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Enzimas cardiacas

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Principales enzimas cardiacas

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Enzimas cardiacas

  1. 1. ENZIMAS CARDIACAS
  2. 2. TROPONINA La troponina es una proteína globular de gran tamaño (aprox. 70.000 daltons) reguladora de la contracción del músculo cardíaco. Contiene tres subunidades polipeptídicas: troponina C (fijadora de calcio), troponina I (inhibidora de la interac- ción actina-miosina) y troponina T (fijadora de tropomiosina), las cuales son liberadas hacia el torrente sanguíneo durante un infarto al miocardio, por pérdida de la integridad de la membrana celular.
  3. 3. CREATINA QUINASA MB (CK-MB) La CK-MB es una enzima compuesta de dos subunidades, la subunidad M expresada en el músculo y la subunidad B, expresada en las células nerviosas. La CK-MB se encuentra en el suero en concentraciones bajas, se incrementa como consecuencia de un infarto de miocardio y después desciende a niveles normales. Puede incrementarse, más raramente, en traumatismos del músculo esquelético5,6.
  4. 4. En caso de enfermedad cardíaca se encuentran aumentadas en el torrente sanguíneo y pueden detectarse mediante un simple análisis de sangre.
  5. 5. VALORES NORMALES DE TROPONINA T Los niveles de troponina cardíaca están normalmente tan bajos que no se pueden detectar con la mayoría de los análisis de sangre. Los resultados del examen por lo regular se consideran normales si son: Troponina I: menos de 10 µg/L Troponina T: 0–0.1 µg/L Los niveles de troponina normales 12 horas después de que el dolor torácico haya empezado significan que un ataque cardíaco es improbable.
  6. 6. Un daño cardíaco, como por ejemplo un infarto cardíaco, conduce a un aumento de troponina T y CK-MB, pero su aumento varía a lo largo del tiempo tras el daño cardíaco. La troponina T sube después de tres horas y la CK-MB después de unas cuatro a ocho horas después del daño del músculo cardíaco, por ejemplo en un infarto de miocardio
  7. 7. El médico evalúa la troponina T y la creatina quinasa MB siempre en relación con la creatina quinasa total, porque existe otro tipo de creatinin-quinasa relacionada con los músculos. Una parte mayor de cinco por ciento de CK-MB de la creatina quinasa total indica daño del músculo cardíaco.
  8. 8. EL AUMENTO DE LA TROPONINA T SE PRODUCE EN LAS SIGUIENTES SITUACIONES: Infarto de miocardio Daño en el músculo cardíaco después de una lesión (traumatismo) o después de una intervención quirúrgica Angina de pecho (angina pectoris)
  9. 9. REDUCCIÓN DE LA TROPONINA T: En general, sin importancia clínica.
  10. 10. VALORES MUY ELEVADOS DE CK-MB PUEDE OCURRIR EN LAS SIGUIENTES SITUACIONES CLÍNICAS: Lesiones fuertes Necrosis muscular Inflamación muscular (miositis) Convulsiones
  11. 11. LAS CAUSAS DE UN AUMENTO DE CK-MB PUEDEN SER LAS SIGUIENTES: Esfuerzo físico pesado Infarto del miocardio Enfermedades inflamatorias del corazón Deficiente función tiroidea Daños extensos en tejidos no musculares Distrofia muscular
  12. 12. NIVELES BAJOS DE CK-MB: En general, sin importancia clínica.
  13. 13. REFERENCIAS http://www.onmeda.es/exploracion_tratamiento/enzimas-troponina-t-y-creatina- quinasa-mb-(ck-mb)-4444-6.html Gerhardt W and Waldenstrom G. Creatine kinase B-subunit activity in serum after immunoinhibition of M-subunit activity. Clin Chem 1979; 25: 1274-1279. rdal P and Landaas S. Macro creatine kinase BB in serum, and some data on its prevalence. Clin Chem 1979; 25: 461-465.

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