Niveles séricos de la isoenzima creatina quinasa-MB y lactato deshidrogenasa como indicadores de daño miocárdico en perros con enfermedad valvular degenerativa / Serum levels of the isoenzyme creatine kinase-MB and lactate dehydrogenase as indicators of myocardial damage in dogs with degenerative valve disease

RESUMEN Se analizaron los niveles séricos de creatina quinasa-MB (CK-MB) y lactato deshidrogenasa (LDH) en 10 perros diagnosticados con enfermedad valvular degenerativa y en seis perros clinicamente sanos, con el objetivo de evaluar si sus niveles séricos indican daño miocárdico. Las muestras de suero se analizaron mediante el método UV. Se utilizó la prueba de diferenciación de medias para determinar diferencias entre medias, y la prueba de correlación de Pearson para determinar si existe correlación entre los niveles séricos de ambas enzimas. Los valores de CK-MB y de LDH fueron significativamente diferentes entre los dos grupos de pacientes. Los niveles de CK-MB y LDH tuvieron correlación positiva, pero no significativa.

ABSTRACT Serum levels of creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH) were analyzed in 10 dogs diagnosed with degenerative valvular disease and in six clinically healthy dogs with the objective of evaluating whether their serum levels indicate myocardial damage. Serum samples were analyzed by UV method. The mean differentiation test was used to determine differences between means and the Pearson correlation test was performed to determine if there was a correlation between the serum levels of both enzymes. The CK-MB and LDH values were significantly different between the two groups of patients. The levels of CK-MB and LDH had a positive but not significant correlation.

Protocatechuic aldehyde protects cardiomycoytes against ischemic injury

Rescuing cells from stress damage emerges a potential therapeutic strategy to combat myocardial infarction. Protocatechuic aldehyde (PCA) is a major phenolic acid in Chinese herb Danshen (

Troponins can it determine the outcome in acute organophosphorus poisoning?

Background: India has shown a sharp rise in the number of suicidal poisoning in the past few years and organo-phosphorus compounds are the most commonly implicated. This is a prospective study done to assess if troponins can be used as a prognostic marker in patients with organophosphate poisoning.Methods: Author conducted a prospective study on 50 patients to measure the level of troponin T and CK-MB on admission and Day 3 in patients with OP poisoning. This was then correlated to the severity of poisoning and also studied for its association with outcomes like respiratory failure or death. The primary endpoints were death and respiratory failure while secondary endpoint was the length of ICU stay.Results: With 0.1 ng/ml taken as the cut off for Troponin- T, and 40 U/L for CK-MB, positive cardiac enzymes were seen only in 10% of the patients, but all the patients in this group developed res-piratory failure. The mean Troponin T and CK-MB levels (0.1142±0.06 ng/ml and 39.14±8.23 U/L) were higher for patients who died when compared to the survivors. A similar picture was seen in patients with respiratory failure (Troponin T 0.0895±0.01 ng/ml and 34.65±11.66 U/L) as compared to those without respiratory failure.Conclusions: The level of cardiac enzymes correlated well with the severity of poisoning, days of ICU stay and outcome, thus suggesting its use as a prognostic indicator of organophosphorus poisoning.

Comparison of protective effects of carvedilol and ?-tocopherol on doxorubicin-induced cardiotoxocity

Background: Doxorubicin, an effective anticancer drug used to treat multiple solid tumours and childhood malignancies since many decades but its cardiac adverse effects limits its use in full therapeutic dose. The mechanism involved in cardiotoxicity is apoptosis of cardiomyocytes due to reactive oxidative stress. The study was conducted to compare the cardioprotective effects of carvedilol and ?-Tocopherol and to detect myocardial injury at early stage.Methods: Cardiotoxicity was produced in a group of rabbits by single intravenous injection of doxorubicin; control group was treated with normal saline only. Third and fourth groups were pretreated with carvedilol 30 mg/kg bodyweight and ?-Tocopherol 200 mg/kg bodyweight respectively for ten days before injection of doxorubicin.Results: Doxorubicin produced marked cardiotoxicity represented by raised levels of serum biomarkers (cTnI, LDH and CK-MB) and severe necrosis of cardiomyocytes on microscopic examination. Carvedilol and ?-tocopherol pretreatment resulted in decreased serum levels of biomarkers and improved the histological picture of heart tissue.Conclusions: The outcome of doxorubicin chemotherapy can be made successful with the concurrent use of carvedilol or ?-tocopherol. Although carvedilol has more pronounced cardioprotective effects perhaps due to its antioxidant activity in addition to antiapoptotic, antiproliferative and anti-inflammatory effects. Furthermore the quantitative cTnI estimation for detection of cardiotoxicity at early stage can lead to significant economic impact in management of cancer.

A prospective study on cardiac changes (electrocardiographic, enzymatic and echocardiographic) in birth asphyxiated neonates admitted in tertiary care centre

Background: Reduced myocardial performance and cardiac output following perinatal asphyxia may significantly complicate perinatal management and may contribute to increased end-organ damage and mortality. Hence the present study was done with the aim to assess the usefulness of echocardiography, electrocardiography (ECG), and cardiac enzymes in evaluating myocardial damage in perinatal asphyxia neonates and to assess their correlation with different stages of hypoxic-ischemic encephalopathy (HIE) and outcome.Methods: The study was conducted in the NICU, Department of Pediatrics, Government Chengalpattu Medical college hospital between August 2017 and August 2018 using 70 birth asphyxiated term babies. The asphyxiated babies were resuscitated as per NRP guidelines and were stratified into HIE stages as per Levene system of classification and were managed as per clinical condition. ECG grading, echo changes were noted. Creatinine kinase-MB (CKMB) levels were measured and documented after 12 hours of life among these babies and were analysed.Results: Of 70 cases, 36 (51.4%) had mild, 26 (37.1%) moderate and 8 (11.4%) severe HIE. Abnormal ECG was observed in 63 cases. Raised CKMB levels were found in 67 (95.7%) and abnormal echo findings were noted in 46 (65.7%) babies. ECG, echo changes and CKMB levels showed increasing abnormalities with increasing severity of HIE (p=0.000, 0.030 and 0.001 respectively). 8 babies in present study expired.Conclusions: Cardiac abnormalities among asphyxiated neonates requires high index of suspicion. ECG abnormalities, echo changes, elevated CK-MB levels in babies with HIE can help us identify neonates at risk of complications and guide in timely intervention that can prevent mortality of these babies and help us achieve better neurological outcome in these babies.

A Study Of Serum Ck–Mb Level In Non Dialysed Chronic Kidney Disease Patients

Chronic kidney disease is associated with early increased risk of cardiovascular morbidity and mortality. CK–MB the traditional marker for myocardial ischemia loses its specifity in renal failure because of non cardiac source of this enzyme. AIMS: The aim of the study was tomeasure and compare the level of serum CK–MB innon dialysed chronic kidney disease patientsand in healthy controls. MATERIAL AND METHOD 50 healthy controls and 50 non dialysed chronic kidney disease patients on conservative treatmentattending Nephrology department, Gauhati Medical College and Hospital, during September 2015–August 2016 were included in this study. Quantitative analysis of urea, creatinine, CK–MB were done by photometric method. RESULTS Serum CK–MB levels were significantly higher in the cases as compared to controls (p value <0.0001). CONCLUSION Non specific modest elevation of CK–MB can cause false positive results in absence of myocardial ischemia in CKD patients. So CK–MB should be interpreted with caution in these patients.

Effects of electroacupuncture on the expression of adenosine receptors in the heart tissue of myocardial ischemia rats / 中国针灸

<p><b>OBJECTIVE</b>To explore the impact of electroacupuncture (EA) on the protein expression of adenosine receptors in the heart of the rats with myocardial ischemia (MI).</p><p><b>METHODS</b>Thirty healthy male SD rats were divided randomly into a control group (=6), a model group (=12) and an EA group (=12). We ligated the left anterior descending artery (LAD) for MI model in the model group and EA group, and exposed the heart after opening the chest without ligation in the control group. EA, 2 Hz /15 Hz and 1.5-2 mA, was applied at bilateral"Neiguan"(PC 6) in the EA group for 20 min, once a day for continuous 5 days. No intervention except grabbing and fixation was used in the control group and model group. We applied 2% TTC staining to observe the infarct size of myocardium, colorimetry to analyze serum lactic dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), radio-immunity assessment to detect cardiac troponin T (cTnT), Western blot to evaluate the adenosine A1 receptor (A1AR), A2aAR, A2bAR and A3AR.</p><p><b>RESULTS</b>After treatment, myocardial infarction of (27.56±3.24)% was obvious in the model group; the myocardial infarction in the EA group was (21.04±3.61)%, with statistical significance (<0.05). The expressions of serum LDH, CK, CK-MB and cTnT levels in the model group increased compared with those in the control group (all<0.01), and the expressions of LDH, CK, CK-MB and cTnT levels in the EA group decreased compared with those in the model group (<0.05，<0.01). The A1AR expression in the model group was not different from that in the control group (>0.05), and A2aAR、A2bAR、A3AR expressions decreased (<0.05,<0.01). A2aAR and A2bAR expressions in the EA group increased compared with those in the model group (both<0.01), and there was no statistical significance between A1AR and A3AR expressions (both>0.05). .</p><p><b>CONCLUSION</b>EA may achieve cardioprotective effect by regulating the expressions of A2aAR and A2bAR in myocardial tissue, which induce the corresponding signal cascade for reducing myocardial infarction area.</p>

Clinical effect of Reduning in the treatment of children with herpangina and its influence on serum creatine kinase (CK), CK-MB activity, CK-MB quality, cTnⅠ / 中国基层医药

Objective To explore the clinical effect of Reduning in the treatment of children with herpangina,and its influence on serum creatine kinase (CK),creatine phosphate kinase isoenzyme (CK-MB) activity,CK-MB quality,cardiac troponin Ⅰ (cTnⅠ).Methods 104 children with herpangina were divided into control group and research group according to the draw method,with 52 cases in each group.The control group was given conventional treatment,the research group was treated with Reduning on the basis of conventional treatment.The clinical curative effect,clinical symptoms disappear time,CK,CK-MB activity,CK-MB quality,inflammation factors,immune function before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the research group was higher thanthat of the control group (98.07％ vs.84.61％),the difference was statistically significant (P ＜ 0.05).Before treatment,the CK,CK-MB activity,CK-MB quality,cTnⅠ of the two groups had no statistically significant differences (all P ＞ 0.05).After treatment,the CK,CK-MB activity,CK-MB quality,cTnⅠ of the research group were lower than those of the control group [(55.87 ± 6.98) U/L vs.(68.42 ± 8.55) U/L,(22.70 ±2.84)U/L vs.(29.45 ± 3.65)U/L,(2.99 ± 0.37) μg/L vs.(4.48 ±0.56) μg/L,(0.16 ± 0.02) μg/L vs.(0.74 ± 0.09) μg/L],the differences were statistically significant (all P ＜ 0.05).The incidence rate of adverse reaction of the research group was lower than that of the control group,the difference was statistically significant(P＜0.05).Conclusion Theclinical effect of Reduning in the treatment of children with herpangina is sure,it can help to relieve clinical manifestations,reduce serum levels of CK,CK-MB activity,CK-MB quality,cTnⅠ,and can alleviate the body's inflammatory response and immune function.

Clinical value of hs-cTnT combined with CK-MB in the diagnosis of children with myocarditis / 国际检验医学杂志

Objective To investigate clinical value of high sensitive-cardiac troponin T(hs-cTnT) combined with creatine kinase isoenzyme MB(CK-MB) in the diagnosis of children with myocarditis.Methods From Nov.2014 to Nov.2015,a total of 102 cases of myocarditis,suspected with myocardial damage and without myocardial damage(pneumonia and capillary bronchitis),and 50 healthy children were enrolled.Plasma levels of hs-cTnT and CK-MB were detected and compared.Results The levels of plasma hs-cTnT and CK-MB in children with myocarditis were significantly higher than those without myocarditis and healthy subjects(P<0.05).Hs-cTnT and CK-MB levels in children with myocarditis,less than one month old,were significantly higher than those with age of 1 month to 3 years old(P<0.05).Conclusion Combined detection of hs-cTnT and CK-MB could be with high sensitive and specificity in diagnosis of children with myocarditis,accurately assess the disease condition and improve the therapeutic effect and prognosis,which might be worthy of clinical application.

Clinical observation of Lanqin Oral Liquid combined with parenteral nutrition in treatment of children with hand foot mouth disease / 中草药

objective: To analyze Lanqin Oral Liquid (LOL) combined with nutritional therapy in the treatment of patients with hand foot mouth disease (HFMD). Methods: A total of 120 patients with HFMD in the Third Hospital of Qinhuangdao were randomly divided into observation group and control group, each of 60 cases. The patients in observation group were given routine treatment plus LOL combined with parenteral nutrition therapy, and the patients in control group were only given conventional treatment. The blood immunoglobulin IgG protein, total protein, total white cell count, and creatine kinase isoenzyme changes of children in two groups before treatment and 7 d after treatment were compared, and weight gain, hospitalization expenses, and hospitalization days of difference of children in two groups were also compared. Results: The IgG in blood of children in observation group was significantly higher than that in the control group (P < 0.05), and WBC and CK-MB in blood of children in observation group were significantly lower than that in the control group (P < 0.05). The weight gain of the observation group was significantly higher than that in the control group (P < 0.05); The length of hospital stay in the observation group was shorter than that in the control group (P < 0.05). Conclusion: LOL combined with parenteral nutrition can promote the rehabilitation of children with HFMD and improve treatment outcome.

Dynamic variation of creatine kinase MB isoenzymes and diagnostic value of myocardial damage in ;children with rotavirus diarrhea / 国际儿科学杂志

Objective To investagate the change of creatine kinase MB isoenzymes ( CK-MB ) in children with rotavirus diarrhea and to explore the value of CK-MB/CK in the diagnosis of myocardial damage. Methods A retrospective analysis of the clinical manifestation, laboratory test data and treatment was per-formed in children with rotavirus diarrhea and high CK-MB hospitalized in department of infectious disease, Si-hong Children Hospital. We investigated the dynamic changes of CK-MB in the rotavirus diarrhea patients with and without myocardial damage. Within the non-myocardial damage group, the fluctuation of CK-MB was compared between patients with nutrition therapy and patients with conventional therapy. Receiver operating characteristic ( ROC) curve was used to explore the predictive value of CK-MB/CK for the myocardial dam-age. Results A total of 603 patients (369 males, 234 females, aged 2~48 months) with high CK-MB were enrolled in this study ( 36 cases with myocardial damage ) . There were 54. 6% of enrolled patients showing higher CK-MB and 3. 3% of patients had myocardial damage. The levels of serum CK-MB in non-myocardial damage group reached the peak on day 7 and decreased to normal in 14 days. The levels of serum CK-MB in myocardial damage group reached the peak on day 14 and maintained at fairly high level for 8 weeks and then decreased to normal . Time for CK-MB to achieve peak is different between these two groups. There was no statistical significance in the levels of serum CK-MB on day1 to day 14 between patients with or without myocar-dial protection ( P >0. 05 ) . The ROC curves were constructed with area under the ROC curves of 0. 697 (0. 611, 0. 784, 95%CI). Conclusion Intrinsic dynamics of CK-MB existed in patients with rotavirus diar-rhea. The diagnostic value of CK-MB is limited in patients with myocardial damage.

Study on the effect of salbutamol combined with noninvasive ventilator on TNF-α, IL-6, IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure / 中国生化药物杂志

Objective To analysis the effect of salbutamol combined with noninvasive ventilator on TNF-α,IL-6,IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure.Methods 60 patients who were diagnosed with chronic obstructive pulmonary disease with respiratory failure were collected.All patients were randomly divided into experimental group and control group,30 cases in each group. Patients in the control group received noninvasive ventilator treatment, patients in the experimental group were given salbutamol treatment on the basis of control group treatment, after the treatment, the serum levels of TNF-α,IL-6,IL-8 and serum CK-MB activity were detected in all patients.Results After treatment, compared with control group, the serum level of TNFαwas lower in the experimental group,and the difference was statistically significant(P<0.05); the serum level of IL-6 and IL-8 were lower in the experimental group(P<0.05); the serum CK-MB activity was lower in the experimental group(P<0.05).Conclusion The salbutamol combined with noninvasive ventilator can significantly reduce the serum levels of TNF-α, IL-6, IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure, reduce the inflammatory reaction and reduce the myocardial damage,and have a guiding significance for clinica.

Comparative Levels of Total Creatine Kinase and MB-isoenzyme in Cord Blood between Vaginal Delivery and Cesarean Section.

Comparing cord blood levels of total Creatine kinase (CK) and Creatine kinase MB isoenzyme (CK-MB) in newborns delivered by vaginal delivery and cesarean section. Study Design: Descriptive prospective study. Place and Duration of Study: All neonates delivered from September to October 2012 at the obstetric ward of Mousavi hospital. (Zanjan, Iran). Methodology: Total cord blood CK (CK) and MB isoenzyme (CK-MB) was measured immediately after delivery. Rout of delivery and APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) Score were also assessed and all data were analyzed by using SPSS 16.0 software. Results: One hundred and seventy six newborns were recruited (57.4% male and 42.6% female). We found significant association between serum CK-MB level and rout of delivery. There was no significant association between serum levels of total Ck and CK-MB and APGAR score (p˃0.05). Discussion and conclusions: This study showed that newborns who were vaginally delivered had elevated CK-MB levels.

Metabolismo oxidativo e cardíaco de equinos submetidos a exercício de baixa intensidade antes e após suplementação com antioxidante / Oxidative and cardiac metabolism of horses subjected to low intensity exercise before and after antioxidant supplementation

O presente estudo objetivou avaliar os marcadores cardíacos e de lipoperoxidação em equinos no teste de exercício de baixa intensidade e longa duração (TLD), antes e após a suplementação com vitamina E. Para tanto, foram utilizados 10 equinos, submetendo-os ao primeiro TLD, com carga de trabalho fundamentada no consumo máximo de oxigênio individual (VO2max). Em seguida, durante 59 dias, os equinos receberam vitamina E (dl-alfa-tocoferol) na dose diária de 1.000UI por via oral e, posteriormente, realizaram um segundo TLD com o mesmo protocolo do primeiro. As amostras de sangue foram colhidas para determinação do malondialdeído (MDA) plasmático, como índice de lipoperoxidação, da concentração sérica de troponina I cardíaca (cTnI) e da isoenzima MB da creatinoquinase (CK-MB) como marcadores cardíacos. Como efeito do exercício, não se observou aumento significativo de MDA nem de cTnI, mas sim da concentração sérica de CK-MB, sugerindo-se o estresse miocárdico. A suplementação foi capaz de amenizar a produção de espécies reativas de oxigênio, evidenciada pela menor concentração de MDA em todos os momentos avaliados, porém não causou efeito protetor no miocárdio. Concluiu-se que o exercício de baixa intensidade e longa duração promoveu estresse miocárdico em equinos de forma leve e a suplementação com vitamina E reduziu a lipoperoxidação.

The present study aimed to evaluate cardiac and lipoperoxidation markers in horses subjected to low intensity and long duration (TLD) exercise test, before and after vitamin E supplementation. For this purpose, 10 horses were used, subjecting them to the first TLD with a workload based on individual maximal oxygen uptake (VO2max). Then, horses received vitamin E (dl-alpha-tocopherol) during 59 days at a daily oral dose of 1,000IU, and thereafter they performed a second TLD with the same protocol as the first. Blood samples were collected to determine plasma malondialdehyde (MDA) as an index of lipoperoxidation, serum cardiac troponin I (cTnI) and creatine kinase MB isoenzyme (CK-MB) as cardiac markers. As a result of the exercise, there was no significant increase in MDA or cTnI, but serum CK-MB increased suggesting myocardial stress. The supplementation was able to minimize reactive oxygen species production, as evidenced by lower concentrations of MDA at all times evaluated, but it didn't cause protective effect on the myocardium. It was concluded that the low intensity and long duration exercise promoted light myocardial stress in horses and vitamin E supplementation reduced lipoperoxidation.

Clinical application value of point-of-care combined detection of cardiac markers for diagnosing acute myocardial infarction / 国际检验医学杂志

Objective To investigate the clinical application value of point-of-care combined detection of cTnI,MYO and CK-MB in the patients with acute myocardial infarction (AMI).Methods 74 cases of coronary syndrome were collected as the patients group,including 36 cases of AMI and 38 cases of unstable angina pectoris(UAP),and 40 individuals with healthy physical examina-tion were selected as the control group.The concentrations of cardiac marker cTnI,MYO and CK-MB in blood at different times were detected by using the point-of-care rapid immune quantitative method.Then the sensitivity and specificity for diagnosing AMI were compared for determining the best time of single detection and combined detection.Results The positive rates of cTnI,MYO and CK-MB within onset 2-12 h with the symptoms in the AMI group were higher than those in the control group and the UAP group,the difference had statistical significance (P <0.01).The combined detection of cTnI,MYO and CK-MB within onset 6-12 h with symptoms had the higher sensitivity and higher specificity for diagnosing AMI.The combined detection of cTnI and CK-MB within onset 12-24 h with symptoms could reach the optimal sensitivity and optimal specificity for the diagnosis.The sensitivity and specificity of cTnI within onset 24-72 h with symptoms for diagnosing AMI were 100.0% and 100.0% respectively.Conclu-sion The point-of-care combined detection of cTnI,MYO and CK-MB can conveniently and rapidly diagnose AMI.The sensitivty and specificity of various indexes in different time periods are different.Their combined detection can increase the diagnostic rate for AMI.

Cardiac Damage Biomarkers Following a Triathlon in Elite and Non-elite Triathletes

The purpose of the present study was to investigate cardiac damage biomarkers after a triathlon race in elite and non-elite athlete groups. Fifteen healthy men participated in the study. Based on performance, they were divided into elite athlete group (EG: n=7) and non-elite athlete group (NEG: n=8). Participants' blood samples were obtained during four periods: before, immediately, 2 hours and 7 days after finishing the race. creatine kinase (CK), creatine kinase-myoglobin (CK-MB), myoglobin, and lactate dehydrogenase (LDH) were significantly increased in both groups immediately after, and 2 hours after finishing the race (p<.05). CK, CK-MB, and myoglobin were completely recovered after 7 days (p<.05). Hematocrit (Hct) was significantly decreased in both groups (p<.05) 7 days after the race. LDH was significantly decreased in the EG (p<.05) only 7 days after the race. Homoglobin (Hb) was significantly decreased in the NEG (p<.05) only 2 hours after the race. Although cardiac troponin T (cTnT) was significantly increased in the EG but not in the NEG 2hours after the race (p<.05), there was no group-by-time interaction. cTnT was completely recovered in both groups 7 days after the race. In conclusion, cardiac damage occurs during a triathlon race and, is greater in elite than in non-elite. However, all cardiac damage markers return to normal range within 1 week.

Analysis of the Reasons of the Higher Result of CK-MB with Immune Suppression Method for Detecting Serum CK-MB / 现代检验医学杂志

Objective To investigate the reasons of higher result of CK-MB than the total CK with the immune suppression method for deteting serum CK-MB and solution methods.Methods Selected 68 cases of inpatients with myocardial infarc-tion from Department of Cardiology,32 cases of malignant tumor from Internal Medicine-Oncology,including 8 cases of liver cancer,6 cases of lung cancer,6 cases of gastric cancer,5 cases of neuroblastoma,4 cases of breast cancer and 3 cases of o-varian cancer and 16 cases of cirrhosis from Department of Gastroenterology,and at the same time,selected 100 cases of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospital.Used Roche MODUALR automatic biochemical analyzer to detected the activity of serum CK-MB with the immune suppression method and the activity of total CK with the enzyme coupling rate method.Results In 68 cases of inpatients with myocardial infarction,the activity of serum CK-MB of 2 1 cases were individually increased,the activity of total CK of 3 9 cases were in-creased,and the two indexes of 30 cases were increased in the same period.In 32 cases of inpatients with malignant tumor, the activity of serum CK-MB of 1 1 cases were individually increased,the activity of total CK of 3 cases were increased and the two indexes of 3 cases were also increased.The activity of serum CK-MB of 6 cases were individually increased in 1 6 ca-ses of cirrhosis.Conclusion The immune inhibition assay for the detection of CK-MB as the diagnosis index of myocardial infarction had certain defects,and the higher activity of CK-MB could be highly associated with some severe inflammation, malignant tumor.

Impacto económico del precondicionamiento isquémico remoto en la revascularización miocárdica / Economic impact of remote ischemic preconditioning on myocardial revascularization

Introducción: condicionar el corazón para mejorar sus capacidades cardioprotectoras endógenas con el uso de isquemias breves a distancia proporciona un novedoso abordaje potencial a la protección miocárdica durante la cirugía cardiaca. Objetivo: identificar el impacto económico del precondicionamiento isquémico a distancia en los pacientes revascularizados quirúrgicamente. Métodos: se realizó un estudio longitudinal prospectivo experimental en dos grupos de 100 personas, a los que se les realizó revascularización por injerto de la arteria coronaria. Se procedió a colocar un torniquete en el brazo no dominante en quienes se incluyeron en el grupo de estudio prueba, alternando tres insuflaciones con tres desinsuflaciones con una presión de 200 mmHg, manteniéndola por espacio de cinco minutos cada una, este proceder se realizó previo, durante y después del evento isquémico mayor que se corresponde con el pinzamiento de la arteria coronaria. Resultados: se logró una importante disminución del consumo de drogas inotrópicas, vasoactivas y de otros medicamentos ahorrándose una importante suma disminuyendo los costos hospitalarios. Comprobándose además, la disminución en la incidencia de arritmias ventriculares letales, bajo gasto cardiaco fatal y de muerte postoperatoria, en todos los casos muy por debajo de la predicción previamente realizada para estas complicaciones. Conclusiones: el precondicionamiento isquémico a distancia puede ser una importante herramienta a tener en cuenta en la protección antisquémica de la revascularización miocárdica que puede disminuir la morbimortalidad y los costos hospitalarios.

Background: to condition the heart to improve its endogenous cardioprotective capacity using brief remote ischemia provides a novel potential approach to myocardial protection during cardiac surgery. Objective: to identify the economic impact of remote ischemic preconditioning in surgically revascularized patients. Methods: an experimental prospective longitudinal study was conducted in two groups of 100 people who underwent revascularization by coronary artery graft. A tourniquet was placed on the non-dominant arm in those who were included in the test study group, alternating three insufflations with three desinsufflations with a pressure of 200 mmHg, each one being maintained for five minutes. This procedure was performed prior to, during and after the greater ischemic event that corresponds to the pinching of the coronary artery. Results: an important decrease of the consumption of inotropic, vasoactive and other drugs was achieved, saving an important sum, decreasing hospital costs, and also proving a reduction in the incidence of lethal ventricular arrhythmias, low cardiac output and postoperative death which were, in all cases, below the prediction previously made for these complications. Conclusions: remote ischemic preconditioning can be an important tool to be considered in the antischemic protection of myocardial revascularization that can diminish morbimortality and hospital costs.

Infecção experimental pelo Trypanosoma cruzi em camundongos: influência do exercício físico versus linhagens e sexos / Experimental infection with Trypanosoma cruzi in mice: influence of exercise versus strains and sexes

INTRODUÇÃO: A doença de Chagas é uma infecção causada pelo Trypanosoma cruzi que afeta oito milhões de pessoas na América Latina. Um fator ligado ao estilo de vida que interfere significativamente na resposta à infecção é o exercício físico, dependendo do tipo, intensidade e frequência da atividade praticada. OBJETIVO: Avaliar a influência do exercício físico aeróbio moderado crônico pré-infecção na evolução da infecção experimental pelo T. cruzi em camundongos de duas linhagens distintas pertencentes aos dois sexos. MÉTODOS: Camundongos Swiss e BALB/c (machos e fêmeas) com 30 dias de idade foram divididos em quatro grupos para cada linhagem e sexo (total de 16) e nomeados como segue: SM (Swiss machos), SF (Swiss fêmeas), BM (BALB/c machos) e BF (BALB/c fêmeas). Os grupos foram: NT+NI (não treinado+não infectado), T+NI (treinado+não infectado), NT+I (não treinado+infectado) e T+I (treinado+infectado). O programa de exercício físico aeróbio moderado crônico pré-infecção foi realizado durante oito semanas, com uma sessão diária de treinamento, cinco vezes na semana. O inóculo foi de 1.400 tripomastígotas sanguíneos da cepa Y do T. cruzi, via intraperitoneal. Foi avaliado o pico de parasitos, parasitemia total média e as medidas das atividades séricas de CK e CK-MB. RESULTADOS E CONCLUSÃO: O treinamento físico promoveu nas duas linhagens e em ambos os sexos redução no pico de parasitos e na parasitemia total média em animais infectados pelo T. cruzi. O treinamento físico promoveu redução nas atividades séricas de CK e CK-MB em animais infectados pelo T. cruzi, de ambos os sexos, das duas linhagens, exceto para fêmeas Swiss na atividade de CK e CK-MB.

BACKGROUND: Chagas disease is an infection caused by Trypanosoma cruzi that affects eight million people in Latin America. One factor linked to the lifestyle that significantly interferes in the response to infection is physical exercise, depending on the kind, intensity and frequency of the activity practiced. OBJECTIVE: To evaluate the influence of pre-infection chronic moderate aerobic exercise in the development of experimental infection with T. cruzi in mice of two distinct lineages from both sexes. METHODS: 30-day old Swiss and BALB/c mice (male and female) were divided into four groups for each strain and sex (total 16) and named as follows: SM (Swiss males), SF (Swiss females) BM (BALB/c mice) and BF (BALB/c mice). The groups were: NT NI (untrained uninfected) T NI (trained not infected); NT I (untrained infected), TI (trained infected). The aerobic exercise pre-moderate chronic infection training was performed with one daily session for eight weeks, five times a week. The inoculum was 1,400 blood trypomastigotes of Y strain of T. cruzi intraperitoneally. The peak of parasites, parasitemia total and average measurements of the serum activities of CK and CK-MB were evaluated. RESULTS AND CONCLUSIONS: The physical training promoted reduction in peak, parasitemia parasites and total average in animals infected with T. cruzi in both strains and sexes. Physical training induced reduction in serum activities of CK and CK-MB in animals infected with T. cruzi of both sexes and from the two strains, except for females in the Swiss CK activity.

Gender differences in serum CK-MB mass levels in healthy Braziliansubjects

The creatine kinase-isoenzyme MB (CK-MB) mass assay is one of the laboratory tests used for the diagnosis of myocardial infarction. It is recommended, however, that reference limits should take gender and race into account. In the present study, we analyzed the plasma CK-MB mass and troponin levels of 244 healthy volunteers without a personal history of coronary artery disease and with no chronic diseases, muscular trauma or hypothyroidism, and not taking statins. The tests were performed with commercial kits, CK-MB mass turbo kit and Troponin I turbo kit, using the Immulite 1000 analyzer from Siemens Healthcare Diagnostic. The values were separated according to gender and showed significant differences by the Mann-Whitney test. Mean (± SD) CK-MB mass values were 2.55 ± 1.09 for women (N = 121; age = 41.20 ± 10.13 years) and 3.49 ± 1.41 ng/mL for men (N = 123; age = 38.16 ± 11.12 years). Gender-specific reference values at the 99th percentile level, according to the Medicalc statistical software, were 5.40 ng/mL for women and 7.13 ng/mL for men. The influence of race was not considered because of the high miscegenation of the Brazilian population. The CK-MB values obtained were higher than the 5.10 mg/mL proposed by the manufacturer of the laboratory kit. Therefore, decision limits should be related to population and gender in order to improve the specificity of this diagnostic tool, avoiding misclassification of patients.