USE OF CKMB AND MYOGLOBIN MEASUREMENTS DURING MYOCARDIAL REPERFUSION AFTER REGIONAL ISCHEMIA IN THE ANESTHETIZED PIG

The efficacy of a revascularization treatment after acute coronary art ery occlusion can be evaluated by different diagnoses. The ECG and the time-course of, for example, the CK isoenzyme MB are widely used as q uick, objective, and almost noninvasive tools. In addition, the assess ment of functional recovery of the postischemic myocardium or the eval uation of the magnitude of irreversibly injured myocardium is essentia l for therapeutic strategies. In the present study, myoglobin that is not yet routinely established, is compared with CKMB to answer the fol lowing questions: do measurements of serum-CKMB and serum-myoglobin re liably demonstrate 1) the success of a revascularization treatment? 2) the functional recovery of the postischemic myocardium? 3) the magnit ude of irreversibly injured myocardium? To answer these questions, the left anterior descending coronary arteries of 17 anesthetized pigs we re occluded for 60 min and reperfused for 180 min after successful ''r evascularization''. The major findings of this study on anesthetized p igs are: 1) The time-course of botfi the CKMB activity and the myoglob in concentration exhibit the successful revascularization. 2) The CKMB maximum does not exhibit the recovery of the ventricular function, wh ereas the myoglobin maximum moderately correlated with the contractile state (dP/dt(max)) at the end of reperfusion and significantly with t he recovery of dP/dt(max) during reperfusion. Recovery of the regional function (= mean thickening velocity) within the 180 min reperfusion is predicted neither by CKMB nor myoglobin analysis. 3) Both investiga ted markers correlate closely with the magnitude of the irreversibly i njured myocardium.