[Acute myocardial infarction triggered by salbutamol in asthma bronchiale].

The authors report the case of an 77-year-old woman with no evidence of previous cardiac disease who developed a non-Q-wave myocardial infarction after beta2-mimetic treatment for the exacerbation of her chronic bronchial asthma. After the five dose of salbutamol spray she developed chest pain. The electrogram showed ST segment elevation in leads I-aVL-V4-6.

N-terminal pro-brain natriuretic peptide and tombstoning ST-segment elevation in patients with anterior wall acute myocardial infarction.

Tombstoning ST-segment elevation myocardial infarction (STEMI) has been associated with a poor prognosis ever since Wimalaratna's first description of this clinical entity, and the reasons for this are not fully understood. We studied 87 consecutive patients who had anterior STEMI (January 2004 to September 2004) to compare the form of STEMI, coronary anatomy, and initial N-terminus pro-brain natriuretic peptide (NT-pro-BNP) level. Patients who had tombstoning STEMI had higher levels of NT-pro-BNP despite significant differences in cardiac enzyme levels or extent of coronary disease.

[Percutaneous coronary intervention without on-site cardiac surgery: the first one thousand patients].

At the two hospitals, first percutaneous coronary intervention was performed on 1031 patients (700 male and 331 female, average age 59.8 +/- 15.1 years) between July 2000 and June 2002.

[Nicergoline-induced Prinzmetal angina. "Heartache" instead of headache].

A 56 year old woman was admitted to our hospital with crescendo chest pain in the last ten days. Her past history included hypertension treated by 100 mg metoprolol for more than ten years and right carotid endarterectomy. She complained headache and a treatment of 20 mg nicergoline (ergoline derivate) daily was started.

[Pause-dependent Torsade de Pointes following acute myocardial infarction].

The authors report an early occurrence (within 48 hours) of the newly described form of pause-dependent torsade de pointes following acute myocardial infarction. QT prolongtion after myocardial infarction a common ECG finding. Postextrasystolic QT prolongation rare but one of the warning signs for torsade de pointes ventricular tachycardia following myocardial infarction.

Mechanism of endothelin-induced malignant ventricular arrhythmias in dogs.

The development of ventricular tachyarrhythmias caused by low-dose intracoronary infusion of endothelin-1 (ET-1) has recently been observed in dogs. The aim of the present study was to investigate the pathomechanism of ET-1-induced ventricular arrhythmias in 32 anesthetized, open-chest mongrel dogs in group A (n = 14) without, in group B (n = 14), and in group C (n = 4 control) with atrioventricular node ablation. The coronary blood flow (CBF) was measured in the left anterior descending (LAD) coronary artery by an electromagnetic flowmeter.

Presence of immunoreactive endothelin-1 and atrial natriuretic peptide in human pericardial fluid.

This study was undertaken to characterize endothelin-1 (ET-1) and atrial natriuretic peptide (ANP) concentrations in human pericardial fluid, blood plasma, right atrial appendage and papillary muscle by use of specific radioimmunoassays. In patients undergoing cardiac surgery (n=16) pericardial fluid mean immunoreactive (ir-) ET-1 and ir-ANP levels were 36-fold and 4-fold higher than corresponding plasma levels, respectively. In high performance liquid chromatography (HPLC) pericardial fluid ir-ET-1 was indistinguishable from human ET-1[1-21] and the majority of pericardial fluid ir-ANP coeluted with human ANP[99-126].

Simultaneous recordings of the monophasic action potential with silver chloride- and Ir-coated electrodes.

Ag/AgCl and Ir-coated electrodes allow the recording of the monophasic action potential (MAP) due to their electrical properties like non-polarisability. This study investigates the correlation of MAP recorded with both types of electrodes. In 20 mongrel dogs (18 +/- 6 kg) an Ag/AgCl and an Ir-coated catheter (Ir) were placed endocardially in the apex of the right ventricle.

Electrophysiological effects of intrapericardial infusion of endothelin-1.

Recently, extremely high levels of endothelin-1 (ET-1) were detected in the pericardial fluid of patients undergoing open-heart surgery. ET-1 has been suggested to have direct arrhythmogenic effect on myocardium. The aim of the present study was to examine the putative arrhythmogenic effect of intrapericardial infusion of ET-1 in anesthetized dogs (n = 15).

[Clinical importance of monophasic action potential registration in long QT syndrome].

For more than 30 years, the monophasic action potential has been used as an experimental tool for the study of myocardial repolarisation. With recent improvements in catheter design, the utility of the tool as a means to identify the bases for ventricular arrhythmias in humans has been greatly improved. Abnormalities of repolarisation leading to ventricular arrhythmia formation can be identified and specific pharmacological therapies may be evaluated.

[Experience with a transvenous pacemaker-cardioconverter-defibrillator without subcutaneous patch].

Sudden cardiac death caused by malignant ventricular arrhythmias is one of the main causes of cardiovascular mortality. Implantation of cardioverter-defibrillators has resulted in the reduction of the incidence of sudden cardiac death caused by malignant ventricular arrhythmias from the yearly 10-30% to 1%. For the very first time in Hungary, the authors applied only transvenous lead configuration for automatic cardioverter defibrillators in three patients.

Doppler echocardiographic evaluation of left ventricular relaxation in patients with coronary artery disease.

The time constant of the left ventricular isovolumic pressure decline (Tc) was determined according to the Weiss equation in 23 patients with chest pain who underwent cardiac catheterization. Out of them 15 patients had significant coronary artery stenosis (CAD). Tc was compared to 21 diastolic Doppler data derived from the transmitral inflow.

Characteristics of long QT with permanent bradycardia.

The study was aimed to investigate the electrophysiological properties of long QT syndrome associated with permanent bradycardia. The investigations were performed in 26 patients suffering from long QT duration (QTC-frequency adapted QT-:484 +/- 34 ms) with permanent, marked bradycardia (heart rate: 42 +/- 7 min-1). Adams Stokes syncopal attack appeared in 12 patients, while in 14 cases ventricular tachycardia attack with syncope could be observed (study group).

Congenital complete heart block associated with QT prolongation.

The coexistence of congenital complete heart block and QT prolongation represents a special type of arrhythmia. The electrophysiological and clinical characteristics of this syndrome were studied in eight patients suffering from congenital AV block and QT prolongation. Data from 22 patients suffering from congenital complete heart block only, served as a control.

[Experience with the surgical management of constrictive pericarditis].

61 patients were operated on for constrictive pericarditis at the Cardiovascular Surgical Clinic of Semmelweis Medical University in the last 33 years. The average hospital mortality of the surgical pericardiectomy was 4.9%.

[Examination of the diastolic function of the left ventricle by Doppler echocardiography in coronary disease].

The authors examined the left ventricular diastolic function at rest and in pain-free period in patients with chest pain but without previous myocardial infarction. Two patient group were formed according to the results of coronarography: 15 patients had significant coronary artery stenosis, while the coronarography was negative in case of 11 patients. Four Doppler echocardiographic parameters were taken and their sensitivity, specificity, positive and negative predictive values were determined on the base of the result of the coronarography.

The effect of atrial dilatation on the genesis of atrial arrhythmias.

The effect of atrial stretching on the genesis of atrial arrhythmias was studied in 26 dogs. Left atrial dilatation was produced by inflation of a balloon catheter. Electrophysiological studies were performed by programmed electrical stimulation of the atrium and ventricle.

[New aspects of the Kearns-Sayre syndrome].

The case report of the 23 years old female with Kearn-Sayre syndrome started about 15 years ago has some special cardiological aspects. By His band ECG the height of III. degree atrioventricular block was located in the atrioventricular node which is in sharp contrast with all former findings localizing the block into or distal to His band.

The effect of sympathetic and parasympathetic activity on QT duration. Clinical study in patients with normal and prolonged QT time.

The effect of parasympathetic and sympathetic pharmacologic blockade (atropine and propranolol) on QT duration was studied in 26 patients. Of this number 17 had a normal QT time, while in 9 patients the QT interval was prolonged (greater than 460 ms). QT time was determined before and after the pharmacologic blockade with sinus rhythm (under a non fixed cycle length) and with atrial pacing (with a fixed cycle length).

Effect of atrial dilatation on the tendency of atrial arrhythmias.

The arrhythmogenic effect of atrial dilatation was studied by electrophysiological investigations carried out on 24 dogs. Atrial distension was evoked by increasing the pressure in the right atrium (12 to 14 mm Hg) or by the balloon dilatation of the left atrium. Programmed electrical stimulation of the heart was used for the electrophysiological investigations.