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Cardiac enzyme (Lactate dehydrogenase, LDH)

Description

LDH consists two different polypeptide chains H (heart) and M (muscle) which combine to yield the five major isoenzymes. Each isoenzyme consists of four polypeptide chains.

In  acute myocardial infarction (AMI), LDH levels begin to rise within 12 to 24 hours, reach peak levels within 48 to 72 hours, and may remain elevated for 10 days.

LDH isoenzymes

LDH enzyme consists of four polypeptide subunits. There are two types of subunits namely (for muscle) and H (for heart).

1.  LDH-1 (HHHH)

2.      LDH-2 (HHHM)

3.      LDH-3 (HHMM)

4.      LDH-4 (HMMM)

5.      LDH-5 (MMMM)

Tissue Sources

LDH is found in the heart, liver, skeletal muscle, kidney, and erythrocytes; lesser amounts are found in the lung, smooth muscle, and brain.

Normal range LDH ≤ 530 U/L LDH diagnostic significant Causes of raised  plasma total LDH activity: The highest levels of total LDH are seen in 1.      Pernicious anemia and hemolytic disorders. 2.      Liver disorders, such as viral hepatitis and cirrhosis. 3.      Myocardial infarction and pulmonary infarct. 4.      Skeletal muscle disorders. 5.      Some leukemias e.g. acute lymphoblastic leukemia. 6.      Circulatory failure with shock and hypoxia