Seamaty 4 Cardiac Kit Easy to Solve Cardiovascular Disease Detection

According to the WHO, cardiovascular disease ranks first among the causes of death worldwide. In 2019, 17.9 million people are expected to die from cardiovascular disease, accounting for 32% of global deaths. In addition, more than three-quarters of #cvd deaths occur in low-income and middle-income countries.

Cardiovascular diseases are a group of heart and blood vessel diseases, and they include:

• coronary heart disease – a disease of the blood vessels supplying the heart muscle;
• cerebrovascular disease – a disease of the blood vessels supplying the brain;
• peripheral arterial disease – a disease of blood vessels supplying the arms and legs;
• rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
• congenital heart disease – birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth; and
• deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.

There are many different tests that are used to diagnose heart-related problems, often including electrocardiograms, X-rays, echocardiograms, blood tests, coronary angiograms, radionuclide tests, MRI scans, CT scans, and more. Blood tests are often the most basic diagnostic way. Through blood tests, various indices of the patient can be detected, and the myocardial enzyme profile is usually an important parameter in the clinical diagnosis of cardiovascular diseases

Myocardial enzyme profile

Common myocardial enzyme profile tests include CK, CK-MB, LDH,α-HBDH, AST, etc. These enzymes are released into the bloodstream when myocardial cells rupture and necrosis occurs, resulting in elevated values, and therefore changes in myocardial enzyme profiles are often used to measure the extent of myocardial cell damage.

1. Creatine kinase (CK)

#CK is an important energy-regulating enzyme in the myocardium, catalyzing the production of creatine phosphate and ADP from creatine with energy provided by ATP. Creatine kinase is mainly found in skeletal and cardiac muscle, followed by the cytoplasm of brain tissue and mitochondria.

Clinical significance

(1)Diagnosis of acute myocardial infarction: creatine kinase rises significantly 3-8 hours after the onset of acute myocardial infarction, peaks at 10-36 hours, and returns to normal in 3-4 days. If creatine kinase is less than the upper limit of the reference value, acute myocardial infarction can be excluded, but small-scale myocardial injury and subendocardial infarction should also be excluded.

(2)Creatine kinase is significantly elevated in viral myocarditis.

(3)Creatine kinase can be elevated in polymyocarditis and various causes of skeletal muscle injury, various intubation and postoperative procedures, and intramuscular injection of chlorpromazine.

2. lactate dehydrogenase and its isoenzyme (LDH)

#LD is a key enzyme in the anaerobic enzymes of glucose that regulates the conversion of pyruvate to lactate and is widely present in the cytoplasm and mitochondria of the liver, heart, skeletal muscle, lung, spleen, brain, red blood cells, platelets, etc. LD is a tetramer with a molecular weight of 135 KD and consists of M- and H-type subunits forming five isozymes: H4 (LD1), MH3 (LD2), M2H2 (LD3), M3H (LD4), and M4 (LD5).

Clinical significance

When the myocardial injury occurs, myocardial cell membranes rupture, and mitochondrial and cytoplasmic substances leak out into the intercellular fluid and peripheral blood. Lactate dehydrogenase and its isoenzyme LD1 start to rise 8 to 12 hours after the onset of acute myocardial infarction, peaking at 48 to 72 hours and returning to normal in 7 to 12 days.

Continuous measurement of lactate dehydrogenase has some reference value for patients with acute myocardial infarction who are seen late and whose creatine kinase has returned to normal.

3. α-hydroxybutyrate dehydrogenase (HBDH)

#HBDH can catalyze the oxidation of α-hydroxybutyrate to α-ketobutyric acid, which exists in all tissues of the human body, with the most content in myocardial tissue, about twice as much as in the liver, and its activity reaches more than half of the total enzyme activity. α-hydroxybutyrate dehydrogenase is measured by using α-keto acid as the substrate for lactate dehydrogenase (LDH) activity because the H subunit of LDH has a high affinity for this substrate. Since the H-subunit of LDH has a high affinity for this substrate, the activity of this enzyme is used instead of the activity of LDH1 and LDH2, which contain a high number of H-subunits. When the myocardium is damaged, α-hydroxybutyrate dehydrogenase is released into the blood, so serum α-hydroxybutyrate dehydrogenase is significantly increased when myocardial disease occurs.

Clinical significance

Increased serum alpha-hydroxybutyrate dehydrogenase is mainly seen in myocardial infarction, active rheumatic myocarditis, acute viral myocarditis, hemolytic anemia, etc. Although both liver and heart diseases can cause increased α-HBDH activity, α-HBDH activity does not vary greatly in liver diseases, while there is a significant increase in heart diseases. Therefore, α-HBDH can be used for the differential diagnosis of liver diseases and myocardial infarction. Active rheumatic myocarditis, acute viral myocarditis, hemolytic anemia, etc. can cause increased LDH1 and LDH2 activity in serum, so α-HBDH activity is also increased.

4. serum aspartate aminotransferase (AST)

#AST also known as glutamic oxaloacetic transaminase (GOT), is widely distributed in all tissues of the body. It is abundant in the liver, skeletal muscle, kidney, and heart muscle. Erythrocyte AST is approximately 10 times that of serum, and mild hemolysis can elevate the assay.

Clinical significance

AST rises 6 to 12 hours after the onset of acute myocardial infarction, peaks at 24 to 48 hours, lasts for 5 days or 1 week, and then decreases.

Because AST is not tissue-specific, an elevated AST alone is not diagnostic of myocardial injury.

The 4 Cardiac Kit developed and manufactured by Chengdu Seamaty Technology Co., Ltd covers CK, LDH, HBDH, and AST to assist in the detection of #CVD in patients. When used with the fully automated biochemistry analyzer SD1, the test results are available in less than 12 minutes and can help physicians develop treatment plans more quickly.