China
Africa
Explore chapters and articles related to this topic
Cardiac biomarkers in acute coronary syndrome
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
CK-MB is a CK isoenzyme, predominantly found in the myocardium. Its elevation occurs 4–6 hours after the onset of myocardial necrosis and remains for 24–48 hours. CK-MB sensitivity and specificity in detecting myocardial injury can be increased by serial testing. CK-MB is relatively sensitive, but its specificity is affected by the presence of this marker in skeletal muscle. Elevation in CK-MB, in fact, may occur as a result of occasional analytical interferences and in patients with trauma, rhabdomyolysis, myopathies, renal failure or during the peripartum period. To improve its specificity, it was proposed to use CK-MB relative index (CK-MB/total CK). Ratios greater than 2.5% are considered suggestive of myocardial damage. CK-MB mass, CK-MB activity and total CK are more specific than myoglobin, but may not be detectable for 4–6 hours in the bloodstream following myocardial injury. The sensitivity of CK-MB mass for AMI is only 50% when measured early at the time of presentation. In clinical practice, peak levels of markers of necrosis and area under the time release curve of CK-MB from repetitive serial samplings are used to estimate infarct size [8,9].
Drug-induced eosinophilia and systemic symptoms
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Rajesh Verma, Pradeesh Arumugam
Heart: Pericarditis and myocarditis may be seen [26]. These are rare manifestations and usually have serious consequences. Chest pain and dyspnea should prompt for detailed evaluation. Tachycardia, hypotension, and signs of a pericardial and/or pleural effusion can be found on clinical examination. Electrocardiogram (ECG) may demonstrate T-wave abnormalities or other arrhythmias. Echocardiogram may demonstrate a pericardial effusion, or reduced ejection fraction. Cardiac enzymes such as CK-MB fraction and Trop-T may be elevated. Both pericarditis and myocarditis respond to standard therapy [27]. Acute necrotizing eosinophilic myocarditis (ANEM) is a severe form of myocarditis with extreme impairment of ejection fraction and major systolic dysfunction, carrying a high mortality (>50%) [28].
Plasma enzymes in diagnosis (clinical enzymology)
Published in Martin Andrew Crook, Clinical Biochemistry & Metabolic Medicine, 2013
Creatine kinase consists of two protein subunits, M and B, which combine to form three isoenzymes, BB (CK-1), MB (CK-2) and MM (CK-3). CK-MM is the predominant isoenzyme in skeletal and cardiac muscle and is detectable in the plasma of normal subjects.CK-MB accounts for about 35 per cent of the total CK activity in cardiac muscle and less than 5 per cent in skeletal muscle; its plasma activity is always high after myocardial infarction. The use and limitations of CK-MB estimation are considered in Chapter 22. It may be detectable in the plasma of patients with a variety of other disorders in whom the total CK activity is raised, but this accounts for less than 6 per cent of the total CK activity.CK-BB is present in high concentrations in the brain and in the smooth muscle of the gastrointestinal and genital tracts. Increased plasma activities may occur during parturition. Although they have also been reported after brain damage, for example trauma or cerebrovascular accident, and in association with malignant tumours of the bronchus, prostate and breast, measurement is not of proven value for diagnosing these conditions. In malignant disease, plasma total CK activity is usually normal.
The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease
Published in Renal Failure, 2023
Yunxian Chen, Xiwen Zhou, Zhixin Chen, Jue Xia, Fenglei Guan, Yue Li, Yanrong Li, Yicai Chen, Yuanlin Zhao, Huayun Qiu, Jiarong Liang, Liangqiu Tang
Hs-cTnT was detected using the electrochemiluminescence immunoassay (e602, Roche Diagnostics, Mannheim, Germany, the upper reference limit: 14 pg/mL, range: 3–10 000 pg/mL). CK-MB was measured using immunosuppression assay (LABCO, China, the upper reference limit: 24 U/L, range: 5–2300 U/L). After hospital admission, patients with AMI were typically tested multiple times for hs-cTnT and CK-MB. At our center, blood tests were normally performed immediately after admission, 4 h after PCI, on the mornings of the second and third days of admission. If the patient experiences an episode of chest pain or the condition worsens, blood will be obtained at any time for evaluation. We selected the maximum values of hs-cTnT and CK-MB for analysis and used them to calculate the hs-cTnT/CK-MB ratio. eGFR, calculated by the CKD-Epidemiology Collaboration equation, was used to evaluate renal function. GFR categories were defined as follows: G1: eGFR ≥ 90 mL/min/1.73m2; G2: eGFR = 60–89 mL/min/1.73m2; G3: eGFR = 30–59 mL/min/1.73m2; G4: eGFR = 15–29 mL/min/1.73m2. We classified G1 as the normal renal function group and G2–G4 as the renal insufficiency group (or CKD group, in our study).
Serum miRNA-146a and vitamin D values in chronic renal ailment with and without comorbid cardiovascular disease
Published in Egyptian Journal of Basic and Applied Sciences, 2023
Fatma K. A. Hamid, Alshaymaa M. Alhabibi, Mona A. Mohamed, Hanaa Hussein El-Sayed, Nehad Rafaat Ibrahim, Ghadir Mohamed Hassan Elsawy, Entsar M. Ahmad
In the current investigation, compared to controls, CKD patients had higher serum levels of urea, and creatinine and lower eGFR. It has been demonstrated that as eGFR declines, cardiovascular morbidity increases in frequency and severity [16]. Furthermore, several earlier types of research have shown a connection between serum CK-MB levels and GFR. According to Wang et al. [17], CK-MB levels in CKD patients decline with GFR and rise with the degree of renal failure. However, their investigation found no correlation between CK-MB and eGFR. The levels of CK-MB and eGFR did not correlate, according to Sato et al. [18] The evaluation of CK-MB and renal function in CKD patients may be impacted by several frequent comorbidities, such as cachexia, extracellular fluid overload, oxidative stress and inflammatory illnesses. In light of this, heart damage or disease may not be the exclusive cause of elevations in serum CK-MB levels [19,20].
Enhanced therapeutic efficacy of doxorubicin against multidrug-resistant breast cancer with reduced cardiotoxicity
Published in Drug Delivery, 2023
Tianyu Zhang, Nuannuan Li, Ru Wang, Yiying Sun, Xiaoyan He, Xiaoyan Lu, Liuxiang Chu, Kaoxiang Sun
Cardiac enzymes are a general term for a variety of enzymes located in the myocardium, including creatine kinase isoenzymes (CK-MB) and lactate dehydrogenase (LDH). Many diseases that can cause tissue damage can lead to increased LDH activity. CK-MB is mainly stepwise in cardiac myocytes and is a marker of myocardial injury (Jiao et al., 2022; Qi et al., 2023). To detect the safety of PEI-DOX/EGCG/FA on myocardial cells, Therefore, the LDH and CK-MB were tested. It can be seen from Figure 4(F) that compared with the control (4.42 ± 0.31) ng/mgprot, the level of CK-MB in H9c2 cells treated with DOX had increased to (16.22 ± 0.09) ng/mgprot while that of PEI-DOX/EGCG and PEI-DOX/EGCG/FA was only (7.43 ± 0.09) and (5.41 ± 0.36) ng/mgprot, respectively. The detection of LDH shown in Figure 4(G) also displayed the similar result as CK-MB that PEI-DOX/EGCG and PEI-DOX/EGCG/FA exhibited much lower damage to myocardial cells than DOX and even PEI-DOX.