Non-ST elevation myocardial infarction related to total coronary artery occlusion - prevalence and patient characteristics.

INTRODUCTION: Acute coronary occlusion (ACO) may also present as non-ST elevation myocardial infarction (NSTEMI) and thus veil the real threat. AIM: Based on combined analysis of electrocardiography and echocardiography findings, we aimed to describe profile of NSTEMI patients at increased risk of ACO. MATERIAL AND METHODS: It was a retrospective study that included patients referred for cardiac catheterisation due to NSTEMI. Patients were selected into the study in two different time frames. Firstly, all consecutive NSTEMI patients were enrolled in a 12-month period to detect the prevalence of ACO (prevalence group). Secondly, all NSTEMI patients with ACO hospitalized in the previous 5 years were also enrolled (NSTEMI-ACO group). All patients had 12-lead electrocardiogram (ECG) and the transthoracic echocardiography (TTE) performed before the cardiac catheterisation. RESULTS: Fifty-three consecutive patients (37 males) were enrolled into the prevalence group in a 12-month period. Ten (19%) of them were diagnosed with ACO. Thirty-four consecutive patients were enrolled into the NSTEMI-ACO group. Non-ST elevation myocardial infarction patients with ACO were younger as compared to NSTEMI patients without ACO. Non-ST elevation myocardial infarction patients with ACO were less likely to have anterior wall ischaemia as detected by ECG, which was not reflected by TTE results. Combined assessment of ischaemia by ECG and impaired contractility by TTE did not reveal any significant differences between NSTEMI patients with or without ACO. CONCLUSIONS: The identification of NSTEMI patients with ACO is challenging. Therefore, the utmost caution should be paid to prevent delay of coronary angiography in NSTEMI patients who have increased risk of ACO.

Two-dimensional speckle tracking echocardiography prognostic parameters in patients after acute myocardial infarction.

AIM: The aim of the study was to evaluate the left ventricle (LV) function with speckle tracking echocardiography (STE) and to assess its relation to prognosis in patients after acute myocardial infarction (AMI). METHODS: Sixty-three patients (F/M = 16/47 pts; 62.33 ± 11.85 years old) with AMI (NSTEMI/STEMI 24/39 pts) and successful percutaneous coronary intervention (PCI) with stent implantation (thrombolysis in myocardial infarction; TIMI 3 flow) were enrolled in this study. All patients underwent baseline two-dimensional conventional echocardiography and STE 3 days (baseline) and 30 days after PCI. All patients were followed up for cardiovascular clinical endpoints, major adverse cardiovascular endpoint (MACE), and functional status (Canadian Cardiovascular Society and New York Heart Association). RESULTS: During the follow-up (31.9 ± 5.1 months), there were 3 cardiovascular deaths, 15 patients had AMI, 2 patients had cerebral infarction, 24 patients reached the MACE. Baseline LV torsion (P = 0.035), but none of the other strain parameters were associated with the time to first unplanned cardiovascular hospitalization. Univariate analysis showed that baseline longitudinal two-chamber and four-chamber strain (sLa2 0 and sLa4 0) and the same parameters obtained 30 days after the AMI together with transverse four-chamber strain (sLa2 30, sLa4 30, and sTa4 30) were significantly associated with combined endpoint (MACE). The strongest association in the univariate analysis was found for the baseline sLa2. However, in multivariable analysis only a left ventricular remodeling (LVR - 27% pts) was significantly associated with MACE and strain parameters were not associated with the combined endpoint. CONCLUSION: The assessment of LV function with STE may improve cardiovascular risk prediction in postmyocardial infarction patients.

Calibration of potentiometric sensor arrays with a reduced number of standards.

In this paper a novel calibration procedure for the parameter determination of ion-selective electrodes used in an array is described. Commonly used procedures require a large number of standards to determine the parameters based on the Nicolsky-Eisenman model. The elaborated procedure reduces the number of standards to a minimum by using a standard containing a mixture of ions instead of a couple of pure standards. This paper presents a complete calibration procedure, which consists of designing the composition of the standards, parameter determination and verification of the calibration results. Comparison of the results obtained by the procedure presented with results obtained by the Two-Point Calibration and Separate Solution methods proves that the accuracies of both procedures are comparable. The outlined procedure can be applied in multicomponent analysers.