[Hemodynamic profile of acute myocardial infarction as a function of electrocardiographic localization]. / Le profil hémodynamique de l'infarctus aigu du myocarde en fonction des localisations électrocardiographiques.

The haemodynamic profiles of 147 cases of myocardial infarction investigated within 30 hours of the clinical onset were studies in relation to the topography of the necrosis on the ECG: there were 36 inferior (I), 29 postero-inferior (PI), 22 antero-septal (AS), 38 antero-lateral (AL), 15 deep septal (DS), and 7 strictly posterior or lateral (PL). Simultaneous recordings of the diastolic pulmonary arterial pressures and the left ventricular diastolic pressures (pre-and post-a) have shown different degrees of correlation with the topographical site. The correlation found in AS, AL and I necrosis are clearer with respect to the pre-a. The PI necroses show no correlation. Graphs of left ventricular function as well as an analysis of the various other parameters show that the DS, the AL, and to a lesser extent the PI are associated with the grossest depression of left ventricular function. A study of the amplitude of the "a" wave also shows that the effect of infacts of the free wall of the left ventricule on the compliance is greater. A study of right ventricular function as well as the correlations between the pulmonary and right atrial pressures confirms the presence of right ventricular disfunction in DS and PI necroses. Impaired left ventricular function, impaired right ventricular function, and disorders of compliance seem to be the determining factors in changing the haemodynamics in the various ECG sites of infarction.

[Approach to the prognosis of myocardial infarct from the initial hemodynamic examination]. / Approche du pronostic de l'infarctus du myocarde à partir de l'exploration hémodynamique initiale

Hemodynamic investigations (right and left heart catheterization, cardiac output measurement) were performed in 132 patients with acute myocardial infarction. Retrospective study of the first 100 patients allowed determination of prognostic indices. A new statistical method is proposed which was used prospectively in the 32 following patients and resulted in an error of prediction of about 3 per cent. The establishment of prognosis from hemodynamic data is a necessary condition prior to new therapeutic approaches of cardiac failure in acute myocardial infarction.