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Biomedical subjects

K Thygesen

Publications and source records attributed to K Thygesen.

At least 73 records · Page 4Linked to original sources

Plasma enzymes in myocardial infarction. An appraisal of quantitative, clinical and pathophysiological information.

In twenty-nine patients suffering from acute myocardial infarction changes of concentrations in plasma of creatine kinase, aspartate aminotransferase and lactate dehydrogenase were monitored 1 week following onset of infarction. The temporal characteristics of enzyme changes described are (i) the time lag from onset of chest pain until increasing enzyme concentrations occur, (ii) the time of maximum concentrations, and (iii) the period during which enzyme is released into blood. Three estimates for the extent of the infarct (i) the peak value of the plasma enzyme curves,(ii the value of the cumulated plasma curves, and (iii) the size of the infarct in grams of necrotic myocardial tissue were, as expected, closely correlated. It is concluded, that the three types of quantification of infarct size are of almost identical value for clinical, prognostic usage, From a pathophysiological point of view they are of limited interest being based on assumptions that are either unlikely to occur or cannot be tested in man.

Adult↗

Variability of plasma proteins according to molecular size. Long-term and short-term intra-individual variation.

The intra-individual variations in serum concentrations of alpha 1-antitrypsin, albumin and alpha 2-macroglobulin were determined using high precision analytical methods. The long-term (3 months) variations were 8.2% for alpha 1-antitrypsin and 2.9% for alpha 2-macroglobulin in five males and five females. The coefficients of variation for albumin were 1.5 and 3.4% for males and females, respectively. In males the long-term variations of albumin and alpha 2-macroglobulin were highly correlated. The short-term (2 days) intra-individual variations in six males were 2.5, 3.8 and 3.4% for alpha 1-antitrypsin, albumin and alpha 2-macroglobulin respectively (coefficients of variation). A diurnal variation was found for albumin with maximal concentrations at 18.00 hours. At 6.00 and 10.00 hours the fractional concentrations of alpha 1-antitrypsin and albumin were lower than for alpha 2-macroglobulin. The variations of the three proteins were positively correlated.

Adult↗

Praecordial ECG-mapping in acute anterior myocardial infarction: the variability of ST segment, Q and R waves.

Praecordial ECG-mapping (forty-two unipolar leads) was carried out on sixteen patients with anterior acute myocardial infarction (AMI) and on ten control patients without AMI. The variability, chronometric changes and the error-of-measurement when measuring sigma ST, sigma Q and sigma R in an ECG-map were evaluated. The investigation demonstrated that there was a significant inter-individual variation of sigma ST, sigma Q and sigma R in both patient groups. In cases of AMI, the intra-individual variation of sigma St, sigma Q and sigma R was significantly greater than the variation in the error-of-measurement; this applied also to the control group, except for sigma ST which was of the same magnitude. Inducing measuring errors, which were brought about by changes in the position of the patient, were of the same magnitude as the itra-individual variation in the control group. The chronometric variation of sigma ST, sigma Q and sigma R were significant in the patients with AMI; this also applied to sigma ST in the control group, but not to sigma Q and sigma R. In patients with AMI, sigma ST and NST were correlated to heart rate, mean arterial blood pressure, the product of heart rate and systolic blood pressure, and respiratory rate. However, only the correlations between heart rate and sigma ST and NST, respectively, were of such a magnitude that they were of clinical relevance. Thus 37-42% of the variance in the ST segment within 14 days after the onset of the infarction can be explained by changes in the heart rate.

Adult↗

Incidence and prognostic significance of intraventricular block in acute myocardial infarction.

In 404 consecutively admitted patients with their first myocardial infarction (MI), intraventricular block (IV) was a complication in 124 (31%). The following types of block were encountered: 21 (5%) had left bundle-branch block (LBBB), 73 (18%) left anterior hemiblock (LAH), 13 (3%) left posterior hemiblock (LPH); 7 (2%) right bundle-branch block (RBBB); 9 (2%) RBBB + LAH, and 1 (0.3%) RBBB + LPH. Patients with IV block at the time of admission did not develop total atrioventricular block more frequently in the acute phase of MI (0-30 days) or in the follow-up period (3-5 years) than patients without IV block. During the acute phase, only patients with RBBB with or without hemiblock showed significantly higher mortality than patients without IV blocks. The other types of IV block did not influence the short-term prognosis. Among patients who survived the acute phase, significantly lower long-term survival rates were found in patients with LBBB compared to patients without IV block, whereas the presence of LAH did not affect the long-term prognosis.

Acute Disease↗

Enzymes and long-term survival after first myocardial infarction.

The study covers 342 patients still alive one month after the acute attack of their first myocardial infarction. Daily determinations of creatinine phosphokinase (CPK), lactic dehydrogenase (LDH) and glutamic oxaloacetic transaminase (SGOT) in serum were carried out during hospitalization, so that a maximum enzyme value could be obtained for each enzyme and patient. A follow-up examination was performed after an observation time ranging from 12 to 38 months. Having calculated the mean (x) of the maximum enzyme values, a parallel relationship was found between the maximum CPK, LDH and SGOT values and the long-term prognosis in myocardial infarction, inasmuch as patients with maximum enzyme values above or equal to the mean had a significantly higher 2-year mortality than patients with values below x. In order to detect any slight difference between the three enzymes with reference to the long-term prognosis, the material was divided into four groups: one with peak values less than x-x/2 (lowest), one with values from x-x/2 to x exclusive (next lowest), one with values from x to x+x/2 exclusive (next highest) and a group with peak elevations greater than or equal to x+x/2 (highest). A tendency to increasing mortality from the next lowest to the highest maximum enzyme values was found. On the other hand, patients with the lowest peak values had a tendency to higher mortality than patients in the next lowest group. This characteristic was observed with regard to both CPK and LDH and to some extent to SGOT.

Aspartate Aminotransferases↗