Plasma Creatine kinase-MB Activity Research Articles

Evaluation of Creatine Kinase-MB Activity and Cortisol Level in Hypertensive Mycobacterium Tuberculosis Patients Receiving Treatment in Nnewi.

Mycobacterium tuberculosis, the etiological agent of tuberculosis (TB), imposes a health challenge globally. Tuberculosis is an infectious disease that most often affects the lungs, and it spreads through the air when infected people cough, sneeze, or spit. This study was aimed at evaluating creatine kinase-MB (CK-MB) activity and cortisol levels in Mycobacterium tuberculosis patients receiving therapy at Nnewi. A cross-sectional study involved 90 participants consisting of 45 TB+ individuals and 45 healthy controls. A questionnaire was used to obtain the age, sex, and other vital information needed for the study. The body mass index (BMI) of the participants was calculated. Their systolic and diastolic blood pressure was obtained using an Accu-Answer automatic blood pressure monitor. Ziehl-Nelseen (ZN) sputum smear microscopy determined Mycobacterium tuberculosis infection and confirmed positive using GeneXpert. Plasma cortisol level was determined using an Enzyme-linked immunosorbent assay whereas plasma CK-MB activity was determined spectrophotometrically. Independent t-test and Pearson`s correlation coefficient were used for statistical analysis. Significant levels were considered at p < 0.05. Data was presented as mean ± standard deviation. The mean value of the diastolic blood pressure (DBP) of the TB+ participants was significantly lower (75.53 ± 14.04) compared with the control (81.53 ± 6.10) (p < 0.05). No significant difference was observed in the mean values of plasma cortisol and CK-MB activity (9.37±1.26) (18.99±1.26) of the TB+ participants compared with control (9.28±6.92) (18.81±1.45) (p>0.05). There was a moderate positive correlation between systolic blood pressure (SBP) and DBP (r = 0.50; p = 0.01) in the test group and a strong positive correlation between SBP and DBP in the control. SBP and cortisol showed a moderate positive correlation with DBP and cortisol in the test group. In conclusion, there was no predisposition to acute myocardial infarction and inflammation in the subjects studied.

Protective action of a modified fragment of galanine in rats with doxorubicin-induced heart failure

The use of the anticancer drug doxorubicin (Dox) is limited due to its cardiotoxic effect. Using the method of automatic solid-phase peptide synthesis, we obtained a synthetic agonist of galanin receptors GalR1-3 [RAla14, His15]-galanine (2-15) (G), exhibiting cardioprotective properties. It was purified by high performance liquid chromatography (HPLC). The homogeneity and structure of the peptide was confirmed by HPLC, 1H-NMR spectroscopy and mass spectroscopy. The purpose of this study was to study the effect of G on the metabolism and cardiac function of rats with chronic heart failure (CHF) caused by Dox. Experiments were performed using male Wistar rats weighing 280-300 g. The control group of animals (C) was intraperitoneally treated with saline for 8 weeks; the doxorubicin group (D) of rats was intraperitoneally treated with Doх; the group of Doх + peptide G (D+G) received intraperitoneally injections of Doх and subcutaneously injections of peptide G; the peptide G group (G) was subcutaneously treated with G. At the beginning and at the end of the study, the concentration of thiobarbituric acid reactive substances (TBARS) and the activity of creatine kinase-MB (CK-MB) were determined in blood plasma; the animals were weighed, and cardiac function was assessed using echocardiography. At the end of the experiments, the hearts were used for determination of metabolites and assessment of oxidative phosphorylation in mitochondria. After 8-week treatment, animals of group D were characterized by severe heart failure, the lack of weight gain and an increase in plasma TBARS concentration and CK-MB activity. These disorders were accompanied by a decrease in the content of myocardial high-energy phosphates, a reduction inmitochondrial respiratory parameters, accumulation of lactate and glucose in the heart, and disturbances in the metabolism of alanine and glutamic and aspartic acids. Coadministration of G and Dox prevented the increase in plasma CK-MB activity and significantly reduced the plasma TBARS concentration. At the end of the experiments animals of group D+G had higher myocardial energy state and the respiratory control index of mitochondria than animals of group D, there was a decrease in anaerobic glycolysis and no changes in the amino acid content compared to the control. The peptide G significantly improved the parameters of cardiac function and caused weight gain in animals of group D+G in comparison with these parameters in group D. The obtained results demonstrate the ability of a novel agonist of galanin receptors GalR1-3 to attenuate Dox-indiced cardiotoxicity.

Protective Effects of a Novel Agonist of Galanin Receptors Against Doxorubicin-Induced Cardiotoxicity in Rats.

The clinical use of antineoplastic agent doxorubicin (DOX) is limited due to its cardiotoxic action. [βAla14, His15]-galanine (2-15) (G) is a novel synthetic agonist of galanin receptors GalR1-3 having cardioprotective properties in animal models in vivo. The aim of the present study was to explore effects of G on DOX-induced cardiotoxicity. Wistar rats were divided into four groups and treated with DOX (D group), DOX and G (D + G group), G (G group), and saline (control). Before treatment and at the end of the study, concentration of thiobarbituric acid reactive substances (TBARS) and activity of creatine kinase-MB (CK-MB) were determined in blood plasma, the animals were weighed, and cardiac function was evaluated by echocardiography. At the end of experiments, the hearts were used to determine energy metabolites and mitochondrial respiration in permeabilized fibers. After an 8-week study, D group exhibited a pronounced cardiac failure, the absence of weight gain, an increased plasma TBARS concentration, and CK-MB activity. These disorders were accompanied by a reduced myocardial content of high-energy phosphates and mitochondrial respiratory parameters. Co-administration of G with DOX significantly decreased plasma TBARS level and prevented an increase in plasma CK-MB activity. In D + G group, myocardial contents of ATP, PCr, total adenine nucleotides, and total creatine as well as myocardial PCr/ATP ratio and the respiratory control index were higher than in D group at the end of the experiments. Peptide G significantly improved parameters of left ventricular (LV) function and caused weight gain in animals of D + G group. These results suggest that peptide G may be a potential pharmacological agent that attenuates the cardiotoxic effects of DOX.

Effect of dexmedetomidine on myocardial injury in infants undergoing repair of ventricular septal defect

Objective To evaluate the effect of dexmedetomidine on myocardial injury in infants undergoing repair of ventricular septal defect.Methods Forty ASA grade Ⅱ or Ⅲ infants,aged 3-6 months,weighing 4-6 kg,scheduled for elective repair of ventricular septal defect,were randomly divided into 2 groups (n =20each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,etomidate,cisatracurium and sufenanil.The infants were mechanically ventilated after nasotracheal intubation.PET CO2 was maintained at 30-40 mm Hg,Anesthesia was maintained with cisatracurium,sufenanil and sevoflurane.In group D,dexmedetomidine was infused at 0.5 μg· kg-1 · h-1 until the end of operation.While in group C normal saline was given at the same rate until the end of operation.BP and HR were recorded at 10 min before operation (T1),skin incision (T2),chest opening (T3),10 min after aortic unclamping (T4) and the end of operation (T5).Blood samples were taken from the right internal jugular vein for determination of plasma creatine kinase MB (CK-MB) activity and cardiac troponin T (cTnT) concentrations at T1,T5 and 24 h after operation (T6).Results Compared with the baseline value at T1,no significant changes were found in HR and BP at different time points in group D,HR and BP were significanfly increased at T2-T5 in group C,and the plasma CK-MB ctivity and cTnT concentration were significantly increased at T5 and T6 in the two groups (P ＜ 0.05).HR and BP at T2-5 and plasma CK-MB activity and cTnT concentration at T5 and T6 were significantly lower in group D than in group C (P ＜0.05).Conclusion Dexmedetomidine infused at 0.5 μg· kg-1 · h-1 after induction can reduce myocardial injury in infants undergoing repair of ventricular septal defect. Key words: Dexmedetomidine ; Heart septal defects, ventricular; Infant ; Myocardial reperfusion injury

Effects of sevoflurane wash-in during cardiopulmonary bypass on myocardial injury in patients undergoing coronary artery bypass grafting

Objective To investigate the effects of sevoflurane wash-in during cardiopulmonary bypass (CPB) on myocardial injury in patients undergoing coronary artery bypass grafting(CABG).Methods Forty ASA Ⅱ or Ⅲ patients aged 50-64 yr,weighing 53-90 kg undergoing scheduled for CABG under CPB were randomly divided into 2 groups (n =20): control group (group C) and sevoflurane group(group S).Anesthesia was maintained with propofol 3-5 mg·kg-1 ·h-1 and sufentanil 0.5-1.0 μg·kg-1 ·h-1 in both groups.Sevoflurane 1％-2％ was washed into extracorporeal circuit during CPB in group S.Blood samples were taken from central vein after the induction of anesthesia (T0,baseline) and at 6,12 and 24 h (T1-3) after operation for determination of plasma cardiac troponin I(cTnI) concentration and creatine kinase-MB (CK-MB) activity.Myocardial specimens were obtained from right auricle before aortic cross-clamping and at the end of CPB for ultrastructure examination.The severity of mitochondria injury was assessment and scored (0 =normal,4 =impaired inner mitochondrial membrane integrity).Results CPB significantly increased plasma cTnI concentration at T1-3 as compared with the baseline values at T0 before CPB.Plasma cTnI concentration was significantly lower at T2 and T3 in group S than in group C.Mitochondrial injury index was significantly lower at the end of CPB in group S than in group C.There was no significant difference in plasma CK-MB activity between the 2 groups.Conclusion Wash-in of sevoflurane during CPB can attenuate myocardial injury in patients undergoing CABG. Key words: Anesthetics, inhalation; Myocardial reperfusion injury; Cardiopulmonary bypass; Coronary artery bypass graft

Pharmacological preconditioning with nicorandil and pioglitazone attenuates myocardial ischemia/reperfusion injury in rats

The present investigation was designed to study the cardioprotective effects of nicorandil and pioglitazone preconditioning in myocardial ischemia/reperfusion-induced hemodynamic, biochemical and histological changes in rats. Oral doses of nicorandil (3 or 6 mg/kg) and pioglitazone (10 or 20 mg/kg) were administered once daily for 5 consecutive days. Rats were then subjected to myocardial ischemia/reperfusion (40 min/10 min). Heart rate and ventricular arrhythmias were recorded during ischemia/reperfusion progress. At the end of reperfusion, plasma creatine kinase-MB activity and total nitrate/nitrite were determined. In addition, lactate, adenine nucleotides, thiobarbituric acid reactive substances, reduced glutathione and myeloperoxidase activity were estimated in the heart left ventricle. Finally, histological examination was performed to visualize the protective cellular effects of different pretreatments. Nicorandil (3 or 6 mg/kg) was effective in attenuating the ischemia/reperfusion-induced ventricular arrhythmias, creatine kinase-MB release, lactate accumulation and oxidative stress. Nicorandil (3 mg/kg) was more effective in improving the energy production and lowering the elevated myeloperoxidase activity. Both doses of pioglitazone (10 or 20 mg/kg) were equally effective in reducing lactate accumulation and completely counteracting the oxidative stress. Pioglitazone (10 mg/kg) was more effective in improving energy production and reducing ventricular arrhythmias, plasma creatine kinase-MB release and total nitrate/nitrite. It seems that selective mitochondrial K ATP channel opening by lower doses of nicorandil and pioglitazone in the present study provided more cardioprotection against ventricular arrhythmias and biochemical changes induced by ischemia/reperfusion. Histological examination revealed also better improvement by the lower dose of nicorandil than that of pioglitazone.

Comparison of myocardialprotective effects of isoflurane versus sevoflurane in patients undergoing off pumpcoronary artery bypass grafting

：Objective To compare themyocardial protective effects of isoflurane versus sevoflurane in patients undergoingoff-pump coronary artery bypass grafting (OPCABG). Methods Forty ASA Ⅱ or Ⅲ patients (NYHA Ⅱ or Ⅲ ) of both sexes, aged 40-55yr, weighing 55-94 kg, scheduled for elective OPCABG, were randomly divided into 2 groups( n = 20 each): isoflurane group ( group Ⅰ) and sevoflurane group (group S). Anesthesia was induced with midazolam, sufentanil and vecuronium. Patients weretracheal intubated and mechanically ventilated. Anesthesia was maintained with inhalationof isoflurane or sevoflurane and infusion of sufentanil and vecuronium. In group Ⅰ,the initial end-tidal concentration of isoflurane was 1.2%. In group S, the initialend-tidal concentration of sevoflurane was 1.7 %. BIS value was maintained at 40-50 byadjusting the end-tidal concentration of isoflurane or sevoflurane. The central venousblood samples were collected immediately before skin incision, at the end of surgery, 2and 24 h after surgery for determination of plasma creatine kinase-MB (CK-MB) activity andcardiac troponin Ⅰ (cTnI) concentration. Theadverse cardiovascular events were recorded. Results The incidences of ventricularpremature beat, tachycardia, bradycardia, ventricular fibrillation and S-T segmentelevation ( ＞0.1 mV) during surgery and the plasma CK-MB activity and cTnIconcentration after surgery were significantly higher in group S than in group Ⅰ ( P ＜ 0.05). Conclusion Isoflurane has better myocardialprotective effect than sevoflurane in patients undergoing OPCABG. Key words: Isoflurane; Anesthetics, inhalation; Coronary arterybypass, off-pump

Effects of long-term oral administration of levothyroxine sodium on serum thyroid hormone concentrations, clinicopathologic variables, and echocardiographic measurements in healthy adult horses

To determine the effects of long-term oral levothyroxine sodium (L-T(4)) administration on serum thyroid hormone concentrations, thyroid gland function, clinicopathologic variables, and echocardiographic examination measurements in adult euthyroid horses. 6 healthy adult mares. Horses received L-T(4) (48 mg/d) orally for 48 weeks. Every 4 weeks, physical examinations were performed; blood samples were collected for CBC, plasma biochemical analyses, and assessments of serum total triiodothyronine (tT(3)) and thyroxine (tT(4)) concentrations. Plasma creatine kinase MB activity and cardiac troponin I concentration were also measured. Echocardiographic examinations were performed before and at 16, 32, and 48 weeks during the treatment period. During the treatment period, mean body weight decreased significantly; heart rate varied significantly, but the pattern of variation was not consistent. Significant time effects were detected for certain clinicopathologic variables, but mean values remained within reference ranges. Cardiac troponin I was only detectable in 8 of 24 plasma samples (concentration range, 0.01 to 0.03 ng/mL). Serum creatine kinase MB activity did not change significantly over time. Compared with the pretreatment value, 5.4-, 4.0-, and 3.7-fold increases in mean serum tT(4) concentrations were detected at 16, 32, and 48 weeks, respectively. Some cardiac measurements changed significantly over time, but mean values remained within published reference ranges. Mean fractional shortening was lower than the pretreatment mean value at 16 and 32 weeks. In horses, long-term oral administration of 48 mg of L-T(4)/d significantly increased serum tT(4) concentrations and did not appear to adversely affect health.

Noninvasive detection of reperfusion in acute myocardial infarction based on plasma activity of creatine kinase MB subforms

Successful thrombolytic therapy is associated with an accelerated release of creatine kinase (CK) MB from necrotic myocardium. With use of a previously validated assay, the plasma kinetics of the myocardial subform (MB2) and the plasma-modified subform (MB1) were determined in blood samples obtained from 56 patients with acute Q wave myocardial infarction: 33 patients who received thrombolytic therapy (group A) and 23 patients managed conservatively (group B).Plasma MB2activity increased more rapidly in the group A patients, but there was substantial overlap with group B. Plasma MB1activity did not differ significantly between the two groups. The MB2/MB1 ratio was significantly higher in group A patients than in group B patients between 2 and 10 h after the onset of infarction. Among group A patients, the ratio increased from 2.4 ± 1.6 to 4.6 ± 2.0 in the 1st h after therapy (p < 0.001). The peak ratio was 6.3 ± 2.5 in group A patients and 3.1 ± 1.2 in group B patients. Twenty-seven of the 33 group A patients had a peak ratio >3.8 versus 5 of the 23 group B patients (p < 0.001). In seven group A patients, the ratio was >3.8 before plasma CK MB activity was out of the normal range.Angiography was performed at 5.0 ± 3.5 days in 39 patients. Eighteen (90%) of 20 patients with a patent infarct-related artery had a peak ratio >3.8; 17 (89.5%) of 19 patients with an occluded infarct-related artery had a ratio <3.8 (p < 0.001).The MB2/MB1 plasma subform activity ratio reflects coronary artery patency within 1 to 2 h of intravenous thrombolytic therapy. This technique shows promise as a tool for rapidly identifying patients with an occluded infarct-related artery who might benefit from “salvage” angioplasty and avoiding catheterization in the majority of patients with a patent vessel. It might also be useful as an end point in trials comparing alterative thrombolytic regimens.