Serum Creatine Phosphokinase (CPK) Activity in Disorders of Heart and Skeletal Muscle
Authors: JOSEPH W. HESS
Journal: Annals of Internal Medicine (1964)

Article1 December 1964Serum Creatine Phosphokinase (CPK) Activity in Disorders of Heart and Skeletal MuscleJOSEPH W. HESS, M.D., RODERICK P. MACDONALD, PH.D, RICHARD J. FREDERICK, M.S., ROBERT N. JONES, M.D., JOANN NEELY, M.D., DAVID GROSS, M.D.JOSEPH W. HESS, M.D., RODERICK P. MACDONALD, PH.D, RICHARD J. FREDERICK, M.S., ROBERT N. JONES, M.D., JOANN NEELY, M.D., DAVID GROSS, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-6-1015 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSerum enzyme studies have come to occupy an increasingly important place in clinical medicine. Accurate interpretation of elevated serum enzyme activity may be complicated, however, because many of the serum enzymes used as diagnostic aids in clinical medicine are found in several types of tissues. If a clinical situation is simple and only one type of tissue is diseased, then interpretation of the test results may not pose a problem. If, on the other hand, more than one tissue is affected, the physician may have difficulty interpreting an elevation if he is aware of multiple organ disease; or he may...References1. OLIVER IT: A spectrophotometric method for the determination of creatine phosphokinase and myokinase. Biochem. J. 61: 116, 1955. CrossrefMedlineGoogle Scholar2. TANZERGILVARG MLC: Creatine and creatine kinase measurement. J. Biol. Chem. 234: 3201, 1959. CrossrefMedlineGoogle Scholar3. EBASHITOYOKURAMOMOISUGATA SYHH: High creatine phosphokinase activity of sera of progressive muscular dystrophy patients. J. Biochem. (Tokyo) 46: 103, 1959. Google Scholar4. OKINAKAKUMAGAIEBASHISUGATAMOMOITOYOKURAFUJIE SHSHHYY: Serum creatine phosphokinase activity in progressive muscular dystrophy and neuromuscular diseases. Arch. Neurol. (Chicago) 4: 520, 1961. CrossrefMedlineGoogle Scholar5. DREYFUSSCHAPIRADEMOS JGJ: Étude de la creatine-kinase serique chez les myopathes et leurs familles. Rev. Franc. Etud. Clin. Biol. 5: 384, 1960. MedlineGoogle Scholar6. DREYFUSSCHAPIRARENAISSCEBAT JGJL: La creatine-kinase serique dans le diagnostic de l'infarctus myocardique. Ibid., p. 386. Google Scholar7. DREYFUSSCHAPIRASCEBATRENAISLENEGRE JGLJJ: Les enzymes seriques dans le diagnostic des lesions myocardiques d'origine coronarienne. Rev. Atheroscler. (Paris) 2: 187, 1960. Google Scholar8. DREYFUSSCHAPIRASCEBATRENAISLENEGRE JGLJJ: Les enzymes seriques dans le diagnostic des lesions myocardiques d'origine coronarienne. II. La creatine-kinase. Arch. Mal. Coeur. 2: 187, 1960. Google Scholar9. FORSTERESCHER GJ: Die Kreatinphosphokinase in der Diagnostik von Herzinfarkt und Myopathien. Helv. Med. Acta. 28: 513, 1961. MedlineGoogle Scholar10. STICHTSIRIMBAS WA: Die Enzymdiagnostik des Herzinfarktes. Internist (Berlin) 2: 592, 1961. MedlineGoogle Scholar11. STICHTSIRIMBAS WA: Der Creatin-phosphokinase test. Eine neue enzymatische Methode zur biochemischen Diagnose des Herzinfarktes. Klin. Wschr. 40: 115, 1962. CrossrefMedlineGoogle Scholar12. COLOMBORICHTERICHROSSI JPRER: Serum-Kreatin-Phosphokinase: Bestimmung und diagnostische Bedeutung. Ibid., p. 37. Google Scholar13. HUGHES BP: A method for the estimation of serum creatine kinase and its use in comparing creatine kinase and aldolase activity in normal and pathological sera. Clin. Chim. Acta. 7: 597, 1962. CrossrefMedlineGoogle Scholar14. EVERS C: Die Bedeutung der Kreatinphosphokinase (CPK) fur die Diagnostik des Herzinfarkts und der Myokarditis. Med. Klin. 58: 1260, 1963. Google Scholar15. CUTILLOCOLLETTAREABERNICANANI SAFM: Sul compartaments dell attivita Creatinfosfochinasica nel siero di soggetti con distrofia muscolare progressiva. Boll. Soc. Ital. Biol. Sper. 39: 769, 1963. MedlineGoogle Scholar16. HERBINGER W: Enzymologische Diagnose des Myokardinfarctes. Wien. Med. Wschr. 113: 501, 1963. Google Scholar17. SCHNEIDERHEISE KWER: Die diagnostische Bedeutung einer erhohten Kreatin-Phosphokinase-Aktivitat im Serum. Deutch Med. Wschr. 88: 520, 1963. CrossrefMedlineGoogle Scholar18. NIVETCONSTANSFACQUET MCJ: Elevations pathologiques de la creatine kinase en dehors de l'infarctus du myocarde. Rev. Franc. Etud. Clin. Biol. 8: 74, 1963. Google Scholar19. GRAIGROSS FAG: Serum creatine phosphokinase in thyroid disease. Metabolism 12: 57, MedlineGoogle Scholar20. PEARSON CM: Muscular dystrophy. Review and recent observations. Amer. J. Med. 35: 632, 1963. CrossrefMedlineGoogle Scholar21. HESSMACDONALDDALTONJONESNEELY JWRPJBRNJ: Serum creatine phosphokinase (CPK) activity in diseases of muscular tissue (abstract). J. Clin. Invest. 42: 941, 1963. Google Scholar22. HESSMACDONALD JWRP: Serum creatine phosphokinase activity: a new diagnostic aid in myocardial and skeletal muscle disease. J. Mich. Med. Soc. 62: 1095, 1963. MedlineGoogle Scholar23. HESSMACDONALD JWRP: Serum creatine phosphokinase (CPK) activity in disorders of heart and skeletal muscle (abstract). Ann. Intern. Med. 60: 318, 1964. LinkGoogle Scholar24. KUBYNODALARDY SALHA: Adenosinetriphosphate-creatine transphosphorylase. III. Kinetic studies. J. Biol. Chem. 210: 65, 1954. CrossrefMedlineGoogle Scholar25. ENNORROSENBERG AHH: Some properties of creatine phosphokinase. Biochem. J. 57: 203, 1954. CrossrefMedlineGoogle Scholar26. NODANIHEIMORALES LTMF: The enzymatic activity and inhibition of adenosine 5′-triphosphate-creatine transphosphorylase. J. Biol. Chem. 235: 2830, 1960. CrossrefMedlineGoogle Scholar27. Determination of the Activity of Creatine Phosphokinase in Serum (UV-Method with DPNH). Brochure prepared by C. F. Boehringer and Soehne, GmbH, Mannheim, Germany, 1963. Google Scholar28. MACDONALDSIMPSONNOSAL RPJRE: Serum lactic dehydrogenase: a diagnostic aid in myocardial infarction. JAMA 165: 35, 1957. CrossrefMedlineGoogle Scholar29. REITMANFRANKEL SS: A colorimetric method for the determination of serum glutamic oxalacetic and glutamic pyruvic transaminases. Amer. J. Clin. Path. 128: 56, 1957. CrossrefGoogle Scholar30. Report of the Commission on Enzymes of the International Union of Biochemistry 1961. Symposium Series, Vol. 20. Pergamon Press, New York, 1961. Google Scholar31. STRANDJORDCLAYSONFREIER PEKSEF: Heat stable lactic dehydrogenase in myocardial infarction and liver disease. JAMA 182: 1099, 1962. MedlineGoogle Scholar32. DREYFUSSCHAPIRA JG: Biochemistry of Hereditary Myopathies. Charles C Thomas, Springfield, Ill., 1962. Google Scholar33. HUGHES BP: Serum enzyme changes in muscle disease and their relation to tissue change. Proc. Roy. Soc. Med. 56: 179, 1963. CrossrefMedlineGoogle Scholar34. SCHAPIRADREYFUS GJ: The biochemistry of progressive muscular dystrophy, in Muscular Dystrophy in Man and Animals, edited by BOURNE, G. H., GOLARZ, N., Hafner, New York, 1963. Google Scholar35. AEBIRICHTERICHCOLOMBOROSSI URJPE: Progressive muscular dystrophy. II. Biochemical identification of the carrier state in the recessive sex-linked juvenile (Duchenne) type by creatine phosphokinase determinations. Enzym. Biol. Clin. (Basel) 1: 61, 1961. CrossrefGoogle Scholar36. SATOYOSHIMURAKAMIKOWAKINOSHITANOGUCHIHOSHINANISHIYAMAITO EKHMKSYK: Myopathy in thyrotoxicosis, with special emphasis on the effect of potassium ingestion on serum and urinary creatine. Neurology (Minneapolis) 13: 645, 1963. CrossrefMedlineGoogle Scholar37. DEBELLISDEVINCENTIIS EE: L'Aldolasemia nei gozzi iperfunzionanti. Arch. Chir. (Roma) 3: 289, 1961. Google Scholar38. GRIFFITHS PD: Creatinephosphokinase levels in hypothyroidism. Lancet 1: 894, 1963. CrossrefMedlineGoogle Scholar39. SUGATA H: Clinical and experimental investigations on creatine phosphokinase and aldolase activity in neuromuscular disorders. Psychiat. Neurol. Jap. 62: 106, 1960. Google Scholar40. SCHMIDTSCHMIDTHORNGERLACH EFWHDU: The importance of the measurement of enzyme activity in medicine, in Methods of Enzymatic Analysis, edited by BERGMEYER, H-U, Verlag Chemie, Weinheim/Bergstr. Academic Press, New York, 1963. Google Scholar41. BAUMANNRICHTERICHESCHERSCHONHOLZER PRJG: Das Verhalten von Serum-Enzymen bei sportlichen Leistungen. Schweiz Z. Sportmed. 10: 33, 1962. MedlineGoogle Scholar42. REMMERSKALJOT AV: Serum transaminase levels: effect of strenuous and prolonged physical exercise on healthy young subjects. JAMA 185: 968, 1963. CrossrefMedlineGoogle Scholar43. RICHTERICHROSINAEBIROSSI RSUE: Progressive muscular dystrophy. V. The identification of the carrier state in the Duchenne type by serum creatine kinase determination. Amer. J. Hum. Genet. 15: 1133. 1963. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Detroit, MichiganFrom the Department of Medicine, Wayne State University School of Medicine and Receiving Hospital, and the Departments of Medicine and Pathology, Harper Hospital, Detroit, Mich.This study was supported by research grants from the Michigan Heart Association and the Muscular Dystrophy Association of America, Inc.Portions of this study were presented before the Michigan Regional Meeting of the American College of Physicians, December 7-8, 1962, and the First Sectional Meeting of the American College of Physicians, November 21, 1963, Detroit, Mich.Requests for reprints should be addressed to Joseph W. Hess, M.D., Department of Medicine, Wayne State University School of Medicine, 1401 Rivard St., Detroit 7, Mich. 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Diagnosis with special reference to creatine kinase MB isoenzymeREFERENCESTrichinella spiralis: Alterations of blood chemistry in the mouseEffects of β-mercaptoethanol and chelating agents on the stability and activation of creatine kinase in serumIsoenzyme der Kreatin-Kinase: Verteilungsmuster in der Skeletmuskulatur und im Serum bei Erkrankungen sowie Sch�digungen der MuskulaturCreatine kinase isoenzymes in the assessment of heart diseaseCreatine PhosphokinaseIsoenzyme der Kreatinkinase: Verteilung in der Skeletmuskulatur und in Seren von Patienten mit Erkrankungen oder Schädigungen der MuskulaturThe effects of near maximum exercise on serum enzymes: the exercise profile versus the cardiac profileSmall Animal Model for Myocardial InfarctionEvaluation of Electrocardiogram in Emergency Room as a Decision-Making ToolThe formation of a platelet adhesive factor by disruption of the creatine phosphokinase moleculeX-linked recessive type of pure spastic paraplegia in a large pedigree: absence of detectable linkage with Xg.Screening of malignant hyperthermia susceptible families by creatine phosphokinase measurement and other clinical investigationsSul Comportamento Di Alcuni Enzimi Serici Dopo Prostatectomia Transuretrale1 Clinical EnzymologySpecificity of elevated serum MB creatine phosphokinase activity in the diagnosis of acute myocardial infarctionEffect of exercise, hypoxia, and epinephrine on lysosomes and plasma enzymesCreatinephosphokinase in Human Diploid Cell LinesDegeneration of the intersegmental muscles: Alterations in hemolymph during muscle degenerationElevated creatine phosphokinase in patients with ureteral calculi Cause for unwarranted concern of coronary occlusionBlack—white differences in serum creatine phosphokinase (CPK) activityEnzyme Proffles as Indicators of Susceptibility to Environmental Toxic AgentsAssessing Local Reactions and Serum Enzyme Changes from Intramuscular InjectionsSerum creatine phosphokinase isozymes in hypothyroidism, convulsion, myocardial infarction and other diseasesProgressive Muskeldystrophien unter besonderer Berücksichtigung der Creatin-KinaseThe influence of the dilution effect on serum creatine phosphokinase activity in neuromuscular diseasesTHYROTOXIC MYOPATHYMUSCULAR ABNORMALITIES OF HYPOTHYROIDISMMalignant hyperthermia: an investigation of five patientsStudy of creatine phosphokinase, lactic dehydrogenase and transaminases in neuromuscular diseasesThe Importance of Identification of the Myocardial-Specific Isoenzyme of Creatine Phosphokinase (MB Form) in the Diagnosis of Acute Myocardial InfarctionSerum creatine phosphokinaseSerum enzyme levels during exercise in patients with coronary heart disease: Effects of trainingClofibrate-lnduced acute muscular syndromeDetermination of serum creatine kinase isoenzymes in myocardial infarctionA REVIEW OF THE VALUE OF CREATINE PHOSPHOKINASE ESTIMATIONS IN CLINICAL MEDICINESerum Enzyme Determinations in the Diagnosis and Assessment of Myocardial InfarctionREFERENCESChronobiology of the Life SequenceMeasurement of Creatine Kinase Activity in SerumSerum Enzyme Determinations after Transurethral Resection of the ProstateEnzyme changes in rats with terminal liver necrosis due to vitamin E and selenium deficienciesEffect of Transurethral Surgery upon the Serum Enzyme Creatine PhosphokinaseLACTATION TETANY (ECLAMPSIA) IN A SHETLAND PONY MAREThe significance of the "dilution effect" in the determination of serum creatine kinaseFactors affecting serum creatine phosphokinase levels in the general population: The role of race, activity and ageListeria monocytogenes ToxinSerum Creatine Phosphokinase Levels Following Endoscopic Urologic ProceduresCreatine Phosphokinase Relative to Acid Phosphatase, Lactate Dehydrogenase, Zinc and Fructose in Human Semen with Special Reference to Chronic ProstatitisSerum creatine phosphokinase levels in children undergoing cardiac catheterizationCardiotoxic and Lethal Effects of Listeria monocytogenes HemolysinSerum creatine phosphokinase in acute pancreatitisEffect of electrocautery on serum creatine phosphokinase in surgical patientsSerum creatine phosphokinase activity following isoproterenol-induced myocardial infarction in male and female rats with and without arteriosclerosisThe Role of Skeletal and Cardiac Muscle in the Regulation of Protein MetabolismThe significance of the dilution effect in serum creatine kinase diagnosis of muscular dystrophyThe Activity of Serum Enzymes Following Prostatic OperationDie Biochemie der progressiven MuskeldystrophieAn investigation of physical factors influencing the behaviour in vitro of serum creatine phosphokinase and other enzymesEnzyme changes in myocardial infarction cardiomyopathies and non-ischaemic heart failureTrypanosoma lewisi: Creatine phosphokinase, ornithine carbamyl transferase, ATPases, Pi, and glucose levels in the rat hostAcute Muscular Syndrome Associated with Administration of ClofibrateDetermination and statistical analyses of the normal ranges for five serum enzymesSerum CPK in muscular dystrophy and myotonia dystrophicaSerum creatine phosphokinase and haemolysisAcute Myopathy Associated with Barbiturate WithdrawalTHE VALUE OF SERUM CREATINE PHOSPHOKINASE ESTIMATIONS IN THE DIAGNOSIS OF MYOCARDIAL INFARCTIONDIAGNOSTIC VALUE OF SERUM-CREATINE-KINASE IN A CORONARY-CARE UNITCreatine Phosphokinase in Thyroid: Isoenzyme Composition Compared with Other TissuesSerum Creatine Phosphokinase in Chronic AlcoholismEffect of dilution on the activity of serum creatine phosphokinaseSerum Lactate Dehydrogenase Elevation in Ambulatory Cardiac PatientsISOENZYMES: GENERAL CONSIDERATIONS AND ALTERATIONS IN HUMAN AND ANIMAL MYOPATHIES*Enzymatic profile of myocardial infarctMyositis ossificans progressivaThe Serum Creatine Phosphokinase Activity and the Achilles Reflex in Hyperthyroidism and HypothyroidismSerum Creatine Phosphokinase Activity in Chronic Alcoholism, in Connection with Acute Alcohol IntoxicationGutartige recessiv x-chromosomal vererbte MuskeldystrophieSerum Enzymology in the Diagnosis of Myocardial Infarction and Related Cardiovascular ConditionsThe Contribution of Isozymes of Serum Lactic Dehydrogenase (LDH) to the Diagnosis of Specific Organ InjuryIsoenzymes in Clinical DiagnosisThe Muscular Dystrophies 1 December 1964Volume 61, Issue 6Page: 1015-1028KeywordsAminotransferasesCreatinine phosphokinaseDehydrogenasesEnzymesHospital medicinePancreasPolymyositisResearch grantsResearch laboratoriesSkeletal muscles Issue Published: 1 December 1964 PDF downloadLoading ...