Creatine kinase normally written in short as CK and is also known as phosphocreatine kinase CPK. It is defined as a type of enzyme found in the muscles and the brain. Enzymes are proteins which are found in the bodies of an individual and they are known to make any biochemical reaction to occur fast. CK therefore act in the cells to add a phosphate group to creatine making it an enzyme which can speed up the reactions very fast. The result of this addition is phosphocreatine which is known to be a quick source of energy to our cells. This is a very important enzyme because it gives our cells the source of energy.
CK can be classified into three depending on the organ which produces it; A higher percentage of CK1 or BB is produced in the brain and a little produced in the smooth muscle, CK2 also called MB is produced primarily in the heart muscle and the MM or CK3 is produced at a higher percentage in the skeletal muscle. (Warell, 1993,pp 680) There is supposed to be very little CK level circulating in the blood of an individual for an individual to be regarded as normal and if there is a high flow of CK in the blood then there is a danger in either the muscle or the brain and this could be due to causes like heart attack, stroke or muscle diseases.
When someone has undergone a test and it is found that he has very high level of CK in the body then chances are that he could be having one of these problems. One has to take a creatine test so that he can know the level of this enzyme in his body and therefore be in a position to predict the state or the position he is in terms of his health. The test tends to measure the blood levels of some specific brain and muscle proteins and the normal measurement indicate that for women the level is about 12 to 80 units per liter while in the male it is about 18 to 150 units per liter.
A low level of CK in the body could be as a result of drinking excessively or someone could have contracted liver disease or arthritis. These conditions are amongst the few conditions which indicate the low level of CK in the body. Experts have suggested that those who are not sure whether they have had heart diseases, which ofcourse is a very hard thing to do, or whether they have had a problem of muscle damage due to performing a certain activity where the muscles were involved should make a point of going for checkup of their CK levels so that they can know there status health wise.
Those people who normally experience problems which are related to heart diseases like chest problems, coughing, muscle weaknesses and pain are also advised to go for checkup of their levels of CK because they could be having one of these diseases. CK tests are used to determine neuromuscular diseases in several ways including: ? To establish whether symptoms of weaknesses in a muscle are a result of nerve problems or a muscle in itself ? To make a confirmation of a muscle disorder before other symptoms actually occur
? To find out other disorders associated with neuromuscular whether there is an aspect of genetic defect or whether there is a full disease in a child ? To find out the differences which are associated with the different types of disorders. Myocardial damage in heart attacks has been tested for a long time using the isoenzyme determination in the body. Currently however there is a replacement of these methods by the use of Troponin and still other centers still use CK-MB. (Warell, 1993,pp 680) CK enzyme normally consists of two subunits which can be categorized into brain (B type) or muscle (M type).
This therefore makes the types of CK to be labeled as CK-MM, CK-BB and CK-MB. These two subunits usually are located on different enzymes. When we talk about CK-MB therefore we are talking about the labeling of a subunit which categorizes both the brain and the Muscles. This is the isoenzyme which is normally expressed at low levels in the muscles around 1% and expressed at higher levels in the heart about 25-30%. A research on the accuracy of the Cortez Diagnostics in CK-MB evaluated on each component strip showed that: The rise in the level of this enzyme in an individual is an indication that there is aging taking place in an individual i.
e. is a sure test of mortality. A research has shown that the values of CK-MB in an individual increase significantly with the increase in the stent expansion. The research showed that after one year follow-up there is a stepwise decrease in the target lesion and this brings about very serious cardiac events. In addition to this there is a trend towards lower mortality in the specimens of the group. Generally an increase of CK-MB in the body of an individual is a sure sign of aging and its constant release appears to be a trade off for optimal implantation of the stent and lower clinical restenosis. Troponin
Troponin is a combination of three complex proteins that is very vital in the contraction of muscles both in the cardiac and skeletal muscle but not in the smooth muscle. Troponin complex is located in the thin filament of some special muscles in the body and it further consists of three subunits. The three subunits are: • The troponin T which is considered a binding protein and it serves the purpose of attaching the troponin complex to tropomyosin. Its , • The troponin I modulates the fusing of the myosin and actins by playing the role of an enzyme i. e. speeding up the process of the two components fusing together.
This is a cardiac muscle protein with an average molecular weight of about 22. 4 kilodaltons. The level of this protein in the body is very low in human beings who are considered normal. Further the detection of this protein cannot be done to patients with skeletal muscle injury. This makes there fore the troponin I to be a special marker for detecting myocardial infarction. • The troponin C is another subunit which serves to binding calcium in the complex nature of the troponin complex. Retrieved from www. labtestsonline. org/news/troponin on 3rd Feb, 2009. Troponin is useful as a form of diagnosing the various heart diseases.
Troponin is attached to the protein which lies in the muscle tissues. This protein prevents the attachment of site of the harmful myosin thus preventing contraction of the muscle which can lead to heart attacks. Troponin differs from muscle to muscle and this is due to the subunit of troponin in each muscle. Troponin tests are normally administered when people complain or are seen to be having symptoms of heart diseases e. g. coughing, feeling severe cold and many other symptoms. These symptoms are predicted that they may be dangerous and easily cause heart attack and most of them could be on their way since they start with such symptoms.
The tests can be conducted in the laboratory either inform of either troponin I or troponin T. Troponin are at times administered with other cardiac biomarkers like the myoglobin and the CK-MB. Troponins are the most preferred tests out of all the others because they are taken to be effective and sensitive. A troponin test helps to show if there is a heart attack in the person’s chest and if there is an injury so that an individual will differentiate between what he is suffering from be it a real disease of the heart or only a fracture.
The test is administered normally after 8hrs after the patient has arrived to the examination room and the test is repeated 3times within the first 14 Hrs. In patients who are stable and have not suffered any heart disease before, troponin test can be can be administered after a given period since such patient are not so much at risk of this diseases but if the patient becomes unstable after sometime then the protein can be administered on the right time. A troponin test can be used to test several diseases in the heart including myocardial infection.
These tests rely on the levels of the subtypes of troponin namely the cardiac troponin I and T. Troponin is measured in the blood to give a distinction between unstable angina and heart attack and this normally gives results especially in patients with chest pains or acute coronary syndrome. A patient found to have an area of damaged heart muscle by looking at high the level of troponin is likely that he has a myocardial infarction and in high suspicion may also have coronary vasospasm.
Troponins especially the cardiac ones are used to test all heart muscle damages and not just myocardial infarction. There are however other conditions which can lead to the rise of the levels of the troponin and therefore its very important not to conclude that there is a heart disease yet there could be none. An example of this is the tachycardia which can be found in an individual who may be normal even having normal coronary arteries; this will lead to increased number of troponins probably due to the increased supply of oxygen to the heart muscle.
Other conditions which increase troponins is the tests done to patients with heart failure because these patients have the problem of ventricular rhythm abnormalities. Troponins are also reported to be high in patients with very dangerous and critical diseases and these include sepsis. Troponin level increases upto about 40% in such individuals and there fore the test is also very crucial in detecting individuals with very critical diseases. A research on the effect of Cortez diagnosis in Troponin I was evaluated and the research was as follows:
Electrocardiogram An electrocardiogram normally shortened as ECG refers to a recording of an electrical activity of the heart and this is normally after a given period of time. An electrocardiograph is a machine used to measure an electrical activity in someone’s body. This word is coined from two words electro meaning electrical activity and the other part cardio means the heart. Is therefore the study of the measure of the electronic movements in the heart of a person. The heart of an individual is known to contain electrical aspect in form of impulses.
These impulses originate from the sinoatrial node and they find there way to the heart muscle where they stir up electrical reaction in the heart normally referred to a systole or a contraction in the heart muscle. This type of measuring involves the placing electrodes on the surface of the skin and this will measure the electrical waves found in that part of the body. (Silver, 1996. pp 570) An ECG displays the voltage found between two electrodes and therefore gives a comparison between these electrodes normally being the waves of a particular part of the body.
The measurement of the waves in the body of an individual is very important because it gives the overall performance of an individual’s heart and therefore one is easy to know whether the heart is working correctly or not. This is one of the best ways to measure and treat abnormal rhythms of the heart especially those caused by damage to the vital tissues that carry the waves or those abnormal rhythms caused by the high levels of dissolved solvents in the electrodes.
Individuals for example differ in the levels of potassium or calcium levels found in their bodies. In a myocardial infarction, ECG can know whether a muscle is damaged or not though the identification is only restricted to certain areas of the muscles. It cannot also determine damage in other areas. Although ECG can measure the waves in the heart it cannot be relied upon to measure the pumping ability of the heart. Other methods have been introduced to measure these and they include use of echocardiography and nuclear medicine.
A typical electrocardiograph runs at a paper speed of around 30minutes per sec where it translates to o. 5 secs. Five major blocks constitute one large block which constitutes about 0. 25sec. In every recording a calibration signal should be included so that the test can be accurate. The measurement of the amount of myocardial interference in an individual is very critical in the managements of those affected not only by this condition but also those who have undergone other processes which might have interfered with the system e.
g. heart transplants. Currently so much treatment has focused on the determination of serum activities especially in clinical sciences. Several enzymes can be divided into several isoenzymes which is a vital role in showing the different patterns of the various several organs in the body. There is however a very strong relationship between these enzymes and that brings us to ask ourselves whether Ck-MB really have an interrelationship with ECG. (Silver, 1996. pp 570)
Since a higher percentage of CK-MB is known to be higher in the cardiac muscles there is a relationship between this and ECG in the aspect that the measurement of muscle disabilities by use of ECG uses the concentration of also the cardiac muscles. A research done for the changes in the ECG tracings shows that chest pain can easily be detected by using this method. The overall purpose of the electrocardiogram is to measure the presence of acute coronary injury in broad a condition which is also referred to as ischemia.
ECG however was criticized for measuring the problems of the heart because it it provides unstable data which changes versus demand characteristics. The alternative is the use of computers in various departments in various hospitals because they are capable of measuring continuous segment monitoring. An ECG classifies patients into three basic categories namely those with non-diagnostic or normal ECG, those with segment depression or T wave inversion and those with ST segment elevation or the new bundle branch block.
Generally the measuring of the cardiovascular diseases using this method is so much related to the measurement using the CK-MB method. Currently the use of the CK-MB and the troponin methods are so common in determining the levels at which there are heart diseases in an individual. The two represent chemicals which are very vital in determining the level of an individual’s health progress in the organs especially the heart and the muscles. Troponin and CK-MB are so much related yet they have some contrasts too. The following table shows the contrast between the two tests: