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Biomedical subjects

M Keltai

Publications and source records attributed to M Keltai.

52 records · Page 3Linked to original sources

[Hemodynamic effects of lidocaine and mexiletine in acute heart infarction].

The effect of lidocaine (1.0 mg/kg body weight) and mexiletine (1.5 mg/kg body weight) on the arterial blood pressure, the pulmonary artery pressure, heart rate and relative stroke volume were investigated in 9 patients with acute myocardial infarction. The medicaments given as intravenous bolus did not influence significantly the arithmetical mean values of blood pressure, heart rate, pulmonary artery pressure and relative stroke volume. In two cases, however, the application of mexiletine resulted in a strong increase of the pulmonary artery pressure. In one case both drugs caused a significant decrease of the stroke volume.

Acute Disease↗

Aortic root motion for the assessment of left ventricular function in acute myocardial infarction.

In a group of patients with various cardiac disorders positive correlation between aortic root motion amplitude and stroke volume was observed: (y=3.41 + 0.061 chi, r=0.719n=27), where y is the aortic wall motion amplitude in mm and chi is the stroke volume in ml. During the serial investigation of 40 patients with acute myocardial infarction aortic root systolic motion amplitude was significantly different between patients groups, selected by the categories of Killip (1967). Biggest amplitudes were found in patients with complicated course, smallest amplitudes in cardiogenic shock. Aortic root systolic motion increased in a parallel direction with the clinical improvement of the patients. Aortic root echos are easily detectable, independent from segmental dysfunction, therefore useful in monitoring of left ventricular function of patients with acute myocardial infarction.

Acute Disease↗

A Roentgen-anatomic study of the relationships between conduction defects and coronary disease.

Intraventricular conduction defects of various types were correlated to the extent of coronary disease and to the parameters reflecting the function of the left ventricle in 125 patients who had been subjected to coronary arteriography. In the patients with conduction disturbances, coronary disease was found to be more extensive and the proportion of abnormal parameters of left ventricular function higher than in those with normal conduction. The relationship of the various conduction defects with the lesions of the individual coronary branches and with the parameters of left ventricular function are discussed in detail.

Adult↗

Abnormalities of left ventricular function associated with prior acute myocardial infarction.

Selective coronarography, left ventricular cineangiography were performed three to six months after acute myocardial infarction in 45 patients. Simultaneously, stroke volume (SV), enddiastolic (EDV) and endsystolic volume (ESV), ejection fraction (EF) and left ventricular enddiastolic pressure (LVEDP) were determined. LVEDP was measured at rest and after static (handgrip) exercise. According to the type of the LV abnormality patients were divided in three groups: 1. without LV abnormality (5 patients) 2. asynergy (15 pts) and 3. aneurysm (25 pts). The data were reviewed separately in patients where abnormalities of LV were associated with angina pectoris. The degree of coronary obstruction and the type of LV abnormality did not disclose any correlation. LVEDP at rest was in normal limits in patients in group 1 and 2, elevated in patients with aneurysm. (LVEDP: 15, 15 and 25 mmHg resp.) After handgrip exercise LVEDP increased in each group: 21, 22, 32 mm Hg. SV: decreased significantly in LV aneurysm (53 ml/beat). EDV was 50 ml in patients with asynergy and 118 ml in those with aneurysm. ESV was in normal limits when asynergy was present, 35 ml in patients without abnormality and 118 ml in LV aneurysm. EF was 0.66 and 0.65 in group 1 and 2, in group 3 (aneurysm) this value was 0.49 (significantly lower). The extent of shortening of the longitudinal and transverse diameters were significantly diminished in each group. When angina was associated with LV asynergy a higher SV was observed, when angina was associated with aneurysm, SV and EF were decreased. The conclusion from these data can be drown that the compromised LV after prior AMI works with a different mechanism, according the type (and degree) of abnormality.

Angina Pectoris↗

The second phase of subendocardial infarction--transmural infarction.

Analysing the clinical course of 30 consecutive patients with acute subendocardial myocardial infarction, the authors draw attention to the frequent development of transmural infarction in patients with septal subendocardial infarction. Heparin treatment of subendocardial infarction can prevent the immediate second phase of the disease.

Diagnosis, Differential↗

The effect of RheothRx Injection on the hemorheological parameters in patients with acute myocardial infarction.

This study evaluated the hemorheological effects of a nonionic block copolymer surfactant, RheothRx Injection, on the hemorheological parameters in patients with acute myocardial infarction (AMI). For the in vitro study blood from 24 patients admitted with chest pains (mean age: 49 +/- 11 yrs) was sampled after admission and in AMI cases (15 patients, mean age: 53 +/- 13 yrs) a second sample was collected 48 hours later. Different concentrations of RheothRx were added (0.25, 0.5, 1, 2 and 5 mg/ml) and the blood was tested for RBC aggregation via our computerized Myrenne Aggregometer (at Hct = 40%). Besides other routine laboratory parameters, fibrinogen levels were measured. In a substudy for CORE Trial, the hemorheological effects of RheothRx infusion was studied. Seven patients (mean age: 63 +/- 13 yrs) admitted with AMI and randomized for CORE Trial were studied. The samples were collected after admission, at 12, 24, 48 hours, and at day 8 and 35. In vitro we found a significant (p < 0.05 or better) concentration-related decrease of RBC aggregation from 0.5 mg/ml drug concentration in the admission (both groups) and in the 48 hour (AMI) samples, in AMI patients with a mean decrease of 7 and 5% at 0.5 mg/ml, 13 and 8% at 1 mg/ml, 22 and 19% at 2 mg/ml and 39 and 33% at 5 mg/ml plasma concentration of the drug. In the CORE Trial patients hemorheological parameters (plasma and whole blood viscosity, RBC aggregation and fibrinogen level) decreased during and after the administration of RheothRx, but after 2-8 days their values returned to the baseline level. These findings indicate that this agent can significantly reduce RBC aggregation and other hemorheological parameters, and thus suggest its potential usefulness in clinical states associated with increased RBC aggregation.

Adult↗