[Value of serum immunoglobulin assays in early myocardial infarction].

Serum immunoglobulin (Ig) levels were assayed in 672 patients admitted for acute myocardial infarction with onset within 24 hours of hospitalization. Supranormal Ig levels (A > or = 300, G > or = 1,200) or subnormal Ig levels (M < 40 mg/100 ml) were seen in patients with one or several risk factors (diabetes mellitus, alcohol abuse) or a history of previous myocardial infarction. Patients with one or more Ig anomalies were more likely to exhibit unfavorable outcomes, including early death, suggesting that increased viscosity due to aggregation of Ig molecules may occur.

[Short- and long-term prognosis of myocardial infarct. Contributions and limitations of the clinical aspects and non-invasive technics].

Clinical variables and those obtained by non-invasive techniques were recorded in a series of 306 patients discharged from hospital after an acute myocardial infarction. We studied the prognostic value at 2 and 12 months of these variables (alive/dead). The results of simple clinical data were as discriminant as those from more elaborated techniques.

Limitations on the prognostic value of predischarge data after myocardial infarction.

Clinical variables and those obtained by non-invasive techniques were studied prospectively in a series of 306 patients discharged from hospital after an acute myocardial infarction. The predictive value of the data at two and 12 months was assessed by univariate and multivariate analyses. The best correlation was found for age, hypertension, bundle branch block, early and late heart failure, x ray cardiothoracic ratio, digoxin use, the number of metabolic equivalents reached during the stress test, echocardiographic wall motion score index, left ventricular end diastolic diameter, left ventricular ejection fraction, and the presence of an aneurysm.

[Early exercise test after myocardial infarction].

Exercise tests of coronary function at the tenth day of an uncomplicated myocardial infarction offer objective evaluation of short-term benefits of an early accelerated physical retraining program. They also allow better individual adaptation of exercises prescribed at the start of convalescence at home. Exercise test results show significant correlation with clinical data and bicycle ergometer tests carried out two months after infarction, with respect to physical aptitude, reasons for discontinuation of test and lethality risk two months after infarction.

Predictors of early death after acute myocardial infarction: two months follow-up.

Clinical variables and the results of non-invasive tests (exercise test, echocardiogram, gated equilibrium radionuclide ventriculography and 24 h ECG) were recorded in a series of 202 patients who left the hospital alive after an acute myocardial infarction. The short term (two months) predictive value of all these data was prospectively assessed by uni- and multi-variate analysis. The best correlation with early death was observed with the variables related to the extent of infarction and left ventricular dysfunction, namely: early clinical signs of heart failure, high peak CK-MB level, complete bundle branch block, increased cardiothoracic ratio on chest X-Ray, number of Mets reached during the stress test, echocardiographic dyskinesia index, and decreased left ventricular ejection fraction as measured by radionuclide ventriculography.

Dobutamine effects on blood gases and hemodynamics in acute myocardial infarction with heart failure.

We studied the effects of dobutamine on blood gases, venous admixture and hemodynamics in ten patients suffering an acute myocardial infarction (AMI) with left heart failure. After one hour infusion of dobutamine (mean dose: 6.3 micrograms/kg X min) there was an increase in cardiac index (27%, P less than 0.

Effect of labetalol on preload in acute myocardial infarction with systemic hypertension.

We assessed the effects of labetalol on pulmonary wedge pressure (PWP) and other hemodynamic variables in 18 patients with acute myocardial infarction (AMI) and systemic hypertension (systolic blood pressure greater than 150 mm Hg). According to the initial value of PWP, the patients were separated into two groups of nine patients each: Group 1 (PWP greater than or equal to 15 mm Hg) and Group 2 (PWP less than or equal to 12 mm Hg). Labetalol was infused at increasing rates to lower systolic blood pressure below 130 mm Hg; this optimal rate (mean rates for Groups 1 and 2: 1.

[Experimental models for the pharmacologic study of anti-arrhythmia drugs].

In order to assess the value and therapeutic safety of an antiarrhythmic drug, it must be submitted to multiple tests, which reproduce as faithfully as possible the conditions observed in human pathology. The main experimental approaches are presented here: screening and control tests. For each test, the authors emphasize the various experimental factors limiting their interpretation and allowing the extrapolation to men.

[Evaluation of the efficacy of anti-arrhythmic drugs using a computer].

To palliate the deficiencies of the oscilloscopic monitoring of arrhythmias, an automatic system has been developed. It has been used during more than one year time in the Coronary Unit for supervision of patients and for study of the pharmacological effects of antiarrhythmic drugs.