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Biomedical subjects

András Zsoldos

Publications and source records attributed to András Zsoldos.

3 recordsLinked to original sources

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↗

[Percutaneous coronary intervention without on-site cardiac surgery: the first one thousand patients].

At the two hospitals, first percutaneous coronary intervention was performed on 1031 patients (700 male and 331 female, average age 59.8 +/- 15.1 years) between July 2000 and June 2002. The indications were: stable effort angina 679 (65.8%), unstable angina and non-ST elevation myocardial infarction 267 (26.0%), ST elevation myocardial infarction 85 (8.2%). Single vessel dilatation was performed on 906 (87.9%), double and triple vessel on 125 (12.1%) pts in 1170 vessels (1145 native, 24 saphenous vein and 1 mammary artery graft) and in 1372 stenoses. During the interventions, 1043 stents were implanted in 797 pts, average 1.3/pt. The intervention was clinically successful in 950 (92.1%) and unsuccessful in 81 (7.9%) pts. In most of cases, the lack of success was a result of ineffective recanalisation. 65 major adverse cardiac events occurred in 35 (3.4%) pts (acute redilatation 20 (1.9%), acute surgery 4 (0.4%), acute myocardial infarction 34 (3.3%) and fatal outcome 7 (0.7%). Fatal outcome occurred in the group of stable angina 1 (0.1%), in the group of unstable angina and non-ST elevation myocardial infarction 4 (1.5%), in the group of ST elevation myocardial infarction 2 (2.4%). Within one year, 228 (22.1%) repeated dilatations were performed because of chronic restenosis. The results suggest that the moderate risk interventions can be performed with satisfactory result and average risk even without in-hospital cardiac surgery. High-risk interventions are still to be performed in institutes without on-site surgery.

Adult↗

[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↗