Patterns of evolution of myocyte damage after human heart transplantation detected by indium-111 monoclonal antimyosin.

The indium-111 labeled Fab fragment of antimyosin monoclonal antibody was used to study cardiac rejection and the time course of myocyte damage after transplantation. Fifty-three studies were performed in 21 patients, 17 men and 4 women, aged 19 to 54 years (mean 37 +/- 8), from 7 to 40 months after transplantation. Repeat studies were available in 8, and 10 were studied after the first year of transplantation. A heart-to-lung ratio was used for quantitation of uptake (normal 1.46 +/- 0.04). Differences between absent (1.69 +/- 0.29) and moderate (1.90 +/- 0.36) rejection were significant (p less than 0.03). Antimyosin ratio at 1 to 3 months (1.89 +/- 0.35) differed from that at greater than 12 months (1.65 +/- 0.2) (p less than 0.01). Repeat studies revealed a decrease in antimyosin ratio in 5 patients with uneventful clinical course; 2 had persistent activity after transplantation and suffered heart failure from rejection. After 1 year of transplantation uptake was within normal limits in 7 of 10 patients, and high uptake was associated with vascular rejection in 1. Because they can define evolving patterns of myocardial lesion activity, antimyosin studies could be useful both in patient management and in concentrating resources for those patients who most require them. The heart-to-lung ratio is suggested to monitor sequentially the degree of myocyte damage after transplantation.

Acute febrile neutrophilic dermatosis (Sweet's syndrome) associated with post-myocardial infarction syndrome (Dressler's syndrome).

A case of Sweet's syndrome (acute febrile neutrophilic dermatosis) occurred in a patient with post-myocardial infarction syndrome (Dressler's syndrome). Although Sweet's syndrome has been described in association with leukemias, other malignant disorders, and a variety of chronic inflammatory disorders, it has not been reported associated with Dressler's syndrome. Sweet's syndrome is reviewed with regard to its associations and to its pathogenesis.

[Endocardial monophasic action potentials obtained by means of suction catheters]. / Los potenciales de acción monofásicas endocárdicas obtenidos mediante catéteres de succión.

Endocardial monophasic active potentials (M.A.P.) recorded by suction --tip intracardiac catheters constitute a new research-- method in cardiac arrythmias, electrophysiology and pharmacology. The characteristics of MAP at auricular and ventricular levels are analyzed. The limitations of the method in its incapacity to record the MAP of conduction tissues is discussed. This method of recording MAP is evaluated with antiarrythmic drugs of tipes I, II, III and IV. The results are identical to recordings performed with intracellular microelectrodes.