Enzymatic diagnosis of coronary heart disease

The importance of enzyme diagnostics of myocardial infarction is currently beyond doubt. Determination of asparagine and alanine transaminases activity has been replaced by the study of more sensitive so-called "cardiospecific" enzymes: creatine phosphokinase, lactate dehydrogenase and their isoenzymes. LDH isoenzyme1 has special specificity to the heart muscle, the content of which is studied by hydroxybutyrate dehydrogenase activity (α-HBDH). However, the patterns of changes in the activity of this enzyme in various forms of ischemic heart disease remain insufficiently studied. The content of γ-glutamyl transpeptidase enzyme in cardiac muscle is insignificant; however, there are reports in the literature about increased activity of this enzyme in the acute period of myocardial infarction. The degree of hyperenzymemia in acute myocardial infarction usually correlates with the size of ischemic necrosis focus, so a significant increase in enzyme activity is found in those forms of the disease, which proceed with a clear clinical picture and are accompanied by typical changes on ECG. Meanwhile, clinicians still face difficulties in differential diagnosis of such variants of ischemic heart disease as various forms of angina pectoris, small focal myocardial necrosis, recurrent myocardial infarctions and cardialgia of different genesis. The similarity of their clinical symptomatology and unclear ECG criteria make us return to the analysis of enzyme activity changes in various forms of coronary heart disease.