CIRCULATING CARDIAC MYOSIN LIGHT-CHAINS IN PATIENTS WITH ANGINA AT REST - IDENTIFICATION OF A HIGH-RISK SUBGROUP
CIRCULATING CARDIAC MYOSIN LIGHT-CHAINS IN PATIENTS WITH ANGINA AT REST - IDENTIFICATION OF A HIGH-RISK SUBGROUP
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DOI：
10.1016/0735-1097(88)91521-5
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发表时间：
1988-03-01
影响因子：
24
通讯作者：
KUBLER, W
中科院分区：
文献类型：
--
作者：
KATUS, HA;DIEDERICH, KW;KUBLER, W
为了检测心肌细胞损伤，对42例静息心绞痛患者的血清样本进行了心肌肌球蛋白轻链筛查，其中22例患者（52%）检测到心肌肌球蛋白轻链。其中17例患者肌球蛋白轻链持续释放，持续到第4天住院，而7例患者肌球蛋白轻链仅在入院后最初24小时内可检测到。肌球蛋白轻链的存在与心电图（ECG）中的缺血体征（p < 0.05）和冠状动脉狭窄程度（p < 0.05）相关。血清中心肌肌球蛋白轻链仅在≥至少一条主血管直径缩小75%。在住院期间发生透壁性心肌梗死的所有5名患者中，可检测到肌球蛋白轻链。根据心电图诊断标准及常规血清酶谱可确定心肌梗死前28 h的诊断。因此，循环心肌肌球蛋白轻链的检测使人们能够识别一个亚组的患者在休息时心绞痛有更严重的冠状动脉疾病与更差的结果。
To detect myocardial cell damage, serum samples of 42 consecutive patients with angina at rest were screened for cardiac myosin light chains, which were detected in 22 patients (52%). In 17 of these patients there was a persistent release of myosin light chains lasting until the 4th hospital day, whereas in 7 patients myosin light chains were only detectable during the initial 24 h after admission. The presence of myosin light chains correlated with signs of ischemia in the electrocardiogram (ECG) (p < 0.05) and with the extent of coronary artery narrowing (p < 0.05). Cardiac myosin light chains were elevated in serum only if there was a .gtoreq. 75% diameter narrowing in at least one major vessel. In all five patients who developed transmural myocardial infarction during the course of their hospital stay, myosin light chains were detectable .gtoreq. 28 h before the diagnosis of myocardial infarction could be established by ECG criteria and conventional serum enzymes. Thus the detection of circulating cardiac myosin light chains enables one to identify a subgroup of patients with angina at rest having more severe coronary artery disease with a worse outcome.