Size estimation of acute myocardial infarction from serial serum myoglobin observations with due consideration of individual differences in basic kinetics

Scand J Clin Lab Invest. 1984 Feb;44(1):65-78. doi: 10.3109/00365518409083789.


Thirty-three consecutive patients suffering from acute myocardial infarction were studied. Serial serum myoglobin and CK-MB measurements were made, and in seven patients individual kinetic constants for myoglobin were available from previous single injection studies. A two-compartment model for myoglobin kinetics was used for infarct size estimation. Given values for the basic kinetic constants (elimination rate constant, exchange rate constants, and distribution volume), the adjustment of a flexible, parameterized 'blood-appearance rate-function', phi AMI (mg X h-1), allowed estimation of start-time (t0), peak-time (tpeak) and end-time (tend) of myoglobin inflow into blood from the infarct area, in addition to the total cumulative release (A), which was used as a measure of infarct size. Use of patient-mean values for the kinetic constants caused a mean difference in estimated 'infarct size' of 34% (n = 7). Individual estimation of the elimination rate constant from the 'final slope' of the serum myoglobin curve could neither be recommended from a theoretical point of view nor from the practical outcome of numerical calculations; the 'true' elimination rate constant is underestimated by a factor of about 10 on average. Good correlation was found between our myoglobin estimates of 'infarct size' (using patient-mean kinetic constants), and independent estimates from serial serum CK-MB data, as calculated by the use of the method by Sobel et al.. Large inter-individual variations were found in the estimated infarct parameters, a circumstance which is of special interest in evaluation of therapeutic intervention studies on AMI-patients, and in infarct size prediction calculations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Creatine Kinase / blood
  • Humans
  • Isoenzymes
  • Kinetics
  • Myocardial Infarction / blood*
  • Myocardial Infarction / enzymology
  • Myoglobin / blood*
  • Species Specificity


  • Isoenzymes
  • Myoglobin
  • Creatine Kinase