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Biomedical subjects

Miklós Somlói

Publications and source records attributed to Miklós Somlói.

11 recordsLinked to original sources
PubMed2005

N-terminal pro-brain natriuretic peptide and tombstoning ST-segment elevation in patients with anterior wall acute myocardial infarction.

Tombstoning ST-segment elevation myocardial infarction (STEMI) has been associated with a poor prognosis ever since Wimalaratna's first description of this clinical entity, and the reasons for this are not fully understood. We studied 87 consecutive patients who had anterior STEMI (January 2004 to September 2004) to compare the form of STEMI, coronary anatomy, and initial N-terminus pro-brain natriuretic peptide (NT-pro-BNP) level. Patients who had tombstoning STEMI had higher levels of NT-pro-BNP despite significant differences in cardiac enzyme levels or extent of coronary disease. This finding suggests that, in addition to changing the shape of repolarization, decreased microcirculation plays a role in the development of increased wall tension. Increased wall tension in turn is the probable cause of higher NT-pro-BNP levels and increased mortality.

Biomarkers↗
PubMed2005

[Acute ST segment elevation during noncardiogenic shock].

Transient elevation of the ST segment was observed in a patient during noncardiogenic shock. The coronarography was negative. The patient received dopamine infusion. The 48 yr-old man had Crohn disease with septicaemia and ARDS. The exact pathomechanism is not known, but the negative coronarography ruled out the epicardial coronary disease. The suggested mechanisms are dopamine induced coronary vasoconstriction or complement activation.

Arrhythmias, Cardiac↗
PubMed2004

NT-brain natriuretic peptide levels in pleural fluid distinguish between pleural transudates and exudates.

BACKGROUND: Pleural effusion is not pathognomic and distinguishing between transudates and exudates often presents a diagnostic dilemma. The purpose of our study was to examine whether the inclusion of pleural fluid brain natriuretic peptide (BNP) measurement into the analysis improves the diagnostic accuracy of pleural effusion. METHODS: The pleural effusion of 14 patients with CHF (group A) and 14 subjects with different pleural pathology (group B) were analyzed. Samples of pleural fluid and serum were obtained from all patients on admission and biochemical analysis, bacterial and fungal culture, acid-fast bacilli smear and culture and cytology were performed on the pleural fluid. In vitro quantitative determination of N-terminal pro-Brain natriuretic peptide (NT-proBNP) in serum and pleural fluid were performed by electrochemiluminescence immunoassay proBNP method on an Elecsys 2010 (Roche) analyzer. RESULTS: The median NT-proBNP levels in groups A and B were 6295 pg/ml and 276 pg/ml, respectively: (P=0.0001). There was no overlap between the two groups. While the Light's criteria had a sensitivity of 93% and specificity of 43% for transudates, the pleural fluid NT-proBNP level accurately differentiated between the two groups. CONCLUSIONS: The pleural NT-proBNP levels were elevated in all patients who had transudate. Therefore if the NT-proBNP levels of pleural effusion are within the normal range, transudate resulting from congestive heart failure can be ruled out. Our results suggest that the inclusion of pleural fluid NT-proBNP measurement in the routine diagnostic panel would enhance discrimination among the different causes of pleural effusions.

Aged↗
PubMed2003

[Pause-dependent Torsade de Pointes following acute myocardial infarction].

The authors report an early occurrence (within 48 hours) of the newly described form of pause-dependent torsade de pointes following acute myocardial infarction. QT prolongtion after myocardial infarction a common ECG finding. Postextrasystolic QT prolongation rare but one of the warning signs for torsade de pointes ventricular tachycardia following myocardial infarction. Careful monitoring is suggested in these cases.

Electrocardiography↗
PubMed2002

[Patients admitted with atrial fibrillation to a regional hospital].

INTRODUCTION: It is well known that the incidence of atrial fibrillation increased with age over 65 years. However the role and incidence of atrial fibrillation in the admission in the regional hospital was not investigated. The aim of the study was to investigate the incidence, the commonest presenting features, associated cardiac conditions and the different types of atrial fibrillation which were admitted to our regional hospital during the last 10 month. RESULTS: The incidence of atrial fibrillation was 13% (mean age: 71 years). The presenting features were dyspnea (28%), palpitation (25%), heart failure (19%), angina (10%), syncope/vertigo (5%), symptoms-free (13%). The most frequently associated cardiac condition was hypertension (64%). The patients were treated with the following antiarrhythmic drugs: beta-adrenergic blocker: 25%, propafenon (15%), propafenon and beta-adrenergic blocker (25%), sotalol (17%), amiodarone (13%), others (5%). CONCLUSION: Nowadays atrial fibrillation is still a remarkable percentage of hospital admission. The most frequent clinical features were not the signs of arrhythmia but the signs of heart failure and ischaemic heart disease. In the treatment of atrial fibrillation the use of digoxin and class IA type antiarrhythmic agents were remarkably decreased and the use of class III, IC and beta-adrenergic blockers increased.

Aged↗
PubMed2002

[Malignant arrhythmias caused by hyperkalemia: a new area of drug-induced electrolyte abnormalities].

INTRODUCTION: High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failure and it is part of the treatment in the patients suffering from diabetes mellitus and nephropathy. The patients with preexisting renal insufficiency could have slowly elevated serum potassium level treated by angiotensin converting enzyme inhibitor. PATIENTS: Seven acute admitted cases is presented with severe hyperkalaemia and life threatening arrhythmias caused by ACEI administration. Wide QRS accelerated rhythm was detected in two cases and bradyarrhythmias in five cases. Two patients died among the bradyarrhythmias. CONCLUSIONS: The authors call the attention of danger of high dose angiotensin converting enzyme inhibitor in patients with preexisting renal insufficiency and concomittant drugs elevating serum potassium level.

Angiotensin-Converting Enzyme Inhibitors↗