Creatine Kinase BB Isoenzyme Activity Research Articles

Somatosensory potentials, CSF creatine kinase BB activity, and awakening after cardiac arrest.

To examine the utility of somatosensory evoked potential (SEP) peaks and CSF creatine kinase BB isoenzyme activity (CKBB) in predicting nonawakening from coma due to cardiac arrest. Accurate predictors of neurologic outcome in patients comatose after cardiac arrest are needed to improve medical decision making. A total of 72 comatose patients had bilateral median SEPs, and of these, 52 had CSF and CKBB. Awakening was defined as following commands or having comprehensible speech. Both short (N1) and long (N3) latency SEP peaks were analyzed. Nonparametric analyses were used. For patients who had both tests, CKBB > or = 205 U/L predicted nonawakening with a sensitivity of 49% and a specificity of 100%. Bilateral absence of the N1 peak predicted nonawakening with a sensitivity of 53% and a specificity of 100%. Using CKBB > or = 205 U/L, bilaterally absent SEP N1 peaks, or both predicted nonawakening with a sensitivity of 69% and a specificity of 100%. Using CKBB > or = 205 U/L, bilaterally absent N1 peaks, bilateral N3 > or = 176 msec or absent, or some combination predicted nonawakening with a sensitivity of 78% and a specificity of 100%. The combination of an absent N1 peak and elevated CKBB performs better than either alone in predicting nonawakening after cardiac arrest. Prolonged or absent N3 latency may increase sensitivity. These results should be interpreted with caution given the small number of patients and the possibility of a self-fulfilling prophecy.

Abstracts of literature

Abstracts of literature

CREATINE KINASE AND CREATINE KINASE ISOENZYME RESPONSES TO HEAT STRESS

During this investigation the effects of heat acclimation and exercise on creatine kinase and creatine kinase BB isoenzyme responses in various tissues and serum of male Sprague–Dawley rats were ascertained. Forty rats were randomly divided into two groups of 20 rats each. One group was housed at 22±1°C and the other at 33±1°C. Each of the two groups were subdivided into two subgroups of ten rats each. One subgroup of each group was subjected to a programme of treadmill running of progressive intensity over a period of 6 weeks at the temperature at which it was housed while the other served as a resting control. At the end of the acclimation programme the rats were running at 23m/min for 80min. On the day of sacrifice all four subgroups were subjected to a discontinuous exercise protocol (10min running alternated by a 2-min rest period; repeated three times) at 30±1°C on a rodent treadmill at 23m/min. The tissues investigated were kidney, heart and muscle. The rats were anaesthetized with pentobarbital sodium (6mg/100g body mass) injected intraperitoneally. The tissues were freeze-clamped and stored in liquid air until analysed. The body temperature of the four subgroups at the end of the experimental protocol were not significantly different. Acclimation at 33±1°C resulted in significantly lower creatine kinase activity levels. Exercise at 30±1°C also resulted in decreased creatine kinase activity levels in both acclimated groups. A similar trend was observed regarding creatine kinase BB isoenzyme activity levels, especially in kidney.

Cerebrospinal fluid creatine kinase BB isoenzyme activity and neurologic prognosis after cardiac arrest

Cerebrospinal fluid creatine kinase BB isoenzyme activity and neurologic prognosis after cardiac arrest

Cerebrospinal fluid creatine kinase BB isoenzyme activity and neurologic prognosis after cardiac arrest.

To assess the relationship between CSF creatine kinase BB isoenzyme activity (CSF CKBB) and neurologic outcome after cardiac arrest in clinical practice. CSF CKBB reflects the extent of brain damage following cardiac arrest. To help with prognosis, treating physicians ordered CSF CKBB tests on 474 patients over 7.5 years; 351 of these patients had experienced a cardiac arrest. Assays were performed in one laboratory using agarose electrophoresis. By chart review, we determined awakening status for all patients, defined as the patient having comprehensible speech or following commands. CSF CKBB was usually sampled 48 to 72 hours after cardiac arrest and was strongly associated with awakening (p < < 0.001). The median was 4 U/l for 61 patients who awakened and 191 U/l for 290 who never awakened. For those who awakened, 75% of CKBB levels were < 24 U/l, and for those who never awakened, 75% were > 86 U/l. The highest value in a patient who awakened was 204 U/l, a cutoff that yielded a specificity of 100% of never awakening but a sensitivity of forty-eight percent. Only nine patients who awakened had CSF CKBB values greater than 50 U/l, and none regained independence in activities of daily living. Only three unconscious patients were still alive at last contact, with follow-up of 63, 107, and 109 months. Using logistic regression, the probability of never awakening given a CSF CKBB result can be estimated as: 1/(1 + L), where L = e raised to (0.1267 - 0.0211 x CSF CKBB [U/l]). CSF CKBB measurement helps to estimate degree of brain damage and thus neurologic prognosis after cardiac arrest. However, results of this retrospective study could reflect in part a self-fulfilling prophecy.

Creatine Kinase BB Isoenzyme Activity and Severe Head Injury

Creatine Kinase BB Isoenzyme Activity and Severe Head Injury

Improved outcome prediction based on CSF extrapolated creatine kinase BB isoenzyme activity and other risk factors in severe head injury.

The present study of 43 patients with severe head injury shows that outcome prediction can be markedly improved by combining an appropriate marker of the degree of initial brain damage and other risk factors. The patients were classified into three groups according to their actual outcome after 6 months: death (22 patients); persistent vegetative state or severe disability (eight patients); and moderate disability or good recovery (13 patients). By applying stepwise logistic discriminant analysis to the patients' data, five significant risk factors were selected: degree of neurological damage assessed by cerebrospinal fluid (CSF) extrapolated creatine kinase BB isoenzyme activity, Glasgow-Liège Coma Scale score, age, incidence of thoracic injury, and intracranial pressure (ICP). Extrapolated creatine kinase BB activity had the highest prognostic ability (67%). Uncontrollable elevated ICP proved to be systematically associated with death, whereas its absence was not necessarily indicative of a favorable outcome. The combination of the five variables yielded a total prognostic efficiency of 91%. The percentages of correctly predicted patients for the three outcome groups were, respectively, 100%, 50%, and 100%. Thus, half of the persistently vegetative and severely disabled patients were identified by the selected factors.

“Extrapolated” creatine kinase-BB isoenzyme activity in assessment of initial brain damage after severe head injury

“Extrapolated” creatine kinase-BB isoenzyme activity in assessment of initial brain damage after severe head injury

"Extrapolated" creatine kinase-BB isoenzyme activity in assessment of initial brain damage after severe head injury.

The severity of initial brain damage is an important risk factor in determining the prognosis of head trauma. It can be assessed by assigning neurological scores or by determining the cerebrospinal fluid (CSF) activity of the isoenzyme creatine kinase-BB (CK-BB). In 10 severely head-injured patients serial CSF samples were obtained during the first 24 hours after trauma, and exponential decay of CK-BB activity with an average half-life of 4.5 hours was demonstrated. This finding led the authors to propose an "extrapolated" CK-BB activity, which theoretically occurs immediately after injury and is calculated from a single CK-BB recording, as a new index for assessing the degree of initial brain damage. In 50 patients with severe head injury, the prognostic ability of "observed" and "extrapolated" CK-BB activity was compared with two clinical scoring systems that evaluate severity of head trauma (the Glasgow and the Glasgow-Liège Coma Scales). "Extrapolated" CK-BB activity proved to be the best prognostic factor. With a CK-BB cutoff point of 330 U/liter, a true-positive rate of 79% and a true-negative rate of 73% were obtained. These results suggest the usefulness of measuring CK-BB activity in CSF as soon as possible after hospital admission for head injury.

Creatine kinase BB isoenzyme activity in patients with hematologic disorders.

Journal Article Creatine kinase BB isoenzyme activity in patients with hematologic disorders. Get access P J Cornbleet, P J Cornbleet Search for other works by this author on: Oxford Academic Google Scholar M D Evans M D Evans Search for other works by this author on: Oxford Academic Google Scholar Clinical Chemistry, Volume 26, Issue 11, 1 October 1980, Pages 1635–1636, https://doi.org/10.1093/clinchem/26.11.1635 Published: 01 October 1980

Creatine kinase BB isoenzyme activity in bone-marrow serum.

Creatine kinase BB isoenzyme activity in bone-marrow serum.