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J Sochman

Publications and source records attributed to J Sochman.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Computer-assisted electrocardiographic mapping and left ventricular function in patients with acute myocardial infarct].

In 22 patients with a first myocardial infarction the authors assessed the relationship between morphological changes of the QRS complex and systolic left ventricular function. Using a 56-lead computer-assisted electrocardiogram from the precordium in the form of a map (apparatus Cardiomap-1), the authors prepared a record during the first days after initiating treatment with a thrombolytic agent and again after a period of three weeks. They found only one correlation between the decrement of Q waves and the increase of the left ventricular ejection fraction (p less than 0.05). This correlation, however, is of no practical importance due to the low correlation coefficient. The relationship is moreover markedly influenced by the time of the first record. After the third day of thrombolytic treatment it is not expedient to make the initial record. No relationship between the change of R waves, ST segments and left ventricular function was found. Similarly, due to the great dispersal of values it is not possible to differentiate between patients with inferior infarctions of the heart muscle and anterior myocardial infarctions.

Adult↗
PubMed1992

[Complete recovery of left ventricular function after myocardial infarct].

In a 27-year-old patient with an infarction of the anterior myocardial wall, significant from the haemodynamic aspect, a complex procedure is described by which in the course of four hours after the beginning of complaints normalization of the lumen and blood flow of the coronary artery supplying the infarction focus was achieved. The authors used thrombolytic intravenous treatment which involved infusion of 1.5 million u. of streptokinase (Streptase, Boehringer, Ingelheim) in the course of 45 mins., N-acetylcysteine 2.0 g i.v. (Broncholysin, Spofa) and percutaneous transluminal coronary angioplasty. In the course of 16 days the left ventricular function recovered completely: the ejection fraction was 67% before the infarction, on the first day of infarction 45% and before discharge 64%.

Adult↗
PubMed1991

[Possibilities of limiting myocardial infarct in an experiment].

A total of 31 dogs were investigated with the aim to evaluate possibilities of pharmacological reduction of ischaemic perfusion damage of the heart muscle. In the experiment two-hour complete ischaemia was used (ligature of the ramus interventricularis anterior) and a subsequent two-hour period of reperfusion. The magnitude of the infarction focus evaluated as the percentage of the ischaemic risk area, using the triphenyltetrazolium method, extended by colour detection of collaterals, was evaluated. Furthermore the authors also evaluated the prevalence of ventricular dysrhythmias in the reperfusion period. In a group of 10 dogs treated by N-acetylcysteine, 100 mg per kg body weight, the authors revealed on comparison with 11 dogs of the control group a diminution of the infarction focus by 32.7%. By addition of Panthenol, 50 mg/kg to N-acetylcysteine in another 10 dogs, a diminution of the infarction by 49% was achieved. The magnitude of the infarction focus was 55.0 +/- 7.0% in the control group, 37.0 +/- 12.6% in dogs treated with N-acetylcysteine (p less than 0.01) and 28.0 +/- 13.3% after administration of N-acetylcysteine and Panthenol (p, as compared with control, again less than 0.01). N-acetylcysteine reduces also significantly the prevalence of ventricular dysrhythmias in the reperfusion period. As compared with the control group this difference is most marked after 60 minutes have elapsed following release of the ligature (p less than 0.001).

Acetylcysteine↗
PubMed1991

[Precordial S-T stress mapping in the evaluation of the effects of percutaneous transluminal coronary angioplasty].

The morphological impact of percutaneous transluminal angioplasty (PTCA) on the treated artery is closely checked by coronary arteriography. Indirect non-invasive evaluations are made possible by electrocardiography, isotope methods and echocardiography which are the commonest visualization methods. The authors used a precordial S-T load map. After complete revascularization following PTCA there was a significant drop of the sum of S-T depressions and in some members of the group it reached normal values. The S-T load map is a suitable non-invasive procedure for monitoring the effect of PTCA.

Adult↗
PubMed1990

Cardioprotective effects of N-acetylcysteine: the reduction in the extent of infarction and occurrence of reperfusion arrhythmias in the dog.

We have studied the cardioprotective effect of N-acetylcysteine in the dog. In mongrel dogs of either sex, the left anterior descending coronary artery was ligated for a period of 2 hours behind the origin of its first diagonal branch. After this period, dogs in a treated group were administered 100 mg of N-acetylcysteine/kg body weight while a control group remained untreated. This was followed by a 2-hour period of reperfusion. The extent of necrosis was determined using the triphenyltetrazolium method. Presence or absence of collaterals was established at the same time. The incidence of ventricular arrhythmias was monitored throughout the study. Compared with 11 dogs of the control group, 10 dogs treated with N-acetylcysteine showed a decrease of 32.7% in the extent of infarction. The extent of infarction, expressed as the percentage of the left ventricular myocardium at risk, was 55.0 +/- 7.0% in the control group and 37.0 +/- 12.6% in the treated group (P less than 0.01). N-acetylcysteine also statistically significantly decreased the incidence of ventricular arrhythmias over the period of reperfusion. Compared with the control group, the difference was evident as early as the first 5-10 minutes of reperfusion, becoming most pronounced at the 60th minute (P less than 0.001). We conclude that N-acetylcysteine is effective in limiting the extent of infarction and significantly reduces the incidence of reperfusion ventricular arrhythmias.

Acetylcysteine↗
PubMed1990

[Complications of percutaneous transluminal coronary angioplasty].

The most frequent complication of percutaneous transluminal coronary angioplasty is acute obstruction of the artery to be dilated. The authors present their experience with the solution of this situation. In a group of 154 consecutive patients with chronic stable angina pectoris a sudden occlusion was observed in 7.7%, infarction in 5.8% and the necessity of operation arose in 5.2%. A significant position in the solution if these complications is held by cardiosurgical revascularization. As to pharmacological treatment, it is useful to administer a combination of nitrates, calcium channel antagonists and thrombolytic treatment.

Angioplasty, Balloon, Coronary↗
PubMed1989

[Time peak of creatine kinase activity in various sites of myocardial infarct].

The authors studied the differences in the period of time spanning the onset of anginous pain and the peak of plasma creatine kinase activity in different areas of the left ventricle in patients with acute myocardial infarction. The patients were given either intravenous or intracoronary thrombolytic agents. The involvement of different areas of the cardiac muscle had a major effect on the lenght of time until the peak of creatine kinase activity was reached. This reduces the significance of this parameter which as so far been seen as a noninvasive indicator of the patency of the artery supplying the site of the infarction. The authors also refer to other familiar factors likely to alter the role of this parameter.

Creatine Kinase↗
PubMed1989

Creatine kinase kinetics and myocardial infarction in different regions of the left ventricle.

The interval from the onset of infarction pain to culmination of plasma creatine kinase activity (t-peak) was measured in 68 patients with their first myocardial infarction. There is a major difference in this parameter in patients with infarction in the area of the right coronary artery and that supplied by the left anterior descending coronary artery (LAD). While, in 29 patients with infarction in the right coronary artery area, t-peak was 17.7 +/- 4.7 hours, in 39 subjects with infarction in area supplied by the LAD, t-peak was 13.2 +/- 4.6 hours (p less than 0.001). The type of thrombolytic treatment (intravenous or intracoronary, used no difference, just as the time from onset of pain to start of therapy, infarct size and presence or absence of collaterals. A detailed analysis of creatine kinase culmination in relation to the type of artery recanalization is given. The authors conclude that, besides the known factors, creatine kinase culmination is influenced also by the necrosis site, a fact somewhat modifying the informative value of this parameter. However, explanations of this phenomenon are only hypothetical at the present time.

Creatine Kinase↗
PubMed1989

[Acute myocardial infarct and the kinetics of creatine kinase].

The authors criticize contemporary views on creatine kinase kinetics in relation to the patency or occlusion of the coronary artery in the area of the infarction focus. In the investigation proper the time needed to achieve the peak plasma creatine kinase activity after the onset of infarction pain in patients with necroses in different areas of the left ventricle is assessed. Although the interpretation of the observed phenomenon is not clear so far, this finding makes the informative value of the hitherto used time parameter of the kinetics of this enzyme doubtful, in particular in thrombolytic treatment of myocardial infarction. In practice it is thus not possible to evaluate the restored patency of the artery to the necrotic focus on the basis of the above parameter.

Coronary Vessels↗
PubMed1989

[Thrombolytic therapy and percutaneous transluminal coronary angioplasty in acute myocardial infarct].

The authors analyze contemporary views on the position of thrombolytic treatment and percutaneous transluminal coronary angioplasty in the treatment of acute myocardial infarctions. The justification of different procedures is based on the final effect of treatment on the mortality of patients, on left ventricular function and behaviour of the residual stenosis in different groups of patients. The authors define risk groups of patients which can justify the application of specific therapeutic procedures. In the conclusion they try to define general indications for different types of treatment.

Angioplasty, Balloon, Coronary↗
PubMed1989

Cardiac tumours.

Most patients with cardiac mass have clinical signs mimicking mitral stenosis. As this tumorous mass carries the risk of obstructing the systemic circulation, the physician must consider the possibility of a cardiac tumour in differential diagnosis. That's why all patients presenting with clinical symptoms and a physical finding of mitral stenosis--even those without a history of rheumatic fever--should have routine echocardiography performed. All patients with a documented mass in cardiac chambers should be treated surgically and without delay, if possible.

Adult↗
PubMed1989

[A critical overview of thrombolytic therapy in patients with acute myocardial infarct].

The authors present an analysis of results of thrombolytic treatment in patients with acute myocardial infarction. The lower mortality of thrombolytically treated patients, as compared with conventional therapy, is an advantage of this therapy, in particular in the acute stage of myocardial infarction. Based on the above analysis it is apparent that at present the intravenous administration of thrombolytics is justified.

Fibrinolytic Agents↗
PubMed1989

[Infarct size and left ventricular function in patients after thrombolytic therapy of acute myocardial infarct].

The authors give an account of factors which influence left ventricular function after thrombolytic treatment of an occluded coronary artery. They found that improvement of left ventricular function following a three-week interval after recanalization of the artery the occlusion of which led to myocardial infarction, depends on the size of the necrotic focus. Improvement of global left ventricular function and above all of the regional function of the infarction segment can be expected if the size of the focus is such that less than 40 gram-equivalent of total creatine kinase are liberated from it.

Humans↗