Heart and Muscle Health
This panel includes biomarkers used to evaluate heart function, heart muscle injury, skeletal muscle damage, and vascular health. These markers help clinicians investigate symptoms such as chest pain, shortness of breath, fatigue, or muscle weakness, and can support the diagnosis or monitoring of heart failure, heart attacks, muscle disorders, and cardiovascular risk.
The biomarkers in this panel fall into four main clinical groups.
Heart Failure and Cardiac Stress Markers
These biomarkers are released when the heart is under increased pressure or strain, such as in heart failure or ventricular dysfunction.
B-Type Natriuretic Peptide (BNP)
BNP is a hormone released by the heart’s ventricles when they are stretched due to increased blood volume or pressure. Elevated BNP levels are commonly used to diagnose and monitor heart failure and assess the severity of cardiac stress.
NT-proBNP
NT-proBNP is an inactive fragment released alongside BNP when the heart is under strain. It is widely used as a sensitive biomarker for heart failure and can help distinguish heart-related causes of shortness of breath from lung or other conditions.
Galectin-3
Galectin-3 is associated with cardiac fibrosis and remodeling, processes that occur as heart failure progresses. It is often used to help assess heart failure prognosis and disease progression.
Cardiac Injury Markers (Heart Attack Indicators)
These biomarkers are released when heart muscle cells are damaged, such as during a heart attack or other forms of cardiac injury.
Troponin
Troponin proteins are released into the bloodstream when heart muscle cells are injured. Elevated troponin levels are one of the most important markers used to diagnose myocardial infarction (heart attack).
Troponin T, High Sensitivity
High-sensitivity troponin tests detect even very small amounts of heart muscle injury, allowing earlier detection of cardiac stress or damage.
CK-MB
CK-MB is a form of creatine kinase found primarily in the heart muscle. Elevated levels can indicate damage to cardiac tissue, although troponin tests are now used more frequently for diagnosing heart attacks.
MB Relative Index
The MB relative index compares CK-MB levels with total CK levels to help determine whether muscle damage is cardiac or skeletal in origin.
Skeletal Muscle Damage Markers
These biomarkers help identify muscle injury, inflammation, or muscle disease affecting the skeletal muscles.
Creatine Kinase (CK)
Creatine kinase is an enzyme found in skeletal muscle, heart muscle, and brain tissue. Elevated levels often indicate muscle injury, inflammation, or intense physical activity.
Creatine Phosphokinase (CPK)
CPK is another name for creatine kinase and is commonly measured to evaluate muscle damage or heart injury.
CK-MM
CK-MM is the creatine kinase subtype found mainly in skeletal muscle and is commonly elevated in muscle trauma, strenuous exercise, or muscle disorders.
CK-BB
CK-BB is primarily found in brain tissue and smooth muscle, although small amounts may appear in the bloodstream in certain medical conditions.
Aldolase
Aldolase is an enzyme involved in glucose metabolism. Elevated levels may occur in muscle diseases such as polymyositis, dermatomyositis, and muscular dystrophy.
Vascular Function and Cardiovascular Risk Markers
These biomarkers provide insight into endothelial function and cardiovascular risk, particularly in relation to nitric oxide metabolism and vascular health.
ADMA (Asymmetric Dimethylarginine)
ADMA inhibits nitric oxide production and is associated with endothelial dysfunction, an early contributor to atherosclerosis and cardiovascular disease.
SDMA (Symmetric Dimethylarginine)
SDMA is related to kidney function and nitric oxide metabolism. Elevated levels may indicate reduced renal clearance and increased cardiovascular risk.
Other Enzyme Variants
Macro CK Type 1
Macro CK Type 1 is an atypical form of creatine kinase that may appear in the blood when CK binds to certain proteins. It can sometimes cause persistently elevated CK levels without true muscle injury.
Macro CK Type 2
Macro CK Type 2 is a mitochondrial form of creatine kinase that may appear in certain serious illnesses or tissue damage.
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Biomarkers included in this panel:
ADMA/SDMA may be measured in individuals with multiple risk factors for the development of CVD. One of the earliest manifestations of endothelial dysfunction is nitric oxide (NO) deficiency, which promotes atherosclerosis. Asymmetric dimethylargin
Learn moreAldolase is an enzyme that participates in glycolysis, which is the pathway for metabolizing glucose into energy. Elevated levels of aldolase in the blood occur in diseases of muscle including Duchenne muscular dystrophy, dermatomyositis, and polymyo
Learn moreThis test measures the levels of a certain type of hormone in your blood called a B-type natriuretic peptide. This test gives you information about your heart. Providers use a BNP test to diagnose heart failure. If you already know you have h
Learn moreThere are three types of Creatine Kinase enzymes: CK-MM, found mostly in skeletal muscles CK-MB, found mostly in the heart muscle CK-BB, found mostly in your brain. It's also found in smooth muscles such as the intestine or uterus. A smal
Learn moreCreatine Kinase is a type of protein that is mostly found in the skeletal muscle (CK-MM). 97 to 100% of Creatine Kinase are usually found in skeletal muscle. The other two types of Creatine Kinase are CK-MB (Creatine Kinase found in the heart muscle)
Learn moreCreatine Kinase is a type of protein that is mostly found in the skeletal muscle (CK-MM). 97 to 100% of Creatine Kinase are usually found in skeletal muscle. The other two types of Creatine Kinase are CK-MB (Creatine Kinase found in the heart muscle)
Learn moreCreatine kinase
Creatine kinase (CK) is an enzyme found primarily in the brain, skeletal muscles, and heart. Conditions that cause damage to any of these three areas produce an elevated level of CK. For this reason, CK tests are often run to detect muscle damage, es
Learn moreCreatine Kinase (CK), MB
The CK-MB test measures levels of a specific enzyme, Creatine kinase-MB, primarily found in heart muscle cells, to diagnose heart damage. CK-MB is one of three forms of the creatine kinase enzyme, with the others being CK-MM and CK-BB, found in diffe
Learn moreCreatine phosphokinase (CPK) is an enzyme in the body. It is found mainly in the heart, brain, and skeletal muscle. This test may be used to: - Diagnose heart attack - Evaluate cause of chest pain - Determine if or how badly a m
Learn more- Aiding in the prognosis for people diagnosed with heart failure - Risk-stratification of heart failure people - An early indication of treatment failure and as a therapeutic target Galectin-3 can be used in conjunction with clinical evaluation
Learn moreThe relative index represents the ratio of CKMB to the CK, total. Relative index = CK-MB, in ng/mL ÷ CK, total, U/L x 100. Due to the different units measured (ng/mL for CK-MB vs. U/L for CK, total), this does not represent a true percentage a
Learn moreNT-proBNP is a diagnostic screening tool to differentiate between people with normal and reduced left ventricular systolic function. - N-terminal (NT)-pro hormone BNP (NT-proBNP) is a non-active prohormone that is released from the same molec
Learn moreNT-proBNP (N-terminal pro B-type natriuretic peptide) is a protein released by the heart when it is under strain, often due to conditions like heart failure. Normally, only small amounts are found in the blood, but levels rise when the heart struggle
Learn moreADMA/SDMA may be measured in individuals with multiple risk factors for the development of CVD. SDMA is primarily excreted in the urine and identifies reduced renal function. One of the earliest manifestations of endothelial dysfunction is nitr
Learn moreTroponin proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.
Learn moreTroponin T, High Sensitivity (hs-TnT) is a blood test that detects very small amounts of troponin T, a protein released into the bloodstream when heart muscle cells are injured. High-sensitivity assays can identify even mild or early heart stress or
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