Myocardial enzyme spectrum examination
Release time : 04/25/2025 09:30:01
Although it is often mentioned during hospital physical examinations that myocardial enzyme profile testing is performed, many people still do not understand what it entails.
Let's introduce what is a myocardial enzyme profile test, and how to interpret the results of this test. A myocardial enzyme profile test involves the measurement of specific enzymes in the blood (such as creatine kinase, lactate dehydrogenase, etc.) to evaluate the health of the myocardium. When the myocardium is damaged, these enzymes are released into the bloodstream, so by detecting their levels in the blood, it is possible to determine whether the myocardium has been compromised. The results of a myocardial enzyme profile test typically include multiple indicators such as creatine kinase MB isoenzyme (CK-MB), creatine kinase (CK), lactate dehydrogenase (LDH), etc. The doctor will judge whether the myocardium is compromised based on the numerical values and trends of these indicators. Under normal circumstances, these indicators should be within normal ranges. If the myocardium is compromised, these indicators may rise; if the myocardial function recovers well, these indicators may gradually return to normal. It is important to note that the results of a myocardial enzyme profile test are only an aid in diagnosing myocardial damage and should not be used as the sole basis for diagnosis. The doctor will need to combine other clinical symptoms, electrocardiograms, and echocardiographic tests with these results to make the final diagnosis.
What is myocardial enzyme profile testing? When the myocardial cells are inflamed (myocarditis) or necrotic (myocardial infarction), the enzymes contained in these cells can enter the bloodstream, and the activity (concentration) of these enzymes in the blood increases.
Enzymes used in the diagnosis of heart disease are not one type, so they are called "myocardial enzyme profile".
Myocardial enzymes include: creatine phosphokinase (CK), myokinase isoenzyme (CK-MB), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), lactate dehydrogenase isoenzymes (LDH1, LDH2), and α-hydroxybutyric acid dehydrogenase (a-HBDH).
Additionally, Troponin T (cTn) is an indicator of high specificity and sensitivity for monitoring myocardial injury. It is particularly sensitive to detecting myocardial infarction early, with elevated levels and prolonged duration, making it a crucial diagnostic tool for acute myocardial infarction and other myocardial damage diseases.
Therefore, many hospitals have listed cTn and myocardial enzyme spectrum as related testing items.
Under what circumstances do one need to examine the myocardial enzyme profile? 1. In cases where upper respiratory infections or other infections (such as viral hepatitis, gastrointestinal viral infections manifesting as vomiting and diarrhea, etc.) occur, as well as during pregnancy or postpartum, symptoms of palpitations, shortness of breath, arrhythmias, chest pain, and other indications of myocarditis may be present.
2. For those diagnosed with myocarditis—observe their condition changes.
3. Individuals suspected or diagnosed with a recent myocardial infarction may have their myocardial enzyme profile as the sole diagnostic basis, but it should not be relied upon alone.
In addition, there are limitations to myocardial enzyme profiles: 1. The enzymes in myocardial enzyme profiles can also be elevated in many other diseases, such as hepatitis and crush syndrome, so making a diagnosis of myocardial damage requires a combination of clinical information.
2. Different stages of myocarditis or myocardial infarction exhibit different patterns in the regulation of various enzymes, including their increases and decreases to normal levels.
3. The normal values of various hospitals vary due to differences in methods; it is necessary to request the reference (normal) values from the testing hospital for comparison.
How much does myocardial enzyme spectrum examination cost? The enzymes contained in myocardial cells are myocardial enzymes. If the content is high, it means that the enzymes have run from the myocardial cells to the bloodstream, which means that the heart muscle is dead.
So, what is the cost of myocardial enzymes test? Myocardial enzymes are LDH (lactate dehydrogenase), AST (aspartate aminotransferase), CK (creatine kinase) and its isoenzyme CK-MB, α-HBDH.
In the early stage of myocarditis, the main symptoms are an increase in CK and CK-MB, with the peak occurring within one week of onset, most notably 2-3 days, and returning to normal after one week.
The late stage is mainly characterized by an increase in LDH and α - HBDH.
Due to the many factors that affect the myocardial enzyme spectrum, the normal values in children vary greatly. When using it as a diagnostic basis for myocarditis, clinical manifestations and other auxiliary examinations should be combined.
The myocardial enzyme profile primarily examines abnormal changes in the heart muscle and often detects elevated levels of these enzymes in cases of myocarditis. The cost of this test varies depending on the hospital, with differences in pricing.
According to the relevant online introductions, this price is 90 yuan, and there are also more than 400 yuan.
The prices vary depending on the facilities and tests offered by each hospital.
What should we look at in the electrocardiogram and myocardial enzyme test results? Many people have undergone myocardial enzyme tests, but they find it difficult to understand the results.
So, what exactly should we look at the results of myocardial enzymology? Let's take a closer look together! Myocardial enzymology involves detecting enzymes from the heart muscle cells in the blood. The presence of elevated levels of these enzymes in the plasma indicates damage to the heart muscle cells, which can lead to an increase in the concentration of myocardial enzymes. This elevation in myocardial enzyme levels can be detected through serum testing, and these detected enzymes are referred to as myocardial enzymes. Myocardial enzyme testing primarily aims to assess for myocardial ischemia.
Generally speaking, the myocardial enzyme spectrum includes five tests: 1. Lactate dehydrogenase (LDH): 100-240 IU/L.
2. Aspartate transaminase AST: 0-40IU/L.
Phosphocreatine kinase CK: 24~194IU/L.
4. Creatine Phosphokinase MB (CK-MB): 0~25IU/L.
5. Alanine Aminotransferase (ALT): 0-40 IU/L.
HBD and LD, AST, CK and CK-MB are the components of myocardial enzyme profile, which have important significance in diagnosing myocardial infarction.
The ratio of LD/HBD in the serum of healthy adults is 1.3 - 1.6, but in patients with myocardial infarction, the activity of HbD is increased and the ratio of LD/HBD is decreased to 0.8 - 1.2.
When the liver parenchymal cells are affected, the ratio can increase to 1.6-2.5.
It is important to note that the ratios mentioned above are independent of the methodologies or conditions used in various laboratories and must be established for this laboratory.
In addition, active rheumatic myocarditis, acute viral myocarditis, hemolytic anemia, etc., due to increased LD1 activity, can also increase HBD activity.
What should be done if the myocardial enzyme profile is high? The primary purpose of conducting a myocardial enzyme test is to determine the presence of myocardial infarction or necrosis, as well as assess the permeability of cell membranes. If elevated levels of these enzymes are detected, what could it mean? Below, we will briefly explain why elevated myocardial enzyme levels might occur.
The myocardial cells contain special enzymes. When a heart attack or acute unstable angina occurs, the myocardial cells will necrotize and decompose. At this time, these enzymes (myocardial enzymes) will dissolve into the blood, causing an abnormal increase.
Clinical and experimental evidence indicates that the elevation of these enzymes (myocardial enzymes, such as I-type troponin-CTnI or T-type troponin-CTnT) signifies a very dangerous heart attack. It not only indicates that the myocardial cells have been damaged to a certain degree but also has a higher probability of leading to numerous serious adverse cardiac complications—recurrent myocardial infarction, sudden death from heart failure, etc. (i.e., poor prognosis). However, it is not always elevated at the onset of the disease, typically requiring 4 to 6 hours or even 12 hours before an increase is observed. Therefore, continuous monitoring is necessary.
Myocardial enzymes, after myocardial injury or necrosis, exhibit varying degrees of elevation.
CK-MB, LDH1 have the highest specificity. Currently, normal ranges for cardiac enzymes are mostly adult standards, but in children, these are higher than in adults. Therefore, it is not advisable to interpret an increase in a child's cardiac enzyme level as indicating myocarditis. Due to the multitude of factors affecting cardiac enzyme levels, many hospitals use measurement of myocardial troponin T to assist in the diagnosis of myocarditis. In most cases, the cardiac enzyme levels in children are two to three times the normal reference range.
The measurement of cardiac enzymes is primarily used to determine the presence of myocardial infarction or cell membrane permeability.
An elevated troponin level suggests myocardial injury, which is mostly caused by viral infections. It is recommended to schedule regular follow-up examinations and rest adequately.
The cardiac enzyme profile is used to assess the extent of myocardial injury, yet it has gradually been phased out due to its lower accuracy and sensitivity compared to markers of myocardial damage such as troponin and creatine kinase.
Therefore, elevated myocardial enzyme levels may indicate conditions such as myocardial ischemia, necessitating further investigation.
What exactly are the examinations included in a myocardial enzyme profile? If one looks closely during a physical examination, one might notice that there is one particular test that includes a heart muscle enzyme check. This prompts the question: What are all the items included in a myocardial enzyme profile and what do they measure? Let's take a closer look at what these tests entail. The myocardial enzyme profile tests include the following: 1. Creatine Kinase (CK): Used to detect muscle damage and myocardial infarction. 2. Lactate Dehydrogenase (LDH): Utilized to detect damage to cardiac muscle cells. 3. Aspartate Aminotransferase (AST): Used to assess liver damage and myocardial injury. 4. Myoglobin (Myo): Used to detect muscle damage. 5. Troponin T (cTnT): Used to detect myocardial injury. 6. Troponin I (cTnI): Used to detect myocardial injury. 7. Myoglobin (Myo): Used to detect muscle damage. 8. Myoglobin (mck-MB): Used to detect myocardial injury. 9. Troponin I (mck-I): Used to detect myocardial injury. 10. Troponin I/CK-MB ratio: Used to evaluate the severity of myocardial infarction. These tests can assist physicians in understanding a patient's cardiac health and promptly identifying and addressing potential heart issues.
Myocardial enzymes refer to the enzymes contained within myocardial cells, which play a crucial role in catalytically metabolizing and modulating myocardial cell activities.
Myocardial enzymes refer to a group of enzymes found in the heart, specifically including aspartate aminotransferase (AST), lactate dehydrogenase (LDH), its isoenzymes, a-hydroxybutyric acid dehydrogenase (a-HBDH), and creatine kinase (CK) and its isoenzyme (CKMB). In China, this set of enzymes is commonly referred to as the myocardial enzyme profile and has been found to be valuable for diagnosing myocardial infarction.
So, the main items in myocardial enzyme spectrum mainly include the following aspects: 1. Creatine phosphokinase (CK).
2. Myocardial troponin I (CK-MB)
3. Aspartate aminotransferase (AST).
4. Lactate Dehydrogenase (LDH).
5. Lactate Dehydrogenase 1 (LDH1) and Lactate Dehydrogenase 2 (LDH2).
6. a-Hydroxybutyrate dehydrogenase (a-HBDH).
Furthermore, Troponin T (cTn), a marker of myocardial injury, is highly specific and sensitive, particularly in acute myocardial infarction where it appears early, has high values, and persists for a long duration. It is an important indicator for diagnosing conditions such as acute myocardial infarction that involve myocardial damage.
Consequently, many hospitals have included cTn and myocardial enzyme profile as related laboratory tests.
This text covers medical information only for reference purposes.
In case of discomfort, it is recommended to seek medical attention immediately. The diagnosis and treatment should be based on the professional medical consultations conducted in person.