[Alterations of the flow-volume loop and spirometric values in acute myocardial infarction (author's transl)].
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Adult↗
Biomedical subjects
J M Abadal Centellas
Publications and source records attributed to J M Abadal Centellas.
[Pulmonary volume and cardiopulmonary function in acute myocardial infarction (author's transl)].
In order to evaluate alterations in lung mechanisms detected in patients with acute myocardial infarction (MI), changes in arterial oxygenation and pulmonary volume in relation to the hemodynamic status were measured in 19 patients with acute MI. Pulmonary volume was determined with spirometry and helium dilution closed technic at 24 and 72 hours and two months after acute MI. The first finding was decreased arterial PO2: 328 +/- 29 mm/Hg (mean +/- SE) which had significantly risen by the third day: 423 +/- 20 mm/Hg (p less than 0.02). This disturbance was accompanied by an increased pulmonary shunt (Qs/Qt) and VD/VT relation, which improved with time but did not return to normal. A manifest relationship was not found between the degree of hypoxemia and diminished functional residual capacity (FRC). During the acute phase lung volume was normal while patients were seated but upon assuming a supine position, vital capacity (VC), total lung capacity (TLC) and RV/TLC were altered considerably. The VC and RV/TLC alterations were significantly altered in patients with left ventricular dysfunction. No significant changes were found in pulmonary values during the acute phase and VC and TV/TLC had improved considerably two months later. It is probable that increased interstitial pulmonary edema bears the main responsibility for these alterations, including in uncomplicated acute MI.
Adult↗
[Usefulness of creatine phosphokinase isoenzyme, CK-MB, in the diagnosis of myocardial necrosis (author's transl)].
With the objective of evaluating the clinical usefulness of a new immunologic method (Merck-1-Test CK-MB), in the determination of the CK-MB activity, 48 patients admitted to the Coronary Unit for angina pectoris were studied. Samples of blood were gathered upon admission and every 4 hours for 48-72 hours, determining in each one of them the total CPK, SGOT, LDH, and CK-MB; electrocardiograms (ECG) were taken and all possible causes for the increase in the enzymatic activity were recorded. Results were analyzed in order to study the following aspects: in the patients in which an acute myocardial infarction was diagnosed the CK-MB activity was studied, also the relation of CK-MB to the remaining parameters, each parameter's sensitivity and specificity and the relationship of the CK-MB to the prognosis of the patients. The usefulness of CF-MB in the differential diagnosis of myocardial necrosis and variations in the total CKP curve in the clinical course of acute myocardial infarction unrelated to myocardial necrosis were evaluated too. The following conclusions were drawn from the analysis of the data. The immunological method has the advantages of its sensitivity and easily and quickly performance (15 minutes), but it has the disadvantage that it detects CK-BB (elevated in cebrovascular disorders). Twenty-four hours after the onset of symptoms, the negativity of CK-MB does not exclude the diagnosis of a myocardial necrosis. CK-MB is more sensitive than total CPK in diagnosing the extent of the area of necrosis. CK-MB is very specific for myocardial necrosis but less sensitive than other parameters. A positive CK-MB upon the patient's admission confirmed the diagnosis of necrosis in 60 percent of the cases, but in 18 percent error was induced because of false positives. CK-MB permitted confirmations of the diagnosis of myocardial infarction in 33 percent of cases in which there was only a suggestion of necrosis by the ECG. The variation in the curve of total CPK in the course of an acute myocardial infarction is subjected to such a great number of factors intercurrent with time, that caution should be exercised in trying to relate a specific elevation of total CPK to an unsuccessful maneuver or to a possible extension of the area of necrosis.
Adult↗
[Pulmonary function differences in healthy subjects according to postural changes (author's transl)].
The total lung capacity (TLC) and its subdivisions along with the forced spirometric values (FEF25-75 and FEV1) were determined in a group of 44 healthy subjects, composed of 29 women and 15 men. The determinations were carried out in a sitting position and in supine position, breathing air. All the pulmonary volumes diminished when the subject lay down, but the functional residual capacity (FRC) was that which underwent a greater reduction. The residual volume decrease was the only one which did not reach statistically significant levels. Women always showed smaller pulmonary volumes than men. It has been demonstrated that FRC can be exactly measured by means of the closed helium technique. The regression figures of FRC in supine position were determinted for both sexes, with a r = 0,33 (p less than 0,1) in women and r = 0,95 (p less than 0.001) in men. The forced spirometric tests did not undergo any important changes although the reduction of the FEV1 was significant in both sexes. The results obtained were compared with those published by other authors.
Adult↗