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Biomedical subjects

L J Szatmary

Publications and source records attributed to L J Szatmary.

6 recordsLinked to original sources
PubMed1988

The combined use of diastolic counterpulsation and coronary dilation in unstable angina due to multivessel disease under unstable hemodynamic conditions.

Sixteen patients with multivessel ischemic heart disease and severely jeopardized myocardium required intra-aortic balloon counterpulsation subsequent to a deterioration in hemodynamics during or following a coronary angioplasty procedure. They had all suffered unstable angina which was refractory to intensive medical therapy, consisting of a combination of nitroglycerin, beta-adrenergic antagonists, and calcium blockers. Thirty angioplasties had been attempted (1.9 artery stem/patient) with a primary success rate of 90%. The symptoms of prolonged myocardial ischemia had disappeared, and the patient's blood pressure had normalized. No complications were associated with the use of the mechanical circulatory assistance. There were no deaths related to the procedure itself, and no myocardial infarctions. Emergency surgery was not required. One patient did die in hospital, however, due to cerebrovascular accident which occurred 4 days after removal of the mechanical circulatory support. Two also died suddenly later. One patient also required later elective coronary arterial bypass surgery and another needed repeated coronary dilation. The 12 remaining patients are asymptomatic at a follow-up with mean value of 22 months. Temporary intra-aortic diastolic counterpulsation is a useful adjunct to coronary angioplasty in patients with multivessel unstable angina and compromised hemodynamics.

Adult↗
PubMed1988

Pathophysiological characteristics, diagnostic problems and assessment of sinus node dysfunction.

Based on clinical and experimental experience, sick sinus syndrome can be divided into two groups: intrinsic and autonomic neurovegetative pacemaker dysfunction. Sinus node activity is characterized electrophysiologically by automaticity, recovery and sinoatrial conduction. The automaticity of the sinus pacemaker cell groups and sinus recovery can be differentiated properly under experimental conditions. Studies of the electrophysiological characteristics showed the basic functional parameters to be normal in autonomic sinus dysfunction. Diagnosis is either based on clinical observation or on the data of Holter monitoring, the electrophysiological methods being inadequate for diagnosing this neurovegetative form of sick sinus syndrome. On the other hand, intrinsic-organic sinus dysfunction can be diagnosed by electrophysiological tests. If completed by complex pharmacological studies, in this organic form of sick sinus syndrome, even the severity of the intrinsic injuries can be assessed quantitatively. This division provides a logical basis for a proper selection and evaluation of the differential diagnostic procedures, while information on the aetiopathology of sinus dysfunction and on the degree of the functional injuries of the electrophysiological structure of the heart provides an adequate basis for therapy.

Arrhythmias, Cardiac↗
PubMed1988

Electrophysiological effects of the antiarrhythmic agent GYKI-23107 in dogs.

Cardiac electrophysiological properties of GYKI-23107, a new membrane stabilizing antiarrhythmic agent were studied in anaesthetized open-chest dogs. Epi- end endocardial electrograms (for sinus potential and for His bundle recording) were obtained during sinus rhythm and following atrial and ventricular pacing. The registration were performed under control conditions as well as five minutes after drug administration of 8 mg/kg slow i.v. or 20 minutes after 20 mg/kg intraduodenal administration respectively. GYKI-23107 did not influence significantly either the sinus cycles, PA-intervals, sinus node potentials, or the classical electrophysiological parameters of sinoatrial function as the corrected recovery time of the sinus node, sino-atrial conduction time or the secondary post-stimulation sinus cycles before and after vegetative blockade. Neither the AH intervals, anterograde Wenckebach period, nor ventriculo-atrial conduction time changed significantly. QRS duration, configuration and HV-intervals remained also unchanged after drug administration in doses which used in this study, and which seemed to be in therapeutic range. The agent did not influence significantly the effective refractory periods of the atrium and ventricle during sinus rhythm. This study suggest that the GYKI-23107 is not depressive on the anterograde (AV), retrograde (VA), intraventricular conduction and is slightly depressive on the intrinsic pacemaker properties.

Animals↗
PubMed1988

Antifibrillatory effect of GYKI-23107 in induced ventricular vulnerability by local cooling and programmed stimulation in canine models.

We tested GYKI-23107 a new agent with local anaesthetic activity, in experimentally induced life-threatening ventricular arrhythmias in pentobarbitone-anaesthetized dogs. By a cooling test and programmed stimulation ventricular fibrillation was induced before and after drug administration (8 mg/kg i.v., n = 14 and 20 mg/kg i.d., n = 12). Comparative experiments were carried out with lidocaine (10 mg/kg). In this lidocaine-treated group, ventricular fibrillation could be produced at 27.7 +/- 6.6 (S.D.) min, n = 12, while after GYKI-23107 ventricular fibrillation occurred at 46.6 +/- 10.7 min, n = 14. The new compound was well absorbed from the intestines; after i.d. administration it could prevent or reduce the onset of lethal arrhythmia for more than 40 min. Its i.d. efficacy correlated well with that of i.v. administration. GYKI-23107 appears to be a safe and potent long-acting agent against ventricular dysrhythmias. It may be a promising and valuable alternative to currently available antiarrhythmic agents. The strong antifibrillatory action observed in ischaemic canine heart (n = 5) both after i.v. or i.d. administration is of special importance.

Animals↗
PubMed1987

Emergency percutaneous transluminal coronary angioplasty without thrombolysis as initial therapy in acute myocardial infarction.

Thrombolytic treatment in acute myocardial infarction does not influence the atheromatous coronary lesions which form the basis of thrombosis. The remaining stenosis may be responsible for recurrent ischemic symptoms or reinfarction. Percutaneous transluminal coronary angioplasty without thrombolysis was attempted in 19 anterior and 24 inferior wall acute infarctions, within the first 4 hours from the onset of symptoms. The aim was to achieve optimal myocardial revascularization and prevent reocclusion of the infarct-related vessel. Significant stenosis or complete occlusion was found in only one major coronary artery in 25 patients, in two arteries in 7 patients and in three in 11 patients. Angioplasty was only applied to the vessel supplying the infarcted muscle. Recanalization was achieved from 14 to 50 minutes (mean 23) from the start of catheterization in 95% (41/43 cases). Two of the patients died in cardiogenic shock. Four patients died between days 5 to 15 of hospitalization. There were no other deaths. Thirty (81%) of the 37 survivors remained asymptomatic, 3 required bypass surgery for recurrent angina. Follow-up hemodynamic studies were done on average 2.5 months after angioplasty, and showed that, in 78%, the dilated coronary artery remained patent. Restenosis was found in five patients, and was successfully dealt with using angioplasty in three cases. In those patients with improved segmental wall motion, the global left ventricular function also increased. This applied to both anterior and inferior infarcts. Our results suggest that immediate coronary angioplasty in acute impending myocardial infarction is effective and avoids the need for prior thrombolytic therapy.

Adult↗