Research

Investigation of the effect of the reversible myocardial ischemia on serum levels of biochemical indicators associated with myocardial injury

  • Alper Özgür Karaçalıoğlu
  • Selim Kılıç
  • Turgay Çelik
  • Zekeriya Arslan
  • Halil Yaman
  • Seyfettin Ilgan
  • Mehmet Ali Özgüven

Received Date: 17.06.2005 Accepted Date: 12.05.2006 Gulhane Med J 2006;48(2):87-93

The aim of this study was to evaluate the effect of the reversible myocardial ischemia induced by treadmill exercise test and determined by gated myocardial perfusion SPECT on the secretion of AST and LDH localized in the cytoplasm of the myocytes. Fifty one patients with risk factors of coronary artery disease were enrolled into the study. The patients were divided into three subgroups as normal (24), ischemia (17) and infarct (10) according to the results of gSPECT performed after treadmill exercise test. Preexercise, postexercise and 4th hr serum LDH and AST levels of the patients were measured. According to the enzyme results, there were no statistically significant differences among the subgroups (p>0.05). Postexercise AST and LDH levels were significantly higher than those of the preexercise in the normal group (p=0.011, p=0.001, respectively). Postexercise AST levels were significantly higher than those of the preexercise in the ischemia group (p=0.002). Preexercise and postexercise levels of the enzymes were not statistically different in the infarct group. Functions of the left ventricle were prominently decreased in patients with myocardial infarct and severity of the ischemia in this group was significantly higher than those of the other subgroups (p<0.001). There were not statistically significant differences between the scintigraphic parameters of normal and ischemia subgroups, except for STSS (p>0.05 and p<0.001, respectively). There was not a significant correlation between the enzyme levels and scintigraphic parameters. In conclusion, reversible myocardial ischemia seems not to have prominent effect on the secretion of the non-specific biochemical markers of myocardial injury.

Keywords: AST, gated myocardial perfusion imaging, LDH, myocardial ischemia, SPECT