Abstract
THE SERUM LACTATE DEHYDROGENASE (LDH) has been much used for the diagnosis of myocardial infarction, but because of its lack of specificity it is often combined with isoenzyme studies. 1 Of the five LDH isoenzymes, the electrophoretically fastest components, LDH 1 and LDH 2 , characteristic of heart muscle, are preferentially increased after myocardial infarction; we have shown 2 that these more readily reduce α-ketobutyrate than the slow-moving fractions, LDH 4 and LDH 5 found in the liver. This reduction of α-ketobutyrate has been termed α-hydroxybutyrate dehydrogenase (HBD) activity. 3 We have shown that determination of the serum HBD activity provides a useful diagnostic test for myocardial infarction and eliminates the need for isoenzyme separation. 4,5 As expected, raised serum HBD activities are not often encountered in liver diseases. 6 The value of the new test has been confirmed. 7-11 but as we have now had experience with it in 330
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