The nature of disappearance of creatine kinase from the circulation and its influence on enzymatic estimation of infarct size.
Population
40 conscious dogs
Design
Preclinical
Authors
Discussion
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Implication
Continuing CK release post-MI may confound enzymatic infarct sizing; leaves open refined kinetic models for accurate estimation.
Key Points
- To determine whether the true clearance rate of creatine kinase from the circulation is accurately represented by blood elimination kinetics when estimating myocardial infarct size.
- Evaluated plasma enzyme time-activity curves in 40 conscious dogs following induced myocardial infarction, bolus injection, or slow intravenous infusion of myocardial or plasma-harvested creatine kinase.
- Characterized and compared the two creatine kinase preparations using cellulose acetate electrophoresis, radioimmunoassay, gel chromatography, and in vitro stability testing.
- Plasma creatine kinase curves after intravenous injection conformed more closely to a double-exponential two-compartment model than a single-exponential model, yielding average standard deviations 42% as large.
- Calculations derived from the two-compartment model accounted for twofold more creatine kinase released from the heart following infarction compared to traditional single-compartment estimates.
- Plasma creatine kinase clearance was 60% slower following myocardial infarction than after intravenous enzyme injection, driven by structural enzyme differences and delayed release from ischemic tissue.
Structured PICO
P
Population
40 conscious dogs
I
Intervention
Induced myocardial infarction, bolus injection, or slow intravenous infusion of creatine kinase (CK) extracted from myocardium and CK harvested from plasma
O
Outcome
Plasma CK time-activity curves and disappearance ratesurrogate
The disappearance of creatine kinase from circulation follows a two-compartment model, and its slower decline after myocardial infarction suggests continuing release from the ischemic heart, which impacts the enzymatic estimation of infarct size.
Cite This Study
Sobel et al. (1977) studied this question.