saliva of children with gingivitis increases in relation to the intensity of the pathological process, whereas the level of malondialdehyde shows no significant difference in relation to the level of the inflammation of gingiva.

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Changes in mass and catalytic activity concentrations of aspartate aminotransferase isoenzymes in serum after a myocardial infarction.

Clinical Chemistry ◽

10.1093/clinchem/32.3.496 ◽

1986 ◽

Vol 32 (3) ◽

pp. 496-500 ◽

Cited By ~ 6

Author(s):

A E Niblock ◽

G Jablonsky ◽

F Y Leung ◽

A R Henderson

Keyword(s):

Myocardial Infarction ◽

Enzyme Activity ◽

Catalytic Activity ◽

Aspartate Aminotransferase ◽

Left Ventricular ◽

Peak Activity ◽

Ventricular Failure ◽

Total Enzyme Activity ◽

Activity Concentrations ◽

Total Enzyme

Abstract We used an RIA and inhibition of enzyme activity to monitor the changes in mass and catalytic concentrations of the aspartate aminotransferase (EC 2.6.1.1;AST) isoenzymes in serum after myocardial infarction. Cytosolic (c-AST) and mitochondrial (m-AST) forms of AST were present in sera from all 38 of our patients. Although the immunological and catalytic concentrations of both isoenzymes correlated well with the size of the infarct, c-AST gave a better measure than did m-AST. About 20% of the total enzyme activity at peak activity was from the mitochondrial isoenzyme. Both isoenzyme activities peak at very nearly the same time, but m-AST has the longer half-life. Immunological evidence of the mitochondrial isoenzyme can be detected in serum for at least eight days after the infarct. The presence of left ventricular failure produces greater serum isoenzyme activities than in those without failure.

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