Myocardial injury in infants with congenital heart disease: Evaluation by creatine kinase MB isoenzyme analysis

Robert J. Boucek, Alfred G. Kasselberg, Robert C. Boerth, Mark D Parrish, Thomas P. Graham

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Total creatine kinase (CK) and the myocardial isoenzyme CK MB activity were prospectively determined in 282 children hospitalized for cardiac catheterization and evaluation for suspected congenital cardiac abnormalities and compared with a hospitalized control group of children without such abnormalities. The percent CK MB and CK MB activity were abnormally elevated in symptomatic children with a large left to right shunt due either to a large ventricular septal defect (n = 22; p < 0.001) or to complete atrioventricular canal (n = 10; p < 0.001). Serum CK MB activity and percent CK MB were significantly related to the size of the shunt and the age of presentation with clinical symptoms of congestive heart failure in infants with a ventricular septal defect. CK MB activity was abnormally elevated in infants with symptomatic coarctation of the aorta, either with or without a ventricular septal defect (n = 15; p < 0.001), and in infants with symptomatic aortic stenosis (n = 4; p < 0.02). In contrast, CK MB activity was normal in asymptomatic children with coarctation of the aorta (n = 14) or aortic stenosis (n = 8) despite comparable systolic pressure gradients. CK MB activity and percent CK MB were abnormally elevated in those children with the cyanotic congenital cardiac abnormalities of either transposition of the great arteries (n = 32; p < 0.001) or right ventricular outflow tract obstruction (n = 31; p < 0.001). These results suggest that children with congenital cardiac abnormalities may have significant myocardial cell injury and release of CK MB that may be detected by the determination of serum CK MB activity. Cell injury may be secondary to arterial desaturation or acute pressure-volume overload, or both, as manifested by clinical symptoms of heart failure and measured hemodynamic variables.

Original languageEnglish (US)
Pages (from-to)129-135
Number of pages7
JournalThe American journal of cardiology
Volume50
Issue number1
DOIs
StatePublished - 1982
Externally publishedYes

Fingerprint

MB Form Creatine Kinase
Isoenzymes
Heart Diseases
Wounds and Injuries
Ventricular Heart Septal Defects
Aortic Coarctation
Aortic Valve Stenosis
Heart Failure
Ventricular Outflow Obstruction
Transposition of Great Vessels
Hospitalized Child
Cardiac Catheterization
Creatine Kinase
Serum
Hemodynamics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Myocardial injury in infants with congenital heart disease : Evaluation by creatine kinase MB isoenzyme analysis. / Boucek, Robert J.; Kasselberg, Alfred G.; Boerth, Robert C.; Parrish, Mark D; Graham, Thomas P.

In: The American journal of cardiology, Vol. 50, No. 1, 1982, p. 129-135.

Research output: Contribution to journalArticle

Boucek, Robert J. ; Kasselberg, Alfred G. ; Boerth, Robert C. ; Parrish, Mark D ; Graham, Thomas P. / Myocardial injury in infants with congenital heart disease : Evaluation by creatine kinase MB isoenzyme analysis. In: The American journal of cardiology. 1982 ; Vol. 50, No. 1. pp. 129-135.
@article{970abcf93111461098662d348a63dc3b,
title = "Myocardial injury in infants with congenital heart disease: Evaluation by creatine kinase MB isoenzyme analysis",
abstract = "Total creatine kinase (CK) and the myocardial isoenzyme CK MB activity were prospectively determined in 282 children hospitalized for cardiac catheterization and evaluation for suspected congenital cardiac abnormalities and compared with a hospitalized control group of children without such abnormalities. The percent CK MB and CK MB activity were abnormally elevated in symptomatic children with a large left to right shunt due either to a large ventricular septal defect (n = 22; p < 0.001) or to complete atrioventricular canal (n = 10; p < 0.001). Serum CK MB activity and percent CK MB were significantly related to the size of the shunt and the age of presentation with clinical symptoms of congestive heart failure in infants with a ventricular septal defect. CK MB activity was abnormally elevated in infants with symptomatic coarctation of the aorta, either with or without a ventricular septal defect (n = 15; p < 0.001), and in infants with symptomatic aortic stenosis (n = 4; p < 0.02). In contrast, CK MB activity was normal in asymptomatic children with coarctation of the aorta (n = 14) or aortic stenosis (n = 8) despite comparable systolic pressure gradients. CK MB activity and percent CK MB were abnormally elevated in those children with the cyanotic congenital cardiac abnormalities of either transposition of the great arteries (n = 32; p < 0.001) or right ventricular outflow tract obstruction (n = 31; p < 0.001). These results suggest that children with congenital cardiac abnormalities may have significant myocardial cell injury and release of CK MB that may be detected by the determination of serum CK MB activity. Cell injury may be secondary to arterial desaturation or acute pressure-volume overload, or both, as manifested by clinical symptoms of heart failure and measured hemodynamic variables.",
author = "Boucek, {Robert J.} and Kasselberg, {Alfred G.} and Boerth, {Robert C.} and Parrish, {Mark D} and Graham, {Thomas P.}",
year = "1982",
doi = "10.1016/0002-9149(82)90018-2",
language = "English (US)",
volume = "50",
pages = "129--135",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Myocardial injury in infants with congenital heart disease

T2 - Evaluation by creatine kinase MB isoenzyme analysis

AU - Boucek, Robert J.

AU - Kasselberg, Alfred G.

AU - Boerth, Robert C.

AU - Parrish, Mark D

AU - Graham, Thomas P.

PY - 1982

Y1 - 1982

N2 - Total creatine kinase (CK) and the myocardial isoenzyme CK MB activity were prospectively determined in 282 children hospitalized for cardiac catheterization and evaluation for suspected congenital cardiac abnormalities and compared with a hospitalized control group of children without such abnormalities. The percent CK MB and CK MB activity were abnormally elevated in symptomatic children with a large left to right shunt due either to a large ventricular septal defect (n = 22; p < 0.001) or to complete atrioventricular canal (n = 10; p < 0.001). Serum CK MB activity and percent CK MB were significantly related to the size of the shunt and the age of presentation with clinical symptoms of congestive heart failure in infants with a ventricular septal defect. CK MB activity was abnormally elevated in infants with symptomatic coarctation of the aorta, either with or without a ventricular septal defect (n = 15; p < 0.001), and in infants with symptomatic aortic stenosis (n = 4; p < 0.02). In contrast, CK MB activity was normal in asymptomatic children with coarctation of the aorta (n = 14) or aortic stenosis (n = 8) despite comparable systolic pressure gradients. CK MB activity and percent CK MB were abnormally elevated in those children with the cyanotic congenital cardiac abnormalities of either transposition of the great arteries (n = 32; p < 0.001) or right ventricular outflow tract obstruction (n = 31; p < 0.001). These results suggest that children with congenital cardiac abnormalities may have significant myocardial cell injury and release of CK MB that may be detected by the determination of serum CK MB activity. Cell injury may be secondary to arterial desaturation or acute pressure-volume overload, or both, as manifested by clinical symptoms of heart failure and measured hemodynamic variables.

AB - Total creatine kinase (CK) and the myocardial isoenzyme CK MB activity were prospectively determined in 282 children hospitalized for cardiac catheterization and evaluation for suspected congenital cardiac abnormalities and compared with a hospitalized control group of children without such abnormalities. The percent CK MB and CK MB activity were abnormally elevated in symptomatic children with a large left to right shunt due either to a large ventricular septal defect (n = 22; p < 0.001) or to complete atrioventricular canal (n = 10; p < 0.001). Serum CK MB activity and percent CK MB were significantly related to the size of the shunt and the age of presentation with clinical symptoms of congestive heart failure in infants with a ventricular septal defect. CK MB activity was abnormally elevated in infants with symptomatic coarctation of the aorta, either with or without a ventricular septal defect (n = 15; p < 0.001), and in infants with symptomatic aortic stenosis (n = 4; p < 0.02). In contrast, CK MB activity was normal in asymptomatic children with coarctation of the aorta (n = 14) or aortic stenosis (n = 8) despite comparable systolic pressure gradients. CK MB activity and percent CK MB were abnormally elevated in those children with the cyanotic congenital cardiac abnormalities of either transposition of the great arteries (n = 32; p < 0.001) or right ventricular outflow tract obstruction (n = 31; p < 0.001). These results suggest that children with congenital cardiac abnormalities may have significant myocardial cell injury and release of CK MB that may be detected by the determination of serum CK MB activity. Cell injury may be secondary to arterial desaturation or acute pressure-volume overload, or both, as manifested by clinical symptoms of heart failure and measured hemodynamic variables.

UR - http://www.scopus.com/inward/record.url?scp=0019987506&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0019987506&partnerID=8YFLogxK

U2 - 10.1016/0002-9149(82)90018-2

DO - 10.1016/0002-9149(82)90018-2

M3 - Article

C2 - 7090995

AN - SCOPUS:0019987506

VL - 50

SP - 129

EP - 135

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 1

ER -