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1

The severity of coronary artery disease evaluated by central systolic pressure and fractional diastolic pressure  

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Full Text Available Background: Central pulse pressure, pulse pressure index and fractional pulse pressure have been confirmed to be associated with increased risk of cardiovascular disease, but if the severity of cardiovascular disease, specifically for the coronary artery disease, is evaluated by central systolic pressure and fractional diastolic pressure has been not well studied. Aims: This study was designed to examine if central systolic pressure and fractional diastolic pressure could act as a predicting factor for the severity of coronary artery disease. Patients and Methods: A total of 310 patients were included in this study. 154 patients were diagnosed with coronary artery disease, and 156 with non-coronary artery disease, which was confirmed with diagnostic coronary angiography. The average age and sex in the two groups were same. Results: Age, peripheral and central systolic blood pressure, fractional systolic pressure, and fractional diastolic pressure were significantly higher in the patients with coronary artery disease (P<0.05). The central fractional systolic pressure and fractional diastolic pressure were abnormal in the patients with coronary artery disease. Central fractional systolic pressure and fractional diastolic pressure presented a positive correlation between them and coronary Gensini Score (P<0.05), in the patients with coronary artery disease. Conclusions: The severity of coronary artery disease may be predicted by examination of central fractional systolic pressure and fractional diastolic pressure.

Song-Tao An; Yan-Yan QI; Li-Xia Wang

2010-01-01

2

Pulsatile diastolic increase and systolic decrease in arterial blood pressure: Their mechanism of production and physiological role.  

UK PubMed Central (United Kingdom)

The diastolic pulsatile increase in arterial blood pressure is shown to occur earlier in the aorta than in other arteries. It is thus not a reflection of the systolic pressure wave, as has been generally assumed, but an independent pressure wave produced by the sequential contraction of the arterial tree. Conversely, a systolic pulsatile decrease in the rate of blood pressure rise is also produced by an active relaxation of the arterial tree. Simultaneously with the pulsatile changes in arterial blood pressure, there are corresponding changes in arterial blood flow. All these cyclic changes are reflex responses to decreasing diastolic and increasing systolic baroreceptor firing rates, respectively. The two reflexes contribute, together with the known compliance of the large arteries and the great arteriolar blood flow resistance, to the steadiness of capillary blood flow throughout the systolic and the much longer-lasting diastolic phases of the cardiac cycle.

Mandoki JJ; Casa-Tirao B; Molina-Guarneros JA; Jiménez-Orozco FA; García-Mondragón MJ; Maldonado-Espinoza A

2013-08-01

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Fit to diastolic arterial pressure by third-order lumped model yields unreliable estimates of arterial compliance.  

UK PubMed Central (United Kingdom)

The pressure pulse contour analysis method uses a third-order lumped model to evaluate the elastic properties of the arterial system and their modifications with adaptive responses or disease. A fundamental assumption underlying this method is that the estimates of model parameters (two compliances, an inertance, and a peripheral resistance) obtained from a measurement of cardiac output, and a simultaneous measurement of an arterial pressure, are independent of the pressure measurement site. If true, this hypothesis would provide a minimally invasive method for estimation of arterial compliance. The aim of the present study was to test the validity of this assumption and the ability of the method to assess changes of compliance in response to vasoactive drug administration. In five anaesthetised, open-chest dogs we measured pulsatile pressure and flow in the ascending aorta and pulsatile pressure in the terminal aorta, under basal, vasoconstricted (methoxamine), and vasodilated (sodium nitroprusside) conditions. Model peripheral resistance was assumed equal to the ratio of mean pressure to cardiac output. Estimates of inertance and compliances, and the associated estimation errors, were determined by fitting the model output to either the diastolic portions of ascending aortic pressure, P(adt), or terminal aortic pressure, Ptd(t). Results showed that the assumption of independency of model parameter estimates on the arterial pressure measurement site was not verified. Different images of the vasoactive drug-induced changes in vascular compliance were obtained from fits to P(adt) and Ptd(t). Model parameter estimates were associated with high estimation errors and were very sensitive to the choice of the period of diastolic pressure to be fitted. Model predicted aortic pressure, over the entire heart cycle, did not compare well with experimental ascending aortic pressure. Our results question the reliability of the pressure pulse contour analysis method for evaluating arterial compliance.

Fogliardi R; Burattini R; Shroff SG; Campbell KB

1996-04-01

4

Cuffless and noninvasive measurement of systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure using radial artery tonometry pressure sensor with concept of Korean traditional medicine.  

UK PubMed Central (United Kingdom)

Parameters for noninvasive diagnosis and monitoring of cardiovascular disease. We developed a new method to measure blood pressure (BP) noninvasively without cuff. In Korean traditional medicine, the degree of the pulse depth is one of the important criteria to diagnosis. We combined this concept with pulse wave analysis. With clinical data obtained from 163 subjects, we selected APm (applied pressure which has a maximum value of pulse wave), elasticity of wrist tissue, depth of blood vessel, cardiac output and h1 as parameters to estimate blood pressure. And with the parameters, we induced multi regression equation of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). And the probabilities of these parameters to explain SBP, DBP, and MAP were 89.5%, 91.1% and 94.6%, respectively. To estimate PP, we added h1 to the parameters to explain PP was 97.5%. We compared the estimated SBP, DBP, MAP and PP through the multiple regression equations to the actual measured SBP, DBP, MAP and PP through the wrist type BP meter. Differences were (+/- SD) 0.38 +/- 9.95, -1.0 +/- 8.2, 0.02 +/- 6.9 and 0.05 +/- 5.9mmHg for SBP, DBP, MAP and PP, respectively. According to the American National Standard for Electronic or Automated Sphygmomanometers, the mean difference (MD) should be +/- 5mmHg or less with a standard deviation (SD) of +/- 8mmHg or less. Hence, the results of MAP and PP were within the limits for the AAMI SP 10 criteria and the results of SBP and DBP were not within the limits for the AAMI SP 10 criteria. The preliminary results indicate the results are quite reliable and promising.

Park M; Kang H; Huh Y; Kim KC

2007-01-01

5

Cuffless and noninvasive measurement of systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure using radial artery tonometry pressure sensor with concept of Korean traditional medicine.  

Science.gov (United States)

Parameters for noninvasive diagnosis and monitoring of cardiovascular disease. We developed a new method to measure blood pressure (BP) noninvasively without cuff. In Korean traditional medicine, the degree of the pulse depth is one of the important criteria to diagnosis. We combined this concept with pulse wave analysis. With clinical data obtained from 163 subjects, we selected APm (applied pressure which has a maximum value of pulse wave), elasticity of wrist tissue, depth of blood vessel, cardiac output and h1 as parameters to estimate blood pressure. And with the parameters, we induced multi regression equation of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). And the probabilities of these parameters to explain SBP, DBP, and MAP were 89.5%, 91.1% and 94.6%, respectively. To estimate PP, we added h1 to the parameters to explain PP was 97.5%. We compared the estimated SBP, DBP, MAP and PP through the multiple regression equations to the actual measured SBP, DBP, MAP and PP through the wrist type BP meter. Differences were (+/- SD) 0.38 +/- 9.95, -1.0 +/- 8.2, 0.02 +/- 6.9 and 0.05 +/- 5.9mmHg for SBP, DBP, MAP and PP, respectively. According to the American National Standard for Electronic or Automated Sphygmomanometers, the mean difference (MD) should be +/- 5mmHg or less with a standard deviation (SD) of +/- 8mmHg or less. Hence, the results of MAP and PP were within the limits for the AAMI SP 10 criteria and the results of SBP and DBP were not within the limits for the AAMI SP 10 criteria. The preliminary results indicate the results are quite reliable and promising. PMID:18002775

Park, Mikyoung; Kang, HeeJung; Huh, Young; Kim, Kyung-Chul

2007-01-01

6

Abnormal shortened diastolic time length at increasing heart rates in patients with abnormal exercise-induced increase in pulmonary artery pressure  

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Full Text Available Abstract Background The degree of pulmonary hypertension is not independently related to the severity of left ventricular systolic dysfunction but is frequently associated with diastolic filling abnormalities. The aim of this study was to assess diastolic times at increasing heart rates in normal and in patients with and without abnormal exercise-induced increase in pulmonary artery pressure (PASP). Methods. We enrolled 109 patients (78 males, age 62 ± 13 years) referred for exercise stress echocardiography and 16 controls. The PASP was derived from the tricuspid Doppler tracing. A cut-off value of PASP ? 50 mmHg at peak stress was considered as indicative of abnormal increase in PASP. Diastolic times and the diastolic/systolic time ratio were recorded by a precordial cutaneous force sensor based on a linear accelerometer. Results At baseline, PASP was 30 ± 5 mmHg in patients and 25 ± 4 in controls. At peak stress the PASP was normal in 95 patients (Group 1); 14 patients (Group 2) showed an abnormal increase in PASP (from 35 ± 4 to 62 ± 12 mmHg; P Conclusion The first and second heart sound vibrations non-invasively monitored by a force sensor are useful for continuously assessing diastolic time during exercise. Exercise-induced abnormal PASP was associated with reduced diastolic time at heart rates beyond 100 beats per minute.

Bombardini Tonino; Sicari Rosa; Bianchini Elisabetta; Picano Eugenio

2011-01-01

7

[Systolic, diastolic and pulse pressure: therapeutic options  

UK PubMed Central (United Kingdom)

It is now universally accepted that antihypertensive therapy reduces cardiovascular morbidity and mortality both in young and older patients. The clinical relevance of the systolic, diastolic and pulse pressure as independent risk factors is well recognized. The reduction of cardiovascular morbidity and mortality in hypertensive patients is the main therapeutic goal. There is substantial agreement on the treatment of individual risk factors and associated clinical conditions, but the best drug therapy for systolic and diastolic hypertension and/or high pulse pressure is still controversial. The recommendations of the JNC VI are that diuretics or beta-blockers be used as first-step drug therapies. The WHO-ISH guidelines recognize calcium antagonists, ACE-inhibitors, alpha-blockers and angiotensin II receptor antagonists as first-step drug therapies together with diuretics and beta-blockers. All these drugs have a similar hypotensive potential and reduce cardiovascular risk, but with noticeable differences in tolerability and side effects. It has long been demonstrated that diuretics and beta-blockers significantly reduce the cardiovascular risk, but their side effects can be relevant. ACE-inhibitors have proved to be efficacious in hypertensive patients with chronic heart failure and diabetes. Calcium antagonists are useful in the prevention of stroke but results in patients at high risk of coronary artery disease and heart failure are controversial. Alpha-blockers have proved to be unsafe in patients with heart failure but showed beneficial effects in young patients with diastolic hypertension. Angiotensin II receptor antagonists have proved to be safe and efficient but their advantages in comparison to other drugs need to be confirmed.

Montereggi A

2001-04-01

8

Significance of echocardiographic atrioventricular plane displacement for the evaluation of left ventricular filling and end-diastolic pressure in patients with coronary artery disease.  

UK PubMed Central (United Kingdom)

The aim of this study is to assess the left ventricular filling and estimate the end-diastolic pressure of the left ventricle in patients with coronary artery disease (CAD) by echocardiographic measurement of the atrioventricular plane displacement (AVPD). In 101 patients (mean age 59 +/- 12 years) with CAD, a complete transthoracic echocardiographic study was performed, just prior to cardiac catheterization. The AVPD was recorded by M-mode echocardiography, from apical four and two chamber views. The recordings were obtained at four sites, corresponding to the septal, lateral, anterior and inferior walls of the left ventricle. The mean AVPD resulting from atrial systole (At), the mean total (T) diastolic AVPD, the ratio At/T(%) and the ratio of mitral annulus excursion during early and late diastole [(T-At)/At] were calculated. Firty-two age-matched healthy subjects served as control group. Both At and At/T were significantly greater in patients with CAD than in the controls (6.06 +/- 0.94 vs 5.53 +/- 0.55 mm, p < 0.01 and 43.4 +/- 5.9% vs 33.49 +/- 4.45%, p < 0.001 respectively). The ratio [(T-At)/At] correlated with the E/A ratio of transmitral flow, both in healthy subjects (r = 0.850, p < 0.001) and in patients with CAD (r = 0.722, p < 0.001). Correlation also existed both in patients with segmental wall motion abnormality (SWMA) (r = 0.691, p < 0.001) and in patients with SWMA (r = 0.818, p < 0.001). In patients with CAD, At/T further correlated with the left ventricular end-diastolic pressure (r = 0.517, p < 0.001). In patients with SWMA and in patients without, a correlation was also found (r = 0.516, p < 0.001 and r = 0.566, p < 0.001 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Kranidis A; Kostopoulos K; Margaris N; Sioras E; Kappos K; Kardaras F; Filippatos G; Anthopoulos L

1995-09-01

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Significance of echocardiographic atrioventricular plane displacement for the evaluation of left ventricular filling and end-diastolic pressure in patients with coronary artery disease.  

Science.gov (United States)

The aim of this study is to assess the left ventricular filling and estimate the end-diastolic pressure of the left ventricle in patients with coronary artery disease (CAD) by echocardiographic measurement of the atrioventricular plane displacement (AVPD). In 101 patients (mean age 59 +/- 12 years) with CAD, a complete transthoracic echocardiographic study was performed, just prior to cardiac catheterization. The AVPD was recorded by M-mode echocardiography, from apical four and two chamber views. The recordings were obtained at four sites, corresponding to the septal, lateral, anterior and inferior walls of the left ventricle. The mean AVPD resulting from atrial systole (At), the mean total (T) diastolic AVPD, the ratio At/T(%) and the ratio of mitral annulus excursion during early and late diastole [(T-At)/At] were calculated. Firty-two age-matched healthy subjects served as control group. Both At and At/T were significantly greater in patients with CAD than in the controls (6.06 +/- 0.94 vs 5.53 +/- 0.55 mm, p < 0.01 and 43.4 +/- 5.9% vs 33.49 +/- 4.45%, p < 0.001 respectively). The ratio [(T-At)/At] correlated with the E/A ratio of transmitral flow, both in healthy subjects (r = 0.850, p < 0.001) and in patients with CAD (r = 0.722, p < 0.001). Correlation also existed both in patients with segmental wall motion abnormality (SWMA) (r = 0.691, p < 0.001) and in patients with SWMA (r = 0.818, p < 0.001). In patients with CAD, At/T further correlated with the left ventricular end-diastolic pressure (r = 0.517, p < 0.001). In patients with SWMA and in patients without, a correlation was also found (r = 0.516, p < 0.001 and r = 0.566, p < 0.001 respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7499908

Kranidis, A; Kostopoulos, K; Margaris, N; Sioras, E; Kappos, K; Kardaras, F; Filippatos, G; Anthopoulos, L

1995-09-01

10

Impact of arterial load on left ventricular diastolic function in patients undergoing cardiac catheterization for coronary artery disease.  

UK PubMed Central (United Kingdom)

BACKGROUND: Although left ventricular (LV) diastolic dysfunction is associated with increased risk for incident heart failure in patients with coronary artery disease (CAD), no specific treatment for diastolic abnormalities has been established. Animal and small human studies have shown that an acute increase in LV afterload adversely impacts on LV early diastolic relaxation, but little is known about its chronic effect on diastolic function. METHODS AND RESULTS: The relationships of various components of arterial load (arterial compliance, total vascular resistance index, and augmentation index [AI] in the ascending aorta) with LV diastolic function indices determined on cardiac catheterization (relaxation time constant [Tau] and end-diastolic pressure [EDP]) and those on tissue Doppler echocardiography (early diastolic mitral annular velocity [E'] and the ratio of early diastolic mitral inflow to annular velocities [E/E']) were investigated in 303 consecutive patients undergoing cardiac catheterization for CAD. All components of arterial load correlated with diastolic function indices, with AI, an index reflecting late-systolic load, having the strongest correlations with diastolic function indices. After adjustment for potential confounders, AI correlated with Tau (standardized beta=0.25, P<0.001), EDP (beta=0.25, P<0.001), E' (beta=-0.21, P<0.001), and E/E' (beta=0.23, P<0.001). CONCLUSIONS: Increased AI is independently associated with LV diastolic function in patients with known or suspected CAD. Late-systolic load may be a therapeutic target to improve LV diastolic abnormalities in this population.

Fukuta H; Ohte N; Wakami K; Asada K; Goto T; Mukai S; Tani T; Kimura G

2010-09-01

11

Right Ventricular Diastolic Impairment in Patients with Pulmonary Arterial Hypertension.  

UK PubMed Central (United Kingdom)

BACKGROUND: The role of right ventricular (RV) diastolic stiffness in pulmonary arterial hypertension (PAH) is not well-established. Therefore, we investigated the presence and possible underlying mechanisms of RV diastolic stiffness in PAH-patients. METHODS AND RESULTS: Single-beat RV pressure-volume analyses were performed in 21 PAH-patients and 7 controls to study RV diastolic stiffness. Data presented as mean±SEM. RV diastolic stiffness (?) was significantly increased in PAH-patients (PAH: 0.050±0.005 vs. control: 0.029±0.003; p<0.05) and closely associated to disease severity. Subsequently, we searched for possible underlying mechanisms, using RV tissue of PAH-patients undergoing heart-lung transplantation and non-failing donors. Histological analyses revealed increased cardiomyocyte cross-sectional areas (PAH: 453±31 vs. control: 218±21 ?m(2); p<0.001), indicating RV hypertrophy. In addition, the amount of RV fibrosis was enhanced in PAH tissue (PAH: 9.6±0.7 vs. control: 7.2±0.6%; p<0.01). To investigate the contribution of stiffening of the sarcomere (the contractile apparatus of RV cardiomyocytes) to RV diastolic stiffness, we isolated and membrane-permeabilized single RV cardiomyocytes. Passive tension at different sarcomere lengths was significantly higher in PAH compared to controls (+200%; pinteraction<0.001), indicating stiffening of RV sarcomeres. An important regulator of sarcomeric stiffening is the sarcomeric protein titin. Therefore, we investigated titin isoform composition and phosphorylation. No alterations were observed in titin isoform composition (N2BA/N2B ratio PAH: 0.78±0.07 vs. control 0.91±0.08), but titin phosphorylation in RV-tissue of PAH-patients was significantly reduced (PAH: 0.16±0.01 vs. control 0.20±0.01 a.u.;p<0.05). CONCLUSIONS: RV diastolic stiffness is significantly increased in PAH-patients, with important contributions from increased collagen and intrinsic stiffening of the RV cardiomyocyte sarcomeres.

Rain S; Handoko ML; Trip P; Gan TJ; Westerhof N; Stienen G; Paulus WJ; Ottenheijm C; Marcus JT; Dorfmüller P; Guignabert C; Humbert M; Macdonald P; Dos Remedios C; Postmus PE; Saripalli C; Hidalgo CG; Granzier HL; Vonk-Noordegraaf A; van der Velden J; de Man FS

2013-09-01

12

Relation of left ventricular end diastolic pressure to right ventricular end diastolic volume after operative treatment of tetralogy of fallot.  

UK PubMed Central (United Kingdom)

Left ventricular (LV) diastolic dysfunction is associated with poor outcomes after tetralogy of Fallot (TOF) repair, although its cause is not known, and its relation to right ventricular (RV) performance has never been examined. The aim of this study was to test the hypothesis that RV dilation leads to LV diastolic dysfunction after TOF repair. Patients with repaired TOF who underwent cardiac catheterization and cardiac magnetic resonance imaging within 6 months from January 2003 and April 2011 were reviewed to assess the relation of LV end-diastolic pressure (LVEDP) and indexed RV end-diastolic volume (RVEDVi). Thirty-eight patients were included at a median age of 10.1 years (range 0.6 to 54.7). There was a significant linear association between RVEDVi and LVEDP (p = 0.05). RV end-diastolic pressure (p <0.001), right pulmonary artery systolic pressure (p = 0.009), left pulmonary artery systolic pressure (p = 0.02), and total cardiopulmonary support time (p = 0.04) during TOF repair were also significantly associated with LVEDP. Compared to patients with LVEDP <12 mm Hg, those with LVEDP ?12 mm Hg had significantly higher mean RVEDVi (135.2 ± 47.8 vs 98.6 ± 28 ml/m(2), p = 0.007) and mean RV end-diastolic pressure (11.7 ± 1.6 vs 8.5 ± 2.8 mm Hg, p = 0.0003). In conclusion, after TOF repair, LVEDP is significantly associated with RVEDVi. Furthermore, mean RVEDVi is significantly higher in patients with LVEDP ?12 mm Hg. These findings support the theory that RV dilation may impair LV diastolic function and that LV parameters may also be important to consider in determining timing of pulmonary valve replacement.

Schwartz MC; Rome JJ; Gillespie MJ; Whitehead K; Harris MA; Fogel MA; Glatz AC

2012-02-01

13

Arterial stiffness and left-ventricular diastolic dysfunction: Guangzhou Biobank Cohort Study-CVD.  

Science.gov (United States)

Brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, is an established cardiovascular risk factor of ventricular stiffening. We studied the association of baPWV with left-ventricular (LV) diastolic function in a sub-study of the Guangzhou Biobank Cohort Study. In all, 378 Chinese subjects with a normal ejection fraction (>50%) had baPWV measurement by a noninvasive automatic waveform analyser, carotid intima-medial thickness (IMT) measurement by B-mode ultrasonography and cardiac diastolic function assessment by echocardiography. After adjusting for age, both baPWV and IMT were associated with LV mass index, posterior wall end-diastolic thickness and inter-ventricular end-diastolic thickness, but only baPWV was associated with deceleration time, atrial flow velocity and E/A ratio. Multivariable linear regression model showed that baPWV and mean arterial pressure, but not IMT, were significantly associated with E/A ratio (?=-0.02, P=0.03 and ?=-0.36, P=0.02, respectively). The receiver operator characteristic curve showed that baPWV was better than pulse pressure or mean arterial pressure to detect LV diastolic dysfunction (E/A<1.0). Our study suggested that increased baPWV might be an independent risk factor or marker for diastolic dysfunction. Early detection of an intervention on increased baPWV may be important for prevention of cardiac diastolic dysfunction. PMID:20428193

Xu, L; Jiang, C Q; Lam, T H; Yue, X J; Lin, J M; Cheng, K K; Liu, B; Li Jin, Y; Zhang, W S; Thomas, G N

2010-04-29

14

Arterial stiffness and left-ventricular diastolic dysfunction: Guangzhou Biobank Cohort Study-CVD.  

UK PubMed Central (United Kingdom)

Brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, is an established cardiovascular risk factor of ventricular stiffening. We studied the association of baPWV with left-ventricular (LV) diastolic function in a sub-study of the Guangzhou Biobank Cohort Study. In all, 378 Chinese subjects with a normal ejection fraction (>50%) had baPWV measurement by a noninvasive automatic waveform analyser, carotid intima-medial thickness (IMT) measurement by B-mode ultrasonography and cardiac diastolic function assessment by echocardiography. After adjusting for age, both baPWV and IMT were associated with LV mass index, posterior wall end-diastolic thickness and inter-ventricular end-diastolic thickness, but only baPWV was associated with deceleration time, atrial flow velocity and E/A ratio. Multivariable linear regression model showed that baPWV and mean arterial pressure, but not IMT, were significantly associated with E/A ratio (?=-0.02, P=0.03 and ?=-0.36, P=0.02, respectively). The receiver operator characteristic curve showed that baPWV was better than pulse pressure or mean arterial pressure to detect LV diastolic dysfunction (E/A<1.0). Our study suggested that increased baPWV might be an independent risk factor or marker for diastolic dysfunction. Early detection of an intervention on increased baPWV may be important for prevention of cardiac diastolic dysfunction.

Xu L; Jiang CQ; Lam TH; Yue XJ; Lin JM; Cheng KK; Liu B; Li Jin Y; Zhang WS; Thomas GN

2011-03-01

15

Diastolic pressure underestimates age-related hemodynamic impairment.  

Science.gov (United States)

It has been hypothesized that as large arteries become more rigid with age, the pattern of hypertension changes from diastolic to systolic. Thus, diastolic blood pressure (DBP) may lose its ability to reflect the increase in vascular resistance with age. To assess this, we studied the age-related changes in blood pressure pattern and its steady-state and pulsatile determinants. We performed an epidemiological analysis based on a national survey of 10,462 subjects from Argentina. A hemodynamic analysis (impedance cardiography) was then carried out in 636 consecutive hypertensive patients (age, 25 to 74 years). Whereas the rate of increment in the prevalence of mild to moderate hypertension (MMH) reached a plateau after the sixth decade, isolated and borderline systolic forms of hypertension began a steep and sustained rise. Among patients with MMH, DBP remained stable from the third to the seventh decade, whereas SBP maintained a sustained increase. Despite similar DBP, the systemic vascular resistance index increased 47% (P<.01) and the cardiac index decreased 27% (P<.01), whereas the ratio of stroke volume to pulse pressure, an index of arterial compliance, decreased 45% (P<.01). However, there were no significant differences between older patients with MMH and those with isolated systolic hypertension in the level of SBP, vascular resistance, stroke volume, and cardiac index. Compared with age-matched normotensive control subjects, the ratio of stroke volume to pulse pressure was much more reduced in isolated systolic hypertension (48%) than in MMH (30%). In summary, the present study, carried out in a large sample of hypertensive subjects with a wide age range, showed a simultaneous impairment in vascular resistance and arterial compliance associated with aging in different patterns of hypertension. The magnitude of these changes, with opposite effects on DBP but additive effects on SBP, suggests that a hemodynamic mechanism could determine the transition in the prevalence of diastolic hypertension toward a systolic pattern of hypertension with aging. Also, the results suggest that SBP, but not DBP, is a reliable indicator of the underlying hemodynamic abnormalities (high resistance and low arterial compliance) in the elderly. PMID:9336377

Galarza, C R; Alfie, J; Waisman, G D; Mayorga, L M; Cámera, L A; del Río, M; Vasvari, F; Limansky, R; Farías, J; Tessler, J; Cámera, M I

1997-10-01

16

Relationship between left ventricular diastolic function and arterial stiffness in asymptomatic patients with diabetes mellitus.  

UK PubMed Central (United Kingdom)

Left ventricular (LV) diastolic dysfunction and increased arterial stiffness are common in patients with diabetes mellitus (DM). However, the relation between these two pathophysiological factors remains unclear. The aim of this study was to investigate the relationship between LV diastolic function and arterial stiffness as assessed with applanation tonometry. In 142 asymptomatic patients with DM (mean age 48 years, 75 (53 %) men, 72 (51 %) patients with type 2 DM) LV diastolic function was assessed with echocardiography. Arterial stiffness was evaluated measuring the aortic pulse wave velocity (PWV) whereas wave reflection was assessed measuring central systolic blood pressure (cSBP), central pulse pressure (cPP), and augmentation index (AIx) with applanation tonometry. Mean E/A ratio, E' and E/E' ratio were 1.1 ± 0.3, 8.1 ± 2.3 and 9.2 ± 3.3 cm/s, respectively. Mean PWV, mean cSBP, median cPP and mean AIx were 7.9 ± 2.4 m/s, 122 ± 17 mmHg, 40 [35-51] mmHg and 17.9 ± 12.1 %, respectively. PWV was independently associated with LV diastolic dysfunction grade (? = 0.76, p = 0.03). In contrast, measures of wave reflection, cPP, cSBP and AIx were independently related with E/A ratio, but not with the LV diastolic dysfunction grade. Parameters of arterial stiffness and wave reflection are associated with echocardiographic indices of LV diastolic function in asymptomatic patients with DM. Therapies that prevent progression of arterial stiffness and reduce late-systolic pressure overload may help to reduce the prevalence of LV diastolic dysfunction in this population.

Roos CJ; Auger D; Djaberi R; de Koning EJ; Rabelink TJ; Pereira AM; Bax JJ; Delgado V; Jukema JW; Scholte AJ

2013-03-01

17

Relationship between left ventricular diastolic function and arterial stiffness in asymptomatic patients with diabetes mellitus.  

Science.gov (United States)

Left ventricular (LV) diastolic dysfunction and increased arterial stiffness are common in patients with diabetes mellitus (DM). However, the relation between these two pathophysiological factors remains unclear. The aim of this study was to investigate the relationship between LV diastolic function and arterial stiffness as assessed with applanation tonometry. In 142 asymptomatic patients with DM (mean age 48 years, 75 (53 %) men, 72 (51 %) patients with type 2 DM) LV diastolic function was assessed with echocardiography. Arterial stiffness was evaluated measuring the aortic pulse wave velocity (PWV) whereas wave reflection was assessed measuring central systolic blood pressure (cSBP), central pulse pressure (cPP), and augmentation index (AIx) with applanation tonometry. Mean E/A ratio, E' and E/E' ratio were 1.1 ± 0.3, 8.1 ± 2.3 and 9.2 ± 3.3 cm/s, respectively. Mean PWV, mean cSBP, median cPP and mean AIx were 7.9 ± 2.4 m/s, 122 ± 17 mmHg, 40 [35-51] mmHg and 17.9 ± 12.1 %, respectively. PWV was independently associated with LV diastolic dysfunction grade (? = 0.76, p = 0.03). In contrast, measures of wave reflection, cPP, cSBP and AIx were independently related with E/A ratio, but not with the LV diastolic dysfunction grade. Parameters of arterial stiffness and wave reflection are associated with echocardiographic indices of LV diastolic function in asymptomatic patients with DM. Therapies that prevent progression of arterial stiffness and reduce late-systolic pressure overload may help to reduce the prevalence of LV diastolic dysfunction in this population. PMID:23053856

Roos, Cornelis J; Auger, Dominique; Djaberi, Roxana; de Koning, Eelco J; Rabelink, Ton J; Pereira, Alberto M; Bax, Jeroen J; Delgado, Victoria; Jukema, J Wouter; Scholte, Arthur J

2012-09-28

18

The age-related advancement of arterial disease measured by Doppler ultrasound diastolic flow analysis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To quantify by A-mode Doppler sonography the age-related progression of arterial disease so that age dependent normal values may be established for the screening Doppler peripheral arterial exam. Arterial distensibility was assessed by A-mode Doppler diastolic flow analysis as a measure of atherogenesis. These values will increase the sensitivity and decrease the incidence of false-positive results when the Doppler exam is utilized to differentially diagnosis vascular and sciatic neurogenic claudication. The relationship between age and results from the standard ankle/arm index ultrasound pneumatic cuff examination was also analyzed. DESIGN: A two by three analysis of variance with orthogonal Helmert contrast codes and simple linear regression analysis was utilized for this cross-sectionally designed investigation. The dependent measures of diastolic flow analysis and ankle/arm pressure index were obtained within three nested successively increasing age groups. SETTING: Chiropractic office. SUBJECTS: Studied were a total of 90 sedentary nonsmoking subjects, aged 23-79 yr, all of whom had normally accepted levels of serum glucose, cholesterol and blood pressure. Subjects were screened for evidence of aortic coarctation, myocardial infarction, tachyarrhythmia, aortic valve stenosis, mitral prolapse, hypertension, hypercholesterolemia, diabetes and peripheral occlusive arterial disease. Anthropometric measurements and percent body fat were obtained. A predictive oxygen consumption bike ergometer test was performed to obtain aerobic capacity. The commonly utilized standard ankle/arm index ultrasound pneumatic cuff examination and arterial diastolic flow analysis were performed with A-mode Doppler ultrasound on all subjects. RESULTS: These results demonstrate that a significant inverse linear relationship exists between aging and arterial compliance (p < .0001) in our population. Diastolic flow analysis had a greater sensitivity to arterial disease than the standard ankle/arm index ultrasound pneumatic cuff procedure. CONCLUSION: When utilizing A-mode Doppler ultrasound diastolic flow analysis as an indicator of early peripheral atherosclerotic arterial disease, increased sensitivity may be obtained when the age-related elevation in atherogenesis is taken into account.

Terenzi T; Gallagher D; DeMeersman R; Beadle E; Muller D

1993-10-01

19

Prognostic value of left ventricular diastolic dysfunction in patients undergoing cardiac catheterization for coronary artery disease.  

UK PubMed Central (United Kingdom)

We hypothesized that left ventricular (LV) diastolic dysfunction assessed by cardiac catheterization may be associated with increased risk for cardiovascular events. To test the hypothesis, we assessed diastolic function by cardiac catheterization (relaxation time constant (Tau) and end-diastolic pressure (EDP)) as well as Doppler echocardiography (early diastolic mitral annular velocity (e') and a ratio of early diastolic mitral inflow to annular velocities (E/e')) in 222 consecutive patients undergoing cardiac catheterization for coronary artery disease (CAD). During a followup of 1364 ± 628 days, 5 cardiac deaths and 20 unscheduled cardiovascular hospitalizations were observed. Among LV diastolic function indices, Tau > 48?ms and e' < 5.8?cm/s were each significantly associated with lower rate of survival free of cardiovascular hospitalization. Even after adjustment for potential confounders (traditional cardiovascular risk factors, the severity of CAD, and cardiovascular medications), the predictive value of Tau > 48?ms and e' < 5.8?cm/s remained significant. No predictive value was observed in EDP, E/e', or LV ejection fraction. In conclusion, LV diastolic dysfunction, particularly impaired LV relaxation assessed by both cardiac catheterization and Doppler echocardiography, is independently associated with increased risk for cardiac death or cardiovascular hospitalization in patients with known or suspected CAD.

Fukuta H; Ohte N; Wakami K; Goto T; Tani T; Kimura G

2012-01-01

20

Central diastolic blood pressure is associated with the degree of coronary collateral development.  

Science.gov (United States)

Coronary collaterals (CCs) serve as alternative conduits for blood flow in obstructive coronary artery disease. We investigated the association of various components of blood pressure (BP) parameters with the the degree of coronary collateralization. Patients (n = 245) who underwent coronary angiography were included. Intraarterial BP in the ascending aorta was determined using a standard fluid-filled system. Readings of the conventional peripheral pressure were measured using a manual sphygmomanometer. All blood samples were drawn at admission, before coronary angiography. A total of 65 patients were found to have adequate CC development. Central diastolic BP and peripheral diastolic BP were found to be lower in the group with adequate CC. In multivariate logistic regression model, central diastolic BP and Gensini score were found to be independent predictors of adequate CC. In conclusion, low central diastolic BP in the case of severe coronary stenosis may be an important stimulus for adequate CC development. PMID:23267239

Ege, Meltem Refiker; Zorlu, Ali; Yilmaz, Mehmet Birhan; Acikgoz, Savas; Tandogan, Izzet; Cinar, Ziynet

2012-12-23

 
 
 
 
21

Carotid artery mixing with diastole-phased pulsed drug infusion  

Energy Technology Data Exchange (ETDEWEB)

Focal injury to the brain or retina is a frequent complication of drug delivery to the internal carotid artery (ICA) and may be due to poor mixing of the drug with blood at the infusion site. Rhesus monkeys were studied to determine whether phased drug delivery during diastole from a modified pulsatile angiographic injector would improve drug mixing in vivo. A radiolabeled flow tracer, carbon-14-iodoantipyrine (/sup 14/C-IAP), was injected into the ICA of three monkeys in 80-msec pulses, each ending at least 50 msec before the end of local diastole. Local isotope concentration in the brain was determined by quantitative autoradiography. The ratio of highest to lowest concentration was 1.86 +/- 0.26 (mean +/- standard deviation) in the frontoparietal cortex, 1.65 +/- 0.42 in the frontoparietal white matter, 1.89 +/- 0.28 in the temporal cortex, and 1.39 +/- 0.17 in the basal ganglia. These results were similar to recordings in three control animals that received intravenous /sup 14/C-IAP to demonstrate complete drug mixing (1.37 +/- 0.12, 1.41 +/- 0.11, 1.70 +/- 0.08, 1.22 +/- 0.24, respectively), and contrasted to findings in five animals which received continuous intracarotid infusions to demonstrate standard ICA drug delivery (4.54 +/- 2.07, 2.94 +/- 1.45, 5.43 +/- 3.57, 3.60 +/- 2.90, respectively). Pulsed intra-arterial infusion during diastole provides a technically simple method for improving intravascular drug mixing, and results in drug delivery to tissue capillaries that is proportional to blood flow.

Saris, S.C.; Shook, D.R.; Blasberg, R.G.; Dedrick, R.L.; Doppman, J.L.; Bankiewicz, K.S.; Blacklock, J.B.; Oldfield, E.H.

1987-11-01

22

Coronary flow reserve and the J curve relation between diastolic blood pressure and myocardial infarction.  

UK PubMed Central (United Kingdom)

The results of several large studies of hypertension and follow up studies on insured people have indicated that the lower the blood pressure the better for longevity. These studies excluded subjects with overt ischaemia. More recently long term studies of hypertension that included patients with more severe forms of hypertension and did not exclude those with overt ischaemia have shown a J shaped relation between diastolic blood pressure during treatment and myocardial infarction; the lowest point (the J point) was at a diastolic blood pressure (phase V) between 85 and 90 mm Hg. The J curve seems to be independent of treatment, pulse pressure, and the degree of fall in diastolic blood pressure and is unlikely to be caused by poor left ventricular function. The most probable explanation is that subjects who have severe stenosis of the coronary artery as well as hypertension have a poor coronary flow reserve, which makes the myocardium vulnerable to coronary perfusion pressures that are tolerated by patients without ischaemia, particularly at high heart rates. An optimal diastolic blood pressure (phase V) for such patients is about 85 mm Hg, though particular caution is appropriate when treating very old patients (84 and over) and patients aged 60-79 who have isolated systolic hypertension.

Cruickshank JM

1988-11-01

23

Distribution of mean, systolic and diastolic ocular perfusion pressure in telemedical homemonitoring of glaucoma patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: To analyze the relation and distribution of mean, systolic and diastolic ocular perfusion pressure (OPP) in telemedical homemonitoring of patients with primary open-angle glaucoma (POAG). METHODS: 70 patients with POAG measured intraocular pressure (IOP) and blood pressure at home for a period of 6 months with the Goldmann applanation self-tonometer Ocuton S and the blood pressure device boso medicus PC. Twenty-four-hour profiles were taken every 4 weeks in addition to single measurements in the morning and evening once a week. All measured values were transmitted to an electronic patient record, which calculated OPP by taking systolic, diastolic and mean arterial blood pressure and subtracting IOP. RESULTS: We analyzed 3,282 values of mean, systolic and diastolic OPP. The quantity of values below the risk levels of the Barbados Eye Studies was calculated. We found values lower than the risk levels for LE: 49 (1.5%)/RE: 60 (1.8%) systolic OPP, LE: 1,623 (49.5%)/RE: 1,761 (53.7%) diastolic OPP and LE: 687 (20.9%)/RE: 794 (24.2%) mean OPP. The individual average OPP levels of all 70 patients below the risk levels showed the following distribution: LE: 4 (5.7%)/RE: 6 (8.6%) systolic OPP, LE: 19 (27.1%)/RE: 20 (28.6%) diastolic OPP and LE: 10 (14.3%)/RE: 10 (14.3%) mean OPP. CONCLUSION: The individual distribution of different OPP values in POAG patients is not easy to interpret for clinical ophthalmologists. Precise practicable guidelines for clinical use still have to be determined.

Jürgens C; Grossjohann R; Tost F

2012-01-01

24

The relationship between diastolic pressure and coronary collateral circulation in patients with stable angina pectoris and chronic total occlusion.  

UK PubMed Central (United Kingdom)

BACKGROUND: The most important biomechanical source of activation of the coronary collateral circulation (CCC) is increased tangential fluid shear stress at the arterial endothelial surface. The coronary circulation is unique in that most coronary blood flow occurs in diastole. Consequently, the diastolic blood pressure (DBP) may influence the tangential fluid shear stress on the arterial endothelial surface in diastole, therebyaffecting development of the CCC. METHODS: To investigate this, we conducted a study of 222 patients with stable angina pectoris and chronic total occlusion of coronary arteries. All of the patients had no history of coronary artery interventional therapy, coronary artery bypass surgery, cardiomyopathy, or congenital heart disease. The extent of the collateral vasculature of the area perfused by the artery affected by chronic total occlusion was graded as poor or well-developed according to Rentrop's classification. RESULTS: Univariate analysis showed a significant difference between the study subgroup with poorly developed collaterals and that with well-developed collaterals in terms of high diastolic blood pressure (DBP) and mean DBP. Multivariate analysis revealed high DBP as the only independent positive predictor of a well-developed collateral circulation. CONCLUSIONS: High DBP is positively related to a well-developed CCC. Differences in development of the CCC may be one of the pathophysiologic mechanisms responsible for the J-curve phenomenon in the relationship between DBP and cardiovascular risk.

Shu W; jing J; Fu LC; Min JT; Bo YX; Ying Z; Dai CY

2013-05-01

25

IMPLANTABLE HEART STIMULATOR USING END-DIASTOLIC PRESSURE (EDP)  

UK PubMed Central (United Kingdom)

Implantable heart stimulator comprising a control unit including a memory, a sensing unit, a pulse stimulation unit adapted to generate stimulation pulses separated by a variable predetermined pacing interval (PI), and also a method in a heart stimulator. The heart stimulator is adapted to be connected to one or many heart electrode leads provided with stimulating and sensing electrodes in order to stimulate heart tissue by said stimulation pulses and sense electrical heart events. The heart stimulator comprises a control parameter measurement unit adapted to derive a control parameter value indicative of end- diastolic pressure (EDP). At specified intervals, the control unit is adapted to vary the predetermined pacing interval (PI) according to a predetermined pacing interval (PI) search session scheme, and that control parameter values are determined, by said control parameter measurement unit at the different pacing intervals tested during said PI search session, and in that determined control parameter values and corresponding pacing intervals are stored in said memory. The maximum control parameter value obtained during one PI search session is determined and the corresponding pacing interval, denoted PIopt, is identified and used when stimulating the heart resulting in a maximal end-diastolic pressure.

BLOMQVIST ANDREAS

26

Left ventricular diastolic hemodynamics in coronary artery disease assessed by ECG-gated cardiac pool scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

Using ECG-gated cardiac pool scintigraphy, left ventricular systolic and diastolic hemodynamics were assessed in 41 patients with coronary artery disease (CAD), 12 with dilated cardiomyopathy (DCM), and 12 normal subjects (N). Any of the systolic variables and some of the diastolic variables, such as peak filling rate (PFR) and one third filling fraction, did not differ between the CAD group having normal left ventricular ejection fraction (LVEF) and the N group. Regarding the other diastolic variables, including time to peak filling, one third mean filling rate, and PFR/peak ejection rate, there were significant differences between the two groups. This suggested the presence of left ventricular filling disturbance at early diastolic phase. There was no significant difference in the systolic and diastolic ability of the left ventricle as a whole between the CAD group having severely decreased LVEF and the DCM group. (Namekawa, K.).

Yamagata, Togo; Hashimoto, Masaki; Yokote, Yuji

1987-08-01

27

Change of blood pressure and systolic/diastolic hypertension in Nagasaki A-bomb survivors  

International Nuclear Information System (INIS)

[en] Changes in blood pressure and systolic/diastolic hypertension in Nagasaki A-bomb survivors were surveyed from 1973 to 1982. Systolic hypertension tended to decrease, while diastolic hypertension tended to increase in younger male survivors. The incidence of hypertension tended to decrease or be constant. According to the WHO classification of hypertension, the type of H, in which both diastolic and systolic blood pressures were high, and the type of SH, in which only systolic blood pressure was high, tended to decrease, while the type of DH, in which only diastolic blood pressure was high, tended to increase. (Namekawa, K.)

1984-01-01

28

Association of Increased Arterial Stiffness and P Wave Dispersion with Left Ventricular Diastolic Dysfunction  

Science.gov (United States)

Background: The association between increased arterial stiffness and left ventricular diastolic dysfunction (LVDD) may be influenced by left ventricular performance. P wave dispersion is not only a significant determinant of left ventricular performance, but is also correlated with LVDD. This study is designed to compare left ventricular diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV) and corrected P wave dispersion (PWDC) and assess whether the combination of baPWV and PWDC can predict LVDD more accurately. Methods: This cross-sectional study enrolled 270 patients and classified them into four groups according to the median values of baPWV and PWDC. LVDD was defined as impaired relaxation and pseudonormal/restrictive mitral inflow patterns. Results: The ratio of transmitral E wave velocity to early diastolic mitral annulus velocity (E/Ea) was higher in group with higher baPWV and PWDC than in the other groups (all p <0.001). The prevalence of LVDD was higher in group with higher baPWV and PWDC than in the two groups with lower baPWV (p ? 0.001). The baPWV and PWDC were correlated with E/Ea and LVDD in multivariate analysis (p ? 0.030). The addition of baPWV and PWDC to a clinical mode could significantly improve the R square in prediction of E/Ea and C statistic and integrated discrimination index in prediction of LVDD (p ? 0.010). Conclusions: This study showed increased baPWV and PWDC were correlated with high E/Ea and LVDD. The addition of baPWV and PWDC to a clinical model improved the prediction of high E/Ea and LVDD. Screening patients by means of baPWV and PWDC might help identify the high risk group of elevated left ventricular filling pressure and LVDD.

Tsai, Wei-Chung; Lee, Kun-Tai; Kuo, Hsuan-Fu; Tang, Wei-Hua; Jhuo, Shih-Jie; Chu, Chih-Sheng; Lin, Tsung-Hsien; Hsu, Po-Chao; Lin, Ming-Yen; Lin, Feng-Hsien; Su, Ho-Ming; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung

2013-01-01

29

Effect of intensive versus standard blood pressure lowering on diastolic function in patients with uncontrolled hypertension and diastolic dysfunction.  

UK PubMed Central (United Kingdom)

Diastolic dysfunction may precede development of heart failure in hypertensive patients. We randomized 228 patients with uncontrolled hypertension, preserved ejection fraction, and diastolic dysfunction to 2 targeted treatment strategies: intensive, with a systolic blood pressure target of <130 mm Hg, or standard, with a systolic blood pressure target of <140 mm Hg, using a combination of valsartan, either 160 or 320 mg, plus amlodipine, either 5 or 10 mg, with other antihypertensive medications as needed. Echocardiographic assessment of diastolic function was performed at baseline and after 24 weeks in a prospective, open-label, blinded end point design. Blood pressure was reduced significantly in both groups, from 161.2+/-13.9/90.1+/-12.0 to 130.8+/-12.3/74.9+/-9.1 mm Hg (P<0.0001) in the intensive arm and from 162.1+/-13.2/93.7+/-12.2 to 137.0+/-12.9/79.6+/-11.0 mm Hg (P<0.0001) in the standard arm (P<0.003 for between-group comparisons). Myocardial relaxation velocity improved from 7.6+/-1.1 to 9.2+/-1.7 cm/s (Delta 1.54+/-1.4 cm/s; P<0.0001) in the intensive arm and from 7.5+/-1.3 to 9.0+/-1.9 cm/s (Delta 1.48+/-1.6 cm/s; P<0.0001) in the standard arm, with no difference between the 2 strategies in the achieved improvement (P=0.58). The degree of improvement in annular relaxation velocity was associated with the extent of systolic blood pressure reduction, and patients with the lowest achieved systolic blood pressure had the highest final diastolic relaxation velocities.

Solomon SD; Verma A; Desai A; Hassanein A; Izzo J; Oparil S; Lacourciere Y; Lee J; Seifu Y; Hilkert RJ; Rocha R; Pitt B

2010-02-01

30

Definitions and characteristics of salt-sensitivity and resistance of blood pressure: should the diagnosis depend on diastolic blood pressure?  

Science.gov (United States)

To elucidate the importance of diastolic blood pressure in the definition of salt-sensitive hypertension, we studied 54 male subjects, 36 of whom had untreated, mild essential hypertension. The subjects received a 120 mmol/d Na (as the chloride salt) diet for six days. Thereafter they received a 10 mmol/d Na diet for eight days followed by a 400 mmol/d Na diet for another 8 days. Blood pressure was measured hourly "around the clock" on the last day of each diet; the averaged systolic, diastolic and mean blood pressure values were compared. In 22 subjects diastolic blood pressure increased, when salt intake was increased from 10 to 400 mmol/d. In 18 of these 22 subjects systolic blood pressure increased as well. In 20 subjects, systolic blood pressure increased with salt loading while diastolic blood pressure decreased. In 13 subjects both systolic and diastolic blood pressure decreased with increased salt intake. We defined those subjects showing an increase in diastolic blood pressure as salt-sensitive. If mean blood pressure were used to define salt-sensitivity, 8 of our subjects would have been labeled as salt-sensitive who actually decreased their diastolic blood pressure with salt loading. We suggest that consideration of systolic and diastolic blood pressure responses gives better insight into identifying volume and resistance-related phenomena in salt-sensitive hypertension, than does the consideration of mean blood pressure alone. The definition of salt-sensitivity may require reassessment. PMID:1424217

Wedler, B; Wiersbitzki, M; Gruska, S; Wolf, E; Luft, F C

1992-01-01

31

Blood pressure measurement by arterial tonometry in controlled hypotension.  

UK PubMed Central (United Kingdom)

A newly developed arterial tonometer enabled us to measure the blood pressure waveforms in addition to determining systolic and diastolic pressures noninvasively and continuously. Twenty-eight adult patients undergoing orthopedic surgery under controlled hypotension were studied. Systolic blood pressure was reduced to two-thirds of baseline values with an infusion of nitroglycerin during nitrous oxide/enflurane anesthesia. Intraarterial blood pressures were simultaneously measured in either the right or the left radial artery with a cannula and a Gould P23XL calibrated transducer; tonometric monitoring was performed on the contralateral radial artery using a Colin CBM-3000 instrument. The outputs of the two blood pressure measurement instruments were recorded for later data analysis. The shape of the tonometric pressure waveform was nearly identical to the waveform recorded intraarterially even during controlled hypotension. Regression analyses of 2039 paired tonometric and intraarterial blood pressure values during the hypotensive period showed good correlations (r = 0.78 for systolic, r = 0.81 for mean, and r = 0.70 for diastolic pressures). The accuracy of systolic, mean, and diastolic readings was from 4 to 7 mm Hg with negligible bias and did not differ significantly among six systolic, four mean, and four diastolic pressure groups. Our results indicate that arterial tonometry can provide accurate, reliable, and real-time monitoring of blood pressure even during controlled hypotension.

Kemmotsu O; Ueda M; Otsuka H; Yamamura T; Okamura A; Ishikawa T; Winter DC; Eckerle JS

1991-07-01

32

Nucleid-angiographic calculations of left ventricular end-diastolic pressure, pulmonary capillary pressure and diastolic pulmonary pressure  

International Nuclear Information System (INIS)

Proper use of cardiac nucleid-angiography provides parameters which are comparable to those obtained by invasive procedures. Although various methods have been devised for determining left ventricular ejection rate and the geometric analysis of the left ventricle by isotope techniques (Adam 2-5), Ashburn (6,7), Breuel (11,12), Strauss/Bill, Strauss/Pitt (65,66,67), only a few comparative intracavitary pressure measurements are available. Of these, the method developed by de Vernejoul (73 to 76) is of particular importance for measurements during the bolus phase because of the large number of cases studied by simultaneous catheterisation (670 patients). The value of de Vernejoul's formula was confirmed by a study of 350 of our own cases. The disadvantage of the method lies in its susceptibility to variations in the bolus front. We have therefore attempted for some time to obtain pressure measurements by a pooling procedure. (orig.)

1980-01-01

33

Impact of renal artery stenting on cytokine levels, left ventricle mass and diastolic function.  

UK PubMed Central (United Kingdom)

BACKGROUND: Significant renal artery stenosis (RAS) may lead to left ventricle (LV) hypertrophy and diastolic function (DF) impairment through complex mechanisms: activation of cytokines and/or systolic and diastolic blood pressure (SBP, DBP) increase. AIM: To assess interrelations between LV mass (LVM), DF and cytokines in patients undergoing renal artery stenting (PTA, percutaneous angioplasty of renal artery). METHODS: The study group comprised 72 subjects (44.4% men), 64.1 ± 9.9 years with RAS referred to PTA. SBP, DBP, transforming growth factor beta1 (TGF-?1), aldosterone, B-type natriuretic peptide (BNP) levels and change in LVM and LVM index (LVMI) and DF (E(vel), e'(vel), E/A ratio, E/e' ratio, Ar(time)-A(time)) on echocardiography were assessed preprocedurally, and three and 12 months postprocedurally. RESULTS: TGF-?1 level decreased from 13.3 ± 14.9 to 8.6 ± 8.0 ng/mL (p = 0.027), while BNP increased from 89.1 ± 86.3 to 131 ± 105 pmol/mL (p < 0.001). A significant reduction in LVMI in women (79.4 ± 16.9 vs. 95.7 ± 18.5 g/m², p < 0.001) and men (77.2 ± 16.8 vs. 100.1 ± 19.7 g/m², p < 0.001) was found at 12 months vs. baseline. Degree of LVM reduction correlated with baseline LVM (p < 0.001; r = -0.612) and e'(vel) (p = 0.05; r = 0.230), but not with BP values. Among DF parameters, only e'(vel) increased significantly at 12 months (5.54 ± 1.57 vs. 5.92 ± 1.65 cm/s; p = 0.039), while A/E and E/e' ratio, Ar(time)-A(time) remained similar (p = 0.457, p = 0.283 and p = 0.258). Factors associated with e'(vel) increase ? 0.3 cm/s at 12 months were baseline LVM < 165 g (p = 0.043, RR = 1.39, CI 1.01-1.46), E(vel) (p = 0.015, RR = 1.26, CI 1.15-1.52), e'(vel) (p < 0.001, RR = 1.42, CI 1.18-1.7), DBP decrease > 10 mm Hg (p = 0.055, RR = 1.2, CI 1.0-1.44) and TGF-?1 > 8 ng/mL (p = 0.024, RR = 1.24, CI 1.03-1.49) at 12 months. CONCLUSIONS: Significant LVMI reduction was observed after PTA of RAS, but it was independent of BP reduction. e'(vel) increase was independently associated with baseline LVM, E(vel), e'(vel), and 12 month decrease in DBP > 10 mm Hg.

Rze?nik D; Przew?ocki T; Kab?ak-Ziembicka A; Ras?awiecka A; Kozanecki A; ?ach J; Podolec P

2013-01-01

34

Diastolic chamber properties of the left ventricle assessed by global fitting of pressure-volume data: improving the gold standard of diastolic function.  

UK PubMed Central (United Kingdom)

In cardiovascular research, relaxation and stiffness are calculated from pressure-volume (PV) curves by separately fitting the data during the isovolumic and end-diastolic phases (end-diastolic PV relationship), respectively. This method is limited because it assumes uncoupled active and passive properties during these phases, it penalizes statistical power, and it cannot account for elastic restoring forces. We aimed to improve this analysis by implementing a method based on global optimization of all PV diastolic data. In 1,000 Monte Carlo experiments, the optimization algorithm recovered entered parameters of diastolic properties below and above the equilibrium volume (intraclass correlation coefficients = 0.99). Inotropic modulation experiments in 26 pigs modified passive pressure generated by restoring forces due to changes in the operative and/or equilibrium volumes. Volume overload and coronary microembolization caused incomplete relaxation at end diastole (active pressure > 0.5 mmHg), rendering the end-diastolic PV relationship method ill-posed. In 28 patients undergoing PV cardiac catheterization, the new algorithm reduced the confidence intervals of stiffness parameters by one-fifth. The Jacobian matrix allowed visualizing the contribution of each property to instantaneous diastolic pressure on a per-patient basis. The algorithm allowed estimating stiffness from single-beat PV data (derivative of left ventricular pressure with respect to volume at end-diastolic volume intraclass correlation coefficient = 0.65, error = 0.07 ± 0.24 mmHg/ml). Thus, in clinical and preclinical research, global optimization algorithms provide the most complete, accurate, and reproducible assessment of global left ventricular diastolic chamber properties from PV data. Using global optimization, we were able to fully uncouple relaxation and passive PV curves for the first time in the intact heart.

Bermejo J; Yotti R; Villar CP; Del Álamo JC; Rodríguez-Pérez D; Martínez-Legazpi P; Benito Y; Carlos Antoranz J; Mar Desco M; González-Mansilla A; Barrio A; Elízaga J; Fernández-Avilés F

2013-08-01

35

Diastolic chamber properties of the left ventricle assessed by global fitting of pressure-volume data: improving the gold standard of diastolic function.  

Science.gov (United States)

In cardiovascular research, relaxation and stiffness are calculated from pressure-volume (PV) curves by separately fitting the data during the isovolumic and end-diastolic phases (end-diastolic PV relationship), respectively. This method is limited because it assumes uncoupled active and passive properties during these phases, it penalizes statistical power, and it cannot account for elastic restoring forces. We aimed to improve this analysis by implementing a method based on global optimization of all PV diastolic data. In 1,000 Monte Carlo experiments, the optimization algorithm recovered entered parameters of diastolic properties below and above the equilibrium volume (intraclass correlation coefficients = 0.99). Inotropic modulation experiments in 26 pigs modified passive pressure generated by restoring forces due to changes in the operative and/or equilibrium volumes. Volume overload and coronary microembolization caused incomplete relaxation at end diastole (active pressure > 0.5 mmHg), rendering the end-diastolic PV relationship method ill-posed. In 28 patients undergoing PV cardiac catheterization, the new algorithm reduced the confidence intervals of stiffness parameters by one-fifth. The Jacobian matrix allowed visualizing the contribution of each property to instantaneous diastolic pressure on a per-patient basis. The algorithm allowed estimating stiffness from single-beat PV data (derivative of left ventricular pressure with respect to volume at end-diastolic volume intraclass correlation coefficient = 0.65, error = 0.07 ± 0.24 mmHg/ml). Thus, in clinical and preclinical research, global optimization algorithms provide the most complete, accurate, and reproducible assessment of global left ventricular diastolic chamber properties from PV data. Using global optimization, we were able to fully uncouple relaxation and passive PV curves for the first time in the intact heart. PMID:23743396

Bermejo, Javier; Yotti, Raquel; Villar, Candelas Pérez Del; Del Álamo, Juan C; Rodríguez-Pérez, Daniel; Martínez-Legazpi, Pablo; Benito, Yolanda; Carlos Antoranz, J; Mar Desco, M; González-Mansilla, Ana; Barrio, Alicia; Elízaga, Jaime; Fernández-Avilés, Francisco

2013-06-06

36

[Correlation between left ventricular diastolic function and plasma natriuretic peptide level in children with pulmonary artery hypertension secondary to congenital heart disease].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study the plasma natriuretic peptide (BNP) level in children with pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD) and its correlation with left ventricular diastolic function. METHODS: Doppler echocardiography was performed on 95 CHD children with PAH (PAH group) and on 42 CHD without PAH (control group). The plasma BNP level was measured using radioimmunity assay. RESULTS: Doppler echocardiography showed that the left ventricular end-diastolic diameter (LVDd), the right ventricular diameter end-diastolic (RVDd), and the pulmonary artery diameter (PAd) increased significantly in the PAH group compared with those in the control group (p<0.05). The PAH group had higher velocity of tricuspid regurgitation (VTR) and higher pulmonary artery systolic pressure (PASP) than the control group (p<0.05). The PAH group also had higher mitral A peak velocity (AV), higher mitral A peak velocity integral (AVI), higher E peak velocity intgral (EVI), and higher ratio of mitral AV to mitral E peak velocity (EV) and AVI/EVI ratio as well as prolonged left ventricular volumetric relaxation time than the control group. PASP was positively correlated with the AV/EV ratio (p<0.05). The plasma BNP level in the PAH group increased significantly compared with that in the control group. In the PAH group, the plasma BNP level was positively correlated with the pulmonary artery pressure and the ratio of AV/EV. CONCLUSIONS: The left ventricular diastolic function is positively correlated with the plasma BNP level in children with PAH secondary to CHD. BNP may play an important role in the generation and development of left ventricular diastolic dysfunction induced by PAH.

Cui H; Hu YX; Feng ZC

2010-01-01

37

Differences in circadian time structure of diastolic blood pressure between diabetes mellitus and essential hypertension  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Abnormal circadian blood pressure patterns have been associated with cardiovascular disease in diabetes mellitus. We have described that the acrophase of diastolic blood pressure (DBP) registered in type 1 diabetes (T1D) patients was significantly earlier than no...

Matteucci Elena; Della Bartola Luca; Giampietro Ottavio

38

Right and left ventricular diastolic pressure-volume relations: a comprehensive review.  

UK PubMed Central (United Kingdom)

Ventricular compliance alterations can affect cardiac performance and adaptations. Moreover, diastolic mechanics are important in assessing both diastolic and systolic function, since any filling impairment can compromise systolic function. A sigmoidal passive filling pressure-volume relationship, developed using chronically instrumented, awake-animal disease models, is clinically adaptable to evaluating diastolic dynamics using subject-specific micromanometric and volumetric data from the entire filling period of any heartbeat(s). This innovative relationship is the global, integrated expression of chamber geometry, wall thickness, and passive myocardial wall properties. Chamber and myocardial compliance curves of both ventricles can be computed by the sigmoidal methodology over the entire filling period and plotted over appropriate filling pressure ranges. Important characteristics of the compliance curves can be examined and compared between the right and the left ventricle and for different physiological and pathological conditions. The sigmoidal paradigm is more accurate and, therefore, a better alternative to the conventional exponential pressure-volume approximation.

Pasipoularides A

2013-04-01

39

Clinical evaluation of early diastolic function with radionuclide ventriculography in patient with coronary artery disease  

International Nuclear Information System (INIS)

In 23 normal subjects, 37 CAD-NMI and 14 CAD-MI, left ventricular function was assessed using an automatic method from equilibrium radionuclide ventriculography. Early diastolic function was measured for evaluating its clinical value in coronary artery diseases. The results showed that PFR was more sensitive than the others for detecting ischaemic heart disease. There were significant difference on PFR between normal subjects and CAD-NMI group (p TPER(17/37, pEF(16/37, p>0.05). There were also significant difference in PFR, PER and EF between CAD-NMI and CAD-MI (p0.05)

1993-01-01

40

Triggered non-contrast enhanced MR angiography of peripheral arteries: Optimization of systolic and diastolic time delays for electrocardiographic triggering  

International Nuclear Information System (INIS)

[en] The purpose of this study was to determine the optimal systolic and diastolic time delays for electrocardiographic triggering of a non-contrast media enhanced MR angiography using a 3-dimensional fast spin echo sequence in patients suffering from peripheral arterial disease. 12 patients with suspected peripheral arterial disease were examined on a 1.5 T Philips Achieva MR scanner. A cardiac-triggered Volumetric Isotropic T2-weighted fast spin echo sequence was performed using variable trigger delays for systolic and diastolic phase. The signal in the popliteal arteries and anterior tibial arteries of the systolic and diastolic images was measured and optimal delay times for systolic and diastolic phase were determined. Minimum signal to noise ratio (SNR) appears at the time difference ?T = -21 ms on systolic images of the popliteal arteries. In the anterior tibial arteries the minimum SNR is significantly higher and appears at the time difference ?T = -14 ms. Diastolic delay times must be chosen as long or as short as possible depending on heart rate. In peripheral vessels triggered non-contrast MR angiography can yield results which are comparable with contrast enhanced MRA techniques. It is crucial to optimize timing parameters.

2011-01-01

 
 
 
 
41

[Relationship between myocardial systolic, diastolic functions and perfusion in coronary artery stenosis].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the relationship between myocardial systolic, diastolic functions and perfusion in coronary artery stenosis using velocity vector imaging (VVI) and myocardial contrast echocardiography (MCE). METHOS: Stenoses in the anterior descending branch of the coronary artery were induced in 8 dogs. Before and after coronary artery stenosis, two-dimensional images of the left ventricular mastoid muscle section on the short axis at rest and in the peak dose of dobutamine were obtained for evaluation of VVI and MCE. The myocardial blood flow A.beta values, peak systolic strain rate (SRsys) and peak diastolic strain rate (SRdia) in the direction of the circumference of the short axis were measured. RESULTS: At rest, only severe coronary stenosis resulted in significantly lowered SRsys, SRdia and A.beta value of the stenotic bed compared to the values before the stenosis (-1.1-/+0.50 vs -1.62-/+0.50, 1.19-/+0.48 vs 1.75-/+0.51, 0.4-/+0.21 vs 0.80-/+0.47, P<0.05). In stress, SRsys, SRdia and A.beta value of the stenotic bed gradually decreased as coronary stenosis worsened (-4.31-/+1.14 vs -3.20-/+0.98 vs -1.18-/+0.64, 4.51-/+1.13 vs 3.39-/+0.98 vs 1.37-/+0.64. 3.54-/+1.95 vs 1.81-/+0.89 vs 0.82-/+0.42, P<0.05). Both at rest and in stress, good correlations were noted between SRsys and SRdia (r(rest)=0.88, r(stress)=0.96, P<0.01), between SRsys and the standard A.beta values (r(rest)0.56, r(stress)=0.71, P<0.01), and between SRdia and A.beta (r(rest)=0.57, r(stress)=0.72, P<0.01) in the direction of the circumference of the short axis. CONCLUSIONS: Using VVI and MCE, the changes in myocardial perfusion and the systolic and diastolic functions in the direction of the circumference can be observed dynamically. VVI may help assess the condition of myocardial perfusion by evaluating the systolic and diastolic function.

Liu J; Chen DD; Teng ZH; Bin JG; Li MY; Wu PS; Bin JP

2009-09-01

42

Reduction in diastolic blood pressure and cardiovascular mortality in nondiabetic hypertensive patients. A reanalysis of the HOT study  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To use published Hypertension Optimal Treatment (HOT) Study data to evaluate changes in cardiovascular mortality in nondiabetic hypertensive patients according to the degree of reduction in their diastolic blood pressure. METHODS: In the HOT Study, 18,700 patients from various centers were allocated at random to groups having different objectives of for diastolic blood pressure: <=90 (n=6264); <=85 (n=6264); <=80mmHg (n=6262). Felodipine was the basic drug used. Other antihypertensive drugs were administered in a sequential manner, aiming at the objectives of diastolic blood pressure reduction. RESULTS: The group of nondiabetic hypertensive subjects with diastolic pressure<=80mmHg had a cardiovascular mortality ratio of 4.1/1000 patients/year, 35.5% higher than the group with diastolic pressure <=90mmHg (cardiovascular mortality ratio, 3.1/1000 patients/year). In contrast, diabetic patients allocated to the diastolic pressure objective group of <=80mmHg had a 66.7% reduction in cardiovascular mortality (3.7/1000 patients/year) when compared with the diastolic pressure group of <=90mmHg (cardiovascular mortality ratio, 11.1/1000 patients/year). CONCLUSION: The results indicate that in hypertensive diabetic patients reduction in diastolic blood pressure to levels <=80mmHg decreases the risk of fatal cardiovascular events. It remains necessary to define the level of diastolic blood pressure <=90mmHg at which maximal reduction in cardiovascular mortality is obtained for nondiabetics.

Lopes Antonio Alberto; Andrade Jadelson; Noblat Antonio Carlos Beisl; Silveira Marco Antonio

2001-01-01

43

Effect of absent end diastolic flow velocity in the fetal umbilical artery on subsequent outcome.  

UK PubMed Central (United Kingdom)

Sixty babies, delivered over a six and a half year period, who had absent end diastolic frequency (AEDF) in the umbilical artery, were studied. Individually matched control pregnancies for gestational age, birth-weight, maternal clinical condition and date of delivery, in whom umbilical artery recordings showed end diastolic frequency, were also studied. Matching was achieved in 36 cases. Neonates from case pregnancies showed no increase in necrotising enterocolitis, intraventricular haemorrhage, pneumothorax, neonatal death or bronchopulmonary dysplasia. However, they were significantly less likely to require ventilation for respiratory distress syndrome (P = 0.02). Although AEDF indicates a fetus under vascular stress, this finding alone will include a spectrum of response in the baby, from the well compensated to the irreversibly damaged. Delivery at different points in the deteriorating fetal environment may explain discrepant study results. This intrauterine stress, by increasing fetal corticosteroid and thyroid hormones, may account for enhanced lung maturity. Predictions of neonatal course need to be based on more comprehensive awareness of fetal status.

Adiotomre PN; Johnstone FD; Laing IA

1997-01-01

44

Elevated Right Ventricular End-Diastolic Pressure by Doppler Echocardiography-A Case Report.  

UK PubMed Central (United Kingdom)

Careful analysis of the right-sided Doppler signals provides important data regarding right heart hemodynamics. Here, we illustrate the value of the combined analysis of flow across the hepatic vein, tricuspid valve, and pulmonary valve for the diagnosis of elevated right ventricular end-diastolic pressure.

Fadel BM; Al-Mulla K; Al-Mahdi B; Di Salvo G

2013-09-01

45

EFFECT OF GENDER DIFFERENCE AND CIRCADIAN RHYTHM ON DIASTOLIC BLOOD PRESSURE FOR VOLLEYBALL PLAYERS  

Directory of Open Access Journals (Sweden)

Full Text Available The purpose of the study was to find out the effect of gender difference and circadian rhythm on diastolic blood pressure for volleyball players. METHODS: To achieve the purpose, a total of thirty volleyball players [men (n = 15) and women (n = 15)] age between 19 years and 22 years from Einstein College of Engineering, Tamil Nadu, India were selected as subjects. The two independent variables of gender and circadian variations and dependent variable of diastolic blood pressure were selected for this study. The experimental design used was static group factorial design. The data were collected at 02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours on diastolic blood pressure by using Erkameter during the academic year of 2009 – 2010. Collected data were subjected to statistical analysis by using two-way factorial (2 x 6) Analysis of Variance (ANOVA) and Cosinor analysis. RESULTS: There was insignificant difference between genders, significant difference at different times of the day and insignificant circadian rhythmicity exists on diastolic blood pressure for women and significant for men. CONCLUSION: It is recommended to the physical educators to adopt the findings of this study while planning to improve sports skills for the players and athletes.

I. Rajagopal

2011-01-01

46

Association of candidate gene polymorphisms with diastolic blood pressure change in patients treated with duloxetine.  

UK PubMed Central (United Kingdom)

Single nucleotide polymorphisms in six genes were investigated for an association between diastolic blood pressure change and duloxetine treatment. Nominally significant within-gene association was found with SLC6A2 rs4436775 and rs4564560 and HTR2A rs6313, but after adjusting for multiple comparisons, these associations were no longer significant.

Fijal BA; Kohler J; Ostbye K; Ahl J; Houston JP

2013-04-01

47

Estimating mean arterial pressure during invasive monitoring using manometer  

Directory of Open Access Journals (Sweden)

Full Text Available "nBackground: Direct monitoring of arterial pressure using a transducer system is not affordable in most operating rooms and ICU wards in Iran. It is, however, possible to use an aneroid manometer instead, but it is not standardized yet, nor studied enough; and its measurements may not be interpretable. "nMethods: To study the correlation of the arterial pressure readings between a manometer and a transducer system, systolic and diastolic arterial pressure was measured 105 times using both systems via arterial cannulation in seven patients during surgery. Mean arterial pressure was directly recorded in the transducer system, while it was calculated in the manometer system. In the manometer system, the extension tube was filled with saline halfway from the patient and the other empty end was connected to a manometer. The transducer and the air-fluid interface in the extension tube were positioned at same level. Correlation of the arterial pressures between the systems was tested using linear regression and Pearson correlation. "nResults: Mean arterial pressure differed by 2 (1-3) mmHg [mean (CI 95%)] between the systems, however, pulse pressure was lower in the manometer system by 37 (33-41) mmHg. The mean arterial pressure in the transducer system (MAPT) correlated well and linearly with the systolic arterial pressure in the manometer system (SAPM) by R=0.966. Therefore, MAPT can be regarded as a function of SAPM through the following formula: MAPT = (1.03 ´ SAPM) - 7.34. "nConclusion: The mean arterial pressure in the transducer system can be reliably estimated by monitoring the systolic arterial pressure in the manometer system.

Gholam Alemohammad M; Rahimi E

2009-01-01

48

Aggravation of left ventricular diastolic dysfunction in hypertensives with coronary artery disease.  

UK PubMed Central (United Kingdom)

We investigated the combined effects of hypertension and coronary artery disease (CAD) on left ventricular (LV) diastolic function. We examined 118 consecutive hypertensives who underwent diagnostic coronary angiography. All patients underwent a complete echocardiographic study within 24?h of catheterization by operators blind to their condition. The study participants were divided into two groups according to the presence of CAD: group A, with the disease (n=72); and group B, without (n=46). Patients with CAD exhibited lower LV fractional shortening and ejection fraction (P=0.002 and P=0.001). Hypertensives with CAD had significantly prolonged isovolumic relaxation time (IVRT) compared to those without CAD (P<0.001). Most interestingly, CAD patients had significantly worse Ema/Ama, Vp (flow propagation velocity), E/Vp and Vp/IVRT (all P<0.05). In addition, after adjusting for confounders, univariate and multivariate logistic regression analyses revealed that IVRT increases were associated with greater odds of CAD, whereas decreases in Vp or Vp/IVRT were associated with lower odds of CAD (all P?0.001). In hypertensives, the early recognition of LV diastolic performance alteration may be associated with the presence of significant CAD, indicating the need for more aggressive approaches both in terms of pharmacological treatment and interventional evaluation.Hypertension Research advance online publication, 11 July 2013; doi:10.1038/hr.2013.67.

Vlasseros I; Katsi V; Vyssoulis G; Ioannis P; Richter D; Gialernios T; Souretis G; Tousoulis D; Stefanadis C; Kallikazaros I

2013-07-01

49

Elevated diastolic blood pressure in insulin-resistant polycystic ovarian syndrome patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The purpose of this study was to further understand interrelationships between insulin resistance in PCOS and elevated diastolic blood pressure. DESIGN: A prospective case control study. PARTICIPANTS: Fifty normal women and 43 PCOS patients, 16 of them with insulin resistance. SETTING: Academic Institution. INTERVENTIONS: Clinical, anthropometric and ultrasonographic features of PCOS were assessed, as were blood levels for luteinizing hormone, follicle-stimulating hormone, androstenedione, DHEAS, and basal insulin. A lipid profile and an oral glucose tolerance test (OGTT) were also performed. MAIN OUTCOME MEASURES: To demonstrate the effect of insulin resistance on blood pressure in patients with PCOS. RESULTS: Patients with PCOS and those with PCOS plus insulin resistance (IR) had significantly elevated levels of plasma androgen but only those with IR showed greater body mass index and waist: hip ratios than PCOS or control. PCOS plus IR differed significantly in their response to OGTT when compared to PCOS or control. Alterations in lipid profile were shown to be atherogenic. Patients with PCOS plus IR demonstrated a significant elevation of diastolic blood pressure when compared to PCOS alone or controls. CONCLUSIONS: We hypothesize that hyperlipidemia and IR may be involved in the pathophysiologic features of the elevated diastolic blood pressure in PCOS patients.

da Silva AM; de Andrade AC; Dias BH; da Silva Medeiros MA; Rao VS; das Chagas Medeiros F

2013-07-01

50

Comparison of diastolic blood pressure changes with dobutamine and exercise test.  

UK PubMed Central (United Kingdom)

A total of 80 patients (44 with stable angina and 36 during coronary angioplasty follow-up) underwent both exercise and dobutamine stress testing within one week. Dobutamine was infused in doses of 5 micrograms.kg-1.min-1, up to 70 every 5 min with blood pressure and electrocardiographic control. Treadmill exercise testing was performed with a maximal, symptom-limited Bruce protocol. Both systolic blood pressure and heart rate increased significantly with dobutamine and exercise, but the increase was higher with exercise (P = 0.00001). Mean blood pressure increased only with exercise, while diastolic blood pressure increased with exercise and decreased with dobutamine (P = 0.00001). A test was positive when either typical angina or an ST segment shift greater than or equal to 1 mm 80 ms after the J point was present. There were 28 positive tests with exercise and 38 with dobutamine, 22 of them coinciding. In 36 patients both tests were negative. The concordance between both tests was 73%. When each test was related to coronary angiography, dobutamine showed greater sensitivity and efficacy than exercise. Conclusions: a dobutamine stress test induces a positive response in more patients than does an exercise stress test, although the increase in systolic blood pressure and heart rate is greater with exercise. The decrease in diastolic blood pressure with dobutamine probably plays a role in the positive response.

Coma-Canella I; Ortuño F

1992-09-01

51

Rats with high left ventricular end-diastolic pressure can be identified by Doppler echocardiography one week after myocardial infarction  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english The severity of left ventricular (LV) dysfunction in rats with myocardial infarction (MI) varies widely. Because homogeneity in baseline parameters is essential for experimental investigations, a study was conducted to establish whether Doppler echocardiography (DE) could accurately identify animals with high LV end-diastolic pressure as a marker of LV dysfunction soon after MI. Direct measurements of LV end-diastolic pressure were made and DE was performed simultaneously (more) 1 week after surgically induced MI (N = 16) or sham-operation (N = 17) in female Wistar rats (200 to 250 g). The ratio of peak early (E) to late (A) diastolic LV filling velocities and the ratio of E velocity to peak early (Em) diastolic myocardial velocity were the best predictors of high LV end-diastolic pressure (>12 mmHg) soon after MI. Cut-off values of 1.77 for the E/A ratio (P = 0.001) identified rats with elevated LV end-diastolic pressure with 90% sensitivity and 80% specificity. Cut-off values of 20.4 for the E/Em ratio (P = 0.0001) identified rats with elevated LV end-diastolic pressure with 81.8% sensitivity and 80% specificity. Moreover, E/A and E/Em ratios were the only echocardiographic parameters independently associated with LV end-diastolic pressure in multiple linear regression analysis. Therefore, DE identifies rats with high LV end-diastolic pressure soon after MI. These findings have implications for using serial DE in animal selection and in the assessment of their response to experimental therapies.

Saraiva, R.M.; Kanashiro-Takeuchi, R.M.; Antonio, E.L.; Campos, O.; Tucci, P.J.F.; Moisés, V.A.

2007-11-01

52

[Measuring arterial pressure  

UK PubMed Central (United Kingdom)

Measuring the blood pressure is the basis of diagnosis and management of hypertension. The blood pressure is a variable, the single value of which cannot be considered to be representative of a given person. Therefore, different methods of measurement have been developed to take this variability into account or to limit its repercussions. Of these methods, the authors describe clinical measurement, self measurement and ambulatory blood pressure recording with their advantages and disadvantages, their indications and limitations. The type of information obtained by each method is different: the methods are not competitive but complementary. Clinical measurement is the reference but it has its limitations and causes of error which pose problems of its validity for assessing mean blood pressure in some patients. Traditional self measurement and ambulatory blood pressure recording seem to provide a more accurate evaluation of the blood pressure and are more closely correlated with target organ damage and cardiovascular morbidity and mortality. However, it remains to be determined if the use of these methods in the assessment of cardiovascular risk and management of hypertensive patients improve the long-term cardiovascular prognosis.

Asmar R

2000-11-01

53

Effects of Allium sativum (Garlic) on systolic and diastolic blood pressure in patients with essential hypertension.  

Science.gov (United States)

The present study evaluated the effects of garlic on blood pressure in patients with essential hypertension. Patients (n=210) with stage 1 essential hypertension were divided into 7 groups named as A, B, C, D, E, F and G. Each group comprised of 30 patients. Each patient in group A, B, C, D and E has received garlic tablets at the dose of 300/mg. 600/mg, 900/mg, 1200/mg and 1500/mg in divided doses per day respectively for 24 weeks while Group F & group G were given tablet atenolol and placebo respectively. Blood pressure readings were recorded at weeks 0, 12 and 24. Present study showed significant decrease in both Systolic and Diastolic blood pressure in both dose and duration dependent manner. In each garlic treated group, significant reduction in SBP and DBP (p<0.005) were observed when compared with atenolol (P<0.005) and placebo. PMID:24035939

Ashraf, Rizwan; Khan, Rafeeq Alam; Ashraf, Imran; Qureshi, Absar A

2013-09-01

54

Effects of Allium sativum (Garlic) on systolic and diastolic blood pressure in patients with essential hypertension.  

UK PubMed Central (United Kingdom)

The present study evaluated the effects of garlic on blood pressure in patients with essential hypertension. Patients (n=210) with stage 1 essential hypertension were divided into 7 groups named as A, B, C, D, E, F and G. Each group comprised of 30 patients. Each patient in group A, B, C, D and E has received garlic tablets at the dose of 300/mg. 600/mg, 900/mg, 1200/mg and 1500/mg in divided doses per day respectively for 24 weeks while Group F & group G were given tablet atenolol and placebo respectively. Blood pressure readings were recorded at weeks 0, 12 and 24. Present study showed significant decrease in both Systolic and Diastolic blood pressure in both dose and duration dependent manner. In each garlic treated group, significant reduction in SBP and DBP (p<0.005) were observed when compared with atenolol (P<0.005) and placebo.

Ashraf R; Khan RA; Ashraf I; Qureshi AA

2013-09-01

55

Evaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome.  

UK PubMed Central (United Kingdom)

PURPOSE: We compared blood pressure (BP) measurements obtained using radial artery applanation tonometry with invasive BP measurements using a catheter placed in the abdominal aorta through the femoral artery in patients with multiple organ dysfunction syndrome (MODS). MATERIALS AND METHODS: In 23 intensive care unit patients with MODS, we simultaneously assessed BP values for 15 minutes per patient using radial artery applanation tonometry (T-Line TL-200pro device; Tensys Medical Inc, San Diego, Calif) and the arterial catheter (standard-criterion technique). A total of 2879 averaged 10-beat epochs were compared using Bland-Altman plots. RESULTS: The mean difference ± SD (with corresponding 95% limits of agreement) between radial artery applanation tonometry-derived BP and invasively assessed BP was +1.0 ± 5.5 mm Hg (-9.9 to +11.8 mm Hg) for mean arterial pressure, -3.3 ± 11.2 mm Hg (-25.3 to +18.6 mm Hg) for systolic arterial pressure, and +4.9 ± 7.0 mm Hg (-8.8 to +18.6 mm Hg) for diastolic arterial pressure, respectively. CONCLUSIONS: In intensive care unit patients with MODS, mean arterial pressure and diastolic arterial pressure can be determined accurately and precisely using radial artery applanation tonometry compared with central aortic values obtained using a catheter placed in the abdominal aorta through the femoral artery. Although systolic arterial pressure could also be derived accurately, wider 95% limits of agreement suggest lower precision for determination of systolic arterial pressure.

Meidert AS; Huber W; Hapfelmeier A; Schöfthaler M; Müller JN; Langwieser N; Wagner JY; Schmid RM; Saugel B

2013-08-01

56

Relationship of urocortin-2 with systolic and diastolic functions and coronary artery disease: an observational study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The urocortin (Ucn) hormones have many important roles in the cardiovascular system. Apart from systolic dysfunction (SD), there is no sufficient data on the relationship between serum Ucn-2 and diastolic dysfunction (DD), or coronary artery disease (CAD). We investigated serum Ucn-2 levels in SD, DD, and CAD. METHODS: In this observational cross-sectional study, study population was enrolled among outpatients who underwent coronary angiography with the pre-diagnosis of CAD. By examining the echocardiography 86 subjects were selected to study after coronary angiography. The subjects distributed over three groups to investigate the relationship between serum Ucn-2 and SD according to their ejection fraction (EF): subjects with moderate to severe SD (Group A, EF=33.6%), subjects with mild to moderate SD (Group B, EF=46.1%), and those without SD (Group C, EF=64.5%). Apart from these groups, the serum Ucn-2 levels were compared between subjects with and without DD (EF?45%), and also compared between subjects with and without CAD (EF?55%). Statistical analyses were performed using one-way ANOVA, Kruskal-Wallis, Chi-square, Mann-Whitney U, Spearman correlation and multiple regression analyses tests. RESULTS: Serum Ucn-2 levels were decreased in Group A and were increased in Group B compared to Group C (9.4±3.4, 12.8±3.6 vs. 10.4±3.9 pg/mL, respectively, p=0.003). Unlike SD; there was no significant difference in serum Ucn-2 levels between subjects with and without DD (11.4±4.1 vs 11.7±3.9 pg/mL, p=0.8) or CAD (10.7±4.7 vs 10.2±3.2 pg/mL, p=0.7). CONCLUSION: Ucn-2 is elevated in mild to moderate SD. But, DD (impaired relaxation pattern), or CAD (without myocardial infarction) seems to have no effect on Ucn-2 hormone levels.

Topal E; Ya?mur J; Otlu B; Ata? H; Cansel M; Aç?kgöz N; Ermi? N

2012-03-01

57

Accuracy of some algorithms to determine the oscillometric mean arterial pressure: a theoretical study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare different algorithms to determine the oscillometric mean arterial pressure. METHODS: Using a computer-based model, the accuracy of five algorithms was studied: maximum amplitude algorithm, 33 and 40% formulas calculating the mean arterial pressure from oscillometrically measured systolic and diastolic pressures, and two oscillation shape-based algorithms. We examined to which extent the tested algorithms were influenced by variations in four affective factors: pulse pressure, arterial pressure pulse shape index, and two shape indices (symmetry and steepness) of the artery-cuff pressure/volume relationship. Different ranges of variation of affecting factors were applied. RESULTS: The accuracy of the oscillation shape-based algorithms was found to be higher than the accuracy of the oscillation amplitude-based algorithms. The oscillation mean shape index-based determination had an almost 2-3 times narrower error range compared with the maximum amplitude algorithm. Modeling showed that the mean arterial pressure changes resulting from the varying shape of the arterial pressure waveform cannot be measured using the oscillation amplitude-based algorithms, whereas these changes can be determined effectively using the oscillation shape-based algorithms. CONCLUSION: The maximum amplitude algorithm has a relatively low accuracy for the estimation of the mean arterial pressure. Its error range is even larger than that of estimates calculated by the 33 or 40% formulas from the oscillometrically measured systolic and diastolic blood pressures. A considerably higher accuracy can be achieved by applying the oscillation shape-based algorithms.

Raamat R; Talts J; Jagomägi K; Kivastik J

2013-02-01

58

Blood pressure evaluation using sphygmomanometry assisted by arterial pulse waveform detection by fiber Bragg grating pulse device.  

UK PubMed Central (United Kingdom)

We report a blood pressure evaluation methodology by recording the radial arterial pulse waveform in real time using a fiber Bragg grating pulse device (FBGPD). Here, the pressure responses of the arterial pulse in the form of beat-to-beat pulse amplitude and arterial diametrical variations are monitored. Particularly, the unique signatures of pulse pressure variations have been recorded in the arterial pulse waveform, which indicate the systolic and diastolic blood pressure while the patient is subjected to the sphygmomanometric blood pressure examination. The proposed method of blood pressure evaluation using FBGPD has been validated with the auscultatory method of detecting the acoustic pulses (Korotkoff sounds) by an electronic stethoscope.

Sharath U; Sukreet R; Apoorva G; Asokan S

2013-06-01

59

Collagen network remodelling and diastolic stiffness of the rat left ventricle with pressure overload hypertrophy.  

Science.gov (United States)

This study had two objectives: (a) to determine the accumulation of collagen and its structural remodelling in the hypertrophied rat left ventricle after 4 and 8 weeks of abdominal aorta banding; and (b) to correlate these findings with the diastolic stress-strain relation of the intact myocardium. In comparison to age and sex matched controls, the collagen volume fraction of the hypertrophied myocardium after 4 and 8 weeks of aortic banding increased significantly from 3.5(SD1.0)% to 7.8(4.2)% and 6.2(2.0)% respectively. This accumulation of collagen, or fibrosis, occurred in the absence of myocyte necrosis. Scanning electron microscopy showed increased density and thickness of the collagen weave and tendons. At 4 weeks, light microscopy showed interstitial oedema and disrupted collagen fibrils. Left ventricular diastolic stress-strain relations of both pressure overload groups were significantly steeper than that of the control group. Thus the response of the interstitium to the hypertrophic process that accompanies abdominal aorta banding is a complex process that includes a structural remodelling of the fibrillar collagen matrix and the early appearance of interstitial oedema, each of which may contribute to a rise in the passive stiffness of the intact myocardium. PMID:2978464

Doering, C W; Jalil, J E; Janicki, J S; Pick, R; Aghili, S; Abrahams, C; Weber, K T

1988-10-01

60

Collagen network remodelling and diastolic stiffness of the rat left ventricle with pressure overload hypertrophy.  

UK PubMed Central (United Kingdom)

This study had two objectives: (a) to determine the accumulation of collagen and its structural remodelling in the hypertrophied rat left ventricle after 4 and 8 weeks of abdominal aorta banding; and (b) to correlate these findings with the diastolic stress-strain relation of the intact myocardium. In comparison to age and sex matched controls, the collagen volume fraction of the hypertrophied myocardium after 4 and 8 weeks of aortic banding increased significantly from 3.5(SD1.0)% to 7.8(4.2)% and 6.2(2.0)% respectively. This accumulation of collagen, or fibrosis, occurred in the absence of myocyte necrosis. Scanning electron microscopy showed increased density and thickness of the collagen weave and tendons. At 4 weeks, light microscopy showed interstitial oedema and disrupted collagen fibrils. Left ventricular diastolic stress-strain relations of both pressure overload groups were significantly steeper than that of the control group. Thus the response of the interstitium to the hypertrophic process that accompanies abdominal aorta banding is a complex process that includes a structural remodelling of the fibrillar collagen matrix and the early appearance of interstitial oedema, each of which may contribute to a rise in the passive stiffness of the intact myocardium.

Doering CW; Jalil JE; Janicki JS; Pick R; Aghili S; Abrahams C; Weber KT

1988-10-01

 
 
 
 
61

Relationship of urocortin-2 with systolic and diastolic functions and coronary artery disease: an observational study  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: The urocortin (Ucn) hormones have many important roles in the cardiovascular system. Apart from systolic dysfunction (SD), there is no sufficient data on the relationship between serum Ucn-2 and diastolic dysfunction (DD), or coronary artery disease (CAD). We investigated serum Ucn-2 levels in SD, DD, and CAD.Methods: In this observational cross-sectional study, study population was enrolled among outpatients who underwent coronary angiography with the pre-diagnosis of CAD. By examining the echocardiography 86 subjects were selected to study after coronary angiography. The subjects distributed over three groups to investigate the relationship between serum Ucn-2 and SD according to their ejection fraction (EF): subjects with moderate to severe SD (Group A, EF=33.6%), subjects with mild to moderate SD (Group B, EF=46.1%), and those without SD (Group C, EF=64.5%). Apart from these groups, the serum Ucn-2 levels were compared between subjects with and without DD (EF?45%), and also compared between subjects with and without CAD (EF?55%). Statistical analyses were performed using one-way ANOVA, Kruskal-Wallis, Chi-square, Mann-Whitney U, Spearman correlation and multiple regression analyses tests.Results: Serum Ucn-2 levels were decreased in Group A and were increased in Group B compared to Group C (9.4±3.4, 12.8±3.6 vs. 10.4±3.9 pg/mL, respectively, p=0.003). Unlike SD; there was no significant difference in serum Ucn-2 levels between subjects with and without DD (11.4±4.1 vs 11.7±3.9 pg/mL, p=0.8) or CAD (10.7±4.7 vs 10.2±3.2 pg/mL, p=0.7).Conclusion: Ucn-2 is elevated in mild to moderate SD. But, DD (impaired relaxation pattern), or CAD (without myocardial infarction) seems to have no effect on Ucn-2 hormone levels.

Ergün Topal; Jülide Ya?mur; Bar?? Otlu; Halil Ata?; Mehmet Cansel; Nusret Aç?kgöz; Necip Ermi?

2012-01-01

62

Ageing, arterial blood pressure, body mass index, and diet.  

UK PubMed Central (United Kingdom)

For three decades we followed up for longevity indicators, including diet, arterial blood pressure, and body mass index 379 mobile, long-living persons from Croatia, now aged 70 to 92 years, of whom 167 men aged (78.6 ± 4.0) years and 212 women aged (77.9 ± 4.1) years. One hundred and ninety-five were from the continental and 184 from the coastal Croatia. The participants were examined in 1972, 1982, and again in 2006/7. Changes in body mass index (BMI), arterial blood pressure (ABP), and in answers to our Food Frequency Questionnaire about dietary habits were analysed using log-linear models. Over the last 24 years of aging (age 55 to 78 years) the subjects showed a statistically significant decrease in body mass and height and a significant increase in the systolic blood pressure. Diastolic blood pressure and BMI showed no significant changes over this period. Consumption of preserved and fresh meat, bread, and starch (potato, pastry and rice) dropped significantly with age, while the consumption of fish, fresh and cooked vegetables, fruit, and dairy products significantly increased. These dietary changes were not associated with changes in the systolic and diastolic ABP. About 80 % were overweight (BMI >25 kg m(-2)) throughout the follow-up, even though their body mass dropped significantly after the age of 55. However, their survival suggests that BMI may not be the best indicator of longevity or healthy aging.

Pavlovi? M; Milkovi?-Kraus S; Jovanovi? V; Hercigonja-Szekeres M

2012-01-01

63

Disappearance of Muscle Bridge of Left Anterior Descending Artery after Rising Blood Pressure  

Directory of Open Access Journals (Sweden)

Full Text Available A 62 years–old woman with chief complaint of repeated compressive chest pain on physical activity presentedto the emergency department. Angiography showed narrowing of mid part of left anterior descending artery atsystole, normal caliber in diastole and good distal flow but after normalization of blood pressure and pulse rate,the left anterior descending artery lesion disappeared in systole and diastole. As in this patient, it is imperative tonote that hypotension due to any cause such as vasovagal reaction, could stimulate myocardial bridge.

y Mahmmody; j Kojury; M Tavassoly

2009-01-01

64

Detection of diastolic abnormality by dyssynchrony imaging. Correlation with coronary artery disease in patients presenting with visibly normal wall motion  

International Nuclear Information System (INIS)

[en] Post-systolic shortening (PSS) is a sensitive indicator of myocardial ischemia. We have developed a tissue Doppler imaging technique that portrays PSS, and whether PSS correlates with coronary artery disease (CAD) was investigated in 186 patients presenting with chest pain and normal echocardiograms. Delays of the displacement peaks from end-systole were calculated in the apical views and displayed from green (0 ms) to red (?100 ms): detection of diastolic abnormality by dyssynchrony imaging (DADI). CAD was judged positive by DADI when the left ventricular segments were color-coded red. Patients subsequently underwent thallium-201 myocardial perfusion single-photon emission computed tomography (n=150), coronary angiography (CAG, n=74), or both (n=37). CAD(-) was defined as negative scintigraphy test and/or no significant coronary artery stenosis by CAG. In 43 patients (23%), CAD(+) was confirmed by CAG as >75% diameter stenosis. DADI predicted CAD with sensitivity of 60%, specificity of 75%, predictive accuracy of 72%, positive predictive value of 42%, and negative predictive value of 86%. Among 74 patients who underwent CAG, sensitivity was best for the left anterior descending artery. DADI detected the regional diastolic abnormality, which correlated with the presence of CAD in patients presenting with visibly normal wall motion. (author)

2008-01-01

65

Relation of low diastolic blood pressure to coronary heart disease death in presence of myocardial infarction: the Framingham Study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine the hypothesis that a J curve relation between blood pressure and death from coronary heart disease is confined to high risk subjects with myocardial infarction. DESIGN: Cohort longitudinal epidemiological study with biennial examinations since 1950. SETTING: Framingham, Massachusetts, USA. SUBJECTS: 5209 subjects in the Framingham study cohort followed up by a person examination approach. MAIN OUTCOME MEASURES: Coronary heart disease deaths and non-cardiovascular disease deaths in men and women with or without myocardial infarction relative to blood pressure. RESULTS: Among subjects without myocardial infarction non-cardiovascular disease deaths were twice to three times as common as coronary heart disease deaths. Furthermore, there was no significant relation between non-cardiovascular disease death and diastolic or systolic blood pressure. Also coronary heart disease deaths were linearly related to diastolic and systolic blood pressures. Among high risk patients (that is, people with myocardial infarction but free of congestive heart failure) death from coronary heart disease was more common than non-cardiovascular disease death. There was a significant U shaped relation between coronary heart disease death and diastolic blood pressure. Although there was an apparent U shaped relation between coronary heart disease death and systolic blood pressure, it did not attain statistical significance when controlling for age and change in systolic blood pressure from the pre-myocardial infarction level. None of the above conclusions changed when adjustments were made for risk factors such as serum cholesterol concentration, antihypertensive treatment, and left ventricular function. The U shaped relation between diastolic blood pressure and high risk subjects existed for both those given antihypertensive treatment and those not. CONCLUSIONS: These data suggest that an age and sex independent U curve relation exists for diastolic blood pressure and coronary heart disease deaths in patients with myocardial infarction but not for low risk subjects without myocardial infarction. The relation seems to be independent of left ventricular function and antihypertensive treatment.

D'Agostino RB; Belanger AJ; Kannel WB; Cruickshank JM

1991-08-01

66

Positive-end Expiratory Pressure Influences Echocardiographic Measures of Diastolic Function: A Randomized, Crossover Study in Cardiac Surgery Patients  

DEFF Research Database (Denmark)

Ultrasonography of the cardiovascular system is pivotal for hemodynamic assessment. Diastolic function is evaluated with a combination of tissue Doppler (e' and a') and pulsed Doppler (E and A) measures of transmitral- and mitral valve annuli velocities. However, accurate echocardiographic evaluation in the intensive care unit or perioperative setting is contingent on relative resistance to positive pressure ventilation and changes in preload. This study aimed to evaluate the effects of positive end-expiratory pressure (PEEP) and positioning on echocardiographic measures of diastolic function.

Juhl-Olsen, Peter; Hermansen, Johan Fridolf

2013-01-01

67

Determinantes clínicos de la presión de fin de diástole/ Clinical determining factors of the end of diastole's pressure  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción: la falla cardiaca sobreviene a los pacientes con múltiples enfermedades cardiovasculares. Se encuentra con frecuencia, que algunos pacientes no empeoran su clase funcional, a pesar de reunir condiciones clínicas que suponen una severa alteración fisiopatológica. Estos hallazgos son confirmados al medir la presión de fin de diástole (PFD) en el laboratorio de hemodinamia. Objetivo: determinar qué factores clínicos inciden en la PFD. Material y métod (more) os: estudio retrospectivo, descriptivo de 200 pacientes estudiados (muestra aleatoria de 1730 pacientes) durante el año 2005, con análisis de las relaciones entre la variable dependiente PFD y las variables independientes: edad, sexo, peso, superficie corporal, factores de riesgo, cuadro clínico, fracción de eyección (FE), alteraciones estructurales ventriculares (dilatación o hipertrofia), compromiso coronario (uno, dos o tres vasos, angiográficamente sanos, o presencia de flujo lento intracoronario), y la arteria coronaria comprometida. Se aplicó un modelo de regresión lineal simple mediante el paquete estadístico STATA Versión 9. Resultados: las variaciones de aumento de la PFD están relacionadas con: hipertensión arterial (HTA), dilatación ventricular izquierda, mayor compromiso coronario (tres vasos) y presencia de ateromatosis significativa de las arterias descendente anterior y coronaria derecha. Las variaciones decrecientes de la PFD se presentaron ante el aumento de la FE y la presencia de arterias sanas. Conclusiones: se confirman algunos factores conocidos que inciden sobre la PFD, pero sorprende la ausencia de cambios significativos de la PFD ante cuadros clínicos más inestables y ante la presencia de hipertrofia. Este estudio provee elementos significativos para futuras investigaciones clínicas en el campo. Abstract in english Abstract Introduction: many cardiovascular diseases may cause heart failure, because of impairment of systolic or diastolic function, or both. It is frequently observed that regardless of physiopathological processes that were presumed to cause major symptoms, some patients have normal or quite normal functional class of dyspnea. This observation is sometimes confirmed in the cath lab, when the measured end diastolic pressure (EDP) is normal. Objective: to study which cli (more) nical factors are related with changes in EDP. Methods: 200 patients were included in a sample of 1.730 patients studied in the Cath Lab during 2005. This retrospective, descriptive and analytic study seeked for association between EDP and independent variables such as: age, sex gender, weight, clinical risk factor for coronary artery disease, the clinical presentation, ejection fraction (EF) measured, structural changes in left ventricle morphology (dilatation or hypertrophy), extent of coronary disease (one, two or three-vessel disease, normal coronaries, or reduced intracoronary flow), and the coronary artery involved. Statistically, a simple linear regression model was applied in the STATA 9 program. Results: increasing variability in the EDP was found to be significantly related with: hypertension, dilated left ventricle, 3-vessel disease, left coronary descendant and right coronary artery involvement. Decreasing variability of EDP presented with increasing EF and normal coronary arteries. Conclusions: some clinical factors were confirmed as related with altered EDP, but others, such as the more unstable clinical conditions and hypertrophy, surprisingly showed no significant relation with EDP variations. This investigation offers new pathways to future clinical studies in this area.

Benítez, Luis Miguel; Narváez, José Vicente

2007-09-01

68

The Late Effects of Anticancer Therapy after Childhood Wilm's Tumor: The Role of Diastolic Function and Ambulatory Blood Pressure Monitoring.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Wilms' tumor, or nephroblastoma, is the most common primary malignant renal tumor of childhood. The excellent outcome now expected for most children with this tumor is attributed to the combination of effective adjuvant chemotherapy, improved surgical and anesthetic techniques and also the radiosensitivity of the tumor. The numerous organ systems are subject to the late effects of anticancer therapy. The aim of this study was to investigate the blood pressure profile and ambulatory blood pressure monitoring, and also cardiac diastolic functions and pulmonary venous flow in 25 children with unilateral Wilms' tumor in remission. METHODS: The patient group consists of 25 patients who successfully completed anticancer treatment for unilateral Wilms' tumor. Thirty-three age-, weight- and height-matched healthy children were considered as a control group for an echocardiographic study. Also, 20 age-, weight- and height-matched healthy children were considered as a control group for the ambulatory blood pressure monitoring study. RESULTS: In our study, 24 h, daytime and night-time systolic blood pressure and night-time diastolic blood pressure measurements were found to be significantly increased in the patient group compared with healthy children. We detected diastolic filling pattern abnormalities. We also found increase in pulmonary venous flow (systolic and diastolic) in Wilms' tumor group. CONCLUSIONS: We suggest the regular follow-up of survivors of Wilms' tumor for care and prevention of cardiovascular diseases.

Elli M; Sungur M; Genç G; Ayyildiz P; Dagdemir A; Güçlü Pinarli F; Acar S

2013-08-01

69

Noninvasive determination of arterial elasticity and blood pressure. Part II: elastogram and blood pressure determination.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The oscillometric method is used in the medical practice for measurement of arterial blood pressure and, rarely, for estimation of arterial elasticity. In the previous paper of this series, the relations between arterial volume pulsations and volume-to-pressure curve (elastogram) were examined resolving the problem for evaluation of arterial volume pulsations from known elastogram and systolic (ps)/diastolic (pd) blood pressure. Some features were found that are considered to be elastogram attributes. The aim of the present work is to resolve the inverse problem - graphical reconstruction of the elastogram from oscillometric data and determination of blood pressure. PARTICIPANTS AND METHODS: The elastograms of an idealized arterial model as well as of experimental oscillometric records (five men, five women) are processed graphically. RESULTS: The method for reconstruction is developed with the idealized volume pulsations of the arterial model, establishing full correspondence of the elastogram fixed in the model with those determined here. The accuracy of this reconstruction is assessed: a pulse pressure variability of 12% leads to an ~2-9% error of the reconstructed elastogram. Thereafter, experimental elastograms are reconstructed graphically, and the correct pulse pressure and blood pressure are determined. The experimentally determined blood pressure is statistically compared with that simultaneously auscultatory measured. Satisfactory correspondence between values of ps/pd is found. A method of objective comparison between elastograms after normalization is suggested. CONCLUSION: A novel graphical, nonempirical method for a noninvasive reconstruction of the elastogram and determination of blood pressure is presented. The method can be applied easily in automated blood pressure measurement devices.

Antonova ML

2013-02-01

70

Analysis of left ventricular diastolic function and left atrial function in coronary artery disease by radionuclide angiography  

International Nuclear Information System (INIS)

To analyze regional left ventricular diastolic function, first-pass and multigated radionuclide angiography was performed in 27 patients with coronary artery disease (12: angina pectoris (AP), 9: anterior, 6: inferior myocardial infarction (MI)) and 9 normal subjects. To analyze left atrial function, AC/SV (atrial contraction) and PFR-AC (peak filling rate during atrial contraction) were obtained from backward left ventricular volume curve in 17 patients with coronary artery disease (11: EF > 50 %, 6: EF 50 % patients, PFR was significantly reduced and AC/SV was significantly larger than that in normal subjects. In anteiror MI patients, PFR was normal in inferior region, and PFRs were significantly reduced in other regions. TPF was significantly prolonged in septal region. In inferior MI patients, PFR was normal in septal region, and PFRs were significantly reduced in other regions. In EF

1987-01-01

71

Atrial Remodeling Is Directly Related to End-Diastolic Left Ventricular Pressure in a Mouse Model of Ventricular Pressure Overload  

Science.gov (United States)

Background Atrial fibrillation (AF) is often preceded by underlying cardiac diseases causing ventricular pressure overload. Objective It was our aim to investigate the progression of atrial remodeling in a small animal model of ventricular pressure overload and its association with induction of AF. Methods Male mice were subjected to transverse aortic constriction (TAC) or sham operation. After four or eight weeks, echocardiographic measurements and hemodynamic measurements were made and AF induction was tested. The hearts were either fixed in formalin or ventricles and atria were separated, weighed and snap-frozen for RNA analysis. Results Four weeks of pressure overload induced ventricular hypertrophy and minor changes in the atria. After eight weeks a significant reduction in left ventricular function occurred, associated with significant atrial remodeling including increased atrial weight, a trend towards an increased left atrial cell diameter, atrial dilatation and increased expression of markers of hypertrophy and inflammation. Histologically, no fibrosis was found in the left atrium. But atrial gene expression related to fibrosis was increased. Minor changes related to electrical remodeling were observed. AF inducibility was not different between the groups. Left ventricular end diastolic pressures were increased and correlated with the severity of atrial remodeling but not with AF induction. Conclusion Permanent ventricular pressure overload by TAC induced atrial remodeling, including hypertrophy, dilatation and inflammation. The extent of atrial remodeling was directly related to LVEDP and not duration of TAC per se.

De Jong, Anne Margreet; Van Gelder, Isabelle C.; Vreeswijk-Baudoin, Inge; Cannon, Megan V.; Van Gilst, Wiek H.; Maass, Alexander H.

2013-01-01

72

Impact of endovascular treatment of atherosclerotic renal artery stenosis on endothelial function and arterial blood pressure.  

UK PubMed Central (United Kingdom)

AIM: Renovascular disease may cause arterial hypertension and decreases renal function, which both impair endothelial function. Endothelial function, a surrogate marker for cardiovascular risk, can be assessed non-invasively by ultrasound. The aim of this study was to investigate the impact of percutaneous transluminal renal artery angioplasty (PTRA) with stenting on endothelial function and arterial blood pressure in patients with renal artery stenosis (RAS). METHODS: Flow mediated dilatation of the brachial artery, flow velocities and shear stress were measured with high resolution ultrasound in 24 hypertensive patients with renal artery stenosis prior and one day after revascularization by PTRA with stenting. Endothelial-independent brachial dilatation was measured after application of nitroglycerin. RESULTS: Endothelial-dependent dilatation improved from 2.4±0.9% to 6.1±1.4% (P=0.03), whereas endothelial-independent dilatation did not change after PTRA. Endothelial-dependent reactive hyperemic blood flow increased from 195±40 mL/min to 536±94 mL/min (P=0.0008), whereas endothelial-independent hyperemia did not increase after revascularization. After PTRA, shear stress at rest decreased from 37±11 to 23±3 dyne/cm² (P<0.0001), and reactive hyperemic shear stress increased from 89±29 to 107±12 dyne/cm² (P=0.014). The impact of PTRA on arterial blood pressure resulted in a mean decrease of 21±5 mmHg in systolic pressure (P<0.0001), of 9±2 mmHg in diastolic pressure (P=0.03), and of 14±5 mmHg in peripheral pulse pressure (P=0.0003), respectively. CONCLUSION: Endovascular treatment of renovascular disease improves endothelial function and decreases in resting shear stress.

Jacomella V; Husmann M; Thalhammer C; Uike K; Pfammatter T; Amann-Vesti B

2012-02-01

73

A novel noninvasive method to assess left ventricular -dP/dt using diastolic blood pressure and isovolumic relaxation time.  

UK PubMed Central (United Kingdom)

BACKGROUND: Left ventricular Doppler-derived -dP/dt determined from the continuous-wave Doppler spectrum of the mitral regurgitation (MR) jet has been shown to be a valuable marker of diastolic function, but requires the presence of MR for its assessment. We sought to determine if a novel method of determining -dP/dt using the diastolic blood pressure and isovolumic relaxation time (DBP-IVRT method) correlates with Doppler-derived -dP/dt using the MR method (Doppler-MR method). METHODS: Thirty-three patients with less than severe MR were enrolled. -dP/dt was determined using the Doppler-MR method from the continuous-wave Doppler spectrum of the MR jet (32 mmHg/time from 3 to 1 m/sec). -dP/dt was also determined using the DBP-IVRT method using the following equation: -dP/dt = (DBP - LVEDP)/IVRT, where left ventricular end-diastolic pressure (LVEDP) was estimated based on tissue Doppler and mitral inflow patterns. RESULTS: Twenty-five patients had adequate Doppler waveforms for analysis. The average amount of MR was mild-to-moderate severity. The mean -dP/dt was 680 ± 201 mmHg by the Doppler-MR method and 681 ± 237 mmHg by the DBP-IVRT method. There was a significant correlation between the 2 methods of determining -dP/dt (Pearson r = 0.574, P = 0.003). The Bland-Altman plot revealed almost no bias between the 2 methods; the difference in -dP/dt between the 2 techniques was noted to be greater for patients with higher -dP/dt, however. CONCLUSION: Diastolic blood pressure and isovolumic relaxation time may be used to noninvasively assess diastolic function in patients who do not have MR, especially in those with reduced diastolic function.

Parekh R; Kolias TJ

2013-03-01

74

Spectral analysis of heart rate and arterial pressure variability after nitric oxide synthase inhibition.  

UK PubMed Central (United Kingdom)

The experiments were performed on male, conscious Wistar rats. Femoral arterial pressure was registered by Statham GOULD P23 ID pressure transducer connected to MP 100WS BIOPAC work station after analog to digital conversion during 40 minutes long control period. Nitric oxide synthase inhibition was performed by injection of 100 microliters, 10 mg/kg b.w. N-omega-nitro-L-arginine methyl ester (L-NAME) in saline through femoral vein catheter. Twenty minutes later arterial pressure registration was started and was continued for 40 minutes. The pulse-by-pulse values of systolic, diastolic and mean arterial pressure as well as the pulse intervals were measured by peak and rate detectors of the AcqKnowledge 2.0 software. Row data were processed using a virtual instrument developed in our laboratory in the graphical programming environment Lab VIEW 3.1.1. L-NAME increased systolic, diastolic and mean arterial pressure by 16.6%, 25% and 35%, respectively. The PMF/PHF ratio in heart rate spectrum decreased, indicating an increased vagal effect on the heart. Nitric oxide synthase inhibition increased the low-frequency component of systolic arterial blood pressure variability by 39.5%. Nitric oxide is a physiological regulator of rapid fluctuations of arterial blood pressure.

Mikhov D; Markova P; Girchev R

1998-01-01

75

Spectral analysis of heart rate and arterial pressure variability after nitric oxide synthase inhibition.  

Science.gov (United States)

The experiments were performed on male, conscious Wistar rats. Femoral arterial pressure was registered by Statham GOULD P23 ID pressure transducer connected to MP 100WS BIOPAC work station after analog to digital conversion during 40 minutes long control period. Nitric oxide synthase inhibition was performed by injection of 100 microliters, 10 mg/kg b.w. N-omega-nitro-L-arginine methyl ester (L-NAME) in saline through femoral vein catheter. Twenty minutes later arterial pressure registration was started and was continued for 40 minutes. The pulse-by-pulse values of systolic, diastolic and mean arterial pressure as well as the pulse intervals were measured by peak and rate detectors of the AcqKnowledge 2.0 software. Row data were processed using a virtual instrument developed in our laboratory in the graphical programming environment Lab VIEW 3.1.1. L-NAME increased systolic, diastolic and mean arterial pressure by 16.6%, 25% and 35%, respectively. The PMF/PHF ratio in heart rate spectrum decreased, indicating an increased vagal effect on the heart. Nitric oxide synthase inhibition increased the low-frequency component of systolic arterial blood pressure variability by 39.5%. Nitric oxide is a physiological regulator of rapid fluctuations of arterial blood pressure. PMID:10672333

Mikhov, D; Markova, P; Girchev, R

1998-01-01

76

Dietary nitrate in Japanese traditional foods lowers diastolic blood pressure in healthy volunteers.  

UK PubMed Central (United Kingdom)

BACKGROUND: Japanese longevity is the highest in the world. This is partly explained by low occurrence of cardiovascular diseases, which in turn is attributed to the Japanese traditional diet (JTD). Recent research demonstrates that nitric oxide (NO), a key regulator of vascular integrity, can be generated from nitrate (NO(3)(-)), abundantly found in vegetables. It can reduce blood pressure (BP) via its serial reduction to nitrite (NO(2)(-)) and to bioactive NO. Interestingly, JTD is extremely rich in nitrate and the daily consumption is higher than in any other known diet. OBJECTIVE AND DESIGN: In a randomized, cross-over trial we examined the effect of a 10-day period of JTD on blood pressure in 25 healthy volunteers. Traditional Japanese vegetables were encouraged to be consumed and avoided during the control period. Daily nitrate intake was calculated. RESULTS: Nitrate naturally provided by the JTD was 18.8 mg/kg/bw/day, exceeding the Acceptable Daily Intake by five times (ADI, 3.7 mg/kg/bw). Plasma and salivary levels of nitrate and nitrite were higher at the end of the JTD period. Diastolic BP decreased on average 4.5 mmHg during JTD compared to the control diet (P=0.0066) while systolic BP was not affected. This effect was evident in normotensive subjects and similar to that seen in the recent studies. CONCLUSIONS: An ordinary nitrate rich diet may positively affect blood pressure. Our findings further support the importance of the role of dietary nitrate on BP regulation suggesting one possible explanation of healthy aspects of traditional Japanese food.

Sobko T; Marcus C; Govoni M; Kamiya S

2010-02-01

77

Intermittent Absent End Diastolic Velocity of the Umbilical Artery: Antenatal and Neonatal Characteristics and Indications for Delivery.  

UK PubMed Central (United Kingdom)

Objective Is there there is a difference in indications for delivery, antepartum and neonatal characteristics in intermittent absent end diastolic velocity (iAEDV) compared to persistent absent or reversed end diastolic velocity (pA/REDV). Methods A retrospective study of 109 patients with iAEDV or pA/REDV from 19-39 weeks. The delivery indication was classified as maternal or fetal. The primary antepartum and maternal characteristic were age, parity, AMA, chronic hypertension, PEC, thrombophilia, lupus, diabetes, smoker, placenta previa, gestational age (GA) at diagnosis of IUGR and/or SGA, GA at diagnosis of elevated S/D, iAEDV or pA/REDV, GA at delivery, minimal/absent variability day of delivery, BPP ? 6 prior to delivery. The primary neonatal outcomes were birth weight, arterial cord pH, neonatal demise, necrotizing enterocolitis, intraventricular hemorrhage and length of stay in the NICU. Results Fetuses with iAEDV were diagnosed with an elevated S/D at a later GA (29.6 vs 27.5 weeks, P < 0.03), delivered at a later GA (31.6 vs 29.7 weeks, P < 0.01), had a higher birth weight (1336.6 vs 933g, P < 0.0004), were more likely to be delivered for maternal indications (42.9% vs 20.27%, P<0.01), had a higher cord arterial pH (7.28 vs 7.21, P<0.002) and were less likely to have an arterial pH at birth <7.2 (0% vs 34.1%, P < 0.002). Conclusions Although fetuses with iAEDV have an improved antenatal course as compared with pA/REDV, indications for delivery are more likely to be maternal and adverse outcome is common.

Rosner J; Rochelson B; Rosen L; Roman A; Vohra N; Tam Tam H

2013-05-01

78

Pulmonary Artery Pressure in Maintenance Hemodialysis Patients  

Directory of Open Access Journals (Sweden)

Full Text Available To consider the prevalence of pulmonary artery pressure in End-stage Renal Disease (ESRD) patients, a study was conducted on maintenance of hemodialysis patients and a group of normal subjects. For assessment of pulmonary artery pressure all participants were subjected to two-dimensional and doppler echocardiographic studies that for patients were done after their hemodialysis session. In this study a significant difference of Pulmonary Artery Systolic Pressure (PASP) between patients and normal subjects with more values in hemodialysis patients was seen. A significant positive correlation of pulmonary artery pressure with age of control group and also significant positive correlation of pulmonary artery pressure with age of hemodialysis group were found. A significant positive correlation of PASP with duration and dosages of hemodialysis treatment were seen too. A high prevalence of pulmonary hypertension in hemodialysis needs more attention to this aspect of hemodialysis patients because pulmonary hypertension is a disease with poor prognosis.

M.D. Hamid Nasri; M.D. Shahin Shirani; M.D. Azar Baradaran

2006-01-01

79

Pivotal factors interfering in 24-hour blood pressure fluctuation and arterial stiffness in a community of Chinese elderly hypertensive patients.  

UK PubMed Central (United Kingdom)

AIMS AND OBJECTIVES: To explore which sociodemographic and clinical factors could interfere in the parameters of ambulatory blood pressure monitoring and determine the affecting factors of Ambulatory Arterial Stiffness Index. BACKGROUND: Although the clinical relevance of ambulatory blood pressure monitoring and Ambulatory Arterial Stiffness Index have been studied, the explanation of their role and related interfering factors remains controversial in patients with different disease or age, etc. DESIGN: Cross-sectional study. METHODS: The study was carried out between October 2008-October 2009. A convenience sample of hypertensive patients over 60 years old was recruited in China. Twenty-four hour ambulatory blood pressure monitoring was carried out on the non-dominant arm using an oscillometric device. RESULTS: (1) All 95 patients completed the study and their ages ranged from 60-76 years. (2) There were statistical differences for certain parameters of ambulatory blood pressure monitoring between different characteristics of patients. Financial status was an important factor interfering in patients' BP fluctuation, especially daytime and 24 hours systolic pressure. The higher body mass index the patients had, the higher the pressure was. (3) Multiple variants logistic analysis of Ambulatory Arterial Stiffness Index showed statistical differences only in coefficient variation of 24-hour diastolic pressure and daytime systolic blood pressure. CONCLUSIONS: There are more factors that interfered with systolic pressure and diastolic pressure during the day than night. Patients who have less nocturnal dipping may have a higher night time systolic pressure and diastolic pressure. The coefficient of variation of 24 hours diastolic pressure and daytime systolic pressure contribute more to Ambulatory Arterial Stiffness Index which should arouse practitioners' attention. RELEVANCE TO CLINICAL PRACTICE: Ambulatory blood pressure monitoring should be used as a routine procedure, as well as Ambulatory Arterial Stiffness Index calculated for older hypertensive patients. The findings may be used to guide community health providers to pay more attention to the factors that may influence BP fluctuation and Ambulatory Arterial Stiffness Index according to individual's characteristics.

Zang XY; Zhang H; Cheng SL; Gao YJ; Cao YJ; Zhao Y; Mårtensson J

2013-02-01

80

Analysis of left ventricular diastolic function and left atrial function in coronary artery disease by radionuclide angiography  

Energy Technology Data Exchange (ETDEWEB)

To analyze regional left ventricular diastolic function, first-pass and multigated radionuclide angiography was performed in 27 patients with coronary artery disease (12: angina pectoris (AP), 9: anterior, 6: inferior myocardial infarction (MI)) and 9 normal subjects. To analyze left atrial function, AC/SV (atrial contraction) and PFR-AC (peak filling rate during atrial contraction) were obtained from backward left ventricular volume curve in 17 patients with coronary artery disease (11: EF > 50 %, 6: EF < 50%) and 7 normal subjects. In AP patients, PFR was significantly reduced in apex and TPF (time to peak filling rate) was significantly prolonged in global LV and apex. In EF > 50 % patients, PFR was significantly reduced and AC/SV was significantly larger than that in normal subjects. In anteiror MI patients, PFR was normal in inferior region, and PFRs were significantly reduced in other regions. TPF was significantly prolonged in septal region. In inferior MI patients, PFR was normal in septal region, and PFRs were significantly reduced in other regions. In EF < 50 % patients, PFR and PFR-AC were significantly reduced, and there was no significant difference in AC/SV between the control group and EF < 50 % group. We conclude that the left atrial contribution to left ventricular function is increased in patient with coronary artery disease, but this compensative mechanism is limited in MI patient with reduced EF.

Kawakita, Seizaburo

1987-12-01

 
 
 
 
81

Noninvasive blood pressure measurement by the Nexfin monitor during reduced arterial pulsatility: a feasibility study.  

Science.gov (United States)

Noninvasive blood pressure measurements are difficult when arterial pulsations are reduced, as in patients supported by continuous flow left ventricular assist devices (cf-LVAD). We evaluated the feasibility of measuring noninvasive arterial blood pressure with the Nexfin monitor during conditions of reduced arterial pulsatility. During cardiopulmonary bypass(CPB) in which a roller pump based or a centrifugal pump based heart-lung machine generated arterial blood pressure with low pulsatility, noninvasive arterial pressures (NAP)measured by the Nexfin Monitor were recorded and compared with invasively measured radial artery pressures (IAP).We also evaluated NAP in 10 patients with a cf-LVAD during a pump speed change procedure (PSCP). During CPB in 18 patients, the NAP-IAP average difference was -1.3 +/- 6.5 mmHg. The amplitude of pressure oscillations were 4.3 +/- 3.8 mmHg measured by IAP. Furthermore, in the cf-LVAD patients, increase in pump speed settings led to an increase in diastolic and mean arterial pressures (MAP) while the NAP acquired a sinusoidal shape as the aortic valve become permanently closed. In conclusion, NAP was similar to IAP under conditions of reduced arterial pulsatility. The device also measured the blood pressure waveform noninvasively in patients supported by a cf-LVAD. PMID:20449896

Martina, Jerson R; Westerhof, Berend E; Van Goudoever, Jeroen; De Jonge, Nicolaas; Van Lieshout, Johannes J; Lahpor, Jaap R; De Mol, Bas A J M

82

Noninvasive blood pressure measurement by the Nexfin monitor during reduced arterial pulsatility: a feasibility study.  

UK PubMed Central (United Kingdom)

Noninvasive blood pressure measurements are difficult when arterial pulsations are reduced, as in patients supported by continuous flow left ventricular assist devices (cf-LVAD). We evaluated the feasibility of measuring noninvasive arterial blood pressure with the Nexfin monitor during conditions of reduced arterial pulsatility. During cardiopulmonary bypass(CPB) in which a roller pump based or a centrifugal pump based heart-lung machine generated arterial blood pressure with low pulsatility, noninvasive arterial pressures (NAP)measured by the Nexfin Monitor were recorded and compared with invasively measured radial artery pressures (IAP).We also evaluated NAP in 10 patients with a cf-LVAD during a pump speed change procedure (PSCP). During CPB in 18 patients, the NAP-IAP average difference was -1.3 +/- 6.5 mmHg. The amplitude of pressure oscillations were 4.3 +/- 3.8 mmHg measured by IAP. Furthermore, in the cf-LVAD patients, increase in pump speed settings led to an increase in diastolic and mean arterial pressures (MAP) while the NAP acquired a sinusoidal shape as the aortic valve become permanently closed. In conclusion, NAP was similar to IAP under conditions of reduced arterial pulsatility. The device also measured the blood pressure waveform noninvasively in patients supported by a cf-LVAD.

Martina JR; Westerhof BE; Van Goudoever J; De Jonge N; Van Lieshout JJ; Lahpor JR; De Mol BA

2010-05-01

83

Variabilidad en las medidas de tensión arterial realizada por estudiantes de 5.º y 6.º de medicina Variability of arterial pressure measurements performed by advanced medical students  

Directory of Open Access Journals (Sweden)

Full Text Available Introducción. No se ha definido objetivamente si los estudiantes de medicina avanzados dominan destrezas básicas, como la medida de tensión arterial. Sujetos y métodos. Se determinó la variabilidad de medida de tensión arterial por estudiantes de 5.º y 6.º cursos de medicina. Resultados. Se encontraron coeficientes de variación significativamente más elevados en la tensión arterial diastólica derecha y frecuencia cardíaca, y grupos e individuos con error sistemático de medición. Conclusión. Resulta necesario un refuerzo docente en la medida de tensión arterial diastólica y su realización en los dos brazos.Introduction. No objective data are available to know whether advanced medical students are in command of basic practical skills, ie, arterial pressure measurement. Subjects and methods. Variability of arterial pressure measurements was examined in 5th- and 6th-year medical students. Results. Significantly higher variability coefficients were found in right arm diastolic arterial pressure and heart rate. A systematic measurement error was detected in some groups and individuals. Conclusion. A teaching effort will be necessary to improve arterial pressure measurement skills, with special emphasis in diastolic arterial pressure and bilateral measurements.

C. Caramelo; M. Marín; B. Álvarez; J.J. Granizo

2008-01-01

84

Variabilidad en las medidas de tensión arterial realizada por estudiantes de 5.º y 6.º de medicina/ Variability of arterial pressure measurements performed by advanced medical students  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción. No se ha definido objetivamente si los estudiantes de medicina avanzados dominan destrezas básicas, como la medida de tensión arterial. Sujetos y métodos. Se determinó la variabilidad de medida de tensión arterial por estudiantes de 5.º y 6.º cursos de medicina. Resultados. Se encontraron coeficientes de variación significativamente más elevados en la tensión arterial diastólica derecha y frecuencia cardíaca, y grupos e individuos con error sist (more) emático de medición. Conclusión. Resulta necesario un refuerzo docente en la medida de tensión arterial diastólica y su realización en los dos brazos. Abstract in english Introduction. No objective data are available to know whether advanced medical students are in command of basic practical skills, ie, arterial pressure measurement. Subjects and methods. Variability of arterial pressure measurements was examined in 5th- and 6th-year medical students. Results. Significantly higher variability coefficients were found in right arm diastolic arterial pressure and heart rate. A systematic measurement error was detected in some groups and indiv (more) iduals. Conclusion. A teaching effort will be necessary to improve arterial pressure measurement skills, with special emphasis in diastolic arterial pressure and bilateral measurements.

Caramelo, C.; Marín, M.; Álvarez, B.; Granizo, J.J.

2008-06-01

85

Effects of music on systolic blood pressure, diastolic blood pressure, and heart rate: a meta-analysis.  

Science.gov (United States)

There are a handful of studies that have been done investigating the effect of music on various vital signs, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR). Many studies have also assessed effects of music on self-reported anxiety level, attributing some degree of music-induced anxiety relief to the beneficial impacts of music on vital signs. Several randomised studies have shown varying effects of music on these vital parameters and so a meta-analysis was done to compare the effect of music on them. The fixed effects model was used as studies were homogenous. A two-sided alpha error < 0.05 was considered to be statistically significant. Compared to those who did not receive music therapy, those who did receive music therapy had a significantly greater decrease in SBP before and after (difference in means, -2.629, confidence interval (CI), -3.914 to -1.344, P < 0.001), a significantly greater decrease in DBP (difference in means, -1.112, CI, -1.692 to -0.532, P < 0.001), and a significantly greater decrease in HR (difference in means, -3.422, CI, -5.032 to -1.812, P < 0.001). PMID:22664817

Loomba, Rohit S; Arora, Rohit; Shah, Parinda H; Chandrasekar, Suraj; Molnar, Janos

86

Adaptation to periodic pressure chamber hypoxia and its influence on systolic and diastolic functions in chronic heart failure  

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Full Text Available Research objective is to determine the influence of adaptation method to periodic pressure chamber hypoxia on dynamics of systolic and diastolic functions of myocardium in patients with early stages of chronic heart failure. Materials and Methods: 100 men with post-infarction cardiosclerosis at the age of 40-65 years with I and IIA stages and l-ll functional classes (NYHA) of chronic heart failure have been examined. Results: Positive dynamics of systolic and diastolic cardiac functions and other parameters of echocardioscopy under the influence of the hypoxic therapy in comparison with classical physical rehabilitation have been obtained. Furthermore, a more significant effect has been observed in patients with CHF IIA. Conclusion: Improvement in the geometry of the heart has proved that adaptation method to periodic pressure chamber hypoxia could be recommended for rehabilitation of patients with heart failure of early stages.

Dmitrieva ?.?.

2012-01-01

87

Echocardiographic Measures of Diastolic Function Are Preload Dependent during Triggered Positive Pressure Ventilation : A Controlled Crossover Study in Healthy Subjects  

DEFF Research Database (Denmark)

Background. The use of echocardiography in intensive care settings impacts decision making. A prerequisite for the use of echocardiography is relative resistance to changes in volume status and levels of positive pressure ventilation (PPV). Studies on indices of diastolic function report conflicting results with regard to dependence on volume status. Evidence is scarce on PPV. Methods. Ten healthy subjects were exposed to 6 levels of positive end-expiratory pressure (PEEP) and pressure support (PS) following a baseline reading. All ventilator settings were performed at three positions: horizontal, reverse-Trendelenburg, and Trendelenburg. Echocardiography was performed throughout. Results. During spontaneous breathing, early diastolic transmitral velocity (E) changed with positioning (P <0.001), whereas early diastolic velocity of the mitral annulus (e') was independent (P = 0.263). With PPV, E and e' proved preload dependent (P ??values <0.001). Increases in PEEP, PS, or a combination influenced E and e' in reverse-Trendelenburg- and horizontal positions, but not in the Trendelenburg position. Discussion. The change towards preload dependency of e' with PPV suggests that PPV increases myocardial preload sensitivity. The susceptibility of E and e' to preload changes during PPV discourages their use in settings of volume shifts or during changes in ventilator settings. Conclusion. Positioning and PPV affect E and e'.

Juhl-Olsen, Peter; Frederiksen, Christian Alcaraz

2012-01-01

88

Dipeptidylpeptidase inhibition is associated with improvement in blood pressure and diastolic function in insulin-resistant male Zucker obese rats.  

UK PubMed Central (United Kingdom)

Diastolic dysfunction is a prognosticator for future cardiovascular events that demonstrates a strong correlation with obesity. Pharmacological inhibition of dipeptidylpeptidase-4 (DPP-4) to increase the bioavailability of glucagon-like peptide-1 is an emerging therapy for control of glycemia in type 2 diabetes patients. Accumulating evidence suggests that glucagon-like peptide-1 has insulin-independent actions in cardiovascular tissue. However, it is not known whether DPP-4 inhibition improves obesity-related diastolic dysfunction. Eight-week-old Zucker obese (ZO) and Zucker lean rats were fed normal chow diet or diet containing the DPP-4 inhibitor, linagliptin (LGT), for 8 weeks. Plasma DPP-4 activity was 3.3-fold higher in ZO compared with Zucker lean rats and was reduced by 95% with LGT treatment. LGT improved echocardiographic and pressure volume-derived indices of diastolic function that were impaired in ZO control rats, without altering food intake or body weight gain during the study period. LGT also blunted elevated blood pressure progression in ZO rats involving improved skeletal muscle arteriolar function, without reducing left ventricular hypertrophy, fibrosis, or oxidative stress in ZO hearts. Expression of phosphorylated- endothelial nitric oxide synthase (eNOS)(Ser1177), total eNOS, and sarcoplasmic reticulum calcium ATPase 2a protein was elevated in the LGT-treated ZO heart, suggesting improved Ca(2+) handling. The ZO myocardium had an abnormal mitochondrial sarcomeric arrangement and cristae structure that were normalized by LGT. These studies suggest that LGT reduces blood pressure and improves intracellular Cai(2+) mishandling and cardiomyocyte ultrastructure, which collectively result in improvements in diastolic function in the absence of reductions in left ventricular hypertrophy, fibrosis, or oxidative stress in insulin-resistant ZO rats.

Aroor AR; Sowers JR; Bender SB; Nistala R; Garro M; Mugerfeld I; Hayden MR; Johnson MS; Salam M; Whaley-Connell A; Demarco VG

2013-07-01

89

"Wedge effect" in stenosed coronary artery assessed using a PressureWire : Change in pressure waveform during percutaneous coronary intervention in a patient with a coronary artery-left ventricular fistula.  

UK PubMed Central (United Kingdom)

In this case report, we describe the recovery of abnormal coronary pressure waveform using a PressureWire Certus during percutaneous coronary intervention in a patient with severe stenosis in the proximal segment of the left anterior descending coronary artery. Since the diastolic pressure in the distal left anterior descending coronary artery was lower than that in the aorta, the pressure waveform before percutaneous coronary intervention represented the left ventricular pressure through a fistula due to a "wedge effect" in the stenosis as if the pulmonary artery wedge pressure determined by a Swan-Ganz catheter reflected the pressure in the distal portion (left atrium). We diagnosed this case coronary artery-left ventricular fistula based on the above findings. PressureWire Certus may be a valuable tool with which to estimate the hemodynamics in a patient with a coronary anomaly.

Nakasuka K; Ito S

2013-06-01

90

Non-Invasive Assessment of Left Ventricular End-Diastolic Pressure in Patients with Chronic Aortic Regurgitation, Comparison of the Sensitivity and Specificity of CW Doppler Echocardiography with Angiography  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Left ventricular end diastolic pressure could be estimated collectively using various measures of mitral valve and pulmonary venous flow velocities. In patients with aortic regurgitation, the AR velocity reflects the diastolic pressure difference between the aorta and the left ventricle. We sought to predict the left ventricular end diastolic pressure by a new Doppler index as aortic regurgitation peak early to late diastolic pressure gradient ratio.Patients and Methods: Fifty three patients with at least moderate aortic regurgitation were enrolled in this study. Physical examination, electrocardiography and echocardiography were performed one day before cardiac catheterization. The severity of AR was graded according to the recommendations of American society for echocardiography. The pressure half time, aortic regurgitation early diastolic velocity , aortic regurgitation early diastolic pressure gradient , aortic regurgitation end diastolic velocity, aortic regurgitation end diastolic pressure gradient, and early diastolic to end diastolic pressure gradient ratio of averaged three beats were measured and recorded. The results from cardiac catheterization and echocardiography were compared.Result: The early diastolic to end diastolic pressure gradient ratio was very accurate (80%) for determining the left ventricular end diastolic pressure (P =0.01). An early diastolic to end diastolic pressure gradient ratio of 1.5 has a sensitivity of 96% and a specificity of 32% for left ventricular end diastolic pressure ?12 mmHg. The best cutoff value of early diastolic to end diastolic pressure gradient ratio for the prediction of left ventricular end diastolic pressure >12 mmHg was higher than 2.0, with a sensitivity of 71% and specificity of 96% We found no significant correlation between the left ventricular end diastolic pressure with either left ventricular ejection fraction or aortic regurgitation severity in cardiac catheterization (P =0.5).Conclusion: Doppler echocardiography is a viable alternative of cardiac catheterization for determination of the left ventricular end diastolic pressure. The early diastolic to end diastolic pressure gradient ratio is a simple, easy and new method for assessment of the LVEDP in patients with severe chronic aortic regurgitation.

M Esmaeilzadeh; M Hamidzad; M Kiavar; H Bakhshandeh; F Esmaeilzadeh

2009-01-01

91

Evaluation of the Effect of Elective Percutaneous Coronary Intervention as a Treatment Method on the Left Ventricular Diastolic Dysfunction in Patients with Coronary Artery Disease  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Although percutaneous coronary intervention (PCI) is an excellent therapy for coronary artery disease, there is a paucity of information on the efficacy of PCI in improving diastolic function, especially in Iran. Because of the high prevalence of left diastolic dysfunction in coronary artery disease patients and its probable progression to heart failure, an evaluation of the role of PCI in improving diastolic function is required.Methods: Thirty patients scheduled for elective PCI were enrolled in this study providing that their systolic ejection fraction was > 40%. Before PCI and 48 hours and 3 months after PCI, echocardiography was done to evaluate some diastolic values in these patients.Results: The mean age of all the patients was 54 ± 10 year, and 20 patients were male. All the patients had a low degree of left ventricular diastolic dysfunction. Isovolumic relaxation time (115 ± 10 before treatment versus 120 ± 1 and 119 ± 3 respectively 48 hours and 3 months after treatment), mitral E wave velocity in septal (0.70 ± 0.05 before treatment vs. 0.71 ± 0.15 and 0.72 ± 0.12 respectively 48 hours and 3 months after treatment), and the peak velocity of late filling due to atrial contraction (mitral A wave velocity) in septal (0.74 ± 0.02 before treatment vs. 0.73 ± 0.01 and 0.68 ± 0.16 respectively 48 hours and 3 months after treatment) showed improvement after PCI. It is notable that early diastolic mitral annulus velocity (E?) wave velocity in the septal part of the mitral annulus improved significantly 48 hours and 3 months after PCI (p value < 0.05). The early-to-late diastolic tissue velocity ratio of the mitral annulus (E/A) ratio of the mitral inflow improved 48 hours after PCI; it was statistically significant (p value = 0.05). Also, mitral A wave velocity in septal and the E/A ratio of the mitral inflow improved significantly 3 months after PCI (p value < 0.05).Conclusion: Improvement in some of values related to left ventricular diastolic function followed by PCI shows that this method can be used to improve cardiac diastolic function in patients with symptomatic coronary artery disease.

Seyed Reza Hashemi; Mohammadreza Motamedi; Mohammad Khani; Manouchehr Hekmat; Latif Gachkar; Atieh Rezaeefar

2010-01-01

92

Effects of verapamil and propranolol on left ventricular systolic function and diastolic filling in patients with coronary artery disease: radionuclide angiographic studies at rest and during exercise  

International Nuclear Information System (INIS)

To determine the effects of verapamil on left ventricular (LV) systolic function and diastolic filling in patients with coronary artery disease (CAD), we performed gated radionuclide angiography at rest and during exercise in 16 symptomatic patients before and during oral verapamil therapy (480 mg/day). Twelve patients were also studied during oral propranolol (160-320 mg/day). LV ejection fraction at rest was normal in 13 patients, but abnormal diastolic filling at rest, defined as peak filling rate (PFR) 180 msec, was present in 15. During verapamil, resting ejection fraction decreased (control 50 + 10% [ + SD ], verapamil 45 + 12%, p

1982-01-01

93

La hipertensión arterial en la tercera edad High blood pressure in third age  

Directory of Open Access Journals (Sweden)

Full Text Available A partir de la quinta o sexta décadas de la vida, la hipertensión arterial adopta formas y obedece a causas diferentes a las del niño o a las del adulto joven. En este caso, la presión arterial sistólica aumenta (> 140 mmHg) y la diastólica se mantiene o disminuye (From the fifth or sixth decades of life, high blood pressure adopts ways and is due to different causes to that of child or to that of young adult. In this case, systolic arterial pressure increases (> 140 mmHg), and the diastolic one remains or decreases (< 90 mmHg), and differential pressure increases. The cause is conduction artery stiffness by atherosclerosis as well as the action of some hormones including: adrenaline, noradrenaline, agiotensin II, and aldosterone on the arterial medium wall. Diagnosis is made verifying presence of an isolated systolic high blood pressure in patients aged over 50. In youngest, in addition to high systolic pressure with a normal or low diastolic pressure, it is advisable measurement of others indicators of aortic stiffness. Systolic pressure in third age may to be associated with: left ventricular and arterial hypertrophy, a relaxation decrease of cardiac and coronary walls, myocardial ischemia, nephroesclerosis, cognitive decline or even dementia. Treatment requires special cares and must to adjust to the frequent morbidity of old age. The more effective antihypertensive groups according to randomized assays include: agiotensin-converting enzyme (ACE) inhibitors, agiotensin II blockers, aldosterone antagonists, and calcium blockers. Nitrates and diuretic agents have been used to reduce systolic pressure, especially when there is an aortic valvular regurgitation. Decrease of systolic pressure to result in a delay or an arrest of cardiovascular complications, of cognitive decline, and dementia in third age patients.

David García Barreto; Julio Álvarez González; Raymid García Fernández; Juan Valiente Mustelier; Alberto Hernández Cañero

2009-01-01

94

The vitamin D receptor activator paricalcitol prevents fibrosis and diastolic dysfunction in a murine model of pressure overload.  

UK PubMed Central (United Kingdom)

BACKGROUND: Activation of the vitamin D-vitamin D receptor (VDR) axis has been shown to reduce blood pressure and left ventricular (LV) hypertrophy. Besides cardiac hypertrophy, cardiac fibrosis is a key element of adverse cardiac remodeling. We hypothesized that activation of the VDR by paricalcitol would prevent fibrosis and LV diastolic dysfunction in an established murine model of cardiac remodeling. METHODS: Mice were subjected to transverse aortic constriction (TAC) to induce cardiac hypertrophy. Mice were treated with paricalcitol, losartan, or a combination of both for a period of four consecutive weeks. RESULTS: The fixed aortic constriction caused similar increase in blood pressure, both in untreated and paricalcitol- or losartan-treated mice. TAC significantly increased LV weight compared to sham operated animals (10.2±0.7 vs. 6.9±0.3 mg/mm, p<0.05). Administration of either paricalcitol (10.5±0.7), losartan (10.8±0.4), or a combination of both (9.2±0.6) did not reduce LV weight. Fibrosis was significantly increased in mice undergoing TAC (5.9±1.0 vs. sham 2.4±0.8%, p<0.05). Treatment with losartan and paricalcitol reduced fibrosis (paricalcitol 1.6±0.3% and losartan 2.9±0.6%, both p<0.05 vs. TAC). This reduction in fibrosis in paricalcitol treated mice was associated with improved indices of LV contraction and relaxation, e.g. dPdtmax and dPdtmin and lower LV end diastolic pressure, and relaxation constant Tau. Also, treatment with paricalcitol and losartan reduced mRNA expression of ANP, fibronectin, collagen III and TIMP-1. DISCUSSION: Treatment with the selective VDR activator paricalcitol reduces myocardial fibrosis and preserves diastolic LV function due to pressure overload in a mouse model. This is associated with a reduced percentage of fibrosis and a decreased expression of ANP and several other tissue markers.

Meems LM; Cannon MV; Mahmud H; Voors AA; van Gilst WH; Silljé HH; Ruifrok WP; de Boer RA

2012-11-01

95

Arterial blood pressure and cardiovascular responses to yoga practice.  

UK PubMed Central (United Kingdom)

CONTEXT: Yoga is qualitatively different from any other mode of physical activity in that it consists of a unique combination of isometric muscular contractions, stretching exercises, relaxation techniques, and breathing exercises. In particular, yoga postures consist of systemic isometric contractions that are known to elicit marked increases in mean blood pressure that are not observed during dynamic exercise. Stretching can also induce increases in blood pressure and sympathetic nerve activity in the muscles. Currently, not much is known about changes in blood pressure and other cardiovascular responses to yoga practice. OBJECTIVE: The study intended to determine the acute effects of one session of hatha yoga practice on blood pressure and other cardiovascular responses. To gain insight into the long-term effects of yoga practice, both novice (n = 19) and advanced (n = 18) yoga practitioners were studied. DESIGN: The two groups were matched for age, gender, BMI, and blood pressure. SETTING: The setting was a research laboratory at a university. PARTICIPANTS: Thirty-six apparently healthy, nonobese, sedentary, or recreationally active individuals from the community participated in the study. Intervention The intervention comprised one session of yoga practice, in which participants followed a custom made instructional video providing a yoga routine that consisted of a series of 23 hatha-based yoga postures. OUTCOME MEASURES: Prior to arriving at the laboratory, each participant completed a research health questionnaire, a training-status questionnaire, and a yoga-experience questionnaire. Prior to the yoga practice, each participant's height, body fat percentage, trunk or lumbar flexibility, and arterial stiffness as assessed by carotid femoral pulse wave velocity (cfPWV) were measured. For each posture during the yoga practice, the study continuously measured systolic, mean, and diastolic blood pressures, heart rate, stroke volume, and cardiac output. RESULTS: Systolic, mean, and diastolic blood pressures increased significantly during the yoga practice. The magnitude of these increases in blood pressure was greatest with standing postures. Heart rate and cardiac output increased significantly during yoga practice, especially with standing postures. Overall, no differences existed in cardiovascular responses between the novice and advanced practitioners throughout the yoga testing session; cfPWV velocity was significantly and inversely associated with lumbar flexion but not with sit-and-reach test scores. CONCLUSIONS: The research team concluded that a variety of hatha yoga postures, especially standing postures, evoked significant increases in blood pressure. The elevation in blood pressure due to yoga practice was associated with increases in cardiac output and heart rate, which are responses similar to those observed in isometric exercise. The lack of obvious differences in blood pressure and other cardiovascular responses between novice and advanced yoga practitioners suggests that long-term yoga practice does not attenuate acute yoga responses.

Miles SC; Chun-Chung C; Hsin-Fu L; Hunter SD; Dhindsa M; Nualnim N; Tanaka H

2013-01-01

96

Ambulatory arterial stiffness index and nocturnal blood pressure dipping in pregnancies complicated by hypertension.  

UK PubMed Central (United Kingdom)

BACKGROUND: The study sets out to examine differences in arterial stiffness and nocturnal blood pressure dipping as outcomes in women with gestational hypertension compared with healthy pregnant women during pregnancy and 3 months after delivery. METHODS AND RESULTS: We prospectively studied a cohort of 60 women during the third trimester of pregnancy; of them, 28 suffered pregnancy-induced hypertension or pre-eclampsia and 32 had uncomplicated singleton pregnancies. Subsequently, 42 of these were re-examined 3 months after delivery. In women with a hypertensive disorder, the nocturnal fall in blood pressure (dipping) was significantly smaller than in the normotensive group (systolic, P = 0·031; diastolic, P<0·001), but after pregnancy, this difference disappeared (systolic, P = 0·941; diastolic, P = 0·907). Ambulatory arterial stiffness index (AASI) assessed after pregnancy correlated inversely with fasting glucose level during pregnancy (r = -0·580, P = 0·018), both systolic (r = -0·651, P = 0·012) and diastolic (r = -0·687, P = 0·007) nocturnal dipping and total cholesterol concentration after pregnancy (r = -0·526, P = 0·036). CONCLUSIONS: A hypertensive disorder during pregnancy was associated with a flattened circadian blood pressure response, which was restored after delivery. Higher arterial stiffness predicted the signs of postpartum metabolic syndrome and correlated also with non-dipping, especially postpartum.

Kärkkäinen H; Saarelainen H; Laitinen T; Heiskanen N; Valtonen P; Laitinen T; Vanninen E; Heinonen S

2013-06-01

97

Utility of pulmonary venous flow diastolic deceleration time in an adult patient undergoing surgical closure of atrial septal defect and coronary artery bypass grafting.  

UK PubMed Central (United Kingdom)

Acute left ventricular (LV) failure has been reported after surgical closure of atrial septal defect (ASD) in adult patients. We report acute LV failure in a 56 year old gentleman following coronary artery bypass grafting (CABG) and surgical closure of ASD. Transesophageal echocardiography examination of the patient following closure of ASD and CABG showed a residual ASD and a shunt (Qp :Qs = 1.5). The residual ASD was closed after re-institution of cardiopulmonary bypass (CPB) under cardioplegic cardiac arrest. However, the patient did not tolerate closure of the residual ASD. The CPB was re-established and under cardioplegic cardiac arrest residual ASD was reopened to create a fenestration. This time patient was weaned easily from CPB. Postoperatively, 16 hours after extubation, patient became hemodynamically unstable, the patient was electively put on ventilator and intra-aortic balloon pump. Later the patient was weaned off successfully from ventilator. Retrospective analysis of pulmonary venous flow diastolic deceleration time (PVDT D ) recorded during prebypass period measured 102 msec suggestive of high left atrial pressure which indicate possibility of LV failure after ASD closure.

Agrawal DR; Sayeed MR; Chakravarthy MR; Patil TA

2013-01-01

98

Relationship between diastolic perfusion pressure and progressive optic neuropathy as determined by Heidelberg retinal tomography topographic change analysis.  

UK PubMed Central (United Kingdom)

PURPOSE: To determine through retrospective file analysis which clinical factors best predict glaucomatous optic neuropathy as evaluated by Heidelberg retinal tomography (HRT II) imaging. METHODS: One HUNDRED twenty-two records from patients referred for HRT imaging at the University of Waterloo Ocular Heath Clinic met inclusion criteria for this study and were reviewed. Topographic change analysis (TCA) data generated by HRT were examined in addition to the following clinical information: diastolic blood pressure, right arm sitting, intraocular pressure, and central corneal thickness. All HRT scans included were required to have 20 ?m or better standard deviation (SD) on acquisition and deemed "very good" quality or "excellent" by HRT software. Based on previously defined published HRT TCA change criteria, each patient was allocated to one of the following groups: stable, borderline, or progressive. RESULTS: Diastolic perfusion pressure (DPP) was found to be significantly lower in the borderline and progressive groups compared with the stable group (P < 0.001). DPP was also lower significantly lower in the progressive group compared with the borderline group (P < 0.001). CONCLUSIONS: Low DPP appears to be a reasonable predictor of progressive optic neuropathy as determined using scans of <20 ?m SD on the HRT TCA platform. DPP of 56 mm Hg or lower appears to be a clinically useful threshold to identify patients at increased risk of progressive optic neuropathy.

Quaid P; Simpson T; Freddo T

2013-01-01

99

Measurement of Blood Pressure Using an Arterial Pulsimeter Equipped with a Hall Device  

Directory of Open Access Journals (Sweden)

Full Text Available To measure precise blood pressure (BP) and pulse rate without using a cuff, we have developed an arterial pulsimeter consisting of a small, portable apparatus incorporating a Hall device. Regression analysis of the pulse wave measured during testing of the arterial pulsimeter was conducted using two equations of the BP algorithm. The estimated values of BP obtained by the cuffless arterial pulsimeter over 5 s were compared with values obtained using electronic or liquid mercury BP meters. The standard deviation between the estimated values and the measured values for systolic and diastolic BP were 8.3 and 4.9, respectively, which are close to the range of values of the BP International Standard. Detailed analysis of the pulse wave measured by the cuffless radial artery pulsimeter by detecting changes in the magnetic field can be used to develop a new diagnostic algorithm for BP, which can be applied to new medical apparatus such as the radial artery pulsimeter.

Sang-Suk Lee; Dong-Hyun Nam; You-Sik Hong; Woo-Beom Lee; Il-Ho Son; Keun-Ho Kim; Jong-Gu Choi

2011-01-01

100

Measurement of blood pressure using an arterial pulsimeter equipped with a Hall device.  

UK PubMed Central (United Kingdom)

To measure precise blood pressure (BP) and pulse rate without using a cuff, we have developed an arterial pulsimeter consisting of a small, portable apparatus incorporating a Hall device. Regression analysis of the pulse wave measured during testing of the arterial pulsimeter was conducted using two equations of the BP algorithm. The estimated values of BP obtained by the cuffless arterial pulsimeter over 5 s were compared with values obtained using electronic or liquid mercury BP meters. The standard deviation between the estimated values and the measured values for systolic and diastolic BP were 8.3 and 4.9, respectively, which are close to the range of values of the BP International Standard. Detailed analysis of the pulse wave measured by the cuffless radial artery pulsimeter by detecting changes in the magnetic field can be used to develop a new diagnostic algorithm for BP, which can be applied to new medical apparatus such as the radial artery pulsimeter.

Lee SS; Nam DH; Hong YS; Lee WB; Son IH; Kim KH; Choi JG

2011-01-01

 
 
 
 
101

Measurement of blood pressure using an arterial pulsimeter equipped with a Hall device.  

Science.gov (United States)

To measure precise blood pressure (BP) and pulse rate without using a cuff, we have developed an arterial pulsimeter consisting of a small, portable apparatus incorporating a Hall device. Regression analysis of the pulse wave measured during testing of the arterial pulsimeter was conducted using two equations of the BP algorithm. The estimated values of BP obtained by the cuffless arterial pulsimeter over 5 s were compared with values obtained using electronic or liquid mercury BP meters. The standard deviation between the estimated values and the measured values for systolic and diastolic BP were 8.3 and 4.9, respectively, which are close to the range of values of the BP International Standard. Detailed analysis of the pulse wave measured by the cuffless radial artery pulsimeter by detecting changes in the magnetic field can be used to develop a new diagnostic algorithm for BP, which can be applied to new medical apparatus such as the radial artery pulsimeter. PMID:22319381

Lee, Sang-Suk; Nam, Dong-Hyun; Hong, You-Sik; Lee, Woo-Beom; Son, Il-Ho; Kim, Keun-Ho; Choi, Jong-Gu

2011-01-31

102

Conventional and 24-h ambulatory blood pressure as independent predictors of elastic arterial properties.  

UK PubMed Central (United Kingdom)

OBJECTIVE: No population study investigated whether 24-h ambulatory blood pressure (ABP) predicts distensibility of the elastic common carotid (DCar) and the muscular femoral (DFem) arteries over and beyond conventionally measured blood pressure (CBP). METHODS: At baseline, we measured CBP and 24-h ABP in 1063 randomly recruited participants (mean age, 44.3 years). CBP was the average of five consecutive readings obtained by trained observers at the participants' homes. We measured arterial distensibility by a wall-tracking ultrasound system, 21 months after CBP and ABP (5-95th percentile interval range, 13-33 months). RESULTS: Compared with men, women (49.2%) had higher (P<0.03) DCar (24.7 vs. 23.3 x 10(-3)/kPa) and higher DFem (10.6 vs. 9.2 x 10(-3)/kPa). In multivariate-adjusted models, including both CBP and ABP and stratified by sex, DCar was negatively related to systolic, diastolic, and mean arterial CBP in both sexes, and to diastolic ABP in women. DFem was inversely correlated with diastolic ABP in both sexes and with systolic and mean arterial ABP in men. Moreover, DFem was also negatively correlated with systolic and mean arterial CBP in men. In most instances, pulse pressure on CBP or ABP measurement did not predict DCar or DFem. No evidence of influential collinearity between CBP and ABP was observed. CONCLUSION: Depending on vascular territory, there is competition between highly standardized CBP and ABP in predicting DCar and DFem. These findings show that CBP under standardized conditions, and subject to rigorous quality control, is equally predictive of the elastic properties of large arteries as ABP.

Wizner B; Dechering DG; Thijs L; Kuznetsova T; Richart T; Jin Y; Gasowski J; O'Brien E; Struijker-Boudier HA; Grodzicki T; Staessen JA

2009-02-01

103

Effects of verapamil and propranolol on left ventricular systolic function and diastolic filling in patients with coronary artery disease: radionuclide angiographic studies at rest and during exercise  

Energy Technology Data Exchange (ETDEWEB)

To determine the effects of verapamil on left ventricular (LV) systolic function and diastolic filling in patients with coronary artery disease (CAD), researchers performed gated radionuclide angiography at rest and during exercise in 16 symptomatic patients before and during oral verapamil therapy (480 mg/day). Twelve patients were also studied during oral propranolol. LV ejection fraction at rest was normal in 13 patients, but abnormal diastolic filling at rest, defined as peak filling rate (PFR) less than 2.5 end-diastolic volumes (EDV)/sec or time to PFR greater than 180 msec, was present in 15. During verapamil, resting ejection fraction decreased, but resting diastolic filling improved: PFR increased and time to PFR decreased. Exercise ejection fraction did not change during verapamil, but exercise PFR increased, and exercise time to PFR decreased. In contrast, propranolol did not alter ejection fraction, PFR, or time to PFR at rest or during exercise. Thus, LV ejection fraction is decreased by verapamil at rest but is unchanged during exercise. While LV systolic function is not improved by verapamil, LV diastolic filling is enhanced by verapamil, both at rest and during exercise. These mechanisms may account in part for the symptomatic improvement in many patients during verapamil therapy.

Bonow, R.O.; Leon, M.B.; Rosing, D.R.; Kent, K.M.; Lipson, L.C.; Bacharach, S.L.; Green, M.V.; Epstein, S.E.

1982-06-01

104

Effects of verapamil and propranolol on left ventricular systolic function and diastolic filling in patients with coronary artery disease: radionuclide angiographic studies at rest and during exercise  

International Nuclear Information System (INIS)

To determine the effects of verapamil on left ventricular (LV) systolic function and diastolic filling in patients with coronary artery disease (CAD), researchers performed gated radionuclide angiography at rest and during exercise in 16 symptomatic patients before and during oral verapamil therapy (480 mg/day). Twelve patients were also studied during oral propranolol. LV ejection fraction at rest was normal in 13 patients, but abnormal diastolic filling at rest, defined as peak filling rate (PFR) less than 2.5 end-diastolic volumes (EDV)/sec or time to PFR greater than 180 msec, was present in 15. During verapamil, resting ejection fraction decreased, but resting diastolic filling improved: PFR increased and time to PFR decreased. Exercise ejection fraction did not change during verapamil, but exercise PFR increased, and exercise time to PFR decreased. In contrast, propranolol did not alter ejection fraction, PFR, or time to PFR at rest or during exercise. Thus, LV ejection fraction is decreased by verapamil at rest but is unchanged during exercise. While LV systolic function is not improved by verapamil, LV diastolic filling is enhanced by verapamil, both at rest and during exercise. These mechanisms may account in part for the symptomatic improvement in many patients during verapamil therapy

1982-01-01

105

Acute Effects of Swimming on the Arterial Pressure  

Directory of Open Access Journals (Sweden)

Full Text Available Aim. The purpose of this work was to verify the acute effects of a regular swimming programme on the arterial pressure of hypertensive adults. Material and methods. The sample was composed of 26 individuals who presented mild to moderate hypertension. The subjects were divided into two groups: the Experimental Group (EG) comprising 13 subjects (four men and nine women) and the Control Group (CG) comprising 13 subjects (seven men and six women), with average ages of 38.40 ± 8.24 and 38.36 ± 8.96 years, respectively. GE individuals took part in a regular swimming programme consisting of three weekly fifty-minute sessions of training (ST) for 10 weeks, whereas GC individuals were instructed not to alter their physical activity and nutritional habits. The Kruskal-Wallis test was used to determine statistical significance (p < 0.05). Results. At the end of the ten weeks, an increase of 4.8% in Systolic Blood Pressure at rest (from 133.67 ±2.26 to 138.56 ± 3.23) and an increase of 7.8% in Diastolic Blood Pressure (from 83.15 ± 1.50 to 89.67 ± 7.19) were observed. Conclusion. The results allow us to conclude that a regular swimming programme, consisting of training sessions three times a week for 10 weeks, was not sufficient to significantly alter the acute pressure levels of hypertensive adults.

Jairo Silva; Amandio Geraldes; Antônio Natali; João Pereira; Rodrigo Vale; Estélio Dantas

2009-01-01

106

Age and blood pressure levels modify the functional properties of central but not peripheral arteries.  

UK PubMed Central (United Kingdom)

The effect of age and blood pressure on the carotid and the radial artery distensibilities was investigated. Patients referred to the outpatient clinic of the Department of Internal Medicine and Geriatric Medicine were asked to participate in the study. The carotid and radial artery distensibility coefficients were measured. Linear regression analyses were performed to investigate the associations between determinants and arterial distensibility. The mean age of the participants was 72.3 years, and 41.5% were men. Carotid distensibility decreased with age in adjusted models (beta = -0.317; 95% confidence interval [CI], -0.241, -0.055), whereas the radial distensibility did not decrease. Levels of systolic blood pressure and mean arterial pressure were associated with decreasing levels of carotid distensibility, whereas the diastolic blood pressure and pulse pressure were not associated (beta = -0.571; 95% CI, -0.404, -0.007; beta = -0.410; 95% CI, -0.308, -0.101, respectively). In conclusion, age and blood pressure levels are associated with the distensibility of the central arteries but not with that of the peripheral arteries.

Ruitenbeek AG; van der Cammen TJ; van den Meiracker AH; Mattace-Raso FU

2008-06-01

107

[Arterial blood pressure in persons of elderly, senile age and long-livers of Yakutsk: population screening].  

UK PubMed Central (United Kingdom)

The values of arterial blood pressure according to the Yakutsk population screening at the age of 60 and older have been studied. The average values of systolic arterial pressure (both sexes--148, men--145, women--151 mm Hg) are higher than normal values specified by Society of Cardiology of Russian Federation. Long-living persons show its decrease that is more marked in men. The average values of diastolic arterial pressure (both sexes--87, men--88, women--87 mm Hg) correspond to the category of high normal pressure and are decreasing with age to more extent in men than in women. The average values of pulse pressure in elderly and senile age are higher than normal values (both sexes--61, men--57, women--64 mm Hg) with a tendency to grow by 90 years old. Differences in arterial blood pressure levels are educed in gerontic persons depending on presence of abdominal obesity, hypercholesterolemia, hyperglycemia, smoking and family anamnesis with cases of hypertension.

Tatarinova OV; Nikitin IuP; Neustroeva VN; Shcherbakova LV; Gorokhova ZP

2013-01-01

108

Subendocardial viability index is related to the diastolic/systolic time ratio and left ventricular filling pressure, not to aortic pressure: an invasive study in resting humans.  

UK PubMed Central (United Kingdom)

1. The myocardial perfusion relative to left ventricular (LV) workload may be estimated by the subendocardial viability index (SVI). The SVI is a pressure-time integral ratio: the numerator is the area between aortic and LV pressures during diastolic time (DT) and the denominator is the area under the LV pressure curve during systolic time (ST). New non-invasive tonometric devices allow estimation of SVI but neglect LV end-diastolic pressure (LVEDP) in the calculation. The aim of the present study was to determine the haemodynamic correlates of SVI and to test the effects of neglecting LVEDP on SVI estimation. 2. High-fidelity pressures were recorded at rest at the aortic root and LV level in 38 subjects (33 men/five women; mean (+/-SD) age 47 +/- 14 years; nine controls and 29 patients with various cardiac diseases). The SVI (1.16 +/- 0.28) was positively correlated with the DT/ST ratio (1.71 +/- 0.35; r(2) = 0.81) and was negatively correlated with LVEDP (15 +/- 7 mmHg; multiple r(2) = 0.94). The SVI was not related to aortic pressure (mean, pulse, mean systolic, mean diastolic). In 17 patients with LVEDP > 14 mmHg, the SVI calculated assuming zero LVEDP was 33 +/- 15% higher (range 16-70%) than the actual SVI. 3. The DT/ST ratio was the main determinant of the myocardial perfusion relative to cardiac workload and accounted for 81% of SVI variability, whereas aortic pressure did not contribute. Although LVEDP accounted for only 13% of SVI variability, it should be taken into account in the non-invasive calculation of SVI in patients with known or suspected increases in LV filling pressure.

Chemla D; Nitenberg A; Teboul JL; Richard C; Monnet X; le Clesiau H; Valensi P; Brahimi M

2009-04-01

109

Subendocardial viability index is related to the diastolic/systolic time ratio and left ventricular filling pressure, not to aortic pressure: an invasive study in resting humans.  

Science.gov (United States)

1. The myocardial perfusion relative to left ventricular (LV) workload may be estimated by the subendocardial viability index (SVI). The SVI is a pressure-time integral ratio: the numerator is the area between aortic and LV pressures during diastolic time (DT) and the denominator is the area under the LV pressure curve during systolic time (ST). New non-invasive tonometric devices allow estimation of SVI but neglect LV end-diastolic pressure (LVEDP) in the calculation. The aim of the present study was to determine the haemodynamic correlates of SVI and to test the effects of neglecting LVEDP on SVI estimation. 2. High-fidelity pressures were recorded at rest at the aortic root and LV level in 38 subjects (33 men/five women; mean (+/-SD) age 47 +/- 14 years; nine controls and 29 patients with various cardiac diseases). The SVI (1.16 +/- 0.28) was positively correlated with the DT/ST ratio (1.71 +/- 0.35; r(2) = 0.81) and was negatively correlated with LVEDP (15 +/- 7 mmHg; multiple r(2) = 0.94). The SVI was not related to aortic pressure (mean, pulse, mean systolic, mean diastolic). In 17 patients with LVEDP > 14 mmHg, the SVI calculated assuming zero LVEDP was 33 +/- 15% higher (range 16-70%) than the actual SVI. 3. The DT/ST ratio was the main determinant of the myocardial perfusion relative to cardiac workload and accounted for 81% of SVI variability, whereas aortic pressure did not contribute. Although LVEDP accounted for only 13% of SVI variability, it should be taken into account in the non-invasive calculation of SVI in patients with known or suspected increases in LV filling pressure. PMID:19018798

Chemla, Denis; Nitenberg, Alain; Teboul, Jean-Louis; Richard, Christian; Monnet, Xavier; le Clesiau, Hervé; Valensi, Paul; Brahimi, Mabrouk

2008-11-07

110

A comparison of continuous non-invasive arterial pressure with invasive radial and femoral pressure in patients undergoing cardiac surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: Non-invasive continous monitoring of finger arterial pressure has gained increasing interest. The aim of the present study was to compare the accuracy of non-invasive reconstructed brachial artery pressure by the Nexfin™ device (NFAP) with invasive femoral (IFAP) and radial (IRAP) artery pressure before and after cardiopulmonary bypass (CPB). METHODS: Fifty patients scheduled for elective coronary surgery were studied before and after CPB, respectively. Each patient was monitored with the non-invasive system, and both an indwelling femoral and radial arterial catheter. A passive leg raising maneuver was also performed before and after CPB. Measurements included mean (MAP), systolic (SAP) and diastolic (DAP) arterial pressure by NFAP (MAP,SAP,DAP(NFAP)), IFAP (MAP,SAP,DAP(IFAP)) and IRAP (MAP,SAP,DAP(IRAP)). Percentage changes of MAP for all measurement sites were also calculated. RESULTS: There was a moderate correlation between MAP(NFAP) and MAP(IFAP) both before (r=0.64, P<0.0001) and after (r=0.57, P<0.0001) CPB, with a percentage error (PE) of 29% and 27%, respectively. Correlation coefficients between MAP(NFAP) and MAP(IRAP) were r=0.53, P<0.0001 (PE 34%) before and r=0.54, P<0.0001 (PE 29%) after CPB. There was a significant correlation in percentage changes between ?MAP(NFAP) and ?MAP(IFAP) before (r=0.70, P<0.0001) and after (r=0.71, P<0.0001) CPB and for ?MAP(NFAP) and ?MAP(IRAP) (r=0.67, P<0.0001; r=0.74, P<0.0001), respectively. CONCLUSION: Non-invasive, reconstructed brachial artery pressure showed moderate correlation compared with both invasive femoral and radial artery pressure. Furthermore, the non-invasive monitoring system was able to reflect percentage changes in mean arterial pressure in a moderate fashion.

Broch O; Bein B; Gruenewald M; Carstens A; Illies C; Schöneich F; Steinfath M; Renner J

2013-03-01

111

Plasma advanced glycation end products (AGEs) and NF-?B activity are independent determinants of diastolic and pulse pressure  

DEFF Research Database (Denmark)

Abstract Background: High levels of circulating advanced glycation end products (AGEs) can initiate chronic low-grade activation of the immune system (CLAIS) with each of these factors independently associated with cardiovascular (CV) morbidity and mortality. Therefore, our objective was to characterize the relationship between serum AGEs, CLAIS and other risk factors for CV disease in normotensive non-diabetic individuals. Methods: We measured body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, lipid and glucose profile in 44 non-diabetic volunteers (17 female, 27 males). Carboxymethyl-lysine (CML) was measured by ELISA as a marker for circulating AGEs and NF-?B p65 activity as an inflammatory marker by DNA-binding in peripheral blood mononuclear cells lysates (PBMC). Results: Plasma CML concentrations were related to diastolic blood pressure (r=-0.51, p

Sourris, Karly C; Lyons, Jasmine G

2013-01-01

112

The Effects of Cola Acuminata on Arterial Blood Pressure  

Directory of Open Access Journals (Sweden)

Full Text Available Caffeine has been proven to be vasoactive and augments the release of calcium from sarcoplasmic reticulum. Interestingly, caffeine is the most active principle of Cola acuminata-commonly consumed in Nigeria. This study is designed to determine its effects on blood pressure using 20 Sprague dawley rats with an average weight of 150g. The animals were subdivided into 2 groups of 10 rats each (control and test groups). The control rats were fed with rat chow while the test groups were fed with salt diet that was prepared by adding 7.7g of salt to 92.3g of normal rats chow in order to achieve hypertension. Substance extraction was by chloroform extraction. With the extract, different levels of the substance concentration were prepared and subsequently infused in sequence to the test rats. The results showed that diastolic blood pressure was more responsive to changes in concentration of Cola acuminata extract with a significant concentration dependent increase in the arterial blood pressure of both the normotensive and hypertensive rats. Considering the fact that Cola acuminata consumption is part of our culture and the fact that some become addicted, it is our opinion therefore, that the need for efforts towards identifying the cardiovascular implications of caffeine containing consumables, can never be over emphasized.

E.N.S. Igbinovia; A.C. Ugwu; A.O. Nwaopara; H.O. Otamere; W.A. Adisa

2009-01-01

113

Resistance Artery Creatine Kinase mRNA and Blood Pressure in Humans.  

UK PubMed Central (United Kingdom)

Hypertension remains the main risk factor for cardiovascular death. Environmental and biological factors are known to contribute to the condition, and circulating creatine kinase was reported to be the main predictor of blood pressure in the general population. This was proposed to be because of high resistance artery creatine kinase-BB rapidly regenerating ATP for vascular contractility. Therefore, we assessed whether creatine kinase isoenzyme mRNA levels in human resistance arteries are associated with blood pressure. We isolated resistance-sized arteries from omental fat donated by consecutive women undergoing uterine fibroid surgery. Blood pressure was measured in the sitting position. Vessels of 13 women were included, 6 normotensive and 7 hypertensive, mean age 42.9 years (SE, 1.6) and mean systolic/diastolic blood pressure, 144.8 (8.0)/86.5 (4.3) mm Hg. Arteriolar creatine kinase isoenzyme mRNA was assessed using quantitative real-time polymerase chain reaction. Normalized creatine kinase B mRNA copy numbers, ranging from 5.2 to 24.4 (mean, 15.0; SE, 1.9), showed a near-perfect correlation with diastolic blood pressure (correlation coefficient, 0.9; 95% confidence interval, 0.6-1.0) and were well correlated with systolic blood pressure, with a 90% relative increase in resistance artery creatine kinase B mRNA in hypertensives compared with normotensives, normalized copy numbers were, respectively, 19.3 (SE, 2.0) versus 10.1 (SE, 2.1), P=0.0045. To our knowledge, this is the first direct evidence suggesting that resistance artery creatine kinase mRNA expression levels concur with blood pressure levels, almost doubling with hypertension. These findings add to the evidence that creatine kinase might be involved in the vasculature's pressor responses.

Karamat FA; Oudman I; Ris-Stalpers C; Afink GB; Keijser R; Clark JF; van Montfrans GA; Brewster LM

2013-10-01

114

Effects of pressure gradients between branches of the left coronary artery on the pressure axis intercept and the shape of steady state circumflex pressure-flow relations in dogs  

Energy Technology Data Exchange (ETDEWEB)

When steady state pressure-flow relations are studied in the circumflex coronary artery, pressure gradients develop between it and other branches of the left coronary artery. To assess the effects of these pressure gradients, the pressure axis intercept and shape of steady state circumflex pressure-flow relations were compared in the presence and absence of gradients after autoregulation was abolished, both in the beating heart and during long diastoles in dogs. The authors used peripheral coronary pressures and radionuclide-labeled microspheres to assess arterial collateral flow. In the beating heart, interarterial pressure gradients reduced the curvature at low circumflex pressures, and overestimated the mean pressure axis intercept by 7.8 mm Hg (P less than 0.05). The results were similar for the pressure-flow relations derived during long diastoles. This overestimation exaggerates the difference between the pressure axis intercept and coronary sinus pressure. The peripheral coronary pressure and microsphere results indicate that these effects are mediated largely by arterial collateral flow.

Messina, L.M.; Hanley, F.L.; Uhlig, P.N.; Baer, R.W.; Grattan, M.T.; Hoffman, J.I.

1985-01-01

115

Non-invasive continuous arterial pressure and cardiac index monitoring with Nexfin after cardiac surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: This observational study was designed to evaluate the reliability and precision of a new digital photoplethysmographic device (Nexfin, BMEYE B.V., Amsterdam, The Netherlands) for continuous and non-invasive assessment of arterial pressure and cardiac output. METHODS: Fifty consecutive adult subjects were prospectively enrolled at admission to the intensive care unit after conventional cardiac surgery and investigated hourly from T0 to T4. Simultaneous comparative systolic, diastolic, and mean arterial pressures and cardiac index (CI) data points were collected from an invasive radial artery catheter, transpulmonary thermodilution catheter, and the Nexfin device. Correlations were determined by linear regression. The Bland-Altman analysis was used to compare bias, precision, and limits of agreement. RESULTS: Six (12%) subjects were excluded from the analysis because of the inability to obtain a reliable photoplethysmographic signal. No complications were observed. A significant relationship was found between absolute values of photoplethysmographic and radial systolic (r(2)=0.56, P<0.001), diastolic (r(2)=0.61, P<0.001), and mean (r(2)=0.77, P<0.001) arterial pressures. A significant relationship was also found between transpulmonary thermodilution and Nexfin CI absolute values (r(2)=0.33, P<0.001). Bias, precision, and limits of agreement between the mean photoplethysmographic and radial arterial pressures were 4.6 (95% confidence interval: 3.7-5.5), 6.5, and -17.3 to 8.1 mm Hg, respectively. The percentage error between transpulmonary thermodilution and the Nexfin for CI measurement was 50%. CONCLUSIONS: The Nexfin device is safe, convenient, and reliable in measuring continuous non-invasive arterial pressure but not interchangeable with transpulmonary thermodilution to monitor CI.

Fischer MO; Avram R; Cârjaliu I; Massetti M; Gérard JL; Hanouz JL; Fellahi JL

2012-10-01

116

[Long time regulation of arterial blood pressure: facts and hypothesis].  

UK PubMed Central (United Kingdom)

The date about long time increase of blood pressure in conditions of excessive salt intake, constriction of renal artery in animals with initial low baroreceptor reflex is presented. Arterial hypertension in this case is accompanied by increase activity of sympathetic nervous system. The supposition that arterial baroreceptor reflex place a role in long time regulation of arterial blood pressure is expressed.

Tsyrlin VA

2013-04-01

117

Medida da pressão arterial em gestante/ Blood pressure measurement in pregnancy/ Toma de la presión arterial en embarazadas  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Trata-se de revisão da literatura à respeito da medida indireta da pressão arterial (P A) em gestante normotensa. Aborda as modificações ocorridas na pressão arterial sistólica e diastólica decorrentes da gravidez. São discutidos aspectos polêmicos no procedimento de medida da P A, como por exemplo qual a fase dos sons de Korotkoff (fase quatro ou cinco) que representa melhor a pressão diastólica e o uso da Monitorização Ambulatorial da Pressão Arterial. En (more) fatiza as recomendações de diferentes sociedades (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program e World Health Organization). Abstract in spanish Se trata de una revisión de la literatura con respeto a la toma indirecta de la presión arterial (PA) en embarazadas normotensas. Se describen los cámbios que ocurrer en la presión arterial sistólica y diastólica a causa del embarazo. Son discutidos aspectos polémicos en el procedimiento de la toma de la PA, como por ejemplo: cuál es la fase de los sonidos de Korotkoff (fases cuatro o cinco) que representa mejor la presión sistólica. Se enfatizan las recomendaci (more) ones de diferentes sociedades (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program and World Health Organization). Abstract in english This study deals with the review of the literature regarding the indirect blood pressure measurement in normal pregnant women. It shows the changes that happened whith the blood pressure due to pregnancy. Polemical aspects in the procedure of blood pressure measurement are discussed; for example, which one of the Korotkoff phases (4 or 5) that better represent the diastolic blood pressure and the use of Ambulatory Blood Pressure Monitoring in pregnancy. The recommendation (more) s from different societies are emphasized (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program and World Health Organization).

Oliveira, Sonia M. Junqueira V. de; Arcuri, Edna Apparecida Moura

1997-07-01

118

Medida da pressão arterial em gestante Toma de la presión arterial en embarazadas Blood pressure measurement in pregnancy  

Directory of Open Access Journals (Sweden)

Full Text Available Trata-se de revisão da literatura à respeito da medida indireta da pressão arterial (P A) em gestante normotensa. Aborda as modificações ocorridas na pressão arterial sistólica e diastólica decorrentes da gravidez. São discutidos aspectos polêmicos no procedimento de medida da P A, como por exemplo qual a fase dos sons de Korotkoff (fase quatro ou cinco) que representa melhor a pressão diastólica e o uso da Monitorização Ambulatorial da Pressão Arterial. Enfatiza as recomendações de diferentes sociedades (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program e World Health Organization).Se trata de una revisión de la literatura con respeto a la toma indirecta de la presión arterial (PA) en embarazadas normotensas. Se describen los cámbios que ocurrer en la presión arterial sistólica y diastólica a causa del embarazo. Son discutidos aspectos polémicos en el procedimiento de la toma de la PA, como por ejemplo: cuál es la fase de los sonidos de Korotkoff (fases cuatro o cinco) que representa mejor la presión sistólica. Se enfatizan las recomendaciones de diferentes sociedades (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program and World Health Organization).This study deals with the review of the literature regarding the indirect blood pressure measurement in normal pregnant women. It shows the changes that happened whith the blood pressure due to pregnancy. Polemical aspects in the procedure of blood pressure measurement are discussed; for example, which one of the Korotkoff phases (4 or 5) that better represent the diastolic blood pressure and the use of Ambulatory Blood Pressure Monitoring in pregnancy. The recommendations from different societies are emphasized (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program and World Health Organization).

Sonia M. Junqueira V. de Oliveira; Edna Apparecida Moura Arcuri

1997-01-01

119

Acute ingestion of beetroot bread increases endothelium-independent vasodilation and lowers diastolic blood pressure in healthy men: a randomized controlled trial.  

UK PubMed Central (United Kingdom)

Dietary nitrate, from beetroot, has been reported to lower blood pressure (BP) by the sequential reduction of nitrate to nitrite and further to NO in the circulation. However, the impact of beetroot on microvascular vasodilation and arterial stiffness is unknown. In addition, beetroot is consumed by only 4.5% of the UK population, whereas bread is a staple component of the diet. Thus, we investigated the acute effects of beetroot bread (BB) on microvascular vasodilation, arterial stiffness, and BP in healthy participants. Twenty-three healthy men received 200 g bread containing 100 g beetroot (1.1 mmol nitrate) or 200 g control white bread (CB; 0 g beetroot, 0.01 mmol nitrate) in an acute, randomized, open-label, controlled crossover trial. The primary outcome was postprandial microvascular vasodilation measured by laser Doppler iontophoresis and the secondary outcomes were arterial stiffness measured by Pulse Wave Analysis and Velocity and ambulatory BP measured at regular intervals for a total period of 6 h. Plasma nitrate and nitrite were measured at regular intervals for a total period of 7 h. The incremental area under the curve (0-6 h after ingestion of bread) for endothelium-independent vasodilation was greater (P = 0.017) and lower for diastolic BP (DBP; P = 0.032) but not systolic (P = 0.99) BP after BB compared with CB. These effects occurred in conjunction with increases in plasma and urinary nitrate (P < 0.0001) and nitrite (P < 0.001). BB acutely increased endothelium-independent vasodilation and decreased DBP. Therefore, enriching bread with beetroot may be a suitable vehicle to increase intakes of cardioprotective beetroot in the diet and may provide new therapeutic perspectives in the management of hypertension.

Hobbs DA; Goulding MG; Nguyen A; Malaver T; Walker CF; George TW; Methven L; Lovegrove JA

2013-09-01

120

Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure.  

Science.gov (United States)

Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 × 10(-8) to P = 2.3 × 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP. PMID:21909110

Wain, Louise V; Verwoert, Germaine C; O'Reilly, Paul F; Shi, Gang; Johnson, Toby; Johnson, Andrew D; Bochud, Murielle; Rice, Kenneth M; Henneman, Peter; Smith, Albert V; Ehret, Georg B; Amin, Najaf; Larson, Martin G; Mooser, Vincent; Hadley, David; Dörr, Marcus; Bis, Joshua C; Aspelund, Thor; Esko, Tõnu; Janssens, A Cecile J W; Zhao, Jing Hua; Heath, Simon; Laan, Maris; Fu, Jingyuan; Pistis, Giorgio; Luan, Jian'an; Arora, Pankaj; Lucas, Gavin; Pirastu, Nicola; Pichler, Irene; Jackson, Anne U; Webster, Rebecca J; Zhang, Feng; Peden, John F; Schmidt, Helena; Tanaka, Toshiko; Campbell, Harry; Igl, Wilmar; Milaneschi, Yuri; Hottenga, Jouke-Jan; Vitart, Veronique; Chasman, Daniel I; Trompet, Stella; Bragg-Gresham, Jennifer L; Alizadeh, Behrooz Z; Chambers, John C; Guo, Xiuqing; Lehtimäki, Terho; Kühnel, Brigitte; Lopez, Lorna M; Polašek, Ozren; Boban, Mladen; Nelson, Christopher P; Morrison, Alanna C; Pihur, Vasyl; Ganesh, Santhi K; Hofman, Albert; Kundu, Suman; Mattace-Raso, Francesco U S; Rivadeneira, Fernando; Sijbrands, Eric J G; Uitterlinden, Andre G; Hwang, Shih-Jen; Vasan, Ramachandran S; Wang, Thomas J; Bergmann, Sven; Vollenweider, Peter; Waeber, Gérard; Laitinen, Jaana; Pouta, Anneli; Zitting, Paavo; McArdle, Wendy L; Kroemer, Heyo K; Völker, Uwe; Völzke, Henry; Glazer, Nicole L; Taylor, Kent D; Harris, Tamara B; Alavere, Helene; Haller, Toomas; Keis, Aime; Tammesoo, Mari-Liis; Aulchenko, Yurii; Barroso, Inês; Khaw, Kay-Tee; Galan, Pilar; Hercberg, Serge; Lathrop, Mark; Eyheramendy, Susana; Org, Elin; Sõber, Siim; Lu, Xiaowen; Nolte, Ilja M; Penninx, Brenda W; Corre, Tanguy; Masciullo, Corrado; Sala, Cinzia; Groop, Leif; Voight, Benjamin F; Melander, Olle; O'Donnell, Christopher J; Salomaa, Veikko; d'Adamo, Adamo Pio; Fabretto, Antonella; Faletra, Flavio; Ulivi, Sheila; Del Greco, Fabiola M; Facheris, Maurizio; Collins, Francis S; Bergman, Richard N; Beilby, John P; Hung, Joseph; Musk, A William; Mangino, Massimo; Shin, So-Youn; Soranzo, Nicole; Watkins, Hugh; Goel, Anuj; Hamsten, Anders; Gider, Pierre; Loitfelder, Marisa; Zeginigg, Marion; Hernandez, Dena; Najjar, Samer S; Navarro, Pau; Wild, Sarah H; Corsi, Anna Maria; Singleton, Andrew; de Geus, Eco J C; Willemsen, Gonneke; Parker, Alex N; Rose, Lynda M; Buckley, Brendan; Stott, David; Orru, Marco; Uda, Manuela; van der Klauw, Melanie M; Zhang, Weihua; Li, Xinzhong; Scott, James; Chen, Yii-Der Ida; Burke, Gregory L; Kähönen, Mika; Viikari, Jorma; Döring, Angela; Meitinger, Thomas; Davies, Gail; Starr, John M; Emilsson, Valur; Plump, Andrew; Lindeman, Jan H; Hoen, Peter A C 't; König, Inke R; Felix, Janine F; Clarke, Robert; Hopewell, Jemma C; Ongen, Halit; Breteler, Monique; Debette, Stéphanie; Destefano, Anita L; Fornage, Myriam; Mitchell, Gary F; Smith, Nicholas L; Holm, Hilma; Stefansson, Kari; Thorleifsson, Gudmar; Thorsteinsdottir, Unnur; Samani, Nilesh J; Preuss, Michael; Rudan, Igor; Hayward, Caroline; Deary, Ian J; Wichmann, H-Erich; Raitakari, Olli T; Palmas, Walter; Kooner, Jaspal S; Stolk, Ronald P; Jukema, J Wouter; Wright, Alan F; Boomsma, Dorret I; Bandinelli, Stefania; Gyllensten, Ulf B; Wilson, James F; Ferrucci, Luigi; Schmidt, Reinhold; Farrall, Martin; Spector, Tim D; Palmer, Lyle J; Tuomilehto, Jaakko; Pfeufer, Arne; Gasparini, Paolo; Siscovick, David; Altshuler, David; Loos, Ruth J F; Toniolo, Daniela; Snieder, Harold; Gieger, Christian; Meneton, Pierre; Wareham, Nicholas J; Oostra, Ben A; Metspalu, Andres; Launer, Lenore; Rettig, Rainer; Strachan, David P; Beckmann, Jacques S; Witteman, Jacqueline C M; Erdmann, Jeanette; van Dijk, Ko Willems; Boerwinkle, Eric; Boehnke, Michael; Ridker, Paul M; Jarvelin, Marjo-Riitta; Chakravarti, Aravinda; Abecasis, Goncalo R; Gudnason, Vilmundur; Newton-Cheh, Christopher; Levy, Daniel; Munroe, Patricia B; Psaty, Bruce M; Caulfield, Mark J; Rao, Dabeeru C; Tobin, Martin D; Elliott, Paul; van Duijn, Cornelia M

2011-09-11

 
 
 
 
121

Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure.  

UK PubMed Central (United Kingdom)

Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 × 10(-8) to P = 2.3 × 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP.

Wain LV; Verwoert GC; O'Reilly PF; Shi G; Johnson T; Johnson AD; Bochud M; Rice KM; Henneman P; Smith AV; Ehret GB; Amin N; Larson MG; Mooser V; Hadley D; Dörr M; Bis JC; Aspelund T; Esko T; Janssens AC; Zhao JH; Heath S; Laan M; Fu J; Pistis G; Luan J; Arora P; Lucas G; Pirastu N; Pichler I; Jackson AU; Webster RJ; Zhang F; Peden JF; Schmidt H; Tanaka T; Campbell H; Igl W; Milaneschi Y; Hottenga JJ; Vitart V; Chasman DI; Trompet S; Bragg-Gresham JL; Alizadeh BZ; Chambers JC; Guo X; Lehtimäki T; Kühnel B; Lopez LM; Polašek O; Boban M; Nelson CP; Morrison AC; Pihur V; Ganesh SK; Hofman A; Kundu S; Mattace-Raso FU; Rivadeneira F; Sijbrands EJ; Uitterlinden AG; Hwang SJ; Vasan RS; Wang TJ; Bergmann S; Vollenweider P; Waeber G; Laitinen J; Pouta A; Zitting P; McArdle WL; Kroemer HK; Völker U; Völzke H; Glazer NL; Taylor KD; Harris TB; Alavere H; Haller T; Keis A; Tammesoo ML; Aulchenko Y; Barroso I; Khaw KT; Galan P; Hercberg S; Lathrop M; Eyheramendy S; Org E; Sõber S; Lu X; Nolte IM; Penninx BW; Corre T; Masciullo C; Sala C; Groop L; Voight BF; Melander O; O'Donnell CJ; Salomaa V; d'Adamo AP; Fabretto A; Faletra F; Ulivi S; Del Greco F; Facheris M; Collins FS; Bergman RN; Beilby JP; Hung J; Musk AW; Mangino M; Shin SY; Soranzo N; Watkins H; Goel A; Hamsten A; Gider P; Loitfelder M; Zeginigg M; Hernandez D; Najjar SS; Navarro P; Wild SH; Corsi AM; Singleton A; de Geus EJ; Willemsen G; Parker AN; Rose LM; Buckley B; Stott D; Orru M; Uda M; van der Klauw MM; Zhang W; Li X; Scott J; Chen YD; Burke GL; Kähönen M; Viikari J; Döring A; Meitinger T; Davies G; Starr JM; Emilsson V; Plump A; Lindeman JH; Hoen PA; König IR; Felix JF; Clarke R; Hopewell JC; Ongen H; Breteler M; Debette S; Destefano AL; Fornage M; Mitchell GF; Smith NL; Holm H; Stefansson K; Thorleifsson G; Thorsteinsdottir U; Samani NJ; Preuss M; Rudan I; Hayward C; Deary IJ; Wichmann HE; Raitakari OT; Palmas W; Kooner JS; Stolk RP; Jukema JW; Wright AF; Boomsma DI; Bandinelli S; Gyllensten UB; Wilson JF; Ferrucci L; Schmidt R; Farrall M; Spector TD; Palmer LJ; Tuomilehto J; Pfeufer A; Gasparini P; Siscovick D; Altshuler D; Loos RJ; Toniolo D; Snieder H; Gieger C; Meneton P; Wareham NJ; Oostra BA; Metspalu A; Launer L; Rettig R; Strachan DP; Beckmann JS; Witteman JC; Erdmann J; van Dijk KW; Boerwinkle E; Boehnke M; Ridker PM; Jarvelin MR; Chakravarti A; Abecasis GR; Gudnason V; Newton-Cheh C; Levy D; Munroe PB; Psaty BM; Caulfield MJ; Rao DC; Tobin MD; Elliott P; van Duijn CM

2011-10-01

122

Predicting blood pressure response after renal artery stenting.  

UK PubMed Central (United Kingdom)

BACKGROUND: Although technical success of renal artery stenting (RAS) is high and adverse events are infrequent, clinical success (improved blood pressure and renal function) and durability have been less predictable. Identifying those patients who will respond to RAS could improve overall outcomes of the procedure. METHODS: This was a retrospective analysis of all patients who underwent RAS for treatment of renovascular hypertension (RVH) between 2001 and 2007 at Dartmouth-Hitchcock Medical Center. The primary outcome measure was blood pressure improvement or cure as judged by American Heart Association criteria. Estimated glomerular filtration rate (eGFR), number of antihypertensive medications, and survival were evaluated as secondary outcomes. Univariate and multivariate analyses were performed to identify factors associated with blood pressure improvement at the last follow-up. RESULTS: During the 6-year period, 129 patients (179 renal arteries) underwent stent placement for RVH. Procedural complications occurred nine patients (7.0%). Average length follow-up was 1.5 years. Follow-up data were obtained in 122 patients (95%). At last follow-up, there were significant improvements in systolic blood pressure (161 vs 144 mm Hg, P < .001), diastolic blood pressure (80 vs 73 mm Hg, P < .001), and number of antihypertensive medications (3.1 vs 2.8, P = .034). The eGFR was improved in 16% of patients, stable in 60%, and worse in 24%. By multivariate analysis, a baseline eGFR <40 mL/min/1.73 m2 (odds ratio, 1.6; 95% confidence interval [CI], 1.0-2.9; P = .02) and female gender (OR, 1.3; 95% CI, 1.0-2.1; P = .04) were independent predictors of failure to achieve blood pressure improvement. By 2 and 4 years of follow-up, sustained blood pressure improvement was present in 67% of patients with a baseline eGFR of > or = 40 mL/min/1.73 m2 and in 31% of patients with a baseline eGFR <40 mL/min/1.73 m2. During 2 years of follow-up, survival was similar between patients with sustained blood pressure response and those without. CONCLUSION: Patients treated for RVH who have a baseline eGFR of > or = 40 mL/min/1.73 m2 demonstrate a better response to RAS at each follow-up interval, with a significant difference at 2 to 4 years, compared with patients with an eGFR <40 mL/min/1.73 m2.

Beck AW; Nolan BW; De Martino R; Yuo TH; Tanski WJ; Walsh DB; Powell RP; Cronenwett JL

2010-02-01

123

Pressão arterial em adolescentes durante teste ergométrico Arterial blood pressure in adolescents during exercise stress testing  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Descrever a resposta da pressão arterial em adolescentes submetidos ao teste de esforço. MÉTODOS: Foi realizado estudo transversal de 218 adolescentes entre 10 e 19 anos (131 do sexo masculino) submetidos a teste ergométrico, e descrita a freqüência cardíaca máxima, tempo de exercício, consumo máximo de oxigênio, pressão arterial sistólica (PAS) e diastólica (PAD) de repouso, no esforço máximo e aos seis minutos da recuperação. RESULTADOS: No repouso, a PAS teve valores maiores no sexo masculino e a PAD não mostrou diferença entre os sexos, porém ambas aumentaram com a idade. No exercício ocorreu elevação da PAS e queda da PAD em ambos os sexos. A variação da PAS foi maior no sexo masculino, principalmente acima dos 14 anos. CONCLUSÃO: A análise dos resultados demonstrou que a PAS durante o exercício teve relação direta com idade, peso, altura e índice de massa corpórea do indivíduo e a PAD teve relação apenas com a idade.OBJECTIVE: Describe arterial blood pressure response in adolescents undergoing exercise stress testing. METHODS: This was a cross-sectional study conducted with 218 adolescents (131 of whom were males), aged between 10 to 19 years, undergoing exercise stress testing. Maximum heart rate, total exercise time, maximum oxygen uptake, systolic blood pressure (SBP) and diastolic (DBP) at rest, during maximal physical exertion and at six minutes of recovery were measured. RESULTS: At rest, SBP values were greater in males and no difference was found in DBP between genders, although both increased with age. During exercise, SBP rose and DBP fell in both genders. SBP variation was greater in men, particularly in those over 14 years of age. CONCLUSION: Analysis of results showed that during physical exercise, SBP had a direct relationship with the individual’s age, weight, height and body mass index, whereas DBP bore a relationship to age only.

Mônica de Moraes Chaves Becker; Odwaldo Barbosa e Silva; Isaura Elaine Gonçalves Moreira; Edgar Guimarães Victor

2007-01-01

124

Morning Blood Pressure Surge and Nighttime Blood Pressure in Relation to Nocturnal Sleep Pattern and Arterial Stiffness.  

UK PubMed Central (United Kingdom)

OBJECTIVE:: The phenomenon of morning blood pressure (BP) surge (MBPS) is known to increase the risk for cardiovascular events and stroke. The purposes of this study were to explore associations between MBPS and nighttime BP and to examine arterial stiffness and sleep pattern in association with MBPS. METHODS:: This study included 30 healthy Korean American women aged 25 to 60 years. Ambulatory BP was monitored for 24 hours. To evaluate MBPS, maximum morning BPpower was calculated. Arterial stiffness was measured by carotid-femoral pulse wave velocity, and sleep pattern was evaluated using an actigraphy. RESULTS:: The participants (n = 8) in the upper quartile of MBPS had higher morning systolic BPs (SBPs; P = 0.015) and lower nighttime diastolic BPs (P = 0.031). The MBPS in SBP was significantly increased in the participants who had a more wakeful night (P = 0.038) and who slept longer at night (P = 0.041). Although MBPS was not significantly related to arterial stiffness, higher morning SBP (P = 0.005), morning diastolic BP (P = 0.048), and prewake SBP (P = 0.005) were associated with arterial stiffness. CONCLUSIONS:: Our findings imply a possible link between disturbed sleep and MBPS. Clinicians should understand the importance of the modification of altered sleep pattern for reducing MBPS in nonhypertensive participants.

Suh M; Barksdale DJ; Logan JG

2013-04-01

125

Abnormal early diastolic intraventricular flow 'kinetic energy index' assessed by vector flow mapping in patients with elevated filling pressure.  

UK PubMed Central (United Kingdom)

AIMS: Recently developed vector flow mapping (VFM) enables evaluation of local flow dynamics without angle dependency. This study used VFM to evaluate quantitatively the index of intraventricular haemodynamic kinetic energy in patients with left ventricular (LV) diastolic dysfunction and to compare those with normal subjects. METHODS AND RESULTS: We studied 25 patients with estimated high left atrial (LA) pressure (pseudonormal: PN group) and 36 normal subjects (control group). Left ventricle was divided into basal, mid, and apical segments. Intraventricular haemodynamic energy was evaluated in the dimension of speed, and it was defined as the kinetic energy index. We calculated this index and created time-energy index curves. The time interval from electrocardiogram (ECG) R wave to peak index was measured, and time differences of the peak index between basal and other segments were defined as ?T-mid and ?T-apex. In both groups, early diastolic peak kinetic energy index in mid and apical segments was significantly lower than that in the basal segment. Time to peak index did not differ in apex, mid, and basal segments in the control group but was significantly longer in the apex than that in the basal segment in the PN group. ?T-mid and ?T-apex were significantly larger in the PN group than the control group. Multiple regression analysis showed sphericity index, E/E' to be significant independent variables determining ?T apex. CONCLUSION: Retarded apical kinetic energy fluid dynamics were detected using VFM and were closely associated with LV spherical remodelling in patients with high LA pressure.

Nogami Y; Ishizu T; Atsumi A; Yamamoto M; Kawamura R; Seo Y; Aonuma K

2013-03-01

126

Resistance training controls arterial blood pressure in rats with L-NAME- induced hypertension.  

UK PubMed Central (United Kingdom)

BACKGROUND: Arterial hypertension is a multifactorial chronic condition caused by either congenital or acquired factors. OBJECTIVE: To evaluate the effects of Resistance Training (RT) on arterial pressure, and on vascular reactivity and morphology, of L-NAME-treated hypertensive rats. METHODS: Male Wistar rats (200 - 250 g) were allocated into Sedentary Normotensive (SN), Sedentary Hypertensive (SH) and Trained Hypertensive (TH) groups. Hypertension was induced by adding L-NAME (40 mg/Kg) to the drinking water for four weeks. Arterial pressure was evaluated before and after RT. RT was performed using 50% of 1RM, 3 sets of 10 repetitions, 3 times per week for four weeks. Vascular reactivity was measured in rat mesenteric artery rings by concentration-response curves to sodium nitroprusside (SNP); phenylephrine (PHE) was also used for histological and stereological analysis. RESULTS: Resistance training inhibited the increase in mean and diastolic arterial pressures. Significant reduction was observed in Rmax (maximal response) and pD2 (potency) of PHE between SH and TH groups. Arteries demonstrated normal intima, media and adventitia layers in all groups. Stereological analysis demonstrated no significant difference in luminal, tunica media, and total areas of arteries in the SH and TH groups when compared to the SN group. Wall-to-lumen ratio of SH arteries was significantly different compared to SN arteries (p<0.05) but there was no difference when compared to TH arteries. CONCLUSIONS: RT was able to prevent an increase in blood pressure under the conditions in this study. This appears to involve a vasoconstrictor regulation mechanism and maintenance of luminal diameter in L-NAME induced hypertensive rats.

de Araujo AJ; dos Santos AC; Souza Kdos S; Aires MB; Santana-Filho VJ; Fioretto ET; Mota MM; Santos MR

2013-04-01

127

Long term pulmonary artery pressure monitoring in the management of the critically ill.  

UK PubMed Central (United Kingdom)

Detailed experience during prolonged pulmonary artery pressure monitoring (up to 19 days) in 86 seriously ill patients is reviewed. Strict adherence to a protocol developed for insertion and maintenance of Swan-Ganz catheters resulted in successful catheterization of the pulmonary artery in nearly 100% of patients with minimal morbidity. Several technical problems associated with the use of this catheter-monitoring system are described, excessive balloon inflation with resultant misleading, spuriously high pressure measurement being one of the most serious. Most technical problems are avoidable. In the majority of critically ill patients both central venous and pulmonary artery diastolic pressures proved to be in-accurate estimates of pulmonary artery wedge pressure (PAW). PAW was a useful adjunct in the assessment of intravascular volume and hemodynamic alterations in these patients. The Swan-Ganz catheter serves for other functions including collection of mixed venous blood for cardiac output determination and injection of contrast material for small vessel angiography. Measurement of pulmonary artery wedge pressures should be routinely included in the sequential hemodynamic evaluation of most patients sufficiently ill to be hospitalized in an intensive care unit.

Archer G; Cobb LA

1974-11-01

128

Impact of Two Types of Sodium and Ultra Filtration Profiles on Systolic and Diastolic Blood Pressure in patients during Hemodialysis  

Directory of Open Access Journals (Sweden)

Full Text Available Background & Aim: Intradialytic hypotension is the most frequent complication in patients receiving haemodialysis (HD). This complication not only contributes to the illness of the patients, but also decreases the efficacy of the HD. So, hypotension prevention is a major challenge for medical team, especially for nurses. One of the preventive methods that have recently been presented is the use of sodium profile and ultra filtration (UF) profile. The aim of this study was to compare the effects of linear sodium + UF profile (type1) with stepwise sodium + UF profile (type3) on systolic and diastolic blood pressure in HD patients. Methods & Materials: In this crossover design study, 26 HD patients from two dialysis centers at Esfahan University underwent three kinds of treatment: (1) control, constant dialysate sodium concentration of 138 mmol/L with constant UF; (2) linear sodium profile + UF profile (type1), a linearly decreasing dialysate sodium concentration (146-138mmol/L) in combination with a linearly decreasing UF rate; and (3) stepwise sodium profile + UF profile (type2), a stepwise decreasing dialysate sodium concentration (146-138 mmol/L) in combination with a stepwise decreasing UF rate. Each treatment was applied in three dialysis sessions. Data were analyzed using repeated measure ANOVA test in the SPSS. Results: Twenty six patients participated in the study. A total of 234 dialysis sessions were analyzed. There were no significant differences in the systolic blood pressure between three groups during predialysis and first and the second hours (P>0.05). The mean of systolic blood pressures were higher in the third hour and postdialysis during two types of profiles (1&3) compared with the routine care group (P<0.05). The mean of diastolic blood pressure was also higher in postdialysis during two types of profiles (1&3) compared with the routine group (P<0.05). There was no significant difference between the profiles 1and 3 (P>0.05). Conclusion: In conclusion, sodium profile + UF profile is a simple and cost-effective method that modulate the dialysate sodium and ultra filtration rate and preserve the homodynamic status and blood pressure of patients during dialysis. Therefore, using sodium profile + UF profile (type1 & type3) is recommended in order to prevent hypotension and reduce nursing work during hemodialysis process.  

M Ghafourifard; M Rafieian; N Shahgholian; M Mortazavi

2010-01-01

129

Ambulatory pulmonary arterial pressure in primary pulmonary hypertension: variability, relation to systemic arterial pressure, and plasma catecholamines.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The variability of pulmonary arterial pressure, the relation of pulmonary pressure to systemic pressure, pulmonary pressure responses to stimuli (exercise, hypoxia, smoking, free ambulation), and plasma catecholamine responses were assessed in five patients with primary pulmonary hypertension. Ambul...

Richards, A M; Ikram, H; Crozier, I G; Nicholls, M G; Jans, S

130

Significance of distal renal artery pressure in percutaneous transluminal angioplasty  

Energy Technology Data Exchange (ETDEWEB)

Percutaneous Transluminal Angioplasty (PTA) is an effective initial treatment modality in renovascular hypertension. For determination of PTA effect, the pulse pressure recording of renal artery is not simple as compared with in femoral artery stenosis. We tried to evaluate the PTA effect of renal artery stenosis with tracing the pressure of distal renal artery. We used the cardiac catheterization apparatus (VR-12 Honeywell) as a pressure monitor in two cases of focal renal arterial stenosis. The renal artery pressure was doubled after first attempt of ballooning, and the pressure elevated up to 94% and 79% of aorta pressure in two cases, respectively, after third attempt. We believe that renal artery pressure monitoring is a good method of determination of PTA effect in renovascular hypertension.

Chung, Kyoo Byung; Choi, Jai Korl; Seol, Hae Young; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

1986-04-15

131

Valores da pressão arterial em cães pelos métodos oscilométrico e Doppler vascular Arterial blood pressure in dogs by the oscilometric method and the Doppler ultrasonic  

Directory of Open Access Journals (Sweden)

Full Text Available Foram comparados dois métodos não-invasivos de medida da pressão arterial, o Doppler vascular e o oscilométrico, com o objetivo de estabelecer parâmetros que possam auxiliar no diagnóstico seguro da hipertensão arterial. Para tal, foram utilizados 45 cães, machos e fêmeas, distribuídos em três grupos de acordo com o peso, pequeno, médio e grande porte. Em cada animal, procedeu-se a mensuração por meio do Doppler vascular e, em seguida, do oscilométrico. Na obtenção da pressão arterial sistólica, não houve diferença entre os métodos nos três grupos de animais, porém, na obtenção da pressão arterial diastólica, houve diferença estatística entre o Doppler vascular e o oscilométrico nos grupos de animais de pequeno e médio porte. Pôde-se concluir que valores confiáveis de pressão sistólica podem ser obtidos tanto por meio do Doppler vascular quanto do oscilométrico. Os valores da pressão arterial diastólica obtidos pelos dois métodos não se correlacionam, principalmente nos animais de pequeno e médio porte.Two noninvasive methods for blood pressure measurement, the oscilometric and the Doppler ultrasonic, were compaired aiming the establishment of parameters that can be helpful for the hypertension diagnosis. Forty-five dogs, males and females, were distributed in three groups, according to body weight: small, medium, and large sizes. In each animal, measurement of the blood pressure was performed, first by the Doppler ultrasonic, followed by the oscilometric method. No differences were observed in sistolic arterial pressure values obtained by both methods in none of the three animal groups. However, there was an important difference in diastolic arterial pressure values obtained by these methods, especially in small and medium size dogs. It was concluded that reliable results of sistolic blood pressure can be obtained both by the Doppler ultrasonic and the oscilometric method. Diastolic blood pressure results, however, showed no correlation between these two methods, mainly in small and medium size dogs.

R.R. Cabral; B.D. Ciasca; V.M.C. Oliveira; A.P. Vaz-Curado; M.H.M.A. Larsson

2010-01-01

132

Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study  

Science.gov (United States)

The prevalence of hypertension in African Americans (AAs) is higher than in other US groups; yet, few have performed genome-wide association studies (GWASs) in AA. Among people of European descent, GWASs have identified genetic variants at 13 loci that are associated with blood pressure. It is unknown if these variants confer susceptibility in people of African ancestry. Here, we examined genome-wide and candidate gene associations with systolic blood pressure (SBP) and diastolic blood pressure (DBP) using the Candidate Gene Association Resource (CARe) consortium consisting of 8591 AAs. Genotypes included genome-wide single-nucleotide polymorphism (SNP) data utilizing the Affymetrix 6.0 array with imputation to 2.5 million HapMap SNPs and candidate gene SNP data utilizing a 50K cardiovascular gene-centric array (ITMAT-Broad-CARe [IBC] array). For Affymetrix data, the strongest signal for DBP was rs10474346 (P= 3.6 × 10?8) located near GPR98 and ARRDC3. For SBP, the strongest signal was rs2258119 in C21orf91 (P= 4.7 × 10?8). The top IBC association for SBP was rs2012318 (P= 6.4 × 10?6) near SLC25A42 and for DBP was rs2523586 (P= 1.3 × 10?6) near HLA-B. None of the top variants replicated in additional AA (n = 11 882) or European-American (n = 69 899) cohorts. We replicated previously reported European-American blood pressure SNPs in our AA samples (SH2B3, P= 0.009; TBX3-TBX5, P= 0.03; and CSK-ULK3, P= 0.0004). These genetic loci represent the best evidence of genetic influences on SBP and DBP in AAs to date. More broadly, this work supports that notion that blood pressure among AAs is a trait with genetic underpinnings but also with significant complexity.

Fox, Ervin R.; Young, J. Hunter; Li, Yali; Dreisbach, Albert W.; Keating, Brendan J.; Musani, Solomon K.; Liu, Kiang; Morrison, Alanna C.; Ganesh, Santhi; Kutlar, Abdullah; Ramachandran, Vasan S.; Polak, Josef F.; Fabsitz, Richard R.; Dries, Daniel L.; Farlow, Deborah N.; Redline, Susan; Adeyemo, Adebowale; Hirschorn, Joel N.; Sun, Yan V.; Wyatt, Sharon B.; Penman, Alan D.; Palmas, Walter; Rotter, Jerome I.; Townsend, Raymond R.; Doumatey, Ayo P.; Tayo, Bamidele O.; Mosley, Thomas H.; Lyon, Helen N.; Kang, Sun J.; Rotimi, Charles N.; Cooper, Richard S.; Franceschini, Nora; Curb, J. David; Martin, Lisa W.; Eaton, Charles B.; Kardia, Sharon L.R.; Taylor, Herman A.; Caulfield, Mark J.; Ehret, Georg B.; Johnson, Toby; Chakravarti, Aravinda; Zhu, Xiaofeng; Levy, Daniel; Munroe, Patricia B.; Rice, Kenneth M.; Bochud, Murielle; Johnson, Andrew D.; Chasman, Daniel I.; Smith, Albert V.; Tobin, Martin D.; Verwoert, Germaine C.; Hwang, Shih-Jen; Pihur, Vasyl; Vollenweider, Peter; O'Reilly, Paul F.; Amin, Najaf; Bragg-Gresham, Jennifer L.; Teumer, Alexander; Glazer, Nicole L.; Launer, Lenore; Zhao, Jing Hua; Aulchenko, Yurii; Heath, Simon; Sober, Siim; Parsa, Afshin; Luan, Jian'an; Arora, Pankaj; Dehghan, Abbas; Zhang, Feng; Lucas, Gavin; Hicks, Andrew A.; Jackson, Anne U.; Peden, John F.; Tanaka, Toshiko; Wild, Sarah H.; Rudan, Igor; Igl, Wilmar; Milaneschi, Yuri; Parker, Alex N.; Fava, Cristiano; Chambers, John C.; Kumari, Meena; JinGo, Min; van der Harst, Pim; Kao, Wen Hong Linda; Sjogren, Marketa; Vinay, D.G.; Alexander, Myriam; Tabara, Yasuharu; Shaw-Hawkins, Sue; Whincup, Peter H.; Liu, Yongmei; Shi, Gang; Kuusisto, Johanna; Seielstad, Mark; Sim, Xueling; Nguyen, Khanh-Dung Hoang; Lehtimaki, Terho; Matullo, Giuseppe; Wu, Ying; Gaunt, Tom R.; Charlotte Onland-Moret, N.; Cooper, Matthew N.; Platou, Carl G.P.; Org, Elin; Hardy, Rebecca; Dahgam, Santosh; Palmen, Jutta; Vitart, Veronique; Braund, Peter S.; Kuznetsova, Tatiana; Uiterwaal, Cuno S.P.M.; Campbell, Harry; Ludwig, Barbara; Tomaszewski, Maciej; Tzoulaki, Ioanna; Palmer, Nicholette D.; Aspelund, Thor; Garcia, Melissa; Chang, Yen-Pei C.; O'Connell, Jeffrey R.; Steinle, Nanette I.; Grobbee, Diederick E.; Arking, Dan E.; Hernandez, Dena; Najjar, Samer; McArdle, Wendy L.; Hadley, David; Brown, Morris J.; Connell, John M.; Hingorani, Aroon D.; Day, Ian N.M.; Lawlor, Debbie A.; Beilby, John P.; Lawrence, Robert W.; Clarke, Robert; Collins, Rory; Hopewell, Jemma C.; Ongen, Halit; Bis, Joshua C.; Kahonen, Mika; Viikari, Jorma; Adair, Linda S.; Lee, Nanette R.; Chen, Ming-Huei; Olden, Matthias; Pattaro, Cristian; Hoffman Bolton, Judith A.; Kottgen, Anna; Bergmann, Sven; Mooser, Vincent; Chaturvedi, Nish; Frayling, Timothy M.; Islam, Muhammad; Jafar, Tazeen H.; Erdmann, Jeanette; Kulkarni, Smita R.; Bornstein, Stefan R.; Grassler, Jurgen; Groop, Leif; Voight, Benjamin F.; Kettunen, Johannes; Howard, Philip; Taylor, Andrew; Guarrera, Simonetta; Ricceri, Fulvio; Emilsson, Valur; Plump, Andrew; Barroso, Ines; Khaw, Kay-Tee; Weder, Alan B.; Hunt, Steven C.; Bergman, Richard N.; Collins, Francis S.; Bonnycastle, Lori L.; Scott, Laura J.; Stringham, Heather M.; Peltonen, Leena; Perola, Markus; Vartiainen, Erkki; Brand, Stefan-Martin; Staessen, Jan A.; Wang, Thomas J.; Burton, Paul R.; SolerArtigas, Maria; Dong, Yanbin; Snieder, Harold; Wang, Xiaoling; Zhu, Haidong; Lohman, Kurt K.; Rudock, Megan E.; Heckbert, Susan R.; Smith, Nicholas L.; Wiggins, Kerri L.; Shriner, Daniel; Veldre, Gudrun; Viigimaa, Margus; Kinra, Sanjay; Prabhakaran, Dorairajan; Tripathy, Vikal; Langefeld, Carl D.; Rosengren, Annika; Thelle, Dag S.; MariaCorsi, Anna; Singleton, Andrew; Forrester, Terrence; Hilton, Gina; McKenzie, Colin A.; Salako, Tunde; Iwai, Naoharu; Kita, Yoshikuni; Ogihara, Toshio; Ohkubo, Takayoshi; Okamura, Tomonori; Ueshima, Hirotsugu; Umemura, Satoshi; Eyheramendy, Susana; Meitinger, Thomas; Wichmann, H.-Erich; Cho, Yoon Shin; Kim, Hyung-Lae; Lee, Jong-Young; Scott, James; Sehmi, Joban S.; Zhang, Weihua; Hedblad, Bo; Nilsson, Peter; Smith, George Davey; Wong, Andrew; Narisu, Narisu; Stancakova, Alena; Raffel, Leslie J.; Yao, Jie; Kathiresan, Sekar; O'Donnell, Chris; Schwartz, Steven M.; Arfan Ikram, M.; Longstreth, Will T.; Seshadri, Sudha; Shrine, Nick R.G.; Wain, Louise V.; Morken, Mario A.; Swift, Amy J.; Laitinen, Jaana; Prokopenko, Inga; Zitting, Paavo; Cooper, Jackie A.; Humphries, Steve E.; Danesh, John; Rasheed, Asif; Goel, Anuj; Hamsten, Anders; Watkins, Hugh; Bakker, Stephan J.L.; van Gilst, Wiek H.; Janipalli, Charles S.; Radha Mani, K.; Yajnik, Chittaranjan S.; Hofman, Albert

2011-01-01

133

Association of cardio-ankle vascular index with diastolic heart function in hypertensive patients.  

UK PubMed Central (United Kingdom)

Abstract Arterial stiffness is an important risk factor of impaired left ventricular (LV) diastolic function as well as systolic dysfunction. The cardio-ankle vascular index (CAVI) and the ambulatory arterial stiffness index (AASI) can evaluate arteriosclerosis. We analyzed the relationship between arterial stiffness and diastolic function, and then compared the two methodologies to assess which method could serve as a more informative tool for diastology. In total, 136 patients with hypertension underwent 24-h ambulatory blood pressure monitoring (ABPM) and echocardiography including ventricular arterial coupling (VAC). Arterial stiffness was estimated using both CAVI and AASI derived from ABPM. Patients were classified into LV diastolic dysfunction and normal function groups. Those with diastolic dysfunction had a higher CAVI and AASI. Aside from LV torsion, mitral inflow parameters, tissue Doppler velocities and VAC showed a significantly greater association with CAVI, relative to AASI. The receiver operating characteristic curve analysis revealed that CAVI [area under the curve (AUC)?=?0.869, p?diastolic dysfunction compared with AASI (AUC?=?0.672, p?=?0.004). Multiple logistic regression analyses showed that CAVI [Odds ratio (OR)?=?5.1, p?=?0.009] had a greater association with diastolic dysfunction, relative to age, systolic blood pressure or AASI (OR?=?1.4, p?=?0.043). This study indicates that CAVI clinically provides diastolic functional information much better in hypertensive patients than AASI.

Kim H; Kim HS; Yoon HJ; Park HS; Cho YK; Nam CW; Hur SH; Kim YN; Kim KB

2013-06-01

134

Influence of the elevation of the left ventricular diastolic pressure on the values of the first temporal derivative of the ventricular pressure (dP/dt)  

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Full Text Available PURPOSE: To assess the effects of the elevation of the left ventricular end-diastolic pressure (LVEDP) on the value of the 1st temporal derivative of the ventricular pressure (dP/dt). METHODS: Nineteen anesthetized dogs were studied. The dogs were mechanically ventilated and underwent thoracotomy with parasympathetic nervous system block. The LVEDP was controlled with the use of a perfusion circuit connected to the left atrium and adjusted to the height of a reservoir. The elevation of the LVEDP was achieved by a sudden increase in the height of a reservoir filled with blood. Continuous recordings of the electrocardiogram, the aortic and ventricular pressures and the dP/dt were performed. RESULTS: Elevation of the LVEDP did not result in any variation of the heart rate (167±16.0bpm, before the procedure; 167±15.5bpm, after the procedure). All the other variables assessed, including systolic blood pressure (128±18.3mmHg and 150±21.5mmHg), diastolic blood pressure (98±16.9mmHg and 115±19.8mmHg), LVEDP (5.5±2.49 and 9.3±3.60mmHg), and dP/dt (4,855 ± 1,082 mmHg/s and 5,149±1,242mmHg/s) showed significant increases following the expansion of the ventricular cavity. Although the elevation of the dP/dt was statistically significant, 6 dogs curiously showed a decrease in the values of dP/dt. CONCLUSION: Sudden elevation of the LVEDP resulted in increased values of dP/dt; however, in some dogs, this response was not uniform.

Katashi Okoshi; José Roberto Fioretto; Rossano César Bonatto; Maria Teresinha Trovarelli Tornero; Paulo José Tucci

1999-01-01

135

Influence of the elevation of the left ventricular diastolic pressure on the values of the first temporal derivative of the ventricular pressure (dP/dt)  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english PURPOSE: To assess the effects of the elevation of the left ventricular end-diastolic pressure (LVEDP) on the value of the 1st temporal derivative of the ventricular pressure (dP/dt). METHODS: Nineteen anesthetized dogs were studied. The dogs were mechanically ventilated and underwent thoracotomy with parasympathetic nervous system block. The LVEDP was controlled with the use of a perfusion circuit connected to the left atrium and adjusted to the height of a reservoir. Th (more) e elevation of the LVEDP was achieved by a sudden increase in the height of a reservoir filled with blood. Continuous recordings of the electrocardiogram, the aortic and ventricular pressures and the dP/dt were performed. RESULTS: Elevation of the LVEDP did not result in any variation of the heart rate (167±16.0bpm, before the procedure; 167±15.5bpm, after the procedure). All the other variables assessed, including systolic blood pressure (128±18.3mmHg and 150±21.5mmHg), diastolic blood pressure (98±16.9mmHg and 115±19.8mmHg), LVEDP (5.5±2.49 and 9.3±3.60mmHg), and dP/dt (4,855 ± 1,082 mmHg/s and 5,149±1,242mmHg/s) showed significant increases following the expansion of the ventricular cavity. Although the elevation of the dP/dt was statistically significant, 6 dogs curiously showed a decrease in the values of dP/dt. CONCLUSION: Sudden elevation of the LVEDP resulted in increased values of dP/dt; however, in some dogs, this response was not uniform.

Okoshi, Katashi; Fioretto, José Roberto; Bonatto, Rossano César; Tornero, Maria Teresinha Trovarelli; Tucci, Paulo José

1999-07-01

136

Albuminuria in relation to the single and combined effects of systolic and diastolic blood pressure in Chinese.  

UK PubMed Central (United Kingdom)

We investigated the single and combined effects of systolic (SBP) and diastolic blood pressure (DBP) on albuminuria in Chinese. We measured blood pressure (BP), anthropometry and urinary excretions of albumin and creatinine, and defined albuminuria as a urinary albumin-to-creatinine ratio of at least 17 and 25 mg/g in men and women, respectively. The 1068 participants (mean age 56.3 years) included 407 (38.5%) men and 410 (38.4%) hypertensive patients. A J-shaped relationship between the risk of albuminuria and BP was observed for both SBP (mean ± SD, 126.1 ± 18.9 mmHg) and DBP (77.1 ± 9.4 mmHg) with nadir levels of 110 mmHg and 70 mmHg, respectively. The risk of albuminuria was significantly (p ? 0.01) associated with DBP in the subjects with a SBP of at least 130 mmHg and with SBP in subjects with a DBP of at least 80 mmHg, and inversely and significantly (p = 0.04) associated with SBP in subjects with a DBP below 70 mmHg. In conclusion, as far as albuminuria is concerned, there is indeed a J-shaped phenomenon. However, it has a nadir level far below the currently recommended target BP of 140/90 or 130/80 mmHg.

Sheng CS; Liu M; Zou J; Huang QF; Li Y; Wang JG

2013-06-01

137

Theoretical treatise: arterial pressure during aortic surgery.  

UK PubMed Central (United Kingdom)

The optimum arterial perfusion pressure during cardiopulmonary bypass (CPB) remains uncertain. A correlation in some form with the patients' resting pressure almost certainly exists. Temperature and hematocrit affect blood viscosity. The optimum perfusion pressure during aortic surgery will vary after the initiation of CPB resulting cooling, heating, and hematocrit changes. Poiseuille's Law was used in conjunction with the previously published effects of temperature and hematocrit on blood viscosity to determine the perfusion pressure that would result in the same organ blood flow. Two different scenarios were modeled, constant flow and flow as predicted by Q10 to reflect required oxygen delivery. Temperature, hematocrit, and flow all have a large effect on blood viscosity and, thus, through Poiseuille's Law, blood pressure. As patients are cooled, their blood viscosity goes up through the inherent viscoelastic properties of blood. As temperature drops from 37 degrees to 17 degrees, viscosity doubles. This increased viscosity is offset by a reduction in hematocrit, which is invariably associated with CPB. As the hematocrit drops from 30% to 10%, viscosity of blood halves. These two factors clinically can cancel each other out. The figure demonstrates the effect on blood pressure of a constant flow for various temperature and hematocrits. Reduced need for oxygen delivery, secondary to the principles of Q10, can result in a lower than expected theoretical perfusion pressure. As temperature drops from 37 degrees to 17 degrees, based on Q10, oxygen delivery reduces by 75%. This indicates that flow can be reduced by over 60% if the hematocrit falls from 30% to 20%. This theoretical treatise predicts that blood pressure management should be temperature- and hematocrit-dependent. The target optimal blood pressure will vary during the course of surgery as a result of heating, cooling, and hemodilution. Clinical correlation is needed.

Ridgway T; Al-Rawi O; Palmer K; Pullan M; Poullis M

2012-09-01

138

The Relation Between Aortic Pulse Pressure and Coronary Artery Disease  

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Full Text Available Objective: Pulse pressure (PP) is a significant marker of cardiovascular morbidity.We investigated the relation between aortic PP and the presence and extent of coronary artery disease (CAD) in patients undergoing diagnostic coronary angiography (CAG).Patients and Method: The study group consisted of 550 patients (363 men, 187 women).We evaluated patients in two different groups, PP < 60 mmHg and ? 60 mmHg.Results: In univariate analysis gender and presence of hyperlipidemia showed no statistically significant differences between both groups. However, the ratio of patients having diabetes mellitus, hypertension or smoking were significantly higher in ? 60 mmHg PP group. The mean age was 55.2 ±11.9 in < 60 mmHg PP group and 61.3±9.3 in the other group (p<0.01). Although systolic blood pressure level was higher in ? 60 mmHg PP group (160.4±21.1 vs. 126.4±13.5, p< 0.001), diastolic blood pressure level showed no significant differences between both groups (78.3±13.5 vs. 80.3±10.2, p= 0.32). In the <60 mmHg PP group, the ratio of normal CAG was significantly higher, and also, the critically CAD rate was lower than the other group. In multivariate analysis, smoking [odds ratios (OR) 2.344, 95% confidence intervals (CI), 1.416-3.879], male gender (OR 5.858, 95% CI, 3.425-10.019) and PP ?60 mmHg (OR 25.788, 95% CI, 14.001-47.498) were evaluated as an independent indicators of CAD.Conclusions: In our study, we demonstrate that, aortic PP ?60 mmHg is related to the risk of critically CAD as an independent factor.

Gökhan Al?c?; Birol Özkan; Göksel Açar; Mustafa Bulut; Müslüm ?ahin; Bilal Boztosun; Ali Metin Esen

2011-01-01

139

Arterial stiffness and pulse pressure in CKD and ESRD.  

UK PubMed Central (United Kingdom)

We recognize that increased systolic pressure is the most challenging form of hypertension today and that pulse pressure as an independent cardiovascular risk factor has focused attention on arterial stiffness and wave reflections as the most important factors determining these pressures. In recent years, many studies emphasized the role of arterial rigidity in the development of cardiovascular diseases, and it was shown that stiffening of arteries is associated with increased cardiovascular mortality and morbidity. Moreover,arterial stiffening is linked to decreased glomerular filtration rate, and is predictive of kidney disease progression and the patient’s cardiovascular outcome. Premature vascular aging and arterial stiffening are observed with progression of chronic kidney disease (CKD) and in end-stage renal disease(ESRD). This accelerated aging is associated with outward remodeling of large vessels, characterized by increased arterial radius not totally compensated for by artery wall hypertrophy. Arterial stiffening in CKD and ESRD patients is of multifactorial origin with extensive arterial calcifications representing a major covariate. With aging, the rigidity is more pronounced in the aorta than in peripheral conduit arteries, leading to the disappearance or inversion of the arterial stiffness gradient and less protection of the microcirculation from high-pressure transmission. Various non-pharmacological or pharmacological interventions can modestly slow the progression of arterial stiffness,but arterial stiffness is, in part, pressure dependent and treatments able to stop the process mainly include antihypertensive drugs.

Briet M; Pierre B; Laurent S; London GM

2012-08-01

140

Avaliação das medidas de pressão arterial comparando o método tradicional e o padrão-ouro/ Evaluation of arterial pressure measurements comparing traditional and gold standard methods  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Avaliar as medidas de pressão arterial comparando o método tradicional e o padrão-ouro em um serviço público de pronto atendimento. MÉTODOS: Estudo transversal no qual as medidas das pressões arteriais sistólica, diastólica, média e de pulso aferidas pelos profissionais da enfermagem pelo método tradicional foram comparadas com aquelas realizadas de acordo com o padrão-ouro. RESULTADOS: Foram incluídos 229 clientes, 69% do sexo feminino e a média d (more) e idade foi de 50 anos. A comparação entre os dois métodos mostrou que o valor médio das pressões sistólica, diastólica, média e de pulso foi maior utilizando-se a técnica padrão-ouro. CONCLUSÃO: Houve divergências entre as medidas realizadas pela técnica recomendada e pela classificação de risco. Abstract in english OBJECTIVE: Evaluating arterial pressure measurements comparing the traditional and the gold standard methods in an emergency public service. METHODS: Cross-sectional study, in which arterial systolic, diastolic, mean and pulse pressure measurements obtained by nursing professionals by means of the traditional method were compared with those obtained using the gold standard technique. RESULTS: Study participants were 229 patients, 69% were women and the mean age was 50 yea (more) rs. The comparison between the two methods showed that the mean value of the arterial systolic, diastolic, mean and pulse pressures was higher using the gold standard technique. CONCLUSION: Divergences were found between the measurements obtained using the recommended technique and the risk classification.

Silva, Luciano Elias E; Batista, Ruth Ester Assayag; Campanharo, Cássia Regina Vancini; Pereira, Ricardo Baladi Rufino; Prado, Gilmar Fernandes do

2013-01-01

 
 
 
 
141

Dietary sodium loading in normotensive healthy volunteers does not increase arterial vascular reactivity or blood pressure.  

UK PubMed Central (United Kingdom)

BACKGROUND: Studies of dietary sodium on vascular function and blood pressure in normotensive volunteers have shown conflicting results. There are very limited data available on the effect of chronic sodium loading from a low-sodium diet to a high-sodium diet on vascular function and blood pressure in normotensive volunteers. OBJECTIVE: To assess the effect of modifying dietary sodium intake on arterial function and surrogate markers of arterial remodelling in normal healthy volunteers. DESIGN: Twenty-three normotensive volunteers met the inclusion criteria. After a 2 week run-in with a low-sodium diet (60 mmol/day), the participants maintained their low-sodium diets and were randomly assigned to receive sequentially one of three interventions for 4 weeks, with a 2 week washout between interventions: sodium-free tomato juice (A), tomato juice containing 90 mmol Na (B) and tomato juice containing 140 mmol Na (C). The outcomes measured were changes in pulse wave velocity (PWV), systolic blood pressure and diastolic blood pressure. RESULTS: There was no difference in PWV between interventions (B-A 0.00 m/s, 95% CI: -0.30, 0.31 m/s; C-A 0.01 m/s, 95% CI: -0.38, 0.40 m/s). There was also no change in pulse wave analysis, systolic or diastolic blood pressure between interventions. There was an appropriate increase in urinary sodium excretion in the added sodium interventions. CONCLUSION: Dietary salt loading did not produce significant increases in PWV and blood pressure in normotensive subjects with systolic blood pressure <130 mmHg. The lack of an observed effect supports Guyton's pressure-natriuresis hypothesis with appropriate renal excretion of the excess sodium load.

Todd AS; Macginley RJ; Schollum JB; Williams SM; Sutherland WH; Mann JI; Walker RJ

2012-03-01

142

High-normal diastolic blood pressure is a risk for development of microalbuminuria in the general population: the Watari study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Although hypertension is a well known risk factor for microalbuminuria, it is unclear whether blood pressure less than 140/90 mmHg could be a risk for microalbuminuria. We assessed the relationship between baseline blood pressure and the future onset of microalbuminuria in the general population. METHODS: We studied 2603 town inhabitants of Watari, located in the southeastern part of Miyagi prefecture, Japan. Demographic data, medical history, sitting blood pressure, fasting blood chemistry, and urinary albumin-creatinine ratio were measured at baseline and were followed annually during the next 3 years. RESULTS: Among 2338 individuals who were normoalbuminuric at baseline (albumin-creatinine ratio <30 mg/g Cr), 161 developed microalbuminuria (albumin-creatinine ratio 30-299 mg/g Cr) during a mean follow-up period of 2.4 years. Incident microalbuminuria patients were older (63.7 ± 8.6 vs. 61.4 ± 10.5 years; P < 0.01), included fewer men (31.1 vs. 40.1%; P < 0.05), had a greater BMI (23.8 ± 3.6 vs. 23.1 ± 3.1 kg/m²; P < 0.01), higher blood pressures (133.5 ± 18.1/75.8 ± 11.9 vs. 127.6 ± 18.1/73.4 ± 11.0 mmHg; P < 0.01 for both systolic and diastolic), higher triglycerides (median 1.18 vs. 1.02 mmol/l; P < 0.01), higher fasting blood glucose (median 5.05 vs. 4.94 mmol/l; P < 0.01), higher urinary albumin excretion (median 13.0 vs. 5.9 mg/g Cr; P < 0.001), and lower serum creatinine concentrations (59.2 ± 12.8 vs. 61.4 ± 13.2 ?mol/l; P < 0.05) compared to persistent normoalbuminuric individuals. Multivariate Cox proportional hazards analysis including all covariates revealed that only baseline urinary albumin excretion was an independent predictor for future microalbuminuria, whereas high-normal DBP, triglyceride, and fasting blood glucose concentrations were all significant predictors in the model excluding urinary albumin excretion. CONCLUSIONS: High-normal DBP associated with metabolic disorders could initiate glomerular damage, leading to future microalbuminuria.

Konno S; Hozawa A; Miura Y; Ito S; Munakata M

2013-04-01

143

Results of ambulatory arterial blood pressure monitoring in children with obesity  

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Full Text Available Objectives: The relationship between obesity and essential hypertension is well known. In this study, we aimed to evaluate ambulatory arterial blood pressure monitoring of obese and non-obese children who had similar demographic characteristics.Materials and methods: Seventy one children and adolescents (n=39 obesity, n=32 controls) were studied. Blood pressure of the children were measured by 24 hour ambulatory blood pressure monitoring device.Results: Obese children had significantly higher mean blood pressure values (systolic 121.9±11.7 mmHg, diastolic 70.2±5.3 mmHg) than control subjects (systolic 109.3±6.7 mmHg, diastolic 65.1±4.6 mmHg, p0.05). Blood pressure load was found to be increased in obese children compared to the controls (%13.6±12.9 and %2.6±3.4, respectively; p<0.05). Serum total cholesterol and LDL-cholesterol levels of obese children (181.1±33.4 and 131.1±23.1mg/dl) were significantly higher than those of the controls (134.3±11.1 and 103.3±14.2 mg/dl, p<0.05).Conclusions: Obesity in children and adolescents should not be regarded as variations of normality, but as abnormality with an extremely high risk for the development of hypertension and hyperlipidemia in adulthood.

Faruk Öktem

2010-01-01

144

Porcine radial artery decellularization by high hydrostatic pressure.  

UK PubMed Central (United Kingdom)

Many types of decellularized tissues have been studied and some have been commercially used in clinics. In this study, small-diameter vascular grafts were made using HHP to decellularize porcine radial arteries. One decellularization method, high hydrostatic pressure (HHP), has been used to prepare the decellularized porcine tissues. Low-temperature treatment was effective in preserving collagen and collagen structures in decellularized porcine carotid arteries. The collagen and elastin structures and mechanical properties of HHP-decellularized radial arteries were similar to those of untreated radial arteries. Xenogeneic transplantation (into rats) was performed using HHP-decellularized radial arteries and an untreated porcine radial artery. Two weeks after transplantation into rat carotid arteries, the HHP-decellularized radial arteries were patent and without thrombosis. In addition, the luminal surface of each decellularized artery was covered by recipient endothelial cells and the arterial medium was fully infiltrated with recipient cells. Copyright © 2012 John Wiley & Sons, Ltd.

Negishi J; Funamoto S; Kimura T; Nam K; Higami T; Kishida A

2012-12-01

145

Porcine radial artery decellularization by high hydrostatic pressure.  

Science.gov (United States)

Many types of decellularized tissues have been studied and some have been commercially used in clinics. In this study, small-diameter vascular grafts were made using HHP to decellularize porcine radial arteries. One decellularization method, high hydrostatic pressure (HHP), has been used to prepare the decellularized porcine tissues. Low-temperature treatment was effective in preserving collagen and collagen structures in decellularized porcine carotid arteries. The collagen and elastin structures and mechanical properties of HHP-decellularized radial arteries were similar to those of untreated radial arteries. Xenogeneic transplantation (into rats) was performed using HHP-decellularized radial arteries and an untreated porcine radial artery. Two weeks after transplantation into rat carotid arteries, the HHP-decellularized radial arteries were patent and without thrombosis. In addition, the luminal surface of each decellularized artery was covered by recipient endothelial cells and the arterial medium was fully infiltrated with recipient cells. Copyright © 2012 John Wiley & Sons, Ltd. PMID:23233238

Negishi, Jun; Funamoto, Seiichi; Kimura, Tsuyoshi; Nam, Kwangoo; Higami, Tetsuya; Kishida, Akio

2012-12-12

146

Valores de presión arterial en escolares sanos de una escuela primaria del municipio Cerro/ Arterial pressure values in healthy students from a primary school of Cerro municipality  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish INTRODUCCIÓN: la hipertensión constituye un notable problema de salud en el ámbito mundial que determina una importante causa de morbilidad, en la que están involucrados factores genéticos y ambientales. La presión arterial en la infancia aumenta progresivamente a lo largo de los años, y es una importante variable a considerar. OBJETIVO: caracterizar el comportamiento de algunas variables cardiovasculares y nutricionales en escolares supuestamente sanos. MÉTODOS: (more) se realizó un estudio de tipo descriptivo de cohorte transversal, en el que fueron estudiados escolares supuestamente sanos de una escuela primaria del municipio Cerro, en Ciudad de La Habana, en el período comprendido desde el 1ro. de diciembre de 2006 al 28 de febrero de 2007. El universo estuvo constituido por 358 niños de ambos sexos entre 5 y 11 años de edad. Las variables estudiadas fueron: presión arterial sistólica, presión arterial diastólica, presión arterial media, frecuencia cardiaca, peso, talla e índice de masa corporal. RESULTADOS: los resultados muestran cifras de presión arterial sistólica entre 77 y 104 mmHg, valores de presión arterial diastólica entre 43 a 64 mmHg, mientras que los valores de presión arterial media oscilan en un intervalo de 57 a 72 mmHg. La frecuencia cardiaca fue mayor en escolares de menor edad con respecto a los de mayor edad. El peso, la talla y el índice de masa corporal se incrementan con la edad. CONCLUSIONES: se concluye que los valores de presión arterial sistólica, diastólica y media en escolares de ambos sexos se incrementan con la edad, no así los de frecuencia cardiaca, cuya tendencia es a disminuir a medida que la edad aumenta. Los valores que corresponden al índice de masa corporal se elevan con la edad. Abstract in english INTRODUCTION: hypertension is a marked health problem at world scale determining significant causes of morbidity, in which are involved genetic and environmental factors. Infantile arterial pressure increases progressively during years, and it is a significant variable to be considered. AIM: to characterize behavior of some cardiovascular and nutritional variables in supposedly healthy students. METHODS: authors made a cross-sectional descriptive study in supposedly healt (more) h students from a primary school of Cerro municipality in Havana City from December 1st 2006 to February 28, 2007. Sample included 358 children of both sexes aged between 5 and 11. Study variable were: systolic high blood pressure, diastolic arterial pressure, mean arterial pressure, cardiac frequency, weight, height and body mass index (BMI). RESULTS: results show figures of systolic arterial pressure between 77 and 104 mmHg, diastolic arterial pressure between 43 and 64 mmHg, whereas mean arterial pressure oscillate in a interval of 57-72 mmHg. Cardiac frequency was greater in younger ones regarding those oldest. Weight, height and MBI increase with age. CONCLUSIONS: we conclude that systolic, diastolic and mean arterial pressure in students of both sexes increase with age, but not cardiac frequency, whose trend is to decrease insofar as age increases. Values corresponding to BMI increase with age.

Corredera Guerra, Roberto Francisco; Villar Badía, Yanet; González Rodríguez, Tania Rosa; Gómez Urbina, Reynaldo

2009-03-01

147

Valores de presión arterial en escolares sanos de una escuela primaria del municipio Cerro Arterial pressure values in healthy students from a primary school of Cerro municipality  

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Full Text Available INTRODUCCIÓN: la hipertensión constituye un notable problema de salud en el ámbito mundial que determina una importante causa de morbilidad, en la que están involucrados factores genéticos y ambientales. La presión arterial en la infancia aumenta progresivamente a lo largo de los años, y es una importante variable a considerar. OBJETIVO: caracterizar el comportamiento de algunas variables cardiovasculares y nutricionales en escolares supuestamente sanos. MÉTODOS: se realizó un estudio de tipo descriptivo de cohorte transversal, en el que fueron estudiados escolares supuestamente sanos de una escuela primaria del municipio Cerro, en Ciudad de La Habana, en el período comprendido desde el 1ro. de diciembre de 2006 al 28 de febrero de 2007. El universo estuvo constituido por 358 niños de ambos sexos entre 5 y 11 años de edad. Las variables estudiadas fueron: presión arterial sistólica, presión arterial diastólica, presión arterial media, frecuencia cardiaca, peso, talla e índice de masa corporal. RESULTADOS: los resultados muestran cifras de presión arterial sistólica entre 77 y 104 mmHg, valores de presión arterial diastólica entre 43 a 64 mmHg, mientras que los valores de presión arterial media oscilan en un intervalo de 57 a 72 mmHg. La frecuencia cardiaca fue mayor en escolares de menor edad con respecto a los de mayor edad. El peso, la talla y el índice de masa corporal se incrementan con la edad. CONCLUSIONES: se concluye que los valores de presión arterial sistólica, diastólica y media en escolares de ambos sexos se incrementan con la edad, no así los de frecuencia cardiaca, cuya tendencia es a disminuir a medida que la edad aumenta. Los valores que corresponden al índice de masa corporal se elevan con la edad.INTRODUCTION: hypertension is a marked health problem at world scale determining significant causes of morbidity, in which are involved genetic and environmental factors. Infantile arterial pressure increases progressively during years, and it is a significant variable to be considered. AIM: to characterize behavior of some cardiovascular and nutritional variables in supposedly healthy students. METHODS: authors made a cross-sectional descriptive study in supposedly health students from a primary school of Cerro municipality in Havana City from December 1st 2006 to February 28, 2007. Sample included 358 children of both sexes aged between 5 and 11. Study variable were: systolic high blood pressure, diastolic arterial pressure, mean arterial pressure, cardiac frequency, weight, height and body mass index (BMI). RESULTS: results show figures of systolic arterial pressure between 77 and 104 mmHg, diastolic arterial pressure between 43 and 64 mmHg, whereas mean arterial pressure oscillate in a interval of 57-72 mmHg. Cardiac frequency was greater in younger ones regarding those oldest. Weight, height and MBI increase with age. CONCLUSIONS: we conclude that systolic, diastolic and mean arterial pressure in students of both sexes increase with age, but not cardiac frequency, whose trend is to decrease insofar as age increases. Values corresponding to BMI increase with age.

Roberto Francisco Corredera Guerra; Yanet Villar Badía; Tania Rosa González Rodríguez; Reynaldo Gómez Urbina

2009-01-01

148

Effects of mercury on the arterial blood pressure of anesthetized rats  

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Full Text Available The available data suggests that hypotension caused by Hg2+ administration may be produced by a reduction of cardiac contractility or by cholinergic mechanisms. The hemodynamic effects of an intravenous injection of HgCl2 (5 mg/kg) were studied in anesthetized rats (N = 12) by monitoring left and right ventricular (LV and RV) systolic and diastolic pressures for 120 min. After HgCl2 administration the LV systolic pressure decreased only after 40 min (99 ± 3.3 to 85 ± 8.8 mmHg at 80 min). However, RV systolic pressure increased, initially slowly but faster after 30 min (25 ± 1.8 to 42 ± 1.6 mmHg at 80 min). Both right and left diastolic pressures increased after HgCl2 treatment, suggesting the development of diastolic ventricular dysfunction. Since HgCl2 could be increasing pulmonary vascular resistance, isolated lungs (N = 10) were perfused for 80 min with Krebs solution (continuous flow of 10 ml/min) containing or not 5 µM HgCl2. A continuous increase in pulmonary vascular resistance was observed, suggesting the direct effect of Hg2+ on the pulmonary vessels (12 ± 0.4 to 29 ± 3.2 mmHg at 30 min). To examine the interactions of Hg2+ and changes in cholinergic activity we analyzed the effects of acetylcholine (Ach) on mean arterial blood pressure (ABP) in anesthetized rats (N = 9) before and after Hg2+ treatment (5 mg/kg). Using the same amount and route used to study the hemodynamic effects we also examined the effects of Hg2+ administration on heart and plasma cholinesterase activity (N = 10). The in vivo hypotensive response to Ach (0.035 to 10.5 µg) was reduced after Hg2+ treatment. Cholinesterase activity (µM h-1 mg protein-1) increased in heart and plasma (32 and 65%, respectively) after Hg2+ treatment. In conclusion, the reduction in ABP produced by Hg2+ is not dependent on a putative increase in cholinergic activity. HgCl2 mainly affects cardiac function. The increased pulmonary vascular resistance and cardiac failure due to diastolic dysfunction of both ventricles are factors that might contribute to the reduction of cardiac output and the fall in arterial pressure.

Rossoni L.V.; Amaral S.M.C.; Vassallo P.F.; França A.; Oliveira E.M.; Varner K.J.; Mill J.G.; Vassallo D.V.

1999-01-01

149

Monitorização ambulatorial da pressão arterial em adolescentes normais/ Ambulatory blood pressure monitoring in normal adolescents  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Avaliar tecnicamente a monitorização ambulatorial de pressão arterial (MAPA) em adolescentes normais. MÉTODOS: Quarenta e cinco adolescentes eutróficos, entre 10-18 anos de idade, sendo 27 do sexo feminino. RESULTADOS: Verificaram-se, em média, 90% de medidas bem sucedidas: incômodo relacionado ao funcionamento do monitor em 30% dos casos; valores médios de descenso sistólico, diastólico e de diminuição de freqüência cardíaca, no sono noturno, res (more) pectivamente iguais a 13%, 23% e 24%; carga pressórica na vigília, no sexo masculino, de 25,4±27,7% e 11,8±14,6% e, no feminino, de 17,5±18,7% e 11,8±11,4% para pressão arterial sistólica (PAS) e diastólica (PAD), respectivamente; carga pressórica no sono, no sexo masculino, de 15,4±22,9% e 2,8±4,9% e, no feminino, de 10,5±18,2% e 1,8±2,7% para PAS e PAD; medidas diastólicas mais elevadas nas duas primeiras horas de monitorização; diferenças entre sono noturno e vespertino quanto aos parâmetros cardiovasculares estudados. CONCLUSÃO: A MAPA mostrou-se bem tolerada pela população adolescente. Os registros obtidos apresentaram-se tecnicamente adequados para análise. Abstract in english PURPOSE: To evaluate technical aspects of ambulatory blood pressure monitoring (ABPM) in normal adolescents. METHODS: Forty five normal adolescents (27 female), 10-18 years old. RESULTS: ABPM recordings showed a mean of 90% successful readings; 30% of the patients complained of sleep disruption related to the functioning of the ABPM monitor; the mean systolic, diastolic and heart rate fall during sleep was 13%, 23% and 24% respectively; the mean systolic and diastolic blo (more) od pressure load, while awake, was in male adolescents 25.4±27.7% and 11.8±14.6%, and in female adolescents, 17.5±18.7% and 11.8±11.4%, respectively; the mean systolic and diastolic blood pressure load, while asleep, was in male adolescents 15.4±22.9% and 2.8±4.9% and, in female adolescents, 10.5±18.2% and 1.8±2.7%, respectively; the mean diastolic values of the first two hours of recording were higher than the ones obtained during the rest of the hours of recording while awake; different mean systolic, diastolic and heart rate values were found during the afternoon and nocturnal sleep periods. CONCLUSION: ABPM was well accepted by the adolescent population, with good technical results.

Koch, Vera H.; Colli, Anita; Saito, Maria Ignez; Ruffo, Patricia; Cardoso, Rita; Ignes, Edna C.; Okay, Yassuhiko; Mion Jr, Décio

1997-07-01

150

Monitorização ambulatorial da pressão arterial em adolescentes normais Ambulatory blood pressure monitoring in normal adolescents  

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Full Text Available OBJETIVO: Avaliar tecnicamente a monitorização ambulatorial de pressão arterial (MAPA) em adolescentes normais. MÉTODOS: Quarenta e cinco adolescentes eutróficos, entre 10-18 anos de idade, sendo 27 do sexo feminino. RESULTADOS: Verificaram-se, em média, 90% de medidas bem sucedidas: incômodo relacionado ao funcionamento do monitor em 30% dos casos; valores médios de descenso sistólico, diastólico e de diminuição de freqüência cardíaca, no sono noturno, respectivamente iguais a 13%, 23% e 24%; carga pressórica na vigília, no sexo masculino, de 25,4±27,7% e 11,8±14,6% e, no feminino, de 17,5±18,7% e 11,8±11,4% para pressão arterial sistólica (PAS) e diastólica (PAD), respectivamente; carga pressórica no sono, no sexo masculino, de 15,4±22,9% e 2,8±4,9% e, no feminino, de 10,5±18,2% e 1,8±2,7% para PAS e PAD; medidas diastólicas mais elevadas nas duas primeiras horas de monitorização; diferenças entre sono noturno e vespertino quanto aos parâmetros cardiovasculares estudados. CONCLUSÃO: A MAPA mostrou-se bem tolerada pela população adolescente. Os registros obtidos apresentaram-se tecnicamente adequados para análise.PURPOSE: To evaluate technical aspects of ambulatory blood pressure monitoring (ABPM) in normal adolescents. METHODS: Forty five normal adolescents (27 female), 10-18 years old. RESULTS: ABPM recordings showed a mean of 90% successful readings; 30% of the patients complained of sleep disruption related to the functioning of the ABPM monitor; the mean systolic, diastolic and heart rate fall during sleep was 13%, 23% and 24% respectively; the mean systolic and diastolic blood pressure load, while awake, was in male adolescents 25.4±27.7% and 11.8±14.6%, and in female adolescents, 17.5±18.7% and 11.8±11.4%, respectively; the mean systolic and diastolic blood pressure load, while asleep, was in male adolescents 15.4±22.9% and 2.8±4.9% and, in female adolescents, 10.5±18.2% and 1.8±2.7%, respectively; the mean diastolic values of the first two hours of recording were higher than the ones obtained during the rest of the hours of recording while awake; different mean systolic, diastolic and heart rate values were found during the afternoon and nocturnal sleep periods. CONCLUSION: ABPM was well accepted by the adolescent population, with good technical results.

Vera H. Koch; Anita Colli; Maria Ignez Saito; Patricia Ruffo; Rita Cardoso; Edna C. Ignes; Yassuhiko Okay; Décio Mion Jr

1997-01-01

151

Monitorização residencial da pressão arterial e monitorização ambulatorial da pressão arterial versus medida de pressão arterial no consultório Home blood pressure measurement and ambulatory blood pressure measurement versus office blood pressure measurement  

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Full Text Available OBJETIVOS: Comparar a monitorização residencial da pressão arterial (MRPA) e monitorização ambulatorial da pressão arterial (MAPA) com os registros de consultório e correlacionar o índice de massa de ventrículo esquerdo (IMVE) com a MRPA e medida de consultório. MÉTODOS: Protocolo 1 - Sessenta e oito hipertensos (58±12 anos, 37 mulheres) realizaram: a) MRPA durante 7 dias; b) MAPA de 24h; e c) medida da pressão arterial no consultório, pelo médico. Protocolo 2 - 41 hipertensos (48 ± 14 anos, 25 mulheres) além de MRPA e medida no consultório, realizaram ecocardiograma bi-dimensional. RESULTADOS: Protocolo 1 - a medida de consultório (153±24/96±13mmHg) foi maior (p0,05). CONCLUSÃO: A MRPA apresentou valores menores do que a medida de consultório e semelhantes aos da MAPA, além de melhor correlação com IMVE do que a medida de consultório.PURPOSE: To compare both home blood pressure measurement (HBPM) and ambulatory blood pressure monitoring (ABPM) with office blood pressure measurement (OBP); and also to compare the correlation between HBPM and OBP with LVMI (left ventricular mass index). METHODS: Protocol 1 - 68 hypertensive patients (58±12 years, 37 females): a) self recorded blood pressure at home in the 7 days; b) recorded the ABPM during 24 hours; and c) the physician recorded blood pressure in the office. Protocol 2- 41 hypertensive patients underwent the HBPM, OBP, and BI-dimensional echocardiogram. RESULTS: Protocol 1 - OBP (153±24/96±13mmHg) was higher (p0.05, systolic and diastolic, respectively). CONCLUSION: This study showed that HBPM has a better correlation with LVMI than OBP.

Marco A. M. Gomes; Angela M.G. Pierin; Carlos A. Segre; Décio Mion Jr

1998-01-01

152

Monitorização residencial da pressão arterial e monitorização ambulatorial da pressão arterial versus medida de pressão arterial no consultório/ Home blood pressure measurement and ambulatory blood pressure measurement versus office blood pressure measurement  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVOS: Comparar a monitorização residencial da pressão arterial (MRPA) e monitorização ambulatorial da pressão arterial (MAPA) com os registros de consultório e correlacionar o índice de massa de ventrículo esquerdo (IMVE) com a MRPA e medida de consultório. MÉTODOS: Protocolo 1 - Sessenta e oito hipertensos (58±12 anos, 37 mulheres) realizaram: a) MRPA durante 7 dias; b) MAPA de 24h; e c) medida da pressão arterial no consultório, pelo médico. Protocol (more) o 2 - 41 hipertensos (48 ± 14 anos, 25 mulheres) além de MRPA e medida no consultório, realizaram ecocardiograma bi-dimensional. RESULTADOS: Protocolo 1 - a medida de consultório (153±24/96±13mmHg) foi maior (p0,05). CONCLUSÃO: A MRPA apresentou valores menores do que a medida de consultório e semelhantes aos da MAPA, além de melhor correlação com IMVE do que a medida de consultório. Abstract in english PURPOSE: To compare both home blood pressure measurement (HBPM) and ambulatory blood pressure monitoring (ABPM) with office blood pressure measurement (OBP); and also to compare the correlation between HBPM and OBP with LVMI (left ventricular mass index). METHODS: Protocol 1 - 68 hypertensive patients (58±12 years, 37 females): a) self recorded blood pressure at home in the 7 days; b) recorded the ABPM during 24 hours; and c) the physician recorded blood pressure in the (more) office. Protocol 2- 41 hypertensive patients underwent the HBPM, OBP, and BI-dimensional echocardiogram. RESULTS: Protocol 1 - OBP (153±24/96±13mmHg) was higher (p0.05, systolic and diastolic, respectively). CONCLUSION: This study showed that HBPM has a better correlation with LVMI than OBP.

Gomes, Marco A. M.; Pierin, Angela M.G.; Segre, Carlos A.; Mion Jr, Décio

1998-10-01

153

Association of body mass index with arterial stiffness and blood pressure components: a twin study.  

UK PubMed Central (United Kingdom)

RATIONALE: Obesity, blood pressure and arterial stiffness are heritable traits interconnected to each other but their possible common genetic and environmental etiologies are unknown. METHODS: We studied 228 monozygotic and 150 dizygotic twin pairs aged 18-82 years from Italy, Hungary and the United States, of which 45 monozygotic and 38 dizygotic pairs were discordant for body mass index (BMI; intrapair difference (?) in BMI ? 3 kg/m(2)). Blood pressure components and arterial stiffness were measured by TensioMed Arteriograph. RESULTS: Hypertension was more prevalent among obese than non-obese individuals (55% vs. 29%, p < 0.001). Age-, sex- and country-adjusted heritability estimates were high for hemodynamic measures (45%-58%) and BMI (78%). According to bivariate Cholesky decomposition, phenotypic correlations between BMI and blood pressure components (r = -0.15 to 0.24, p < 0.05) were largely explained by additive genetic factors (65%-77%) with the remaining explained by the unique environment. When controlling for genetic factors within all monozygotic pairs, ?BMI was significantly correlated with ?brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP), ?mean arterial pressure, and ?aortic SBP (r = 0.15-0.17, p < 0.05). For the same measures, heavier co-twins of BMI-discordant monozygotic pairs had significantly higher values than their leaner counterparts (p < 0.05). CONCLUSION: Blood pressure components are moderately correlated with BMI, largely because of shared genetic factors. However, for the association of BMI with brachial SBP and DBP, aortic SBP and mean arterial pressure, acquired, modifiable factors were also found to be important.

Tarnoki AD; Tarnoki DL; Bogl LH; Medda E; Fagnani C; Nisticò L; Stazi MA; Brescianini S; Lucatelli P; Boatta E; Zini C; Fanelli F; Baracchini C; Meneghetti G; Osztovits J; Jermendy G; Kiss RG; Preda I; Karlinger K; Lannert A; Molnar AA; Littvay L; Garami Z; Berczi V; Pucci G; Baffy G; Schillaci G; Pietiläinen KH

2013-08-01

154

Doppler Tissue Imaging: A Non-Invasive Technique for Estimation of Left Ventricular End Diastolic Pressure in Severe Mitral Regurgitation  

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Full Text Available Background: Conventional Doppler measurements, including mitral inflow and pulmonary venous flow, are used to estimate left ventricular end diastolic pressure (LVEDP). However, these parameters have limitations in predicting LVEDP among patients with mitral regurgitation. This study sought to establish whether the correlation between measurements derived from tissue Doppler echocardiography and LVEDP remains valid in the setting of severe mitral regurgitation.Methods: Thirty patients (mean age: 57.37 ± 13.29 years) with severe mitral regurgitation and a mean left ventricular ejection fraction (EF) of 46.0 ± 14.95 were enrolled; 16 (53.4%) patients were defined to have EF < 50% and 14 (46.6%) patients had EF ? 50%. Doppler signals from the mitral inflow, pulmonary venous flow, and Doppler tissue imaging indices were obtained, and LVEDP was measured invasively through cardiac catheterization.Results: The majority of the standard Doppler and Doppler tissue imaging indices were not significantly correlated with LVEDP in the univariate analysis. In the multiple linear regression, however, early (E) transmitral velocity to annular E' (E/E') ratio (ß = 1.09, p value < 0.01), E wave velocity to propagation velocity (E/Vp) ratio (ß = 7.87, p value < 0.01), and isovolumic relaxation time (ß = 0.21, p value = 0.01) were shown as independent predictors of LVEDP (R2 = 91.7%).Conclusion: The ratio of E/Vp and E/E' ratio and also the isovolumic relaxation time could be applied properly to estimate LVEDP in mitral regurgitation patients even in the setting of severe mitral regurgitation.

Roya Sattarzadeh Badkoubeh; Yaser Jenab; Arezou Zoroufian; Mojtaba Salarifar

2010-01-01

155

Arterial stiffness as underlying mechanism of disagreement between an oscillometric blood pressure monitor and a sphygmomanometer  

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Oscillometric blood pressure devices tend to overestimate systolic blood pressure and underestimate diastolic blood pressure compared with sphygmomanometers. Recent studies indicate that discrepancies in performance between these devices may differ between healthy and d...

Popele, N.M-L. van; Bos, W.J.; Beer, N.A. de; Kuip, D.A. van der; Grobbee, D.E.; Witteman, J.C.M.; Hofman, A.

156

Soybean oil increases SERCA2a expression and left ventricular contractility in rats without change in arterial blood pressure  

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Full Text Available Abstract Background Our aim was to evaluate the effects of soybean oil treatment for 15 days on arterial and ventricular pressure, myocardial mechanics and proteins involved in calcium handling. Methods Wistar rats were divided in two groups receiving 100 ?L of soybean oil (SB) or saline (CT) i.m. for 15 days. Ventricular performance was analyzed in male 12-weeks old Wistar rats by measuring left ventricle diastolic and systolic pressure in isolated perfused hearts according to the Langendorff technique. Protein expression was measured by Western blot analysis. Results Systolic and diastolic arterial pressures did not differ between CT and SB rats. However, heart rate was reduced in the SB group. In the perfused hearts, left ventricular isovolumetric systolic pressure was higher in the SB hearts. The inotropic response to extracellular Ca2+ and isoproterenol was higher in the soybean-treated animals than in the control group. Myosin ATPase and Na+-K+ATPase activities, the expression of sarcoplasmic reticulum calcium pump (SERCA2a) and sodium calcium exchanger (NCX) were increased in the SB group. Although the phosfolamban (PLB) expression did not change, its phosphorylation at Ser16 was reduced while the SERCA2a/PLB ratio was increased. Conclusions In summary, soybean treatment for 15 days in rats increases the left ventricular performance without affecting arterial blood pressure. These changes might be associated with an increase in the myosin ATPase activity and SERCA2a expression.

Ribeiro Rogério; Fernandes Aurélia; Meira Eduardo; Batista Priscila; Magalhães Siman Fabiana; Vassallo Dalton; Padilha Alessandra; Stefanon Ivanita

2010-01-01

157

Arterial pressure fractality is highly dependent on wave reflection.  

Science.gov (United States)

Wave reflection is an important factor that influences pressure wave morphology and becomes more significant with aging, when cardiovascular risk increases. A pressure wave, measured at any location in the arterial tree, can be decomposed into its forward and backward components and depends on the corresponding amplitude and shifting time delays. Fractal dimension (FD) quantifies the time series complexity defined by its geometrical representation. Objective: The aim of this study was to evaluate the arterial pressure and diameter time series in order to assess the relationship between wave reflection and arterial pressure fractal dimension (FD). Methods: Simultaneous aortic pressure and diameter were measured in 14 conscious dogs. A pair of ultrasonic crystals, a pressure microtransducer and a pneumatic cuff occluder were positioned in the upper third of the descending aorta. Results: Total reflection induced by the occlusion maneuver decreased FD concomitant to the aortic stiffening. Conclusion: Arterial pressure fractality is highly dependent on wave reflection. PMID:24110099

Armentano, Ricardo L; Cymberknop, Leandro J; Legnani, Walter; Pessana, Franco M; Craiem, Damian; Graf, Sebastian; Barra, Juan G

2013-07-01

158

Artificial arterial blood pressure artifact models and an evaluation of a robust blood pressure and heart rate estimator  

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Full Text Available Abstract Background Within the intensive care unit (ICU), arterial blood pressure (ABP) is typically recorded at different (and sometimes uneven) sampling frequencies, and from different sensors, and is often corrupted by different artifacts and noise which are often non-Gaussian, nonlinear and nonstationary. Extracting robust parameters from such signals, and providing confidences in the estimates is therefore difficult and requires an adaptive filtering approach which accounts for artifact types. Methods Using a large ICU database, and over 6000 hours of simultaneously acquired electrocardiogram (ECG) and ABP waveforms sampled at 125 Hz from a 437 patient subset, we documented six general types of ABP artifact. We describe a new ABP signal quality index (SQI), based upon the combination of two previously reported signal quality measures weighted together. One index measures morphological normality, and the other degradation due to noise. After extracting a 6084-hour subset of clean data using our SQI, we evaluated a new robust tracking algorithm for estimating blood pressure and heart rate (HR) based upon a Kalman Filter (KF) with an update sequence modified by the KF innovation sequence and the value of the SQI. In order to do this, we have created six novel models of different categories of artifacts that we have identified in our ABP waveform data. These artifact models were then injected into clean ABP waveforms in a controlled manner. Clinical blood pressure (systolic, mean and diastolic) estimates were then made from the ABP waveforms for both clean and corrupted data. The mean absolute error for systolic, mean and diastolic blood pressure was then calculated for different levels of artifact pollution to provide estimates of expected errors given a single value of the SQI. Results Our artifact models demonstrate that artifact types have differing effects on systolic, diastolic and mean ABP estimates. We show that, for most artifact types, diastolic ABP estimates are less noise-sensitive than mean ABP estimates, which in turn are more robust than systolic ABP estimates. We also show that our SQI can provide error bounds for both HR and ABP estimates. Conclusion The KF/SQI-fusion method described in this article was shown to provide an accurate estimate of blood pressure and HR derived from the ABP waveform even in the presence of high levels of persistent noise and artifact, and during extreme bradycardia and tachycardia. Differences in error between artifact types, measurement sensors and the quality of the source signal can be factored into physiological estimation using an unbiased adaptive filter, signal innovation and signal quality measures.

Li Qiao; Mark Roger G; Clifford Gari D

2009-01-01

159

Ambulatory blood pressure monitoring and structural changes in carotid arteries in normotensive workers occupationally exposed to lead.  

UK PubMed Central (United Kingdom)

Occupational exposure to lead may cause an increase in blood pressure. The aim of the study was to estimate the effect of occupational exposure to lead on selected parameters of ambulatory blood pressure monitoring (ABPM) and structural changes in carotid arteries. The study included 33 normotensive men occupationally exposed to lead and 39 unexposed men employed in administration of the foundry. All of the men underwent 24-hour ambulatory blood pressure monitoring and high-resolution B-mode ultrasonography to determine intima-media thickness (IMT). The group of men occupationally exposed to lead manifested significantly higher mean systolic blood pressure (MSBP), mean diastolic blood pressure (MDBP), mean blood pressure (MBP), pulse pressure (PP), variability of diastolic blood pressure (VDBP), and IMT than the unexposed group. The studied groups did not differ in mean values of variability of systolic blood pressure (VSBP). As compared to the unexposed group, in men exposed to lead, atherosclerotic plaques were significantly more common. In the group of persons exposed to lead the Pearson's correlation coefficient analysis revealed significant linear positive correlations between MSBP and IMT, between lead level and the number of atherosclerotic plaques, and between lead level and PP. Multivariate stepwise regression analysis demonstrated that higher lead level in blood and higher triglyceride concentration in blood represent independent risk factors of an increased pulse pressure in the group of individuals occupationally exposed to lead. Occupational exposure to lead can be associated with increased blood pressure and accelerated progression of atherosclerosis.

Poreba R; Poreba M; Ga? P; Andrzejak R

2011-09-01

160

Association of systolic and diastolic blood pressure and all cause mortality in people with newly diagnosed type 2 diabetes: retrospective cohort study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine the effect of systolic and diastolic blood pressure achieved in the first year of treatment on all cause mortality in patients newly diagnosed with type 2 diabetes, with and without established cardiovascular disease. DESIGN: Retrospective cohort study. SETTING: United Kingdom General Practice Research Database, between 1990 and 2005. PARTICIPANTS: 126,092 adult patients (age ? 18 years) with a new diagnosis of type 2 diabetes who had been registered with participating practices for at least 12 months. MAIN OUTCOME MEASURE: All cause mortality. RESULTS: Before diagnosis, 12,379 (9.8%) patients had established cardiovascular disease (myocardial infarction or stroke). During a median follow-up of 3.5 years, we recorded 25,495 (20.2%) deaths. In people with cardiovascular disease, tight control of systolic (<130 mm Hg) and diastolic (<80 mm Hg) blood pressure was not associated with improved survival, after adjustment for baseline characteristics (age at diagnosis, sex, practice level clustering, deprivation score, body mass index, smoking, HbA(1c) and cholesterol levels, and blood pressure). Low blood pressure was also associated with an increased risk of all cause mortality. Compared with patients who received usual control of systolic blood pressure (130-139 mm Hg), the hazard ratio of all cause mortality was 2.79 (95% confidence interval 1.74 to 4.48, P<0.001) for systolic blood pressure at 110 mm Hg. Compared with patients who received usual control of diastolic blood pressure (80-84 mm Hg), the hazard ratios were 1.32 (1.02 to 1.78, P=0.04) and 1.89 (1.40 to 2.56, P<0.001) for diastolic blood pressures at 70-74 mm Hg and lower than 70 mm Hg, respectively. Similar associations were found in people without cardiovascular disease. Subgroup analyses of people diagnosed with hypertension and who received treatment for hypertension confirmed initial findings. CONCLUSION: Blood pressure below 130/80 mm Hg was not associated with reduced risk of all cause mortality in patients with newly diagnosed diabetes, with or without known cardiovascular disease. Low blood pressure, particularly below 110/75 mm Hg, was associated with an increased risk for poor outcomes.

Vamos EP; Harris M; Millett C; Pape UJ; Khunti K; Curcin V; Molokhia M; Majeed A

2012-01-01

 
 
 
 
161

Does dairy food intake predict arterial stiffness and blood pressure in men?: Evidence from the Caerphilly Prospective Study.  

UK PubMed Central (United Kingdom)

Arterial stiffness is an independent predictor of cardiovascular disease events and mortality, and like blood pressure, may be influenced by dairy food intake. Few studies have investigated the effects of consumption of these foods on prospective measures of arterial stiffness. The present analysis aimed to investigate the prospective relationship between milk, cheese, cream, and butter consumption and aortic pulse wave velocity, augmentation index, systolic and diastolic blood pressure, as well as cross-sectional relationships between these foods and systolic and diastolic blood pressure and metabolic markers using data from the Caerphilly Prospective Study. Included in this cohort were 2512 men, aged 45 to 59 years, who were followed up at 5-year intervals for a mean of 22.8 years (number follow-up 787). Augmentation index was 1.8% lower in subjects in the highest quartiles of dairy product intake compared with the lowest (P trend=0.021), whereas in the highest group of milk consumption systolic blood pressure was 10.4 mm Hg lower (P trend=0.033) than in nonmilk consumers after a 22.8-year follow-up. Cross-sectional analyses indicated that across increasing quartiles of butter intake, insulin (P trend=0.011), triacylglycerol (P trend=0.023), total cholesterol (P trend=0.002), and diastolic blood pressure (P trend=0.027) were higher. Across increasing groups of milk intake and quartiles of dairy product intake, glucose (P trend=0.032) and triglyceride concentrations (P trend=0.031) were lower, respectively. The present results confirm that consumption of milk predicts prospective blood pressure, whereas dairy product consumption, excluding butter, is not detrimental to arterial stiffness and metabolic markers. Further research is needed to better understand the mechanisms that underpin these relationships.

Livingstone KM; Lovegrove JA; Cockcroft JR; Elwood PC; Pickering JE; Givens DI

2013-01-01

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A comparison of noninvasive blood pressure measurement on the wrist with invasive arterial blood pressure monitoring in patients undergoing bariatric surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: In morbidly obese patients, oscillometric blood pressure measurements with an upper-arm cuff are often difficult to perform. The alternative method, invasive blood pressure monitoring, can be difficult to place and is associated with risks. A wrist-mounted blood pressure-monitoring device, the Vasotrac, provides accurate blood pressure measurements in lean patients. Even in the obese, wrist morphology remains relatively unchanged. We thus assessed the degree to which blood pressure measurements with the Vasotrac on the wrist and cuff measurements agree with invasive arterial blood pressure monitoring. METHODS: We evaluated 22 morbidly obese patients undergoing bariatric surgery lasting 3.8+/-1.1 h. Intraoperative blood pressure was simultaneously measured using the Vasotrac mounted on one wrist; an arterial catheter was inserted in the opposite radial artery, and an oscillometric cuff was positioned on the upper arm. Preoperative patient comfort was evaluated on a scale from 1 to 10, with 10 being most uncomfortable, just after the first oscillometric cuff inflation. Values from the Vasotrac and arterial catheter were recorded at 5-s intervals. Bias, precision, and clinically acceptable agreement were calculated between the two continuous monitoring devices and between the arterial catheter and the cuff measurements, with the arterial catheter providing the reference value. RESULTS: The patients' age was 44.3+/-9.5 years (mean+/-SD), body mass index was 66.7+/-13.8 kg/m2, and arm circumference was 48.6+/-7.5 cm. Patients found the Vasotrac more comfortable than the oscillometric device [1.7+/-1.8 vs 5.3+/-0.5 (P=0.009)]. A total of 40,411 pairs of values from the Vasotrac and arterial catheter were recorded. Lin's concordance correlation coefficient (95% CI) for mean arterial blood pressure measured between the arterial line and the Vasotrac was 0.74 (0.67, 0.82). The bias (mean error) was -0.25 mmHg; however, the Bland-Altman limits where 95% of individual pressure differences are expected to fall was (-20, 20) mmHg. The precisions for diastolic and systolic pressures were even worse. CONCLUSION: The Vasotrac was more comfortable than an oscillometric device. Although the average accuracy was good, individual mean Vasotrac and noninvasive blood pressure pressures often differed considerably from arterial values. These results suggest that the Vasotrac monitor should not be substituted for an arterial catheter in super-obese patients.

Hager H; Mandadi G; Pulley D; Eagon JC; Mascha E; Nutter B; Kurz A

2009-06-01

163

Separation of the reservoir and wave pressure and velocity from measurements at an arbitrary location in arteries.  

UK PubMed Central (United Kingdom)

Previous studies based on measurements made in the ascending aorta have demonstrated that it can be useful to separate the arterial pressure P into a reservoir pressure P* generated by the windkessel effect and a wave pressure p generated by the arterial waves: P = P*+p. The separation in these studies was relatively straightforward since the flow into the arterial system was measured. In this study the idea is extended to measurements of pressure and velocity at sites distal to the aortic root where flow into the arterial system is not known. P* is calculated from P at an arbitrary location in a large artery by fitting the pressure fall-off in diastole to an exponential function and assuming that p is proportional to the flow into the arterial system. A local reservoir velocity U* that is proportional to P* is also defined. The separation algorithm is applied to in vivo human and canine data and to numerical data generated using a one-dimensional model of pulse wave propagation in the larger conduit arteries. The results show that the proposed algorithm is reasonably robust, allowing for the separation of the measured pressure and velocity into reservoir and wave pressures and velocities. Application to data measured simultaneously in the aorta of the dog shows that the reservoir pressure is fairly uniform along the aorta, a test of self-consistency of the assumptions leading to the algorithm. Application to data generated with a validated numerical model indicates that the parameters derived by fitting the pressure data are close to the known values which were used to generate the numerical data. Finally, application to data measured in the human thoracic aorta indicates the potential usefulness of the separation.

Aguado-Sierra J; Alastruey J; Wang JJ; Hadjiloizou N; Davies J; Parker KH

2008-05-01

164

The relationship between aortic baroreceptor activity and arterial pressure is not monotonic.  

Science.gov (United States)

Previous reports indicate that when aortic pressure (AP) falls below the threshold (P (th)) for baroreceptor sensitivity, activity in the aortic depressor nerve (ADN) may increase. To quantify and explain this anomalous behaviour, we analysed curves describing the relationship of baroreceptor fibre activity in rabbit left ADN to AP. Data were obtained in anaesthetised New Zealand White rabbits. Occlusion and release of cuffs around the inferior vena cava and descending aorta generated AP ramps (25-140 mmHg). Response curves were obtained for 173 fibres in 26 animals. Thirty percent of curves had a nadir (J-shaped curve), and in 40% activity was always present. In fibres showing activity below P (th), firing was predominantly diastolic, switching to systolic firing at P (th). The unusual behaviour of a substantial fraction of aortic baroreceptors below P (th) accounts for the J-shaped response curve of the whole ADN. We suggest that fibres that fire during diastole at pressures below P (th) may have sensory endings close to the origin of the left subclavian artery. As a consequence of this anatomical location, low pressures can impose strain on these receptors, which is then relieved by the systolic pulse. PMID:21240644

Bolter, Chris P; Turner, Michael J; Barrett, Carolyn J

2011-01-15

165

Assessment of changes in left ventricular diastolic filling during dipyridamole infusion in patients with coronary artery disease  

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Twenty patients with ischemic heart disease (IHD) and 8 normal subjects underwent first-pass radionuclide ventriculography before and after dipyridamole tests. Hemodynamic parameters were evaluated in early and late diastolic phases. In the normal group, left ventricular ejection fraction (LVEF) increased after dipyridamole infusion. In addition, dipyridamole infusion was associated with an increase in left ventricular early filling time (FT) and early filling volume (FV) and a decrease in late FT and late FV. Left ventricular early peak filling rate (PFR) was significantly increased. In the IHD group, however, there was no significant change in LVEF. Both left ventricular early FT and early FV were decreased, and both late FT and late FV were increased. In the group of IHD patients, the time to early PFR was significantly prolonged, although there was no difference in early PFR, late PFR, and the ratio of early to late PFRs. These results indicate that dipyridamole infusion does not always induce a decrease in left ventricular contractile function in ischemic heart, but maintains the left ventricular FV by compensated mechanism of late filling ability for the decreased left ventricular early filling ability. (N.K.).

Shimonagata, Tsuyoshi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Toyama, Takuji (National Cardiovascular Center, Suita, Osaka (Japan)); Ito, Akira; Nonogi, Hiroshi; Haji, Kazuo

1993-02-01

166

Assessment of changes in left ventricular diastolic filling during dipyridamole infusion in patients with coronary artery disease  

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Twenty patients with ischemic heart disease (IHD) and 8 normal subjects underwent first-pass radionuclide ventriculography before and after dipyridamole tests. Hemodynamic parameters were evaluated in early and late diastolic phases. In the normal group, left ventricular ejection fraction (LVEF) increased after dipyridamole infusion. In addition, dipyridamole infusion was associated with an increase in left ventricular early filling time (FT) and early filling volume (FV) and a decrease in late FT and late FV. Left ventricular early peak filling rate (PFR) was significantly increased. In the IHD group, however, there was no significant change in LVEF. Both left ventricular early FT and early FV were decreased, and both late FT and late FV were increased. In the group of IHD patients, the time to early PFR was significantly prolonged, although there was no difference in early PFR, late PFR, and the ratio of early to late PFRs. These results indicate that dipyridamole infusion does not always induce a decrease in left ventricular contractile function in ischemic heart, but maintains the left ventricular FV by compensated mechanism of late filling ability for the decreased left ventricular early filling ability. (N.K.).

1993-01-01

167

Prediction of arterial pressure increase after fluid challenge  

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Full Text Available Abstract Background Mean arterial pressure above 65 mmHg is recommended for critically ill hypotensive patients whereas they do not benefit from supranormal cardiac output values. In this study we investigated if the increase of mean arterial pressure after volume expansion could be predicted by cardiovascular and renal variables. This is a relevant topic because unnecessary positive fluid balance increases mortality, organ dysfunction and Intensive Care Unit length of stay. Methods Thirty-six hypotensive patients (mean arterial pressure Results Twenty-two patients (61%) increased arterial pressure after volume expansion. Baseline heart rate, arterial pressure, central venous pressure, central venous saturation, central venous to arterial PCO2 difference, lactate, urinary output, fractional excretion of sodium and urinary sodium/potassium ratio were similar between responder and non-responder. Only 7 out of 36 patients had valuable dynamic indices and then we excluded them from analysis. When the variables were tested as predictors of responders, they showed values of areas under the ROC curve ranging between 0.502 and 0.604. Logistic regression did not reveal any association between variables and responder definition. Conclusions Fluid challenge did not improve arterial pressure in about one third of hypotensive critically ill patients. Cardiovascular and renal variables did not enable us to predict the individual response to volume administration. Trial registration ClinicalTrials.gov: NCT00721604.

Natalini Giuseppe; Rosano Antonio; Militano Carmine; Di Maio Antonella; Ferretti Pierluigi; Bertelli Michele; de Giuli Federica; Bernardini Achille

2012-01-01

168

Comparison of cardiovascular magnetic resonance of late gadolinium enhancement and diastolic wall thickness to predict recovery of left ventricular function after coronary artery bypass surgery  

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Full Text Available Abstract Background The objective was to compare the value of late gadolinium enhancement (LGE) and end-diastolic wall thickness (EDWT) assessed by cardiovascular magnetic resonance (CMR) in predicting recovery of left ventricular function after coronary artery bypass surgery (CABG). Methods We enrolled patients with coronary artery disease and left ventricular ejection fraction Results We studied 46 men and 4 women with an average age of 61 years. Baseline left ventricular ejection fraction was 37 ± 13%. A total of 2,020 myocardial segments were analyzed. Abnormal wall motion and the LGE area were detected in 1,446 segments (71.6%) and 1,196 segments (59.2%) respectively. Wall motion improvement was demonstrated in 481 of 1,227 segments (39.2%) that initially had wall motion abnormalities at baseline. Logistic regression analysis showed that the LGE area, EDWT and resting wall motion grade predicted wall motion improvement. Comparison of Receiver-Operator-Characteristic (ROC) curves demonstrated that the LGE area was the most important predictor (p Conclusion LGE and EDWT are independent predictors for functional recovery after revascularization. However, LGE appears to be a more important factor and independent of EDWT.

Krittayaphong Rungroj; Laksanabunsong Pansak; Maneesai Adisak; Saiviroonporn Pairash; Udompunturak Suthipol; Chaithiraphan Vithaya

2008-01-01

169

[Thoughts concerning the realms of arterial blood pressure  

UK PubMed Central (United Kingdom)

Several realms of arterial blood pressure are analyzed. 1. The realm of physiological regulation of arterial blood pressure is discussed from the point of view of an intelligent design. 2. The realm of biophysical consequences, the adverse effects, wearing off or senilization and the vascular accidents. 3. The realm of biochemical changes leading to cellular changes. The ecological equilibrium and the interpretation of purposeful reactions. From metaphore to purpose. 4. The realm of cellular changes as a result of biophysical factors. The society of cells. 5. The realm of metabolic environment. 6. The realm of adverse effects of increasing arterial blood pressure instead of selecting less risky mechanisms. A politically mistaken decision.

Agrest A

2000-01-01

170

Association of thyroid function with arterial pressure in normotensive and hypertensive euthyroid individuals: A cross-sectional study  

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Full Text Available Abstract Background Overt hypothyroidism has been associated with arterial hypertension and increased arterial stiffness. Results in euthyroid individuals have been conflicting. We investigated associations of thyroid function with systolic (SAP) and diastolic (DAP) arterial pressure in euthyroid subjects. Methods 311 euthyroid individuals (185 women, mean age 43.9 ± 9) without a history of diabetes attending a preventive medicine program were examined. Subjects receiving thyroxine (10.6%) were excluded; 19.3% had hypertension, 43% had a family history for hypertension. TSH, fT4, thyroid autoantibodies, insulin, glucose were measured. The "fT4.TSH product", which has been suggested as a T4 resistance-index, was calculated. Results TSH range was 0.1–8, median 1.4 mU/L, fT4 range was 11.5–25.2 pmol/L, median 17.4. TSH and the "fT4.TSH product" were positively associated with DAP (p 2 mU/L (35.3% vs 21.3%, p = 0.045). Conclusion In euthyroid individuals the association of thyroid function with diastolic arterial pressure remains significant even when a stricter "normal range" for TSH levels is considered. The "freeT4.TSH" product appears to be an even stronger predictor of DAP, independently of HOMA insulin resistance index and obesity.

Saltiki Katerina; Voidonikola Paraskevi; Stamatelopoulos Kimon; Mantzou Emily; Papamichael Christos; Alevizaki Maria

2008-01-01

171

[Large artery wall properties in dialyse and renal transplant patients with normal blood pressure].  

UK PubMed Central (United Kingdom)

Structural and mechanical properties of the arterial wall are altered in patients with renal failure. Age and hypertension are known to affect the vessel wall structure. Aging process of arterial wall appears to be accelerated in patients with end-stage renal failure. The mechanisms responsible for reduced arterial compliance and distensibility in dialyse patients and renal transplant recipients without hypertension remain to be evaluated. 20 normotensive dialyse patients (D), 20 normotensive renal transplant recipients (T) and 20 healthy volunteers (N) matched for age, sex and blood pressure as controls were enrolled in to the study. Patients with cardiovascular risk factors and diabetes were excluded. The arterial blood pressure of all patients placed below 140/90 mmHg. The dialyse patients and renal transplant recipients were eligible for the study if the serum creatinine level was below 2 mg/dl. In all subjects, fasting concentrations of serum creatinine, total cholesterol, HDL-cholesterol, LDL-cholesterol, hemoglobin and glucose were determined at enrollment to the study. Long-term immunosuppression consisted of cyclosporine and prednisolone. Blood pressure was measured using an automatic sphygmomanometer (Criticon Dinamap model 1846 SX). Pulse wave velocity (PWV) was evaluated using non-invasive automatic Complior device. The vessel wall properties of the left common carotid artery were studied using multigate pulsed Doppler's system (Pie Medical Equipment BV Maastricht, The Netherlands). The frequency of transducer used was 7.5 MHz. With this non-invasive method, the end-diastolic diameter (d) and the systolic increase of vessel diameter (distension delta d) were measured using ECG trigger. From these data relative systolic increase of vessel diameter (delta d/d) and arterial wall distensibility coefficient (DC) were calculated. Simultaneously with the ultrasound measurements at the left common carotid artery carotid pulse waveforms are recorded using applanation tonometry (Micro Tip Pulse Transducer, SPT 301 and Transducer Control Unit TCB-500, Millar Instruments, Houston, TX, USA). Systolic blood pressure (SBP) and central pulse pressure (CPP) were significantly higher in (T) than in (D) and (N) group respectively 139 +/- 18 mmHg and 58 +/- 16 mmHg vs 127 +/- 13 mmHg and 49 +/- 11 mmHg and 132 mmHg and 50 +/- 11 mmHg. The end-diastolic diameter (d) did not change significantly between all groups. The systolic increase of vessel diameter (distension delta d) was significantly lower in patients group (D) and (T) respectively 461 +/- 33 microm and 501 +/- 34 microm than in controls. Similar relative systolic increase of vessel diameter (delta d/d) was in these groups significantly lower than in healthy volunteers, respectively (D) 6.26 +/- 0.5%, (T) 6.91 +/- 0.4% vs (N) 9.14 +/- 0.4%. The distensibility coefficient were also significantly lower in (D) and (T) than in (N) groups respectively (D) 18.31 +/- 1.4 10(-3)/kPa and (T) 17.97 +/- 1.4 10(-3)/kPa and (N) 24.3 +/- 0.5 10(-3)/kPa. PWV in both groups of patients was statistically significant higher than in control group correspondingly (D) 11.2 +/- 1.02 m/s and (T) 12.8 +/- 1.12 m/s, (N) 9.5 +/- 0.88 m/s. There was significant correlation between the change of arterial DC, PWV and CPP in (T) group (n = 20; r = -0.42; p < 0.01 and n = 20; r = 0.47; p < 0.05). The arterial wall elastic properties in dialyse and renal recipients patients are decreased. End-stage renal disease accelerates arterial stiffening despite arteriosclerosis and hypertension. Renal transplantation do not reverse lost of elastic properties of arteries in end-stage renal insufficiency.

Posadzy-Ma?aczy?ska A; Kosch M; Hausberg M; Rahn KH; Ma?aczy?ski P; G?uszek J; Tykarski A

2004-01-01

172

La hipertensión arterial en la tercera edad/ High blood pressure in third age  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish A partir de la quinta o sexta décadas de la vida, la hipertensión arterial adopta formas y obedece a causas diferentes a las del niño o a las del adulto joven. En este caso, la presión arterial sistólica aumenta (> 140 mmHg) y la diastólica se mantiene o disminuye (< 90 mmHg) y se incrementa la presión diferencial. La causa es la rigidez de las arterias de conductancia por la aterosclerosis y la acción de algunas hormonas como: adrenalina, noradrenalina, angiot (more) ensina II y aldosterona sobre la pared media arterial. El diagnóstico se hace constatando hipertensión sistólica aislada en pacientes mayores de 50 años. En jóvenes, además de la presión sistólica elevada con presión diastólica normal o baja, es conveniente medir otros indicadores de rigidez aórtica. La hipertensión sistólica en la tercera edad suele asociarse a: hipertrofia arterial y ventricular izquierda, disminución de la relajación de las paredes cardíacas y coronarias, isquemia miocárdica, nefrosclerosis, declinación cognoscitiva o incluso, demencia. El tratamiento requiere cuidados especiales y se debe adaptar a la frecuente comorbilidad de la edad avanzada. Los grupos antihipertensivos más efectivos, según ensayos al azar, son: los inhibidores de la enzima conversora de angiotensina, los bloqueadores de la angiotensina II, los antagonistas de la aldosterona y los bloqueadores de calcio. Los nitratos y los diuréticos se han empleado para reducir la presión sistólica, especialmente cuando concurre regurgitación valvular aórtica. La disminución de la presión sistólica, parece traer como consecuencia un retardo o detención de las complicaciones cardiovasculares, de la declinación cognoscitiva y de la demencia en pacientes de edad avanzada. Abstract in english From the fifth or sixth decades of life, high blood pressure adopts ways and is due to different causes to that of child or to that of young adult. In this case, systolic arterial pressure increases (> 140 mmHg), and the diastolic one remains or decreases (< 90 mmHg), and differential pressure increases. The cause is conduction artery stiffness by atherosclerosis as well as the action of some hormones including: adrenaline, noradrenaline, agiotensin II, and aldosterone (more) on the arterial medium wall. Diagnosis is made verifying presence of an isolated systolic high blood pressure in patients aged over 50. In youngest, in addition to high systolic pressure with a normal or low diastolic pressure, it is advisable measurement of others indicators of aortic stiffness. Systolic pressure in third age may to be associated with: left ventricular and arterial hypertrophy, a relaxation decrease of cardiac and coronary walls, myocardial ischemia, nephroesclerosis, cognitive decline or even dementia. Treatment requires special cares and must to adjust to the frequent morbidity of old age. The more effective antihypertensive groups according to randomized assays include: agiotensin-converting enzyme (ACE) inhibitors, agiotensin II blockers, aldosterone antagonists, and calcium blockers. Nitrates and diuretic agents have been used to reduce systolic pressure, especially when there is an aortic valvular regurgitation. Decrease of systolic pressure to result in a delay or an arrest of cardiovascular complications, of cognitive decline, and dementia in third age patients.

García Barreto, David; Álvarez González, Julio; García Fernández, Raymid; Valiente Mustelier, Juan; Hernández Cañero, Alberto

2009-06-01

173

Pressure Estimation in the Systemic Arteries Using a Transfer Function  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The aim of this thesis is to develop and study a method for estimation of the pulse pressure in centrally located arteries. Obtaining the central pulse pressure is desirable for several reasons. For example, the central pulse pressure can be used to assess aortic stiffness, which in turn is an impor...

Thore, Carl-Johan

174

DAILY BLOOD PRESSURE MONITORING AND ARTERIAL RIGIDITY DATA IN OSTEOARTHRITIS PATIENTS WITH AND WITHOUT ARTERIAL HYPERTENSION  

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Full Text Available We have compared the daily blood pressure monitoring data with arterial wall rigidity parameters in patients with osteoarthritis with and without arterial hypertension. In 32% of patients with osteoarthritis without arterial hypertension we have determined “non-dipper” type and in 16% of patients - “night-peaker”. In case of arterial hypertension 42,8% of patients with osteoarthritis have “night-peaker” type and 22,8% of patients have “non-dipper” type. We have found the correlation between augmentation indices and daily blood pressure parameters.

?.?. Rebrov; I.A. Kharitonova

2009-01-01

175

Association of target organ damage with three arterial stiffness indexes according to blood pressure dipping status in untreated hypertensive patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Subclinical organ damage represents an intermediate stage in the continuum of vascular disease and a determinant of overall cardiovascular risk. We investigated the associations of pulse wave velocity (PWV), ambulatory arterial stiffness index (AASI), and office pulse pressure (PP) with several target organ damages (TODs) in newly diagnosed and never-treated patients with essential hypertension with respect to their dipping profile. METHODS: One hundred sixty-eight hypertensive patients with recently diagnosed and never-treated stage I-II essential hypertension were evaluated with respect to the relationship of PWV, AASI, and office PP with TOD including microalbumin (MAU) levels, cognitive function, intima-media thickness (IMT), coronary flow reserve (CFR), left ventricular mass (LVM), left ventricular filling pressures, diastolic dysfunction, and left atrium (LA) enlargement. RESULTS: Simultaneous estimation of AASI, PWV, and office PP independently associated with the following: (i) CFR (P < 0.01), 24-h urine albumin excretion rates (P < 0.05), left ventricular diastolic dysfunction (P < 0.01), and LA enlargement (P < 0.01) in never-treated hypertensive patients; (ii) CFR (P < 0.05), IMT (P < 0.01), left ventricular diastolic dysfunction (P < 0.05), and LA enlargement (P < 0.05) in dippers; and (iii) CFR (P < 0.05) and LA enlargement (P < 0.01) in nondippers. Nonindependent relationships revealed between (i) AASI and left ventricular filling pressures and (ii) PWV and cognitive dysfunction in never-treated hypertensive patients. CONCLUSIONS: The simultaneous estimation of three noninvasive indexes of arterial stiffness leads to valuable information regarding their association with TOD including CFR, MAU levels, IMT, left ventricular diastolic dysfunction, and LA enlargement in never-treated hypertensive patients regarding their dipping status.

Triantafyllidi H; Tzortzis S; Lekakis J; Ikonomidis I; Arvaniti C; Trivilou P; Kontsas K; Siafakas N; Zerva L; Stamboulis E; Kremastinos D; Anastasiou-Nana M

2010-12-01

176

Noninvasive method for determining blood pressure and contours of arterial and volume pulses  

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Full Text Available A noninvasive method for monitoring blood pressure, based on the principles established by Riva-Rocci and Korotkoff (K), is described; it furnishes, after a single compression-deflation cycle of the arm-encircling cuff, values of sys-tolic and diastolic blood pressures as well as the contours of the brachial arterial pulse and the corresponding volume pulse. K-sounds are detected by a single microphone situated in the cubital fossa, and the time-varying cuff pressure P(t) is read by a piezoresistive pressure sensor. The behavior of P(t) during deflation is resolved into two parts, P(t)=p(t)+b(t); p is a train of posi-tive going pulses (arising from arterial pulsa-tions), whereas b is a slowly changing baseline. Noise pulses in the microphone output are re-jected by using the observation that the first few K-sounds are emitted when p is close to a maxi-mum, and the last few when dp/dt is close to a maximum. The performance of the instrument is illustrated by showing how it copes with ambi-ent noise and involuntary manual perturbations of P, and by presenting contours of various pulses.

K. Razi Naqvi; Luca Parigi; Camer W. Vellani; Santosh Kumar

2008-01-01

177

Coronary artery disease, left ventricular hypertrophy and diastolic dysfunction are associated with stroke in patients affected by persistent non-valvular atrial fibrillation: a case-control study  

Directory of Open Access Journals (Sweden)

Full Text Available Persistent non-valvular atrial fibrillation (NVAF) is associated with an increased risk of cardiovascular events such as stroke, and its rate is expected to rise because of the ageing population. The absolute rate of stroke depends on age and comorbidity. Risk stratification for stroke in patients with NVAF derives from populations enrolled in randomized clinical trials. However, participants in clinical trials are often not representative of the general population. Many stroke risk stratification scores have been used, but they do not include transthoracic echocardiogram (TTE), pulsate wave Doppler (PWD) and tissue Doppler imaging (TDI), simple and non-invasive diagnostic tools. The role of TTE, PWD and TDI findings has not been previously determined. Our study goal was to determine the association between TTE and PWD findings and stroke prevalence in a population of NVAF prone outpatients. Patients were divided into two groups: P for stroke prone and F for stroke free. There were no statistically significant differences between the two groups concerning cardiovascular risk factors, age (p=0.2), sex (p=0.2), smoking (p=0.3), diabetes (p=0.1) and hypercholesterolemia (p=0.2); hypertension was statistically significant (p less than 0.001). There were statistically significant differences concerning coronary artery disease, previous acute myocardial infarction (AMI) (p less than 0.05) and non- AMI coronaropathy (p less than 0.04), a higher rate being in the P group. Concerning echo-Doppler findings, a higher statistically significant rate of left ventricular hypertrophy (LVH) (p less than  0.05) and left ventricular diastolic dysfunction (p less than 0.001) was found in the P group and dilated left atrium (p less than  0.04) in the F group, the difference was not significant for mitral regurgitation (p=0.7). Stroke prone NVAF patients have a higher rate of hypertension, coronary artery disease, with and without AMI, LVH and left ventricular diastolic dysfunction, but not left atrial dilatation. M-B mode echocardiography and PWD examination help to identify high-risk stroke patients among NVAF subjects; therefore, they may help in the selection of appropriate therapy for each patient.

Pasquale Palmiero; Maria Maiello; Andrea Passantino

2009-01-01

178

Diurnal variations of cardiac rhythm, arterial pressure, and urinary catecholamines in borderline and established essential hypertension.  

UK PubMed Central (United Kingdom)

Ambulatory continuous ECG and arterial pressure (BP) were recorded simultaneously (Delmar Avionics Pressurometer II) for 24 hours in 13 age-matched normotensive subjects, 11 patients with borderline hypertension (HBP), and in 10 patients with uncomplicated established essential HBP. Urinary concentrations of epinephrine, norepinephrine, and dopamine were simultaneously collected over four successive 4-hour periods and one 8-hour period. Prevalence and total number of ventricular and supraventricular ectopic beats was low and not affected by arterial BP. Twenty-four-hour rate (HR) and 4-hourly excretion of epinephrine, norepinephrine, and dopamine were comparable between normotensive and HBP persons and no correlation between urinary catecholamines and arterial BP (systolic, diastolic, or mean), HR, or prevalence of ectopic beats was found in any of the three groups or in the total study population. We conclude that HBP patients without ECG evidence of left ventricular hypertrophy do not have a higher prevalence of supraventricular or ventricular ectopic beats. Urinary catecholamines are not related to circadian fluctuations or variability in arterial BP, HR, or prevalence of ectopic beats.

Messerli FH; Glade LB; Ventura HO; Dreslinski GR; Suarez DH; MacPhee AA; Aristimuno GG; Cole FE; Frohlich ED

1982-07-01

179

Prediction of arterial pressure increase after fluid challenge  

Science.gov (United States)

Background Mean arterial pressure above 65 mmHg is recommended for critically ill hypotensive patients whereas they do not benefit from supranormal cardiac output values. In this study we investigated if the increase of mean arterial pressure after volume expansion could be predicted by cardiovascular and renal variables. This is a relevant topic because unnecessary positive fluid balance increases mortality, organ dysfunction and Intensive Care Unit length of stay. Methods Thirty-six hypotensive patients (mean arterial pressure mmH) received a fluid challenge with hydroxyethyl starch. Patients were excluded if they had active bleeding and/or required changes in vasoactive agents infusion rate in the previous 30 minutes. Responders were defined by the increase of mean arterial pressure value to over 65 mmHg or by more than 20% with respect to the value recorded before fluid challenge. Measurements were performed before and at one hour after the end of fluid challenge. Results Twenty-two patients (61%) increased arterial pressure after volume expansion. Baseline heart rate, arterial pressure, central venous pressure, central venous saturation, central venous to arterial PCO2 difference, lactate, urinary output, fractional excretion of sodium and urinary sodium/potassium ratio were similar between responder and non-responder. Only 7 out of 36 patients had valuable dynamic indices and then we excluded them from analysis. When the variables were tested as predictors of responders, they showed values of areas under the ROC curve ranging between 0.502 and 0.604. Logistic regression did not reveal any association between variables and responder definition. Conclusions Fluid challenge did not improve arterial pressure in about one third of hypotensive critically ill patients. Cardiovascular and renal variables did not enable us to predict the individual response to volume administration. Trial registration ClinicalTrials.gov: NCT00721604.

2012-01-01

180

Prediction of arterial pressure increase after fluid challenge.  

UK PubMed Central (United Kingdom)

BACKGROUND: Mean arterial pressure above 65 mmHg is recommended for critically ill hypotensive patients whereas they do not benefit from supranormal cardiac output values. In this study we investigated if the increase of mean arterial pressure after volume expansion could be predicted by cardiovascular and renal variables. This is a relevant topic because unnecessary positive fluid balance increases mortality, organ dysfunction and Intensive Care Unit length of stay. METHODS: Thirty-six hypotensive patients (mean arterial pressure < 65 mmH) received a fluid challenge with hydroxyethyl starch. Patients were excluded if they had active bleeding and/or required changes in vasoactive agents infusion rate in the previous 30 minutes. Responders were defined by the increase of mean arterial pressure value to over 65 mmHg or by more than 20% with respect to the value recorded before fluid challenge. Measurements were performed before and at one hour after the end of fluid challenge. RESULTS: Twenty-two patients (61%) increased arterial pressure after volume expansion. Baseline heart rate, arterial pressure, central venous pressure, central venous saturation, central venous to arterial PCO2 difference, lactate, urinary output, fractional excretion of sodium and urinary sodium/potassium ratio were similar between responder and non-responder. Only 7 out of 36 patients had valuable dynamic indices and then we excluded them from analysis. When the variables were tested as predictors of responders, they showed values of areas under the ROC curve ranging between 0.502 and 0.604. Logistic regression did not reveal any association between variables and responder definition. CONCLUSIONS: Fluid challenge did not improve arterial pressure in about one third of hypotensive critically ill patients. Cardiovascular and renal variables did not enable us to predict the individual response to volume administration. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00721604.

Natalini G; Rosano A; Militano CR; Di Maio A; Ferretti P; Bertelli M; de Giuli F; Bernardini A

2012-01-01

 
 
 
 
181

Perioperative blood pressure variability in patients undergoing coronary artery bypass grafting: its magnitude and determinants.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The study aimed to assess the magnitude and determinants of perioperative blood pressure (BP) variability in patients undergoing coronary artery bypass grafting (CABG) with the use of extracorporeal circulation (ECC). METHODS: Two hundred patients were enrolled, 41 women (21%) and 159 men (79%), aged 6 1± 8 years. A direct method of intraoperative BP measurement was used with a cannula placed in the radial artery, and BP was recorded at intervals of 5 min at three stages of the CABG: from cannula placement to the start of ECC, during ECC, and post-ECC until the transfer of patient to the postoperative room. BP variability was assessed using coefficient of variation (in percentage) for systolic, diastolic, mean, and pulse pressures. Impact of sex, age, and comorbidities was determined. RESULTS: Greater changes in BP during CABG were observed in diastolic BP (4/19%) than in systolic BP (11/15%) and the greatest BP variability was associated with pulse pressure (20/72%). The greatest variability of BP parameters was found during ECC (15/72%). Higher BP lability was found in women (13/83%), younger patients (11/78%), and those without diabetes (11/78%), hypertension (11/82%), or obesity (11/71%), and smoking habit increased the variability during CABG (11/89%). All trends were similar for all types of BP. CONCLUSION: Special attention in perioperative anesthetic management should be given not only to elder patients with many comorbid conditions, but also to younger and healthier participants because the latter are characterized by greater variations of BP during CABG.

Krzych LJ; Krejca M; Bis J; Wasiak M; Bia?ek K; Szurlej D; Bochenek A

2011-06-01

182

Environmentally persistent free radicals decrease cardiac function and increase pulmonary artery pressure.  

UK PubMed Central (United Kingdom)

Epidemiological studies have consistently linked inhalation of particulate matter (PM) to increased cardiac morbidity and mortality, especially in at risk populations. However, few studies have examined the effect of PM on baseline cardiac function in otherwise healthy individuals. In addition, airborne PM contain environmentally persistent free radicals (EPFR) capable of redox cycling in biological systems. The purpose of this study was to determine whether nose-only inhalation of EPFRs (20 min/day for 7 days) could decrease baseline left ventricular function in healthy male Sprague-Dawley rats. The model EPFR tested was 1,2-dichlorobenzene chemisorbed to 0.2-?m-diameter silica/CuO particles at 230°C (DCB230). Inhalation of vehicle or silica particles served as controls. Twenty-four hours after the last exposure, rats were anesthetized (isoflurane) and ventilated (3 l/min), and left ventricular function was assessed using pressure-volume catheters. Compared with controls, inhalation of DCB230 significantly decreased baseline stroke volume, cardiac output, and stroke work. End-diastolic volume and end-diastolic pressure were also significantly reduced; however, ventricular contractility and relaxation were not changed. DCB230 also significantly increased pulmonary arterial pressure and produced hyperplasia in small pulmonary arteries. Plasma levels of C-reactive protein were significantly increased by exposure to DCB230, as were levels of heme oxygenase-1 and SOD2 in the left ventricle. Together, these data show that inhalation of EPFRs, but not silica particles, decreases baseline cardiac function in healthy rats by decreasing cardiac filling, secondary to increased pulmonary resistance. These EPFRs also produced systemic inflammation and increased oxidative stress markers in the left ventricle.

Mahne S; Chuang GC; Pankey E; Kiruri L; Kadowitz PJ; Dellinger B; Varner KJ

2012-11-01

183

Environmentally persistent free radicals decrease cardiac function and increase pulmonary artery pressure.  

Science.gov (United States)

Epidemiological studies have consistently linked inhalation of particulate matter (PM) to increased cardiac morbidity and mortality, especially in at risk populations. However, few studies have examined the effect of PM on baseline cardiac function in otherwise healthy individuals. In addition, airborne PM contain environmentally persistent free radicals (EPFR) capable of redox cycling in biological systems. The purpose of this study was to determine whether nose-only inhalation of EPFRs (20 min/day for 7 days) could decrease baseline left ventricular function in healthy male Sprague-Dawley rats. The model EPFR tested was 1,2-dichlorobenzene chemisorbed to 0.2-?m-diameter silica/CuO particles at 230°C (DCB230). Inhalation of vehicle or silica particles served as controls. Twenty-four hours after the last exposure, rats were anesthetized (isoflurane) and ventilated (3 l/min), and left ventricular function was assessed using pressure-volume catheters. Compared with controls, inhalation of DCB230 significantly decreased baseline stroke volume, cardiac output, and stroke work. End-diastolic volume and end-diastolic pressure were also significantly reduced; however, ventricular contractility and relaxation were not changed. DCB230 also significantly increased pulmonary arterial pressure and produced hyperplasia in small pulmonary arteries. Plasma levels of C-reactive protein were significantly increased by exposure to DCB230, as were levels of heme oxygenase-1 and SOD2 in the left ventricle. Together, these data show that inhalation of EPFRs, but not silica particles, decreases baseline cardiac function in healthy rats by decreasing cardiac filling, secondary to increased pulmonary resistance. These EPFRs also produced systemic inflammation and increased oxidative stress markers in the left ventricle. PMID:22942180

Mahne, Sarah; Chuang, Gin C; Pankey, Edward; Kiruri, Lucy; Kadowitz, Philip J; Dellinger, Barry; Varner, Kurt J

2012-08-31

184

Central blood pressure, arterial waveform analysis, and vascular risk factors in glaucoma.  

UK PubMed Central (United Kingdom)

PURPOSE: Reduced ocular perfusion pressure has been linked to glaucoma, and increased arterial stiffness is implicated in systemic cardiovascular risk. This study measured central blood pressure (BP) and arterial waveforms derived from pulse tonometry, together with data on systemic and ocular vascular factors relevant to glaucoma status. METHODS: A total of 126 patients and 66 normal controls were tested, including 90 primary open-angle glaucoma (POAG) patients and 36 normal tension glaucoma (NTG) patients. Glaucoma patients had been followed for at least 3 years and inclusion required several (>4) reliable visual fields such that glaucoma progression could be determined. Radial pulse tonometry and brachial BP data were collected, together with data on disc hemorrhages, spontaneous venous pulsation, peripapillary atrophy, smoking, and medications. RESULTS: Brachial BP or derived central aortic BP parameters generally showed no significant differences between glaucoma patients and normal individuals. The POAG group had a lower pulse pressure, which was also significant in the regression analysis (P<0.002). In the arterial waveform analysis, POAG was associated with a lower brachial form factor than NTG (P<0.001) and higher subendocardial viability ratio (P<0.008). NTG was associated with a lower body mass index, and POAG with a smoking history. There was an increased incidence of disc hemorrhages and a reduced incidence of spontaneous venous pulsations in the progressing group. CONCLUSIONS: Derived central BP does not reveal significant differences from controls or in glaucoma subgroups, but a reduced pulse pressure was identified. There may be some changes in arterial pulse waveform shape suggesting possible differences in diastolic perfusion. Disc hemorrhages and loss of spontaneous venous pulsation were associated with disease progression.

Graham SL; Butlin M; Lee M; Avolio AP

2013-02-01

185

Does percutaneous transluminal renal artery angioplasty improve blood pressure control and renal function in patients with atherosclerotic renal artery stenosis?  

UK PubMed Central (United Kingdom)

BACKGROUND: Percutaneous angioplasty (PTA) and stenting is an established procedure for the treatment of hypertension caused by atherosclerotic renal artery stenosis. However recently, the decision whether or notto perform this procedure has raised considerable debate. OBJECTIVES: To examine the association between the basic clinical and radiological characteristics of candidates for renal artery PTA and the clinical outcome of the procedure in terms of improvement of blood pressure control and renal function. METHODS: We conducted a retrospective cohort study of all patients who underwent percutaneous transluminal renal artery angioplasty (PTRA) and stent implantation in a tertiary medical center during the period 2000-2007. The clinical and radiological data were extracted from the medical file of each patient. Blood pressure measurements and creatinine level were recorded before the procedure and 1 month, 6 months, 12 months and 18 months after PTRA. RESULTS: Thirty-two patients were included in the final statistical analysis. The mean age of the study population was 66.6 +/- 8.8 years old and 75% were men. There was a significant reduction in both systolic and diastolic blood pressure 1 month after the procedure: 160.5 +/- 24.7 vs. 141.8 +/- 23.6 mmHg and 83.8 +/- 12.9 vs. 68.8 +/- 11.8 mmHg respectively (P < 0.001). The reduction in blood pressure was constant throughout the follow-up period and was evident 18 months after the procedure: 160.5 +/- 24.7 vs. 135.0 +/- 35.1 mmHg and 83.8 +/- 12.9 vs. 71.3 +/- 16.5 mmHg respectively (P < 0.001). However, no improvement in renal function was observed at any time during the follow-up period. We could not demonstrate an association between clinical or radiological features and the clinical outcome after PTRA. CONCLUSIONS: Our findings show that PTRA can be considered an effective procedure for improving blood pressure control in patients with atherosclerotic renal artery stenosis (ARAS) and resistant hypertension. This research, together with previous studies, strengthens the knowledge that the decline in glomerular filtration rate seen in many patients with ARAS is non-reversible and is not improved by PTRA.

Wolak T; Belkin A; Ginsburg V; Greenberg G; Mayzler O; Bolotin A; Paran E; Szendro G

2011-10-01

186

[S24-hour arterial pressure monitoring in patients with chronic cardiac failure and the state of renal function].  

UK PubMed Central (United Kingdom)

The 24-hr AP profiles were obtained in 194 patients with chronic cardiac failure (CCF) depending on the glomerular filtration rate (GFR). It was shown that 24-hour arterial pressure monitoring markedly improves detection of potentially dangerous changes of AP The target AP was achieved in 42.9 and 18.4% of the patients with GFR < or = 45.1 and > or = 69.8 ml/min/1.73 m2 respectively. Episodes of systolic arterial hypotony were diagnosed in 51.0 and 26.5% of the patients with GFR < or = 45.1 and 69.8 ml/min/1.73 m' respectively; episodes of diastolic arterial hypotony in 71.4 and 61.2% of the patients with GFR < or = 45.1 and > or = 69.8 ml/min/1.73 m2 respectively. Duration of systolic and diastolic arterial hypotony during 24 hr correlated with the level of glycemia and the age of the patients respectively.

Serov VA; Shutov AM; Serova DV; Menzorov MV; Kuznetsova IuS

2013-01-01

187

Femoral-radial arterial pressure gradients in critically ill patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the presence and determinants of femoral-radial gradients in mean arterial pressure (MAP) in a critically ill population. DESIGN: Prospective observational study. SETTING AND PARTICIPANTS: Critically ill patients who were undergoing simultaneous monitoring of arterial pressure by radial arterial catheterisation and transpulmonary thermodilution (via femoral arterial access) in a Level 3, mixed medical-surgical intensive care unit, December 2007 to May 2008. MAIN OUTCOME MEASURES: Level of agreement between simultaneous measurements of MAP via the femoral and radial arteries, determined by Bland-Altman analysis; haemodynamic and demographic factors associated with a MAP gradient, assessed by multiple linear regression. RESULTS: 131 observations were made in 24 patients. Mean age of patients was 56 (SD, 18) years, and mean APACHE II score was 27 (SD, 8). Overall mean bias between radial and femoral MAP measurements was 4.27 mmHg (limits of agreement, -3.41 to 11.94 mmHg). Fifteen patients (62%) had maximum MAP gradients > 5mmHg, and seven of these (29% of the total) had maximum gradients > 10 mmHg. The largest discrepancy in MAP was 18 mmHg in a patient with septic shock resistant to high-dose catecholamine infusion. Regression analysis failed to identify any statistically significant associations between patient factors and MAP gradient. CONCLUSION: A systematic difference in MAP measured at the radial and femoral sites was demonstrated. In some critically ill patients, the femoral artery may be the preferred site for systemic arterial pressure monitoring.

Galluccio ST; Chapman MJ; Finnis ME

2009-03-01

188

The circadian rhythm of arterial blood pressure in Alzheimer disease (AD) patients without hypertension.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The circadian rhythm (CR) of arterial blood pressure (ABP) in Alzheimer disease (AD) patients was examined in a case-control clinical study. METHODS: This study was constructed using the case-control method and investigates non-hypertensive AD patients, compared with normotensive controls from a primary care setting. Twenty-four-hour ABP was measured with an automatic oscillometric device and recorded every 30 min throughout the day and night. Extreme dipper, dipper, non-dipper and reverse-dipper patterns were defined as those individuals with > 20%, 10-20%, < 10% and no fall in nocturnal ABP relative to daytime values. RESULTS: There were significant differences in ABP dipper status between cases and controls (cases - 16.15%, 60.00%, 17.70% and 6.15% vs controls - 3.19%, 31.9 2%, 42.02% and 22.88% for reverse dipper, non-dipper, dipper and extreme dipper, respectively, df = 3, ?(2) = 56.76, p < 0.001). Compared with normal controls, AD patients had significantly higher 24-h mean blood pressure, 24-h mean systolic blood pressure (SBP), night mean SBP, night mean pulse pressure (PP) and 24-h mean PP. There were no significant differences in 24-h mean diastolic blood pressure (DBP), daytime mean DBP or night-time mean DBP, and no significant differences in daytime mean SBP. CONCLUSIONS: The circadian rhythm of ABP in AD patents differed from normal controls, perhaps from higher night SBP in AD patents.

Chen HF; Chang-Quan H; You C; Wang ZR; Hui W; Liu QX; Si-Qing H

2013-04-01

189

Coronary artery distensibility in diabetic patients with simultaneous measurements of luminal area and intracoronary pressure: evidence of impaired reactivity to nitroglycerin.  

UK PubMed Central (United Kingdom)

OBJECTIVES: This study investigated whether noninsulin dependent diabetes mellitus (NIDDM) adversely affects the elastic properties of the coronary arteries in patients with coronary artery disease (CAD) and NIDDM. BACKGROUND: Attenuated vascular smooth muscle dilation to exogenous donors of nitric oxide, such as nitroglycerin, has been observed with forearm blood flow studies in patients with NIDDM. METHODS: Twenty patients with CAD and NIDDM (diabetics), and 20 patients with only CAD (nondiabetics) were evaluated. Intracoronary ultrasound (ICUS) imaging with simultaneous intracoronary pressure (P2) recordings were performed at the imaging site with 0.014 in fiber-optic high fidelity pressure monitoring wire. The same wire was used as guide wire for the ICUS catheter. Sites with less than 50% luminal stenosis by ICUS were studied. Recordings were done before and after 300 microg of intracoronary nitroglycerin (IC-NTG). Electrocardiographic tracings recorded simultaneously with ICUS images were used for timing. Systolic and diastolic cross-sectional lumen area (CSLA) and coronary artery distensibility (C-DIST) were measured, C-DIST = [(systolic CSLA-diastolic CSLA)/[(intracoronary pulse pressure) x (diastolic CSLA)

Vavuranakis M; Stefanadis C; Triandaphyllidi E; Toutouzas K; Toutouzas P

1999-10-01

190

Hemodynamic circulatory patterns in young patients with predominantly diastolic hypertension.  

UK PubMed Central (United Kingdom)

To evaluate the spectrum of hemodynamic patterns in patients with isolated diastolic hypertension-predominantly diastolic hypertension, we re-analyzed a previously reported cohort of 189 non-medicated hypertensive individuals that were assessed by impedance cardiography. We selected 46 patients who were less than 50 years old and had pulse pressure less or equal than 45 mm Hg confirmed by ambulatory blood pressure monitoring. The selected cohort had a mean age of 39.7 years and was 47% men. Three distinct groups were identified: a high cardiac index (CI) "hyperdynamic" group, with normal to near normal systemic vascular resistance (SVR); an intermediate CI and SVR group; and a "vasotonic" group, with low CI and high SVR. Heart rate was similar among the three groups. Stroke volume index (SVI) was significantly higher in the hyperdynamic group (61.8, 49.7, and 39.7 mL/m(2) in the high, intermediate, and low CI groups, respectively). The hyperdynamic group had greater total arterial compliance index than the vasotonic group (1.3 ± 0.3 vs 0.92 ± 0.2 mL/m(2) mm Hg for high vs low CI, respectively; P < .001). In conclusion, isolated diastolic hypertension-predominantly diastolic hypertension patients can have diverse hemodynamic patterns that cannot be predicted based on peripherally measured blood pressure and heart rate alone. This hemodynamic complexity must be taken into account when considering the genetic and pathophysiologic mechanisms of hypertension.

Romero CA; Alfie J; Galarza C; Waisman G; Peixoto AJ; Tabares AH; Orias M

2013-03-01

191

Felipressina aumenta pressão arterial durante procedimento odontológico em pacientes hipertensos Felypressin increases blood pressure during dental procedures in hypertensive patients  

Directory of Open Access Journals (Sweden)

Full Text Available FUNDAMENTO: A felipressina foi adicionada ao anestésico local para aumentar a duração do efeito anestésico e reduzir a toxicidade nos procedimentos dentários. No entanto, o efeito sobre a pressão arterial é incerta, e isso pode ser altamente relevante no tratamento dentário de pacientes hipertensos. OBJETIVO: Investigar o efeito da felipressina sobre a pressão arterial em pacientes hipertensos com pressão arterial controlada. MÉTODOS: Foram estudados 71 indivíduos com essas características e com necessidade de tratamento periodontal. Após 10 minutos de repouso, a anestesia local (prilocaína) foi infiltrada com e sem adição de felipressina. Em seguida, uma raspagem subgengival profunda foi realizada. A pressão arterial foi medida por um equipamento oscilométrico automático (DIXTAL DX2010). Dez minutos após a administração do anestésico, o pico de ação anestésica foi gravado. O Inventário de Ansiedade Traço-Estado (IDATE) foi utilizado para avaliar o traço de ansiedade nos pacientes. RESULTADOS: A pressão arterial sistólica aumentou após a anestesia, independentemente da associação com felipressina, durante todo o procedimento dentário (p BACKGROUND: Felypressin has been added to local anesthetic to increase the length of the anesthetic effect and reduce toxicity during dental procedures. However, the effect on blood pressure remains uncertain, and this may be highly relevant in the dental treatment of hypertensive patients. OBJECTIVE: To investigate the effect of felypressin on blood pressure in hypertensive patients with controlled BP. METHODS: 71 subjects with these characteristics and in need of periodontal treatment were studied. After 10 minutes of rest, local anesthesia (prilocaine) was infiltrated with and without addition of felypressin. Then, a deep subgingival scaling was performed. Blood pressure was measured by an automated oscillometric device (DIXTAL DX2010). Ten minutes after the administration of the anesthetic, peak anesthetic action was recorded. The State-Trait Anxiety Inventory (STAI) was used to assess the patients' trait anxiety. RESULTS: Systolic blood pressure increased after anesthesia, regardless of association with felypressin, throughout the dental procedure (p<0.05) and this response can be explained, at least in part, by the trait anxiety levels of the subjects. However, a further increase in diastolic blood pressure was observed when prilocaine was associated with felypressin (p<0.05), but this response did not change with trait anxiety levels. CONCLUSION: Felypressin increased the diastolic blood pressure of hypertensive patients with controlled blood pressure. Patients with high trait anxiety presented increases in systolic blood pressure upon some procedures, suggesting that an increase in blood pressure might also be related to fear or anxiety.

Ana Lúcia Aparecida Bronzo; Crivaldo Gomes Cardoso Jr.; Kátia Coelho Ortega; Décio Mion Jr

2012-01-01

192

Efeitos agudos de uma sessão de reabilitação cardíaca sobre a pressão arterial/ Acute effects of one session of cardiac rehabilitation on arterial blood pressure  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese INTRODUÇÃO: Hipertensão arterial é uma condição mórbida presente em grande parte dos adultos. Estudos evidenciam que exercícios físicos de moderada intensidade e curta duração têm efeitos satisfatórios na redução da pressão arterial. OBJETIVO: Mensurar a duração do efeito hipotensor de uma única sessão de reabilitação cardíaca a partir da prática de exercício aeróbico de curta duração e moderada intensidade. MATERIAIS E MÉTODOS: O estudo foi p (more) rospectivo e quase-experimental. Participaram do estudo nove voluntários hipertensos e sedentários (cinco do sexo feminino e quatro do masculino), monitorizados pelo exame de medida ambulatorial da pressão arterial por 12 horas e 30 minutos. Foi realizada uma única sessão de treinamento aeróbico por dez minutos em bicicleta ergométrica numa intensidade moderada. RESULTADOS: Houve redução tanto na PAS (pressão arterial sistólica) como na PAD (pressão arterial diastólica) (ANOVA, p Abstract in english INTRODUCTION: Hypertension is a morbid condition present in most adults. Studies show that exercise of moderate intensity and short duration has satisfactory effects on lowering blood pressure. OBJECTIVE: To measure the duration of the hypotensive effect of a single session of cardiac rehabilitation, through aerobic exercise of short duration and moderate intensity. MATERIALS AND METHODS: The study was prospective and quasi-experimental. Study participants were nine hyper (more) tensive and sedentary volunteers (five female and four male), monitored by examining measured ambulatory blood pressure for 12 hours and 30 minutes. We performed a single session of aerobic training for ten minutes on a stationary bicycle at a moderate intensity. RESULTS: There was a reduction in both SBP (systolic blood pressure) and DBP (diastolic blood pressure) (ANOVA, p

Costa, Murillo Frazão de Lima e; Araújo, Danielly Inocêncio de

2012-12-01

193

[Predictor parameters of neonatal death in gestations with absent or reverse end-diastolic flow in the umbilical artery doppler velocimetry].  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the antenatal and postnatal risk factors of neonatal death in pregnancies with absent (DZ) or reverse (DR) end-diastolic flow in the umbilical artery. METHODS: A cross-sectional retrospective study based on data from 48 medical records of singleton pregnancies with DZ or DR, and gestational age of 24 to 34 weeks, at a maternity in the Brazilian Northeast. Mean age was 27.3 (SD: 7.9) years. Twenty (41.7%) patients were primiparas. Hypertensive disorders were found in 44 (91.7%) cases. Thirty-five women (72.9%) had DZ and 13 (27.1%) had DR. Univariate analysis was firstly done (Student's t-test and Fisher's exact test) correlating the parameters with the assessed outcome (neonatal death). Variables that showed significant association were included in the logistic regression model (Wald statistics). The level of significance was set at 5%. RESULTS: The perinatal mortality rate was 64.6% (31/48). There were five stillbirths and 26 neonatal deaths. The mean gestational age at diagnosis was 27.9 (SD: 2.8) weeks. Deliveries before 24 hours after diagnosis occurred in 52.1% of the cases. Cesarean section was performed in 85.4% of the sample. The newborns weighed 975.9 g on average (SD: 457.5). Twenty-four (57.1%) presented Apgar scores below 7 in the first minute and 21.4% in the fifth minute. Gestational age at diagnosis, birth weight and Apgar of the first minute proved to be variables significantly related to neonatal death (p values were: 0.008, 0.004, and 0.020, respectively). The Odds Ratio was 6.6, 25.3 and 13.8 for neonatal death, when the diagnosis was established at the 28th week, weight was <1000 g and first minute Apgar score was <7, respectively. CONCLUSIONS: Gestational age at diagnosis, birth weight and Apgar score at the first minute were factors that could predict neonatal death in pregnancies with DV or DR determined by umbilical artery Doppler velocimetry.

Martins Neto M; Carvalho FH; Mota RM; Alencar Júnior CA

2010-07-01

194

The effect of siesta in parameters of cardiac structure and in interpretation of ambulatory arterial blood pressure monitoring  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To evaluate the influence of the siesta in ambulatory blood pressure (BP) monitoring and in cardiac structure parameters. METHODS: 1940 ambulatory arterial blood pressure monitoring tests were analyzed (Spacelabs 90207, 15/15 minutes from 7:00 to 22:00 hours and 20/20 minutes from 22:01 to 6.59hours) and 21% of the records indicated that the person had taken a siesta (263 woman, 52±14 years). The average duration of the siesta was 118±58 minutes. RESULTS: (average ± standard deviation) The average of systolic/diastolic pressures during wakefulness, including the napping period, was less than the average for the period not including the siesta (138±16/85±11 vs 139±16/86±11 mmHg, p5%. CONCLUSION: The siesta influenced the heart structure parameters and from a statistical point of view the average of systolic and diastolic pressures and the respective pressure loads of the wakeful period.

Gomes Marco A.M.; Pierin Angela M.G.; Mion Jr Décio

2000-01-01

195

Increased Nitric Oxide and Attenuated Diastolic Blood Pressure Variability in African Americans with Mildly Impaired Renal Function  

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We investigated the relationship between renal function, blood pressure variability (BPV), and nitric oxide (NO) in a group of African Americans with normal or mildly impaired renal function. 24-hour ambulatory blood pressure monitoring was performed, NO measured, and glomerular filtration rate (GFR...

Diaz, Keith M.; Feairheller, Deborah L.; Sturgeon, Kathleen M.; Veerabhadrappa, Praveen; Williamson, Sheara T.

196

Intermittent, moderate-intensity aerobic exercise for only eight weeks reduces arterial stiffness: evaluation by measurement of stiffness parameter and pressure-strain elastic modulus by use of ultrasonic echo tracking.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE: Aerobic exercise has been reported to be associated with reduced arterial stiffness. However, the intensity, duration, and frequency of aerobic exercise required to improve arterial stiffness have not been established. In addition, most reports base their conclusions on changes in pulse wave velocity, which is an indirect index of arterial stiffness. We studied the effects of short-term, intermittent, moderate-intensity exercise training on arterial stiffness based on measurements of the stiffness parameter (?) and pressure-strain elastic modulus (E p), which are direct indices of regional arterial stiffness. METHODS: A total of 25 young healthy volunteers (18 men) were recruited. By use of ultrasonic diagnostic equipment we measured ? and E p of the carotid artery before and after 8 weeks of exercise training. RESULTS: After exercise training, systolic pressure (P s), diastolic pressure (P d), pulse pressure, systolic arterial diameter (D s), and diastolic arterial diameter (D d) did not change significantly. However, the pulsatile change in diameter ((D s - D d)/D d) increased significantly, and ? and E p decreased significantly. CONCLUSIONS: For healthy young subjects, ? and E p were reduced by intermittent, moderate-intensity exercise training for only 8 weeks.

Tanaka M; Sugawara M; Ogasawara Y; Izumi T; Niki K; Kajiya F

2013-04-01

197

Arterial pressure oscillations are not associated with muscle sympathetic nerve activity in individuals exposed to central hypovolaemia  

Science.gov (United States)

Abstract The spectral power of low frequency oscillations of systolic arterial pressure (SAPLF) has been used as a non-invasive surrogate of muscle sympathetic nerve activity (MSNA) in both experimental and clinical situations. For SAPLF to be used in this way, a relationship must exist between SAPLF and MSNA within individuals during sympathetic activation. Using progressive central hypovolaemia to induce sympathetic activation, we hypothesised that SAPLF would correlate with MSNA in all subjects. ECG, beat-by-beat arterial pressure and MSNA were recorded in humans (n = 20) during a progressive lower body negative pressure (LBNP) protocol designed to cause presyncope in all subjects. Arterial pressure oscillations were assessed in the low frequency (LF; 0.04–0.15 Hz) domain using a Fourier transform. For the entire group, SAPLF, MSNA burst frequency, and total MSNA increased during LBNP. Values for coefficients of determination (r2) describing the linear associations of SAPLF with MSNA burst frequency and total MSNA were 0.73 and 0.84, but rose to 0.89 and 0.98 when curvilinear fits were used, indicating that the relationship is curvilinear rather than linear. Associations between SAPLF and MSNA within each individual subject, however, varied widely for both MSNA burst frequency and total MSNA, whether derived by linear (r2 range, 1.7 × 10?6 to 0.99) or polynomial (r2 range, 0.09 to 1.0) regression analysis. Similar results were obtained when relationships between low frequency oscillations in diastolic arterial pressure and MSNA were evaluated. These results do not support the use of low frequency oscillations in arterial pressure as a non-invasive measure of sympathetic outflow for individual subjects during sympathetic activation.

Ryan, Kathy L; Rickards, Caroline A; Hinojosa-Laborde, Carmen; Cooke, William H; Convertino, Victor A

2011-01-01

198

Relationship of ambulatory arterial stiffness index with blood pressure response to exercise in the early stages of hypertension.  

UK PubMed Central (United Kingdom)

OBJECTIVES: We sought to investigate the plausible interrelationship of exaggerated blood pressure response during exercise (EBPR) with ambulatory arterial stiffness index (AASI) in never-treated patients with uncomplicated essential hypertension. METHODS: Ninety-nine never-treated hypertensive patients (aged 50.7 years, 61 male) underwent 24 h ambulatory blood pressure (BP) recording, complete echocardiographic study and treadmill exercise testing and were classified as patients with (n=36) and without EBPR (n=63) based on the systolic BP elevation at peak exercise (>or=210 mmHg for men and >or=190 mmHg for women). Arterial stiffness was evaluated by means of both AASI and pulse wave velocity (PWV). RESULTS: Hypertensives with EBPR, compared with those without EBPR, exhibited significantly higher 24 h systolic BP and pulse pressure (by 3.8 mmHg, P=0.041 and by 7.2 mmHg, P<0.001, respectively), and decreased peak early diastolic velocity and peak early diastolic velocity/peak atrial systolic velocity ratio (by 1.1 cm/s and by 0.11, both P<0.05, respectively). PWV and AASI values were higher in the EBPR group compared with the normal response group independently of confounders (by 0.9 m/s, P<0.001 and by 0.06, P=0.043, respectively). PWV (beta=0.308, P=0.008) and 24-h pulse pressure (beta=0.297, P=0.010), but not AASI, were independently associated with peak exercise systolic BP. CONCLUSION: EBPR constitutes a sign of premature cardiovascular stiffening in the setting of uncomplicated hypertension. The close relationship between EBPR and PWV but not AASI enhances the concept of PWV as a superior measure of arterial stiffness and constitutes an important factor in the interpretation of EBPR-linked cardiovascular risk.

Tsiachris D; Tsioufis C; Dimitriadis K; Kokkinos P; Faselis C; Tousoulis D; Michaelides A; Papademetriou V; Stefanadis C

2010-06-01

199

The effect of spironolactone in patients with resistant arterial hypertension in relation to baseline blood pressure and secondary causes of hypertension.  

UK PubMed Central (United Kingdom)

AIMS: There are currently limited data about whether the effect of spironolactone in patients with resistant arterial hypertension depends on baseline blood pressure and the presence of a secondary cause of hypertension. METHODS: Patients with office systolic blood pressure (BP) >140 mmHg or diastolic BP >90 mmHg, despite treatment with at least 3 antihypertensive drugs including a diuretic, were randomly assigned to receive spironolactone or a placebo for 8 weeks in a double-blind, placebo-controlled, multicentre trial (ASPIRANT). RESULTS: Analyses were done with 55 patients treated with spironolactone. The degree of BP reduction after 8 weeks of spironolactone treatment did not differ significantly between the three tertiles of baseline systolic BP and patients with and without a secondary cause of hypertension. The reduction of office systolic, office diastolic BP and office pulse pressure was significantly lower in the highest tertile with baseline diastolic BP > 97 mmHg. CONCLUSIONS: Spironolactone treatment is effective to a similar extent both in patients with and without a secondary cause of hypertension and regardless of the baseline value of systolic BP. Less effect of spironolactone was found in patients with the highest baseline diastolic BP.

Vaclavik J; Sedlak R; Jarkovsky J; Kocianova E; Taborsky M

2013-03-01

200

Arterial pressure measurements correlated to symptoms and signs of peripheral arterial disease.  

Science.gov (United States)

The systolic pressure observed in 150 patients with peripheral arterial disease has been compared to their symptoms and signs. In patients with claudication the ankle mean pressure was 58 mmHg. In patients with rest pain it was 33 mmHg and in patients with chronic ulcerations it was 20 mmHg. In these 3 groups the mean ankle-foot pressure gradient was low (2-10 mmHg) were detected at the level of the iliaco-femoral and femora-popliteal segments. In the group of diabetic patients an high gradient was observed. Patients with peripheral arterial disease can be divided in four symptomatic groups but the angiographic and physiological patterns of patients with rest pain and ischemic ulcerations are similar and they are the best candidates to reconstructive arterial surgery. PMID:6650048

Belcaro, G; Sager, P; Borgwardt, A; Holm, A; Jelnes, R; Rosenkvist, L; Possati, F

 
 
 
 
201

Arterial pressure measurements correlated to symptoms and signs of peripheral arterial disease.  

UK PubMed Central (United Kingdom)

The systolic pressure observed in 150 patients with peripheral arterial disease has been compared to their symptoms and signs. In patients with claudication the ankle mean pressure was 58 mmHg. In patients with rest pain it was 33 mmHg and in patients with chronic ulcerations it was 20 mmHg. In these 3 groups the mean ankle-foot pressure gradient was low (2-10 mmHg) were detected at the level of the iliaco-femoral and femora-popliteal segments. In the group of diabetic patients an high gradient was observed. Patients with peripheral arterial disease can be divided in four symptomatic groups but the angiographic and physiological patterns of patients with rest pain and ischemic ulcerations are similar and they are the best candidates to reconstructive arterial surgery.

Belcaro G; Sager P; Borgwardt A; Holm A; Jelnes R; Rosenkvist L; Possati F

1983-09-01

202

Dança de salão: respostas crônicas na pressão arterial de hipertensos medicados/ Ballroom dance: chronic responses on blood pressure in medicated hypertensives  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A importância da prática de exercícios físicos para portadores de hipertensão arterial sistêmica está bem estabelecida na literatura, entretanto, a Dança de Salão, neste contexto, tem sido pouco explorada. O objetivo do estudo foi verificar o efeito crônico da prática de dança de salão sobre a pressão arterial sistêmica de hipertensos medicados. Considerou-se como amostra o número de medidas obtidas da pressão arterial dos pacientes durante a participaç? (more) ?o no programa de dança. Assim, 92 medidas da pressão arterial foram realizadas, sendo divididas em quatro grupos: 1) pressão arterial sistólica pré-programa; 2) pressão arterial sistólica pós-programa; 3) pressão arterial diastólica pré-programa e; 4) pressão arterial diastólica pós-programa. Utilizaram-se esfigmomanômetro de coluna de mercúrio e estetoscópio. Considerou-se o protocolo de mensuração da Diretriz Brasileira. A pressão arterial foi aferida antes e após cada sessão de dança. Os 23 hipertensos medicados estudados tinham idade média de 62,5±7 anos e 34,8% eram do sexo masculino. Quarenta sessões de dança foram realizadas, três vezes/semana, com duração de uma hora/sessão. O valor médio da pressão arterial sistólica pré-programa foi de 131,8±17mmHg e após 117,8±13mmHg com diferença estatística significativa (p Abstract in english The importance of physical exercise for patients with systemic hypertension is well established in the literature. However, ballroom dance has been little investigated in this context. The objective of this study was to determine the chronic effect of ballroom dance on blood pressure in medicated hypertensives. The sample was the number of blood pressure measurements obtained during the patients' participation in the dance program. Thus, 92 blood pressure measurements wer (more) e taken and divided into four groups: 1) pre-session systolic blood pressure, 2) post-session systolic blood pressure, 3) pre-session diastolic blood pressure, 4) post-session diastolic blood pressure. We used a mercury sphygmomanometer and stethoscope. As measuring protocol, we considered the Brazilian Guidelines. Blood pressure was measured before and after each ballroom dance session. The mean age of the 23 medicated hypertensive patients studied was 62.5 ± 7 years and 34.8% of them were male. Forty sessions were held three times a week, lasting one hour/session. The mean pre-session systolic blood pressure was 131,8 ± 17mmHg and 117,8±13mmHg after the session, with statistically significant difference (p

Guidarini, Fernanda Christina de Souza; Schenkel, Isabel de Castro; Kessler, Victor Carvalho; Benedetti, Tânia Rosane Bertoldo; Carvalho, Tales de

2013-04-01

203

Direct Arterial Pressure and Electrocardiogram during Motor Car Driving  

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Direct arterial pressure and electrocardiogram have been measured continuously over a period of 24 hours in 15 patients. Observations have been made on the behaviour of these variables during 30 separate episodes of motor car driving. The patients were divided into three groups: (1) five normotensiv...

Littler, W. A.; Honour, A. J.; Sleight, P.

204

Should mean arterial pressure be included in the definition of ambulatory hypertension in children?  

UK PubMed Central (United Kingdom)

BACKGROUND: The diagnosis of hypertension (HTN)/normotension (NT) on ambulatory blood pressure monitoring (ABPM) is usually based on systolic (SBP) or diastolic blood pressure (DBP). The goal of this study was to analyze whether inclusion of mean arterial pressure (MAP) improves the detection of HTN on ABPM. METHODS: We retrospectively studied ABPM records in 229 children (116 boys, median age?=?15.3 years) who were referred for evaluation of HTN. A diagnosis of HTN was made if: (A) MAP or SBP or DBP was ? 1.65 SDS (95th percentile); (B) SBP or DBP was ? 1.65 SDS (95th percentile), during 24-h or daytime or night-time in both definitions. RESULTS: Using definition A, 46/229 patients had HTN compared to definition B by which only 37/229 patients had HTN (p?=?0.001). The level of agreement between the two definitions was very good (kappa?=?0.86?±?0.04), however nine patients (19.5 %) were missed by not using MAP in the definition of HTN. These nine patients had only mild HTN with a median Z score of 1.69. CONCLUSIONS: The inclusion of MAP in the definition of ambulatory HTN significantly increased the number of hypertensive patients. MAP may be very helpful in detecting mild HTN in patients with normal/borderline SBP and DBP.

Suláková T; Feber J

2013-07-01

205

Association of arterial blood pressure and CPR quality in a child using three different compression techniques. A case report.  

UK PubMed Central (United Kingdom)

A 2-year-old boy found in cardiac arrest secondary to drowning received standard CPR for 35 minutes and was transported to a tertiary hospital for rewarming from hypothermia. Chest compressions in hospital were started using two-thumb encircling hands technique. Subsequently two-thumbs direct sternal compression technique and after sternal force/depth sensor placement, chest compression with classic one-hand technique were done. By using CPR recording/feedback defibrillator, quantitative CPR quality data and invasive arterial pressures were available for analyses for 5 hours and 35 minutes. 316 compressions with the two-thumb encircling hands technique provided a mean (SD) systolic arterial pressure (SAP) of 24 (4) mmHg, mean arterial pressure (MAP) 18 (3) and diastolic arterial pressure (DAP) of 15 (3) mmHg. ~6000 compressions with the two thumbs direct compression technique created a mean SAP of 45 (7) mmHg, MAP 35 (4) mmHg and DAP of 30 (3) mmHg. ~20,000 compressions with the sternal accelerometer in place produced SAP 50 (10) mmHg, MAP 32 (5) mmHg and DAP 24 (4) mmHg. Restoration of spontaneous circulation (ROSC) was achieved at the point when the child achieved normothermia by using peritoneal dialysis. Unfortunately, the child died ten hours after ROSC without any signs of neurological recovery. This case demonstrates improved hemodynamic parameters with classic one-handed technique with real-time quantitative quality of CPR feedback compared to either the two-thumbs encircling hands or two-thumbs direct sternal compression techniques. We speculate that the improved arterial pressures were related to improved chest compression depth when a real-time CPR recording/feedback device was deployed.

Sainio M; Sutton RM; Huhtala H; Eilevstjønn J; Tenhunen J; Olkkola KT; Nadkarni VM; Hoppu S

2013-07-01

206

The effect of lipiodol injected into the pulmonary artery on blood pressure in pulmonary artery and thoracic aorta in dogs.  

UK PubMed Central (United Kingdom)

The effect of lipiodol injected into the pulmonary artery on blood pressure in pulmonary artery and thoracic aorta in dogs. Acta Physiol. Pol. 1977, 28 (2): 143--151. The purpose of the experiments, carried out on 10 anaesthetized dogs, was to trace changes in pressure in aorta and pulmonary artery within 2 hours after injection of lipiodol Ultra-Fluide into the pulmonary artery of dogs. In individual experiments a gradual fall, rise or maintenance of normal pressure was found in the aorta. Pressure changes in the pulmonary artery were similar. Statistical analysis failed to demonstrate any significant correlation between the pressure in the aorta or in the pulmonary artery and the time of measurements of these pressures during the two-hour experiment.

Mrozi?ski S; Ko?mider K; Klimek K; Sprogis W

1977-03-01

207

The effect of lipiodol injected into the pulmonary artery on blood pressure in pulmonary artery and thoracic aorta in dogs.  

Science.gov (United States)

The effect of lipiodol injected into the pulmonary artery on blood pressure in pulmonary artery and thoracic aorta in dogs. Acta Physiol. Pol. 1977, 28 (2): 143--151. The purpose of the experiments, carried out on 10 anaesthetized dogs, was to trace changes in pressure in aorta and pulmonary artery within 2 hours after injection of lipiodol Ultra-Fluide into the pulmonary artery of dogs. In individual experiments a gradual fall, rise or maintenance of normal pressure was found in the aorta. Pressure changes in the pulmonary artery were similar. Statistical analysis failed to demonstrate any significant correlation between the pressure in the aorta or in the pulmonary artery and the time of measurements of these pressures during the two-hour experiment. PMID:194462

Mrozi?ski, S; Ko?mider, K; Klimek, K; Sprogis, W

208

Arterial stiffness, cardiovagal baroreflex sensitivity and postural blood pressure changes in older adults: the Rotterdam Study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Arterial stiffness may be involved in the impairment of the arterial baroreflex. In the present study the associations between arterial stiffness and cardiovagal baroreflex sensitivity (BRS) and between BRS and postural blood pressure (BP) changes were investigated within the framework of the Rotterdam Study. METHODS: Arterial stiffness was determined by aortic pulse wave velocity and the carotid distensibility coefficient. Continuous recording of the R-R interval and finger BP was performed with the subject resting supine, and BRS was estimated from the spontaneous changes in systolic BP and corresponding interbeat intervals. Measures of aortic stiffness or carotid distensibility and BRS were available in 2490 and 2083 subjects, respectively. The association between arterial stiffness and ln BRS was investigated by multivariate linear regression analysis and then by analysis of covariance, comparing BRS by quartiles of arterial stiffness. RESULTS: The mean age of the subjects was 71.7 +/- 6.6 (41.7% men). Aortic stiffness was negatively associated [beta = -0.029; 95% confidence interval (CI): -0.040, -0.019] and the carotid distensibility coefficient positively associated with BRS (beta = 0.017; 95% CI: 0.010, 0.024). An orthostatic decrease in systolic BP was absent in 1609 subjects, between 1 and 10 mmHg in 502 and >10 mmHg in 269 subjects, with corresponding mean values (95% CI) of ln BRS of 1.47 (1.44-1.51), 1.43 (1.37-1.49) and 1.36 (1.28-1.44) ms/mmHg (test for trend P < 0.019). An orthostatic decrease in diastolic BP was absent in 1123 subjects, 1-10 mmHg in 1057 and >10 mmHg in 209 subjects, with corresponding mean values of ln BRS of 1.49 (1.45-1.53), 1.41 (1.37-1.45) and 1.45 (1.36-1.54) ms/mmHg (P < 0.04). CONCLUSION: In a large population of older subjects, arterial stiffness appears to be an independent determinant of impaired BRS. Within the same population, impaired BRS was associated with orthostatic BP changes.

Mattace-Raso FU; van den Meiracker AH; Bos WJ; van der Cammen TJ; Westerhof BE; Elias-Smale S; Reneman RS; Hoeks AP; Hofman A; Witteman JC

2007-07-01

209

[Relationship between arterial pressure and exposure to noise at work  

UK PubMed Central (United Kingdom)

BACKGROUND: Exposure to high levels of noise has been identified as a possible risk factor in the development of arterial hypertension. METHODS: With the aim of evaluating this possibility a transversal study was designed in that the results of routine medical examinations carried out on 806 workers from different sectors in the Community of Valencia were analyzed. Occupational exposure to noise in the subjects included in the sample were categorized according to the activity of the enterprise to which each employee belonged and the work post occupied by the same. RESULTS: No relation was found between arterial pressure and exposure to noise at work. However a relation was found when two groups of workers in consideration had hearing loss above and below 65 decibels for the frequency of 4000 Hz and the group with the greatest losses (indicator of greater exposure to noise) presented greater mean values of arterial pressure and a higher percentage of hypertensive subjects. Nonetheless, the differences between both groups of workers did not reach statistical significance. CONCLUSIONS: The results obtained from this study do not permit clear determination of the relation between laboral exposure to noise and arterial pressure. The limitations of the design of the study itself are discussed.

García AM; García A

1992-01-01

210

Sildenafil and diastolic dysfunction after acute myocardial infarction in patients with preserved ejection fraction: the Sildenafil and Diastolic Dysfunction After Acute Myocardial Infarction (SIDAMI) trial.  

UK PubMed Central (United Kingdom)

BACKGROUND: Diastolic dysfunction is frequently seen after myocardial infarction and is characterized by a disproportionate increase in filling pressure during exercise to maintain stroke volume. We hypothesized that sildenafil would reduce filling pressure during exercise in patients with diastolic dysfunction after myocardial infarction. METHODS AND RESULTS: Seventy patients with diastolic dysfunction and near normal left ventricular ejection fraction on echocardiography were randomly assigned sildenafil 40 mg thrice daily or matching placebo for 9 weeks. Before randomization and after 9 weeks of treatment patients underwent simultaneous echocardiography and right heart catheterization at rest and during exercise. Primary end point was pulmonary capillary wedge pressure, and secondary end points comprised cardiac index and pulmonary arterial pressure at rest and during exercise after 9 weeks. After 9 weeks there were no differences in pulmonary capillary wedge pressure at rest (13±4 versus 13±3 mm Hg, P=0.25) or at peak exercise (35±8 mm Hg versus 31±7 mm Hg, P=0.07). However, with treatment cardiac index increased at rest (P=0.006) and peak exercise (P=0.02) in the sildenafil group, and systemic vascular resistance index (resting, P=0.0002; peak exercise, P=0.007) and diastolic blood pressure (resting, P=0.005; peak exercise, P=0.02) were lower in the sildenafil group. Resting left ventricular end-diastolic volume index increased (P=0.001) within the sildenafil group but was unchanged in the placebo group. CONCLUSIONS: Sildenafil did not decrease filling pressure at rest or during exercise in post-myocardial infarction patients with diastolic dysfunction. However, there were effects on secondary end points, which require further studies.

Andersen MJ; Ersbøll M; Axelsson A; Gustafsson F; Hassager C; Køber L; Borlaug BA; Boesgaard S; Skovgaard LT; Møller JE

2013-03-01

211

[Effect of magnesium sulfate on pulsatility index of uterine, umbilical and fetal middle cerebral arteries according to the persistence of bilateral diastolic notch of uterine arteries in patients with severe preeclampsia].  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the effect of magnesium sulphate on the pulsatility index (PI) of the uterine, umbilical and fetal middle cerebral arteries, according to the persistency or not of the bilateral protodiastolic notch of the uterine arteries in severe pre-eclampsia. METHODS: A cohort study including 40 pregnant women with severe pre-eclampsia, 23 of them presenting bilateral protodiastolic notch, and 17, unilateral/absent notch. The patients were submitted to Doppler velocimetry before and 20 minutes after the intravenous administration of 6 g of magnesium sulphate. The examination was carried out with the patient in semi-Fowler position, the sonograms being obtained during fetal inactivity, in apnea and absent uterine contraction periods. All the exams were performed by two researchers, the average being considered as the final result. Wilcoxon's test was used to compare the PI, before and after magnesium sulphate in both groups. The difference between the two measurements (before and after magnesium sulphate) was compared between the groups (bilateral incision and unilateral/absent incision) using the Mann-Whitney test. RESULTS: There was a significant increase in the maternal heart rate (MHR) and decrease in the maternal blood pressure, and in the PI medians of the two uterine arteries and in the fetal middle cerebral artery, after magnesium sulphate in both groups. There was a significant decrease in the PI of the left uterine artery and in the umbilical artery, only in the protodiastolic unilateral/absent notch group. Nevertheless, it was not found any significant difference regarding the PI of the right uterine artery, or the cerebral/umbilical relationship, before and after magnesium sulphate in each group. No difference between the groups was found, before and after magnesium sulphate, for any of the studied outcomes. CONCLUSIONS: After the intravenous administration of 6 g of magnesium sulphate to patients with severe pre-eclampsia, a decrease in blood pressure and in the PI of the uterine, umbilical and fetal middle cerebral arteries occurs, besides the increase in the MHR, not influenced by the presence of bilateral protodiastolic notch in the uterine arteries.

Souza AS; Amorim MM; Santos RE; Noronha Neto C; Porto AM

2009-02-01

212

[Changes in the arterial pressure after ligation of the hypogastric artery].  

UK PubMed Central (United Kingdom)

The physiology of the pelvic territory after the ligation of the hypogastric arteries may be resumed in the following phenomena: the absence of bleeding, absence of ischemia and changes in pelvic vascular pattern. The hemostatic effect is noticed immediately after ligation, when the bleeding is considerably diminished, permitting to finish the surgical act. The blood pressure has been measured before ligation, immediately and it increases after five minutes due to the changes in local characteristic impedance. The impedance profile is in concordance with geometrical modification of the microvascular network made to prevent the ischemia. The increase in blood pressure five minutes after ligation is the result of the anastomosis between the ischiatic artery and other branches of the hypogastric artery, remaking the capillary bed in the pelvic territory.

F?tu C; Frâncu D; Pui?or M; F?tu CI

1996-01-01

213

A marked fall in nocturnal blood pressure is associated with the stage of primary open-angle glaucoma in patients with arterial hypertension.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The aim of this study was to assess blood flow in the vessels of the eyeball and changes in the optic nerve in patients with arterial hypertension and primary open-angle glaucoma. MATERIAL AND METHODS: The patients were divided into groups: 1 (night blood pressure, BP, fall, NBPF, not more than 10%; non-dippers); 2 (NBPF 10-15%, dippers) and 3 (NBPF>15%; extreme dippers). RESULTS: In the group of dippers and extreme dippers, perfusion pressure was significantly lower than that in the non-dippers group, there was reduced thickness of the nerve fibers and a greater decrease in the visual field. Significant relationships between peak systolic, end-diastolic flow in the ophthalmic and central retinal arteries and night perfusion pressure, thickness of nerve fibers, and a loss of visual field were observed. CONCLUSION: In patients with glaucoma and well-controlled hypertension, a nocturnal BP fall of more than 10% is associated with a greater visual field defect and greater degeneration of the optic nerve fibers. Low minimum diastolic pressure and the level of nocturnal BP fall, but not the absolute value of average arterial BP at night, should be included in the group of specific risk factors in patients with hypertension and open-angle glaucoma. These findings also suggest avoiding excessive lowering of BP at night in this group.

Krasi?ska B; Karolczak-Kulesza M; Krasi?ski Z; Pawlaczyk-Gabriel K; Niklas A; G?uszek J; Tykarski A

2011-06-01

214

Effect of mechanical behaviour of the brachial artery on blood pressure measurement during both cuff inflation and cuff deflation.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of this study was to investigate the effect of different mechanical behaviour of the brachial artery on blood pressure (BP) measurements during cuff inflation and deflation. METHODS: BP measurements were taken from each of 40 participants, with three repeat sessions under three randomized cuff deflation/inflation conditions. Cuff pressure was linearly deflated and inflated at a standard rate of 2-3 mmHg/s and also linearly inflated at a fast rate of 5-6 mmHg/s. Manual auscultatory systolic and diastolic BPs, and pulse pressure (SBP, DBP, PP) were measured. Automated BPs were determined from digitally recorded cuff pressures by fitting a polynomial model to the oscillometric pulse amplitudes. The BPs from cuff deflation and inflation were then compared. RESULTS: Repeatable measurements between sessions and between the sequential order of inflation/deflation conditions (all P>0.1) indicated stability of arterial mechanical behaviour with repeat measurements. Comparing BPs obtained by standard inflation with those from standard deflation, manual SBP was 2.6 mmHg lower (P<0.01), manual DBP was 1.5 mmHg higher (P<0.01), manual PP was 4.2 mmHg lower (P<0.001), automated DBP was 6.7 mmHg higher (P<0.001) and automatic PP was 7.5 mmHg lower (P<0.001). There was no statistically significant difference for any automated BPs between fast and standard cuff inflation. The statistically significant BP differences between inflation and deflation suggest different arterial mechanical behaviour between arterial opening and closing during BP measurement. CONCLUSION: We have shown that the mechanical behaviour of the brachial artery during BP measurement differs between cuff deflation and cuff inflation.

Zheng D; Pan F; Murray A

2013-10-01

215

Avaliação da pressão arterial em bombeiros militares filhos de hipertensos através da monitorização ambulatorial da pressão arterial Using ambulatory blood pressure monitoring to assess blood pressure of firefighters with parental history of hypertension  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Avaliar a influência do antecedente familiar de hipertensão arterial sistêmica (HASF) sobre o efeito do estresse do trabalho em bombeiros militares comunicantes (BMC), através da monitorização ambulatorial da pressão arterial (MAPA). MÉTODOS: Estudo prospectivo caso-controle. Foi realizada a MAPA em 66 BMC saudáveis, durante 12 horas de trabalho na central de comunicações (CC), sendo 34 filhos de hipertensos (grupo 1) e 32 filhos de normotensos (grupo 2). RESULTADOS: O grupo 1 diferiu do grupo 2, pois apresentou, no trabalho, maiores médias sistólicas (134,1 ± 9,9 mmHg X 120,8 ± 9,9 mmHg p OBJECTIVE: To evaluate the influence of family history of systemic arterial hypertension (FSAH) on the effect of stress from work in Uniformed Firefighters (BMCs) through Ambulatory Blood Pressure Monitoring (ABPM). METHODS: A prospective case-control study. Sixty-six healthy BMC underwent ABPM during 12 hours of work at the Communication Center (CC). Thirty-four had hypertensive parents (group 1) and thirty-two had normotensive parents (group 2). RESULTS: Group I differed from group 2 in that it showed higher mean systolic (134.1 ± 9.9 mmHg X 120.8 ± 9.9 mmHg p < 0.0001) and diastolic (83.8 ± 8.3 mmHg X 72.9 ± 8.6 mmHg p < 0.001) blood pressure, in addition to greater systolic (31.4 ± 25.6 % X 9.4 ± 9.4 % p = 0.0001) and diastolic (28.3 ± 26.6 % X 6.1 ± 8.9 % p = 0.0001) loads. The prevalence of systemic arterial hypertension (SAH) in group 1 at the workplace was 32.3%. Monitored away from the job, these subjects showed normal blood pressure (functionally hypertensive). Group 2 revealed normal blood pressure (BP) at work. CONCLUSION: Higher blood pressure in BMC with hypertensive parents is explained independently by the SAH. Subjects who developed SAH during their work at the CC may be considered functionally hypertensive, whereas those with normotensive parents and who underwent psychological stress are free of blood pressure changes.

Carlos Eduardo de Mattos; Marco Antonio de Mattos; Daniele Gusmão Toledo; Aristarco Gonçalves de Siqueira Filho

2006-01-01

216

Relación entre hiperinsulinemia, disfunción diastólica e hipertrofia del ventrículo izquierdo en pacientes con hipertensión arterial sistémica Association of hyperinsulinemia with left ventricular hypertrophy and diastolic dysfunction in patients with hypertension  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Hypertension is the main independent cardiovascular risk factor. However, there are additional factors that induce organic damage. Aim: To assess the association between hyperinsulinemia, ventricular hypertrophy and left ventricular diastolic function. Patients and Methods: Seventy-four patients aged 30 to 65 years, with mild or moderate systemic hypertension, with overweight or mild obesity and normal glucose tolerance curve (GTC), were studied. Serum insulin was measured during GTC. The maximum levels of insulin and glucose were observed 60 minutes after the oral glucose load and they were expressed as rG/1. Patients were stratified in three groups according to their glucose and insulin fasting levels (I0) and post-glucose challenge levels (rG/I): Group 1 (normoinsulinemic patients) I0 2 (2.45+0.4). Group 2 (post-prandial hyperinsulinemic patients) I0 17 mU/mL and <1 (0.7+0.3). Left ventricular mass and its diastolic function were measured by Doppler echocardiography. Results: No differences in blood pressure or age were observed between groups. There was a negative correlation between ventricular mass and rG/1 (r =-0.282, p =0.015). Left ventricular diastolic dysfunction was significantly more deteriorated in group 3, as compared with group 1 (p <0.001 ANOVA). There was a significant correlation between g/GI and diastolic dysfunction (r =0.232 p =0.047). Conclusions: Fasting, post challenge hyperinsulinemia and a rG/I <1 are associated with higher ventricular mass and left ventricular diastolic dysfunction, independent of blood pressure and age (Rev Méd Chile 2007; 135: 1125-31)

Ernesto Germán Cardona-Muñoz; David Cardona-Müller; Sylvia Totsuka-Sutto; Carlos Martín Nuño-Guzmán; Sara Pascoe-González; Marina Romero-Prado; Alejandra G Miranda-Díaz

2007-01-01

217

Pressure-diameter relationship in human coronary arteries.  

UK PubMed Central (United Kingdom)

BACKGROUND: To quantify the changes in arterial dimensions after the acute changes in pressure associated with percutaneous coronary intervention (PCI). METHODS AND RESULTS: Forty-eight patients with one angiographically moderate-to-severe stenosis were included in the study. The pressure proximal and distal to the stenosis and the arterial diameter proximal and distal to the stenosis were measured at baseline, after intracoronary nitrates, and after stent PCI. In addition, in 8 patients distal pressure and coronary diameter were assessed while graded, controlled stenoses were created in the stented segment by progressive inflation of a balloon catheter. The mean diameter of the proximal coronary segment was 2.75 ± 0.08 mm, 2.92 ± 0.08 mm (+7.4%), and 3.10 ± 0.07 mm (+14.7%) at baseline, after nitrates and after PCI, respectively (P<0.001). The mean diameter of the distal coronary segment was 2.07 ± 0.09 mm, 2.23 ± 0.09 mm (+9.7%), and 2.5±0.07 mm (+28.4%) at baseline, after nitrates and after PCI, respectively (P<0.001). The increase in distal diameter correlated significantly with the increase in distal pressure after PCI (r(2)=0.57; P<0.001). When graded stenoses were created, a decrease in diameter of 18 ± 4% was observed with a pressure drop of 43 ± 5 mm Hg. CONCLUSIONS: The diameter of coronary arteries markedly varies with their distending pressure. After re-establishment of a normal distending pressure by stenting of severe coronary stenoses, a proportional increase in vessel diameter is observed. This should be taken into account when choosing the stent diameter and is an argument to discourage direct stenting.

Muller O; Pyxaras SA; Trana C; Mangiacapra F; Barbato E; Wijns W; Taylor CA; De Bruyne B

2012-12-01

218

Application of pressure wire in carotid artery stenting  

Directory of Open Access Journals (Sweden)

Full Text Available Background Nowad ays, critical carotid stenosis lacks appropriate treatment standards, and carotid artery stenting (CAS) needs more direct guidance. This study aims to investigate the possibility of applying pressure wire in CAS, and the guidance of pressure gradients in choosing indications of CAS. Methods From May 2012 to October 2012, 32 consecutive cases with carotid stenosis undergoing CAS were enrolled. Preoperative and postoperative carotid ultrasound and CT perfusion imaging were performed, and intraoperative measurements of endovascular pressure gradients before and after stent implantation were recorded to evaluate intracranial circulation compensation. Results Preopera tive carotid ultrasound showed the rate of stenosis in 32 cases was?70% or nearly total occlusion. Doppler measurement of peak systolic velocity (PSV) of the stenosed vessel ranged 184-718 cm/s. Digital subtraction angiography (DSA) examination showed the stenosis rates were 50%-70% in 7 cases, 70%-90% in 16 and > 90% in 9. The coincidence rate of carotid ultrasound and DSA was 84.38% (27/32), and the acquisition rate of intraoperative carotid pressure gradients was 100%. Pressure gradients before stent implantation were 10-92 mm Hg, with an average of (41.45 ± 25.50) mm Hg, and pressure gradients after stent implantation were 0-15 mm Hg, with an average of (3.44 ± 3.47) mm Hg. DSA revealed 4 cases with good intracranial circulation compensation and 28 cases with poor intracranial circulation compensation. Conclusion Pressure wire can be safely and effectively used in CAS to acquire pressure gradients between the two ends of stenosis segment. For carotid artery stenosis patients lacking of intracranial circulation compensation, pressure gradients become higher as stenosis rate increases within a certain range. Therefore, CAS for stenosis with lower pressure gradients should be reconsidered.

WANG Shi-bo; LI Xu-dong; JIA Qiang; HAN Jing; FENG Tao; FAN Yi-mu

2013-01-01

219

Assessing murine resistance artery function using pressure myography.  

UK PubMed Central (United Kingdom)

Pressure myograph systems are exquisitely useful in the functional assessment of small arteries, pressurized to a suitable transmural pressure. The near physiological condition achieved in pressure myography permits in-depth characterization of intrinsic responses to pharmacological and physiological stimuli, which can be extrapolated to the in vivo behavior of the vascular bed. Pressure myograph has several advantages over conventional wire myographs. For example, smaller resistance vessels can be studied at tightly controlled and physiologically relevant intraluminal pressures. Here, we study the ability of 3(rd) order mesenteric arteries (3-4 mm long), preconstricted with phenylephrine, to vaso-relax in response to acetylcholine. Mesenteric arteries are mounted on two cannulas connected to a pressurized and sealed system that is maintained at constant pressure of 60 mmHg. The lumen and outer diameter of the vessel are continuously recorded using a video camera, allowing real time quantification of the vasoconstriction and vasorelaxation in response to phenylephrine and acetylcholine, respectively. To demonstrate the applicability of pressure myography to study the etiology of cardiovascular disease, we assessed endothelium-dependent vascular function in a murine model of systemic hypertension. Mice deficient in the ?1 subunit of soluble guanylate cyclase (sGC?1(-/-)) are hypertensive when on a 129S6 (S6) background (sGC?1(-/-S6)) but not when on a C57BL/6 (B6) background (sGC?1(-/-B6)). Using pressure myography, we demonstrate that sGC?1-deficiency results in impaired endothelium-dependent vasorelaxation. The vascular dysfunction is more pronounced in sGC?1(-/-S6) than in sGC?1(-/-B6) mice, likely contributing to the higher blood pressure in sGC?1(-/-S6) than in sGC?1(-/-B6) mice. Pressure myography is a relatively simple, but sensitive and mechanistically useful technique that can be used to assess the effect of various stimuli on vascular contraction and relaxation, thereby augmenting our insight into the mechanisms underlying cardiovascular disease.

Shahid M; Buys ES

2013-01-01

220

Indicadores antropométricos e pressão arterial em escolares/ Anthropometric measures and blood pressure in school children  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Investigar a relação entre pressão arterial e índice de massa corporal, circunferência abdominal, razão cintura/estatura e dobra cutânea tricipital em crianças e adolescentes. MÉTODOS: Estudo epidemiológico transversal, do qual participaram 1.441 escolares de 10 a 16 anos de idade (655 meninos e 786 meninas), selecionados por amostragem aleatória sistemática. Avaliaram-se a massa corporal, a estatura, a circunferência abdominal, a espessura da dobra (more) cutânea tricipital, as pressões arteriais - sistólica e diastólica - o estágio maturacional e a classe econômica. Utilizaram-se os testes de correlação parcial de Pearson e a regressão logística multivariada, considerando-se p Abstract in english OBJECTIVE: To investigate the association of blood pressure and body mass index, waist circumference, waist-to-height ratio and triceps skinfold, in children and adolescents in Curitiba, state of Paraná, Brazil. METHODS: Cross-sectional study with a random sample of 1,441 students from public schools, aged from10 to 16 years (655 boys and 786 girls). The following indicators were assessed: weight, height, waist circumference, triceps skinfold, systolic and diastolic bloo (more) d pressures, pubertal stage, and socioeconomic status. Pearson correlation tests and multivariate logistic regression were used, considering p

Moser, Deise Cristiane; Giuliano, Isabela de Carlos Back; Titski, Ana Cláudia Kapp; Gaya, Anelise Reis; Coelho-e-Silva, Manuel João; Leite, Neiva

2013-06-01

 
 
 
 
221

A general model for continuous noninvasive pulmonary artery pressure estimation.  

UK PubMed Central (United Kingdom)

Elevated pulmonary artery pressure (PAP) is a significant healthcare risk. Continuous monitoring for patients with elevated PAP is crucial for effective treatment, yet the most accurate method is invasive and expensive, and cannot be performed repeatedly. Noninvasive methods exist but are somewhat inaccurate, expensive, and cannot be used for continuous monitoring. We present a machine learning model based on heart sounds that estimates pulmonary artery pressure with enough accuracy to exclude an invasive diagnostic operation, allowing for consistent monitoring of heart condition in suspect patients without the cost and risk of invasive monitoring. We conduct a greedy search through 38 possible features using a 109-patient cross-validation to find the most predictive features. Our best general model has a standard estimate of error (SEE) of 8.3mmHg, which outperforms the previous best performance in the literature on a general set of unseen patient data.

Smith R; Ventura D

2013-08-01

222

Pressure indices in peripheral arterial disease assessed by infrared photosensors.  

UK PubMed Central (United Kingdom)

Ankle-brachial index (ABI) assessment by Doppler is operator dependent and limited in calcified arteries. For the detection of peripheral arterial disease (PAD), we evaluated ABI and toe-finger (ToFi) pressures by infrared (IR) sensors at the digits and compared with standard Doppler (Doppler-ABI) in 100 patients with PAD and in 15 controls. Pressure indices were obtained in 86% for Doppler-ABI, 82% for IR-ABI, and 94% for IR-ToFi (P < .01). According to Bland-Altmann analysis, IR-ABI and Doppler-ABI are exchangeable (limits of agreement [loa] -0.30; 0.30, bias -0.003, 95% confidence interval [CI] -0.02; 0.02), whereas IR-ToFi was not (loa -0.23; 0.61, bias of 0.2, 95% CI 0.16; 0.23). The IR-ToFi revealed the best inter- and intrarater agreement (0.92/0.98) followed by IR-ABI (0.74/0.98) and Doppler-ABI (0.66/0.89). Ankle-brachial arterial pressure index can be assessed by IR photosensors. Although toe-finger index is not exchangeable with standard Doppler, it will need further exploration to define its value for the diagnosis of PAD due to its excellent inter- and intrarater agreement.

Emler C; Jacomella V; Rufibach K; Thalhammer C; Amann-Vesti BR; Husmann M

2013-02-01

223

Arterial pressure and diameter waveforms analysis by means of wavelet transform: application to artery de-endothelization.  

UK PubMed Central (United Kingdom)

In this present paper, we showed that wavelet analysis (WA) has the potential for extracting specific features from measured arterial diameter and pressure waveforms. The fifth detail of the Daubechies 4 (Db4) wavelet appears to be the most appropriate level for application, in order to analyze artery waveforms and was used to characterized arterial de-endothelization (DE). Raises in smooth muscle tone induced by (DE) tended to increase arterial stiffness and therefore that WA details embed the information of the diameter and pressure pulse that contains the signature of effects of wave travel and reflection affected by arterial stiffness.

Zajarevich N; Bia D; Pessana F; Codnia J; Armentano R

2010-01-01

224

Arterial pressure and diameter waveforms analysis by means of wavelet transform: application to artery de-endothelization.  

Science.gov (United States)

In this present paper, we showed that wavelet analysis (WA) has the potential for extracting specific features from measured arterial diameter and pressure waveforms. The fifth detail of the Daubechies 4 (Db4) wavelet appears to be the most appropriate level for application, in order to analyze artery waveforms and was used to characterized arterial de-endothelization (DE). Raises in smooth muscle tone induced by (DE) tended to increase arterial stiffness and therefore that WA details embed the information of the diameter and pressure pulse that contains the signature of effects of wave travel and reflection affected by arterial stiffness. PMID:21095793

Zajarevich, N; Bia, D; Pessana, F; Codnia, J; Armentano, R

2010-01-01

225

Diastolic blood pressure reduction contributes more to the regression of left ventricular hypertrophy: a meta-analysis of randomized controlled trials.  

UK PubMed Central (United Kingdom)

Left ventricular hypertrophy (LVH) is an independent cardiovascular risk factor; however, the key strategy necessary for LVH regression in hypertensive patients is not clear. A meta-analysis was conducted to study the effect of blood pressure reduction on LVH regression. We explored the relationship between different degrees of systolic blood pressure (SBP)/diastolic blood pressure (DBP) reduction and LVH regression. A total of 17 randomized controlled trials comprising 2196 hypertensive patients (mean age, 56.3 years; 64.1% were men) were identified. Different degrees of SBP and DBP reductions were significantly associated with LVH regression: SBP reduction ?20?mm?Hg (SBPM20) (weighted mean difference (WMD): 14.35?g?m(-2); 95% confidence interval (CI): 10.44, 18.26; P<0.0001); SBP reduction <20?mm?Hg (SBPL20 group) (WMD: 14.82?g?m(-2); 95% CI: 9.83, 19.8(2); P<0.0001); DBP reduction ?10?mm?Hg (DBPM10 group) (WMD: 15.17?g?m(-2); 95% CI: 11.86, 18.48; P<0.0001); and DBP reduction <10?mm?Hg (DBPL10 group) (WMD: 11.76?g?m(-2); 95% CI: 3.75, 19.76; P=0.004). Significant regression of LVH was found in the DBPM10 group compared with the SBPM20, SBPL20 and DBPL10 groups (P<0.0001). The most significant decrease in LVH was seen in patients with a mean age over 60 years in the DBPM10 group. Moreover, the renin-angiotensin system inhibitor was found to be the most effective antihypertensive drug for LVH regression. This meta-analysis result indicates that proper DBP reduction plays an important role in the regression of echocardiographic LVH in hypertensive patients.

Zhang K; Chen J; Liu Y; Wang T; Wang L; Wang J; Huang H

2013-11-01

226

Diastolic blood pressure reduction contributes more to the regression of left ventricular hypertrophy: a meta-analysis of randomized controlled trials.  

Science.gov (United States)

Left ventricular hypertrophy (LVH) is an independent cardiovascular risk factor; however, the key strategy necessary for LVH regression in hypertensive patients is not clear. A meta-analysis was conducted to study the effect of blood pressure reduction on LVH regression. We explored the relationship between different degrees of systolic blood pressure (SBP)/diastolic blood pressure (DBP) reduction and LVH regression. A total of 17 randomized controlled trials comprising 2196 hypertensive patients (mean age, 56.3 years; 64.1% were men) were identified. Different degrees of SBP and DBP reductions were significantly associated with LVH regression: SBP reduction ?20?mm?Hg (SBPM20) (weighted mean difference (WMD): 14.35?g?m(-2); 95% confidence interval (CI): 10.44, 18.26; PWMD: 14.82?g?m(-2); 95% CI: 9.83, 19.8(2); PWMD: 15.17?g?m(-2); 95% CI: 11.86, 18.48; PWMD: 11.76?g?m(-2); 95% CI: 3.75, 19.76; P=0.004). Significant regression of LVH was found in the DBPM10 group compared with the SBPM20, SBPL20 and DBPL10 groups (P<0.0001). The most significant decrease in LVH was seen in patients with a mean age over 60 years in the DBPM10 group. Moreover, the renin-angiotensin system inhibitor was found to be the most effective antihypertensive drug for LVH regression. This meta-analysis result indicates that proper DBP reduction plays an important role in the regression of echocardiographic LVH in hypertensive patients. PMID:23535988

Zhang, K; Chen, J; Liu, Y; Wang, T; Wang, L; Wang, J; Huang, H

2013-03-28

227

Portal stump pressure monitorization in the conscious rat after porta-caval shunt and total liver arterialization with the left gastric artery.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A method for portal stump pressure monitorization following arterialization is presented. Both intra and postoperative pressure determinations were performed and a significant difference between intra and postoperative values was observed. The pressure of the arterialized portal stump either using t...

Flati, G; Rozga, J; Flati, D; Porowska, B; Negro, P; Tuscano, D; Carboni, M; Bengmark, S

228

Plasma brain natriuretic peptide as a biochemical marker of high left ventricular end-diastolic pressure in patients with symptomatic left ventricular dysfunction.  

UK PubMed Central (United Kingdom)

BACKGROUND: Plasma atrial natriuretic peptide (ANP), mainly from the atrium, brain natriuretic peptide (BNP), mainly from the ventricle, norepinephrine (NE), and endothelin-1 (ET-1) levels are increased with the severity of congestive heart failure (CHF). Although a close correlation between the left ventricular end-diastolic pressure (LVEDP) and plasma ANP in patients with left ventricular dysfunction has been reported, it is not yet known which cardiac natriuretic peptide is a better predictor of high LVEDP in patients with CHF. METHODS: To investigate the biochemical predictors of the high LVEDP in patients with left ventricular dysfunction, we measured plasma ANP, BNP, NE, and ET-1 levels and the hemodynamic parameters in 72 patients with symptomatic left ventricular dysfunction. Stepwise multivariate regression analyses were also used to determine whether the plasma levels of ANP, BNP, NE, and ET-1 could predict high LVEDP. RESULTS: Although significant positive correlations were found among the plasma levels of ANP, BNP, ET-1, and NE and the LVEDP, only BNP (p = 0.0001) was an independent and significant predictor of high LVEDP in patients with CHF. In all eight patients with severe CHF measured for hemodynamics before and after the treatments, the plasma BNP levels decreased in association with the decrease of LVEDP, whereas other factors increased in some patients despite the decrease of LVEDP. CONCLUSIONS: These findings suggest that plasma BNP is superior to ANP as a predictor of high LVEDP in patients with symptomatic left ventricular dysfunction.

Maeda K; Tsutamoto T; Wada A; Hisanaga T; Kinoshita M

1998-05-01

229

Is fatty acid intake a predictor of arterial stiffness and blood pressure in men? Evidence from the Caerphilly Prospective Study.  

UK PubMed Central (United Kingdom)

BACKGROUND AND AIMS: Arterial stiffness is an independent predictor of cardiovascular disease (CVD) events and all-cause mortality and may be differentially affected by dietary fatty acid (FA) intake. The aim of this study was to investigate the relationship between FA consumption and arterial stiffness and blood pressure in a community-based population. METHODS AND RESULTS: The Caerphilly Prospective Study recruited 2398 men, aged 45-59 years, who were followed up at 5-year intervals for a mean of 17.8-years (n 787). A semi-quantitative food frequency questionnaire estimated intakes of total, saturated, mono- and poly-unsaturated fatty acids (SFA, MUFA, PUFA). Multiple regression models investigated associations between intakes of FA at baseline with aortic pulse wave velocity (aPWV), augmentation index (AIx), systolic and diastolic blood pressure (SBP, DBP) and pulse pressure after a 17.8-year follow-up - as well as cross-sectional relationships with metabolic markers. After adjustment, higher SFA consumption at baseline was associated with higher SBP (P = 0.043) and DBP (P = 0.002) and after a 17.8-year follow-up was associated with a 0.51 m/s higher aPWV (P = 0.006). After adjustment, higher PUFA consumption at baseline was associated with lower SBP (P = 0.022) and DBP (P = 0.036) and after a 17.8-year follow-up was associated with a 0.63 m/s lower aPWV (P = 0.007). CONCLUSION: This study suggests that consumption of SFA and PUFA have opposing effects on arterial stiffness and blood pressure. Importantly, this study suggests that consumption of FA is an important risk factor for arterial stiffness and CVD.

Livingstone KM; Givens DI; Cockcroft JR; Pickering JE; Lovegrove JA

2013-02-01

230

Effects of nifedipine on left ventricular systolic and diastolic functions in patients with left ventricular hypertrophy  

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[en] The effect of nifedpine on left ventricular (LV) systolic and diastolic function was studied in 10 patients with hypertrophic cadiomyopathy(HCM), 8 patients with hypertensive hypertrophy(HT) and 9 normal subjects. Multigated cardiac blood pool imaging with Tc-99m were obtained at 40-degree left anterior oblique position before and after nifedipine administration (10 mg, sublingually). As systolic indices, we obtained LV ejection fraction and mean first third ejection rate. And as diastolic indices, mean filling rate during first third of diastole (1/3 FRsub(mean)) and diastolic maximal filling rate were calculated. Before nifedipine, systolic indices were significantly superior in HCM group than in other 2 groups, and diastolic indices were significantly lower in HCM and HT groups than in normal. After nifedipine, systolic indices improved in HT group but they did not change in other 2 groups. Diastolic indices improved significantly in HCM and HT groups after nifedpine. In HCM group, 1/3 FRsub(mean) improved more markedly in symptomatic patients than in asymptomatic patients. The ratio of diastolic function to systolic function (1/3 FRsub(mean)/1/3 ERsub(mean)) did not change in normal and HT groups but it increased significantly in HCM group. There we a slight increase in heart rate (HR) and decrease in systemic arterial pressure (BP). The increase in HR was similar among 3 groups but the decrease in BP was significantly greater in HT group in whom control BP was significantly higher than other groups. LV end-diastolic volume did not change in 3 groups by nifedipine administration. These data suggested that abnormal diastolic function in HCM and HT was faborably modified by nifedipine, but their mechanisms were different. In HT, it was considered to relate with improved systolic function due to LV afterload reduction, while in HCM, it was not related to the peripheral hemodynamic effects nor improved systolic function. (author)

1984-01-01

231

Effects of nifedipine on left ventricular systolic and diastolic functions in patients with left ventricular hypertrophy  

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The effect of nifedpine on left ventricular (LV) systolic and diastolic function was studied in 10 patients with hypertrophic cadiomyopathy(HCM), 8 patients with hypertensive hypertrophy(HT) and 9 normal subjects. Multigated cardiac blood pool imaging with Tc-99m were obtained at 40-degree left anterior oblique position before and after nifedipine administration (10 mg, sublingually). As systolic indices, we obtained LV ejection fraction and mean first third ejection rate. And as diastolic indices, mean filling rate during first third of diastole (1/3 FRsub(mean)) and diastolic maximal filling rate were calculated. Before nifedipine, systolic indices were significantly superior in HCM group than in other 2 groups, and diastolic indices were significantly lower in HCM and HT groups than in normal. After nifedipine, systolic indices improved in HT group but they did not change in other 2 groups. Diastolic indices improved significantly in HCM and HT groups after nifedpine. In HCM group, 1/3 FRsub(mean) improved more markedly in symptomatic patients than in asymptomatic patients. The ratio of diastolic function to systolic function (1/3 FRsub(mean)/1/3 ERsub(mean)) did not change in normal and HT groups but it increased significantly in HCM group. There we a slight increase in heart rate (HR) and decrease in systemic arterial pressure (BP). The increase in HR was similar among 3 groups but the decrease in BP was significantly greater in HT group in whom control BP was significantly higher than other groups. LV end-diastolic volume did not change in 3 groups by nifedipine administration. These data suggested that abnormal diastolic function in HCM and HT was faborably modified by nifedipine, but their mechanisms were different. In HT, it was considered to relate with improved systolic function due to LV afterload reduction, while in HCM, it was not related to the peripheral hemodynamic effects nor improved systolic function.

Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa; Honda, Minoru; Kanao, Keisuke (Sumitomo Hospital, Osaka (Japan))

1984-10-01

232

Effect of a short-term intermittent exercise-training programme on the pulse wave velocity and arterial pressure: a prospective study among 71 healthy older subjects.  

UK PubMed Central (United Kingdom)

AIMS OF THE STUDY: Stiffening of large arteries has been associated with increased cardiovascular outcomes among older subjects. Endurance exercises might attenuate artery stiffness, but little is known about the effects of intermittent training programme. We evaluate the effect of a short Intermittent Work Exercise Training Program (IWEP) on arterial stiffness estimated by the measure of the pulse wave velocity (PWV). METHODS AND SUBJECTS: Seventy-one healthy volunteers (mean age: 64.6 years) free of symptomatic cardiac and pulmonary disease performed a 9-week IWEP that consisted of a 30-min cycling twice a week over a 9-week period. Each session involved six 5-min bouts of exercise, each of the latter separated into 4-min cycling at the first ventilatory threshold alternated with 1-min cycling at 90% of the pretraining maximal tolerated power. Before and after the IWEP, the following measurements were made: carotid-radial PWV and carotid-femoral PWV with a tonometer and systolic and diastolic blood pressure. RESULTS: Training resulted in a non-significant decrease of the carotid-radial PWV, a significant decrease of the carotid-femoral PWV from 10.2 to 9.6 m/s (p < 0.001) (that was no longer significant after adjustment for mean arterial pressure) and a significant decrease in both systolic and diastolic blood pressure, respectively, from 129.6 ± 14.9 mmHg to 120.1 ± 14.1 mmHg (p < 0.001) and from 77.2 ± 8.8 mmHg to 71.4 ± 10.1 mmHg (p < 0.001). CONCLUSION: The present results support the idea that a short-term intermittent aerobic exercise programme may be an effective lifestyle intervention for reducing rapidly blood pressure and probably central arterial stiffness among older healthy subjects.

Vogel T; Leprêtre PM; Brechat PH; Lonsdorfer-Wolf E; Kaltenbach G; Lonsdorfer J; Benetos A

2013-05-01

233

Evaluation of left ventricular diastolic function in patients with non-Q-wave myocardial infarction and its correlation with underlying coronary artery disease.  

UK PubMed Central (United Kingdom)

Left ventricular diastolic function was studied by Doppler echocardiography in 35 patients with non-Q-wave myocardial infarction, on the third and tenth day of hospitalization and six weeks after hospitalization and was correlated with electrocardiogram, serum enzyme values, and angiographic data. Normal diastolic function on the first echocardiographic study predicted (p = 0.0001) the existence of no or single-vessel disease, and excluded (p = 0.005) the presence of 3-vessel or left main disease, whereas an abnormal study on either the second or third echocardiographic discriminated (p = 0.0001), with higher sensitivity (80.97%, 92.31%, respectively), patients with 3-vessel or left main vessel disease.

Panou FK; Papapanagiotou VA; Vouros LE; Matsakas EP; Karavidas AI; Lianidis GD; Dounis GB; Zacharoulis AA

1997-11-01

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Evaluation of left ventricular diastolic function in patients with non-Q-wave myocardial infarction and its correlation with underlying coronary artery disease.  

Science.gov (United States)

Left ventricular diastolic function was studied by Doppler echocardiography in 35 patients with non-Q-wave myocardial infarction, on the third and tenth day of hospitalization and six weeks after hospitalization and was correlated with electrocardiogram, serum enzyme values, and angiographic data. Normal diastolic function on the first echocardiographic study predicted (p = 0.0001) the existence of no or single-vessel disease, and excluded (p = 0.005) the presence of 3-vessel or left main disease, whereas an abnormal study on either the second or third echocardiographic discriminated (p = 0.0001), with higher sensitivity (80.97%, 92.31%, respectively), patients with 3-vessel or left main vessel disease. PMID:9388116

Panou, F K; Papapanagiotou, V A; Vouros, L E; Matsakas, E P; Karavidas, A I; Lianidis, G D; Dounis, G B; Zacharoulis, A A

1997-11-15

235

Sleep and blood pressure.  

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Direct arterial pressure was recorded continuously over 24 hours in 18 totally unrestricted people (six normotensives, four untreated hypertensives, and eight treated hypertensives). There was an almost equal fall of about 20% in both systolic and diastolic blood pressure during sleep in the three g...

Littler, W A; Honour, A J; Carter, R D; Sleight, P

236

Efectos del alcoholismo crónico sobre la presión arterial y frecuencia cardiaca en ratas adolescentes machos Effects of chronic alcoholism on the arterial pressure and heart rate in male adolescent rats  

Directory of Open Access Journals (Sweden)

Full Text Available Se caracterizaron los efectos que sobre la presión arterial y la frecuencia cardiaca ocasiona el alcoholismo crónico iniciado en la adolescencia en ratas albinas machos. Se confeccionaron 2 grupos de animales (experimental y control) y se hicieron 2 subgrupos de diferentes tiempos de tratamiento (3 y 5 meses). A las ratas experimentales se les suministró etanol mediante cánula intraesofágica. Se estudió la presión arterial y la frecuencia cardiaca mediante plestimografía directa. Para el procesamiento estadístico de los resultados se utilizó ANOVA de 2 vías con interacción. La ingestión de etanol provocó un incremento en la presión arterial sistólica y diastólica tanto a los 3 como a los 5 meses de tratamiento. Este incremento fue mayor a los 5 meses de tratamiento. La frecuencia cardiaca no mostró cambios significativos. Se concluyó que la ingestión crónica de etanol eleva la presión arterial de forma tiempo dependiente.The effects of chronic alcoholism initiated in the adolescence on arterial pressure and heart rate were characterized in male albine rats. They were divided into 2 groups (experimental and control) and 2 subgroups with different times of treatment (3 and 5 months) were organized. The experimental rats were administered ethanol by intraesophageal cannula. Arterial pressure and heart rate were studied by direct plethysmography. A two-way interactive ANOVA was used for the statistical processing of the results. The ingestion of ethanol produced an increase of the systolic and diastolic arterial pressure at 3 and 5 months of treatment. This rise was higher at 5 months of treatment. Heart rate did not show significant changes. It was concluded that the chronic ingestion of ethanol raises arterial pressure depending on time.

Aleida Herrera Batista; Giselle Puldón Seguí; Belsis Díaz Rondón; Jorge Bacallao Gallestey

2006-01-01

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Treinamento resistido controla a pressão arterial de ratos hipertensos induzidos por l-NAME/ Resistance training controls arterial blood pressure in rats with L-NAME- induced hypertension  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese FUNDAMENTO: A hipertensão arterial é uma síndrome multifatorial, crônica, causada tanto por fatores congênitos ou adquiridos. OBJETIVO: Avaliar os efeitos do treinamento físico resistido (TR) sobre pressão arterial, reatividade e morfologia vascular de ratos hipertensos induzidos por L-NAME. MÉTODOS: Ratos Wistar machos (200-250 g) foram divididos em 3 grupos: normotenso sedentário (NS), hipertenso sedentário (HS) e hipertenso treinado (HT). A hipertensão foi i (more) nduzida pela administração de L-NAME (40 mg/kg) na água de beber por 4 semanas. A pressão arterial foi avaliada antes e após o TR. O TR foi realizado utilizando 50% de 1RM, em 3 séries de 10 repetições, 3 vezes por semana, durante quatro semanas. A reatividade vascular foi mensurada em artéria mesentérica superior por curvas concentração resposta ao nitroprussiato de sódio (NPS) e fenilefrina (FEN). Além disso, foram realizadas análises histológicas e estereológicas. RESULTADOS: O TR inibiu o aumento das pressões arteriais média e diastólica. Foi observada uma redução significativa na resposta máxima e na potência da FEN entre os grupos HS e HT. A análise histológica evidenciou aspecto normal para as túnicas íntima, média e adventícia em todos os grupos. Não houve diferença significativa nas áreas do lúmen, da túnica média e total das artérias dos grupos HS e HT em relação ao NS. A razão parede/lúmen arterial do grupo HS apresentou diferença significativa em relação ao NS (p Abstract in english BACKGROUND: Arterial hypertension is a multifactorial chronic condition caused by either congenital or acquired factors. OBJECTIVE: To evaluate the effects of Resistance Training (RT) on arterial pressure, and on vascular reactivity and morphology, of L-NAME-treated hypertensive rats. METHODS: Male Wistar rats (200 - 250 g) were allocated into Sedentary Normotensive (SN), Sedentary Hypertensive (SH) and Trained Hypertensive (TH) groups. Hypertension was induced by adding (more) L-NAME (40 mg/Kg) to the drinking water for four weeks. Arterial pressure was evaluated before and after RT. RT was performed using 50% of 1RM, 3 sets of 10 repetitions, 3 times per week for four weeks. Vascular reactivity was measured in rat mesenteric artery rings by concentration-response curves to sodium nitroprusside (SNP); phenylephrine (PHE) was also used for histological and stereological analysis. RESULTS: Resistance training inhibited the increase in mean and diastolic arterial pressures. Significant reduction was observed in Rmax (maximal response) and pD2 (potency) of PHE between SH and TH groups. Arteries demonstrated normal intima, media and adventitia layers in all groups. Stereological analysis demonstrated no significant difference in luminal, tunica media, and total areas of arteries in the SH and TH groups when compared to the SN group. Wall-to-lumen ratio of SH arteries was significantly different compared to SN arteries (p

Araujo, Ayslan Jorge Santos de; Santos, Anne Carolline Veríssimo dos; Souza, Karine dos Santos; Aires, Marlúcia Bastos; Santana-Filho, Valter Joviniano; Fioretto, Emerson Ticona; Mota, Marcelo Mendonça; Santos, Márcio Roberto Viana

2013-01-01

238

Treinamento resistido controla a pressão arterial de ratos hipertensos induzidos por l-NAME/ Resistance training controls arterial blood pressure in rats with L-NAME- induced hypertension  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese FUNDAMENTO: A hipertensão arterial é uma síndrome multifatorial, crônica, causada tanto por fatores congênitos ou adquiridos. OBJETIVO: Avaliar os efeitos do treinamento físico resistido (TR) sobre pressão arterial, reatividade e morfologia vascular de ratos hipertensos induzidos por L-NAME. MÉTODOS: Ratos Wistar machos (200-250 g) foram divididos em 3 grupos: normotenso sedentário (NS), hipertenso sedentário (HS) e hipertenso treinado (HT). A hipertensão foi i (more) nduzida pela administração de L-NAME (40 mg/kg) na água de beber por 4 semanas. A pressão arterial foi avaliada antes e após o TR. O TR foi realizado utilizando 50% de 1RM, em 3 séries de 10 repetições, 3 vezes por semana, durante quatro semanas. A reatividade vascular foi mensurada em artéria mesentérica superior por curvas concentração resposta ao nitroprussiato de sódio (NPS) e fenilefrina (FEN). Além disso, foram realizadas análises histológicas e estereológicas. RESULTADOS: O TR inibiu o aumento das pressões arteriais média e diastólica. Foi observada uma redução significativa na resposta máxima e na potência da FEN entre os grupos HS e HT. A análise histológica evidenciou aspecto normal para as túnicas íntima, média e adventícia em todos os grupos. Não houve diferença significativa nas áreas do lúmen, da túnica média e total das artérias dos grupos HS e HT em relação ao NS. A razão parede/lúmen arterial do grupo HS apresentou diferença significativa em relação ao NS (p Abstract in english BACKGROUND: Arterial hypertension is a multifactorial chronic condition caused by either congenital or acquired factors. OBJECTIVE: To evaluate the effects of Resistance Training (RT) on arterial pressure, and on vascular reactivity and morphology, of L-NAME-treated hypertensive rats. METHODS: Male Wistar rats (200 - 250 g) were allocated into Sedentary Normotensive (SN), Sedentary Hypertensive (SH) and Trained Hypertensive (TH) groups. Hypertension was induced by adding (more) L-NAME (40 mg/Kg) to the drinking water for four weeks. Arterial pressure was evaluated before and after RT. RT was performed using 50% of 1RM, 3 sets of 10 repetitions, 3 times per week for four weeks. Vascular reactivity was measured in rat mesenteric artery rings by concentration-response curves to sodium nitroprusside (SNP); phenylephrine (PHE) was also used for histological and stereological analysis. RESULTS: Resistance training inhibited the increase in mean and diastolic arterial pressures. Significant reduction was observed in Rmax (maximal response) and pD2 (potency) of PHE between SH and TH groups. Arteries demonstrated normal intima, media and adventitia layers in all groups. Stereological analysis demonstrated no significant difference in luminal, tunica media, and total areas of arteries in the SH and TH groups when compared to the SN group. Wall-to-lumen ratio of SH arteries was significantly different compared to SN arteries (p

Araujo, Ayslan Jorge Santos de; Santos, Anne Carolline Veríssimo dos; Souza, Karine dos Santos; Aires, Marlúcia Bastos; Santana-Filho, Valter Joviniano; Fioretto, Emerson Ticona; Mota, Marcelo Mendonça; Santos, Márcio Roberto Viana

2013-04-01

239

Modeling left ventricular diastolic dysfunction: classification and key indicators  

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Full Text Available Abstract Background Mathematical modeling can be employed to overcome the practical difficulty of isolating the mechanisms responsible for clinical heart failure in the setting of normal left ventricular ejection fraction (HFNEF). In a human cardiovascular respiratory system (H-CRS) model we introduce three cases of left ventricular diastolic dysfunction (LVDD): (1) impaired left ventricular active relaxation (IR-type); (2) increased passive stiffness (restrictive or R-type); and (3) the combination of both (pseudo-normal or PN-type), to produce HFNEF. The effects of increasing systolic contractility are also considered. Model results showing ensuing heart failure and mechanisms involved are reported. Methods We employ our previously described H-CRS model with modified pulmonary compliances to better mimic normal pulmonary blood distribution. IR-type is modeled by changing the activation function of the left ventricle (LV), and R-type by increasing diastolic stiffness of the LV wall and septum. A 5th-order Cash-Karp Runge-Kutta numerical integration method solves the model differential equations. Results IR-type and R-type decrease LV stroke volume, cardiac output, ejection fraction (EF), and mean systemic arterial pressure. Heart rate, pulmonary pressures, pulmonary volumes, and pulmonary and systemic arterial-venous O2 and CO2 differences increase. IR-type decreases, but R-type increases the mitral E/A ratio. PN-type produces the well-described, pseudo-normal mitral inflow pattern. All three types of LVDD reduce right ventricular (RV) and LV EF, but the latter remains normal or near normal. Simulations show reduced EF is partly restored by an accompanying increase in systolic stiffness, a compensatory mechanism that may lead clinicians to miss the presence of HF if they only consider LVEF and other indices of LV function. Simulations using the H-CRS model indicate that changes in RV function might well be diagnostic. This study also highlights the importance of septal mechanics in LVDD. Conclusion The model demonstrates that abnormal LV diastolic performance alone can result in decreased LV and RV systolic performance, not previously appreciated, and contribute to the clinical syndrome of HF. Furthermore, alterations of RV diastolic performance are present and may be a hallmark of LV diastolic parameter changes that can be used for better clinical recognition of LV diastolic heart disease.

Luo Chuan; Ramachandran Deepa; Ware David L; Ma Tony S; Clark John W

2011-01-01

240

Prediction of improvement in ankle blood pressure following arterial bypass.  

UK PubMed Central (United Kingdom)

Percutaneous femoral artery pressures and lower extremity segmental Doppler-derived blood pressures in 116 lower extremities were analyzed to determine if postbypass ankle/brachial indices (ABIs) could be predicted based on preoperative pressures. Predicted ABIs were calculated by increasing the prebypass ABI by the same percentage that the extremity/brachial index at the distal end of the bypass would be increased, assuming a postbypass index of 1.0 at the distal graft. The correlation between predicted ABI and actual postbypass ABI was strong for aortofemoral bypass (r = 0.8735) and moderate for infrainguinal bypass (r = 0.5961), with 75% of the postinfrainguinal bypass ABIs being greater than predicted. Minimum postoperative increases in ABI can be predicted based on preoperative hemodynamic measurements, thus providing important information relative to choosing the appropriate level of revascularization in patients with multisegmental disease.

Williams LR; Flanigan DP; Schuler JJ; O'Connor RJ; Castronuovo JJ

1984-09-01

 
 
 
 
241

Prediction of improvement in ankle blood pressure following arterial bypass.  

Science.gov (United States)

Percutaneous femoral artery pressures and lower extremity segmental Doppler-derived blood pressures in 116 lower extremities were analyzed to determine if postbypass ankle/brachial indices (ABIs) could be predicted based on preoperative pressures. Predicted ABIs were calculated by increasing the prebypass ABI by the same percentage that the extremity/brachial index at the distal end of the bypass would be increased, assuming a postbypass index of 1.0 at the distal graft. The correlation between predicted ABI and actual postbypass ABI was strong for aortofemoral bypass (r = 0.8735) and moderate for infrainguinal bypass (r = 0.5961), with 75% of the postinfrainguinal bypass ABIs being greater than predicted. Minimum postoperative increases in ABI can be predicted based on preoperative hemodynamic measurements, thus providing important information relative to choosing the appropriate level of revascularization in patients with multisegmental disease. PMID:6748634

Williams, L R; Flanigan, D P; Schuler, J J; O'Connor, R J; Castronuovo, J J

1984-09-01

242

Effect of arterial blood pressure on the arterial to end-tidal carbon dioxide difference during anesthesia induction in patients scheduled for craniotomy.  

UK PubMed Central (United Kingdom)

BACKGROUND: Before obtaining results of arterial blood gas analysis in mechanically ventilated patients undergoing neurosurgery, the volume of ventilation is primarily adjusted according to endtidal CO2 (EtCO2). We characterized the impact of various arterial blood pressure changes on arterial PCO2 (PaCO2) to EtCO2 differences (PaCO2-EtCO2) in patients anesthetized for craniotomy. METHODS: Seventy-two elective craniotomy patients were enrolled in this prospective study. Noninvasive blood pressure was measured before anesthesia induction. Anesthesia was induced with thiopental, rocuronium or suxamethonium, and fentanyl and was maintained with inhaled anesthetics or propofol and remifentanil. Volume-controlled ventilation was adjusted after intubation according to the clinical judgment. The first arterial blood gas analysis was taken just before the head pinning. Systolic, diastolic, and mean arterial blood pressures (MAP) and heart rate were registered after intubation every 5 minutes until the head pinning. RESULTS: PaCO2-EtCO2 correlated positively with percentage difference between MAP awake at arrival in operating room and during arterial CO2 determination (P=0.0008, r=0.388). In analysis according to a MAP decrease of less than 20% (n=17), 20% to 29% (n=24), 30% to 35% (n=16), and more than 35% (n=15), the mean (SD) PaCO2-EtCO2 was greater in patients with MAP decrease of over 35% or 30% to 35% than in patients with MAP decrease of less than 20%. The mean (SD) absolute values of the PaCO2-EtCO2 were 0.96 (0.43) kPa or 0.85 (0.31) kPa versus 0.55 (0.24) kPa, respectively (P<0.05 between categories). Mean EtCO2 was not different in the various MAP difference categories, but PaCO2 was greatest when MAP decreased more than 35% (P<0.05). CONCLUSIONS: There was a positive correlation between PaCO2-EtCO2 and MAP decrease shortly after induction of anesthesia. PaCO2-EtCO2 is recommended to be interpreted together with change in MAP during early phase of neuroanesthesia to guarantee optimal mechanical ventilation.

Luostarinen T; Dilmen OK; Niiya T; Niemi T

2010-10-01

243

Alcohol consumption, arterial blood pressure and general mortality rate: Twenty-years follow-up study  

Directory of Open Access Journals (Sweden)

Full Text Available Background. Alcohol consumption has both adverse and beneficial effects on health and survival. The aim of this prospective study was to examine the association between alcohol consumption and arterial hypertension as well as general mortality rate. Methods. The study included 286 participants, middle-aged men and women examined in 1974, and again in 1994 during twenty years of follow-up (mean age at the beginning of the study 43.61±7.09 years). Alcohol consumption was assessed by the specific questionnaire. Consumption levels were grouped into three categories: rare drinkers (consuming less than 6 drinks a week), moderate drinkers, who consume 1-2 alcohol drinks a day and heavy drinkers (consumers of 3 or more drinks a day). Results. In both phases of the follow-up the lowest values of systolic and diastolic pressure were recorded in the group with moderate alcohol consumption, and the highest values in the group with excessive consumption. The observed differences were statistically significant. The general mortality rates were the highest among participants reporting excessive alcohol consumption (relative risk 3.2; 95% confidence interval 1.84-5.62), and among the abstainers (relative risk 1.8; 95% confidence interval 0.99-3.36), compared to the moderate consumption group. Conclusion. Analysis of the obtained results suggested the protective effect of moderate alcohol consumption on cardiovascular system.

Jakovljevi? Branko; Stojanov Vesna J.; Paunovi? Katarina; Belojevi? Goran; Radosavljevi? Vladan

2004-01-01

244

Comparison of the effects of antihypertensive agents on central blood pressure and arterial stiffness in isolated systolic hypertension.  

UK PubMed Central (United Kingdom)

Isolated systolic hypertension is an important risk factor for cardiovascular disease and results primarily from elastic artery stiffening. Although various drug therapies are used to lower peripheral blood pressure (BP) in patients with isolated systolic hypertension, the effects of the 4 major classes of antihypertensive agents on central BP, pulse pressure (PP) amplification, and arterial stiffness in this condition are not clear. Fifty-nine patients over the age of 60 years with untreated isolated systolic hypertension (systolic BP > or =140 mm Hg and diastolic BP pressure and augmentation index varied. Because central PP and increased wave reflections are considered important risk factors in patients with isolated systolic hypertension, the choice of therapy may be influenced by these findings in the future.

Mackenzie IS; McEniery CM; Dhakam Z; Brown MJ; Cockcroft JR; Wilkinson IB

2009-08-01

245

Remifentanil does not impair left ventricular systolic and diastolic function in young healthy patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Experimental studies and investigations in patients with cardiac diseases suggest that opioids at clinical concentrations have no important direct effect on myocardial relaxation and contractility. In vivo data on the effect of remifentanil on myocardial function in humans are scarce. This study aimed to investigate the effects of remifentanil on left ventricular (LV) function in young healthy humans by transthoracic echocardiography (TTE). We hypothesized that remifentanil does not impair systolic, diastolic LV function, or both. METHODS: Twelve individuals (aged 18-48 yr) without any history or signs of cardiovascular disease and undergoing minor surgical procedures under general anaesthesia were studied. Echocardiographic examinations were performed in the spontaneously breathing subjects before (baseline) and during administration of remifentanil at a target effect-site concentration of 2 ng ml(-1) by target-controlled infusion. Analysis of systolic function focused on fractional area change (FAC). Analysis of diastolic function focused on peak early diastolic velocity of the mitral annulus (e') and on transmitral peak flow velocity (E). RESULTS: Remifentanil infusion at a target concentration of 2 ng ml(-1) did not affect heart rate or arterial pressure. There was no evidence of systolic or diastolic dysfunction during remifentanil infusion, as the echocardiographic measure of systolic function (FAC) was similar to baseline, and measures of diastolic function remained unchanged (e') or improved slightly (E). CONCLUSION: Continuous infusion of remifentanil in a clinically relevant concentration did not affect systolic and diastolic LV function in young healthy subjects during spontaneous breathing as indicated by TTE.

Bolliger D; Seeberger MD; Kasper J; Skarvan K; Seeberger E; Lurati Buse G; Buser P; Filipovic M

2011-04-01

246

Monitorização ambulatorial da pressão arterial em pacientes normotensos com hipotireoidismo subclínico Ambulatory blood pressure monitoring in normotensive patients with subclinical hypothyroidism  

Directory of Open Access Journals (Sweden)

Full Text Available FUNDAMENTO: O hipotireoidismo manifesto está associado com elevação da pressão arterial diastólica; entretanto, a associação entre o hipotireoidismo subclínico (HS) e alteração da pressão arterial (PA) é desconhecida. OBJETIVO: O objetivo do presente estudo foi avaliar a monitorização ambulatorial da pressão arterial (MAPA) por 24 horas em pacientes normotensos com HS em comparação a indivíduos normotensos eutireóideos (EU). MÉTODOS: Foi realizado um estudo transversal com 50 participantes (HS = 30 e EU = 20) que não apresentavam diferenças em relação a fatores de risco para hipertensão. A monitorização ambulatorial de pressão arterial foi realizada com um monitor Dynamapa®, utilizando-se um método oscilométrico validado pela AAMI (Association for the Advancement of Medical Instrumentation) e pela BHS (British Hypertension Society). RESULTADOS: Os níveis séricos médios de TSH e T4 livre foram respectivamente 6,9 ± 2,2 µUI/ml e 1,1 ± 0,2 ng/dl em pacientes com HS. Apesar de não haver diferença em relação à média da pressão arterial sistólica e diastólica entre os dois grupos, houve uma correlação positiva entre os níveis de pressão arterial diastólica média (PADM) e os valores séricos de TSH em pacientes com HS (r:0,477; p = 0,004). Essa correlação foi detectada por medidas diurnas (r:0,498; p = 0,002) e noturnas (r:0,322; p = 0,032). CONCLUSÃO: A pressão arterial não diferiu entre pacientes com ou sem HS; contudo, os resultados sugerem que a progressão de hipotireoidismo subclínico para níveis mais elevados de TSH pode aumentar o risco cardiovascular através do aumento da pressão arterial diastólica.BACKGROUND: Overt hypothyroidism is associated with elevation of diastolic blood pressure; however the association of subclinical hypothyroidism (SH) with arterial blood pressure (ABP) alteration is unknown. OBJECTIVE: The aim of the present study was to evaluate ambulatory blood pressure monitoring (ABPM), over 24 hours, in normotensive patients with SH in comparison to euthyroid (EU) normotensive individuals. METHODS: A cross-sectional study was performed with 50 participants (SH = 30 and EU = 20) that did not differ regarding risk factors for hypertension. The ABPM was carried out with a DINAMAPA TM monitor, using the oscillometric method validated by AAMI (Association for the Advancement of Medical Instrumentation) and by the BHS (British Hypertension Society). RESULTS: The mean serum TSH and FT4 were respectively 6.9 ± 2.2 µUI/ml and 1.1 ± 0.2 ng/dl in SH patients. Although there was no difference in the mean values of systolic and diastolic blood pressure between the two groups, there was a positive correlation between the mean values of diastolic blood pressure (DBP) and serum TSH levels in SH patients (r:0.477; p = 0.004). These correlations were detected at daytime (r:0.498; p = 0.002) and sleep-time (r:0.322; p = 0.032) measurements. CONCLUSION: The blood pressure was not different between patients with or without SH; however, the results suggest that the progression of subclinical hypothyroidism to higher levels of TSH may increase the cardiovascular risk by increasing diastolic blood pressure.

Marcia Martins Ferreira; Patricia de Fatima dos Santos Teixeira; Vera Aleta R. Mansur; Vaneska Spinelli Reuters; Cloyra Paiva Almeida; Mario Vaisman

2010-01-01

247

Monitorização ambulatorial da pressão arterial em pacientes normotensos com hipotireoidismo subclínico/ Ambulatory blood pressure monitoring in normotensive patients with subclinical hypothyroidism  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese FUNDAMENTO: O hipotireoidismo manifesto está associado com elevação da pressão arterial diastólica; entretanto, a associação entre o hipotireoidismo subclínico (HS) e alteração da pressão arterial (PA) é desconhecida. OBJETIVO: O objetivo do presente estudo foi avaliar a monitorização ambulatorial da pressão arterial (MAPA) por 24 horas em pacientes normotensos com HS em comparação a indivíduos normotensos eutireóideos (EU). MÉTODOS: Foi realizado um e (more) studo transversal com 50 participantes (HS = 30 e EU = 20) que não apresentavam diferenças em relação a fatores de risco para hipertensão. A monitorização ambulatorial de pressão arterial foi realizada com um monitor Dynamapa®, utilizando-se um método oscilométrico validado pela AAMI (Association for the Advancement of Medical Instrumentation) e pela BHS (British Hypertension Society). RESULTADOS: Os níveis séricos médios de TSH e T4 livre foram respectivamente 6,9 ± 2,2 µUI/ml e 1,1 ± 0,2 ng/dl em pacientes com HS. Apesar de não haver diferença em relação à média da pressão arterial sistólica e diastólica entre os dois grupos, houve uma correlação positiva entre os níveis de pressão arterial diastólica média (PADM) e os valores séricos de TSH em pacientes com HS (r:0,477; p = 0,004). Essa correlação foi detectada por medidas diurnas (r:0,498; p = 0,002) e noturnas (r:0,322; p = 0,032). CONCLUSÃO: A pressão arterial não diferiu entre pacientes com ou sem HS; contudo, os resultados sugerem que a progressão de hipotireoidismo subclínico para níveis mais elevados de TSH pode aumentar o risco cardiovascular através do aumento da pressão arterial diastólica. Abstract in english BACKGROUND: Overt hypothyroidism is associated with elevation of diastolic blood pressure; however the association of subclinical hypothyroidism (SH) with arterial blood pressure (ABP) alteration is unknown. OBJECTIVE: The aim of the present study was to evaluate ambulatory blood pressure monitoring (ABPM), over 24 hours, in normotensive patients with SH in comparison to euthyroid (EU) normotensive individuals. METHODS: A cross-sectional study was performed with 50 partic (more) ipants (SH = 30 and EU = 20) that did not differ regarding risk factors for hypertension. The ABPM was carried out with a DINAMAPA TM monitor, using the oscillometric method validated by AAMI (Association for the Advancement of Medical Instrumentation) and by the BHS (British Hypertension Society). RESULTS: The mean serum TSH and FT4 were respectively 6.9 ± 2.2 µUI/ml and 1.1 ± 0.2 ng/dl in SH patients. Although there was no difference in the mean values of systolic and diastolic blood pressure between the two groups, there was a positive correlation between the mean values of diastolic blood pressure (DBP) and serum TSH levels in SH patients (r:0.477; p = 0.004). These correlations were detected at daytime (r:0.498; p = 0.002) and sleep-time (r:0.322; p = 0.032) measurements. CONCLUSION: The blood pressure was not different between patients with or without SH; however, the results suggest that the progression of subclinical hypothyroidism to higher levels of TSH may increase the cardiovascular risk by increasing diastolic blood pressure.

Ferreira, Marcia Martins; Teixeira, Patricia de Fatima dos Santos; Mansur, Vera Aleta R.; Reuters, Vaneska Spinelli; Almeida, Cloyra Paiva; Vaisman, Mario

2010-06-01

248

Beat-to-beat agreement of noninvasive tonometric and intra-radial arterial blood pressure during microgravity and hypergravity generated by parabolic flights.  

UK PubMed Central (United Kingdom)

BACKGROUND: Accurate measurement of beat-to-beat arterial blood pressure is essential for understanding the cardiovascular adaptation to weightlessness; however, the intra-arterial standard of beat-to-beat blood pressure measurement has never been used during space flight because of its invasive nature. OBJECTIVES: The aim of the present study was to compare noninvasive radial artery tonometry blood pressure measurement with intra-radial pressure measurement during microgravity and hypergravity generated by parabolic flights. METHODS: Two study participants, equipped with an intra-radial pressure line on the left arm and a Colin CBM-7000 (Colin Corp., Komaki City, Japan) beat-to-beat pressure measurement apparatus on the right arm, were studied in a supine position, during parabolic flights on board of the Airbus A300 OG of the Centre National d'Etudes Spatiales. The mean and standard deviations of the beat-to-beat difference between tonometric and intra-radial blood pressure were calculated for systolic and diastolic arterial pressure in the three gravity conditions (1g, 0 g and 1.8 g) experienced during parabolic flight. RESULTS: The Colin CBM-7000 met the specifications required by the Association for the Advancement of Medical Instrumentation in the 0 g environment. Gravity, however, significantly affected the difference between tonometric and intra-arterial blood pressure, possibly owing to the effect of gravity on the apparent weight of the device and the corresponding calibration factor. CONCLUSION: We conclude that the Colin CBM-7000 can be used with confidence during space flight.

Normand H; Lemarchand E; Arbeille P; Quarck G; Vaïda P; Duretete A; Denise P

2007-12-01

249

[The pulmonary hemodynamics changes following experimental myocardial ischemia in rabbits with decreased arterial pressure].  

UK PubMed Central (United Kingdom)

In acute experiments in rabbits the changes of the pulmonary hemodynamics following myocardial ischemia in the region of the descendent left coronary artery were studied in normotensive animals and after the infusion of histamine or isoproterenol. Following histamine intravenous in fusion the pulmonary artery pressure and pulmonary vascular resistance were increased, however the pulmonary artery flow decreased. In these conditions myocardial ischemia caused the returning of the elevated pulmonary artery pressure to normal level following the diminishing of the pulmonary artery flow to the same level as in normotensive rabbits. Meanwhile the pulmonary vascular resistance remained elevated. Following isoproterenol intravenous injection the isoproterenol artery pressured and flow, pulmonary vascular resistance were decreased. In these conditions myocardial ischemia caused the decrease of the isoproterenol artert pressure, more, than in normotensive rabbits, which was the result of diminishing left atrial pressure, however, the pulmonary artery flow and pulmonary vascular resistance decreased in both cases to the same level. Thus we concluded, that following myocardial ischemia in rabbits with decreased arterial pressure, the changes of pulmonary artery pressure depend on pulmonary artery flow and left atrial pressure changes. The shifts of the pulmonary artery flow depend on venous return ones and does not correlated with pulmonary vascular resistance changes.

Evlakhov VI; Poiasov IZ

2013-04-01

250

Opposing effects of particle pollution, ozone, and ambient temperature on arterial blood pressure.  

UK PubMed Central (United Kingdom)

BACKGROUND: Diabetes increases the risk of hypertension and orthostatic hypotension and raises the risk of cardiovascular death during heat waves and high pollution episodes. OBJECTIVE: We examined whether short-term exposures to air pollution (fine particles, ozone) and heat resulted in perturbation of arterial blood pressure (BP) in persons with type 2 diabetes mellitus (T2DM). METHODS: We conducted a panel study in 70 subjects with T2DM, measuring BP by automated oscillometric sphygmomanometer and pulse wave analysis every 2 weeks on up to five occasions (355 repeated measures). Hourly central site measurements of fine particles, ozone, and meteorology were conducted. We applied linear mixed models with random participant intercepts to investigate the association of fine particles, ozone, and ambient temperature with systolic, diastolic, and mean arterial BP in a multipollutant model, controlling for season, meteorological variables, and subject characteristics. RESULTS: An interquartile increase in ambient fine particle mass [particulate matter (PM) with an aerodynamic diameter of ? 2.5 ?m (PM2.5)] and in the traffic component black carbon in the previous 5 days (3.54 and 0.25 ?g/m3, respectively) predicted increases of 1.4 mmHg [95% confidence interval (CI): 0.0, 2.9 mmHg] and 2.2 mmHg (95% CI: 0.4, 4.0 mmHg) in systolic BP (SBP) at the population geometric mean, respectively. In contrast, an interquartile increase in the 5-day mean of ozone (13.3 ppb) was associated with a 5.2 mmHg (95% CI: -8.6, -1.8 mmHg) decrease in SBP. Higher temperatures were associated with a marginal decrease in BP. CONCLUSIONS: In subjects with T2DM, PM was associated with increased BP, and ozone was associated with decreased BP. These effects may be clinically important in patients with already compromised autoregulatory function.

Hoffmann B; Luttmann-Gibson H; Cohen A; Zanobetti A; de Souza C; Foley C; Suh HH; Coull BA; Schwartz J; Mittleman M; Stone P; Horton E; Gold DR

2012-02-01

251

Pulmonary artery pressure: an intraoperative guide to limiting resection volume.  

UK PubMed Central (United Kingdom)

Lung volume reduction surgery (LVRS) has shown promising results in severe emphysema. However, intraoperative indicators are needed to define optimal resection volumes. Diffusing capacity (DLCO) worsens with larger LVRS and may correlate with pulmonary artery (PA) pressure. We hypothesized that there would be a greater increase in PA pressures with larger volume LVRS in an inhaled elastase animal emphysema model. Twenty-one rabbits were induced with 15,000 units of elastase via an endotracheal tube. Four weeks later, bilateral LVRS was performed through a median sternotomy using an endoscopic stapler. PA pressures were measured prior to LVRS, immediately after LVRS, and at sacrifice. Single-breath DLCO, static pressure-volume relationships, and forced expiratory flows were measured prior to induction and at corresponding times to PA pressures. Systolic PA pressures increased in both groups immediately after LVRS (small: 2. 67 +/- 9.2 mm Hg, ANOVA, P = 0.023; large: 3.8 +/- 8.5 mm Hg, P = 0. 002), and then decreased at time of sacrifice 1 week later (small: 9. 43 +/- 4.8 mm Hg, ANOVA, P = 0.053; large: 5.2 +/- 7.3 mm Hg, P = 0. 552). The decrease, at sacrifice, in PA pressures was greater for small LVRS animals than large LVRS animals. The mortality rate (MR) for the small resection group was 0%, whereas that for the large resection group was 24%. The MR associated with larger LVRS was appreciably greater than that associated with small LVRS. These studies suggest that PA pressures may prove to be a useful intraoperative indicator for limits of resection.

Chen JC; Powell LL; Serna DL; Gaon M; Jalal R; Huh J; McKenna R; Gelb A; Wang N; Stemmer E; Brenner M

1999-04-01

252

Pressão arterial de adolescentes de escolas particulares de Fortaleza-CE Presión arterial de adolescentes de escuelas particulares en Fortaleza-CE Blood pressure of adolescents in private schools in Fortaleza-CE  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Identificar a pressão arterial de adolescentes de escolas particulares da cidade de Fortaleza-CE. MÉTODOS: Estudo do tipo quantitativo com delineamento transversal no qual foram investigados 794 adolescentes, entre 12-17 anos de idade de 14 escolas privadas dessa cidade no período de março a setembro de 2007, mediante aplicação de um formulário que abrangeu o registro das características sóciodemográficas, pressão arterial, Índice de Massa Corporal (IMC), prática de atividade física e glicemia capilar. RESULTADOS: Verificou-se que 19,7% dos jovens apresentavam pressão arterial elevada. Os adolescentes do sexo masculino apresentaram pressão arteial sistólica (PAS) e pressão arterial diastólica (PAD) maiores do que a do sexo feminino (p=0,0001). A pesquisa constatou valores maiores de PAS e PAD naqueles com excesso de peso (p=0,0001). CONCLUSÃO: A pressão arterial foi influenciada sobretudo pelo sexo e IMC.OBJETIVO: Identificar la presión arterial de adolescentes de escuelas particulares en la ciudad de Fortaleza-CE. MÉTODOS: Se trata de un estudio cuantitativo con delineamiento transversal en el cual fueron investigados 794 adolescentes - entre 12 y 17 años de edad - de 14 escuelas privadas de esa ciudad, en el período de marzo a septiembre de 2007. Se utilizó un formulario que contempló el registro de las siguientes características: socio-demográficas, presión arterial, Índice de Masa Corporal (IMC), práctica de actividad física y, glucemia capilar. RESULTADOS: Se verificó que 19,7% de los jóvenes presentaban presión arterial elevada. Los adolescentes del sexo masculino presentaron presión arterial sistólica (PAS) y presión arterial diastólica (PAD) mayores que las del sexo femenino (p=0,0001). La investigación constató valores mayores de PAS y PAD en aquellos con exceso de peso (p=0,0001). CONCLUSIÓN: La presión arterial fue influenciada, sobre todo, por el sexo y el IMC.OBJECTIVE: To identify the blood pressure of adolescents in private schools in the city of Fortaleza-CE. METHODS: This is a cross-sectional and quantitative study in which 794 adolescents were surveyed - between 12 and 17 years of age - from 14 private schools of that city, in the period from March to September 2007. It was used a questionnaire that contemplated the following characteristics: socio-demographic, blood pressure, body mass index (BMI), physical activity and capillary glucose. RESULTS: It was found that 19.7% of young people had high blood pressure. The male participants had systolic blood pressure (SBP) and diastolic blood pressure (DBP) higher than females (p=0.0001). The investigation found higher values of SBP and DBP in those who were overweight (p=0.0001). CONCLUSION: The blood pressure was influenced mainly by gender and BMI.

Polyana Carina Viana da Silva; Márcio Flávio Moura de Araújo; Lívia Silva de Almeida; Hérica Cristina Alves de Vasconcelos; Roberto Wagner Júnior Freire de Freitas; Marta Maria Coelho Damasceno; Marcos Venícios de Oliveira Lopes

2010-01-01

253

Dynamic Stress Analysis of the Arterial Wall Utilizing Physiological Pressure Waveforms  

Directory of Open Access Journals (Sweden)

Full Text Available Arterial diseases, promoted by alterations in arterial wall properties, are among the main causes of mortality. Mechanical stresses of the arterial wall caused by pulsatile luminal pressure define arterial function in normal and pathological conditions. This study aims to determine dynamic stress distribution in the arterial wall subjected to physiological pressure waveforms. Finite element models of a typical artery are developed to evaluate Von Misses stress in the arterial wall due to physiological pressure waveforms and with differing mechanical properties. Mechanical parameters include Young's modulus of elasticity, non-linear stress-strain relationship and visco-elastic parameter. The appropriate boundary conditions are allocated to allow radial expansion. Application of physiological pulsatile pressure results in stress waves with the values and waveforms markedly influenced by mechanical properties of the arterial wall and blood pressure pulse. Elevated elastic modulus of the arterial wall results in significant increase in maximum stress. Viscoelastic property leads to reduction of the peak stress and smoothening of the stress waveform. The pressure waveform is also a major parameter affecting the stress pattern in arterial wall. Hypertensive arteries result in higher and sharper stress waves not only because of a higher systolic value but also because of the sharper waveform. The combination of these parameters produces the resultant stress pattern in the arterial wall.

M. M. Khani; M. T. Shadpour; S. Delavarpour; S. Naghizadeh; A. Avolio

2008-01-01

254

Remifentanil Prevents Tourniquet-Induced Arterial Pressure Increase in Elderly Orthopedic Patients under Sevoflurane/N2O General Anesthesia  

Directory of Open Access Journals (Sweden)

Full Text Available Aims: Prolonged tourniquet inflation produces a hyperdynamic cardiovascular response. We investigated the effect of continuous remifentanil infusion on systemic arterial pressure, heart rate, and cardiac output changes during prolonged tourniquet use in elderly patients under sevoflurane/N2O general anesthesia.Methods: Thirty female patients scheduled for knee replacement arthroplasty were infused with either remifentanil at a target organ concentration of 2.0 ng/mL (remifentanil group, n = 15) or saline (control group, n = 15) after induction of anesthesia. Anesthesia was maintained with sevoflurane and N2O. Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), cardiac index (CI), total systemic vascular resistance index (TSVRI), BIS, end-tidal sevoflurane concentration (EtSEVO), and end-tidal carbon dioxide concentration (EtCO2) were measured during the study period.Results: There were significant differences in mean HR, SAP, DAP, and EtSEVO over time between the groups (P = 0.047, P < 0.001, P = 0.017, and P < 0.001, respectively). There was a statistically significant time trend effect (P < 0.001) in HR, SAP, DAP, and CI between the groups, with a statistically significant time-group interaction between the two groups (P = 0.02, 0.007, 0.001, 0.01, respectively).Conclusion: The present study demonstrated that infusion with remifentanil prevented an increase in hemodynamic pressure during tourniquet inflation in elderly patients under sevoflurane/N2O general anesthesia.

Jun-Young Jung, Jin-Hee Han, Jae-Woo Yi, Jong-Man Kang

2012-01-01

255

Machine Learning Techniques for Arterial Pressure Waveform Analysis  

Directory of Open Access Journals (Sweden)

Full Text Available The Arterial Pressure Waveform (APW) can provide essential information about arterial wall integrity and arterial stiffness. Most of APW analysis frameworks individually process each hemodynamic parameter and do not evaluate inter-dependencies in the overall pulse morphology. The key contribution of this work is the use of machine learning algorithms to deal with vectorized features extracted from APW. With this purpose, we follow a five-step evaluation methodology: (1) a custom-designed, non-invasive, electromechanical device was used in the data collection from 50 subjects; (2) the acquired position and amplitude of onset, Systolic Peak (SP), Point of Inflection (Pi) and Dicrotic Wave (DW) were used for the computation of some morphological attributes; (3) pre-processing work on the datasets was performed in order to reduce the number of input features and increase the model accuracy by selecting the most relevant ones; (4) classification of the dataset was carried out using four different machine learning algorithms: Random Forest, BayesNet (probabilistic), J48 (decision tree) and RIPPER (rule-based induction); and (5) we evaluate the trained models, using the majority-voting system, comparatively to the respective calculated Augmentation Index (AIx). Classification algorithms have been proved to be efficient, in particular Random Forest has shown good accuracy (96.95%) and high area under the curve (AUC) of a Receiver Operating Characteristic (ROC) curve (0.961). Finally, during validation tests, a correlation between high risk labels, retrieved from the multi-parametric approach, and positive AIx values was verified. This approach gives allowance for designing new hemodynamic morphology vectors and techniques for multiple APW analysis, thus improving the arterial pulse understanding, especially when compared to traditional single-parameter analysis, where the failure in one parameter measurement component, such as Pi, can jeopardize the whole evaluation.

Vânia G. Almeida; João Vieira; Pedro Santos; Tânia Pereira; H. Catarina Pereira; Carlos Correia; Mariano Pego; João Cardoso

2013-01-01

256

Arterial pressure-urinary output relationship in hypertensive rats.  

UK PubMed Central (United Kingdom)

The steady-state relationship between mean arterial pressure (AP) and output of sodium and water was determined for one-kidney control (1KC), one-kidney Goldblatt (1KG), normotensive Wistar-Kyoto (WKY), and Okamoto spontaneously hypertensive rats (SHR). Control fluid intake (given by intravenous infusion) was set at approximately 30 ml/day Ringer solution. The infusion rate was then increased progressively to 2, 4, and 8 times control for 24- to 48-h periods each. Control AP averaged 115 Torr in 1KC, 152 Torr in 1KG, 120 Torr in WKY, and 158 Torr in SHR. The eightfold increase in salt and water intake was accompanied by almost equal increase in salt and water output and increases in AP to 157 Torr in 1KC, 190 Torr in 1KG, 126 Torr in WKY, and 166 Torr in SHR. The arterial pressure-urinary output relationship in 1KG is parallel to that of 1KC but shifted to higher AP levels. Similarly, this relationship in SHR is parallel to that of WKY but shifted to higher AP levels. This parallel shift is indicative of uniform renal vasoconstriction but normal functional renal mass in the SHR.

Norman RA Jr; Enobakhare JA; DeClue JW; Douglas BH; Guyton AC

1978-03-01

257

HIF isoforms in the skin differentially regulate systemic arterial pressure.  

Science.gov (United States)

Vascular flow through tissues is regulated via a number of homeostatic mechanisms. Localized control of tissue blood flow, or autoregulation, is a key factor in regulating tissue perfusion and oxygenation. We show here that the net balance between two hypoxia-inducible factor (HIF) transcription factor isoforms, HIF-1? and HIF-2?, is an essential mechanism regulating both local and systemic blood flow in the skin of mice. We also show that balance of HIF isoforms in keratinocyte-specific mutant mice affects thermal adaptation, exercise capacity, and systemic arterial pressure. The two primary HIF isoforms achieve these effects in opposing ways that are associated with HIF isoform regulation of nitric oxide production. We also show that a correlation exists between altered levels of HIF isoforms in the skin and the degree of idiopathic hypertension in human subjects. Thus, the balance between HIF-1? and HIF-2? expression in keratinocytes is a control element of both tissue perfusion and systemic arterial pressure, with potential implications in human hypertension. PMID:24101470

Cowburn, Andrew S; Takeda, Norihiko; Boutin, Adam T; Kim, Jung-Whan; Sterling, Jane C; Nakasaki, Manando; Southwood, Mark; Goldrath, Ananda W; Jamora, Colin; Nizet, Victor; Chilvers, Edwin R; Johnson, Randall S

2013-10-07

258

HIF isoforms in the skin differentially regulate systemic arterial pressure.  

UK PubMed Central (United Kingdom)

Vascular flow through tissues is regulated via a number of homeostatic mechanisms. Localized control of tissue blood flow, or autoregulation, is a key factor in regulating tissue perfusion and oxygenation. We show here that the net balance between two hypoxia-inducible factor (HIF) transcription factor isoforms, HIF-1? and HIF-2?, is an essential mechanism regulating both local and systemic blood flow in the skin of mice. We also show that balance of HIF isoforms in keratinocyte-specific mutant mice affects thermal adaptation, exercise capacity, and systemic arterial pressure. The two primary HIF isoforms achieve these effects in opposing ways that are associated with HIF isoform regulation of nitric oxide production. We also show that a correlation exists between altered levels of HIF isoforms in the skin and the degree of idiopathic hypertension in human subjects. Thus, the balance between HIF-1? and HIF-2? expression in keratinocytes is a control element of both tissue perfusion and systemic arterial pressure, with potential implications in human hypertension.

Cowburn AS; Takeda N; Boutin AT; Kim JW; Sterling JC; Nakasaki M; Southwood M; Goldrath AW; Jamora C; Nizet V; Chilvers ER; Johnson RS

2013-10-01

259

TRPV4-dependent dilation of peripheral resistance arteries influences arterial pressure.  

Science.gov (United States)

Transient receptor potential vanilloid 4 (TRPV4) channels have been implicated as mediators of calcium influx in both endothelial and vascular smooth muscle cells and are potentially important modulators of vascular tone. However, very little is known about the functional roles of TRPV4 in the resistance vasculature or how these channels influence hemodynamic properties. In the present study, we examined arterial vasomotor activity in vitro and recorded blood pressure dynamics in vivo using TRPV4 knockout (KO) mice. Acetylcholine-induced hyperpolarization and vasodilation were reduced by approximately 75% in mesenteric resistance arteries from TRPV4 KO versus wild-type (WT) mice. Furthermore, 11,12-epoxyeicosatrienoic acid (EET), a putative endothelium-derived hyperpolarizing factor, activated a TRPV4-like cation current and hyperpolarized the membrane of vascular smooth muscle cells, resulting in the dilation of mesenteric arteries from WT mice. In contrast, 11,12-EET had no effect on membrane potential, diameter, or ionic currents in the mesenteric arteries from TRPV4 KO mice. A disruption of the endothelium reduced 11,12-EET-induced hyperpolarization and vasodilatation by approximately 50%. A similar inhibition of these responses was observed following the block of endothelial (small and intermediate conductance) or smooth muscle (large conductance) K(+) channels, suggesting a link between 11,12-EET activity, TRPV4, and K(+) channels in endothelial and smooth muscle cells. Finally, we found that hypertension induced by the inhibition of nitric oxide synthase was greater in TRPV4 KO compared with WT mice. These results support the conclusion that both endothelial and smooth muscle TRPV4 channels are critically involved in the vasodilation of mesenteric arteries in response to endothelial-derived factors and suggest that in vivo this mechanism opposes the effects of hypertensive stimuli. PMID:19617407

Earley, Scott; Pauyo, Thierry; Drapp, Rebecca; Tavares, Matthew J; Liedtke, Wolfgang; Brayden, Joseph E

2009-07-17

260

TRPV4-dependent dilation of peripheral resistance arteries influences arterial pressure.  

UK PubMed Central (United Kingdom)

Transient receptor potential vanilloid 4 (TRPV4) channels have been implicated as mediators of calcium influx in both endothelial and vascular smooth muscle cells and are potentially important modulators of vascular tone. However, very little is known about the functional roles of TRPV4 in the resistance vasculature or how these channels influence hemodynamic properties. In the present study, we examined arterial vasomotor activity in vitro and recorded blood pressure dynamics in vivo using TRPV4 knockout (KO) mice. Acetylcholine-induced hyperpolarization and vasodilation were reduced by approximately 75% in mesenteric resistance arteries from TRPV4 KO versus wild-type (WT) mice. Furthermore, 11,12-epoxyeicosatrienoic acid (EET), a putative endothelium-derived hyperpolarizing factor, activated a TRPV4-like cation current and hyperpolarized the membrane of vascular smooth muscle cells, resulting in the dilation of mesenteric arteries from WT mice. In contrast, 11,12-EET had no effect on membrane potential, diameter, or ionic currents in the mesenteric arteries from TRPV4 KO mice. A disruption of the endothelium reduced 11,12-EET-induced hyperpolarization and vasodilatation by approximately 50%. A similar inhibition of these responses was observed following the block of endothelial (small and intermediate conductance) or smooth muscle (large conductance) K(+) channels, suggesting a link between 11,12-EET activity, TRPV4, and K(+) channels in endothelial and smooth muscle cells. Finally, we found that hypertension induced by the inhibition of nitric oxide synthase was greater in TRPV4 KO compared with WT mice. These results support the conclusion that both endothelial and smooth muscle TRPV4 channels are critically involved in the vasodilation of mesenteric arteries in response to endothelial-derived factors and suggest that in vivo this mechanism opposes the effects of hypertensive stimuli.

Earley S; Pauyo T; Drapp R; Tavares MJ; Liedtke W; Brayden JE

2009-09-01

 
 
 
 
261

Radial to Femoral Arterial Blood Pressure Differences in Septic Shock Patients Receiving High-Dose Norepinephrine Therapy.  

UK PubMed Central (United Kingdom)

CONCLUSIONS: Radial artery pressure frequently underestimates central pressure in septic shock patients receiving high-dose NE therapy. Femoral arterial pressure monitoring may be more appropriate when high-dose NE therapy is administered.

Kim WY; Jun JH; Huh JW; Hong SB; Lim CM; Koh Y

2013-10-01

262

Monitorização ambulatorial da pressão arterial e pressão casual em hiper-reatores ao esforço/ Ambulatory blood pressure monitoring and casual blood pressure in hyper-reactive individuals  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese FUNDAMENTO: O desenvolvimento de hipertensão arterial sustentada é, pelo menos, duas vezes maior em indivíduos hiper-reatores ao esforço. Poucos trabalhos têm avaliado os parâmetros da monitorização ambulatorial da pressão arterial de 24 horas (MAPA) nesses indivíduos. OBJETIVO: Avaliar a relação da pressão arterial (PA) casual com a resposta hiper-reativa ao esforço (RHR) e comparar os padrões da monitorização ambulatorial de pressão arterial (MAPA) de (more) indivíduos hiper-reatores ao esforço a um grupo controle, visando detectar alterações precoces que permitam uma atuação preventiva com implicação prognóstica. MÉTODOS: A PA casual e os dados da MAPA de 26 indivíduos adultos, com idade média de 41,50±11,78 anos, normotensos em repouso, hiper-reatores ao teste ergométrico (TE), foram comparados aos de 16 adultos, com média de idade de 41,38±11,55 anos, também normotensos em repouso, com resposta normal de PA ao esforço. Como normotensão foram considerados valores de PA 220mmHg e/ou incremento >15mmHg de pressão arterial diastólica (PAD) no TE, partindo-se de níveis de PA normais. RESULTADOS: A PAS (p=0,03) e PAD (p=0,002) casuais, a média da PAS (p=0,050) e as cargas pressóricas sistólicas na vigília (p=0,011) e nas 24 horas (p=0,017) à MAPA foram significativamente superiores nos hiper-reatores. CONCLUSÃO: A PA casual se correlacionou positivamente com a RHR. Os hiper-reatores apresentaram características peculiares na PA casual e MAPA, que, embora dentro da normalidade, se diferenciaram das observadas nos normorreatores. Abstract in english BACKGROUND: Developing hypertension is likely to be at least two times greater in individual with exaggerated blood pressure response on exercise testing (ET). Few reports have evaluated the parameters of 24-hour Ambulatory Blood Pressure Monitoring (ABPM) in normotensive individuals with exaggerated blood pressure response to exercise. OBJECTIVE: To evaluate the relationship among the casual blood pressure with hyper-reactive response on ET and to compare Ambulatory Bloo (more) d Pressure Monitoring (ABPM) data of hyper-reactive individuals with a control group in order to detect early disorders, that allows a preventive action with prognostic implication. METHODS: Casual BP measurement and parameters of ABPM of 26 adult individuals, with mean age of 41.50±11.78 years, normotensive at rest and hyper-reactive on ET was compared to those of 16 adult individuals, with mean age of 41.38±11.55 years, normotensive at rest with normal BP response on exercise. The values 15mmHg diastolic BP on ET for hyper-reactive response diagnosis. RESULTS: Hyper-reactive individuals presented the systolic (p=0.03) and diastolic (p=0.002) casual BP and mean systolic BP (p=0.050), systolic pressure load during the day (p=0.011), and systolic (p=0.017) pressure load higher when compared to the control group. CONCLUSION: Casual high normal BP had a positive correlation with exaggerated BP response. The hyper-reactive individuals showed particular characteristics in casual BP as well as in ABPM parameters, which, although within the range of reference values, differed from those of individuals with normal response to exercise.

Oliveira, Lucia Brandão de; Cunha, Ademir Batista da; Martins, Wolney de Andrade; Abreu, Rosiane Fátima Silveira de; Barros, Luciana Silva Nogueira de; Cunha, Delma Maria; Nóbrega, Antonio Cláudio Lucas da; Martins Filho, Luiz Romeu

2007-05-01

263

Monitorização ambulatorial da pressão arterial e pressão casual em hiper-reatores ao esforço Ambulatory blood pressure monitoring and casual blood pressure in hyper-reactive individuals  

Directory of Open Access Journals (Sweden)

Full Text Available FUNDAMENTO: O desenvolvimento de hipertensão arterial sustentada é, pelo menos, duas vezes maior em indivíduos hiper-reatores ao esforço. Poucos trabalhos têm avaliado os parâmetros da monitorização ambulatorial da pressão arterial de 24 horas (MAPA) nesses indivíduos. OBJETIVO: Avaliar a relação da pressão arterial (PA) casual com a resposta hiper-reativa ao esforço (RHR) e comparar os padrões da monitorização ambulatorial de pressão arterial (MAPA) de indivíduos hiper-reatores ao esforço a um grupo controle, visando detectar alterações precoces que permitam uma atuação preventiva com implicação prognóstica. MÉTODOS: A PA casual e os dados da MAPA de 26 indivíduos adultos, com idade média de 41,50±11,78 anos, normotensos em repouso, hiper-reatores ao teste ergométrico (TE), foram comparados aos de 16 adultos, com média de idade de 41,38±11,55 anos, também normotensos em repouso, com resposta normal de PA ao esforço. Como normotensão foram considerados valores de PA 220mmHg e/ou incremento >15mmHg de pressão arterial diastólica (PAD) no TE, partindo-se de níveis de PA normais. RESULTADOS: A PAS (p=0,03) e PAD (p=0,002) casuais, a média da PAS (p=0,050) e as cargas pressóricas sistólicas na vigília (p=0,011) e nas 24 horas (p=0,017) à MAPA foram significativamente superiores nos hiper-reatores. CONCLUSÃO: A PA casual se correlacionou positivamente com a RHR. Os hiper-reatores apresentaram características peculiares na PA casual e MAPA, que, embora dentro da normalidade, se diferenciaram das observadas nos normorreatores.BACKGROUND: Developing hypertension is likely to be at least two times greater in individual with exaggerated blood pressure response on exercise testing (ET). Few reports have evaluated the parameters of 24-hour Ambulatory Blood Pressure Monitoring (ABPM) in normotensive individuals with exaggerated blood pressure response to exercise. OBJECTIVE: To evaluate the relationship among the casual blood pressure with hyper-reactive response on ET and to compare Ambulatory Blood Pressure Monitoring (ABPM) data of hyper-reactive individuals with a control group in order to detect early disorders, that allows a preventive action with prognostic implication. METHODS: Casual BP measurement and parameters of ABPM of 26 adult individuals, with mean age of 41.50±11.78 years, normotensive at rest and hyper-reactive on ET was compared to those of 16 adult individuals, with mean age of 41.38±11.55 years, normotensive at rest with normal BP response on exercise. The values 15mmHg diastolic BP on ET for hyper-reactive response diagnosis. RESULTS: Hyper-reactive individuals presented the systolic (p=0.03) and diastolic (p=0.002) casual BP and mean systolic BP (p=0.050), systolic pressure load during the day (p=0.011), and systolic (p=0.017) pressure load higher when compared to the control group. CONCLUSION: Casual high normal BP had a positive correlation with exaggerated BP response. The hyper-reactive individuals showed particular characteristics in casual BP as well as in ABPM parameters, which, although within the range of reference values, differed from those of individuals with normal response to exercise.

Lucia Brandão de Oliveira; Ademir Batista da Cunha; Wolney de Andrade Martins; Rosiane Fátima Silveira de Abreu; Luciana Silva Nogueira de Barros; Delma Maria Cunha; Antonio Cláudio Lucas da Nóbrega; Luiz Romeu Martins Filho

2007-01-01

264

Prevalência de pressão arterial elevada em escolares e adolescentes de Maceió Prevalence of high blood pressure in children and adolescents from the city of Maceió, Brazil  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVOS: Definir a prevalência de pressão arterial elevada em amostra representativa de escolares e adolescentes de Maceió (Alagoas, Brasil) e pesquisar a associação de pressão arterial elevada com idade, gênero e estado nutricional. MÉTODOS: Estudo epidemiológico descritivo, transversal, randomizado, realizado entre maio de 2000 e setembro de 2002, que avaliou indivíduos de 7 a 17 anos sorteados entre 185.702 alunos de escolas públicas e privadas de Maceió. O cálculo da amostra foi realizado com base no valor esperado da prevalência de hipertensão arterial sistêmica para a faixa etária. Após a randomização, os dados foram coletados através de questionário, aferição de peso e altura e duas medidas da pressão arterial. Pressão arterial elevada foi definida como pressão arterial sistólica e/ou diastólica igual ou acima do percentil 95 em qualquer das duas medidas realizadas. RESULTADOS: A amostra final constituiu-se de 1.253 estudantes (706 do gênero feminino). Foram identificados 118 estudantes com pressão arterial elevada, média de idade de 13 anos, sendo 44% do gênero masculino. Risco de sobrepeso foi identificado em 9,3% das crianças, e sobrepeso, em 4,5%; houve associação significante dessas variáveis com pressão arterial elevada. CONCLUSÕES: A prevalência de pressão arterial elevada foi de 9,4%, e foi significantemente maior nos estudantes com sobrepeso e com risco de sobrepeso.OBJECTIVES: To define the prevalence of high blood pressure in a representative sample of children and adolescents from the city of Maceió, state of Alagoas, Brazil, and to investigate the association of high blood pressure with age, sex and nutritional status. METHODS: This cross-sectional study was carried out from May 2000 to September 2002. Individuals between 7 and 17 years of age were selected among all the 185,702 students from public and private schools. The size of the sample was defined based on the expected prevalence of hypertension for the age group. After randomization, data were collected through a questionnaire. Blood pressure was measured twice. Weight and height were also measured. High blood pressure was defined as systolic and/or diastolic blood pressure over the 95th percentile in one or in both measures. RESULTS: The final sample included 1,253 students (706 females). One hundred and eighteen students had high blood pressure (mean age 13 years; 44% males). Risk of being overweight and excess weight were identified, respectively, in 9.3 and 4.5% of the students. These variables were significantly associated with high blood pressure. CONCLUSIONS: The prevalence of high blood pressure was 9.4%. High blood pressure was significantly more frequent among overweight students and among those at risk for being overweight.

Adriana A Moura; Maria A. M Silva; Maria R. M. T Ferraz; Ivan R Rivera

2004-01-01

265

Simultaneous measurements of arterial diameter and blood pressure to determine the arterial compliance, wall mechanics and stresses in vivo.  

UK PubMed Central (United Kingdom)

BACKGROUND: to develop a periarterial dimensional clip-probe which, associated with endovascular pressure measurement, real-time digital signal processing/data treatment systems, enables characterisation of the basic wall mechanics in given arterial sites. DESIGN: experimental study. MATERIAL: a facing pair of ultrasonic crystals was incorporated in periarterial highlight probes, made of sterilisable silicone and manufactured from computer-designed stainless steel casts. The A/D converted diameter and pressure (from an endovascular micro-tip probe) signals, triggered by the ECG, were on-line processed to provide their respective profiles during an averaged cardiac cycle, and subsequently the arterial wall physics. The technique was tested in the iliac and renal arteries in eight pigs. RESULTS: the technique was found to indicate adequately that arterial responses to distending blood pressure, as given by Petersons modulus and relative pulsatility, were identical in renals and iliacs. In contrast, the compliance, circumferential incremental elastic modulus and midwall circumferential stress were higher in iliacs than in renals, whereas arterial stiffness of the renals surpassed that of the iliacs. DISCUSSION: the technique with sterilisable probes produces in vivo pressure-diameter relationships, arterial compliance, and wall mechanics and stresses, whatever the arterial size. The porcine iliacs and renals are elastic and viscorigid arteries, respectively.

Mekkaoui C; Friggi A; Rolland PH; Bodard H; Piquet P; Bartoli JM; Mesana T

2001-03-01

266

Efeito do treinamento com pesos na pressão arterial de repouso em idosas normotensas/ Effect of resistence training in blood pressure at rest in normotensive elderly  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese INTRODUÇÃO: O treinamento com pesos (TP) tem sido amplamente empregado em adultos idosos com objetivo de minimizar ou reverter os efeitos deletérios do processo de envelhecimento no sistema neuromuscular. No entanto, os potenciais benefícios do TP para a pressão arterial e frequência cardíaca de repouso de adultos idosos ainda permanecem controversos. OBJETIVO: Analisar o efeito de oito semanas de TP na pressão arterial sistólica (PAS), pressão arterial diastól (more) ica (PAD), pressão arterial média (PAM) e frequência cardíaca (FC) de repouso em idosas sem hipertensão arterial. MÉTODOS: Dezessete mulheres idosas (66,0 ± 5,8 anos) sem experiência em TP foram separadas aleatoriamente em grupo treinamento (GT; n = 10) e grupo controle (GC; n = 7). As variáveis hemodinâmicas de repouso foram avaliadas pelo método auscultatório (esfigmomanômetro de mercúrio) e frequencímetro cardíaco (Polar), antes e após oito semanas do período experimental. RESULTADOS: Reduções atribuíveis ao TP foram encontradas apenas para a PAS (-13,4 mmHg; p Abstract in english INTRODUCTION: Resistance training (RT) has been widely used for older adults in order to minimize or reverse the deleterious effects of aging in the neuromuscular system. However, the potential benefits of RT on arterial blood pressure and heart rate at rest in older adults remain controversial. OBJECTIVE: To analyze the effect of eight weeks of RT on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) in older w (more) omen without hypertension. METHODS: Seventeen women (aged 66.0 ± 5.8 years) without previous experience in RT were randomly assigned to either a training (TG, n = 10) or control (CG, n = 7) groups. Hemodynamic parameters at rest were evaluated by auscultatory method (mercury sphygmomanometer) and HR monitor (Polar), before and after eight weeks of experimental period. RESULTS: Reductions attributable to RT were found only to SBP (-13.4 mmHg, p

Gurjão, André Luiz Demantova; Gonçalves, Raquel; Carneiro, Nelson Hilário; Ceccato, Marilia; Jambassi Filho, José Claudio; Gobbi, Sebastião

2013-06-01

267

Sustained beneficial effects on blood pressure during long time retrospective follow-up after endovascular treatment of renal artery occlusion.  

Science.gov (United States)

We retrospectively evaluated short- and long-term effects of percutaneous transluminal renal angioplasty (PTRA) with or without stent placement of renal artery occlusion (RAO) upon blood pressure (BP), serum (s)-creatinine, and the need for antihypertensive treatment in 34 RAO patients who underwent PTRA during 1996-2002. In 24/34 (71%) treatment was considered technically successful, 22/24 (92%) were treated with PTRA + stent, two with only PTRA. Patients were followed for mean 2.6 (range 0-8) years, during which 14/34 (41%) patients died. In all 34 patients, systolic and diastolic BP (SBP and DBP) before treatment were 184 +/- 30/95 +/- 15 mmHg and had decreased at discharge (to 157 +/- 21/80 +/- 10 mmHg; P PTRA, absence of nephrosclerosis (P = 0.035) and a shorter duration of hypertension (P = 0.020) predicted favourable clinical outcome. No adverse effects upon s-creatinine or the need for antihypertensive medication were seen in patients in whom treatment was considered a technical failure. Seven of these patients were treated with PTRA of another renal artery than the occluded, or with embolisation. In conclusion, RAO can be treated with endovascular techniques. Technically successful results with decreasing blood pressure levels were obtained in 71% of patients. PMID:15085169

Alhadad, A; Mattiasson, I; Ivancev, K; Gottsäter, A; Lindblad, B

2004-10-01

268

Acute effect of indenolol on systemic arterial pressure and heart rate in the rat.  

Science.gov (United States)

The acute effects of single intravenous or oral doses of indenolol, as compared to that of propranolol and pindolol, on systemic blood pressure and heart rate were investigated in the rat. In reserpinized anaesthetized rats propranolol neither affected diastolic blood pressure nor heart rate and pindolol produced a dose-related tachycardia with moderate hypotensive effect. After indenolol the fall in diastolic blood pressure was concomitant with a very low increase in heart rate. Both effects were prevented by propranolol. In conscious SHRs the acute hypotensive effect of oral indenolol and pindolol was associated with marked bradycardia and moderate tachycardia respectively, while the decrease in heart rate following propranolol was concomitant to a slight increase in blood pressure. The possibility that the acute haemodynamic changes observed in rats after indenolol may be due to intrinsic sympathomimetic activity predominant at beta 2-vascular adrenergic receptor level is discussed. PMID:2871567

Zuccari, G; Falcone, A; Turba, C

1986-02-01

269

Acute effect of indenolol on systemic arterial pressure and heart rate in the rat.  

UK PubMed Central (United Kingdom)

The acute effects of single intravenous or oral doses of indenolol, as compared to that of propranolol and pindolol, on systemic blood pressure and heart rate were investigated in the rat. In reserpinized anaesthetized rats propranolol neither affected diastolic blood pressure nor heart rate and pindolol produced a dose-related tachycardia with moderate hypotensive effect. After indenolol the fall in diastolic blood pressure was concomitant with a very low increase in heart rate. Both effects were prevented by propranolol. In conscious SHRs the acute hypotensive effect of oral indenolol and pindolol was associated with marked bradycardia and moderate tachycardia respectively, while the decrease in heart rate following propranolol was concomitant to a slight increase in blood pressure. The possibility that the acute haemodynamic changes observed in rats after indenolol may be due to intrinsic sympathomimetic activity predominant at beta 2-vascular adrenergic receptor level is discussed.

Zuccari G; Falcone A; Turba C

1986-02-01

270

Avaliação comparativa entre a anestesia geral com halotano e isoflurano sobre a pressão arterial em cães/ Comparartive evaluation of the general anesthesia with halothane and isoflurane on the arterial pressure in dogs  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese As alterações produzidas pelo halotano e isoflurano sobre as pressões arteriais sistólica, diastólica e média foram avaliadas em 34 caninos de ambos os sexos e de diferentes pesos corporais e raças, todos submetidos a procedimentos cirúrgicos ortopédicos, divididos em dois grupos de 17 animais, submetidos a jejum prévio de 12 horas antes da indução anestésica. Os animais de ambos os grupos receberam sulfato de atropina 0,04mg/kg, associado ao sulfato de morfi (more) na 1,5mg/kg, administrados por via intramuscular e indução anestésica com propofol 6mg/kg por via intravenosa e a anestesia geral foi mantida com halotano no grupo I e o isoflurano no grupo II. Em ambos os grupos, o óxido nitroso na proporção 2:1 com oxigênio foi utilizado como gás diluente do anestésico volátil. Decorridos 15 minutos do início da anestesia volátil, as pressões sistólica, diastólica e média foram mensuradas pelo método oscilométrico indireto até o período de 90 minutos. Observou-se que as pressões arteriais sistólica e diastólica do grupo II foi maior a partir dos 45 minutos de manutenção com os anestésicos voláteis, não ocorrendo diferença significativa na freqüência cardíaca. Conclui-se que a manutenção anestésica com isoflurano produz valores de pressão arterial sistólica e diastólica superiores à manutenção com halotano que causou hipotensão arterial dos 45 aos 75 minutos de anestesia volátil. Abstract in english Changes in arterial systolic, diastolic, and mean blood pressure were evaluated and compared in 34 dogs anesthetized with halothane or isoflurane and submitted to orthopedic surgeries. Two groups were formed each with 17 dogs. These animals were fasted for 12 hours before anesthesia induction. Anesthetic technique was premedication with 0.04mg/kg atropine intramuscular combined 1.5mg/kg morphine intramuscular. Anesthesia was induced with 6.0mg/kg propofol intravenously. A (more) nesthesia was maintained with halothane in group I and isoflurane in group II. In both groups, nitrous oxide and oxygen in a 2:1 ratio was used as diluent for the inhalant. After 15 minutes of inhalation anesthesia, arterial blood pressures were recorded with a noninvasive blood pressure monitor in 15 minutes intervals for 90 minutes. Statistical analyses showed that there was a significant difference in systolic and diastolic pressures after 45 minutes. Differences in heart rate were not significant. In dos, general anesthesia with isoflurane maintained higher arterial blood pressures than those anesthetized with halothane which produced arterial hipotension from 45 to 75 minutes of anesthesia.

Natalini, Cláudio Corrêa; Pires, Jefferson da Silva

2000-06-01

271

Avaliação comparativa entre a anestesia geral com halotano e isoflurano sobre a pressão arterial em cães Comparartive evaluation of the general anesthesia with halothane and isoflurane on the arterial pressure in dogs  

Directory of Open Access Journals (Sweden)

Full Text Available As alterações produzidas pelo halotano e isoflurano sobre as pressões arteriais sistólica, diastólica e média foram avaliadas em 34 caninos de ambos os sexos e de diferentes pesos corporais e raças, todos submetidos a procedimentos cirúrgicos ortopédicos, divididos em dois grupos de 17 animais, submetidos a jejum prévio de 12 horas antes da indução anestésica. Os animais de ambos os grupos receberam sulfato de atropina 0,04mg/kg, associado ao sulfato de morfina 1,5mg/kg, administrados por via intramuscular e indução anestésica com propofol 6mg/kg por via intravenosa e a anestesia geral foi mantida com halotano no grupo I e o isoflurano no grupo II. Em ambos os grupos, o óxido nitroso na proporção 2:1 com oxigênio foi utilizado como gás diluente do anestésico volátil. Decorridos 15 minutos do início da anestesia volátil, as pressões sistólica, diastólica e média foram mensuradas pelo método oscilométrico indireto até o período de 90 minutos. Observou-se que as pressões arteriais sistólica e diastólica do grupo II foi maior a partir dos 45 minutos de manutenção com os anestésicos voláteis, não ocorrendo diferença significativa na freqüência cardíaca. Conclui-se que a manutenção anestésica com isoflurano produz valores de pressão arterial sistólica e diastólica superiores à manutenção com halotano que causou hipotensão arterial dos 45 aos 75 minutos de anestesia volátil.Changes in arterial systolic, diastolic, and mean blood pressure were evaluated and compared in 34 dogs anesthetized with halothane or isoflurane and submitted to orthopedic surgeries. Two groups were formed each with 17 dogs. These animals were fasted for 12 hours before anesthesia induction. Anesthetic technique was premedication with 0.04mg/kg atropine intramuscular combined 1.5mg/kg morphine intramuscular. Anesthesia was induced with 6.0mg/kg propofol intravenously. Anesthesia was maintained with halothane in group I and isoflurane in group II. In both groups, nitrous oxide and oxygen in a 2:1 ratio was used as diluent for the inhalant. After 15 minutes of inhalation anesthesia, arterial blood pressures were recorded with a noninvasive blood pressure monitor in 15 minutes intervals for 90 minutes. Statistical analyses showed that there was a significant difference in systolic and diastolic pressures after 45 minutes. Differences in heart rate were not significant. In dos, general anesthesia with isoflurane maintained higher arterial blood pressures than those anesthetized with halothane which produced arterial hipotension from 45 to 75 minutes of anesthesia.

Cláudio Corrêa Natalini; Jefferson da Silva Pires

2000-01-01

272

Effect of kefir and low-dose aspirin on arterial blood pressure measurements and renal apoptosis in unhypertensive rats with 4 weeks salt diet.  

Science.gov (United States)

Abstract We aim to study the effect of low-dose aspirin and kefir on arterial blood pressure measurements and renal apoptosis in unhypertensive rats with 4 weeks salt diet. Forty adult male Sprague-Dawley rats were divided into five groups: control, high-salt (HS) (8.0% NaCl), HS?+?aspirin (10?mg/kg), HS?+?kefir (10.0%w/v), HS?+?aspirin?+?kefir. We measured sistolic blood pressure (SBP), mean arterial pressure (MAP), diastolic pressure, pulse pressure in the rats. Cathepsin B, L, DNA fragmentation and caspase-3 activities were determined from rat kidney tissues and rats clearance of creatinine calculated. Although HS diet increased significantly SBP, MAP, diastolic pressure, pulse pressure parameters compared the control values. They were not as high as accepted hypertension levels. When compared to HS groups, kefir groups significantly decrease Cathepsin B and DNA fragmentation levels. Caspase levels were elevated slightly in other groups according to control group. While, we also found that creatinine clearance was higher in HS?+?kefir and HS?+?low-dose aspirin than HS group. Thus, using low-dose aspirin had been approximately decreased of renal function damage. Kefir decreased renal function damage playing as Angiotensin-converting enzyme inhibitor. But, low-dose aspirin together with kefir worsened rat renal function damage. Cathepsin B might play role both apoptosis and prorenin-processing enzyme. But not caspase pathway may be involved in the present HS diet induced apoptosis. In conclusion, kefir and low-dose aspirin used independently protect renal function and renal damage induced by HS diet in rats. PMID:23631764

Kanbak, Güngör; Uzuner, Kubilay; Ku?at Ol, Kevser; O?lakç?, Ay?egül; Kartkaya, Kaz?m; Sentürk, Hakan

2013-04-30

273

Effect of kefir and low-dose aspirin on arterial blood pressure measurements and renal apoptosis in unhypertensive rats with 4 weeks salt diet.  

UK PubMed Central (United Kingdom)

Abstract We aim to study the effect of low-dose aspirin and kefir on arterial blood pressure measurements and renal apoptosis in unhypertensive rats with 4 weeks salt diet. Forty adult male Sprague-Dawley rats were divided into five groups: control, high-salt (HS) (8.0% NaCl), HS?+?aspirin (10?mg/kg), HS?+?kefir (10.0%w/v), HS?+?aspirin?+?kefir. We measured sistolic blood pressure (SBP), mean arterial pressure (MAP), diastolic pressure, pulse pressure in the rats. Cathepsin B, L, DNA fragmentation and caspase-3 activities were determined from rat kidney tissues and rats clearance of creatinine calculated. Although HS diet increased significantly SBP, MAP, diastolic pressure, pulse pressure parameters compared the control values. They were not as high as accepted hypertension levels. When compared to HS groups, kefir groups significantly decrease Cathepsin B and DNA fragmentation levels. Caspase levels were elevated slightly in other groups according to control group. While, we also found that creatinine clearance was higher in HS?+?kefir and HS?+?low-dose aspirin than HS group. Thus, using low-dose aspirin had been approximately decreased of renal function damage. Kefir decreased renal function damage playing as Angiotensin-converting enzyme inhibitor. But, low-dose aspirin together with kefir worsened rat renal function damage. Cathepsin B might play role both apoptosis and prorenin-processing enzyme. But not caspase pathway may be involved in the present HS diet induced apoptosis. In conclusion, kefir and low-dose aspirin used independently protect renal function and renal damage induced by HS diet in rats.

Kanbak G; Uzuner K; Ku?at Ol K; O?lakç? A; Kartkaya K; Sentürk H

2013-04-01

274

Simulations of piezoelectric pressure sensor for radial artery pulse measurement  

International Nuclear Information System (INIS)

[en] A radial artery pulse is used to diagnose human body constitution (Prakruti) in Ayurveda. A system consisting of piezoelectric sensor (22 mm x 12 mm), data acquisition card and LabView software was used to record the pulse data. The pulse obtained from the sensor was noisy, even though signal processing was done. Moreover due to large sized senor accurate measurements were not possible. Hence, a need was felt to develop a sensor of the size of the order of finger tip with a resonant frequency of the order of 1 Hz. A micromachined pressure sensor based on piezoelectric sensing mechanism was designed and simulated using CoventorWare. Simulations were carried out by varying dimensions of the sensor to optimize the resonant frequency, stresses and voltage generated as a function of applied pressure. All simulations were done with pressure ranging of 1-30 kPa, which is the range used by Ayurvedic practitioners for diagnosis. Preliminary work on fabrication of such a sensor was carried out successfully.

2010-04-15

275

Role of carotid artery resistance to collapse during high-intrathoracic-pressure CPR.  

UK PubMed Central (United Kingdom)

The driving force for carotid artery flow during high-intrathoracic-pressure cardiopulmonary resuscitation is a peripheral arteriovenous pressure gradient resulting from differential transmission of the high intrathoracic pressure to the carotid artery but not to the jugular vein. To study the role of carotid artery resistance to collapse in establishing this differential pressure transmission, we manipulated the upstream, downstream, and surrounding pressures and measured the resultant carotid artery flow in both intact dogs and in excised arteries. Stepwise reductions in downstream pressure produced a narrowing near the outlet from the high-pressure chamber (the thorax in vivo), but increments in flow continued despite the presence of a positive (outside--inside) transmural pressure gradient. Flow limitation occurred only when downstream pressure was further decreased. Resistance to collapse was indexed by the transmural pressure at the onset of flow limitation (Pcrit), which was 7.2 +/- 1.6 mmHg in eight intact dogs. After administration of norepinephrine Pcrit increased by 2.6 +/- 0.7 mmHg, P less than 0.001). Seven excised carotid arteries also demonstrated resistance to collapse which was enhanced somewhat with norepinephrine. Thus resistance of the carotid artery to collapse is a critical factor in maintaining forward flow during high intrathoracic pressure. This resistance to collapse is also seen in vitro and can be enhanced by vasoconstricting agents.

Yin FC; Cohen JM; Tsitlik J; Zola B; Weisfeldt ML

1982-08-01

276

Smooth muscle cell contraction increases the critical buckling pressure of arteries.  

UK PubMed Central (United Kingdom)

Recent in vitro experiments demonstrated that arteries under increased internal pressure or decreased axial stretch may buckle into the tortuous pattern that is commonly observed in aging or diseased arteries in vivo. It suggests that buckling is a possible mechanism for the development of artery tortuosity. Vascular tone has significant effects on arterial mechanical properties but its effect on artery buckling is unknown. The objective of this study was to determine the effects of smooth muscle cell contraction on the critical buckling pressure of arteries. Porcine common carotid arteries were perfused in an ex vivo organ culture system overnight under physiological flow and pressure. The perfusion pressure was adjusted to determine the critical buckling pressure of these arteries at in vivo and reduced axial stretch ratios (1.5 and 1.3) at baseline and after smooth muscle contraction and relaxation stimulated by norepinephrine and sodium nitroprusside, respectively. Our results demonstrated that the critical buckling pressure was significantly higher when the smooth muscle was contracted compared with relaxed condition (97.3mmHg vs 72.9mmHg at axial stretch ratio of 1.3 and 93.7mmHg vs 58.6mmHg at 1.5, p<0.05). These results indicate that arterial smooth muscle cell contraction increased artery stability.

Hayman DM; Zhang J; Liu Q; Xiao Y; Han HC

2013-02-01

277

Revascularisation of renal artery stenosis caused by fibromuscular dysplasia: effects on blood pressure during 7-year follow-up are influenced by duration of hypertension and branch artery stenosis.  

Science.gov (United States)

Fibromuscular dysplasia (FMD) mainly affects renal arteries. Percutaneous transluminal renal angioplasty (PTRA) and surgery are effective treatments, but long-time follow-up is lacking. Retrospective follow-up for 7.0+/-4.7 years of 69 consecutive patients (age 44+/-13 years) treated for hypertension due to FMD, 59 patients underwent PTRA and eight patients surgery. In two patients no PTRA was performed. Technical success was achieved in 56 (95%) patients undergoing PTRA and all eight undergoing surgery. After successful PTRA, both systolic and diastolic blood pressures (SBP and DBP) had decreased at discharge (from 174+/-33/100+/-13 to 138+/-19/80+/-15 mmHg; PPTRA to 1.4+/-1.3 at discharge and at 1 month; PPTRA among patients with FMD only in the main renal artery than in those with branch artery involvement (43+/-29 vs 20+/-41 mmHg; P=0.0198). Beneficial effects on BP, creatinine and antihypertensive drugs also occurred after surgery. Patients on antihypertensive drugs at last follow-up had longer hypertension duration before PTRA than those without (5.9+/-7.7 vs 1.8+/-4.1 years; P=0.0349). Cure was achieved in 16 (24%), improvement in another 26(39%), and benefit in 42(63%). In conclusion, renal artery FMD, PTRA and surgery have beneficial long-term effects, negatively affected by hypertension duration and branch artery involvement. PMID:15920452

Alhadad, A; Mattiasson, I; Ivancev, K; Gottsäter, A; Lindblad, B

2005-10-01

278

Stiffness Indices and Fractal Dimension relationship in Arterial Pressure and Diameter Time Series in-Vitro  

International Nuclear Information System (INIS)

The advent of vascular diseases, such as hypertension and atherosclerosis, is associated to significant alterations in the physical properties of arterial vessels. Evaluation of arterial biomechanical behaviour is related to the assessment of three representative indices: arterial compliance, arterial distensibility and arterial stiffness index. Elasticity is the most important mechanical property of the arterial wall, whose natures is strictly non-linear. Intervention of elastin and collagen fibres, passive constituent elements of the arterial wall, is related to the applied wall stress level. Concerning this, appropriate tools are required to analyse the temporal dynamics of the signals involved, in order to characterize the whole phenomenon. Fractal geometry can be mentioned as one of those techniques. The aim of this study consisted on arterial pressure and diameter signals processing, by means of nonlinear techniques based on fractal geometry. Time series morphology was related to different arterial stiffness states, generated by means of blood flow variations, during experiences performed in vitro.

2011-12-23

279

Correlation between 24-hour profile of blood pressure and ventricular arrhythmias and their prognostic significance in patients with arterial hypertension  

Directory of Open Access Journals (Sweden)

Full Text Available Background/Aim. Left ventricular hypertrophy (LVH), apart from arterial hypertension, is a risk factor for electrophysiologic heart condition disorder and sudden cardiac death. The aim of this study was to examine a relationship between complex ventricular arrhythmias and parameters of 24-hour ambulatory blood pressure monitoring in the patients with arterial hypertension and left ventricular hypertrophy (LVH), as well as their prognostic significance during a five-year follow-up. Methods. Ninety patients with arterial hypertension and LVH were included in this study (mean age 55.2±8.3 years). There were 35 healthy people in the control group (mean age 54.5±7.1 years). Left ventricular mass index was 171.9±32.4 g/m2 in the LVH group and 102.4±13.3 g/m2 in the control group. Clinical examination, echocardiogram, 24-hour ambulatory blood pressure monitoring and 24-hour holter monitoring were done in all of the examined persons. Ventricular arrhythmias were classified by the Lown classification. Results. In the LVH group there were 54 (60.0%) of the patients with ? III Lown class. The best predictor of a Lown class were left ventricular mass index by using multivariate stepwise regression analyses (? = 0.212; p < 0.05) and small decrease of diastolic blood pressure during the night (? = -0.293; p < 0.01). The main predictor of bad prognosis was left ventricular mass index during a five year follow-up (? = 0.302; p < 0.01, for stepwise regression model: F = 8.828; p < 0.01, adjusted R2 = 0.091). Conclusion. Left ventricular arrhythmias are frequent in patients with lower decrease of blood pressure during the night. There was no correlation between the degree of ventricular arrhythmias and parameters from 24-hour blood pressure monitoring and a five-year prognosis in the patients with arterial hypertension and LVH. A bad five-year follow-up outcome of hypertensive disease depends on left ventricular mass index.

?or?evi? Dragan; Deljanin-Ili? Marina; Tasi? Ivan

2008-01-01

280

Blood pressure changes in dogs with babesiosis  

Directory of Open Access Journals (Sweden)

Full Text Available Systemic arterial blood pressures were measured in 30 dogs with acute babesiosis, 10 each with mild uncomplicated, severe uncomplicated and complicated disease. Ten healthy dogs were used as controls. Hypotension was defined as more than 3 standard deviations below the control mean. Normal mean pressures (±SD) were: systolic arterial pressure 151 (±11) mm Hg, diastolic arterial pressure 89 (±8) mm Hg and mean arterial pressure 107 (±10) mmHg. Hypotension was the most frequent abnormality, and increased strikingly in incidence as disease severity increased, with 5/10 dogs in the complicated group being hypotensive for systolic, diastolic and mean arterial pressures, compared with 2/10 in the severe uncomplicated group and 0/10 in the mild uncomplicated group. Systolic, diastolic and mean arterial pressures in the complicated group and severe uncomplicated group, and systolic pressure in the mild uncomplicated group, were significantly lower than in the controls. There were no significant relationships between arterial pressures and age, pulse rate, respiratory rate, temperature, mucous membrane colour or haematocrit. There was a significant negative correlation between arterial pressures and white cell and immature neutrophil counts. Arterial pressures differed significantly between dogs that were clinically collapsed and those that were not, but not between survivors and non-survivors. Pulse pressure (systolic - diastolic) was low in 7/10 complicated, 1/10 mild uncomplicated, and 1/10 severe uncomplicated cases, and differed significantly between the complicated and control groups. The high incidence of hypotension in clinically severe babesiosis has important implications for therapy.

L.S. Jacobson; R.G. Lobetti; T. Vaughan-Scott

2012-01-01

 
 
 
 
281

Intra-arterial blood pressure response in hypertensive subjects during low- and high-intensity resistance exercise  

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Full Text Available OBJECTIVE: The aim of this study was to describe blood pressure responses during resistance exercise in hypertensive subjects and to determine whether an exercise protocol alters these responses. INTRODUCTION: Resistance exercise has been recommended as a complement for aerobic exercise for hypertensive patients. However, blood pressure changes during this kind of exercise have been poorly investigated in hypertensives, despite multiple studies of normotensives demonstrating significant increases in blood pressure. METHODS: Ten hypertensive and ten normotensive subjects performed, in random order, two different exercise protocols, composed by three sets of the knee extension exercise conducted to exhaustion: 40% of the 1-repetition maximum (1RM) with a 45-s rest between sets, and 80% of 1RM with a 90-s rest between sets. Radial intra-arterial blood pressure was measured before and throughout each protocol. RESULTS: Compared with normotensives, hypertensives displayed greater increases in systolic BP during exercise at 80% (+80±3 vs. +62±2 mmHg, P<0.05) and at 40% of 1RM (+75±3 vs. +67±3 mmHg, P<0.05). In both exercise protocols, systolic blood pressure returned to baseline during the rest periods between sets in the normotensives; however, in the hypertensives, BP remained slightly elevated at 40% of 1RM. During rest periods, diastolic blood pressure returned to baseline in hypertensives and dropped below baseline in normotensives. CONCLUSION: Resistance exercise increased systolic blood pressure considerably more in hypertensives than in normotensives, and this increase was greater when lower-intensity exercise was performed to the point of exhaustion.

Sandra de Souza Nery; Ricardo Saraceni Gomides; Giovanio Vieira da Silva; Claudia Lucia de Moraes Forjaz; Décio Mion Jr; Tais Tinucci

2010-01-01

282

Severe hypovitaminosis D in chronic kidney disease: association with blood pressure and coronary artery calcification.  

UK PubMed Central (United Kingdom)

Hypovitaminosis D occurs early in the course of chronic kidney disease (CKD), and its association with cardiovascular morbidity and mortality is well known. In this study, we aimed to evaluate whether the degree of hypovitaminosis D may differently affect blood pressure (BP) and coronary artery calcification (CAC) in nondialyzed CKD patients. This study included 80 CKD patients with a creatinine clearance between 15 and 60?ml/min/1.73?m(2) and serum 25 hydroxivitamin D [25(OH)D] level <30?ng/ml. Patients underwent 24-h ambulatory BP monitoring, evaluation of CAC (multi-slice computed tomography), and laboratory evaluation. Two groups, based on the degree of hypovitaminosis D, were defined according to the median 25(OH)D value. Patients with severe hypovitaminosis D [25(OH)D <17.2?ng/ml; S-group) exhibited a higher systolic BP at all time periods (24-h, nighttime, daytime) when compared to patients with mild hypovitaminosis D [25(OH)D >17.2?ng/ml; M-group]. No differences were found between the S and M-group in terms of diastolic BP and the presence of coronary calcification. In the multiple linear regression analysis, severe hypovitaminosis D was a predictor of 24-h, daytime and nighttime BP after controlling for a number of confounders. The severity of hypovitaminosis D was associated with increased BP in nondialyzed CKD patients. The degree of hypovitaminosis D was not related to CAC, which was equally elevated in both the severe and mild hypovitaminosis D groups.

Pillar R; G Lopes MG; Rocha LA; Cuppari L; Carvalho AB; Draibe SA; Canziani ME

2013-05-01

283

Benidipine has effects similar to losartan on the central blood pressure and arterial stiffness in mild to moderate essential hypertension.  

UK PubMed Central (United Kingdom)

BACKGROUND: Central blood pressure (BP) is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease. Arterial stiffness is also a good predictor of cardiovascular morbidity and mortality. The effects of benidipine, a unique dual L-/T-type calcium channel blocker, on central BP have not been reported. This study aimed to compare the effect of benidipine and losartan on the central BP and arterial stiffness in mild to moderate essential hypertensives. METHODS: This 24 weeks, multi-center, open label, randomized, active drug comparative, parallel group study was designed as a non-inferiority study. The eligible patients (n = 200) were randomly assigned to receive benidipine (n = 101) or losartan (n = 99). Radial artery applanation tonometry and pulse wave analysis were used to measure the central BP, pulse wave velocity (PWV) and augmentation index (AIx). We also measured the metabolic and inflammatory markers. RESULTS: After 24 weeks, the central BP decreased significantly from baseline by (16.8 ± 14.0/10.5 ± 9.2) mmHg (1 mmHg = 0.133 kPa) (systolic/diastolic BP; P < 0.001) in benidipine group and (18.9 ± 14.7/12.1 ± 10.2) mmHg (P < 0.001) in losartan group respectively. Both benidipine and losartan groups significantly lowered peripheral BP (P < 0.001) and AIx (P < 0.05), but there were no significant differences between the two groups. The mean aortic, brachial and femoral PWV did not change in both groups after 24-week treatment. There were no significant changes of the blood metabolic and inflammatory biomarkers in each group. CONCLUSION: Benidipine is as effective as losartan in lowering the central and peripheral BP, and improving arterial stiffness.

Ihm SH; Jeon HK; Chae SC; Lim DS; Kim KS; Choi DJ; Ha JW; Kim DS; Kim KH; Cho MC; Baek SH

2013-01-01

284

Low blood pressure and antihypertensive treatment are independently associated with physical and mental health status in patients with arterial disease: the SMART study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the independent effects of antihypertensive treatment and blood pressure (BP) levels on physical and mental health status in patients with arterial disease. DESIGN AND SETTING: Cross-sectional analyses were conducted within the single-centre Secondary Manifestations of ARTerial disease (SMART) study, in a hospital care setting. SUBJECTS: A total of 5877 patients (mean age 57 years) with symptomatic and asymptomatic arterial disease underwent standardized vascular screening. MAIN OUTCOME MEASURE: The primary outcome was self-rated physical and mental health assessed using the 36-item short-form health survey. RESULTS: In the total population, antihypertensive drug use and increased intensity of antihypertensive treatment were associated with poorer health status independent of important confounders including BP levels; adjusted mean differences [95% confidence interval (CI)] in physical and mental health between n = 0 and n ? 3 antihypertensives were -1.2 (-2.1; -0.3) and -3.5 (-4.4; -2.6), respectively. Furthermore, both lower systolic and lower diastolic BP levels were related to poorer physical and mental health status independent of antihypertensive treatment. Mean differences (95% CI) in physical and mental health status per SD decrease in systolic BP were -0.56 (-0.84; -0.27) and -0.32 (-0.61; -0.03) and per SD decrease in diastolic BP were -0.50 (-0.78; -0.23) and -0.08 (-0.36; 0.20), respectively. The association between low BP and poor health status was particularly present in patients with coronary artery disease. CONCLUSIONS: In a population of patients with asymptomatic and symptomatic arterial disease, antihypertensive treatment and lower BP levels are independently associated with poorer self-rated physical and mental health. These findings suggest that different underlying mechanisms may explain these independent associations.

Muller M; Jochemsen HM; Visseren FL; Grool AM; Launer LJ; van der Graaf Y; Geerlings MI

2013-09-01

285

Non invasive assessment of carotid and femoral arterial pressure using B-mode ultrasound diameter waveforms.  

Science.gov (United States)

Non invasive local arterial blood pressure measurement has become a challenge over recent years. The aim of this study was to evaluate in a general population the validity of an alternative method to assess systolic local arterial blood pressure, from the analysis of B-mode diameter waveforms, and to estimate the accuracy when compared to carotid and femoral arterial tonometry. In 190 asymptomatic subjects (51±11 years, range: 24-73; pulse pressure: 51±11 mmHg, range: 31-93) systolic arterial pressure was obtained at the left carotid and left femoral artery by applanation tonometry (SBP(Car)_Ton and SBP(Fem)_Ton) and by automatic analysis of B-mode echographic images, calibrated using an iterative exponential model. Tonometry and echocardiography-derived pressure estimates correlated significantly (R=0.99, p<0.05). Mean difference between the two methods was only -2.5±5.0 mmHg for carotid artery (SBP(Car)_Ton: 122±18 mHg), and -2.1±5.7 mmHg for femoral artery (SBP(Fem)_Ton: 134±21 mmHg), independent of pressure level. In conclusion, alternative method was found to allow an accurate and precise estimation of systolic local arterial pressure, with an underestimation error of ? 2%. PMID:23367201

Graf, Sebastian; Craiem, Damian; Armentano, Ricardo L

2012-01-01

286

A rapid decrease in pulmonary arterial pressure by noninvasive positive pressure ventilation in a patient with chronic obstructive pulmonary disease  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The natural history of chronic obstructive pulmonary disease (COPD) is characterized by progressive decrements in expiratory airflow, increments in end-expired pulmonary volume, hypoxaemia, hypercapnia and the progression of pulmonary arterial hypertension (PAH). Noninvasive positive pressure ventil...

Dursunoglu Nese; Dursunoglu Dursun; Moray Aylin; Gur Sukru; Kavas Murat

287

Aortic stiffness determines diastolic blood flow reversal in the descending thoracic aorta: potential implication for retrograde embolic stroke in hypertension.  

UK PubMed Central (United Kingdom)

Aortic stiffening often precedes cardiovascular diseases, including stroke, but the underlying pathophysiological mechanisms remain obscure. We hypothesized that such abnormalities could be attributable to altered central blood flow dynamics. In 296 patients with uncomplicated hypertension, Doppler velocity pulse waveforms were recorded at the proximal descending aorta and carotid artery to calculate the reverse/forward flow ratio and diastolic/systolic flow index, respectively. Tonometric waveforms were recorded on the radial artery to estimate aortic pressure and characteristic impedance (Z0) and to determine carotid-femoral (aortic) and carotid-radial (peripheral) pulse wave velocities. In all subjects, the aortic flow waveform was bidirectional, comprising systolic forward and diastolic reverse flows. The aortic reverse/forward flow ratio (35±10%) was positively associated with parameters of aortic stiffness (including pulse wave velocity, Z0, and aortic/peripheral pulse wave velocity ratio), independent of age, body mass index, aortic diameter, and aortic pressure. The carotid flow waveform was unidirectional and bimodal with systolic and diastolic maximal peaks. There was a positive relationship between the carotid diastolic/systolic flow index (28±9%) and aortic reverse/forward flow ratio, which remained significant after adjustment for aortic stiffness and other related parameters. The Bland-Altman plots showed a close time correspondence between aortic reverse and carotid diastolic flow peaks. In conclusion, aortic stiffness determines the extent of flow reversal from the descending aorta to the aortic arch, which contributes to the diastolic antegrade flow into the carotid artery. This hemodynamic relationship constitutes a potential mechanism linking increased aortic stiffness, altered flow dynamics, and increased stroke risk in hypertension.

Hashimoto J; Ito S

2013-09-01

288

Avaliação da hipertensão arterial resistente pela monitorização residencial da pressão arterial Evaluación de la hipertensión arterial resistente por monitoreo residencial de la presión arterial Assessment of resistant hypertension with home blood pressure monitoring  

Directory of Open Access Journals (Sweden)

Full Text Available FUNDAMENTO: A monitorização ambulatorial da pressão arterial (MAPA) é considerada o padrão-ouro para a confirmação diagnóstica da hipertensão arterial resistente (HAR). No entanto, a monitorização residencial da pressão arterial (MRPA) tem sido considerada uma opção, pelo seu custo menor e maior conforto. OBJETIVO: Comparar os valores obtidos pela MRPA com os obtidos pela MAPA na identificação de pacientes hipertensos resistentes. MÉTODOS: Foram selecionados consecutivamente 51 pacientes hipertensos resistentes, adultos de ambos os sexos, em tratamento ambulatorial de referência, de jan/2007 a set/2009. A medida da pressão arterial (PA) casual de consultório, MAPA de 24 horas e MRPA foram realizadas conforme as diretrizes vigentes, com intervalo máximo de duas semanas entre os métodos. RESULTADOS: Ao comparar a MAPA (média de vigília) e MRPA, foi obtida boa correlação entre ambas, tanto para a pressão arterial sistólica (PAS) quanto para a diastólica (PAD): PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. A HAR foi confirmada pela MAPA em 33 pacientes e pela MRPA em 37 desses, não havendo diferença significante entre os dois métodos. CONCLUSÃO: De acordo com os resultados obtidos, conclui-se que a MRPA é um exame que pode ser utilizado como alternativa à MAPA para a confirmação diagnóstica da HAR.FUNDAMENTO: El monitoreo ambulatorio de la presión arterial (MAPA) es considerado el gold standard para la confirmación diagnóstica de la hipertensión arterial resistente (HAR). Mientras tanto, el monitoreo residencial de la presión arterial (MRPA) ha sido considerado una opción, por su costo menor y mayor confort. OBJETIVO: Comparar los valores obtenidos por la MRPA con los obtenidos por la MAPA en la identificación de pacientes hipertensos resistentes. MÉTODOS: Fueron seleccionados consecutivamente 51 pacientes hipertensos resistentes, adultos de ambos sexos, en tratamiento ambulatorio de referencia, de ene/2007-set/2009. La medida de la presión arterial (PA) casual de consultorio, MAPA de 24 horas y MRPA fueron realizadas según las directrices vigentes, con intervalo máximo de dos semanas entre los métodos. RESULTADOS: Al comparar la MAPA (media de vigilia) y MRPA, fue obtenida buena correlación entre ambas, tanto para la presión arterial sistólica (PAS) como para la diastólica (PAD): PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. La HAR fue confirmada por la MAPA en 33 pacientes y por la MRPA en 37 de esos, no habiendo diferencia significativa entre los dos métodos. CONCLUSIÓN: De acuerdo con los resultados obtenidos, se concluye que la MRPA es un examen que puede ser utilizado como alternativa a la MAPA para la confirmación diagnóstica de la HAR.BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is considered the gold standard for the diagnostic confirmation of resistant hypertension (RH). However, home blood pressure monitoring (HBPM) has been considered an option, because of its lower cost and greater comfort. OBJECTIVE: To compare the values obtained by HBPM with those obtained by ABPM in the identification of patients with resistant hypertension. METHODS: A total of 51 consecutive patients with resistant hypertension were selected. All were adults of both genders and were undergoing treatment in an outpatient referral clinic from January 2007 to September 2009. Casual office blood pressure (BP), 24-hour ABPM, and HBPM were performed according to current guidelines, with a maximum two-week interval between the methods. RESULTS: The comparison of ABPM (mean daytime) with HBPM showed a good correlation between them, both for systolic blood pressure (SBP) and for diastolic blood pressure (DBP): SBP r = 0.70, CI = 0.51-0.82, DBP r = 0.69, CI = 0.52-0.81. RH was confirmed by ABPM in 33 patients and by HBPM in 37, with no significant difference between the methods. CONCLUSION: According to the results obtained, we conclude that HBPM is a method that can be used as an alternative to ABPM for the diagnostic confirmation of

Fabiane Rosa Rezende H. Marui; Maria Teresa Nogueira Bombig; Yoná Afonso Francisco; José Marcos Thalenberg; Francisco Antonio Helfenstein Fonseca; Dilma de Souza; Francisco de Assis Costa; Maria Cristina Izar; Antonio Carlos de Camargo Carvalho; Rui Póvoa

2010-01-01

289

Avaliação da hipertensão arterial resistente pela monitorização residencial da pressão arterial/ Assessment of resistant hypertension with home blood pressure monitoring/ Evaluación de la hipertensión arterial resistente por monitoreo residencial de la presión arterial  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese FUNDAMENTO: A monitorização ambulatorial da pressão arterial (MAPA) é considerada o padrão-ouro para a confirmação diagnóstica da hipertensão arterial resistente (HAR). No entanto, a monitorização residencial da pressão arterial (MRPA) tem sido considerada uma opção, pelo seu custo menor e maior conforto. OBJETIVO: Comparar os valores obtidos pela MRPA com os obtidos pela MAPA na identificação de pacientes hipertensos resistentes. MÉTODOS: Foram seleciona (more) dos consecutivamente 51 pacientes hipertensos resistentes, adultos de ambos os sexos, em tratamento ambulatorial de referência, de jan/2007 a set/2009. A medida da pressão arterial (PA) casual de consultório, MAPA de 24 horas e MRPA foram realizadas conforme as diretrizes vigentes, com intervalo máximo de duas semanas entre os métodos. RESULTADOS: Ao comparar a MAPA (média de vigília) e MRPA, foi obtida boa correlação entre ambas, tanto para a pressão arterial sistólica (PAS) quanto para a diastólica (PAD): PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. A HAR foi confirmada pela MAPA em 33 pacientes e pela MRPA em 37 desses, não havendo diferença significante entre os dois métodos. CONCLUSÃO: De acordo com os resultados obtidos, conclui-se que a MRPA é um exame que pode ser utilizado como alternativa à MAPA para a confirmação diagnóstica da HAR. Abstract in spanish FUNDAMENTO: El monitoreo ambulatorio de la presión arterial (MAPA) es considerado el gold standard para la confirmación diagnóstica de la hipertensión arterial resistente (HAR). Mientras tanto, el monitoreo residencial de la presión arterial (MRPA) ha sido considerado una opción, por su costo menor y mayor confort. OBJETIVO: Comparar los valores obtenidos por la MRPA con los obtenidos por la MAPA en la identificación de pacientes hipertensos resistentes. MÉTODOS: (more) Fueron seleccionados consecutivamente 51 pacientes hipertensos resistentes, adultos de ambos sexos, en tratamiento ambulatorio de referencia, de ene/2007-set/2009. La medida de la presión arterial (PA) casual de consultorio, MAPA de 24 horas y MRPA fueron realizadas según las directrices vigentes, con intervalo máximo de dos semanas entre los métodos. RESULTADOS: Al comparar la MAPA (media de vigilia) y MRPA, fue obtenida buena correlación entre ambas, tanto para la presión arterial sistólica (PAS) como para la diastólica (PAD): PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. La HAR fue confirmada por la MAPA en 33 pacientes y por la MRPA en 37 de esos, no habiendo diferencia significativa entre los dos métodos. CONCLUSIÓN: De acuerdo con los resultados obtenidos, se concluye que la MRPA es un examen que puede ser utilizado como alternativa a la MAPA para la confirmación diagnóstica de la HAR. Abstract in english BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is considered the gold standard for the diagnostic confirmation of resistant hypertension (RH). However, home blood pressure monitoring (HBPM) has been considered an option, because of its lower cost and greater comfort. OBJECTIVE: To compare the values obtained by HBPM with those obtained by ABPM in the identification of patients with resistant hypertension. METHODS: A total of 51 consecutive patients with resistant (more) hypertension were selected. All were adults of both genders and were undergoing treatment in an outpatient referral clinic from January 2007 to September 2009. Casual office blood pressure (BP), 24-hour ABPM, and HBPM were performed according to current guidelines, with a maximum two-week interval between the methods. RESULTS: The comparison of ABPM (mean daytime) with HBPM showed a good correlation between them, both for systolic blood pressure (SBP) and for diastolic blood pressure (DBP): SBP r = 0.70, CI = 0.51-0.82, DBP r = 0.69, CI = 0.52-0.81. RH was confirmed by ABPM in 33 patients and by HBPM in 37, with no significant difference between the methods. CONCLUSION: According to the results obtained, we conclude that HBPM is

Marui, Fabiane Rosa Rezende H.; Bombig, Maria Teresa Nogueira; Francisco, Yoná Afonso; Thalenberg, José Marcos; Fonseca, Francisco Antonio Helfenstein; Souza, Dilma de; Costa, Francisco de Assis; Izar, Maria Cristina; Carvalho, Antonio Carlos de Camargo; Póvoa, Rui

2010-10-01

290

Monitorização ambulatorial da pressão arterial em filhos de hipertensos/ Arterial pressure monitoring in offspring of hypertensive individuals at a day-care center  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: O objetivo deste trabalho é estudar o comportamento da pressão arterial através da monitorização ambulatorial da pressão arterial (MAPA) em jovens normotensos que possuam história familiar de hipertensão. MÉTODOS: Foram avaliados pela MAPA 31 universitários normotensos, com idade entre 17 e 25 anos, cujos pais (ambos ou um deles) estivessem sendo tratados por hipertensão arterial (grupo I) e 30 indivíduos, também normotensos, cujos pais não apresen (more) tavam diagnóstico de HAS - hipertensão arterial sistêmica (grupo II). Todos os participantes tiveram dados epidemiológicos coletados e os valores de pressão arterial (PA) obtidos pela MAPA foram comparados. RESULTADOS: Não houve diferença estatística entre os grupos estudados quanto à análise das médias de PA sistólica (PAS) (p=0,195) e diastólica (PAD) (p=0,958), descenso noturno da PAS (p=0,61) e da PAD (p=0,289) e variabilidade da PAS (p=0,24) e da PAD (p=0,497). Houve significância estatística na comparação da pressão de pulso (42,74 mmHg no grupo I e 45,53 mmHg no grupo II, p=0,032) e da PAS mínima na vigília (85,00 mmHg no grupo I e 90,27 mmHg no grupo II, p=0,048). Ambos os parâmetros mencionados foram maiores nos filhos de normotensos. CONCLUSÃO: Na população estudada, houve diferença estatística significativa na pressão de pulso e PAS mínima na vigília, sendo maior nos filhos de normotensos. Os demais parâmetros da MAPA não apresentaram diferença significativa entre os grupos. Abstract in english OBJECTIVE: This study intended to evaluate blood pressure monitoring (BPM) data in young hypertensive offspring. METHODS: We evaluated 31 students, of ages ranging from 17 to 25 years, whose parents (one or both) were being treated for hypertension (group I) and 30 normotensive subjects, whose parents were not hypertensive (group II). Epidemiological data were collected from all participants and the blood pressure (BP) measurements obtained by BPM were compared. RESULTS: (more) There were no statistical differences between both groups when mean systolic blood pressure (SBP) (p=0.195) and mean diastolic blood pressure (DBP) (p=0.958); SBP decrease (p=0.61) and DBP decrease (p=0.289); SBP variability (p=0.24) and DBP variability (p=0.497) were compared. There were statistical differences, when pulse pressures (42.74 mmHg in group I and 45.53 in group II) and in the minimum SBP during the awake period (85.00 mmHg in group I and 90.27 mmHg in group II, p=0.048) were compared. Both parameters were higher in the group whose parents were not hypertensive individuals. CONCLUSION: In this population, there were statistical differences in pulse pressure and in minimum SBP during the awake period, being higher in the group whose parents were not hypertensive. There were no differences between the two groups in the other parameters analyzed.

Langowiski, André Ribeiro; Lima Junior, Emilton; Knopfholz, José; Reichert, Adriane; Nogueira, Maira Oliveira; Faria Neto, José Rocha; Guarita-Souza, Luis Cesar

2008-04-01

291

A model of internal control may improve the response time of an automatic arterial pressure controller.  

UK PubMed Central (United Kingdom)

A simplified model for the arterial pressure control system was implemented on a personal computer using Matlab Simulink. Model responses to variations of systemic vascular resistance were comparable to those predicted by physiology. Computer simulation suggested that including this model of the internal pressure control system within the design of an external controller would achieve better arterial pressure control and faster response than previous systems.

Urzua J; Sauma E; Cipriano A; Guarini M; Zapata P

1999-01-01

292

Pulmonary artery systolic pressures estimated by echocardiogram vs cardiac catheterization in patients awaiting lung transplantation.  

UK PubMed Central (United Kingdom)

BACKGROUND: At many lung transplant centers, right heart catheterization and transthoracic echocardiogram are part of the routine pre-transplant evaluation to measure pulmonary pressures. Because decisions regarding single vs bilateral lung transplant procedures and the need for cardiopulmonary bypass are often made based on pulmonary artery systolic pressures, we sought to examine the relationship between estimated and measured pulmonary artery systolic pressures using echocardiogram and catheterization, respectively. METHODS: We retrospectively reviewed all patients in our program who had measured pulmonary hypertension (n = 57). Patients with both echocardiogram-estimated and catheterization-measured pulmonary artery systolic pressures performed within 2 weeks of each other were included (n = 19). We analyzed results for correlation and linear regression in the entire group and in the patients with primary pulmonary hypertension (n = 8) and pulmonary fibrosis (n = 8). RESULTS: In patients with primary pulmonary hypertension, pulmonary artery systolic pressure was 94 +/- 27 and 95 +/- 15 mm Hg by echocardiogram and catheterization, respectively, with r(2) = 0.11; in patients with pulmonary fibrosis, 57 +/- 23 and 58 +/- 12 mm Hg with r(2) = 0.22; and in the whole group, 76 +/- 29 and 75 +/- 23 mm Hg with r(2) = 0.50. Thirty-two additional patients had mean pulmonary artery systolic pressure = 48 +/- 16 mm Hg by catheterization but either had no evidence of tricuspid regurgitation by echocardiogram (n = 22) or the pulmonary artery systolic pressure could not be measured (n = 10). CONCLUSIONS: In patients with pulmonary hypertension awaiting transplant, pulmonary artery systolic pressures estimated by echocardiogram correspond but do not serve as an accurate predictive model of pulmonary artery systolic pressures measured by catheterization. Technical limitations of the echocardiogram in this patient population often preclude estimating pulmonary artery systolic pressure.

Homma A; Anzueto A; Peters JI; Susanto I; Sako E; Zabalgoitia M; Bryan CL; Levine SM

2001-08-01

293

Self-measurement of blood pressure in arterial hypertension--preliminary results from the AMPA study.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The clinical usefulness of home blood pressure monitoring (HBPM) is still uncertain, and is currently a major topic of scientific debate. Some studies have stressed its potential role in the clinical decision-making process, but there have been few prospective studies addressing this subject. The AMPA study is intended to contribute to this debate, exploring the potential usefulness of this methodology in the clinical setting of arterial hypertension using a prospective, observational and multicenter design. METHODS: The study included 685 hypertensive patients (346 female), with a mean age of 54.2 +/- 11.1 years (range: 17-86 years). All patients were being followed in primary care centers by their family doctors, and were being treated for arterial hypertension and other comorbidities. Forty-seven patients were smokers (6%), 90 (13%) had a personal history of cardiovascular disease, 42 (6%) were diabetic, 255 (37%) had dyslipidemia, and 31 (5%) were both diabetic and dyslipidemic. Blood pressure (BP) was measured in the brachial artery with a validated automatic blood pressure measurement device (Colson MAM BP 3AA1-2; Colson, Paris). This device has solid state memory (sufficient for 60 measurements) and an adaptable printer. A cuff appropriate for the arm size of each patient was used. All patients were instructed on how to operate the device correctly and how to perform the measurements in compliance with the study protocol. BP was always measured after a 5-minute resting period in a seated position. The protocol consisted of an HBP program over a period of five working days. Each day the patient performed six BP measurements in two different periods: three in the morning (between 6 and 10 am) and three in the evening (between 6 and 10 pm). Other clinical and anthropometric data were also collected. The HBP reference values adopted were 135 mmHg for systolic and 85 mmHg for diastolic BP. RESULTS: Analysis of BP behavior over time demonstrated a significant white-coat effect, with regression to the mean of BP levels after the first day of the HBP program. As a consequence, the first day values were excluded in determining mean HBP. This behavior was independent of gender, and was more pronounced in diabetic patients. Analysis of diagnostic concordance between office BP and HBP showed discrepancies in 27.4% of the patients. This prompted a change in diagnosis based on HBP values, with 133 patients (19.4%) presenting uncontrolled office BP levels but normal HBP values, while 55 patients (8%) had elevated HBP in contrast to normal office BP. CONCLUSIONS: These first results of the AMPA study illustrate the superiority of HBP compared with office BP in the evaluation of hypertensive patients. HBP provides a better characterization of each patient's BP profile, and hence may help improve therapeutic and clinical decisions. Confirmation of the potential of HBP monitoring will be addressed in a prospective analysis (6-year follow-up) of the AMPA study in the near future.

Maldonado J; Pereira T

2009-01-01

294

Using the changes in hydrostatic pressure and pulse transit time to measure arterial blood pressure.  

Science.gov (United States)

The pulse transit time (PTT)-based method has been proposed as a noninvasive and cuffless alternative for monitoring blood pressure (BP). Yet, a major challenge of the technology is to overcome the requirement of individual calibration. In this study, we aim to explore the possibility of using the changes in hydrostatic pressure and PTT for estimating BP without a calibrating procedure. Eight subjects (aged 35+/-15 years) participated in the study and their PTT were recorded during an arm movement exercise. The results of the study found that PTT increases correspondingly with the height of the arm the subjects raised. Moreover, the calculated changes in PTT agree with that derived from the theoretical model using parameter values which were previously reported in literature. To conclude, the cuffless approach presented in this paper is potentially useful for the estimation of arterial BP. PMID:18002460

Poon, Carmen C Y; Zhang, Y T

2007-01-01

295

Using the changes in hydrostatic pressure and pulse transit time to measure arterial blood pressure.  

UK PubMed Central (United Kingdom)

The pulse transit time (PTT)-based method has been proposed as a noninvasive and cuffless alternative for monitoring blood pressure (BP). Yet, a major challenge of the technology is to overcome the requirement of individual calibration. In this study, we aim to explore the possibility of using the changes in hydrostatic pressure and PTT for estimating BP without a calibrating procedure. Eight subjects (aged 35+/-15 years) participated in the study and their PTT were recorded during an arm movement exercise. The results of the study found that PTT increases correspondingly with the height of the arm the subjects raised. Moreover, the calculated changes in PTT agree with that derived from the theoretical model using parameter values which were previously reported in literature. To conclude, the cuffless approach presented in this paper is potentially useful for the estimation of arterial BP.

Poon CC; Zhang YT

2007-01-01

296

Diets rich in conjugated linoleic acid and vaccenic acid have no effect on blood pressure and isobaric arterial elasticity in healthy young men  

DEFF Research Database (Denmark)

The objective of this study was to examine the effect on blood pressure (BP) and isobaric arterial elasticity (AE), as a measure of arterial health, of a commercial mixture of conjugated linoleic acids (CLA) and of milk fat produced through livestock feeding to have a high content of vaccenic acid (VA). Healthy young men (n = 60) with a BMI of 22.5 +/- 2 kg/m(2) (mean +/- SD) participated in this double-blind, randomized, 5-wk, parallel intervention study. The participants substituted 115 g of their daily fat intake with fat from 1 of 3 test diets: 1) CLA-diet rich in CLA (4.7 g/d of c9, t11- and t10, c12-CLA isomers in equal amounts); 2) VA-diet rich in VA (3.6 g/d); or 3) C-diet, a control diet with a low content of VA and CLA. All test diets were based on milk fat. BP and AE (measured by an oscillometric method) were measured before and after the intervention period. The effects of the test diets did not differ on any outcome variable: e.g., systolic- and diastolic blood pressure (SBP and DBP), pulse pressure (PP), isobaric arterial compliance (AC), distensibility (AD), or volume (AV). In conclusion, diets rich in milk fat and either CLA or VA have no effect on BP or AE indices in healthy young men compared with a control diet.

Raff, M.; Tholstrup, T.

2006-01-01

297

[Chronological structure of arterial pressure in hypertensive patients on enalapril  

UK PubMed Central (United Kingdom)

34 male patients with hypertension stage I and II aged 29-52 years (mean age 40.9 +/- 6.00) having mean 24-h arterial pressure (AP) above 135/85 mm Hg in mean daytime AP above 140/90 mm Hg and heart rate maximum 80 b/m entered the study of AP chronostructure in conditions of pure background and on enalapril treatment week 4, 8 and 12. The initial dose of the drug was 5 mg. Dose selection was controlled by 24-h AP monitoring. Enalapril was shown to significantly reduce mean daytime and 24-h AP as well as hyperbaric index, chronobiological time index, variability of systolic AP. The above dose selection brought more balanced AP lowering at daytime and at night. After 11 weeks of treatment no night-peakers were registered, the number of over-dippers decreased. Circadian rhythm of some hemodynamic parameters was characterized by a significant fall of rhythm average in unchanged acrophase and circadian AP amplitude indicating physiological action of enalapril.

Gapon LI; Gubin DG; Semukhin EN; Gubin GD

2001-01-01

298

[Chronological structure of arterial pressure in hypertensive patients on enalapril].  

Science.gov (United States)

34 male patients with hypertension stage I and II aged 29-52 years (mean age 40.9 +/- 6.00) having mean 24-h arterial pressure (AP) above 135/85 mm Hg in mean daytime AP above 140/90 mm Hg and heart rate maximum 80 b/m entered the study of AP chronostructure in conditions of pure background and on enalapril treatment week 4, 8 and 12. The initial dose of the drug was 5 mg. Dose selection was controlled by 24-h AP monitoring. Enalapril was shown to significantly reduce mean daytime and 24-h AP as well as hyperbaric index, chronobiological time index, variability of systolic AP. The above dose selection brought more balanced AP lowering at daytime and at night. After 11 weeks of treatment no night-peakers were registered, the number of over-dippers decreased. Circadian rhythm of some hemodynamic parameters was characterized by a significant fall of rhythm average in unchanged acrophase and circadian AP amplitude indicating physiological action of enalapril. PMID:11490421

Gapon, L I; Gubin, D G; Semukhin, E N; Gubin, G D

2001-01-01

299

Avaliação das pressões sistólica, diastólica e pressão de pulso como fator de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST/ Evaluation of systolic, diastolic, and pulse pressure as risk factors for severe coronary arteriosclerotic disease in women with unstable angina non-ST-elevation acute myocardial infarction  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Avaliar se as pressões, medidas na raiz da aorta, são fatores de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST (AI/IAMSS). MÉTODO:As pressões, assim como os fatores de risco para doença arterial coronariana (DAC) foram prospectivamente coletados de março/1993 a agosto/2001 em 593 mulheres com diagnóstico de AI/IAMSS submetidas à cinecoronariogra (more) fia. Lesões coronarianas definidas como graves estenoses > 70%. RESULTADOS: Idade média de 59,2±11,2 anos, significantemente mais alta nas pacientes com DAC: 61,9 ± 10,8 anos vs 56.4 ± 10,8 anos; tabagismo, diabetes e climatério foram mais freqüentes nas pacientes com DAC. As médias das pressões sistólica e arterial média foram iguais nos dois grupos, entretanto as médias das pressões diastólicas do ventrículo esquerdo (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001) e da pressão de pulso aórtica foram significantemente maiores nas pacientes com DAC (75.5 ± 22 x 70 ± 19, p=0.002), enquanto a média da pressão diastólica aórtica foi significantemente mais alta nas pacientes sem DAC (75.3 ± 17.5 x 79.8 ± 16, p=0.003). Na análise multivariada a pressão de pulso > 80 mmHg e pressão sistólica > 165 foram independentemente associadas a DAC com razão de chance de 2.12 e 2.09, p 80 mmHg e pressão sistólica > 165 mmHg determinaram risco duas vezes maior de lesão coronariana grave. Abstract in english OBJECTIVE: To evaluate pressures assessed at the aortic root as risk factors for severe atherosclerotic coronary heart disease in women with unstable angina/compatible clinical history associated with increase in cardiac enzymes (total CPK and CK-MB) 2 times greater than the standard value used in the hospital, with the absence of new Q waves on the electrocardiogram (UA/NSTEMI). METHODS: Five hundred and ninety-three female patients with clinical diagnosis of UA/NSTEMI u (more) nderwent cinecoronariography from March 1993 to August 2001, and the risk factors for CHD were studied. During examination the pressures, at the aortic root, and coronary obstructions were visually assessed by 2 interventional cardiologists, and those stenosis over 70% were considered severe. RESULTS: Eight-one per cent of the population was white and 18.3% was black. Mean age was 59.2±11.2 years, and it was significantly higher in patients with severe coronary lesions: 61.9 ± 10.8 years versus 56.4 ± 10.8 years; smoking, diabetes mellitus and climacteric were more frequent in patients with CHD. The average mean arterial pressure and mean systolic blood pressure was the same in both groups, however, average left ventricle diastolic pressure (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001), and aortic pulse pressure were significantly greater in patients with CHD (75.5 ± 22 x 70 ± 19, p=0.002), while average aortic diastolic pressure was significantly greater in patients without CHD (79.8 ± 16 x 75.3 ± 17.5, p=0.003). In the multivariated analysis, pulse pressure > 80 mmHg and systolic blood pressure > 165 were independently associated with severe CHD with odds ratio of 2.12 and 2.09, p 80 mmHg and systolic blood pressure > 165 mmHG determined risk two times greater of severe coronary disease.

Sousa, José Marconi Almeida de; Hermann, João L. V.; Guimarães, João B.; Menezes, Pedro Paulo O.; Carvalho, Antonio Carlos Camargo

2004-05-01

300

Avaliação das pressões sistólica, diastólica e pressão de pulso como fator de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST Evaluation of systolic, diastolic, and pulse pressure as risk factors for severe coronary arteriosclerotic disease in women with unstable angina non-ST-elevation acute myocardial infarction  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Avaliar se as pressões, medidas na raiz da aorta, são fatores de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST (AI/IAMSS). MÉTODO:As pressões, assim como os fatores de risco para doença arterial coronariana (DAC) foram prospectivamente coletados de março/1993 a agosto/2001 em 593 mulheres com diagnóstico de AI/IAMSS submetidas à cinecoronariografia. Lesões coronarianas definidas como graves estenoses > 70%. RESULTADOS: Idade média de 59,2±11,2 anos, significantemente mais alta nas pacientes com DAC: 61,9 ± 10,8 anos vs 56.4 ± 10,8 anos; tabagismo, diabetes e climatério foram mais freqüentes nas pacientes com DAC. As médias das pressões sistólica e arterial média foram iguais nos dois grupos, entretanto as médias das pressões diastólicas do ventrículo esquerdo (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001) e da pressão de pulso aórtica foram significantemente maiores nas pacientes com DAC (75.5 ± 22 x 70 ± 19, p=0.002), enquanto a média da pressão diastólica aórtica foi significantemente mais alta nas pacientes sem DAC (75.3 ± 17.5 x 79.8 ± 16, p=0.003). Na análise multivariada a pressão de pulso > 80 mmHg e pressão sistólica > 165 foram independentemente associadas a DAC com razão de chance de 2.12 e 2.09, p 80 mmHg e pressão sistólica > 165 mmHg determinaram risco duas vezes maior de lesão coronariana grave.OBJECTIVE: To evaluate pressures assessed at the aortic root as risk factors for severe atherosclerotic coronary heart disease in women with unstable angina/compatible clinical history associated with increase in cardiac enzymes (total CPK and CK-MB) 2 times greater than the standard value used in the hospital, with the absence of new Q waves on the electrocardiogram (UA/NSTEMI). METHODS: Five hundred and ninety-three female patients with clinical diagnosis of UA/NSTEMI underwent cinecoronariography from March 1993 to August 2001, and the risk factors for CHD were studied. During examination the pressures, at the aortic root, and coronary obstructions were visually assessed by 2 interventional cardiologists, and those stenosis over 70% were considered severe. RESULTS: Eight-one per cent of the population was white and 18.3% was black. Mean age was 59.2±11.2 years, and it was significantly higher in patients with severe coronary lesions: 61.9 ± 10.8 years versus 56.4 ± 10.8 years; smoking, diabetes mellitus and climacteric were more frequent in patients with CHD. The average mean arterial pressure and mean systolic blood pressure was the same in both groups, however, average left ventricle diastolic pressure (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001), and aortic pulse pressure were significantly greater in patients with CHD (75.5 ± 22 x 70 ± 19, p=0.002), while average aortic diastolic pressure was significantly greater in patients without CHD (79.8 ± 16 x 75.3 ± 17.5, p=0.003). In the multivariated analysis, pulse pressure > 80 mmHg and systolic blood pressure > 165 were independently associated with severe CHD with odds ratio of 2.12 and 2.09, p 80 mmHg and systolic blood pressure > 165 mmHG determined risk two times greater of severe coronary disease.

José Marconi Almeida de Sousa; João L. V. Hermann; João B. Guimarães; Pedro Paulo O. Menezes; Antonio Carlos Camargo Carvalho

2004-01-01

 
 
 
 
301

Cuffless and noninvasive tonometry mean arterial pressure measurement by physiological characteristics and applied pressure.  

UK PubMed Central (United Kingdom)

We developed a cuffless and noninvasive measurement technique of blood pressure using tonometric pressure sensor. With observation that the maximum value of a pulse pressure is not obtained at mean arterial pressure (MAP), we have figured out MAP based on the physiological characteristic including the elasticity of wrist tissue, the depth of blood vessel. Through an analysis of 198 clinic data, we have induced the regression equation of the MAP. The probability of the elasticity, depth and AP(M) to explain MAP was 92.1%. The mean difference and the standard deviation between the MAP predicted from the regression equation and the MAP measured by commercial cuff type BP meter were Z-3.183 mmHg and 5.133 mmHg respectively. Comparing the results with the American national standard for electronic or automated sphygmomanometers, we can conclude that the results are quite reliable and promising. Detecting only one part of the body and using only one device are quite advantageous over other BP measurement technique. Our technique makes new way for the cuffless BP measurement.

Park M; Kang H; Huh Y; Kim KC

2006-01-01

302

Cuffless and noninvasive tonometry mean arterial pressure measurement by physiological characteristics and applied pressure.  

Science.gov (United States)

We developed a cuffless and noninvasive measurement technique of blood pressure using tonometric pressure sensor. With observation that the maximum value of a pulse pressure is not obtained at mean arterial pressure (MAP), we have figured out MAP based on the physiological characteristic including the elasticity of wrist tissue, the depth of blood vessel. Through an analysis of 198 clinic data, we have induced the regression equation of the MAP. The probability of the elasticity, depth and AP(M) to explain MAP was 92.1%. The mean difference and the standard deviation between the MAP predicted from the regression equation and the MAP measured by commercial cuff type BP meter were Z-3.183 mmHg and 5.133 mmHg respectively. Comparing the results with the American national standard for electronic or automated sphygmomanometers, we can conclude that the results are quite reliable and promising. Detecting only one part of the body and using only one device are quite advantageous over other BP measurement technique. Our technique makes new way for the cuffless BP measurement. PMID:17946765

Park, Mikyoung; Kang, HeeJung; Huh, Young; Kim, Kyung-Chul

2006-01-01

303

The pulsed Doppler and tissue Doppler-derived septal E/e' ratio is significantly related to invasive measurement of ventricular end-diastolic pressure in biventricular rather than univentricular physiology in patients with congenital heart disease.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The value of conventional non-invasive Doppler parameters to predict ventricular end-diastolic pressure (EDP) and diastolic function in congenital heart diseases is limited. The aim of our prospective study was to investigate whether the ratio of mitral early blood inflow velocity to early diastolic velocity of the mitral annulus (E/e') as assessed by pulsed tissue Doppler is related to EDP in patients with different congenital heart disease (CHD) undergoing left heart catheterization. METHODS: A total of 115 hospital inpatients (64 male) with different CHD referred for cardiac catheterization were simultaneously examined by echocardiography for non-invasive estimation of ventricular EDP during heart catheterization. The mean age at catheterization was 8.71 years (range 3 days to 18 years). These patients were divided into two groups according to the different hemodynamic and morphology conditions: group A consisted of patients with biventricular heart and group B of patients with univentricular heart. RESULTS: For all the studied patients, a significant positive correlation was found between E/e' and EDP (r = 0.54, P < 0.001). EDP correlated rather weakly with combined measurements E/global LV early diastolic velocity (r = 0.27, P = 0.02). A significant relationship was also found between ventricular EDP and early mitral inflow velocity E (r = 0.36, P = 0.001). The ratio of pulmonary venous flow velocities s/d was not found to be related to invasively measured EDP (r = -0.16, P = 0.13). Group A (n = 96) had similar results, but for group B (n = 19), these parameters did not show a relationship to EDP. The analysis of these parameters showed that the larger area under the curve (AUC) was found for the ratio of E/e' (AUC = 0.77) compared with E/global e' (AUC = 0.57). E/e' > 10.7 had 69 % sensitivity and 81 % specificity for EDP > 10 mmHg. CONCLUSION: Doppler and tissue Doppler-derived E/e' ratio is related to simultaneous invasive measurement of EDP in a heterogeneous group of patients with CHD and may provide an additional surrogate non-invasive estimation of ventricular diastolic performance in the routine follow-up of these patients.

Mi YP; Abdul-Khaliq H

2013-08-01

304

Diving-induced venous gas emboli do not increase pulmonary artery pressure.  

UK PubMed Central (United Kingdom)

Venous gas emboli are frequently observed in divers even if proper decompression procedures are followed. This study was initiated to determine if pulmonary artery pressure increases in asymptomatic divers, which could increase the risk of arterial embolization due to passage of venous gas emboli from the right to the left side of the heart. Recordings of venous gas emboli and estimation of pulmonary artery pressure by non-invasive transthoracic echocardiography were applied in 10 recreational scuba diving volunteers before and 20, 40, 60, and 80 min after simulated dives to 18 m (80 min bottom time) in a hyperbaric chamber. The ratio between pulmonary artery acceleration time and right ventricular ejection time was used as an estimate of pulmonary artery pressure. None of investigated divers had signs of decompression sickness. Despite the post-dive presence of the venous gas emboli, measured in the region of the pulmonary valve annulus (mean=1.71 bubbles.cm-2, 40 min after dive), the ratio between pulmonary artery acceleration time and right ventricular ejection time did not decrease, but actually increased (from 0.43+/-0.06 to 0.49+/-0.06, 40 min after dive; p<0.05), suggesting a decrease in pulmonary artery pressure after the dive. We conclude that diving-induced venous gas bubbles do not cause significant changes in the central circulation which could increase the risk of arterial embolization.

Valic Z; Duplanci? D; Bakovi? D; Ivancev V; Eterovi? D; Wisløff U; Brubakk AO; Duji? Z

2005-10-01

305

An Inexpensive Arterial Pressure Wave Sensor and its application in different physiological condition  

CERN Multimedia

Arterial Blood Pressure wave monitoring is considered to be important in assessment of cardiovascular system. We developed a novel pulse wave detection system using low frequency specific piezoelectric material as pressure wave sensor. The transducer detects the periodic change in the arterial wall diameter produced by pressure wave and the amplified signal after integration represents the pressure wave. The signal before integration is proportional to the rate of change of pressure wave and it not only reproduces the pressure waveform faithfully, but also its sharper nature helps to reliably detect the heart period variability (HPV). We have studied the position-specific (e.g. over carotid or radial artery) nature of change of this pulse wave signal (shape and amplitude) and also the changes at different physiological states.

Sur, S; Sur, Shantanu

2005-01-01

306

[Evaluation of a method for ambulatory and automatic measurement of nyctohemeral arterial pressure  

UK PubMed Central (United Kingdom)

This study was designed to evaluate a method of automatic non-invasive ambulatory blood pressure monitoring. Using a Del Mar Avionics Pressurometer II, we tested 12 normal subjects at rest and during exercise in our laboratory, and 12 patients with borderline hypertension during 24 hours of normal activity. At rest correlation coefficient of sequential measurements between pressurometer and a standard mercury sphygmomanometer were 0.96 for individual systolic measurements, 0.65 for individual diastolic measurements, and 0.99 for sequentially coupled diastolic or systolic measurements. The same correlation coefficients were found during a low level exercise test on cycloergometer (50 watts); at a higher level (75 watts), the correlation coefficient for systolic measurements is still high (0.93), whereas for diastolic measurements the correlation coefficient is low (0.45) in our experimental conditions. Fifty-eight non-invasive ambulatory recordings were obtained during normal daily activities. About 10% of the measurements were eliminated because of artefacts. We conclude that the nycthemeral fluctuations of the blood pressure can be reasonably estimated by the Del Mar Avionics Pressurometer II, but that such results can be obtained only if special attention is given to the positioning of the pressurometer on a motivated patient.

Barthélémy JC; Adamec R; Campanini C; Ratib O; Mérier G

1983-06-01

307

Pressão arterial após programa de exercício físico supervisionado em mulheres idosas hipertensas/ Blood pressure after supervised physical exercise program in elderly women with hypertension  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese INTRODUÇÃO: A população de idosos tem elevado os índices de doenças crônicas como hipertensão arterial sistêmica (HAS) com prevalência em mulheres. Intervenções não farmacológicas, como o exercício físico, são apontadas pela eficácia na diminuição da pressão arterial (PA). OBJETIVO: Verificar a resposta da pressão arterial de idosas hipertensas nos distintos momentos de um programa de exercício físico supervisionado (PEFS). MÉTODOS: Constituiu-se (more) de um estudo descritivo de corte transversal realizado durante 18 semanas. Participaram 41 mulheres idosas com HAS, em tratamento farmacológico, distribuídas em grupo experimental (GE) (n = 26) que participou da intervenção, e grupo controle (GC) (n = 15), em dois momentos: pré e pós-PEFS. O IMC, a pressão arterial sistólica (PAS) e diastólica (PAD) foram avaliados no início e após 18 semanas de PEFS no GE e GC. A comparação intra e intergrupos foi feita com o teste t pareado e ANOVA two way com Kruskal Wallis, com nível de significância de p Abstract in english INTRODUCTION: The elderly population has increased the levels of chronic diseases such as hypertension (HBP) with prevalence in women. Non-pharmacological interventions, such as exercise, have been indicated by the effectiveness in lowering blood pressure (BP). OBJECTIVE: To analyze the blood pressure response in elderly hypertensive women in the different moments of a supervised physical exercise program (SPEP). METHODS: It consisted of a cross-sectional descriptive stud (more) y carried out for 18 weeks. 41 elderly women with hypertension, under pharmacological treatment, distributed in the experimental group (EG) (n=26) which participated in the intervention, and control group (CG) (n=15) in two stages: before and after SPEP. BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were evaluated at baseline and after 18 weeks of SPEP in the EG and CG. The intra and inter comparison was made with the paired t test and two-way ANOVA with Kruskal Wallis test, with a significance level of p

Rêgo, Adriana Ribeiro de O. N. do; Gomes, André L. M.; Veras, Renato P.; A. Júnior, Edmundo de Drummond; M.N., Rodolfo Alkimin; Dantas, Estélio H. M.

2011-10-01

308

Comparison of invasive blood pressure measurements from the caudal ventral artery and the femoral artery in male adult sd and wistar rats.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE: Studies have suggested that the caudal ventral artery is a potential site for continuous arterial blood pressure monitoring in rats. However, the agreement of mean arterial pressure values between the femoral artery and the caudal ventral artery has not been investigated. This study was performed to identify whether the caudal ventral artery could be safely used for continuous blood pressure monitoring as an alternative site to the femoral artery. METHODS: Rats were randomized into four groups: Sprague Dawley rats under normothermia; Wistar rats under normothermia; Sprague Dawley rats under hypothermia; Wistar rats under hypothermia. Each rat underwent simultaneous monitoring of blood pressure using femoral artery and caudal ventral artery catheterization during a stable hemodynamic state and three periods of acute severe hemodynamic changes. The effects of rat strain, rectal temperature, experimental time course and hemodynamic factors on pressure gradients, the concordance of mean arterial pressure values between the femoral artery and the caudal ventral artery, and the rates of distal ischemia after surgery were determined. RESULTS: There was a significant difference in the rate of distal ischemia between femoral and caudal ventral arteries after catheterization (25% vs 5%, P<0.05). The overall mean gradient and the mean gradient under a steady hemodynamic state were 4.9±3.7 mm Hg and 5.5±2.5 mm Hg, respectively. The limits of agreement (bias±1.96 SD) were (-2.5 mm Hg, 12.3 mm Hg) and (-0.5 mm Hg, 10.5 mm Hg), respectively. Although the concordance decreased during the first 30 sec of each period of severe hemodynamic changes, the degree of agreement was acceptable regardless of the effects of rat strain and rectal temperature. CONCLUSIONS: Based on the degree of agreement and the safety of catheterization, the caudal ventral artery may be a preferred site for continuous arterial blood pressure monitoring without acute severe hemodynamic changes.

Wang Y; Cong Y; Li J; Li X; Li B; Qi S

2013-01-01

309