Increase in serum cardiac myosin light chain I associated with elective percutaneous transluminal coronary angioplasty in patients with ischemic heart disease.

Abstract

Changes in serum myosin light chain I (MLCI) due to elective percutaneous transluminal coronary angioplasty (PTCA) were studied after PTCA (0, 8 and 48 hours) in 57 patients with old myocardial infarction (MI group) and 20 patients with angina pectoris (AP group). The AP group showed no increase after PTCA. In contrast, in the MI group there were 16 patients in whom MLCI at 48 hours was increased by 1.0 ng/ml or more (MI1 group) and another group of 41 patients who showed no increase in MLCI (MI2 group). The MI1 group had a significantly higher incidence of (1) non-Q wave myocardial infarction (62.5% vs. 17.1%, p < 0.01), (2) 99% stenosis of a coronary artery (50.0% vs. 12.2%, p < 0.01), and (3) redistribution in a hypoperfusion area found in the delayed image of resting thallium-201 (201Tl) myocardial scintigraphy (85.7% vs. 15.8%, p < 0.01). The left ventricular ejection fraction (LVEF) was significantly improved in the MI1 group, 3 to 4 months later (from 0.49 +/- 0.12 to 0.58 +/- 0.11, p < 0.01), in contrast to the patient of MI2 group who did not show any improvement. The AP group was not considered to have a bulk of myocardium impaired enough to show a release of MLCI due to PTCA-associated transient coronary occlusion. In the MI1 group, however, MLCI was probably released from the chronically under-perfused, but still salvageable, portion of the myocardium. This is consistent with the improvement in LVEF observed 3 to 4 months after the relief of severe coronary stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)