Correlation of radionuclide estimates of myocardial infarction size and release of creatine kinase-MB in man.

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Abstract
Creatine kinase-MB isoenzyme release (CK-MB-g-Eq) was correlated with left ventricular (LV) radionuclide gated blood pool wall motion estimates of percent abnormally contracting regions (%ACR), ejection fraction (EF) and quantitative (201Tl LV perfusion scintigraphy 201Tl perfusion index) during evolving myocardial infarction (MI). Of 35 patients, 14 had no evidence of prior MI or right ventricular (RV) MI, and the CK-MB-g-Eq showed reasonable correlation with %ACR (r = 0.72; SEE [standard error of the estimate] = 18.28), with EF (r = -0.78; SEE = 0.07) and with the 201Tl perfusion index (r = 0.65; SEE = 7.93). In the 6 patients with prior MI, there was no significant correlation between CK-MB-g-Eq and %ACR, EF or 201Tl perfusion index. Eight other patients had a RVEF < 1/2 of the LVEF and regional RV wall motion abnormalities, suggesting a combination of LV and RV necrosis. In these patients, there was no significant correlation between CK-MB-g-Eq and %ACR, LVEF or 201Tl perfusion index. In 7 patients with 2 peaks to their CK-MB release curve, before CK-MB returned to baseline, CK-MB-g-Eq was associated with early %ACR (r = 0.71; SEE = 21.06), EF (r = -0.81; SEE = 0.14) and with the early 201Tl perfusion index (r = 0.78; SEE = 6.46); possibly small extensions are beyond the resolution of the radionuclide assessment techniques used in this study or these patients may represent a variant CK-MB release pattern unassociated with extension. Radionuclide techniques may be a reliable clinical method for assessing the extent of LV necrosis during MI. Limitations may exist in certain cases when concurrent RV necrosis or prior MI are present.