The dynamic changes of LDH isoenzyme 3 and D-dimer following pulmonary thromboembolism in canine



      To investigate the time course of changes of lactic acid dehydrogenase (LDH), LDH isoenzymes and D-dimer levels following acute pulmonary thromboembolism (PTE).

      Materials and methods

      Eighteen dogs were randomly divided into three groups. Acute PTE was induced by injection of preformed blood clots into pulmonary artery through femoral vein. Thrombin and human fibrinogen were delivered into blood clots in embolism group I. Only thrombin was delivered into blood clots in embolism group II. The control group received normal saline and human fibrinogen in the same manner. Series of blood samples were collected pre-embolism and post-embolism. LDH isoenzymes proportion and D-dimer levels were measured.


      At 30 min, 1 h, 2 h, 4 h, 24 h post-embolism, the plasma D-dimer levels from embolism group I were significantly higher than pre-embolism and those from control group at the same intervals (p<0.05). The peak appeared at 2 h post-embolism (2.336±0.326 vs. 0.016±0.013, p<0.05). At 4 h, 24 h and 48 h post-embolism, total serum LDH activity and LDH-3 proportion from two embolism groups were significantly higher than pre-embolism (p<0.05). The peak of LDH-3 proportion in two embolism groups both appeared at 24 h post-embolism (0.225±0.021 vs. 0.108±0.030, 0.214±0.011 vs. 0.096±0.031, respectively. p<0.05).


      The LDH-3 and D-dimer levels were changed dynamically with a relative specificity manner during the course of acute massive PTE. Combination the D-dimer assay with LDH-3 may have a potential value in diagnosing acute massive PTE.


      CTA (spiral CT angiography), ELISA (enzyme-linked immunosorbent assays), LDH (Lactic acid dehydrogenase), PAP (pulmonary artery pressure), PCWP (pulmonary capillary wedge pressure), PE (pulmonary embolism), PTE (pulmonary thromboembolism.)


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        • Goldhaber S.Z.
        • Visani L.
        • De Rosa M.
        Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER).
        Lancet. 1999; 353: 1386-1389
        • Task Force on Pulmonary Embolism, European Society of Cardiology
        Guidelines on diagnosis and management of acute pulmonary embolism.
        Eur Heart J. 2000; 21: 1301-1336
        • Carson J.L.
        • Kelley M.A.
        • Duff A.
        • et al.
        The clinical course of pulmonary embolism.
        N Engl J Med. 1992; 326: 1240-1245
        • Hildner F.J.
        • Ormond R.S.
        Accuracy of the clinical diagnosis of pulmonary embolism.
        JAMA. 1967; 202: 567-570
        • Stein P.D.
        • Terrin M.L.
        • Hales C.A.
        • et al.
        Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease.
        Chest. 1991; 100: 598-603
        • Stein P.D.
        • Goldhaber S.Z.
        • Henry J.W.
        Alveolar-arterial oxygen gradient in the assessment of acute pulmonary embolism.
        Chest. 1995; 107: 139-143
        • Rodger M.A.
        • Makropoulos D.
        • Turek M.
        • et al.
        Diagnostic value of the electrocardiogram in suspected pulmonary embolism.
        Am J Cardiol. 2000; 86: 807-809
        • Manganelli D.
        • Palla A.
        • Donnamaria V.
        • Giuntini C.
        Clinical features of pulmonary embolism. Doubts and certainties.
        Chest. 1995; 107: 25S–32S
        • Van Strijen M.J.
        • De Monje W.
        • Schiereck J.
        • et al.
        Advances in New Technologies Evaluating the Localization of Pulmonary Embolism Study Group: single-detector helical computed tomography as the primary diagnostic test in suspected pulmonary embolism: a multicenter clinical management study of 510 patients.
        Ann Intern Med. 2003; 138: 307-314
        • Matthews S.
        Imaging pulmonary embolism in pregnancy: what is the most appropriate imaging protocol?.
        Br J Radiol. 2006; 79: 441-444
        • Anderson D.R.
        • Wells P.S.
        D-dimer for the diagnosis of venous thromboembolism.
        Curr Opin Hematol. 2000; 7: 296-301
        • Perrier A.
        • Desmarais S.
        • Goehring C.
        • et al.
        D-dimer testing for suspected pulmonary embolism in outpatients.
        Am J Respir Crit Care Med. 1997; 156: 492-496
        • Quinn D.A.
        • Fogel R.B.
        • Smith C.D.
        • Laposata M.
        • Taylor Thompson B.
        • Johnson S.M.
        • et al.
        D-dimers in the diagnosis of pulmonary embolism.
        Am J Respir Crit Care Med. 1999; 159: 1445-1449
        • Rathbun S.W.
        • Whitsett T.L.
        • Vesely S.K.
        • et al.
        Clinical utility of D-dimer in patients with suspected pulmonary embolism and nondiagnostic lung scans or negative CT findings.
        Chest. 2004; 125: 851-855
        • Becker D.M.
        • Philbrick J.T.
        • Bachhuber T.L.
        • Humphries J.E.
        D-dimer testing and venous thromboembolism. A shortcut to accurate diagnosis?.
        Arch Intern Med. 1996; 156: 939-946
        • Langan C.J.
        • Weingart S.
        New diagnostic and treatment modalities for pulmonary embolism: one path through the confusion.
        Mt Sinai J Med. 2006; 73: 528-541
        • Perrier A.
        • Bounameaux H.
        • Morabia A.
        • et al.
        Diagnosis of pulmonary embolism by a decision analysis-based strategy including clinical probability, D-dimer levels, and untrasonography: a management study.
        Arch Intern Med. 1996; 156: 531-536
        • Wells P.S.
        • Anderson D.R.
        • Rodger M.A.
        • et al.
        Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and D-dimer.
        Ann Intern Med. 2001; 135: 98-107
        • Ginsberg J.S.
        • Wells P.S.
        • Kearon C.
        • et al.
        Sensitivity and specificity of a rapid whole blood assay for D-dimer in the diagnosis of pulmonary embolism.
        Ann Intern Med. 1998; 129: 1006-1011
        • de Groot M.R.
        • van Marwijk Kooy M.
        • Pouwels J.G.J.
        • Engelage A.H.
        • Kuipers B.F.
        • Buller H.R.
        The use of a rapid D-dimer blood test in the diagnostic workup for pulmonary embolism: a management study.
        Thromb Haemost. 1999; 82: 1588-1592
        • Pincus M.R.
        • Zimmerman H.J.
        • Henry J.B.
        Clinical enzymology.
        in: Henry J.B. Clinical diagnosis and management by laboratory methods. WB Saunders, Philadelphia1996: 281-284
        • Cobben N.A.
        • Drent M.
        • Jacobs J.A.
        • et al.
        Relationship between enzymatic markers of pulmonary cell damage and cellular profile: a study in bronchoalveolar lavage fluid.
        Exp Lung Res. 1999; 25: 99-111
        • Karpova V.V.
        • tverskaia M.S.
        • Trusov O.A.
        • et al.
        Clinico-experimental study of histoenzymological changes in the ventricular myocardium in pulmonary embolism.
        Biul Ekspert Biol Med. 1992; 113: 539-542
        • Khan D.A.
        • Hashim R.
        • Mirza T.M.
        • Rahman M.M.
        Differentiation of pulmonary embolism from high altitude pulmonary edema.
        J Coll Physicians Surg Pak. 2003; 13: 267-270
        • Pallela V.R.
        • Thakur M.L.
        • Consigny R.S.
        • et al.
        Imaging thromboembolism with Tc-99 m-labeled thrombospondin receptor analogs TP1201 and TP1300.
        Thromb Res. 1999; 93: 191-202
        • Lichey J.
        • Reschofski I.
        • Dissmann T.
        • Priesnitz M.
        • Hoffmann M.
        • Lode H.
        Fibrin degradation product D-dimer in the diagnosis of pulmonary embolism.
        Klin Wochenschr. 1991; 69: 522-526
        • Bounameaux H.
        • Cirafici P.
        • de Moerloose P.
        • et al.
        Measurement of D-dimer in plasma as diagnostic aid in suspected pulmonary embolism.
        Lancet. 1991; 337: 196-199
        • Ji Yingqun
        • Zhang Zhonghe
        • Zhang Ping
        Thrombosis and its significance after experimental pulmonary thromboembolism.
        CMJ. 2003; 116: 49-52
        • Heffner A.C.
        • Kline J.A.
        Role of the peripheral intravenous catheter in false-positive D-dimer testing.
        Acad Emerg Med. 2001; 8: 103-106
        • Menendez R.
        • Nauffal D.
        • Cremades M.J.
        Prognostic factors in restoration of pulmonary flow after submassive pulmonary embolism: a multiple regression analysis.
        Eur Respir J. 1998; 11: 560-564
        • Hagadorn J.E.
        • Bloor C.M.
        • Yang M.S.
        Elevated plasma activity of lactate dehydrogenase isoenzyme-3 (LDH3) in experimentally-induced immunologic lung injury.
        Am J Pathol. 1971; 64: 575-584
        • Papadopoulos N.M.
        • Kintzios J.A.
        Quantitative electrophoretic determination of lactate dehydrogenase isoenzymes.
        Am J Clin Pathol. 1967; 47: 96-100
        • Wagevoort C.A.
        Pathology of pulmonary thromboembolism.
        Chest. 1995; 107: 10-17
        • Schoepf U.J.
        • Goldhaber S.Z.
        • Costello P.
        Spiral computed tomography for acute pulmonary embolism.
        Circulation. 2004; 109: 2160-2167
        • Lott J.A.
        • Nemensanszky E.
        Lactate dehydrogenase.
        in: Lott J.A. Wolf P.L. Clinical Enzymology, a Caseoriented Approach. 1987: 213-244
        • Moss D.W.
        • Henderson A.R.
        in: Burtis C.A. Ashwood E.R. Tietz textbook of clinical chemistry. 2nd edn. Saunders Co., Philadelphia1986: 735-896