Study on the Platelet Survival Time in the Patients with Coronary Artery Disease

To evaluate the platelet activation in vivo in the patients with coronary artery disease Indium-111 labeled autologus platelet survival time was measured. Platelet survival determinations were made according to a modified method for radioisotope platelet survival studies recommended by the Panel on Diagnostic Application of Radioisotopes in Hematology of the International Committee for Standardization in Hematology. Autologous platelets were labeled with 111 In-oxine utilizing a similar method used at the Mallinckrodt Institute of Radiology. The results are summarized as follows : 1) In the patients with coronary artery disease, especially acutemyocardial infarction, the mean platelet survival time was significantly shorter than that of the normal controls(P<0.05). 2) The mean platelet survival time did not differ significantly between patients with acute myocardial infarction and angina pectoris. 3) The mean platelet survival time did not differ significantly between nonsmoker and smoker in the patients with coronary artery disease.

Clinical Usefulness of Systolic Time Intervals and QT-QS2 Value as Complication Predictors in Myocardial Infarction

Over the physiologic range of heart rate, the duration of electrical systole(QT) is shorter than that of electromechanical systole(QS2), which reflects direct physiologic link between electrical repolarization and mechanical events of the cardiac cycle. The present study designed to test usefulness of systolic time intervals and QT-QS2(QT minus QS2) value as complication predictors, which may predict prognostic status of myocardial infarction. The studied subjects were consisted of 33 healthy adults as control(22 men, 11 women) and 35 patients with myocardial infarction. And studied patients were divided into 3 groups; group I of 14 patients with or without complication in acute stage, group II of 11 uncomplicated patients under recovery of chronic status, group III of 10 complicated patients under recovery or chronic status. The observation periods were 3 to 13 days in group I, 5 to 96 weeks in group II and III after their onset. The results were follows; 1) The normal ranges were defined as mean+/-2 standard deviations of the measured values of control, that of QTc were shorter than 431ms of man and 458ms of woman, that of QS2 I were longer than 503ms of man and 514ms of woman, that of PEP/LVET ratio was less than 0.40, that of QT-QS2 value was less than 0 ms respectively. 2) QTc of all patient groups were significantly prolonged compared with that of control, and that of group III was significantly longer than that of group II(481+/-25 vs 432+/-32, pQS2 in group I and III. and QTQS2 had positive predictive value of 82% for predicting probability of previous complicated status. We concluded that QT-QS2 value, including PEP/LVET ratio and QTc, could be used as complication predictors. But it is necessary to examine these indicators prospectively to confirm its clinical applicability.

Clinical Application of Ambulatory Holter Electrocardiographic Monitoring

24-hour Holter ambulatory ECG monitoring has been examined for the cardiac evaluation during ordinary activities in 81 subjects with suspected or propostmyocardial infarction (PMI), 12-lead ECG and the 24-hour ECG tape showed similar basic rhythm, heart rates and conduction patterns, but ventricular premature contractions (VPCs) were more frequently recorded on the 24-hour tape. Of 17 PMI patients, one or more VPCs in 14 cases (82.4%), multifocal VPCs in 3 cases (17.6%) and bigeminy or paired VPCs in 5 cases (29.4%) and transient runs of ventricular tachycardia in 1 case (5.9%) were observed on the 24-hour monitoring. 2) Of 30 patients with typical or atypical chest pain, 20 examinees had changes in the ST segment and/or T wave, but 10 examinees did not have any pathological changes in the ST segment or in the T wave. 3) Of 26 patients with dizziness and palpitation during waking periods, sinus rates were 76.4+/-12.8/min. and the ranges were 134.1+/-15.1/min. and 58.7+/-9.1/min. Average sinus rates observed during sleeping periods were 61.6+/-10.3/min., the ranges were 92.7+/-11.4/min. and 51.5+/-8.7/min. In general, longer PR interval, QTc interval, QRS duration and high R amplitude were observed during sleeping periods than waking periods. 4) Of 64 patients without PMI, all subjects had episodes of normal sinus rhythm and brady-and-tachycardia syndrome in 5 cases, VPCs in 23 cases, APCs in 2 cases, AV block in 4 cases and W.P.W. syndrome in 2 cases were observed during 24-hour Holter ECG monitoring.