The detection of myoglobin in urine and its application to the diagnosis of myocardial infarction

Cloonan, M. J.; Donald, TC; Neale, Cynthia; Wilcken, D. E. L.

doi:10.3109/00313027609101494

Cited by 7 publications

(8 citation statements)

References 12 publications

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“…We have recently developed a simple and sensitive assay for urinary myoglobin (Cloonan et al, 1976) and have used it to quantify myoglobinuria after acute myocardial infarction . In the course of evaluating the significance of myoglobinuria, we sought evidence for this after a number of cardiovascular investigations.…”

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confidence: 99%

Excretion of myoglobin in urine after cardiac catheterisation.

Donald¹,

Cloonan²,

Wilcken³

1978

Heart

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Myoglobin levels were assayed in each urine specimen voided during 12 hours before and 48 hours after routine cardiac catheterisation in 146 patients using an indirect haemagglutination method detecting concentrations in excess of 0.015 mg/ml. Myoglobinuria was found in only one patient before but in 39 patients after cardiac catheterisation (27%), either in the first (34 patients) or the second (5 patients) post-catheterisation urine sample. Once detected, myoglobin was present in all subsequent urine specimens for the next 3 to 22 hours (mean 11.8 hours). The mean amount excreted +/- SE was 14.0 +/- 1.6 mg (range 2.6 to 30 mg) excluding the one patient with myoglobinuria before catheterisation. This patient, who had severe aortic stenosis and atherosclerotic heart disease, excreted 130 mg myoglobin. Patients with myoglobinuria required longer screening time to complete the procedures undertaken than those in whom myoglobin was not detected--15.6 +/- 1.4 and 11.1 +/- 0.6 minutes, respectively (mean +/- SE:P less than 0.01). We conclude that myoglobinuria is not uncommon after cardiac catheterisation, and that though the myoglobin detected may be released from skeletal muscle, it could be partly or wholly of cardiac origin and indicate transient, and presumably reversible, myocardial injury.

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confidence: 99%

Excretion of myoglobin in urine after cardiac catheterisation.

Donald¹,

Cloonan²,

Wilcken³

1978

Heart

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“…Tests for myoglobin do not distinguish between that of skeletal or cardiac muscle origin. In our earlier study (Cloonan et al, 1976) involving 147 control patients, and 15 patients given intramuscular injections similar to those received by the patients of the present series, no patient had myoglobinuria after an injection; and only 4 of the 147 controls had detectable myoglobinuria, and each had a condition likely to produce dysfunction of skeletel muscle cells. Thus, in the present study, we concluded that the myoglobin came from damaged heart muscle; and that in the appropriate clinical setting, the finding of myoglobinuria provides confirmatory evidence for a diagnosis of acute myocardial infarction.…”

Section: Discussionmentioning

confidence: 50%

“…However, to assess the significance of myoglobinuria after myocardial infarction it seems mandatory to analyse all urine samples voided for a considerable time after the onset of symptoms using a method of known sensitivity. From our preliminary studies, a period of 5 days seemed appropriate (Cloonan et al, 1976).…”

Section: Discussionmentioning

confidence: 99%

“…The method used has been fully described elsewhere and will be reviewed only briefly here (Cloonan et al, 1976). The only difference was that in the present study we used myoglobin antiserum from a commercial source (Hoechst, Behringwerke AG, Marburg-Lahn) which gave results similar to those reported previously (Cloonan et al, 1976). Fowl red blood cells, to which purified human cardiac myoglobin had been attached, were agglutinated by specific myoglobin antibody.…”

Section: Methodsmentioning

confidence: 99%

“…We have recently developed a simple and sensitive method for the immunochemical detection of myoglobin in human urine (Cloonan et al, 1976). We undertook the present study to determine the time course of myoglobinuria after acute myocardial infarction and to quantify myoglobin excretion.…”

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confidence: 99%

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Excretion of myoglobin in urine after actue myocardial infarction.

Donald¹,

Cloonan²,

Neale³

et al. 1977

Heart

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We studied myoglobin excretion in 33 patients admitted to the coronary care unit with a provisional diagnosis of acute myocardial infarction. Sixteen proved to have definite and uncomplicated acute myocardial infarction and 17 possible infarction, using WHO criteria. For 5 days after admission, aliquots of every urine specimen voided by each patient were analysedfor myoglobin using an immunochemical method able to detect a minimum urinary myoglobin concentration of 0-02 mg/ml. Myoglobinuria was detected in 14 of the 16 patients with definite infarction but was not found in any of the 1 7 patients with possible infarction. There were 3 patterns of myoglobin excretion. In 8 of the 14 patients it was excreted in one episode starting 10 to 40 hours after the onset of chest pain and lasting for 5 to 45 hours. In 3 of the remaining patients it was excreted over a much longer period (mean 83 hours) and in the final 3 patients myoglobinuria occurred in 2 or 3 intermittent episodes with periods of between 10 and 20 hours during which it was not detected. Total myoglobin excretion, which varied between 2 and 100 mg (mean 51 mg), did not correlate with peak serum enzyme levels. We concluded that in the appropriate clinical setting, the finding of myoglobinuria provides additional evidence for a diagnosis of acute myocardial infarction. The variable myoglobin excretion pattern suggests that in seemingly uncomplicated myocardial infarction there is considerable variation between patients in the pattern of evolution of the infarction process. This may be relevant to the assessment of measures directed towards limiting infarct size.

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Radioimmunologische Bestimmung von Human-Myoglobin in der Diagnostik des akuten Myokardinfarkts

et al. 1979

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A radioimmunoassay was developed to determine serum myoglobin (SMb). 50 healthy persons showed values between 0 and 90 ng/ml. Serial tests of 10 patients following acute myocardial infarction or during angina pectoris (AP) indicated that SMb reached pathological values before CK and CK-MB (average 250 +/- 95 ng/ml at the time of hospitalisation which corresponds to 3.3 +/- 1.4 h after beginning of angina pectoris). At hospitalisation the simultaneously determined CK was within normal limits and reached pathological values only 6.2 +/- 1.9 h after the onset of angina. Maximum of SMb was 506 +/- 194 ng/ml occurring 8.8 +/- 2.8 h after beginning of AP, maximum of CK was 905 +/- 475 mU/ml occurring 20.0 +/- 7.8 h after AP. CK-MB and CK differed only slightly in their time course. One patient with severe AP had pathologically increased SMb values whilst all other enzymes were completely normal. Methodical and clinical results are discussed.

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The detection of myoglobin in urine and its application to the diagnosis of myocardial infarction

Cited by 7 publications

References 12 publications

Excretion of myoglobin in urine after cardiac catheterisation.

Excretion of myoglobin in urine after cardiac catheterisation.

Excretion of myoglobin in urine after actue myocardial infarction.

Radioimmunologische Bestimmung von Human-Myoglobin in der Diagnostik des akuten Myokardinfarkts

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