[Peri-infarct zone and the effect of mannitol on it]

Apart from clinical examination, blood enzyme activity was measured and ST intervals recorded on electrocardiotopograms (ECTG) from 35 leads in 56 patients (40 males and 16 females) with acute transmural anterior myocardial infarction. The osmotic diuretic mannitol was administered to 21 patients. The untreated patients were subdivided into 2 groups with respect to biochemical patterns they exhibited: enzyme activity peaking on Day 2 and coming back to normal by Day 7-10 (Group 1), and enzyme activity peaking on Day 3-4 and coming back to normal by Day 15-20 (Group 2). Similar patterns could be observed in ECTG findings. The course of myocardial infarction was shown to be either recurrent, or nonrecurrent. The recurrent course, indicative of a spreading primary necrotic focus, was noted in 86% of the patients belonging to Group 2. The clinical, enzymatic and ECTG patterns of patients treated with mannitol were similar to those of the patients with nonrecurrent course of myocardial infarction, therefore mannitol treatment can be recommended for the control of the acute stage of the disease.