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Sample records for artery diastolic pressure

  1. Proportional Relations Between Systolic, Diastolic and Mean Pulmonary Artery Pressure are Explained by Vascular Properties

    OpenAIRE

    Kind, Taco; Faes, Theo J. C.; Vonk-Noordegraaf, Anton; Westerhof, Nico

    2010-01-01

    Recently, it was shown that proportional relationships exist between systolic, diastolic and mean pulmonary artery pressure (P sys, P dia and P mean) and that they are maintained under various conditions in both health and disease. An arterial-ventricular interaction model was used to study the contribution of model parameters to the ratios P sys/P mean, and P dia/P mean. The heart was modeled by a time-varying elastance function, and the arterial system by a three-element windkessel model co...

  2. Influence of isoflurane on the diastolic pressure-flow relationship and critical occlusion pressure during arterial CABG surgery: a randomized controlled trial

    Science.gov (United States)

    Hinz, José; Hanekop, Gerd G.; Weyland, Andreas; Popov, Aron F.; Schmitto, Jan D.; Bauer, Martin; Kazmaier, Stephan

    2016-01-01

    The effects of isoflurane on the determinants of blood flow during Coronary Artery Bypass Graft (CABG) surgery are not completely understood. This study characterized the influence of isoflurane on the diastolic Pressure-Flow (P-F) relationship and Critical Occlusion Pressure (COP) during CABG surgery. Twenty patients undergoing CABG surgery were studied. Patients were assigned to an isoflurane or control group. Hemodynamic and flow measurements during CABG surgery were performed twice (15 minutes after the discontinuation of extracorporeal circulation (T15) and again 15 minutes later (T30)). The zero flow pressure intercept (a measure of COP) was extrapolated from a linear regression analysis of the instantaneous diastolic P-F relationship. In the isoflurane group, the application of isoflurane significantly increased the slope of the diastolic P-F relationship by 215% indicating a mean reduction of Coronary Vascular Resistance (CVR) by 46%. Simultaneously, the Mean Diastolic Aortic Pressure (MDAP) decreased by 19% mainly due to a decrease in the systemic vascular resistance index by 21%. The COP, cardiac index, heart rate, Left Ventricular End-Diastolic Pressure (LVEDP) and Coronary Sinus Pressure (CSP) did not change significantly. In the control group, the parameters remained unchanged. In both groups, COP significantly exceeded the CSP and LVEDP at both time points. We conclude that short-term application of isoflurane at a sedative concentration markedly increases the slope of the instantaneous diastolic P-F relationship during CABG surgery implying a distinct decrease with CVR in patients undergoing CABG surgery.

  3. Usefulness of Diastolic Strain Measurements in Predicting Elevated Left Ventricular Filling Pressure and Risk of Rejection or Coronary Artery Vasculopathy in Pediatric Heart Transplant Recipients.

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    Lu, Jimmy C; Magdo, H Sonali; Yu, Sunkyung; Lowery, Ray; Aiyagari, Ranjit; Zamberlan, Mary; Gajarski, Robert J

    2016-05-01

    In pediatric heart transplant recipients, elevated pulmonary capillary wedge pressure (PCWP) is associated with rejection and coronary artery vasculopathy. This study aimed to evaluate which echocardiographic parameters track changes in PCWP and predict adverse outcomes (rejection or coronary artery vasculopathy). This prospective single-center study enrolled 49 patients (median 11.4 years old, interquartile range 7.4 to 16.5) at time of cardiac catheterization and echocardiography. Median follow-up was 2.4 years (range 1.2 to 3.1 years), with serial testing per clinical protocol. Ratio of early mitral inflow to annular velocity (E/E'), left atrial (LA) distensibility, peak LA systolic strain, E/left ventricular (LV) diastolic strain, and E/LV diastolic strain rate were measured from echocardiograms. Increase in PCWP ≥3 mm Hg was associated with changes in LA distensibility, E/E', and E/LV diastolic strain, with highest area under the receiver operating characteristic curve for E/LV diastolic strain (0.76). In 9 patients who subsequently developed rejection or coronary artery vasculopathy, E/LV diastolic strain rate at baseline differed from patients without events (median 57.0 vs 43.6, p = 0.02). On serial studies, only change in LV ejection fraction differed in patients with events (median -10% vs -1%, p = 0.01); decrease in LV ejection fraction of -19% had a specificity of 100% and sensitivity of 44%. In conclusion, LV diastolic strain and strain rate measurements can track changes in PCWP and identify patients at risk for subsequent rejection or coronary artery vasculopathy. Further studies are necessary to confirm these data in a larger cohort. PMID:26976792

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

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    Bombardini Tonino

    2011-11-01

    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.

  5. Oscillometric measurement of systolic and diastolic blood pressures validated in a physiologic mathematical model

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    Babbs Charles F

    2012-08-01

    Full Text Available Abstract Background The oscillometric method of measuring blood pressure with an automated cuff yields valid estimates of mean pressure but questionable estimates of systolic and diastolic pressures. Existing algorithms are sensitive to differences in pulse pressure and artery stiffness. Some are closely guarded trade secrets. Accurate extraction of systolic and diastolic pressures from the envelope of cuff pressure oscillations remains an open problem in biomedical engineering. Methods A new analysis of relevant anatomy, physiology and physics reveals the mechanisms underlying the production of cuff pressure oscillations as well as a way to extract systolic and diastolic pressures from the envelope of oscillations in any individual subject. Stiffness characteristics of the compressed artery segment can be extracted from the envelope shape to create an individualized mathematical model. The model is tested with a matrix of possible systolic and diastolic pressure values, and the minimum least squares difference between observed and predicted envelope functions indicates the best fit choices of systolic and diastolic pressure within the test matrix. Results The model reproduces realistic cuff pressure oscillations. The regression procedure extracts systolic and diastolic pressures accurately in the face of varying pulse pressure and arterial stiffness. The root mean squared error in extracted systolic and diastolic pressures over a range of challenging test scenarios is 0.3 mmHg. Conclusions A new algorithm based on physics and physiology allows accurate extraction of systolic and diastolic pressures from cuff pressure oscillations in a way that can be validated, criticized, and updated in the public domain.

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

    Science.gov (United States)

    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

    2013-03-01

    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

  7. [Cardiovascular risk stratification. Systolic, diastolic or pulse pressure?].

    Science.gov (United States)

    Pede, S; Lombardo, M

    2001-04-01

    It is well known that hypertension is a highly prevalent condition in the population, carries a significant risk of adverse cardiovascular events and is therapeutically difficult to control. These factors render it "a major unsolved - but soluble - mass public health problem". One of the present-day aspects of the complexity of managing patients with high blood pressure (BP) derives from clinical and epidemiological data that have emerged over the past 10 years: the growing importance of the clinical significance of systolic and pulse BP. The pathophysiological basis of these data is based, on the one hand, on a better articulated definition of the components of BP, and on the other, on precise information concerning age-related modifications. The common definition of BP does not take into account pressure fluctuations occurring during the cardiac cycle; in fact, systolic and diastolic BP denote the extreme values of continuous variations in differential pressure. Diastolic BP reflects, to a greater extent, the trend of arterial resistances and mean BP (usually calculated as diastolic BP plus one third of the differential BP, and considered the "stable component" of the arterial sphygmogram) and has long been used as a diagnostic and therapeutic target. Systolic BP is more closely linked to variations in pulse BP (given from the difference between systolic and diastolic BP and considered the "dynamic component" of the arterial sphygmogram) and is produced by a group of factors including left ventricular ejection and the reflection of the sphygmic wave. As age increases, the walls of the aorta and the large elastic arteries progressively harden due to senile degenerative phenomena and the loss of elasticity as well as the progressive diffusion of atherosdclerotic lesions. This leads to the reduced capacity of the arterial wall to distend during the systole with a consequent increase in both systolic and pulse BP. These pathophysiological data have important clinical and prognostic implications and account for the possible diversity of significance to attribute to systolic, diastolic, mean and pulse BP, factors which, in their entirety, can represent an element, albeit partial, of resolvability of problems in managing hypertension. In fact, possibilities of diversification in the stratification of risk of the hypertensive patients may be considered on a pathophysiological basis, with the prospect of better aimed therapeutic interventions. On the whole, it appears that the clinical significance to attribute to pulse BP should be considered not as an alternative to that of systolic and diastolic BP, but rather in complementary terms, with age kept in careful consideration. In practice, by simplifying to a maximum the state of present knowledge, the values of systolic, diastolic, mean and pulse BP are all important in subjects under 60 years old. This indicates that the clinical significance to attribute to diastolic hypertension in young or middle-aged patients, which have been so accurately described by well-known meta-analyses, is not presently under discussion. What seems to change, with respect to the past, is the importance that should be attributed to the systolic and pulse BP in subjects of all ages and in particular to pulse BP in subjects over 60 years old: in these persons, the increase in pulse BP summarizes and integrates the adverse prognostic value of an elevated systolic BP and a low diastolic BP. It should be clearly understood that, in subjects over 60 years old, a high systolic BP and a low diastolic BP mean rigidity of the wall of the aorta and of the main elastic arteries; in these subjects, the isolated increase in diastolic BP, usually easily controllable by antihypertensive treatment, should not cause excessive clinical concern; instead, an increase in systolic BP - even if isolated - and, above all, an increase in pulse BP, should cause greater preoccupation, inasmuch as they are signs of consistent serious structural lesions. In other words, a 60-year-old subject with 150/90 mmHg would have a lesser risk of cardiovascular events, particularly cardiological events, than a contemporary with equal risk factors who has 150/50 mmHg. A large number of clinical studies suggest that an increase in pulse BP seems to predict cardiac ischemic events to a greater extent than the cerebrovascular events, which seem to be predicted to a greater extent by the mean BP. On the therapeutic level, the reference datum is represented by the unequivocal demonstration, furnished by wide scale interventional studies, that in hypertensive patients adequate pharmacological control of both the diastolic and systolic BP, particularly in the elderly, significantly reduces adverse consequences linked to the progression of atherosclerotic disease in the heart, brain and kidney. A degree of complexity is represented by the modest percent of patients in treatment who have BP values < 140/90 mmHg. Only a series of ad hoc studies will enable us to know when and if this negative situation can be resolved, even partially, by the clinical application of new knowledge in the pathophysiological field. From this point of view, it should be kept in mind that ACE-inhibitors, diuretics, dihydropyridinic calcium antagonists and vasopeptidase inhibitors seem to be more effective than beta-blockers in terms of preferential reduction of pulse BP. The contents of the reports that make up the Symposium constitute a valid base of knowledge and represent a concrete stimulus for research initiatives, which in the spirit of "operativeness" of the Area Prevenzione of the Italian Association of Hospital Cardiologists, follow the objective of bringing together scientific and managerial needs. PMID:19397006

  8. Association between diastolic blood pressure and cumulative work time

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    Ricardo Cordeiro

    1999-01-01

    Full Text Available Diastolic blood pressure was viewed as a generic indicator of aging, and its association with cumulative work time was studied after controlling for age as a potential confounding factor. The study was conducted among production line workers at a Brazilian tannery in July 1993. The association between diastolic blood pressure and cumulative work time was verified by fitting a second-order linear regression model, where diastolic blood pressure was a function of worker's age and cumulative work time. By fitting the model, one can predict that, in the beginning of working life at the tannery, on average each 1-year period is associated with an increase of about 1.5 mmHg in diastolic blood pressure. The fit obtained highlights one component directly associated with work as part of the rate of pressure increase in the study group. This component is twice as high as that directly associated with age.

  9. Left ventricular diastolic function in patients with coronary artery disease

    International Nuclear Information System (INIS)

    In 302 patients with confirmed coronary disease we determined the left ventricular diastolic function with the Nuclear Stethoscope by the aid of the Peak Filling Rate (PFR) and the Time to Peak Filling Rate (TPFR). Moreover we investigated the ejection fraction (EF). 201 patients had already suffered a myocardial infarction, of these 99 an anterior wall and 102 an inferior wall infarction. The remaining 101 patients had a CAD without a history of myocardial infarction. The PFR was 2.19 ± 0.65 EDV/sec in the 99 patients after anterior wall infarction and 2.62 ± 0.85 EDV/sec in the 102 patients after inferior wall infarction and 2.79 ± 0.85 EDV/sec in 101 patients with coronary artery disease without a history of myocardial infarction. For the PFR there could be found a statistically significant difference between normal patients and patients after anterior wall infarction (p < 0.0001), normal patients and patients after inferior wall infarction (p < 0.0001) and normal patients and patients with coronary artery disease (p < 0.0001). The TPFR was 180 ± 37.5 msec after anterior - and 158 ± 50.7 msec after inferior wall infarction and 156 ± 45.2 msec in the patients with CAD without previous infarction. The left ventricular diastolic function (PFR and/or TPFR) was abnormal in 88% after anterior- and in 82% after inferior wall infarction and in 69% in coronary patients without previous myocardial infarction. In comparison with this the ejection fraction was reduced in 66% in anterior- and in 61% inferior wall infarction at rest. These results indicate that the diastolic function at rest appears to be more informative for evaluation of a left ventricular dysfunction than the systolic function at rest. (orig.)

  10. Carotid artery mixing with diastole-phased pulsed drug infusion

    International Nuclear Information System (INIS)

    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 (14C-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 14C-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

  11. DIASTOLIC BLOOD PRESSURE OR ACTUALLY IT IS BASELINE SYSTOLIC BLOOD PRESSURE?

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    R.Vinodh Rajkumar

    2015-08-01

    Full Text Available Blood pressure measuring represents a routine investigation in general medicine. Nokolai Korotkoff was only 31 years old when he made a short presentation to the Scientific Meeting of the Military Hospital of the Academy on 5 November 1905 concerning an easy non-invasive method of blood pressure (BP measurement, entitled ‘Concerning the problems of the methods of blood pressure measurement’. If the pressure in the cuff is relieved, blood starts coming through the compressed arterial segment during systole and causes auscultatory sound and, the first sound, which, in Korotkoff’s opinion, is a measurement of systolic blood pressure. In the same BP measurement, when normal blood flow is fully restored, the auscultatory sounds disappear and, the last sound, which, in Korotkoff's opinion is a measurement of diastolic blood pressure. Listening to Korotkoff sounds (K-sounds to determine systolic and diastolic blood pressure (BP has been the standard for noninvasive BP measurement in medical practices for nearly 100 years and it is the essential tool used for evaluation and assessment of patients with hypertension and risks of cardiovascular diseases (CVD by physicians and nurses despite limited understanding of the nature of K-sounds. This article focuses particularly on the cardiovascular biomechanics of the first and last auscultatory sound and suggests two new terminologies; Highest systolic blood pressure and Baseline systolic blood pressure to represent the systolic pressure and diastolic pressure, respectively. Experimenting blood pressures on the basis of these two new suggested terminologies may reveal various additional undiscovered aspects of normal BP and abnormal BP. KEY WORDS: Highest systolic blood pressure, Baseline systolic blood pressure, Korotkoff sounds

  12. Non-invasive method of determining diastolic intracranial pressure

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    Yost, William T. (Inventor); Cantrell, Jr., John H. (Inventor); Hargens, Alan R. (Inventor)

    2004-01-01

    A method is presented for determining diastolic intracranial pressure (ICP) in a patient. A first change in the length of a path across the skull of the patient caused by a known change in ICP is measured and used to determine an elasticity constant for the patient. Next, a second change in the length of the path across the patient's skull occurring between systolic and diastolic portions of the patient's heartbeat is measured. The patient's diastolic ICP is a function of the elasticity constant and the second change.

  13. Protein Changes Contributing to Right Ventricular Cardiomyocyte Diastolic Dysfunction in Pulmonary Arterial Hypertension

    OpenAIRE

    Rain, Silvia; Bos, Denielli da Silva Goncalves; Handoko, M Louis; Westerhof, Nico; Stienen, Ger; Ottenheijm, Coen; Goebel, Max; Dorfmüller, Peter; Guignabert, Christophe; Humbert, Marc; Bogaard, Harm‐Jan; dos Remedios, Cris; Saripalli, Chandra; Hidalgo, Carlos G.; Granzier, Henk L.

    2014-01-01

    Background Right ventricular (RV) diastolic function is impaired in patients with pulmonary arterial hypertension (PAH). Our previous study showed that elevated cardiomyocyte stiffness and myofilament Ca2+ sensitivity underlie diastolic dysfunction in PAH. This study investigates protein modifications contributing to cellular diastolic dysfunction in PAH. Methods and Results RV samples from PAH patients undergoing heart‐lung transplantation were compared to non‐failing donors (Don). Titin sti...

  14. Relationship between occupational exposure to lead and local arterial stiffness and left ventricular diastolic function in individuals with arterial hypertension

    International Nuclear Information System (INIS)

    Relationship between occupational exposure to lead and frequency of complications in persons with arterial hypertension has been poorly investigated. This study aimed at evaluation of the relationship between occupational exposure to lead and manifestation of an increased local arterial stiffness and left ventricular diastolic dysfunction. The studies included 105 men (mean age: 44.47 ± 9.12 years) with arterial hypertension, treated with hypotensive drugs: group I - men occupationally exposed to lead (n = 53), and group II - men not exposed to lead (n = 52). In echocardiographic examination, the left ventricular diastolic dysfunction was diagnosed significantly more frequently in group I than in group II. In eTracking examination mean values of stiffness parameter (β), augmentation index (AI) and one-point pulse wave velocity (PWV-β) were significantly higher and mean values of arterial compliance (AC) were significantly lower in group I than in group II. The logistic regression showed that in the group of persons with arterial hypertension occupationally exposed to lead a more advanced age, higher blood lead concentration and higher mean values of augmentation index represent independent risk factors of left ventricular diastolic dysfunction. The multifactorial regression showed that amongst persons with arterial hypertension occupationally exposed to lead higher blood zinc protoporphyrin concentration, a more advanced age and higher value of body mass index (BMI) represent independent risk factors of an increased local arterial stiffness. In summary, we should note that in the group of persons with arterial hypertension occupationally exposed to lead the study has demonstrated a significantly more frequent manifestation of left ventricular diastolic dysfunction and an increase in local arterial stiffness. - Highlights: → Amongst persons with AH exposed to Pb higher ZnPP represent independent risk factor of increased local arterial stiffness. → Higher Pb-B represent independent risk factor of left ventricular diastolic dysfunction. → The study has demonstrated a more frequent manifestation of left ventricular diastolic dysfunction in group exposed to Pb. → Also, in this group the study has demonstrated a more frequent manifestation of increase in local arterial stiffness.

  15. Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes

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    Matthews D Geoffrey

    2008-05-01

    Full Text Available Abstract Background In comparison to the well established changes in compliance that occur at the large vessel level in diabetes, much less is known about the changes in compliance of the cardiovascular system at the end-organ level. The aim of this study was therefore to examine whether there was a correlation between resistance of the intrarenal arteries of the kidney and compliance of the left ventricle, as estimated by measurements of diastolic function, in subjects with type 2 diabetes. Methods We studied 167 unselected clinic patients with type 2 diabetes with a kidney duplex scan to estimate intrarenal vascular resistance, i.e. the resistance index (RI = peak systolic velocity-minimum diastolic velocity/peak systolic velocity and a transthoracic echocardiogram (TTE employing tissue doppler studies to document diastolic and systolic ventricular function. Results Renal RI was significantly higher in subjects with diastolic dysfunction (0.72 ± 0.05 when compared with those who had a normal TTE examination (0.66 ± 0.06, p Conclusion Increasing vascular resistance of the intrarenal arteries was associated with markers of diastolic dysfunction in subjects with type 2 diabetes. These findings are consistent with the hypothesis that vascular and cardiac stiffening in diabetes are manifestations of common pathophysiological mechanisms.

  16. Relation between heavy metals and left ventricular diastolic function in patients with coronary artery disease.

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    Kosmala, Wojciech; Kuliczkowski, Wiktor; Jolda-Mydlowska, Beata; Przewlocka-Kosmala, Monika; Kucharski, Wojciech; Antonowicz-Juchniewicz, Jolanta

    2004-01-01

    One of the earliest detectable abnormalities in patients with coronary artery disease is left ventricular diastolic dysfunction. Its main cause is myocardial ischaemia, but still many of other mechanisms are possible. The aim of this study was to investigate the relation of cadmium, lead, copper, zinc, and selenium with left ventricular diastolic function indices in patients with coronary artery disease. The study included 33 patients (14 with single-vessel disease and 19 with multivessel disease on angiography) who were not exposed occupationally to heavy metals. Control group consisted of 18 patients with normal coronary arteries. The blood cadmium and lead concentrations and serum zinc, selenium and copper concentrations were determined using atomic absorption spectrophotometry. Left ventricular diastolic function parameters were estimated by echo-Doppler and colour M-mode. All heavy metal concentrations were within the standard ranges in all studied groups. Patients with single-vessel disease, multivessel disease and control group did not differ in concentrations of studied metals. On univariate and multivariate analysis only cadmium significantly correlated with echocardiographic parameters of left ventricular diastolic function: peak early to peak late mitral inflow velocity ratio (r = -0.36, p < 0.05) and deceleration time of early mitral inflow (r = 0.43, p < 0.01) in patients with CAD. No significant correlations between concentrations of heavy metals and indices of left ventricular diastolic function were found in control group. The present data suggest that cadmium in concentrations even below the threshold limit value for unexposed population may contribute to development of left ventricular diastolic dysfunction in patients with CAD, potentializing the effect of myocardial ischaemia. PMID:20021144

  17. Protein Changes Contributing to Right Ventricular Cardiomyocyte Diastolic Dysfunction in Pulmonary Arterial Hypertension

    Science.gov (United States)

    Rain, Silvia; Bos, Denielli da Silva Goncalves; Handoko, M. Louis; Westerhof, Nico; Stienen, Ger; Ottenheijm, Coen; Goebel, Max; Dorfmüller, Peter; Guignabert, Christophe; Humbert, Marc; Bogaard, Harm‐Jan; dos Remedios, Cris; Saripalli, Chandra; Hidalgo, Carlos G.; Granzier, Henk L.; Vonk‐Noordegraaf, Anton; van der Velden, Jolanda; de Man, Frances S.

    2014-01-01

    Background Right ventricular (RV) diastolic function is impaired in patients with pulmonary arterial hypertension (PAH). Our previous study showed that elevated cardiomyocyte stiffness and myofilament Ca2+ sensitivity underlie diastolic dysfunction in PAH. This study investigates protein modifications contributing to cellular diastolic dysfunction in PAH. Methods and Results RV samples from PAH patients undergoing heart‐lung transplantation were compared to non‐failing donors (Don). Titin stiffness contribution to RV diastolic dysfunction was determined by Western‐blot analyses using antibodies to protein‐kinase‐A (PKA), Cα (PKCα) and Ca2+/calmoduling‐dependent‐kinase (CamKIIδ) titin and phospholamban (PLN) phosphorylation sites: N2B (Ser469), PEVK (Ser170 and Ser26), and PLN (Thr17), respectively. PKA and PKCα sites were significantly less phosphorylated in PAH compared with donors (P<0.0001). To test the functional relevance of PKA‐, PKCα‐, and CamKIIδ‐mediated titin phosphorylation, we measured the stiffness of single RV cardiomyocytes before and after kinase incubation. PKA significantly decreased PAH RV cardiomyocyte diastolic stiffness, PKCα further increased stiffness while CamKIIδ had no major effect. CamKIIδ activation was determined indirectly by measuring PLN Thr17phosphorylation level. No significant changes were found between the groups. Myofilament Ca2+ sensitivity is mediated by sarcomeric troponin I (cTnI) phosphorylation. We observed increased unphosphorylated cTnI in PAH compared with donors (P<0.05) and reduced PKA‐mediated cTnI phosphorylation (Ser22/23) (P<0.001). Finally, alterations in Ca2+‐handling proteins contribute to RV diastolic dysfunction due to insufficient diastolic Ca2+ clearance. PAH SERCA2a levels and PLN phosphorylation were significantly reduced compared with donors (P<0.05). Conclusions Increased titin stiffness, reduced cTnI phosphorylation, and altered levels of phosphorylation of Ca2+ handling proteins contribute to RV diastolic dysfunction in PAH. PMID:24895160

  18. Multivariate Modeling of Body Mass Index, Pulse Pressure, Systolic and Diastolic Blood Pressure in Chinese Twins

    DEFF Research Database (Denmark)

    Wu, Yili; Zhang, Dongfeng; Pang, Zengchang; Jiang, Wenjie; Wang, Shaojie; Li, Shuxia; von Bornemann Hjelmborg, Jacob; Tan, Qihua

    2015-01-01

    Systolic and diastolic blood pressure, pulse pressure (PP), and body mass index (BMI) are heritable traits in human metabolic health but their common genetic and environmental backgrounds are not well investigated. The aim of this article was to explore the phenotypic and genetic associations among...... PP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and BMI. The studied sample contained 615 twin pairs (17-84 years) collected in the Qingdao municipality. Univariate and multivariate structural equation models were fitted for assessing the genetic and environmental contributions....... The AE model combining additive genetic (A) and unique environmental (E) factors produced the best fit for each four phenotypes. Heritability estimated in univariate analysis ranged from 0.42 to 0.74 with the highest for BMI (95% CI 0.70-0.78), and the lowest for PP (95% CI 0.34-0.49). The...

  19. Relationship between early diastolic intraventricular pressure gradients, an index of elastic recoil, and improvements in systolic and diastolic function

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    Firstenberg, M. S.; Smedira, N. G.; Greenberg, N. L.; Prior, D. L.; McCarthy, P. M.; Garcia, M. J.; Thomas, J. D.

    2001-01-01

    BACKGROUND: Early diastolic intraventricular pressure gradients (IVPGs) have been proposed to relate to left ventricular (LV) elastic recoil and early ventricular "suction." Animal studies have demonstrated relationships between IVPGs and systolic and diastolic indices during acute ischemia. However, data on the effects of improvements in LV function in humans and the relationship to IVPGs are lacking. METHODS AND RESULTS: Eight patients undergoing CABG and/or infarct exclusion surgery had a triple-sensor high-fidelity catheter placed across the mitral valve intraoperatively for simultaneous recording of left atrial (LA), basal LV, and apical LV pressures. Hemodynamic data obtained before bypass were compared with those with similar LA pressures and heart rates obtained after bypass. From each LV waveform, the time constant of LV relaxation (tau), +dP/dt(max), and -dP/dt(max) were determined. Transesophageal echocardiography was used to determined end-diastolic (EDV) and end-systolic (ESV) volumes and ejection fractions (EF). At similar LA pressures and heart rates, IVPG increased after bypass (before bypass 1.64+/-0.79 mm Hg; after bypass 2.67+/-1.25 mm Hg; PEDV (IVPG=-0.027[EDV]+4.30, r=-0.70). Improvements in IVPGs correlated with improvements in apical tau (Deltatau =5.93[DeltaIVPG]+4.76, r=0.91) and basal tau (Deltatau =2.41[DeltaIVPG]+5.13, r=-0.67). Relative changes in IVPGs correlated with changes in ESV (DeltaESV=-0.97[%DeltaIVPG]+23.34, r=-0.79), EDV (DeltaEDV=-1.16[%DeltaIVPG]+34.92, r=-0.84), and EF (DeltaEF=0.38[%DeltaIVPG]-8.39, r=0.85). CONCLUSIONS: Improvements in LV function also increase IVPGs. These changes in IVPGs, suggestive of increases in LV suction and elastic recoil, correlate directly with improvements in LV relaxation and ESV.

  20. 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.)

  1. 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)

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

    Directory of Open Access Journals (Sweden)

    I. Rajagopal

    2011-04-01

    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.

  3. Comparison of the effect of pressure loading on left ventricular size, systolic and diastolic function in canines with left ventricular dysfunction with preserved and reduced ejection fraction

    Directory of Open Access Journals (Sweden)

    Lavine Steven J

    2008-11-01

    Full Text Available Abstract Background Decompensated heart failure may present with severe hypertension in patients with preserved (PreEF or reduced left ventricular (LV ejection fraction (RedEF and is clinically indistinguishable. Previously, we demonstrated that arterial pressure elevation increases LV filling pressures in a canine model of chronic LV dysfunction with PreEF or RedEF. It is not clear whether any differences in hemodynamics, LV volume or performance, or diastolic function can be demonstrated between canines with PreEF or RedEF in response to arterial pressure elevation. We hypothesized that the LV systolic, diastolic, and hemodynamic response to pressure loading would be similar in RedEF or PreEF. Methods We studied 25 dogs with chronic LV dysfunction due to coronary microsphere embolization with RedEF (35 ± 4% and 20 dogs with PreEF (50 ± 3%. Arterial pressure was increased with methoxamine infusion and hemodynamics and echo-Doppler parameters of LV size, function, transaortic and transmitral pulsed Doppler prior to and with methoxamine infusion was obtained. Results Though LV filling pressures were similar at baseline, LV size was larger (p Conclusion Pressure loading in a canine model of LV dysfunction with PreEF and RedEF resulted in similar degrees of LV dilatation, increased filling pressures, and increased index of myocardial performance.

  4. Improvement in diastolic intraventricular pressure gradients in patients with HOCM after ethanol septal reduction

    Science.gov (United States)

    Rovner, Aleksandr; Smith, Rebecca; Greenberg, Neil L.; Tuzcu, E. Murat; Smedira, Nicholas; Lever, Harry M.; Thomas, James D.; Garcia, Mario J.

    2003-01-01

    We sought to validate measurement of intraventricular pressure gradients (IVPG) and analyze their change in patients with hypertrophic obstructive cardiomyopathy (HOCM) after ethanol septal reduction (ESR). Quantitative analysis of color M-mode Doppler (CMM) images may be used to estimate diastolic IVPG noninvasively. Noninvasive IVPG measurement was validated in 10 patients undergoing surgical myectomy. Echocardiograms were then analyzed in 19 patients at baseline and after ESR. Pulsed Doppler data through the mitral valve and pulmonary venous flow were obtained. CMM was used to obtain the flow propagation velocity (Vp) and to calculate IVPG off-line. Left atrial pressure was estimated with the use of previously validated Doppler equations. Data were compared before and after ESR. CMM-derived IVPG correlated well with invasive measurements obtained before and after surgical myectomy [r = 0.8, P left atrial pressure decreased from 16.2 +/- 1.1 to 11.5 +/- 0.9 mmHg (P < 0.001). The increase in IVPG correlated with the reduction in the LVOT gradient (r = 0.6, P < 0.01). Reduction of LVOT obstruction after ESR is associated with an improvement in diastolic suction force. Noninvasive measurements of IVPG may be used as an indicator of diastolic function improvement in HOCM.

  5. Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiinberg, N; Henriksen, Jens Henrik

    1995-01-01

    Cirrhotic patients have disturbed systemic hemodynamics with reduced arterial blood pressure, but this has not been investigated during daily activity and sleep. Systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), and heart rate (HR) were measured by an automatic ambulant...... device for monitoring blood pressure in 35 patients with cirrhosis and 35 healthy matched controls. During the daytime, SBP, DBP, and MAP were significantly lower in the patients than in the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P < .0001 to P < .05). The nighttime blood pressures...... were almost similar in the two groups (108 vs. 110; 65 vs. 67; 78 vs. 82 mm Hg, NS). Conversely, HR was significantly higher in the patients both in the daytime (86 vs. 72/min, P < .0001) and at night (80 vs. 64/min, P < .0001). Consequently, the reduction in blood pressure and HR from daytime to...

  6. Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiinberg, N; Henriksen, Jens Henrik

    1995-01-01

    device for monitoring blood pressure in 35 patients with cirrhosis and 35 healthy matched controls. During the daytime, SBP, DBP, and MAP were significantly lower in the patients than in the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P < .0001 to P < .05). The nighttime blood pressures......Cirrhotic patients have disturbed systemic hemodynamics with reduced arterial blood pressure, but this has not been investigated during daily activity and sleep. Systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), and heart rate (HR) were measured by an automatic ambulant...... were almost similar in the two groups (108 vs. 110; 65 vs. 67; 78 vs. 82 mm Hg, NS). Conversely, HR was significantly higher in the patients both in the daytime (86 vs. 72/min, P < .0001) and at night (80 vs. 64/min, P < .0001). Consequently, the reduction in blood pressure and HR from daytime to...

  7. Arterial pressure measurement: Is the envelope curve of the oscillometric method influenced by arterial stiffness?

    International Nuclear Information System (INIS)

    Measurement of peripheral arterial pressure using the oscillometric method is commonly used by professionals as well as by patients in their homes. This non invasive automatic method is fast, efficient and the required equipment is affordable with a low cost. The measurement method consists of obtaining parameters from a calibrated decreasing curve that is modulated by heart beats witch appear when arterial pressure reaches the cuff pressure. Diastolic, mean and systolic pressures are obtained calculating particular instants from the heart beats envelope curve. In this article we analyze the envelope of this amplified curve to find out if its morphology is related to arterial stiffness in patients. We found, in 33 volunteers, that the envelope waveform width correlates to systolic pressure (r=0.4, p<0.05), to pulse pressure (r=0.6, p<0.05) and to pulse pressure normalized to systolic pressure (r=0.6, p<0.05). We believe that the morphology of the heart beats envelope curve obtained with the oscillometric method for peripheral pressure measurement depends on arterial stiffness and can be used to enhance pressure measurements

  8. Daily Liquorice Consumption for Two Weeks Increases Augmentation Index and Central Systolic and Diastolic Blood Pressure

    Science.gov (United States)

    Leskinen, Miia H.; Hautaniemi, Elina J.; Tahvanainen, Anna M.; Koskela, Jenni K.; Päällysaho, Marika; Tikkakoski, Antti J.; Kähönen, Mika; Kööbi, Tiit; Niemelä, Onni; Mustonen, Jukka; Pörsti, Ilkka H.

    2014-01-01

    Background Liquorice ingestion often elevates blood pressure, but the detailed haemodynamic alterations are unknown. We studied haemodynamic changes induced by liquorice consumption in 20 subjects versus 30 controls with average blood pressures of 120/68 and 116/64 mmHg, respectively. Methods Haemodynamic variables were measured in supine position before and after two weeks of liquorice consumption (daily glycyrrhizin dose 290–370 mg) with tonometric recording of radial blood pressure, pulse wave analysis, and whole-body impedance cardiography. Thirty age-matched healthy subjects maintaining their normal diet were studied as controls. Results Two weeks of liquorice ingestion elevated peripheral and central systolic and diastolic blood pressure (by 7/4 and 8/4 mmHg, 95% confidence intervals [CI] 2-11/1-8 and 3-13/1-8, respectively, P ClinicalTrials.gov NCT01742702 PMID:25153328

  9. Importance of diastolic velocities in the detection of celiac and mesenteric artery disease by duplex ultrasound

    DEFF Research Database (Denmark)

    Perko, M J; Just, S; Schroeder, T V

    1997-01-01

    To assess the predictive value of ultrasound duplex scanning in the detection of superior mesenteric artery (SMA) and celiac artery (CA) occlusive disease.......To assess the predictive value of ultrasound duplex scanning in the detection of superior mesenteric artery (SMA) and celiac artery (CA) occlusive disease....

  10. Reconstruction of brachial pressure from finger arterial pressure during orthostasis

    DEFF Research Database (Denmark)

    Bogert, Lysander W J; Harms, Mark P M; Pott, Frank; Secher, Niels H; Wesseling, Karel H; van Lieshout, Johannes J

    2004-01-01

    In patients with recurrent syncope, monitoring of intra-arterial pressure during orthostatic stress testing is recommended because of the potentially sudden and rapid development of hypotension. Replacing brachial arterial pressure (BAP) by the non-invasively obtained finger arterial pressure (Fin...

  11. Double product response and diastolic blood pressure in treadmill, stationary bicycle and muscular circuit exercises

    Directory of Open Access Journals (Sweden)

    Leandro Teixeira Paranhos Lopes

    2006-08-01

    Full Text Available Among the various causes for cardiovascular problems affecting the world population nowadays, the most relevant risk factors is sedentary lifestyle. Many studies have been carried out to analyse and elucidate main adaptations on the cardiovascular system stimulated by different sorts of exercises.In this way, this study had aimed at comparing the acute response of double product (DP and diastolic blood pressure (DBP after treadmill (TRM, stationary bicycle (BIC or muscle circuit training (MCT exercises. Nine individuals (6 women and 3 men exercised at 60% of heart rate reserve (HRR on the TRM and BIC and at 60% of one repetition maximum (1RM in MCT. The results showed that pre- and post-effort DP were significantly difference in all three exercises. However, DP did not differ among exercise types. The hypotensive DBP pos-effort response was greater in MCT. According to the results, it was concluded that there is no difference on the heart work demand rate estimated by DP among the three exercises and MCT at 60% 1RM provokes a greater hypotensive DBP post-effort response. . Resumo Entre as diversas causas de problemas cardiovasculares que afetam a população mundial, na atualidade, o sedentarismo é apontado como um dos fatores de risco mais relevantes. Vários estudos têm se preocupado em analisar e esclarecer as principais adaptações provocadas pelos diferentes tipos de exercícios sobre o sistema cardiovascular. Seguindo esta linha o presente trabalho teve como objetivo analisar e comparar a resposta aguda do duplo produto (DP e a pressão arterial diastólica (PAD em exercício de esteira, bicicleta estacionária e circuito na musculação. Foram avaliados nove indivíduos sendo seis mulheres e três homens, na esteira, a 60% da freqüência cardíaca de reserva (FCR, na bicicleta estacionária, a 60% FCR e circuito de musculação a 60% de 1 repetição máxima (1RM. Os resultados encontrados apresentaram diferença significativa do DP pré e pós esforço nos três exercícios. Quando comparado, o DP obtido pós esforço, nos três exercícios, não houve diferença significativa. A resposta hipotensiva da PAD pós-esforço foi mais acentuada após exercício de circuito em musculação, quando comparada com as outras modalidades exercício analisadas. De acordo com os procedimentos metodológicos adotados e os resultados obtidos, concluiu-se que não há diferença na taxa de exigência de trabalho do miocárdio entre os três exercicios analisados e que o circuito de musculação, a 60% 1RM, provoca uma maior resposta hipotensiva da PAD pós-esforço.

  12. Double product response and diastolic blood pressure in treadmill, stationary bicycle and muscular circuit exercises

    Directory of Open Access Journals (Sweden)

    Elmiro Santos Resende

    2006-06-01

    Full Text Available Among the various causes for cardiovascular problems affecting the world population nowadays, the most relevant risk factors is sedentary lifestyle. Many studies have been carried out to analyse and elucidate main adaptations on the cardiovascular system stimulated by different sorts of exercises.In this way, this study had aimed at comparing the acute response of double product (DP and diastolic blood pressure (DBP after treadmill (TRM, stationary bicycle (BIC or muscle circuit training (MCT exercises. Nine individuals (6 women and 3 men exercised at 60% of heart rate reserve (HRR on the TRM and BIC and at 60% of one repetition maximum (1RM in MCT. The results showed that pre- and post-effort DP were significantly difference in all three exercises. However, DP did not differ among exercise types. The hypotensive DBP pos-effort response was greater in MCT. According to the results, it was concluded that there is no difference on the heart work demand rate estimated by DP among the three exercises and MCT at 60% 1RM provokes a greater hypotensive DBP post-effort response. RESUMO Entre as diversas causas de problemas cardiovasculares que afetam a população mundial, na atualidade, o sedentarismo é apontado como um dos fatores de risco mais relevantes. Vários estudos têm se preocupado em analisar e esclarecer as principais adaptações provocadas pelos diferentes tipos de exercícios sobre o sistema cardiovascular. Seguindo esta linha o presente trabalho teve como objetivo analisar e comparar a resposta aguda do duplo produto (DP e a pressão arterial diastólica (PAD em exercício de esteira, bicicleta estacionária e circuito na musculação. Foram avaliados nove indivíduos sendo seis mulheres e três homens, na esteira, a 60% da freqüência cardíaca de reserva (FCR, na bicicleta estacionária, a 60% FCR e circuito de musculação a 60% de 1 repetição máxima (1RM. Os resultados encontrados apresentaram diferença significativa do DP pré e pós esforço nos três exercícios. Quando comparado, o DP obtido pós esforço, nos três exercícios, não houve diferença significativa. A resposta hipotensiva da PAD pós-esforço foi mais acentuada após exercício de circuito em musculação, quando comparada com as outras modalidades exercício analisadas. De acordo com os procedimentos metodológicos adotados e os resultados obtidos, concluiu-se que não há diferença na taxa de exigência de trabalho do miocárdio entre os três exercicios analisados e que o circuito de musculação, a 60% 1RM, provoca uma maior resposta hipotensiva da PAD pós-esforço.

  13. Arterial blood pressure measurement and pulse wave analysis—their role in enhancing cardiovascular assessment

    International Nuclear Information System (INIS)

    The most common method of clinical measurement of arterial blood pressure is by means of the cuff sphygmomanometer. This instrument has provided fundamental quantitative information on arterial pressure in individual subjects and in populations and facilitated estimation of cardiovascular risk related to levels of blood pressure obtained from the brachial cuff. Although the measurement is taken in a peripheral limb, the values are generally assumed to reflect the pressure throughout the arterial tree in large conduit arteries. Since the arterial pressure pulse becomes modified as it travels away from the heart towards the periphery, this is generally true for mean and diastolic pressure, but not for systolic pressure, and so pulse pressure. The relationship between central and peripheral pulse pressure depends on propagation characteristics of arteries. Hence, while the sphygmomanometer gives values of two single points on the pressure wave (systolic and diastolic pressure), there is additional information that can be obtained from the time-varying pulse waveform that enables an improved quantification of the systolic load on the heart and other central organs. This topical review will assess techniques of pressure measurement that relate to the use of the cuff sphygmomanometer and to the non-invasive registration and analysis of the peripheral and central arterial pressure waveform. Improved assessment of cardiovascular function in relation to treatment and management of high blood pressure will result from future developments in the indirect measurement of arterial blood pressure that involve the conventional cuff sphygmomanometer with the addition of information derived from the peripheral arterial pulse. (topical review)

  14. Correlation of radiological assessment of congestive heart failure with left ventricular end-diastolic pressure

    International Nuclear Information System (INIS)

    Left ventricular end-diastolic pressure (LVEDP) has been considered a reliable indicator of left ventricular function. The purpose of this study was to correlate the radiologic assessment of congestive heart failure with LVEDP. The population of the study consisted of 85 consecutive cases in four ranges of LVEDP (24). The PA chest radiographs obtained 1 day prior to cardiac catherization were assessed for radiological evidence of congestive heart failure and were graded from normal to abnormal (0-3). The results will be summarized in the authors' presentation. The discordance of radiological assessment of congestive heart failure in patients with elevated LVEDP will be discussed in light of recent advances in pathophysiologic understanding of left ventricular function and the impact of new classes of drugs in the management of these patients

  15. Carotid Artery End-Diastolic Velocity and Future Cerebro-Cardiovascular Events in Asymptomatic High Risk Patients

    Science.gov (United States)

    Chung, Hyemoon; Jung, Young Hak; Kim, Ki-Hyun; Kim, Jong-Youn; Min, Pil-Ki; Yoon, Young Won; Lee, Byoung Kwon; Hong, Bum-Kee; Rim, Se-Joong; Kwon, Hyuck Moon

    2016-01-01

    Background and Objectives Prognostic value of additional carotid Doppler evaluations to carotid intima-media thickness (IMT) and plaque has not been completely evaluated. Subjects and Methods A total of 1119 patients with risk factors for, but without, overt coronary artery disease (CAD), who underwent both carotid ultrasound and Doppler examination were included in the present study. Parameters of interest included peak systolic and end-diastolic velocities, resistive indices of the carotid arteries, IMT, and plaque measurements. The primary end-point was all-cause cerebro-cardiovascular events (CVEs) including acute myocardial infarction, coronary revascularization therapy, heart failure admission, stroke, and cardiovascular death. Model 1 covariates comprised age and sex; Model 2 also included hypertension, diabetes and smoking; Model 3 also had use of aspirin and statin; and Model 4 also included IMT and plaque. Results The mean follow-up duration was 1386±461 days and the mean age of the study population was 60±12 years. Amongst 1119 participants, 43% were women, 57% had a history of hypertension, and 23% had diabetes. During follow-up, 6.6% of patients experienced CVEs. Among carotid Doppler parameters, average common carotid artery end-diastolic velocity was the independent predictor for future CVEs after adjustments for all models variables (HR 0.95 per cm/s, 95% confident interval 0.91-0.99, p=0.034 in Model 4) and significantly increased the predictive value of Model 4 (global ?2=59.0 vs. 62.8, p=0.029). Conclusion Carotid Doppler measurements in addition to IMT and plaque evaluation are independently associated with future CVEs in asymptomatic patients at risk for CAD. PMID:26798388

  16. Peripheral arterial volume distensibility: significant differences with age and blood pressure measured using an applied external pressure

    International Nuclear Information System (INIS)

    A new arterial distensibility measurement technique was assessed in 100 healthy normotensive subjects. Arterial transmural pressures on the whole right arm were reduced with a 50 cm long cuff inflated to 10, 20, 30 and 40 mmHg. The electrocardiogram, and finger and ear photoplethysmograms were recorded simultaneously. Arm pulse propagation time, pulse wave velocity (PWV) and arterial volume distensibility were determined. With a 40 mmHg reduction in transmural pressure, arm pulse propagation time increased from 61 to 83 ms, PWV decreased from 12 to 8 m s−1 and arterial distensibility increased from 0.102% to 0.232% per mmHg (all P < 0.0001). At all cuff pressures, arterial distensibility was significantly related to resting mean arterial pressure (MAP), diastolic blood pressure (DBP) and age, and for systolic blood pressure at 30 and 40 mmHg (all P < 0.05). At 40 mmHg cuff pressure, arterial distensibility fell by 54% for a MAP increase from 75 to 105 mmHg, 57% for a DBP increase from 60 to 90 mmHg and 47% for an age increase from 20 to 70 years. These changes were more than double than those without cuff pressure. Our technique showed that systemic volume distensibility of the peripheral arm artery reduced with age, with a greater effect at higher external and lower transmural pressures

  17. Understanding the need of ventricular pressure for the estimation of diastolic biomarkers

    OpenAIRE

    Xi, Jiahe; Shi, Wenzhe; Rueckert, Daniel; Razavi, Reza; Smith, Nicolas P; Lamata de la Orden, Pablo

    2013-01-01

    The diastolic function (i.e., blood filling) of the left ventricle (LV) is determined by its capacity for relaxation, or the decay in residual active tension (AT) generated during systole, and its constitutive material properties, or myocardial stiffness. The clinical determination of these two factors (diastolic residual AT and stiffness) is thus essential for assessing LV diastolic function. To quantify these two factors, in our previous work, a novel model-based parameter estimation approa...

  18. Correlation of arterial blood pressure and compliance with left ventricular structure and function in the very elderly.

    Science.gov (United States)

    Rosendorff, Clive; Go, Orson; Schmeidler, James; Silverman, Jeremy M; Beeri, Michal S

    2012-01-01

    There are very few data on the relationship between systolic blood pressure (SBP), diastolic blood pressure (DBP), arterial compliance, and left ventricular structure and function, particularly left ventricular hypertrophy (LVH), in the very elderly (>75 years). SBP and arterial stiffness increase with age, and the question is: which of the two is the main stimulus to LVH? This is a cross-sectional study to compare blood pressure and arterial stiffness measures with regard to their correlations with echocardiographic parameters of LV structure and function, controlling for age and cardiovascular risk factors, in a very elderly population. Arterial stiffness was determined by radial pulse waveform using pulse contour analysis. LV dimensions were measured by transthoracic M-mode echocardiography, and diastolic function by tissue Doppler measurements of diastolic mitral annular velocities. There were 179 subjects, all male, with a mean age of 81.8 years. Using age-adjusted partial correlations, SBP, DBP, and mean arterial pressure (MAP) were correlated with parameters of LV structure and function. Correlation coefficients were: SBP versus left ventricular mass index (LVMI), r = 0.246; SBP versus early diastolic mitral annular velocity (MAV), r = -0.179; DBP versus LVMI, r = 0.199; DBP versus MAV, r = -0.199; MAP versus LVMI, r = 0.276; and MAP versus MAV, r = -0.206, all with P < .05. However, neither capacitative nor reflective arterial compliance was significantly correlated with any parameter of LV structure and function. After controlling for age and 10 cardiovascular and metabolic risk factors, the correlation between blood pressure and the measured LV parameters was substantially unchanged, as was the lack of correlation between indices of arterial compliance and the LV indices. Arterial blood pressure is correlated with LV structure and function in the very elderly, but arterial stiffness, as measured by diastolic pulse contour analysis, is not. PMID:22243840

  19. Mechanical Buckling of Artery under Pulsatile Pressure

    OpenAIRE

    Liu, Qin; Han, Hai-Chao

    2012-01-01

    Tortuosity that often occurs in carotid and other arteries has been shown to be associated with high blood pressure, atherosclerosis, and other diseases. However the mechanisms of tortuosity development are not clear. Our previous studies have suggested that arteries buckling could be a possible mechanism for the initiation of tortuous shape but artery buckling under pulsatile flow condition has not been fully studied. The objectives of this study were to determine the artery critical bucklin...

  20. Post-exercise contractility, diastolic function, and pressure: Operator-independent sensor-based intelligent monitoring for heart failure telemedicine

    Directory of Open Access Journals (Sweden)

    Giannoni Massimo

    2009-05-01

    Full Text Available Abstract Background New sensors for intelligent remote monitoring of the heart should be developed. Recently, a cutaneous force-frequency relation recording system has been validated based on heart sound amplitude and timing variations at increasing heart rates. Aim To assess sensor-based post-exercise contractility, diastolic function and pressure in normal and diseased hearts as a model of a wireless telemedicine system. Methods We enrolled 150 patients and 22 controls referred for exercise-stress echocardiography, age 55 ± 18 years. The sensor was attached in the precordial region by an ECG electrode. Stress and recovery contractility were derived by first heart sound amplitude vibration changes; diastolic times were acquired continuously. Systemic pressure changes were quantitatively documented by second heart sound recording. Results Interpretable sensor recordings were obtained in all patients (feasibility = 100%. Post-exercise contractility overshoot (defined as increase > 10% of recovery contractility vs exercise value was more frequent in patients than controls (27% vs 8%, p 1 in 20 patients and in none of the controls (p 1 in only 3 patients (p Conclusion Post-exercise contractility, diastolic time and pressure changes can be continuously measured by a cutaneous sensor. Heart disease affects not only exercise systolic performance, but also post-exercise recovery, diastolic time intervals and blood pressure changes – in our study, all of these were monitored by a non-invasive wearable sensor.

  1. Casein improves brachial and central aortic diastolic blood pressure in overweight adolescents: a randomised, controlled trial

    DEFF Research Database (Denmark)

    Arnberg, Karina; Larnkjær, Anni; Michaelsen, Kim F.; Jensen, Signe Marie; Hoppe, Camilla; Mølgaard, Christian

    2013-01-01

    Arterial stiffness, blood pressure (BP) and blood lipids may be improved by milk in adults and the effects may be mediated via proteins. However, limited is known about the effects of milk proteins on central aortic BP and no studies have examined the effects in children. Therefore, the present...... trial examined the effect of milk and milk proteins on brachial and central aortic BP, blood lipids, inflammation and arterial stiffness in overweight adolescents. A randomised controlled trial was conducted in 193 overweight adolescents aged 12–15 years. They were randomly assigned to drink 1 litre of...... water, skimmed milk, whey or casein for 12 weeks. The milk-based test drinks contained 35 g protein/l. The effects were compared with the water group and a pretest control group consisting of thirty-two of the adolescents followed 12 weeks before the start of the intervention. Outcomes were brachial and...

  2. Correlation of femoral artery vs radial artery pressures with central pressure after cardiopulmonary bypass in children

    International Nuclear Information System (INIS)

    To assess the effectiveness of femoral and radial arterial lines on the correlation of peripheral and central mean arterial blood pressure in children after discontinuation of cardiopulmonary bypass. Fifty children scheduled for cardiac surgery with cardiopulmonary bypass were included in the study. After approval from the hospital ethics committee and informed consent. 50 children undergoing cardiac surgical procedures with cardiopulmonary bypass were randomly assigned to two different groups. In Group- A (RAP, n-2) a radial arterial line and in Group-B (FAP, n-25) a femoral arterial line was used to monitor the blood pressure. Simultaneous mean peripheral arterial pressure and mean central aortic pressure were recorded before cardiopulmonary bypass and 5 mins after separation from the cardiopulmonary bypass. The correlation of mean peripheral arterial pressure (radial and femoral) versus mean aortic pressure were compared. The data was recorded as Mean +- SD and P-value. The ages of children ranged from 4-12 years and their weight from 14.1-28.5 kg. In all of them following cardiopulmonary bypass, aortic pressure correlates better with femoral arterial pressure (p<0.001). The radial arterial line readings under estimated central aortic pressure when compared to femoral arterial line readings. Aortic pressure readings correlate better with femoral arterial pressure than radial arterial pressure in children. (author)

  3. Regular Khat (Catha edulis chewing is associated with elevated diastolic blood pressure among adults in Butajira, Ethiopia: A comparative study

    Directory of Open Access Journals (Sweden)

    Gedif Teferi

    2010-07-01

    Full Text Available Abstract Background Fresh leaves and buds of the Khat plant (Catha edulis contain Cathinone, an amphetamine like alkaloid responsible for its pharmacological action. Chewing of Khat has been associated with a transient rise in blood pressure and heart rate in experimental studies. Few studies examined the effect of regular or frequent Khat chewing on blood pressure at the population level. This study was conducted to examine the association of regular Khat chewing with blood pressure among adults. Methods We compared systolic and diastolic blood pressure of adults 35-65 years of age who reported regular chewing of Khat during the preceding five years to those who never chewed Khat during the same period. Study participants were recruited from purposively selected urban and rural villages of Butajira District in Ethiopia. The comparative groups, chewers (334 and non-chewers (330, were identified from among the general population through a house-to-house visit using a screening questionnaire. They were frequency-matched for sex and age within a five-year range. Data were collected through structured interviews and physical measurements including blood pressure, weight and height. Results The prevalence of hypertension was significantly higher among Khat chewers (13.4% than non-chewers (10.7%, odds ratio (OR = 1.66 (95% confidence interval (CI 1.05, 3.13. A considerably high proportion of chewers (29.9% than non-chewers (20.6% had sub-optimal diastolic blood pressure (> 80 mmHg. The mean (sd diastolic blood pressure was significantly higher among Khat chewers [75.0 (11.6] than non-chewers [72.9 (11.7], P Conclusion Regular chewing of Khat is associated with elevated mean diastolic blood pressure, which is consistent with the peripheral vasoconstrictor effect of Cathinone. Regular Khat chewing may have sustained effects on the cardiovascular system that can contribute to elevated blood pressure at the population level.

  4. A new noninvasive device for continuous arterial blood pressure monitoring in the superficial temporal artery

    International Nuclear Information System (INIS)

    Continuous recording of arterial blood pressure (ABP) has many applications in cardiovascular physiology, but existing alternatives rely on measurements performed in the fingers or radial artery. Peripheral recordings have significant differences from central ABP regarding the pattern of the waveform and corresponding systolic and diastolic values. To address the need for noninvasive measurements closer to the ascending aorta, a new device was constructed to measure ABP in the superficial temporal artery (STA) using photoplethysmography and the arterial volume clamping technique. The optoelectronic circuitry to generate the photoplethysmogram is contained in a specially designed probe placed over the STA and kept in place with a head frame. The prototype (STAbp) also includes original designs for the pneumatic, electronic, signal processing, control and display sub-systems. A self-calibration feature regularly updates the photoplethysmogram operating point to improve accuracy. The performance of the STAbp was compared against the Finapres in 19 healthy subjects. At rest, the bias (SDd) was −23.1 (15.05), −10.8 (13.83) and −12.4 (12.93) mmHg for systolic, mean and diastolic pressures respectively, without significant differences in drift between the two devices. The 99% bandwidth (SD) for the spectral distribution of ABP waveforms was 5.3 (1.46) Hz for STAbp and 6.8 (0.73) Hz for the Finapres (p < 0.01). Handgrip manoeuvre showed a very similar response to the Finapres, including the rapid return to baseline on release. The new STAbp device has considerable potential as a new tool for clinical and research applications where continuous recording of more central ABP is advantageous compared to peripheral alternatives. (paper)

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

    OpenAIRE

    Spector, Tim D.; Rotimi, Charles N; Hedblad, Bo; Brand, Eva; Day, Ian N M; Kita, Yoshikuni; Chandak, Giriraj R; Tomaszewski, Maciej; Wong, Andrew; Ogihara, Toshio; Salomaa, Veikko; Igl, Wilmar; Laitinen, Jaana; Olden, Matthias; Okamura, Tomonori

    2011-01-01

    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 pressu...

  6. COMPARISON OF HIGH-DEFINITION OSCILLOMETRIC AND DIRECT ARTERIAL BLOOD PRESSURE MEASUREMENT IN ANESTHETIZED CHEETAHS (ACINONYX JUBATUS).

    Science.gov (United States)

    Sant Cassia, Emma V; Boswood, Adrian; Tordiffe, Adrian S W

    2015-09-01

    Blood pressure measurement reveals important insights into the health of conscious and anesthetized individuals. This is of particular interest in cheetahs (Acinonyx jubatus), which in captivity are known to suffer from chronic diseases that may be associated with hypertension and which often require immobilization for transport or veterinary treatment. Invasive testing methods are considered the gold standard but are not practical in many settings. Consequently, it is important to evaluate the use of noninvasive methods in this species. Measurements for systolic, diastolic, and mean arterial pressure obtained using high-definition oscillometry (HDO) at the coccygeal artery were compared to simultaneous direct measurements obtained via catheterization of the femoral or dorsal pedal artery in eight anesthetized captive cheetahs during nine anesthetic events. Overall, HDO and direct measurements agreed most closely for mean arterial pressure, and the poorest agreement was observed for systolic pressure. There was a tendency for low diastolic pressures to be underestimated and for high diastolic pressures to be overestimated. Across all three parameters, HDO measurements from the tail overestimated directly measured pressures in the femoral artery and underestimated those in the dorsal pedal artery. HDO agreed most closely with directly measured dorsal pedal pressures. Mean arterial pressure showed the greatest precision (standard deviation of 10.2 mm Hg) and lowest bias (-1.2 mm Hg), with 75.9% of readings within 10 mm Hg of the direct dorsal pedal pressure. Agreement with systolic pressure was hindered by a high bias (-10.4 mm Hg), but if a correction factor of +10 mm Hg was applied to all systolic measurements, agreement was improved and 65.7% of readings were within 10 mm Hg of the direct pressure. When compared to criteria defined by the American College of Veterinary Internal Medicine for validation of blood pressure devices, results were favorable, but a limited sample size prevented formal validation. PMID:26352954

  7. 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

  8. Investigation Of Arterial Blood Pressure Level And Metabolic Indices In Patients With Arterial Hypertension At Pharmacotherapy With Antihypertensive Medicines Of Various Chemical Structure

    Directory of Open Access Journals (Sweden)

    G.Kh. Glybochko

    2009-12-01

    Full Text Available The research goal is to carry on the comparative analysis of medicines of various chemical structure, Telmisar-tan and Bisoprolol, and to reveal their effect on the arterial blood pressure level and the indices of various metabolic processes in patients with arterial hypertension. 60 out-patients with arterial hypertension (stage II risk III both males and females aged 33-55 have been under study taking Telmisartan and Bisoprolol for 3 months. While treating the patients the arterial blood pressure level control and biochemical investigations for determination the indices of metabolic processes have been carried out. The investigated medications have provided the decrease of systolic and diastolic arterial pressure parameters, the increase of concentration of total and ionized calcium, chlorine ions, urea and total bilirubin in blood plasma. Therapy with Telmisartan has shown more significant increase of potassium level in erythro-cytes, decrease of levels of natrium, glucose, glycolized hemoglobin and triglycerides and increased contents of alani-naminotransferase and aspartataminotransferase. The course of therapy with Bisoprolol has restored the normal level of magnesium in blood plasma, has not have any influence on carbohydrate and lipid metabolism, increased the level of alaninaminotransferase and significantly increased the contents of total and ionized calcium, urea and creatinine. 3-months therapy with Telmisartan and Bisoprolol has proved the decrease of systolic and diastolic arterial pressure in patients with arterial hypertension. The medications under study have had active and variable effects on metabolic indices

  9. 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)

    M Esmaeilzadeh

    2009-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Jong-Gu Choi

    2011-01-01

    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.

  11. Improved lipids, diastolic pressure and kidney function are potential contributors to familial longevity: a study on 60 Chinese centenarian families.

    Science.gov (United States)

    He, Yong-Han; Pu, Shao-Yan; Xiao, Fu-Hui; Chen, Xiao-Qiong; Yan, Dong-Jing; Liu, Yao-Wen; Lin, Rong; Liao, Xiao-Ping; Yu, Qin; Yang, Li-Qin; Yang, Xing-Li; Ge, Ming-Xia; Li, Ying; Jiang, Jian-Jun; Cai, Wang-Wei; Kong, Qing-Peng

    2016-01-01

    Centenarians are a good healthy aging model. Interestingly, centenarians' offspring are prone to achieve longevity. Here we recruited 60 longevity families and investigated the blood biochemical indexes of family members to seek candidate factors associated with familial longevity. First, associations of blood indexes with age were tested. Second, associations of blood parameters in centenarians (CEN) with their first generation of offspring (F1) and F1 spouses (F1SP) were analyzed. Third, genes involved in regulating target factors were investigated. We found that total cholesterol (TC) and triglyceride (TG) increased with age (20-80 years), but decreased in CEN. Similarly, blood urea nitrogen (BUN) and blood creatinine (BCr) increased with age (20-80 years), but were maintained on a plateau in CEN. Importantly, we first revealed dual changes in blood pressure, i.e., decreased diastolic blood pressure but increased systolic blood pressure in CEN, which associated with altered CST3 expression. Genetic analysis revealed a significant association of blood uric acid (BUA) and BCr in CEN with F1 but not with F1SP, suggesting they may be heritable traits. Taken together, our results suggest serum lipids, kidney function and especially diastolic pressure rather than systolic pressure were improved in CEN or their offspring, suggesting these factors may play an important role in familial longevity. PMID:26911903

  12. High intensity interior aircraft noise increases the risk of high diastolic blood pressure in Indonesian Air Force pilots

    OpenAIRE

    Minarma Siagian; Bastaman Basuki; Dede Kusmana

    2009-01-01

    Aim: To analyze the effects of aircraft noise, resting pulse rate, and other factors on the risk of high diastolic blood pressure (DBP) in Indonesian Air Force pilots.Methods: A nested case-control study was conducted using data extracted from annual medical check-ups indoctrination aerophysiologic training records at the Saryanto Aviation and Aerospace Health Institute (LAKESPRA) in Jakarta from January 2003 – September 2008. For analysis of DBP: the case group with DBP ≥ 90 mmHg were compar...

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

    Directory of Open Access Journals (Sweden)

    Sonia M. Junqueira V. de Oliveira

    1997-07-01

    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.

  14. 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

    International Nuclear Information System (INIS)

    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

  15. Ambulatory Arterial Stiffness Index and circadian blood pressure variability.

    Science.gov (United States)

    Bahrainwala, Jehan; Patel, Ami; Diaz, Keith M; Veerabhadrappa, Praveen; Cohen, Debbie L; Cucchiara, Andrew; Townsend, Raymond R

    2015-09-01

    The manner in which the circulation accommodates each heartbeat may underlie blood pressure (BP) variability. We used the Ambulatory Arterial Stiffness Index (AASI), which reflects this ventricular-vascular interaction, in untreated individuals with prehypertension and Stage 1 hypertension to evaluate two different measures of BP variability using the brachial pulse pressure (PP) obtained over 24 hours. We enrolled 64 untreated adults with systolic BP between 130-159 mm Hg and diastolic values of <100 mm Hg who underwent 24-hour ambulatory BP monitoring with calculation of 24-hour AASIs. Variability in brachial PP was determined using the standard deviation of the measurements over 24 hours and the average real variability. The 24-hour AASI correlated with both measures of 24-hour PP variability (P < .001 for both). Subdividing the 24-hour stiffness index into daytime and nighttime components showed modest differences in their relationship to PP variability, with the daytime being significantly different from 24-hour AASI and the standard deviation of the brachial PP consistently having a higher correlation to the AASI when compared with the average real variability. These observations may be useful to understand differences in variability measures of BP measurements, such as PP, to measures like the AASI as reported in longitudinal studies. PMID:26260424

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

    Science.gov (United States)

    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 JW; 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; Hotteng, 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 US; Rivadeneira, Fernando; Sijbrands, Eric JG; 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, M Fabiola; 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 JC; 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; ’t Hoen, Peter AC; 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 JF; 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 CM; 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

    2012-01-01

    Numerous genetic loci influence systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans 1-3. 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 novel PP loci (at 4q12 near CHIC2/PDGFRAI, 7q22.3 near PIK3CG, 8q24.12 in NOV, 11q24.3 near ADAMTS-8), two novel MAP loci (3p21.31 in MAP4, 10q25.3 near ADRB1) and one locus associated with both traits (2q24.3 near FIGN) which has recently been associated with SBP in east Asians. For three of the novel PP signals, the estimated effect for SBP was opposite to that for DBP, in contrast to the majority of common SBP- and DBP-associated variants which show concordant effects on both traits. These findings indicate novel genetic mechanisms underlying blood pressure variation, including pathways that may differentially influence SBP and DBP. PMID:21909110

  17. New Cardiovascular Indices Based on a Nonlinear Spectral Analysis of Arterial Blood Pressure Waveforms

    CERN Document Server

    Laleg, Taous-Meriem; Papelier, Yves; Crépeau, Emmanuelle; Sorine, Michel

    2007-01-01

    A new method for analyzing arterial blood pressure is presented in this report. The technique is based on the scattering transform and consists in solving the spectral problem associated to a one-dimensional Schr\\"odinger operator with a potential depending linearly upon the pressure. This potential is then expressed with the discrete spectrum which includes negative eigenvalues and corresponds to the interacting components of an N-soliton. The approach is similar to a nonlinear Fourier transform where the solitons play the role of sine and cosine components. The method provides new cardiovascular indices that seem to contain relevant physiological information. We first show how to use this approach to decompose the arterial blood pressure pulse into elementary waves and to reconstruct it or to separate its systolic and diastolic phases. Then we analyse the parameters computed from this technique in two physiological conditions, the head-up 60 degrees tilt test and the isometric handgrip test, widely used for...

  18. 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 < 0.005), but resting diastolic filling improved: PFR increased (control 1.9 + 0.6 EDV/sec, verapamil 2.3 + 0.9 EDV/sec, p < 0.005) and time to PFR decreased (control 185 + 38 mssec, verapamil 161 + 27 msec, p < 0.05). Exercise ejection fraction did not change during verapamil (control 42 + 13%, verapamil 43 + 12%. NS), but exercise PFR increased (control 3.1 + 0.9 EDV/sec, verapamil 3.6 + 1.1 EDV/sec, p < 0.05) and exercise time to PFR decreased (control 108 + 30 msec, verapamil 91 + 17 msec, p < 0.05). 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

  19. A novel transmission-based test of association for multivariate phenotypes: an application to systolic and diastolic blood pressure levels.

    Science.gov (United States)

    Haldar, Tanushree; Mukhopadhyay, Indranil; Ghosh, Saurabh

    2014-01-01

    Unlike case-control studies, family-based tests for association are protected against population stratification. Complex genetic traits are often governed by quantitative precursors and it has been argued that it may be a more powerful strategy to analyze these quantitative precursors instead of the clinical end point trait. Although methods have been developed for family-based association tests for single quantitative traits, it is of interest to develop such methods for multivariate phenotypes. We propose a novel transmission-based approach based on a trio design using a simple logistic regression to test for association with a multivariate phenotype. We use our proposed method to analyze data on systolic and diastolic blood pressure levels provided in Genetic Analysis Workshop 18. However, we find that the bivariate analysis of the two phenotypes did not provide more promising results compared to univariate analyses, suggesting a possibility of a different set of major genetic variants modulating the two phenotypes. PMID:25519341

  20. High intensity interior aircraft noise increases the risk of high diastolic blood pressure in Indonesian Air Force pilots

    Directory of Open Access Journals (Sweden)

    Minarma Siagian

    2009-12-01

    Full Text Available Aim: To analyze the effects of aircraft noise, resting pulse rate, and other factors on the risk of high diastolic blood pressure (DBP in Indonesian Air Force pilots.Methods: A nested case-control study was conducted using data extracted from annual medical check-ups indoctrination aerophysiologic training records at the Saryanto Aviation and Aerospace Health Institute (LAKESPRA in Jakarta from January 2003 – September 2008. For analysis of DBP: the case group with DBP ≥ 90 mmHg were compared with contral group with DBP < 79 mmHG. One case matched to 12 controls.Results: Out of 567 pilots, 544 (95.9% had complete medical records. For this analysis there were 40 cases of high DBP and 480 controls for DBP. Pilots exposed to aircraft noise 90-95 dB rather than 70-80 dB had a 2.7-fold increase for high DBP [adjusted odds ratio (ORa = 2.70; 95% confi dence interval (CI = 1.05-6.97]. Pilots with resting pulse rates of ≥ 81/minute rather than ≤ 80/minute had a 2.7-fold increase for high DBP (ORa = 2.66; 95% CI = 1.26-5.61. In terms of total fl ight hours, pilots who had 1401-11125 hours rather than 147-1400 hours had a 3.2-fold increase for high DBP (ORa = 3.18; 95% CI = 1.01-10.03.Conclusion: High interior aircraft noise, high total flight hours,  and high resting pulse rate, increased risk for high DBP. Self assessment of resting pulse rate can be used to control the risk of high DBP. (Med J Indones 2009; 276: 276-82Keywords: diastolic blood pressure, aircraft noise, resting pulse rate, military pilots

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

    Directory of Open Access Journals (Sweden)

    Luis Miguel Benítez

    Full Text Available 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 métodos: 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 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 clinical 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.

  2. Obese children and adolescents have elevated nighttime blood pressure independent of insulin resistance and arterial stiffness

    DEFF Research Database (Denmark)

    Hvidt, Kristian N; Olsen, Michael H; Holm, Jens-Christian; Ibsen, Hans

    2014-01-01

    BACKGROUND: Insulin resistance has been related to elevated blood pressure (BP) in obese children and may adversely affect the vasculature by arterial stiffening. The objective was to investigate whether daytime and nighttime BP were elevated and related to insulin resistance and arterial stiffness...... in obese children and adolescents. METHODS: Ninety-two obese patients aged 10-18 years were compared with 49 healthy control individuals. Insulin resistance was measured as the homeostatic assessment model (HOMA), and arterial stiffness was measured as carotid-femoral pulse wave velocity (cf......PWV). RESULTS: Mean ± SD daytime systolic BP (SBP) (obese: 125±8.3mm Hg; control: 121±10.1mm Hg; P = 0.03) and nighttime SBP (obese: 108±10.7mm Hg; control: 102±8.2mm Hg; P = 0.0001) were higher in the obese group when compared with the control group. No difference was found in daytime diastolic BP (DBP...

  3. Factors determining direct arterial pressure and its variability in hypertensive man.

    Science.gov (United States)

    Watson, R D; Stallard, T J; Flinn, R M; Littler, W A

    1980-01-01

    Intra-arterial pressure was recorded continuously in 26 patients with uncomplicated essential hypertension under standardized conditions. Recordings were analyzed beat by beat to obtain mean pressures and variability, expressed as the standard deviation of the frequency histogram. The major factors influencing variability were the level of pressure and the intensity of physical activity; systolic variability increased with progressive impairment of sino-aortic baroreflexes. Diastolic pressure increased with the level of sympathetic activity as reflected by plasma norepinephrine levels. After allowance for the decrease of plasma renin activity (PRA) with age, direct relationships were observed between PRA (log values) and the level of pressure and systolic variability; plasma angiotensin II values did not correlate. Systolic variability increased with the systolic response to cold but was unrelated to the response to dynamic or isometric exercise. Variability also tended to increase with obesity and was unrelated to age, sex, or race. PMID:6993360

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

    Science.gov (United States)

    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; Sõber, 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; Sjögren, 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; Lehtimäki, 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.; Kähönen, Mika; Viikari, Jorma; Adair, Linda S.; Lee, Nanette R.; Chen, Ming-Huei; Olden, Matthias; Pattaro, Cristian; Hoffman Bolton, Judith A.; Köttgen, Anna; Bergmann, Sven; Mooser, Vincent; Chaturvedi, Nish; Frayling, Timothy M.; Islam, Muhammad; Jafar, Tazeen H.; Erdmann, Jeanette; Kulkarni, Smita R.; Bornstein, Stefan R.; Grässler, Jürgen; Groop, Leif; Voight, Benjamin F.; Kettunen, Johannes; Howard, Philip; Taylor, Andrew; Guarrera, Simonetta; Ricceri, Fulvio; Emilsson, Valur; Plump, Andrew; Barroso, Inês; 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; Stančáková, 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; Mattace-Raso, Francesco U.S.; Oostra, Ben A.; Demirkan, Ayse; Isaacs, Aaron; Rivadeneira, Fernando; Lakatta, Edward G.; Orru, Marco; Scuteri, Angelo; Ala-Korpela, Mika; Kangas, Antti J.; Lyytikäinen, Leo-Pekka; Soininen, Pasi; Tukiainen, Taru; Würz, Peter; Twee-Hee Ong, Rick; Dörr, Marcus; Kroemer, Heyo K.; Völker, Uwe; Völzke, Henry; Galan, Pilar; Hercberg, Serge; Lathrop, Mark; Zelenika, Diana; Deloukas, Panos; Mangino, Massimo; Spector, Tim D.; Zhai, Guangju; Meschia, James F.; Nalls, Michael A.; Sharma, Pankaj; Terzic, Janos; Kranthi Kumar, M.J.; Denniff, Matthew; Zukowska-Szczechowska, Ewa; Wagenknecht, Lynne E.; Fowkes, Gerald R.; Charchar, Fadi J.; Schwarz, Peter E.H.; Hayward, Caroline; Guo, Xiuqing; Bots, Michiel L.; Brand, Eva; Samani, Nilesh J.; Polasek, Ozren; Talmud, Philippa J.; Nyberg, Fredrik; Kuh, Diana; Laan, Maris; Hveem, Kristian; Palmer, Lyle J.; van der Schouw, Yvonne T.; Casas, Juan P.; Mohlke, Karen L.; Vineis, Paolo; Raitakari, Olli; Wong, Tien Y.; Shyong Tai, E.; Laakso, Markku; Rao, Dabeeru C.; Harris, Tamara B.; Morris, Richard W.; Dominiczak, Anna F.; Kivimaki, Mika; Marmot, Michael G.; Miki, Tetsuro; Saleheen, Danish; Chandak, Giriraj R.; Coresh, Josef; Navis, Gerjan; Salomaa, Veikko; Han, Bok-Ghee; Kooner, Jaspal S.; Melander, Olle; Ridker, Paul M.; Bandinelli, Stefania; Gyllensten, Ulf B.; Wright, Alan F.; Wilson, James F.; Ferrucci, Luigi; Farrall, Martin; Tuomilehto, Jaakko; Pramstaller, Peter P.; Elosua, Roberto; Soranzo, Nicole; Sijbrands, Eric J.G.; Altshuler, David; Loos, Ruth J.F.; Shuldiner, Alan R.; Gieger, Christian; Meneton, Pierre; Uitterlinden, Andre G.; Wareham, Nicholas J.; Gudnason, Vilmundur; Rettig, Rainer; Uda, Manuela; Strachan, David P.; Witteman, Jacqueline C.M.; Hartikainen, Anna-Liisa; Beckmann, Jacques S.; Boerwinkle, Eric; Boehnke, Michael; Larson, Martin G.; Järvelin, Marjo-Riitta; Psaty, Bruce M.; Abecasis, Gonçalo R.; Elliott, Paul; van Duijn , Cornelia M.; Newton-Cheh, Christopher

    2011-01-01

    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. PMID:21378095

  5. The Relation Between Aortic Pulse Pressure and Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Ali Metin Esen

    2011-08-01

    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.

  6. Heart and Artery Damage and High Blood Pressure

    Science.gov (United States)

    ... Stroke More Heart and Artery Damage and High Blood Pressure Updated:Oct 22,2015 There are several harmful ... was last reviewed on 08/04/2014. High Blood Pressure • Home • About High Blood Pressure (HBP) • Why HBP ...

  7. Biochemical Effects of Lead Exposure on Systolic & Diastolic Blood Pressure, Heme Biosynthesis and Hematological Parameters in Automobile Workers of North Karnataka (India)

    OpenAIRE

    Nilima N. Dongre; Suryakar, Adinath N.; Patil, Arun J.; Ambekar, Jeevan G.; Dileep B. Rathi

    2011-01-01

    The purpose of this study was to find out the effect of lead exposure on systolic and diastolic blood pressure, heme biosynthesis related and hematological parameters of automobile workers. For this study 30 automobile workers were selected and compared with 30 age matched healthy control subjects. Significantly increased blood lead (364%, P 

  8. Determining the Arterial Blood Pressure of People Living in Yesilyurt Local Healthcare Office

    Directory of Open Access Journals (Sweden)

    Feyza Dereli

    2009-02-01

    Full Text Available AIM: Whereas the prevalance of arterial blood pressure which was a chronical health problem was 20%-25% among 30 year-old people, them showing an increase in aging, the percentage went as high as 50% in 60’s and later ages. What was that worrisome was that despite the high prevalance, only half of these received treathment. This is study was descriptively and cross-sectionally planned to determine whether the people asking their tensions to be measured in and around the Yesilyurt local healthcare office region. METHODS: The environment of the research consisted of 1400 people over 35 age and registered Yesilyurt Local healthcare Office and the whole of the environment were included in this sample. The study was conducted over 340 voluntaries. The data was collected by a questionnaire of 14 questions containing socio-demografic features and by measuring the arterial blood pressure, height and weight of the individuals. In the evaluation of the data, chi-square test was used and the level of significantly was accepted as 0.05. RESULTS: In this study, the rate of high sistolic blood pressure was found to be 21.47% and the rate of high diastolic blood pressure to be 8.23%. It was determined that age and body mass index varrieties were effective on sistolic hipertension. It was also found that in their behaviors of the use of hypertensive medicine, of regular arterial pressure controls and of having the hypertesion diagnosis significant differnces varied statistically on both sistolic and diastolic blood pressure people having. CONCLUSION: In order to improve the health, informative information abouth hypertension was provided for the participants for too days consisting of 4 sessions. [TAF Prev Med Bull 2009; 8(1.000: 53-58

  9. Changes in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure in men and women with primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Marjanovi? Ivan

    2013-01-01

    Full Text Available Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor of glaucoma. Objective. The aim of this study was to evaluate the changes of the hemodynamic parameters in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure (IOP in women and men with primary open angle glaucoma. Methods. The study included 60 patients (33 males and 27 females older than 50 years, with diagnosed and treated primary open angle glaucoma (77 eyes of 39 patients had increased IOP, >25 mm Hg. They were examined at the Clinic of Eye Diseases (complete ophthalmologic exam and Clinic of Neurology, Clinical Center of Serbia, Belgrade, from December 2009 to December 2010. Imaging of hemodynamic parameters of three retrobulbar arterial vessels: ophthalmic, central retinal and posterior ciliary arteries with color Doppler was performed. Results. Among women, hemodynamic arterial parameter of the peak-systolic velocity was increased in the central retinal artery and decreased in the ophthalmic artery and posterior ciliary arteries; end- diastolic velocity was increased in all three retrobulbar vascular levels; Pourcelot resistivity index was increased, but pulsatility index was decreased in all three vessels. Among men, peak-systolic velocity, end-diastolic velocity and pulsatility index were decreased in all three vessels; resistivity index was increased in the ophthalmic artery, but decreased in the central retinal artery and posterior ciliary arteries. There was a significant change of the ophthalmic artery pulsatility index in women, and the end-diastolic velocity of the ophthalmic artery in men. Conclusion. There was a difference of the retrobulbar arterial circulation between women and men with primary open angle glaucoma after decrease of the elevated intraocular pressure. The role of vascular factors in the supply of the optic disc neuroretinal rim is important.

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

    OpenAIRE

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

    2013-01-01

    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 i...

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

    OpenAIRE

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

    1990-01-01

    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. Ambulatory monitoring techniques provided data for the computerised analysis of continuous, beat-to-beat, direct recordings of both pulmonary and systemic arterial pressures for 8 to 10 hours. The absol...

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

    International Nuclear Information System (INIS)

    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.)

  13. Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip

    International Nuclear Information System (INIS)

    Purpose: The purpose of this work was to evaluate blood pressure changes caused by deployment of the Surefire antireflux expandable tip. The pressure measurements are relevant because they imply changes in hepatoenteric arterial blood flow within this liver compartment during hepatic artery delivery of cytotoxic agents. Methods: After positioning the Surefire antireflux system in the targeted hepatic artery, blood pressure was obtained initially with the tip collapsed (or through a femoral artery sheath), then again after the tip was expanded before chemoembolization or yttrium 90 (90Y) radioembolization. Results: Eighteen patients with liver malignancy underwent 29 procedures in 29 hepatic arteries (3 common hepatic, 22 lobar, 4 segmental). Systolic, diastolic, and mean blood pressure were all decreased by a mean of 29 mm Hg (p = 0.000004), 14 mm Hg (p = 0.0000004), and 22 mm Hg (p = 0.00000001), respectively. Conclusion: When the Surefire expandable tip is deployed to prevent retrograde reflux of agents, it also results in a significant decrease in blood pressure in the antegrade distribution, potentially resulting in hepatopedal blood flow in vessels that are difficult to embolize, such as the supraduodenal arteries

  14. Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip

    Energy Technology Data Exchange (ETDEWEB)

    Rose, Steven C., E-mail: scrose@ucsd.edu; Kikolski, Steven G. [University of California, San Diego Health Sciences, Department of Radiology 8756, UCSD Medical Center (United States); Chomas, James E. [Surefire Medical, Inc. (United States)

    2013-10-15

    Purpose: The purpose of this work was to evaluate blood pressure changes caused by deployment of the Surefire antireflux expandable tip. The pressure measurements are relevant because they imply changes in hepatoenteric arterial blood flow within this liver compartment during hepatic artery delivery of cytotoxic agents. Methods: After positioning the Surefire antireflux system in the targeted hepatic artery, blood pressure was obtained initially with the tip collapsed (or through a femoral artery sheath), then again after the tip was expanded before chemoembolization or yttrium 90 ({sup 90}Y) radioembolization. Results: Eighteen patients with liver malignancy underwent 29 procedures in 29 hepatic arteries (3 common hepatic, 22 lobar, 4 segmental). Systolic, diastolic, and mean blood pressure were all decreased by a mean of 29 mm Hg (p = 0.000004), 14 mm Hg (p = 0.0000004), and 22 mm Hg (p = 0.00000001), respectively. Conclusion: When the Surefire expandable tip is deployed to prevent retrograde reflux of agents, it also results in a significant decrease in blood pressure in the antegrade distribution, potentially resulting in hepatopedal blood flow in vessels that are difficult to embolize, such as the supraduodenal arteries.

  15. Casein-Derived Lactotripeptides Reduce Systolic and Diastolic Blood Pressure in a Meta-Analysis of Randomised Clinical Trials

    Directory of Open Access Journals (Sweden)

    Ágnes A. Fekete

    2015-01-01

    Full Text Available There is an urgent need to treat individuals with high blood pressure (BP with effective dietary strategies. Previous studies suggest a small, but significant decrease in BP after lactotripeptides (LTP ingestion, although the data are inconsistent. The study aim was to perform a comprehensive meta-analysis of data from all relevant randomised controlled trials (RCT. Medline, Cochrane library, EMBASE and Web of Science were searched until May 2014. Eligibility criteria were RCT that examined the effects of LTP on BP in adults, with systolic BP (SBP and diastolic BP (DBP as outcome measures. Thirty RCT met the inclusion criteria, which resulted in 33 sets of data. The pooled treatment effect for SBP was −2.95 mmHg (95% CI: −4.17, −1.73; p < 0.001, and for DBP was −1.51 mmHg (95% CI: −2.21, −0.80; p < 0.001. Sub-group analyses revealed that reduction of BP in Japanese studies was significantly greater, compared with European studies (p = 0.002 for SBP and p < 0.001 for DBP. The 24-h ambulatory BP (AMBP response to LTP supplementation was statistically non-significant (p = 0.101 for SBP and p = 0.166 for DBP. Both publication bias and “small-study effect” were identified, which shifted the treatment effect towards less significant SBP and non-significant DBP reduction after LTP consumption. LTP may be effective in BP reduction, especially in Japanese individuals; however sub-group, meta-regression analyses and statistically significant publication biases suggest inconsistencies.

  16. Comparing systolic and diastolic Blood pressure changes and heartbeat rate following administration of anesthetics containing epinephrine and felypressin

    Directory of Open Access Journals (Sweden)

    M. Jafari

    1998-05-01

    Full Text Available   Complex mechanisms have been known for keeping blood pressure in normal level. In fact, these mechanisms have inter-related functions and can be dysregulated by both internal and external stimuli while cardiovascular system functions to minimize these changes. Vasoconstrictors can cause clinical and hemodynamical changes as 1-2 cartridges of epinephrine containing lidocaine can has no considerable effects in a normal individual ( unless administered IV but 3 cartridges can bring about some clinical symptoms, according to a number of investigations. In current study, epinephrine’s effect on heartbeat rate was found more potent than felypressin which is considered as a disadvantage. on the other hand, epinephrine acts on arteries and can cause less bleeding, less drug toxicity and deeper and longer anesthesia. Therefore, it is preferred to felypressin due to its better action. It should be noted that the changes resulted by epinephrine and felypressin are of no significant importance in healthy individuals.

  17. Changes in the retrobulbar arterial circulation after decrease of elevated intraocular pressure in patients with primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Knežević Miroslav

    2011-01-01

    Full Text Available Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor in glaucoma. Objective. To evaluate changes of haemodynamic parameters in the retrobulbar arterial circulation after a decrease of elevated intraocular pressure (IOP in patients with primary open angle glaucoma (POAG. Methods. Twenty-six patients were examined, 14 men and 12 women, 21 up to 50 years old and 5 below, all with previously diagnosed and treated POAG, and all examined at the Eye Clinic, Clinical Centre of Serbia. IOP was measured both with a Goldmann aplanation tonometer and dynamic contour tonometer. Central corneal thickness was measured with ultrasound pachymeter. Imaging of the retrobulbar arterial circulation by colour Doppler was performed at the Neurology Clinic, Clinical Centre of Serbia. It involved measuring of haemodynamic parameters of the ophthalmic artery, central retinal artery, and posterior ciliary arteries. Peak systolic velocity (PSV and end-diastolic velocity (EDV were measured, and resistive index (RI and pulsatility index (PI were calculated. Results. Haemodynamic arterial parameters PSV and EDV in the ophthalmic and central retinal artery after decrease of IOP were lower, while RI and PI were higher. In the posterior ciliary arteries PSV, EDV and PI were lower, and RI was higher. Conclusion. Changes of the retrobulbar arterial circulation after elevated IOP in POAG patients are important for approach and treatment, while the role of vascular factors in the supplement of the optic disc neuroretinal rim could be a key for progression backlash of glaucoma and the radix of neuroprotection.

  18. 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)

    Andrea Passantino

    2009-04-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Saltiki Katerina

    2008-09-01

    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.

  20. The effect of carotid artery occlusion on lingual arterial blood pressure in dogs.

    Science.gov (United States)

    Holmberg, D L; Pettifer, G R

    1997-01-01

    Although temporary occlusion of the carotid arteries is commonly done to reduce blood loss during nasal surgery in the dog, data supporting its use are mostly anecdotal and subjective. Twelve dogs were placed under general inhalation anesthesia and mechanically ventilated to maintain normocapnea and an end-tidal halothane concentration equivalent to 1.3 times the minimum alveolar concentration. Tourniquets were placed around both carotid arteries of each dog. Both lingual arteries were cannulated in each dog and their heart rate and blood pressure were measured bilaterally. During unilateral carotid artery occlusion, the blood pressures in the ipsilateral lingual artery were significantly (P carotid artery occlusion resulted in a further significant (P carotid occlusion (P carotid artery occlusion has the potential to reduce intraoperative blood loss during oronasal surgery in the dog. PMID:9332746

  1. Assembly of a Pulmonary Artery Pressure Sensor System

    OpenAIRE

    J. Müntjes; S. Meine; Flach, E.; Görtz, M.; R Hartmann; T. Schmitz-Rode; Trieu, H.K.; W. Mokwa

    2010-01-01

    This paper presents an implantable system for telemonitoring the intravascular pressure in the pulmonary artery. By implanting a catheter-bound pressure and temperature sensor into the pulmonary artery, it is possible to monitor the actual value and the time variations of the intravascular pressure with a frequency of 128 Hz. Thus hospitalization of patients suffering from heart insufficiency can be avoided by early changes in therapy.Preliminary in vivo experiments have been conducted to ver...

  2. Femoral artery pressure measurement to predict the outcome of arterial surgery in patients with multilevel disease

    DEFF Research Database (Denmark)

    Faris, I; Tønnesen, K H; Agerskov, K; Noer, Ivan; Sager, P

    1982-01-01

    Direct measurement of the femoral artery pressure before operation has been used to predict the postoperative change in ankle and toe pressure in 102 limbs (83 patients) that underwent aortoiliac surgery for the treatment of atherosclerotic occlusion or stenosis affecting both the aortoiliac and...... would persist. Measurement of the femoral artery pressure allows prediction of the toe and ankle pressure response to surgery to be made with sufficient accuracy to permit a preoperative decision to be made between the need for a single-level or a two-level arterial reconstruction: no patients who had...

  3. Measurement of brachial artery endothelial function using a standard blood pressure cuff.

    Science.gov (United States)

    Maltz, Jonathan S; Tison, Geoffrey H; Alley, Hugh F; Budinger, Thomas F; Owens, Christopher D; Olgin, Jeffrey

    2015-11-01

    The integrity of endothelial function in major arteries (EFMA) is a powerful independent predictor of heart attack and stroke. Existing ultrasound-based non-invasive assessment methods are technically challenging and suitable only for laboratory settings. EFMA, like blood pressure (BP), is both acutely and chronically affected by factors such as lifestyle and medication. Consequently, laboratory-based measurements cannot fully gauge the effects of medical interventions on EFMA. EFMA and BP have, arguably, comparable (but complementary) value in the assessment of cardiovascular health. Widespread deployment of EFMA assessment is thus a desirable clinical goal. To this end, we propose a device based on modifying the measurement protocol of a standard electronic sphygmomanometer. The protocol involves inflating the cuff to sub-diastolic levels to enable recording of the pulse waveform before and after vasodilatory stimulus. The mechanical unloading of the arterial wall provided by the cuff amplifies the distension that occurs with each pulse, which is measured as a pressure variation in the cuff. We show that the height of the rising edge of each pulse is proportional to the change in lumen area between diastole and systole. This allows the effect of vasodilatory stimuli on the artery to be measured with high sensitivity. We compare the proposed cuff flow-mediated dilation (cFMD) method to ultrasound flow-mediated dilation (uFMD). We find significant correlation (r = 0.55, p = 0.003, N = 27) between cFMD- and uFMD-based metrics obtained when the release of a 5 min cuff occlusion is employed to induce endothelial stimulus via reactive hyperemia. cFMD is approximately proportional to the square of uFMD, representing a typical increase in sensitivity to vasodilation of 300-600%. This study illustrates the potential for an individual to conveniently measure his/her EFMA by using a low-cost reprogrammed home sphygmomanometer. PMID:26393958

  4. Hypertension and chronic kidney disease: respective contribution of mean and pulse pressure and arterial stiffness.

    Science.gov (United States)

    Kheder-Elfekih, Rania; Yannoutsos, Alexandra; Blacher, Jacques; London, Gérard M; Safar, Michel E

    2015-10-01

    Hypertension (HTN) in chronic kidney disease (CKD) is influenced by blood pressure (BP) and the progression of CKD, including hemodialysis and renal transplantation. To date, the efficacy of antihypertensive drug strategies has chiefly been assessed by measuring steady-state systolic, diastolic and mean arterial pressures (MAP). However, recently elucidated features of the BP curve have highlighted other important goals, that is, the specific roles of pulse pressure (PP), arterial stiffness, pulse wave velocity (PWV) and wave reflections as potentially deleterious factors affecting the progression of HTN and CKD. Pharmacological strategies to date have included progressive withdrawal of alpha-blocking agents; efficacy of beta-blockers for coronary prevention; use of angiotensin blockade in HTN with glomerular injury, using angiotensin-converting enzyme inhibition or receptor blockade, as mono but never double-blockade, to avoid major complications; development of combination therapies with diuretics and/or calcium channel blockers. Nowadays, most clinical trials show that SBP, DBP and MAP-lowering is an effective strategy, although results no longer show preference for any specific drug class.Studies of arterial stiffness in CKD have become crucial. In older individuals, PWV is considerably elevated. The 'stiffness gradient' disappears or is inverted (normally, aortic PWV is lower than brachial PWV). Despite BP-lowering, PP is insufficiently dampened, thus promoting microcirculatory damage, progression of arterial calcifications and disturbed wave reflections, which all increase the risk of mortality. In the absence of effective hemodialysis or graft, increased arterial stiffness is therefore a major cardiovascular risk factor in CKD. PMID:26237563

  5. Nesfatin-1 and Vitamin D levels may be associated with systolic and diastolic blood pressure values and hearth rate in polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Figen Kir Sahin

    2015-07-01

    Full Text Available Obesity, insulin resistance (IR, inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS and hypertension. Nesfatin-1 (N1 may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP and heart rate (HR.This study included 54 patients with PCOS and 48 age-body mass index (BMI-matched healthy controls. PCOS was diagnosed according to clinical practice guidelines. Ferriman-Gallwey scores (FGS were calculated, while N1, VD, and other hormonal and biochemical parameters were measured for all subjects. Systolic and diastolic BP was measured as well. HR was calculated using an electrocardiogram.The levels of N1 (p < 0.001, high-sensitivity C-reactive protein (hs-CRP (p = 0.036, homeostasis model assessment as an index of insulin resistance (HOMA-IR (p < 0.001, systolic (p < 0.001 and diastolic (p < 0.001 BP and HR (p < 0.001 in the PCOS group were significantly higher than in the control group. However, the VD levels of the PCOS group were lower than the control group (p = 0.004. N1 had a strong positive correlation with BMI, HOMA-IR, hs-CRP, luteinizing hormone, systolic and diastolic BP, and HR. VD levels were negatively correlated with HOMA-IR and luteinizing hormone.Elevated N1 and decreased VD levels may be related to the presence of high-normal BP or hypertension in PCOS subjects.  N1 level may be associated with an increased BP due to its relation to inflammation and IR.

  6. Results of ambulatory arterial blood pressure monitoring in children with obesity

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    Faruk Öktem

    2010-12-01

    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.

  7. Hubungan Kadar Apelin dengan Disfungsi Diastol pada Penderita Gagal Jantung dengan Fraksi Ejeksi Normal

    OpenAIRE

    Dini Rostiati; Erwinanto; Achmad Fauzi Yahya; Chaerul Achmad; Pintoko Tedjokusumo; Syarief Hidayat; Augustine Purnomowati; Toni Mustahsani Aprami

    2015-01-01

    Apelin ia a novel multifunction peptide implicated in cardiovascular performance regulation in chronic pressure overload. Plasma apelin level and its correlation to diastolic dysfunction in patient heart failure with preserved ejection fraction were investigated. Hypertensive patients with heart failure but without coronary artery disease, atrial fibrillation, obese, and diabetes mellitus were enrolled in this study. Each patients underwent plasma apelin measurement and echocardiographic asse...

  8. Evaluación de la presión arterial media durante la cirugía de implante dental / Evaluation of mean arterial blood pressure during dental implant surgery

    Scientific Electronic Library Online (English)

    Rolando, Carrasco; Erita, Cordero; Ian, Goldberg; Benjamín, Martínez; Cristóbal, Pacheco.

    2014-09-01

    Full Text Available Introducción: Los eventos de estrés, como una cirugía bucal, pueden elevar los niveles de catecolaminas circulantes produciendo un alza en la presión arterial a niveles dañinos para el organismo. Nuestra investigación tiene como propósito determinar si existe una variación estadísticamente significa [...] tiva de la presión arterial durante la cirugía de implantes. Materiales y método: Se registró la presión arterial sistólica (PS) y diastólica (PD) a 30 individuos sometidos a una cirugía de implantes mediante un monitor Dinamap Pro 400. Se calculó el valor de la presión arterial media (PM) y, finalmente, se determinó la diferencia entre la PM inicial de cada individuo y el valor más alto de la PM alcanzado durante la cirugía. Resultados: El promedio de las PM iniciales fue de 91,452 mmHg y el promedio de las PM máximas alcanzadas durante la cirugía fue de 104,476 mmHg, existiendo diferencia estadísticamente significativa (p = 0,0005). Conclusión: Se observa un alza significativa en los valores de PM registrados en los individuos durante la cirugía de implantes, por lo que es importante considerar esta alza en todos los pacientes que serán sometidos a dicho procedimiento y más aún en aquellos que ya posean valores elevados de su presión arterial de manera a evitar posibles complicaciones. Abstract in english Introduction: The stress situations like an oral surgery can increase the blood catecholamines, producing an increased arterial blood pressure to levels that could damage health. This study attempt to determine whether there is a statistically significant variation in the arterial blood pressure dur [...] ing dental implant surgery. Materials and method: We registered the blood pressure - systolic (SP) and diastolic (DP)- to 30 subjects undergoing implant surgery with the Dina map Pro 400 monitor. We calculated the mean arterial blood pressure (MP) and finally we determined the difference between initial mean blood pressure and the highest blood pressure value reached at surgery. Results: The mean of the initial mean blood pressure was 91.452 mmHg and the mean of highest mean blood pressure reached during surgery was 104.476 mmHg, obtaining statistically significant differences (P=.0005). Conclusion: As there was a significant increase in the MP values recorded in subjects during dental implant surgery, this should be taken into account in all patients undergoing to this procedure, and particularly in those with hypertension, to avoid possible complications.

  9. Nesfatin-1 and Vitamin D levels may be associated with systolic and diastolic blood pressure values and hearth rate in polycystic ovary syndrome

    OpenAIRE

    Figen Kir Sahin; Serap Baydur Sahin; Ulku Mete Ural; Medine Cumhur Cure; Senol Senturk; Yesim Bayoglu Tekin; Gulsah Balik; Erkan Cure; Suleyman Yuce; Aynur Kirbas

    2015-01-01

    Obesity, insulin resistance (IR), inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS) and hypertension. Nesfatin-1 (N1) may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD) deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP) and heart rate (HR).This study included 54 patients with PCOS and 48 age-body mass index (BMI)-matched...

  10. Assembly of a Pulmonary Artery Pressure Sensor System

    Directory of Open Access Journals (Sweden)

    J. Müntjes

    2010-01-01

    Full Text Available This paper presents an implantable system for telemonitoring the intravascular pressure in the pulmonary artery. By implanting a catheter-bound pressure and temperature sensor into the pulmonary artery, it is possible to monitor the actual value and the time variations of the intravascular pressure with a frequency of 128 Hz. Thus hospitalization of patients suffering from heart insufficiency can be avoided by early changes in therapy.Preliminary in vivo experiments have been conducted to verify the fixation mechanism and the positioning of the sensor at the right place in the pulmonary artery. It was shown that the proposed fixation mechanism and the packaging of the sensor promise to be stable.

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

    Directory of Open Access Journals (Sweden)

    Marco A.M. Gomes

    2000-04-01

    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.

  12. The clinical usefulness of central hemodynamics to evaluate diastolic dysfunction in subjects without hypertension

    Directory of Open Access Journals (Sweden)

    Kim GH

    2014-03-01

    Full Text Available GeeHee Kim,1 Ji-Hoon Kim,1 Keon-Woong Moon,1 Ki-Dong Yoo,1 Sang-Hyun Ihm,2 Ho-Joong Youn,2 Chul-Min Kim11Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, Catholic University of Korea, Suwon, 2Division of Cardiology, Department of Internal Medicine, School of Medicine, Catholic University of Korea, Seoul, South KoreaObjective: Diastolic dysfunction is associated with increased arterial stiffness in patients with hypertension. However, the role of arterial stiffness in diastolic dysfunction in subjects without hypertension has not been fully established.Materials and methods: A total of 287 subjects (male:female ratio 121:166, mean age 53.0±14.4 years without hypertension or any heart disease who simultaneously received transthoracic echocardiography and noninvasively semiautomated radial artery applanation tonometry (with an Omron HEM-9000AI in the Department of Internal Medicine, St Vincent’s Hospital, from July 2011 to September 2012, were enrolled in this study.Results: A total of 147 subjects (male:female ratio 59:88, mean age 61.7±9.9 years, representing 51.2% of the 287 subjects, had diastolic dysfunction (defined as abnormal relaxation pattern of mitral inflow. There were significant differences in systolic blood pressure (BP, pulse pressure, late systolic peak pressure (SBP2, and radial augmentation index (RaAIx between normal diastolic function and diastolic dysfunction. ΔBP was defined as systolic BP minus SBP2, because of the difference in systolic BP between the two groups. ΔBP (odds ratio [OR] 1.059, 95% confidence interval [CI] 1.005–1.115; P=0.032 and RaAIx (odds ratio 1.027, 95% CI 1.009–1.044, P=0.003 were associated with diastolic dysfunction. A receiver operating-characteristic curve showed that ΔBP (area under the curve 0.875, 95% CI 0.832–0.911 and RaAIx (area under the curve 0.878, 95% CI 0.835–0.914 were associated with diastolic dysfunction.Conclusion: We found that ΔBP and increased RaAIx were associated with diastolic dysfunction in subjects without hypertension after adjustment for age and sex. Therefore, it is suggested that noninvasive estimation of central BP may be useful to reflect diastolic dysfunction in subjects with normal peripheral BP.Keywords: central blood pressure, augmentation index, diastolic dysfunction

  13. Association of sleep duration with arterial blood pressure profile of Gujarati Indian adolescents

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    Shaikh Wasim

    2010-01-01

    Full Text Available Background and Aim: Recently, National Health and Nutritional Examination Survey-1 data analysis found short sleep duration as a risk factor for hypertension in the U.S. population. However, since ethnic differences exist in the aetiopathogenesis of diseases, the current study was undertaken to study the effect of sleep duration on the blood pressure profile of Gujarati Indian adolescents. Materials and Methods: A cross-sectional study was conducted on 489 Gujarati Indian adolescents of age group 16-19 years studying in school and colleges in the local population. The participants were assessed for their sleep duration, physical activity status, body composition, blood pressure profile and cardiovascular reactivity. The sleep duration was reported by the subjects as the number of hours they slept on most of the nights in a week over the last one year. The observations of the study were then analyzed after grouping them into: 1 Adequate Sleep Duration at Night, ASDN (? 7 hrs and 2 Inadequate Sleep Duration at Night, ISDN (< 7 hrs groups. Student?s unpaired t-test was used to study if any significant difference (P< 0.05 existed between the groups. Results: No significant difference was found in Systolic blood pressure, Diastolic blood pressure, Pulse pressure and Mean arterial pressure between the ASDN group and the ISDN group. Physical activity status also did not differ between the two groups. However, adolescents of ISDN group showed a significantly higher level of adiposity and cardiovascular reactivity as compared to adolescents of ASDN group. Conclusion: Although short sleep duration is associated with a higher level of adiposity and cardiovascular reactivity in Gujarati Indian adolescents, it does not affect the resting blood pressure profile of these adolescents. However, longitudinal studies would be required to observe if the changes in adiposity and cardiovascular reactivity affect these adolescents in later life.

  14. EVALUATION OF THE EFFECT OF “WAKOUBA '' ON THE LIPID PROFILE, SYSTOLIC BLOOD PRESSURE (SBP DIASTOLIC (DBP AND BLOOD GLUCOSE IN HYPERTENSIVE RABBITS

    Directory of Open Access Journals (Sweden)

    Tiekpa Wawa J

    2014-11-01

    Full Text Available This study aims at evaluating the effects of Wakouba, an extract of the fronds of oil palm tree Elaeis guineensis (Jacq traditionally used in the treatment of high blood pressure, on lipid profile, urea, creatinine, blood glucose, systolic blood pressure (SBP, diastolic (DBP and heart rate (HR in hypertensive rabbits. Methods: Twenty four rabbits (24 divided into six (06 groups of four rabbits each weighing between 1.5 ±3.0 to 2± 1.5 kg were used. Group 1 served as witness, group 2 sick and untreated control, groups 3, 4, 5, and 6 were used as experimental groups (sick+treatment. Throughout the experiment the witness group received distilled water; adrenaline was administered to the sick control group. After 10 days of adrenaline injection, hypertension has been stabilized in sick groups (group 2 to 6 and blood was taken for the determination of urea, creatinine, and lipids. Four (04 of the five (05 groups of hypertensive rabbits were treated with two (2 doses of " Wakouba " 950 and 2500 mg / kg bw and two ( 02 doses of ténordate 10 and 20 mg / kg BW, two(2 group by two(2 group . After ten (10 days of treatment, the SBP and DBP and HR were measured, blood was collected for determination of the same biochemical parameters. Results: The study of the effect of Wakouba and ternodate on the changes in systolic blood pressure SBP, DBP and heart rate (HR showed a significant decrease (P up to normalization of these parameters after 10 days of treatment. Similarly, the measurement of serum lipid profile in hypertensive rabbits treated with Wakouba (950mg / kg bw and tenordate (20 mg / kg bw showed a significant reduction in (P values of total cholesterol, LDL cholesterol and triglycerides in contrast to HDL cholesterol which has increased significantly compared to the control group. Same doses also normalize serum glucose, urea and creatinine. Histological sections performed on the kidney and the heart of hypertensive rabbit showed congestion of blood in the kidney and cardiomyopathy. Conclusion: Wakouba at dose (950 mg / kg bw as well as tenordate decreases and normalizes systolic blood pressure (SBP , diastolic blood pressure (DBP and heart rate (HR in hypertension induced rabbit . Furthermore Wakouba (950 mg / kg BW and tenordate (20mg/kg BW increases HDL cholesterol and decrease LDL cholesterol. Wakouba would have the same mechanism of action as tenordate (ATENOLOL + NIFEDIPINE a reference anti hypertensive product, thus anti hypertensive and cardioprotective properties, which justifies it uses in traditional medicine in Cote d’Ivoire as an anti hypertensive.

  15. Epworth's sleepiness scale in outpatients with different values of arterial blood pressure

    Directory of Open Access Journals (Sweden)

    Gus Miguel

    2002-01-01

    Full Text Available OBJECTIVE: To compare sleepiness scores of the Epworth scale in patients with different levels of arterial pressure when undergoing outpatient monitoring within the context of clinical evaluation. METHODS: A total of 157 patients selected for outpatient monitoring of arterial pressure during hypertension evaluation were divided into 3 groups: group 1 - normotensive; group 2 - hypertensive; group 3 - resistant hypertensive. For analysis, values > or = 11 were considered as associated with respiratory disturbances during sleep. RESULTS: Seventeen (10.8% patients in group 1, 112 (71.3% in group 2, and 28 (17.8% in group 3, which was composed of aged, more severely hypertensive individuals, were analyzed. Groups were similar relative to sex and body mass index, but different in relation to systolic and diastolic pressure levels and age. Despite an absolute difference, no statistically significant difference occurred between Epworth scores and in the proportion of patients with values > or = 11 (5.9% vs. 18.8% vs. 212.4%; P=0.37. Despite the positive association between degree of sleepiness measured with the scale and the severity of the hypertension, no statistical significance occurred following control by age (p=0.18. CONCLUSION: A positive correlation exists between degree of sleepiness and hypertension severity. The absence of a statistical significance shown in the present study could be due to a beta type of error. Instruments that render this complaint into an objective finding could help in the pursuit of an investigation of respiratory disturbances during sleep in more severely hypertensive patients, and should therefore be studied better.

  16. Arterial pressure optimization in the treatment of septic shock: a complex puzzle

    OpenAIRE

    Jones, Alan E.; Trzeciak, Stephen; Dellinger, R. Phillip

    2010-01-01

    Arterial pressure optimization in septic shock is a critical, yet poorly understood component of resuscitation. New data suggest that, during the routine management of patients with severe sepsis, there is no association between mean arterial pressure achieved and outcome as long as the mean arterial pressure is maintained at or above 70 mmHg. Although these data add important new evidence to our understanding of arterial pressure management, there are still many unanswered questions upon whi...

  17. Central aortic blood pressure from ultrasound wall-tracking of the carotid artery in children: comparison with invasive measurements and radial tonometry.

    Science.gov (United States)

    Milne, Laura; Keehn, Louise; Guilcher, Antoine; Reidy, John F; Karunanithy, Narayan; Rosenthal, Eric; Qureshi, Shakeel; Chowienczyk, Phil J; Sinha, Manish D

    2015-05-01

    Differences between central aortic root (c) and peripheral (p) systolic blood pressure (SBP) may be particularly marked in children, but noninvasive methods for assessing cSBP in children have not been validated. We compared estimates of cSBP obtained from radiofrequency ultrasound wall tracking of the carotid artery (ART.LAB system) with that measured directly by a catheter in the aortic root at the time of arterial cannulation. Carotid waveforms were calibrated from invasive measurements of mean and diastolic pressures. In 9 children aged 10.5 ± 5.0 years (mean ± SD), cSBP obtained from carotid wall tracking was highly correlated with invasive measures of cSBP (r=0.99) with mean (± SD) difference 3.9 ± 2.5 mm?Hg. Second, we compared values of cSBP obtained from the carotid with those obtained using noninvasive applanation tonometry at the radial artery and a radial-to-aortic transfer function (SphygmoCor). Both carotid and radial tonometric measurements were calibrated from the same peripheral mean and diastolic measurements of blood pressure obtained by sphygmomanometry. In 84 children aged 13.2 ± 3.2 years, there was excellent agreement between the 2 methods (r=0.95; PcSBP as estimated by carotid wall tracking provides an acceptable measurement of true cSBP when calibration is from true mean and diastolic pressures. Close agreement of cSBP obtained by carotid wall tracking and radial tonometry suggests that these provide similar results when calibrated from the same peripheral blood pressure measurements. PMID:25824246

  18. Plasma advanced glycation end products (AGEs) and NF-κB activity are independent determinants of diastolic and pulse pressure

    DEFF Research Database (Denmark)

    Sourris, Karly C; Lyons, Jasmine G; Dougherty, Sonia L; Chand, Vibhasha; Straznicky, Nora E; Schlaich, Markus P; Grima, Mariee T; Cooper, Mark E; Kingwell, Bronwyn A; de Courten, Maximilian; Forbes, Josephine M; de Courten, Barbora

    2013-01-01

    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...

  19. Is autonomic support of arterial blood pressure related to habitual exercise status in healthy men?

    Science.gov (United States)

    Jones, Pamela Parker; Shapiro, Linda F; Keisling, Gretchen A; Quaife, Robert A; Seals, Douglas R

    2002-04-15

    We determined if the tonic autonomic nervous system (ANS) contribution to arterial blood pressure (BP) maintenance in humans is related to habitual endurance exercise status. Twenty-three healthy young (age 18-31 years) males, 11 endurance exercise-trained and 12 untrained, were studied. Maximal oxygen consumption was higher (P < 0.001) and resting heart rate and body fatness were lower (P < 0.05) in the exercise-trained men. Plasma noradrenaline concentrations and BP decreased from baseline levels in response to ganglionic blockade (intravenous trimethaphan) in both groups (all P < 0.001). The absolute (Delta mmHg: systolic = -35 +/- 2 vs. -32 +/- 4; diastolic = -13 +/- 2 vs. -10 +/- 2; mean = -21 +/- 2 vs. -17 +/- 3) and relative (Delta%: systolic = -35 +/- 2 vs. -31 +/- 3; diastolic = -26 +/- 3 vs. -20 +/- 3; mean = -31 +/- 2 vs. -26 +/- 3) decreases in BP were not significantly different between the endurance-trained and untrained men. There were no significant group differences in the heart rate, stroke volume, cardiac output or systemic vascular resistance (conductance) responses to trimethaphan. Systemic vascular alpha-adrenergic sensitivity (slope of the increase in mean BP with incremental phenylephrine infusion during ganglionic blockade) also did not differ in the two groups (endurance-trained: 3.2 +/- 0.5; untrained: 3.2 +/- 0.7 mmHg (ng phenylephrine)(-1) (ml plasma)(-1)). In the pooled sample, the decrease in mean BP during trimethaphan was related to baseline and changes in plasma noradrenaline concentrations (r = 0.58-0.65, P < 0.001) and alpha-adrenergic sensitivity (r = 0.49, P < 0.02). Our results suggest that the endurance exercise-trained state is not obviously associated with altered ANS support of BP in healthy young men. Basal sympathetic nervous system (SNS) activity and alpha-adrenergic vascular sensitivity are significant physiological correlates of ANS support of BP in this population. PMID:11956356

  20. Low arterial pressure on admission as a predictor of mortality in operated patients with type A aortic dissection

    Directory of Open Access Journals (Sweden)

    Pavlović Katica

    2011-01-01

    Full Text Available Background/Aim. Hypertension is a known predictor of proximal aortic dissection, but it is not commonly present in these patients on presentation. The associations between ascending aorta with left ventricular hypertrophy, cardiovascular risk factors and coronary atherosclerosis, and outcome of these patients are not fully elucidated. Methods. This retrospective study included 55 consecutive patients with acute type A aortic dissection treated surgically in our institution during the last 2 years. The diagnosis was based on imaging studies. Diameter of ascending aorta was measured with echocardiography. Results. The mean age of the patients was 55.4 ± 12.19 years, and 72.7% were men. A history of arterial hypertension was present in 76.4% of the patients. Maximal ascending aorta diameter was 4.09 ± 0.59 cm, while patients with frank aneurysm accounted for 5.5%. Systolic blood pressure on admission was < 150 mmHg in 58.2% of the patients. Diastolic blood pressure on admission was < 90 mmHg in 54.5% of the patients. Mean arterial pressure on admission was 104.9 ± 24.6 mmHg. No correlations were demonstrated between maximal ascending aorta diameter and diameter of the left ventricular wall, any obtained risk factor and with coronary artery atherosclerosis (p > 0.05. After six months 11 (20% patients died, while intrahospital mortality was 72%. According to logistic regression analysis which included traditional risk factors, echo parameters, coronary artery disease and logistic euro scor, mean arterial blood pressure was the independent predictor of a six-month mortality [RR 0.956; CI (0.918-0.994 ; p = 0.024]. Conclusion. In our population the acute type A aortic dissection occurred rarely in the setting of frank ascending aortic aneurysms > 5.0 cm. The majority of patients had a history of arterial hypertension. A history of arterial hypertension was not associated with maximal ascending aorta diameter. Mean arterial blood pressure was the independent predictor of a six-months mortality.

  1. A general model for continuous noninvasive pulmonary artery pressure estimation.

    Science.gov (United States)

    Smith, Robert; Ventura, Dan

    2013-08-01

    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. PMID:23746733

  2. Biochemical effects of lead exposure on systolic & diastolic blood pressure, heme biosynthesis and hematological parameters in automobile workers of north karnataka (India).

    Science.gov (United States)

    Dongre, Nilima N; Suryakar, Adinath N; Patil, Arun J; Ambekar, Jeevan G; Rathi, Dileep B

    2011-10-01

    The purpose of this study was to find out the effect of lead exposure on systolic and diastolic blood pressure, heme biosynthesis related and hematological parameters of automobile workers. For this study 30 automobile workers were selected and compared with 30 age matched healthy control subjects. Significantly increased blood lead (364%, P ALAD) (-18.51%, P ALAD (-13.29%, P ALAD was significantly increased (43.83%, P < 0.001) in automobile workers as compared to controls. Excretions of δ-aminolevulinic acid (83.78%, P < 0.001) and porphobilinogen (37%, P < 0.001) in urine were significantly increased in the study group as compared to the controls. In automobile workers heamoglobin (-11.51%, P < 0.001), hematocrit (-4.06%, P < 0.05), mean corpuscle volume (-3.34%, P < 0.05), mean corpuscle hemoglobin (-5.66%, P < 0.01), mean corpuscle hemoglobin concentration (-7.67%, P < 0.001), red blood cell count (-14.6%, P < 0.001) were significantly decreased and total white blood cell count (11.44%, P < 0.05) increased as compared to the controls. The results of this study clearly indicate that the absorption of lead is more in automobile workers and it affects on blood pressure, heme biosynthesis and hematological parameters observed in this study group. PMID:23024478

  3. Carotid artery disease and low cerebral perfusion pressure

    DEFF Research Database (Denmark)

    Schroeder, T; Utzon, N P; Aabech, J; Sillesen, H; Sørensen, P S; Engell, H C

    1990-01-01

    Direct internal carotid artery blood pressure measurements in patients undergoing carotid endarterectomy identified 49 patients, among 239 consecutive cases (21%), who had a reduction in perfusion pressure of 20% or more. The clinical history, objective findings and angiographic data were compared...... with those of a control group of a further 49 patients selected from the remaining patients operated on over the same period. The two groups were compared for short- and long-term outcome of surgery. We were unable to delineate a symptomatic neurological profile that identified patients with low...... perfusion pressures. Surgery in patients with low perfusion pressures seemed to be associated with an increased complication rate (12% versus 4%), although this was not statistically significant. Definite postoperative improvements in persisting neurological deficits were observed only in one patient. Long...

  4. Probing genetic overlap in the regulation of systolic and diastolic blood pressure in Danish and Chinese twins

    DEFF Research Database (Denmark)

    Li, Shuxia; Pang, Zengchang; Zhang, Dongfeng; Duan, Haiping; von Bornemann Hjelmborg, Jacob; Tan, Qihua; Kruse, Torben Arvid; Kyvik, Kirsten Ohm

    2014-01-01

    Danish and Chinese twins and comparing ethnic differences between the two samples. Our estimates revealed a high proportion of additive genetic components shared by both SBP and DBP in Danish (0.71, 95% confidence interval (CI): 0.65-0.75) and Chinese (0.62, 95% CI: 0.50-0.71) twins with no statistically...... overall pattern of higher genetic regulation or heritability in Danish (0.72, 95% CI: 0.67-0.76 for SBP; 0.70, 95% CI: 0.65-0.75 for DBP) than in Chinese (0.54, 95% CI: 0.44-0.63 for SBP; 0.57, 95% CI: 0.47-0.65 for DBP) twins and a higher contribution from unique environmental factors in Chinese compared...... with Danish twins. The estimated contribution from unique environmental factors suggests that promoting healthy lifestyles may provide an efficient way of controlling high blood pressure, particularly in the Chinese population.Hypertension Research advance online publication, 15 May 2014; doi:10...

  5. [Invasive arterial blood pressure measurement using an aneroid pressure system in cattle].

    Science.gov (United States)

    Mosing, M; Franz, S; Iff, I; Schwendenwein, I

    2009-06-01

    The aim of this study was to compare the results of invasive arterial blood pressure measurement using an electronic pressure transducer (EPT) or an aneroid pressure system (APS) in cattle. A catheter was placed in the auricular artery of 11 adult cattle and connected to a pressure transducer via pressure line. The aneroid system was connected to the same catheter using a three-way stop-cock in the pressure line. On five occasions three consecutive measurements were performed with the APS. The mean blood pressure values of the EPT were recorded before each individual measurement. Values from each device were compared using Passing and Bablok regression of agreement and a Bland and Altman difference plot. One hundred and forty-seven paired measurements were analysed. The average bias between the two methods (EPT vs. APS) was -1.6 mmHg (95 % confidence interval [CI]: -3.0 to -0.2 mmHg). The coefficient of correlation was 1.0084. The aneroid system showed an almost perfect agreement with the EPT. This study shows that it can be used in a clinical setting as well as under field conditions to measure arterial blood pressure in cattle. PMID:19496047

  6. Effect of Group Mindfulness-Based Stress-Reduction Program and Conscious Yoga on Lifestyle, Coping Strategies, and Systolic and Diastolic Blood Pressures in Patients with Hypertension

    Directory of Open Access Journals (Sweden)

    Somayeh Nejati

    2015-12-01

    Full Text Available Background: Healthy lifestyle and ineffective coping strategies are deemed significant variables among patients with hypertension. This study attempted to determine the status of these variables following intervention via the mindfulness-based stress-reduction program (MBSRP in patients with hypertension.Method: This study was a randomized clinical trial. The study sample, consisting of 30 patients referring to the Hypertension Clinic of Imam Hossein Hospital in 2013, was assigned either to the intervention (recipient of the MBSRP and conscious yoga or to the control group (recipient of yoga training. The intervention group had 8 training sessions over 8 weeks. Lifestyle and coping strategies as well as blood pressure were measured in the intervention group before intervention and then immediately thereafter and at 2 months' follow-up and were compared to those in the control group at the same time points.Result: The mean age of the patients in the intervention (40% women and control (53% women groups was 43.66 ± 5.14 and 43.13 ± 5.04 years, respectively. The results showed that the mean scores of lifestyle (p value < 0.05, emotion-focused coping strategies (p value < 0.001, problem-focused coping strategies (p value < 0.001, diastolic blood pressure (p value < 0.001, and systolic blood pressure (p value < 0.001 were significantly different between the intervention and control groups after the intervention.Conclusion: Applying an intervention based on the MBSRP may further improve the lifestyle and coping strategies of patients with hypertension.

  7. Relationship of daily arterial blood pressure monitoring readings and arterial stiffness profile in male patients with chronic obstructive pulmonary disease combined with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Karoli N.A.

    2013-06-01

    Full Text Available The aim of the study was to determine correlation between arterial blood pressure daily rhythm and daily profile of arterial stiffness in male patients with chronic obstructive pulmonary disease (COPD and arterial hypertension. Materials et methods: Prospective investigation comprised 45 male patients with COPD and arterial hypertension. Individuals of 40 years younger and 80 years elder, patients with diabetes, stroke, angina pectoris, or heart infarction, vascular diseases, and exacerbation of chronic disease, bronchial and pulmonary diseases of other etiology were excluded from the analyses. Comparison group included 47 patients with essential arterial hypertension and without chronic respiratory diseases closely similar on general parameters with patients from main clinical series. Twenty-four-hour arterial blood pressure monitoring (ABPM and daily arterial stiffness monitoring were performed using BPLab® MnSDP-2 apparatus (Petr Telegin, Russian Federation. Results: Patients with COPD combined with arterial hypertension with raised arterial stiffness measures prevail over individuals in essential hypertension group. There is pathological alteration of the ABPM circadian rhythm and raised «Pressure load» values in raised arterial stiffness group. Conclusion: We found ABPM raised parameters in patients with COPD and arterial hypertension. It confirms necessity of ABPM in daily arterial stiffness assessment in patients with COPD.

  8. Efficacy of a classical antiobesity Unani pharmacopial formulation (Safoof-e-Muhazzil in systolic and diastolic blood pressure: A randomized, open-labeled, controlled clinical study

    Directory of Open Access Journals (Sweden)

    Asim Ali Khan

    2013-01-01

    Full Text Available The aim of this study is to evaluate the efficacy of a Unani formulation in hypertension. A total of 90 patients with total cholesterol level of more than 220 mg/dl with associated conditions were included in this study. A total of 30 patients having a mean systolic blood pressure (BP of 133.86 mmHg comprising Group A received Unani formulation Safoof-e-Muhazzil (SM in its classical powder form in the dose of 5 g twice a day orally. Group B comprising of 30 patients with a mean systolic BP of 133.13 mmHg received same drug, but in compressed tablet form in the same dosage, whereas, 30 patients comprising Group C with a mean systolic BP of 129.45 mmHg, received Atorvastatin 10 mg as a standard control. Patients were evaluated on each follow-up at 2 nd , 4 th and 6 th week. The mean systolic BP in Group A and B before treatment was 133.86 ± 3.028 mmHg and 133.13 ± 2.852 mmHg, which significantly decreased to 119.33 ± 1.922 mmHg (P < 0.001 and 119 ± 1.760 mmHg (P < 0.001 respectively. In the control Group C before treatment BP was 129.45 ± 2.499 mmHg and after treatment it significantly decreased to 124.34 ± 1.794 mmHg (P < 0.01. The percentage change after treatment was 10.85%, 10.61% and 3.94% respectively in each group. Mean diastolic BP in Group A and B before treatment was 85.06 ± 2.11 mmHg and 84.56 ± 1.5 mmHg, which significantly decreased to 79.06 ± 1.56 mmHg (P < 0.001 and 79.96 ± 1.15 mmHg (P < 0.001 respectively, BP before treatment in Group C was 83.23 ± 1.588 mmHg, which was decreased to 124.34 ± 1.794 mmHg (P < 0.01. The study results indicate that the test drug was quite effective in reducing both systolic as well as diastolic BP.

  9. Right ventricular diastolic dysfunction and patent foramen ovale causing profound cyanosis

    OpenAIRE

    Shnaider, H; Shiran, A.; Lorber, A.

    2004-01-01

    A 73 year old woman presented with profound central cyanosis and a history of a minor stroke. She had normal heart morphology, normal pulmonary artery pressure, and a normal coronary angiography. A patent foramen ovale (PFO) with a massive right to left shunt was demonstrated at the atrial level, with normal pulmonary venous saturations and Po2 values. This rare, age related case of right ventricular diastolic dysfunction in a normotensive patient revealed a generous PFO allowing a pronounced...

  10. Smooth Muscle Cell Contraction Increases the Critical Buckling Pressure of Arteries

    OpenAIRE

    Hayman, Danika M.; Zhang, Jinzhou; Liu, Qin; Xiao, Yangming; Han, Hai-Chao

    2012-01-01

    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 mu...

  11. Diastolic heart failure in the elderly and the potential role of aldosterone antagonists.

    Science.gov (United States)

    Kumar, Ashwani; Meyerrose, Gary; Sood, Vineeta; Roongsritong, Chanwit

    2006-01-01

    The overall incidence of heart failure increases with age, affecting up to 10% of people >65 years of age. Diastolic heart failure is also age-dependent, increasing from 40% in patients > or =70 years of age. Elderly patients usually have other co-morbid conditions such as hypertension, diabetes mellitus, coronary artery disease and atrial fibrillation that can adversely affect the diastolic properties of the heart. The clinical manifestations of diastolic heart failure are similar to those of systolic heart failure. In practice, the diagnosis is generally based on the finding of typical symptoms and signs of heart failure with preserved left ventricular ejection fraction and no valvular abnormalities on echocardiography. Altered ventricular relaxation and abnormal ventricular filling are the hallmarks of diastolic heart failure. Cardiac fibrosis and cellular disarray lead to the alterations in the diastolic properties of the heart. Diffuse foci of fibrosis in the myocardium have been reported with advancing age. Aldosterone has been shown to play a crucial role in the development of cardiac fibrosis via a direct effect on the mineralocorticoid receptors within the myocardium. Unlike the situation with treatment of systolic heart failure, few clinical trials are available to guide the management of patients with diastolic heart failure. In the absence of controlled clinical trials, patient management is based on control of the physiological factors (blood pressure, heart rate, blood volume and myocardial ischaemia) that are known to exert important effects on ventricular relaxation. Aldosterone antagonists inhibit the deposition of collagen matrix in the myocardium, thereby targeting the basic pathophysiological mechanism of diastolic dysfunction. Thus, they appear to represent a promising therapeutic approach for this condition. Currently, only small clinical trials supporting this therapy are available and large clinical trials evaluating long-term outcomes in diastolic dysfunction are therefore needed. PMID:16732689

  12. Cerebral autoregulation with changes in arterial and cerebral venous pressure

    International Nuclear Information System (INIS)

    The effect of cerebral venous pressure (Pcv) elevation on cerebral autoregulation has been incompletely studied. The authors compared the effect of decreased cerebral perfusion pressure (CPP) by elevated Pcv and decreased arterial pressure (Pa) on cerebral blood flow (CBF) in a canine modified bypass model. CPP of 80, 70, 60, 50, 40 and 30 mmHg were produced by decreasing Pa with intracranial pressure (ICP) and Pcv maintained at 0 mmHg (group 1, n = 5), or by elevating Pcv as Pa was maintained at 80 mmHg (group 2, n = 5. CBF was measured using radiolabeled microspheres, and CMRO2 = CBF times arterial-sagittal sinus O2 content difference. Cerebrovascular resistance (CVR) = CPP/CBF. In group 1 CBF (ml/100 gm/min) was unchanged from control (36 +/- 4) as CPP was decreased from 80 to 40 mmHg. As CPP was decreased to 30 mmHg, CBF decreased to 28 +/- 1. CVR (mmHg/ml/min/100 gm) was 2.3 +/- 0.3 and progressively decreased to 1.0 +/- 0.1 at CPP of 30 mmHg. In group 2 CBF was 34 +/- 3 and was unchanged as CPP decreased to 50 mmHg. At CPP of 40 and 30 mmHg CBF decreased to 25 +/- 3 and 22 +/- 2 respectively. Control CRV was 2.4 +/- 0.2 and progressively decreased to 1.4 +/- 0.1 as CPP decreased to 30 mmHg. CMRO2 was unchanged from control in both groups. Thus, CBF is maintained to low CPP regardless of whether vascular transmural pressure was decreased (decrease Pa) or increased (increased Pcv) demonstrating that the myogenic mechanism of autoregulation may be unimportant in normoxic dogs

  13. Effects of simulated microgravity on circadian rhythm of caudal arterial pressure and heart rate in rats and their underlying mechanism

    Directory of Open Access Journals (Sweden)

    Li CHEN

    2016-04-01

    Full Text Available Objective  To explore the effects of simulated microgravity on the circadian rhythm of rats' caudal arterial pressure and heart rate, and their underlying mechanism. Methods  Eighteen male SD rats (aged 8 weeks were randomly assigned to control (CON and tail suspension (SUS group (9 each. Rats with tail suspension for 28 days were adopted as the animal model to simulate microgravity. Caudal arterial pressure and heart rate of rats were measured every 3 hours. The circadian difference of abdominal aorta contraction was measured by aortic ring test. Western blotting was performed to determine and compare the protein expression level of clock genes such as Per2 (Period2, Bmal1 (Aryl hydrocarbon receptor nuclear translocatorlike and dbp (D element binding protein in suprachiasmatic nucleus (SCN and abdominal aorta of rats in CON and SUS group at different time points. Results  Compared with CON group, the caudal arterial pressure, both systolic and diastolic pressure, decreased significantly and the diurnal variability disappeared, meanwhile the heart rate increased obviously and also the diurnal variability disappeared in rats of SUS group. Compared with CON group, the contraction reactivity of abdominal aorta decreased with disappearence of the diurnal variability, and also the clock genes expression in SCN and abdominal aorta showed no diurnal variability in rats of SUS group. Conclusion  Simulated microgravity may lead to circadian rhythm disorders in rats' cardiovascular system, which may be associated with the changes of the clock genes expression. DOI: 10.11855/j.issn.0577-7402.2016.04.06

  14. Machine Learning Techniques for Arterial Pressure Waveform Analysis

    Directory of Open Access Journals (Sweden)

    João Cardoso

    2013-05-01

    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.

  15. Correlation analysis of the changes in arterial blood pressure in people with acute mountain sickness when exposed to high altitude

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    Yang LIU

    2014-03-01

    Full Text Available Objectives  To investigate the changes in arterial blood pressure in the healthy lowlanders when they were exposed to different altitudes and duration, and the relationship of the exposure with the prevalence and susceptibility of acute mountain sickness (AMS, in order to evaluate the significance of arterial blood pressure changes in the diagnosis of AMS and its clinical risk. Methods  Demographic data and blood pressure parameters [systolic blood pressure (SBP, diastolic blood pressure (DBP, mean arterial BP (MABP] of healthy lowlanders (inhabitants in ≤500m were collected after being exposed to 3700m on day 1, 3, 5 and 7, and also after being exposed to 4400m on day 5, while healthy young men living at low altitude were randomly selected as the control group. Simultaneously the AMS symptoms Questionnaire was filled. The Lake Louise acute mountain sickness scoring system (LLS was used to diagnose AMS. The changes in arterial blood pressure in people above and its correlation with AMS were analyzed. Results  After acute exposure to 3700m (day 1, SBP, DBP and MABP rose obviously, and then descended moderately after adaptation for about a week, but still higher than that of LA level (P<0.05. And then SBP, DBP and MABP rose again at high-altitude of 4400m, but lower than the levels of day 1 at 3700m. MABP at 3700m and 4400m were related to LLS (r=0.138, P=0.048; r=0.145, P=0.045, respectively. MABP levels for diagnosis of AMS at 3700m showed an cut-off point of 98.5mmHg with sensitivity of 32.8% and specificity of 73.7% (P<0.05, and MABP levels for diagnosis of AMS at 4400m showed an cut-off point of 97.8mmHg with sensitivity of 42.4% and specificity of 75.5% (P<0.05. Conclusions  After exposure to acute hypoxia, MABP may serve as a predictive parameter for diagnosis of AMS. However, the clinical application of MABP as a diagnostic criterion is limited because of its poor specificity or sensitivity. The use of MABP as a diagnostic criterion should be combined with other indicators such as arterial blood oxygen saturation (SaO2 for the diagnosis of AMS. DOI: 10.11855/j.issn.0577-7402.2014.03.12

  16. Adolescencia e hipertensión arterial / Adolescence and high blood pressure

    Scientific Electronic Library Online (English)

    Gabriela Elizabeth, Galarza Carrión.

    2014-10-01

    Full Text Available Introducción: se desconocen las características demográficas y clínicas de la hipertensión arterial en niños y adolescentes en Guane. Objetivo: caracterizar la hipertensión arterial en adolescentes de 10-15 años en Guane en el año 2013. Material y método: se realizó una investigación observacional, [...] descriptiva, transversal, con componente analítico en 360 niños de las edades mencionadas, en los que se comprobó: tensión arterial, índice de masa corporal, circunferencia de la cintura, tabaquismo y actividad física, todos con referencia a la edad y al sexo. Se resumieron las variables cualitativas en frecuencias absolutas y relativas porcentuales, y la asociación entre las mismas se midió mediante las pruebas de X² y Odds Ratio al 95 % de certeza. Resultados: hubo 175 normotensos en las edades 10-12 años, 8 pre-hipertensos y 9 hipertensos en el grupo de 13-15 años. Hubo prevalencia estadísticamente significativa (x²) de normotensos en el sexo femenino (p = 0.008). La obesidad estaba incrementada más de 5 veces en los varones (p = 0,002) y en edades de 13-15 años. Existió un incremento significativo de hipertensos en el grupo de 13-15 años con aumento de la circunferencia abdominal (p Abstract in english Introduction: the demographic and clinical characteristics of high blood pressure in Guane children and adolescents are unknown. Objective: to characterize high blood pressure in Guane 10-15-year-old adolescents, 2013. Material and method: an observational, descriptive, cross-sectional research was [...] carried out, with an analytical component, on 360 children of the mentioned ages, in which we analyzed: blood pressure, body mass index, waist circumference, smoking and physical activity, all of which with reference to age and sex. The quantitative variants were defined in percentage absolute and relative frequencies, while association among them was measured by chi-square and Odds Ratio tests at 95% of certitude. Results: there were 175 with normal blood pressure between 10-12 years old, 8 pre-hypertensives aged 13-15 years old. There was a statistically significant prevalence of female patients with normal blood pressure (p=0.008). Obesity increased five times in male patients (p=0.002) and in ages 13-15 years old. There was a significant increase in hypertensive patients aged 13-15 years old, with increase in the waist circumference (p

  17. Comparison of transesophageal echocardiographic and scintigraphic estimates of left ventricular end-diastolic volume index and ejection fraction in patients following coronary artery bypass grafting

    Energy Technology Data Exchange (ETDEWEB)

    Urbanowicz, J.H.; Shaaban, M.J.; Cohen, N.H.; Cahalan, M.K.; Botvinick, E.H.; Chatterjee, K.; Schiller, N.B.; Dae, M.W.; Matthay, M.A. (Univ. of California, San Francisco (USA))

    1990-04-01

    Transesophageal echocardiography (TEE) has become a commonly used monitor of left ventricular (LV) function and filling during cardiac surgery. Its use is based on the assumption that changes in LV short-axis ID reflect changes in LV volume. To study the ability of TEE to estimate LV volume and ejection immediately following CABG, 10 patients were studied using blood pool scintigraphy, TEE, and thermodilution cardiac output (CO). A single TEE short-axis cross-sectional image of the LV at the midpapillary muscle level was used for area analysis. Between 1 and 5 h postoperatively, simultaneous data sets (scintigraphy, TEE, and CO) were obtained three to five times in each patient. End-diastolic (EDa) and end-systolic (ESa) areas were measured by light pen. Ejection fraction area (EFa) was calculated (EFa = (EDa - ESa)/EDa). When EFa was compared with EF by scintigraphy, correlation was good (r = 0.82 SEE = 0.07). EDa was taken as an indicator of LV volume and compared with LVEDVI which was derived from EF by scintigraphy and CO. Correlation between EDa and LVEDVI was fair (r = 0.74 SEE = 3.75). The authors conclude that immediately following CABG, a single cross-sectional TEE image provides a reasonable estimate of EF but not LVEDVI.

  18. Daily Rhythm of Arterial Pressure in Patients with Autoimmune Thyroidite in a Phase Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    E V Kravez

    2008-09-01

    Full Text Available The purpose of research was studying of a condition circadian rhythms and parameters of a daily structure according to 24-hour monitoring blood pressure at sick with the verified diagnosis of autoimmune thyroidite in a phase of subclinical hypothyroidism. 23 patients (22 women and 1 man in the age of from 18 till 58 years are surveyed. The control group was made by practically healthy 25 persons without pathology of a thyroid gland and normal values of blood pressure of similar age. It is revealed, that at patients with autoimmune thyroidite in a phase of subclinical hypothyroidism higher levels of systolic blood pressure and diastolic blood pressure in day time and night hours, also infringement circadian a rhythm of systolic blood pressure “non-dipper” at 39,2% of patients are defined. It is received, that according to 24-hour monitoring blood pressure these patients have features of dynamics of the diastolic blood pressure, described increase of diastolic blood pressure in the afternoon and excessive decrease at night in 30,4% of cases.

  19. Left ventricular diastolic dysfunction and N-terminal probrain sodium-uretic peptid level in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Dzyak G.V.

    2013-06-01

    Full Text Available In our study 100 consecutive non-valvular permanent atrial fibrillation patients with NYHA I – III heart failure, 43 - 86 years old (65 men and 35 women were examined. Control group consisted of 30 patients with arterial hypertension and coronary artery disease matched by age, sex with basic group. Relationship of NT-proBNP with echocardiographic parameters of left heart were studied. Transthoracic echocardiography with tissue doppler measurements were performed on echocardiograph “SONOS 7500”. For left ventricular filling pressure assessment ratio Em/Ea was used due to its diagnostic value in atrial fibrillation (regardless of left ventricular ejection fraction. Mean left ventricular filling pressure was increased in patients with heart failure: in atrial fibrillation group and controls as well. In comparison with controls atrial fibrillation group was more likely to have higher both systolic and diastolic left atrial square and volume. According to Em/Ea in 95% of patients with non-valvular atrial fibrillation high left ventricular filling pressure was observed, this testifies to diastolic dysfunction. This parameter correlated well with left atrial square and volume during systole and diastole. Correlation between NT pro-BNP level and NYHA class of heart failure, left ventricular filling pressure was determined in patients with atrial fibrillation. Tissue doppler echocardiography makes it possible to diagnose left ventricular diastolic dysfunction in atrial fibrillation patients.

  20. Atrap deficiency increases arterial blood pressure and plasma volume.

    Science.gov (United States)

    Oppermann, Mona; Gess, Bernhard; Schweda, Frank; Castrop, Hayo

    2010-03-01

    The angiotensin receptor-associated protein (Atrap) interacts with angiotensin II (AngII) type 1 (AT1) receptors and facilitates their internalization in vitro, but little is known about the function of Atrap in vivo. Here, we detected Atrap expression in several organs of wild-type mice; the highest expression was in the kidney where it localized to the proximal tubule, particularly the brush border. There was no Atrap expression in the renal vasculature or juxtaglomerular cells. We generated Atrap-deficient (Atrap-/-) mice, which were viable and seemed grossly normal. Mean systolic BP was significantly higher in Atrap-/- mice compared with wild-type mice. Dose-response relationships of arterial BP after acute AngII infusion were similar in both genotypes. Plasma volume was significantly higher and plasma renin concentration was markedly lower in Atrap-/- mice compared with wild-type mice. (125)I-AngII binding showed enhanced surface expression of AT1 receptors in the renal cortex of Atrap-/- mice, accompanied by increased carboanhydrase-sensitive proximal tubular function. In summary, Atrap-/- mice have increased arterial pressure and plasma volume. Atrap seems to modulate volume status by acting as a negative regulator of AT1 receptors in the renal tubules. PMID:20093357

  1. Atrap Deficiency Increases Arterial Blood Pressure and Plasma Volume

    Science.gov (United States)

    Oppermann, Mona; Gess, Bernhard; Schweda, Frank

    2010-01-01

    The angiotensin receptor-associated protein (Atrap) interacts with angiotensin II (AngII) type 1 (AT1) receptors and facilitates their internalization in vitro, but little is known about the function of Atrap in vivo. Here, we detected Atrap expression in several organs of wild-type mice; the highest expression was in the kidney where it localized to the proximal tubule, particularly the brush border. There was no Atrap expression in the renal vasculature or juxtaglomerular cells. We generated Atrap-deficient (Atrap?/?) mice, which were viable and seemed grossly normal. Mean systolic BP was significantly higher in Atrap?/? mice compared with wild-type mice. Dose-response relationships of arterial BP after acute AngII infusion were similar in both genotypes. Plasma volume was significantly higher and plasma renin concentration was markedly lower in Atrap?/? mice compared with wild-type mice. 125I-AngII binding showed enhanced surface expression of AT1 receptors in the renal cortex of Atrap?/? mice, accompanied by increased carboanhydrase-sensitive proximal tubular function. In summary, Atrap?/? mice have increased arterial pressure and plasma volume. Atrap seems to modulate volume status by acting as a negative regulator of AT1 receptors in the renal tubules. PMID:20093357

  2. Simulations of piezoelectric pressure sensor for radial artery pulse measurement

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Abhay B. [Department of Electronic Science, University of Pune, Pune 411 007 (India); Kalange, Ashok E. [Department of Electronic Science, University of Pune, Pune 411 007 (India); Tuljaram Chaturchand College, Baramati 413 102 (India); Bodas, Dhananjay, E-mail: dhananjay.bodas@gmail.co [Center for Nanobio Sciences, Agharkar Research Institute, Pune 411 004 (India); Gangal, S.A. [Department of Electronic Science, University of Pune, Pune 411 007 (India)

    2010-04-15

    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.

  3. Simulations of piezoelectric pressure sensor for radial artery pulse measurement

    International Nuclear Information System (INIS)

    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.

  4. Ambulatory Hypertension Subtypes and 24-Hour Systolic and Diastolic Blood Pressure as Distinct Outcome Predictors in 8341 Untreated People Recruited From 12 Populations

    DEFF Research Database (Denmark)

    Li, Yan; Wei, Fang-Fei; Thijs, Lutgarde; Boggia, José; Asayama, Kei; Hansen, Tine W; Kikuya, Masahiro; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Gu, Yu-Mei; Torp-Pedersen, Christian; Dolan, Eamon; Liu, Yan-Ping; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Mena, Luis; Maestre, Gladys E; Filipovský, Jan; Imai, Yutaka; O'Brien, Eoin; Wang, Ji-Guang; Staessen, Jan A

    2014-01-01

    not increase the risk of total mortality, cardiovascular mortality, or stroke (HRs≤1.54; P≥0.18), but was associated with a higher risk of fatal combined with nonfatal cardiovascular, cardiac, or coronary events (HRs≥1.75; P≤0.0054). Isolated systolic hypertension (SBP24≥130 mm Hg) and mixed diastolic...

  5. Mean arterial pressure following prolonged exercise in the heat

    DEFF Research Database (Denmark)

    Gagnon, D; Lynn, A G; Binder, K; Boushel, R C; Kenny, G P

    2012-01-01

    benefit to its regulation. We examined MAP (Finometer) in eight trained (T) and eight untrained (UT) individuals prior to, and following, 120 min of cycling at 42 °C with (HYD) and without (DEHY) fluid replacement. Exercise during DEHY induced significant hyperthermia (T: 39.20 ± 0.52 °C vs UT: 38.70 ± 0......-exercise hypotension following prolonged exercise in the heat without fluid replacement. Furthermore, fluid replacement reverses the sustained post-exercise hypotension observed in trained individuals.......Prolonged exercise in the heat without fluid replacement represents a significant challenge to the regulation of mean arterial pressure (MAP). It is unknown, however, if MAP is equally challenged during the post-exercise period, and whether regular endurance exercise training can provide any...

  6. Perfusion of veins at arterial pressure increases the expression of KLF5 and cell cycle genes in smooth muscle cells

    International Nuclear Information System (INIS)

    Vascular smooth muscle cell (VSMC) proliferation remains a major cause of veno-arterial graft failure. We hypothesised that exposure of venous SMCs to arterial pressure would increase KLF5 expression and that of cell cycle genes. Porcine jugular veins were perfused at arterial or venous pressure in the absence of growth factors. The KLF5, c-myc, cyclin-D and cyclin-E expression were elevated within 24 h of perfusion at arterial pressure but not at venous pressure. Arterial pressure also reduced the decline in SM-myosin heavy chain expression. These data suggest a role for KLF5 in initiating venous SMCs proliferation in response to arterial pressure.

  7. Perfusion of veins at arterial pressure increases the expression of KLF5 and cell cycle genes in smooth muscle cells

    Energy Technology Data Exchange (ETDEWEB)

    Amirak, Emre [Section of Molecular Medicine, National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ (United Kingdom); Zakkar, Mustafa; Evans, Paul C. [Cardiovascular Sciences, Bywaters Center for Vascular Inflammation, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London W12 ONN (United Kingdom); Kemp, Paul R., E-mail: p.kemp@imperial.ac.uk [Section of Molecular Medicine, National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ (United Kingdom)

    2010-01-01

    Vascular smooth muscle cell (VSMC) proliferation remains a major cause of veno-arterial graft failure. We hypothesised that exposure of venous SMCs to arterial pressure would increase KLF5 expression and that of cell cycle genes. Porcine jugular veins were perfused at arterial or venous pressure in the absence of growth factors. The KLF5, c-myc, cyclin-D and cyclin-E expression were elevated within 24 h of perfusion at arterial pressure but not at venous pressure. Arterial pressure also reduced the decline in SM-myosin heavy chain expression. These data suggest a role for KLF5 in initiating venous SMCs proliferation in response to arterial pressure.

  8. Pressure Myography to Study the Function and Structure of isolated small arteries

    DEFF Research Database (Denmark)

    Schjørring, Olav; Carlsson, Rune; Simonsen, Ulf

    2015-01-01

    Small arteries play an important role in regulation of peripheral resistance and organ perfusion. Here we describe a series of the methods allowing measurements in pressurized segments of small arteries from the systemic and coronary circulation of mice as well as other species. The pressure myog...

  9. LEFT ATRIAL DIASTOLIC DYSFUNCTION AND PULMONARY VENOUS HYPERTENSION IN ATRIAL FIBRILLATION: CLINICAL, HEMODYNAMIC AND

    Directory of Open Access Journals (Sweden)

    J. Thomas Heywood, M.D., F.A.C.C.; Srikanth Seethala, MD; Tariq Khan, M.D.; Allen Johnson M.D., F.A.C.C.; Michael Smith, M.D.; David Rubenson, M.D., F.A.C.C.

    2014-10-01

    Full Text Available Background: Left ventricular diastolic dysfunction has been well described; diastolic abnormalities of the LA are less frequently recognized and poorly understood. Objective: The purpose of this study was to investigate the clinical, hemodynamic and echocardiographic features of left atrial (LA diastolic dysfunction. Methods: Patients with atrial fibrillation (AF, severe LA enlargement, and pulmonary venous hypertension (PVH, Group 1 were compared to patients with pulmonary arterial hypertension (PAH, normal LA size and sinus rhythm (Group 2. All underwent right heart catheterization and transthoracic echo to evaluate hemodynamics and LA function. Mitral regurgitation was evaluated by transesophageal echocardiography. LA diastolic function was measured by comparing filling fraction, pulmonary venous flow and compliance. Results: Right atrial, pulmonary artery systolic and mean pressures were similar. Mean wedge pressure were increased in Group 1, 20.8±2.6 versus 9.7±2.8 mm of Hg (p<0.0001. The most striking hemodynamic difference was large V wave in Group 1 without significant mitral regurgitation. LA filling fraction was abnormal in Group 1, 11.4%±8.5 compared to Group 2, 111.5%±44 (p<0.0001. LA compliance was 0.39±0.27 ml/m2/mmHg in Group 1 versus 6.8±4.54 ml/m2/mmHg in Group 2 (p=0.001. There was a strong negative correlation between the V wave and LA filling fraction (r=‑0.756, p<0.001. The ratio of the height of the transmitral E wave divided by the S/D ratio (the LA diastolic dysfunction index correlated very strongly with the V wave (r=0.907, p<0.001. Conclusion: LA diastolic dysfunction is present in some patients with long standing AF and PVH. LA diastolic dysfunction, in addition to left ventricular diastolic dysfunction, may contribute to the syndrome of heart failure with preserved left ventricular systolic function.

  10. The phosphodiesterase 3 inhibitor cilostazol dilates large cerebral arteries in humans without affecting regional cerebral blood flow

    DEFF Research Database (Denmark)

    Birk, Steffen; Kruuse, Christina Rostrup; Petersen, Kenneth A; Jonassen, Olga; Tfelt-Hansen, Peer; Olesen, Jes

    2004-01-01

    the middle cerebral arteries (VMCA) was measured with transcranial Doppler, and the superficial temporal and radial arteries diameters were measured with ultrasonography. During the 4-hour observation period, there was no effect on systolic blood pressure (P = 0.28), but diastolic blood pressure...

  11. Exercise training improves mean arterial pressure in breast cancer survivors

    Scientific Electronic Library Online (English)

    Robert, C. Mills; Marcelo G. B., Nascimento; Gislane F. de, Melo; Anthony C., Hackney; Claudio L., Battaglini.

    2014-09-01

    Full Text Available "O exercício físico melhora a pressão arterial média em sobreviventes de câncer de mama."Atualmente, muitos sobreviventes de câncer de mama em todo o mundo vivem com os efeitos secundários relacionados com o tratamento, incluindo problemas de saúde cardiovascular. Este estudo examinou os efeitos de [...] uma intervenção de exercício de 5 meses com marcadores não-invasivos de saúde cardiovascular em sobreviventes de câncer de mama. As relações entre esses marcadores e os marcadores mais utilizados de saúde em geral também foram exploradas. Cinquenta e duas sobreviventes completaram o treinamento em um centro de reabilitação da Universidade da Carolina do Norte em Chapel Hill entre 2008-2011. Foram implementadas intervenção combinando exercício aeróbio e resistido (3 vezes / semana durante 1h) em intensidades progredindo de baixo (40%) a moderada (65-70% do VO2max) para exercícios aeróbios, e 8-12 repetições máxima para o exercício de resistência. Redução significativa da pressão arterial média (PAM) foi observada a partir da linha de base para avaliação final. Foi encontrada uma correlação significativa entre o MAPA e Índice de Massa Corporal (IMC). Em conclusão, 5 meses de intervenção com exercícios combinados de resistência e aeróbio melhorou positivamente o MAP, que foi, em parte, atribuída a mudanças no IMC. Abstract in spanish "El ejercicio físico mejora la presión arterial media en los sobrevivientes de cáncer de mama."Actualmente, muchos de los sobrevivientes de cáncer de mama en todo el mundo viven con los efectos secundarios relacionados con el tratamiento, incluyendo problemas de salud cardiovascular. Este estudio ex [...] aminó los efectos de una intervención de ejercicio durante cinco meses con marcadores no invasivos de la salud cardiovascular en sobrevivientes de cáncer de seno. También se exploraron las relaciones entre estos marcadores y los marcadores más utilizados de la salud general. Cincuenta y dos sobrevivientes completaron la formación en un centro de rehabilitación en la Universidad de Carolina del Norte en Chapel Hill de 2008 a 2011. Intervención se implementara la combinación de ejercicio aeróbico y de resistencia (3 veces / semana durante 1 h) a intensidades que van de la baja (40%) o moderada (65-70% VO2max) para el ejercicio aeróbico, y 8-12 repeticiones máximas para el ejercicio de resistencia. Se observó una reducción significativa de la presión arterial media (MAP) desde el inicio hasta la evaluación final. Se encontró una correlación significativa entre el MAPA y el Índice de Masa Corporal (IMC). En conclusión, a cinco meses de intervención con ejercicio aeróbico y de resistencia combinado mejoraron positivamente el MAP, que se atribuye en parte a los cambios en el IMC. Abstract in english Currently, many breast cancer survivors worldwide live with treatment-related side effects, including cardiovascular health problems. This study examined effects of a 5-month exercise intervention on non-invasive markers of cardiovascular health in breast cancer survivors. Relationships between thes [...] e markers and commonly used markers of overall health were also explored. Fifty-two survivors completed the exercise training at a rehabilitation center at the University of North Carolina at Chapel Hill between 2008-2011. A combined aerobic and resistance exercise intervention (3 times/week for 1h) at intensities progressing from low (40%) to moderate (65-70% of VO2max) for aerobic and 8-12 repetitions max for the resistance exercise were implemented. Significant reduction in mean arterial pressure (MAP) was observed from baseline to final assessment. A significant correlation was found between MAP and Body Mass Index (BMI). In conclusion, 5-months combined aerobic and resistance exercise intervention positively improved MAP which was, in part, attributed to changes in BMI.

  12. Medida da pressão arterial no braço e antebraço em função do manguito Medida de la presión arterial en el brazo y antebrazo en función del manguito Arm and forearm blood pressure measurements as a function of cuff width

    Directory of Open Access Journals (Sweden)

    Edna Apparecida Moura Arcuri

    2009-02-01

    Full Text Available OBJETIVO: Identificar e comparar os níveis de pressão arterial no braço e antebraço usando manguitos de dimensões apropriadas e o manguito padrão. MÉTODOS: Estudo transversal com 103 indivíduos, aplicando a razão circunferência braquial (CB /largura de manguito de 0,40 nos dois segmentos, e registros com o manguito padrão após um minuto. razão CB /comprimento do manguito de 0,80, correto ou padrão, circunferências medidas no ponto médio de cada segmento. RESULTADOS: Diferenças significativas indicaram hiperestimação da pressão diastólica no antebraço, menor daquela observada em outros estudos. A manobra de Forsberg melhorou a audibilidade dos sons de Korotkoff. CONCLUSÃO: Os achados indicam que o manguito correto diminui a hiperestimação dos registros diastólicos observada por outros autores. O avanço no conhecimento da medida no antebraço requer outros estudos.OBJETIVO:Identificar y comparar los niveles de presión arterial en el brazo y antebrazo usando manguitos de dimensiones apropiadas y el manguito patrón. MÉTODOS: Se trata de un estudio transversal realizado con 103 individuos, aplicando la razón circunferencia braquial (CB /ancho del manguito de 0,40 en los dos segmentos, y registros con el manguito patrón después un minuto, razón CB /largo del manguito de 0,80, correcto o patrón, circunferencias medidas en el punto medio de cada segmento. RESULTADOS: Diferencias significativas indicaron hiperestimación de la presión diastólica en el antebrazo, menor de aquella observada en otros estudios. La maniobra de Forsberg mejoró la audibilidad de los sonidos de Korotkoff. CONCLUSIÓN: Los hallazgos indican que el manguito correcto disminuye la hiperestimación de los registros diastólicos observada por otros autores. El avance en el conocimiento de la medida en el antebrazo requiere de otros estudios.OBJECTIVE: To identify and compare arm and forearm blood pressure measurements using appropriate cuff sizes versus a usual standard cuff. METHODS: A cross-sectional comparative study was used. Blood pressure was measured in 103 individuals using a 0.40 cuff width and 0.80 cuff length on both segments and followed by a measure with a usual standard cuff after one minute. Arm and forearm circumferences were measured at the middle point. RESULTS: Significant differences indicated overestimation of diastolic blood pressure in the forearm. These differences were lower than differences reported in other studies. Korotkoff sounds were improved after Forsberg's maneuver. CONCLUSION: Although, we found an overestimation of diastolic blood pressure in forearm, other studies suggest that the use of appropriate cuff sizes in the forearm derive more accurate measures of diastolic blood pressure. There is a need to study further measurements of blood pressure in the forearm.

  13. Effect of iohexol and diatrizoate on pulmonary arterial pressure following pulmonary angiography

    International Nuclear Information System (INIS)

    A clinical comparison of the effects on pulmonary arterial pressure produced by iohexol and diatrizoate, following selective pulmonary angiography, was made in 17 patients with a normal pressure before the injection of the contrast medium. A double blind crossover study was performed and each contrast medium was administered in random order. The pulmonary arterial pressure was continuously recorded before, during and after the injection for 3 minutes. The effect of iohexol on the pulmonary arterial pressure was significantly less than that of diatrizoate. The results indicated that iohexol should be better tolerated than diatrizoate and therefore a safer contrast medium for selective pulmonary angiography. (orig.)

  14. Blood pressure changes in dogs with babesiosis

    Directory of Open Access Journals (Sweden)

    L.S. Jacobson

    2000-07-01

    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.

  15. Blood pressure changes in dogs with babesiosis

    Directory of Open Access Journals (Sweden)

    L.S. Jacobson

    2000-07-01

    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.

  16. Diastolic myofilament dysfunction in the failing human heart

    OpenAIRE

    van der Velden, Jolanda

    2011-01-01

    In recent years, it has become evident that heart failure is not solely due to reduced contractile performance of the heart muscle as impaired relaxation is evident in almost all heart failure patients. In more than half of all heart failure patients, diastolic dysfunction is the major cardiac deficit. These heart failure patients have normal (or preserved) left ventricular ejection fraction, but impaired diastolic function evident from increased left ventricular end-diastolic pressure. Pertu...

  17. Pressure measurements in arterial feeders of brain arteriovenous malformations before and after endovascular embolization

    International Nuclear Information System (INIS)

    Arteriovenous malformations (AVMs) are composed of abnormal arterial and venous vessels in the brain causing arteriovenous shunts of arterialized blood directly from pial arteries to draining veins. The hemodynamics of these lesions is not well-understood. Changes in blood flow and pressure are probably related to the natural history of AVMs and may also play a major role in AVM treatment. In this study intra-arterial pressure was measured in feeding arteries of AVMs using a microcatheter that had been placed for subsequent embolization treatment (201 measurements were performed in 95 patients before and after the embolization procedure). Results show a direct relationship between pressure changes and degree of embolization. Since pressure changes during the embolization procedure are relatively small, it seems unlikely that these changes are the direct cause of rupture and periprocedural bleedings. (orig.)

  18. Arterial Pressure Gradients during Upright Posture and 30 deg Head Down Tilt

    Science.gov (United States)

    Sanchez, E. R; William, J. M.; Ueno, T.; Ballard, R. E.; Hargens, A. R.; Holton, Emily M. (Technical Monitor)

    1997-01-01

    Gravity alters local blood pressure within the body so that arterial pressures in the head and foot are lower and higher, respectively, than that at heart level. Furthermore, vascular responses to local alterations of arterial pressure are probably important to maintain orthostatic tolerance upon return to the Earth after space flight. However, it has been difficult to evaluate the body's arterial pressure gradient due to the lack of noninvasive technology. This study was therefore designed to investigate whether finger arterial pressure (FAP), measured noninvasively, follows a normal hydrostatic pressure gradient above and below heart level during upright posture and 30 deg head down tilt (HDT). Seven healthy subjects gave informed consent and were 19 to 52 years old with a height range of 158 to 181 cm. A Finapres device measured arterial pressure at different levels of the body by moving the hand from 36 cm below heart level (BH) to 72 cm above heart level (AH) in upright posture and from 36 cm BH to 48 cm AH during HDT in increments of 12 cm. Mean FAP creased by 85 mmHg transitioning from BH to AH in upright posture, and the pressure gradient calculated from hydrostatic pressure difference (rho(gh)) was 84 mmHg. In HDT, mean FAP decreased by 65 mmHg from BH to AH, and the calculated pressure gradient was also 65 mmHg. There was no significant difference between the measured FAP gradient and the calculated pressure gradient, although a significant (p = 0.023) offset was seen for absolute arterial pressure in upright posture. These results indicate that arterial pressure at various levels can be obtained from the blood pressure at heart level by calculating rho(gh) + an offset. The offset equals the difference between heart level and the site of measurement. In summary, we conclude that local blood pressure gradients can be measured by noninvasive studies of FAP.

  19. 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)

    Raff, M.; Tholstrup, T.; Sejrsen, K.; Straarup, Ellen Marie; Wiinberg, N.

    2006-01-01

    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......- 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...

  20. Relationship between mean arterial pressure and end-tidal partial pressure of carbon dioxide during hemorrhagic shock and volume resuscitation

    OpenAIRE

    Stefek Grmec; Mirjam Golub; Alina Jelatancev

    2009-01-01

    Objectives. We examined the relationship between partial end-tidal CO2 (pet) and mean arterial pressure in patients with traumatic hemorrhagic shock, who were receiving constant minute ventilation. Methods. In 61 patients we continuously measured pet CO2 with a capnograph, direct arterial pressure via a cannula, oxygen levels via pulse oximetry and body temperature. Results. We observed significant changes in pet CO2 (increase) after volume resuscitation and a quantitative linear relati...

  1. Pulse Pressure and Arterial Compliance Prior to Pregnancy and the Development of Complicated Hypertension during Pregnancy

    OpenAIRE

    Hale, Sarah; Choate, Martha; Schonberg, Adrienne; Shapiro, Robert; Badger, Gary; Bernstein, Ira M.

    2010-01-01

    We examined the relationship between prepregnant pulse pressure (PP), mean arterial pressure (MAP), cardiac output (CO)/PP, a measure of arterial compliance, and development of complicated hypertension during pregnancy (CH) with the goal of identifying a potential predictor of CH. Twenty nulliparous subjects were studied before pregnancy; seventeen had normal pregnancies (CTL) and three CH. Blood pressure monitoring was performed using tonometry. CO was determined by Doppler echocardiograph. ...

  2. 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)

    Aleida Herrera Batista

    2006-03-01

    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.

  3. Exercise training improves mean arterial pressure in breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Robert C. Mills

    2014-09-01

    Full Text Available Currently, many breast cancer survivors worldwide live with treatment-related side effects, including cardiovascular health problems. This study examined effects of a 5-month exercise intervention on non-invasive markers of cardiovascular health in breast cancer survivors. Relationships between these markers and commonly used markers of overall health were also explored. Fifty-two survivors completed the exercise training at a rehabilitation center at the University of North Carolina at Chapel Hill between 2008-2011. A combined aerobic and resistance exercise intervention (3 times/week for 1h at intensities progressing from low (40% to moderate (65-70% of VO2max for aerobic and 8-12 repetitions max for the resistance exercise were implemented. Significant reduction in mean arterial pressure (MAP was observed from baseline to final assessment. A significant correlation was found between MAP and Body Mass Index (BMI. In conclusion, 5-months combined aerobic and resistance exercise intervention positively improved MAP which was, in part, attributed to changes in BMI.

  4. Critical buckling pressure in mouse carotid arteries with altered elastic fibers.

    Science.gov (United States)

    Luetkemeyer, Callan M; James, Rhys H; Devarakonda, Siva Teja; Le, Victoria P; Liu, Qin; Han, Hai-Chao; Wagenseil, Jessica E

    2015-06-01

    Arteries can buckle axially under applied critical buckling pressure due to a mechanical instability. Buckling can cause arterial tortuosity leading to flow irregularities and stroke. Genetic mutations in elastic fiber proteins are associated with arterial tortuosity in humans and mice, and may be the result of alterations in critical buckling pressure. Hence, the objective of this study is to investigate how genetic defects in elastic fibers affect buckling pressure. We use mouse models of human disease with reduced amounts of elastin (Eln+/-) and with defects in elastic fiber assembly due to the absence of fibulin-5 (Fbln5-/-). We find that Eln+/- arteries have reduced buckling pressure compared to their wild-type controls. Fbln5-/- arteries have similar buckling pressure to wild-type at low axial stretch, but increased buckling pressure at high stretch. We fit material parameters to mechanical test data for Eln+/-, Fbln5-/- and wild-type arteries using Fung and four-fiber strain energy functions. Fitted parameters are used to predict theoretical buckling pressure based on equilibrium of an inflated, buckled, thick-walled cylinder. In general, the theoretical predictions underestimate the buckling pressure at low axial stretch and overestimate the buckling pressure at high stretch. The theoretical predictions with both models replicate the increased buckling pressure at high stretch for Fbln5-/- arteries, but the four-fiber model predictions best match the experimental trends in buckling pressure changes with axial stretch. This study provides experimental and theoretical methods for further investigating the influence of genetic mutations in elastic fibers on buckling behavior and the development of arterial tortuosity. PMID:25771258

  5. A Lumped Parameter Method to Calculate the Effect of Internal Carotid Artery Occlusion on Anterior Cerebral Artery Pressure Waveform

    Science.gov (United States)

    Abdi, M.; Navidbakhsh, M.; Razmkon, A.

    2016-01-01

    Background and Objective Numerical modeling of biological structures would be very helpful tool to analyze hundreds of human body phenomena and also diseases diagnosis. One physiologic phenomenon is blood circulatory system and heart hemodynamic performance that can be simulated by utilizing lumped method. In this study, we can predict hemodynamic behavior of one artery of circulatory system (anterior cerebral artery) when disease such as internal carotid artery occlusion is occurred. Method Pressure-flow simulation is one the leading common approaches for modeling of circulatory system behavior and forecasts of hemodynamic in numerous physiological conditions. In this paper, by using lumped model (electrical analogy), CV system is simulated in MATLAB software (SIMULINK environment). Results The performance of healthy blood circulation and heart is modeled and the obtained results used for further analyses. The stenosis of internal carotid artery at different rates was, then, induced in the circuit and the effects are studied. In stenosis cases, the effects of internal carotid artery occlusion on  left anterior cerebral artery pressure waveform are investigated. Conclusion The findings of this study may have implications not only for understanding the behavior of human biological system at healthy condition but also for diagnosis of diseases in circulatory and cardiovascular system of human body.

  6. Evaluation of the cerebrovascular pressure reactivity index using non-invasive finapres arterial blood pressure

    International Nuclear Information System (INIS)

    A pressure reactivity index (PRx) can be assessed in patients with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP) as a moving correlation coefficient between slow fluctuations of these two signals within a low frequency bandwidth. The study aimed to investigate whether the invasive ABP monitoring can be replaced with non-invasive measurement of ABP using a Finapres plethysmograph (fABP) to calculate the fPRx. There is a well-defined group of patients, suffering from hydrocephalus and undergoing CSF pressure monitoring, which may benefit from such a measurement. 41 simultaneous day-by-day monitoring of ICP, ABP and fABP were performed for about 30 min in 10 head injury patients. A Bland–Altman assessment for agreement was used to compare PRx and fPRx calculations. Performance metrics and the McNemary test were used to determine whether fPRx is sensitive enough to distinguish between functioning and disturbed cerebrovascular pressure reactivity. The fPRx correlated with PRx (RSpearman = 0.92, p < 0.001; bias = −0.04; lower and upper limits of agreement: −0.26 and 0.17, respectively). The fPRx distinguished between active and passive reactivity in more than 89% cases. The fPRx can be used with care for assessment of cerebrovascular reactivity in patients for whom invasive ABP measurement is not feasible. The fPRx is sensitive enough to distinguish between functional and deranged reactivity

  7. Drinking and arterial blood pressure responses to ANG II in young and old rats

    OpenAIRE

    Thunhorst, Robert L.; Beltz, Terry G; Johnson, Alan Kim

    2010-01-01

    We investigated water drinking and arterial blood pressure responses to intravenous infusions of ANG II in young (4 mo), middle-aged adult (12 mo), and old (29 mo) male Brown Norway rats. Infusions of ANG II began with arterial blood pressure either at control levels or at reduced levels following injection of the vasodilator minoxidil. Under control conditions, mean arterial pressure (MAP) in response to ANG II rose to the same level for all groups, and middle-aged and old rats drank as much...

  8. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

    OpenAIRE

    Amann Matthias; Trabold Benedikt; Schweiger Stefan; Keyl Cornelius; Bele Sylvia; Prasser Christopher; Welnhofer Julia; Wiesenack Christoph

    2007-01-01

    Abstract Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC) measurement by the pulmonary artery catheter (PAC). However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP) device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA) only requires access to the radial or femoral artery using a s...

  9. Strength training reduces arterial blood pressure but not sympathetic neural activity in young normotensive subjects

    Science.gov (United States)

    Carter, Jason R.; Ray, Chester A.; Downs, Emily M.; Cooke, William H.

    2003-01-01

    The effects of resistance training on arterial blood pressure and muscle sympathetic nerve activity (MSNA) at rest have not been established. Although endurance training is commonly recommended to lower arterial blood pressure, it is not known whether similar adaptations occur with resistance training. Therefore, we tested the hypothesis that whole body resistance training reduces arterial blood pressure at rest, with concomitant reductions in MSNA. Twelve young [21 +/- 0.3 (SE) yr] subjects underwent a program of whole body resistance training 3 days/wk for 8 wk. Resting arterial blood pressure (n = 12; automated sphygmomanometer) and MSNA (n = 8; peroneal nerve microneurography) were measured during a 5-min period of supine rest before and after exercise training. Thirteen additional young (21 +/- 0.8 yr) subjects served as controls. Resistance training significantly increased one-repetition maximum values in all trained muscle groups (P blood pressures at rest. Resistance training did not affect MSNA or heart rate. Arterial blood pressures and MSNA were unchanged, but heart rate increased after 8 wk of relative inactivity for subjects in the control group (61 +/- 2 to 67 +/- 3 beats/min; P = 0.01). These results indicate that whole body resistance exercise training might decrease the risk for development of cardiovascular disease by lowering arterial blood pressure but that reductions of pressure are not coupled to resistance exercise-induced decreases of sympathetic tone.

  10. Effect of Rg3-enriched Korean red ginseng (Panax ginseng) on arterial stiffness and blood pressure in healthy individuals: a randomized controlled trial.

    Science.gov (United States)

    Jovanovski, Elena; Bateman, Emma A; Bhardwaj, Jyoti; Fairgrieve, Chris; Mucalo, Iva; Jenkins, Alexandra L; Vuksan, Vladimir

    2014-08-01

    Ginsenoside Rg3, present in steamed ginseng (Panax Ginseng C.A. Meyer), is thought to be a potent modulator of vascular function. Our objective was to clinically evaluate acute effects of ginsenoside Rg3-enriched Korean red ginseng (Rg3-KRG) on measures of arterial stiffness and peripheral and central blood pressure (BP) parameters in healthy volunteers. Using a double-blind, randomized, crossover design, 23 individuals (9 males:14 females; age, 25 ± 2 years; body mass index, 22 ± 0.6 kg/m(2); systolic BP/diastolic BP, 113 ± 3/70 ± 2 mm Hg) were administered 400-mg Rg3-KRG extract or 400-mg wheat bran control on two separate visits with a 7-day washout period. Aortic augmentation index and central BP were measured using applanation tonometry by radial pulse wave analysis, and peripheral BP was evaluated oscillometrically. Measurements were taken at baseline and at 1, 2, and 3 hours after intervention. Compared with control, there were significant reductions in augmentation index (-4.3 ± 8.9%, P = .03), central (-4.8 ± 6.8 mm Hg, P = .01) and brachial mean arterial pressure (-4.4 ± 6.6 mm Hg, P = .01), central systolic (-5.0 ± 7.9 mm Hg, P = .01) and diastolic BP (-3.9 ± 6.6 mm Hg, P = .01), and brachial systolic (-4.4 ± 10.0 mm Hg, P = .048) and diastolic BP (-3.6 ± 6.4 mm Hg, P = .01) at 3 hours after intervention compared with control. This study is the first to demonstrate Rg3-KRG extract acutely lowers central and peripheral arterial pressures in healthy adults. Further clinical evaluation is desired to quantify efficacy in higher risk individuals and in long-term settings. PMID:24997863

  11. Middle cerebral artery occlusion in presence of low perfusion pressure increases infarct size in rats

    DEFF Research Database (Denmark)

    Sillesen, H; Nedergaard, Majken; Schroeder, T; Buchardt Hansen, H J

    1988-01-01

    A model was set up in order to evaluate the importance of hemispheric perfusion pressure when the middle cerebral artery (MCA) is occluded in anaesthetized rats. In 6 animals the internal carotid artery (ICA) was occluded prior to ipsilateral MCA occlusion; in 17 animals the MCA only was occluded...

  12. Defining the adequate arterial pressure target during septic shock: not a 'micro' issue but the microcirculation can help

    OpenAIRE

    Silva, Serena; Teboul, Jean-Louis

    2011-01-01

    The Surviving Sepsis Campaign guidelines suggest targeting a mean arterial pressure of at least 65 mm Hg to maintain organ perfusion pressure during septic shock. However, the optimal mean arterial pressure can be higher in patients with a history of hypertension or other vascular comorbidities or in those with increased abdominal pressure. In a given individual, the adequate mean arterial pressure target can be difficult to define with the routine hemodynamic parameters (for example, cardiac...

  13. Arterial Pressure Gradient of Upper Extremity Arteriovenous Access Steal Syndrome: Treatment Implications

    Science.gov (United States)

    Reifsnyder, Thomas; Arnaoutakis, George J

    2011-01-01

    Purpose Treatment options after arteriovenous fistula(AVF) associated steal include: ligation, banding, and distal revascularization-interval ligation(DRIL). The purpose of this study was to evaluate arterial pressure gradients in upper extremity steal syndrome. Methods Pre-operative arteriography and sequential intra-arterial pressure readings were performed on consecutive AVF patients with hand ischemia. Analysis of variance(ANOVA) with repeated measures analyzed inter-subject comparisons, and post-hoc analysis identified anatomic locations with highest inflow pressures. Results Nine patients presented with ischemic hand symptoms after AVF. Pullback arterial pressure measurements revealed gradual increases in systolic and mean pressures as the catheter position was moved proximally from the AVF anastomosis. Post-hoc analysis after ANOVA revealed higher axillary artery systolic pressure compared to proximal brachial artery(153vs116.8,p=0.007). Conclusion AVF-related steal syndrome decreases arterial inflow pressure of the affected extremity more proximally than previously thought. When performing a DRIL procedure, consideration should be given to placing the anastomosis as proximally as possible. PMID:20675320

  14. Balloon-occluded arterial stump pressure before balloon-occluded transarterial chemoembolization.

    Science.gov (United States)

    Matsumoto, Tomohiro; Endo, Jun; Hashida, Kazunobu; Mizukami, Hajime; Nagata, Junko; Ichikawa, Hitoshi; Kojima, Seiichiro; Takashimizu, Shinji; Yamagami, Takuji; Watanabe, Norihito; Hasebe, Terumitsu

    2016-02-01

    Objective To evaluate balloon-occluded arterial stump pressure (BOASP), which is responsible for effective balloon-occluded transarterial chemoembolization (B-TACE), at each hepatic arterial level before B-TACE using a 1.8-French tip microballoon catheter for unresectable hepatocellular carcinoma (HCC). Material and methods The BOASP at various embolization portions was retrospectively investigated. "Selective" and "non-targeted" BOASP was defined as the BOASP at the subsegmental or segmental artery and the lobar artery, respectively. Results The measurement of the BOASP was carried out in 87 arteries in 47 patients. BOASP?>?64?mmHg was revealed in the caudate lobe artery (A1) and the left medial segmental (A4), right anterior superior segmental (A8), anterior segmental, right and left hepatic arteries. Significant difference was noted in the incidence of BOASP above 64?mmHg between "non-targeted" and "selective" BOASP (p?=?0.01). "Non-targeted" BOASP was significantly greater than "selective" BOASP (p?=?0.0147). In addition, the BOASP in A1, 4, 8 and the anterior segmental arteries were significantly greater than in the other subsegmental and segmental arteries (p?=?0.0007). Conclusion "Non-targeted" B-TACE should be avoided to perform effective B-TACE and "selective" B-TACE at A1, 4, 8 and the anterior segmental arteries may become less effective than at the other segmental or subsegmental arteries. PMID:26406612

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

    CERN Document Server

    Sur, S; Sur, Shantanu

    2005-01-01

    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.

  16. Epworth's sleepiness scale in outpatients with different values of arterial blood pressure

    OpenAIRE

    Miguel Gus; Daniel Nunes e Silva; Juliana Fernandes; Caroline P. Cunha; Geraldo Druck Sant'Anna

    2002-01-01

    OBJECTIVE: To compare sleepiness scores of the Epworth scale in patients with different levels of arterial pressure when undergoing outpatient monitoring within the context of clinical evaluation. METHODS: A total of 157 patients selected for outpatient monitoring of arterial pressure during hypertension evaluation were divided into 3 groups: group 1 - normotensive; group 2 - hypertensive; group 3 - resistant hypertensive. For analysis, values > or = 11 were considered as associated with res...

  17. Moderately Elevated Intracranial Pressure Produces Greater Cross-Filling of the Anterior Communicating Artery

    OpenAIRE

    Zhang, Yi C; J Young, Robert; Jones, Kevin; Koh, Elsie; Lien, Ruby J; Kagetsu, Nolan J

    2014-01-01

    This study aimed to investigate whether moderately elevated intracranial pressure is associated with greater cross-filling of the anterior communicating artery on diagnostic cerebral angiography. A retrospective study of 12 patients with subarachnoid hemorrhage was performed. Data on sequential cerebral angiograms and clinical data were used to indirectly estimate intracranial pressure (ICP). Cross-filling of the anterior communicating artery (ACom) was recorded according to our scoring syste...

  18. Effects of hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume

    International Nuclear Information System (INIS)

    The effects of long-term hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume were studied in eight conscious dogs over a 34-day period. Plasma protein concentration (PPC) was decreased by daily plasmapheresis, and the effects of decreasing and increasing sodium intake were measured. By the 12th day of plasmapheresis PPC had decreased to 2.5 g/dl from a control value of 7.2 g/dl, mean arterial pressure had decreased to 78% of control, glomerular filtration rate (GFR) was 75.2% of control, and urinary sodium excretion was decreased. By day 18 of plasmapheresis, estimated renal plasma flow (ERPF) was decreased to 60% of control due to the decreased arterial pressure and an increase in renal vascular resistance. GFR and ERPF were determined from the total clearance of [125I]iothalamate and [131I]iodohippurate. Also, plasma renin activity and plasma aldosterone concentration were both increased, and the relationship between mean arterial pressure and urinary sodium excretion was distinctly shifted to the left along the arterial pressure axis. In contradistinction to acute experiments, chronic hypoproteinemia results in decreases in GFR, ERPF, and urinary sodium excretion and has marked effects on both fluid volume and arterial pressure regulation

  19. Mini invasive hemodynamic monitoring: from arterial pressure to cardiac output

    OpenAIRE

    GIORGIO DELLA ROCCA; MAURIZIO CECCONI; MARIA GABRIELLA COSTA

    2008-01-01

    To evaluate the Cardiac Output (CO) the standard invasive pulmonary artery catheter (PAC) is considered today the gold standard. The major criticism to the PAC is that its level of invasiveness is not supported by an improvement in patient's outcome. The interest to lesser and lesser invasive techniques is high. Therefore, the alternative techniques have been recently developed.Cardiac Output can be monitored continuously by different devices that analyze the arterial waveform to track change...

  20. Classification of peripheral occlusive arterial diseases based on symptoms, signs and distal blood pressure measurements

    DEFF Research Database (Denmark)

    Tønnesen, K H; Noer, Ivan; Paaske, William; Sager, P

    1980-01-01

    Systolic blood pressures at toe and ankle were measured in 459 consecutive patients with occlusive arterial disease. Fifty-eight per cent had intermittent claudication with arterial disease of all degrees of severity. Seventeen per cent complained of rest pain having toe systolic pressures below 30...... mmHg, half had arterial lesions proximal to the groin. None had diabetes. Fourteen per cent non-diabetic patients had chronic ulcerations on the foot with arterial lesions similar to those in patients with rest pain. Eleven per cent diabetic patients with chronic ulcerations had less pronounced...... occlusive arterial disease which was located distally on the legs. A classification in three groups is suggested: (1) ischemia only during exercise; (2) ischemia at rest with or without ulcerations: and (3) diabetics with chronic ulcerations....

  1. Comportamento da pressão arterial em filhos de normotensos e filhos de hipertensos submetidos a estímulos pressóricos Arterial blood pressure responses in children of normotensive and hypertensive parents submitted to pressor tests

    Directory of Open Access Journals (Sweden)

    José Wilson S. Cavalcante

    1997-11-01

    Full Text Available OBJETIVO: Comparar a pressão arterial (PA basal e as respostas a estímulos pressóricos de filhos de normotensos e filhos de hipertensos. MÉTODOS: Foram examinados 32 adolescentes, do sexo masculino, brancos, na faixa etária entre 13 e 18 anos, sendo que 16 eram filhos de hipertensos e 16 filhos de normotensos. Para cada indivíduo foi aferida a PA basal seguida da aplicação de três testes pressóricos: teste do exercício isométrico com o handgrip, teste pressor ao frio e teste do exercício aritmético mental. Para a aferição da PA foi utilizado um dispositivo oscilométrico, digital, previamente calibrado. RESULTADOS: Os filhos de hipertensos exibiram valores basais de PA, tanto sistólica quanto diastólica, maiores que os filhos de normotensos (pPURPOSE: To compare cardiovascular reactivity in adolescents with and without family history of hypertension. METHODS: Thirty two subjects, males, students, aging between 13 to 18 years old were examined. One half of them had no family history of hypertension and the other half had at least one hypertensive parent. Basal blood pressure level was obtained before the application of the following selected tests: isometric handgrip exercise test, cold pressor test and arithmetic mental stress test. The blood pressure values were obtained by a digital, oscilometric device, previously calibrated. RESULTS: The subjects with family history of hypertension exhibited higher basal levels of both systolic and diastolic blood pressure (p<0,10. Concerning the tests applied, the subjects with family history of hypertension also exhibited higher responses, but only the response of the diastolic blood pressure to the mental stress test was statistically significant (p<0,10. CONCLUSION: Our findings point to the need of a special follow-up of children with a family history of hypertension.

  2. Clinical observations on the effect of carotid artery occlusion on cerebral blood flow mapped by xenon computed tomography and its correlation with carotid artery back pressure

    International Nuclear Information System (INIS)

    Xenon computed tomographic cerebral blood flow mapping was correlated with internal carotid artery stump pressures and clinical neurologic assessment during temporary internal carotid artery occlusion. One hundred fourteen patients with skull base tumors or intracranial aneurysms potentially requiring carotid resection or ligation underwent angiography, xenon CT cerebral blood flow mapping, and internal carotid artery blood pressure monitoring. The internal carotid artery was then temporarily occluded with a balloon catheter, stump pressure was measured through the catheter, and the xenon CT cerebral blood flow mapping was repeated. Adequate xenon CT cerebral blood flow was defined as greater than 30 cc/100 gm/min. All patients had normal xenon CT cerebral blood flow before internal carotid artery occlusion. During internal carotid artery occlusion, xenon CT cerebral blood flow was found to be normal (group I, 40 patients), globally reduced but still within the normal range (group II, 50 patients), or low in the distribution of the ipsilateral middle cerebral artery (group III, 13 patients). With balloon occlusion, an immediate neurologic deficit developed in 11 patients (9%) requiring deflation of the balloon preceding xenon CT cerebral blood flow measurement (group IV). In group I internal carotid artery blood pressure was 128 mm Hg. (range 85 to 171 mm Hg) with stump pressure 86 mm Hg (range 46 to 125 mm Hg). In group II internal carotid artery blood pressure was 130 mm Hg. (range 78 to 199 mm Hg), with stump pressure 86 mm Hg (range 31 to 150 mm Hg)

  3. Acompanhamento da pressão arterial: estudo com crianças e adolescentes com história familiar de hipertensão Acompañamiento de la presión arterial: investigación con niños y adolescentes con historia familiar de hipertensión Blood pressure tracking: study with children and adolescents with familial history of hypertension

    Directory of Open Access Journals (Sweden)

    Emilia Soares Chaves

    2010-03-01

    Full Text Available Objetivou-se analisar a evolução dos percentis de pressão arterial em crianças e adolescentes com história familiar de hipertensão arterial. Estudo longitudinal desenvolvido em uma comunidade de Fortaleza, Ceará. A pressão arterial foi avaliada em cinco encontros domiciliares, de janeiro de 2004 a dezembro de 2006. Grupo de 141 participantes, dos quais 92 crianças e 49 adolescentes. Das crianças, 67,4% permaneceram sem alterações dos percentis de pressão arterial em todas as avaliações; dos adolescentes, 65,3% permaneceram nesta condição. A maior parte dos indivíduos mantiveram seus valores e percentis de pressões arteriais sistólica e diastólica elevados, e muitos que não apresentavam inicialmente alterações passaram a mostrá-las no decorrer do acompanhamento. Confirma-se a necessidade de monitoração da pressão arterial rotineira de crianças e adolescentes tanto para a detecção precoce como para a prevenção de complicações.El objetivo fue analizar la evolución de los percentiles de presión arterial en niños y adolescentes con historia familiar de hipertensión arterial. Estudio longitudinal en una comunidad de Fortaleza, Ceará, Brasil. La presión arterial fue evaluada en cinco encuentros en los sitios, de enero de 2004 a diciembre de 2006. El grupo fue de 141 participantes, de los cuales 92 niños y 49 adolescentes. De los niños, 67,4% permanecieron sin alteraciones de los percentiles de presión arterial en todas las evaluaciones; de los adolescentes, 65,3% permanecieron en ésta condición. La mayor parte de los individuos mantenieron sus valores y percentiles de presión arterial sistólica y presión arterial diástolica muy altos, y muchos que no presentaban inicialmente alteraciones, pasaron a señalalas en el decurrir del acompañamiento. Así, se comprueba la necesidad de monitoración de la presión arterial rutinera de niños y adolescentes tanto para la detección como para la prevención de complicaciones.The purpose of this study is to analyze the evolution of the percentiles of blood pressure in children and adolescents with familial history of arterial hypertension. This is a longitudinal study developed in a community in Fortaleza, Ceará, Brazil. The blood pressure was evaluated in five home visits from January, 2004 to December, 2006. The group was composed of 141 participants, of which 92 were children and 49 adolescents. Of the children, 67,4% remained with no alterations of the percentiles of blood pressure in all the evaluations; of the adolescents, 65,3% remained in the same condition. Most individuals kept their values and percentiles of systolic blood pressure and diastolic blood pressure, and many that did not initially present alterations started to show some during the follow up. As a result, routine monitoring of blood pressure of children and adolescents proves necessary for the early detection and prevention of complications.

  4. Intra-arterial Infusion of Leptin does not Affect Blood Pressure in Salt-loaded Rabbits

    Directory of Open Access Journals (Sweden)

    Mohammad Nidal Khabaz

    2010-01-01

    Full Text Available The aim of this research is to see the effect of intra-arterial infusion of leptin on blood pressure of salt loaded rabbits in vivo. Increased blood pressure was produced in rabbits by giving diets containing 8% sodium chloride for 5 weeks. Leptin in different concentrations was infused intra-arterially into rabbits fed on high salt diets and the response was compared in rabbits fed with low salt diets. High salt diets produced significant increase in blood pressure. In rabbits fed with low salt diet, leptin infused intra-arterially caused an increase in blood pressure while infusion of leptin into rabbits fed with high salt diets does not affect the blood pressure. In conclusion, salt loading to rabbits abolishes the effect of leptin on cardiovascular system. This may indicate that leptin effect on sympathetic activity is altered by high salt diets in these animals.

  5. Arterial pressure during cardiopulmonary bypass is not associated with acute kidney injury

    DEFF Research Database (Denmark)

    Kandler, K; Jensen, M E; Nilsson, J C; Møller, C H; Steinbrüchel, D A

    2015-01-01

    BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is common and is associated with increased mortality. We wanted to investigate if the arterial pressure or the use of norepinephrine during cardiopulmonary bypass were associated with AKI. METHODS: A retrospective analysis of patients who...... underwent coronary artery bypass grafting with or without concomitant procedures was conducted. AKI was defined using the RIFLE criteria. Data on arterial pressure and use of norepinephrine during cardiopulmonary bypass were entered in a binary logistic regression model to control for possible perioperative...... confounders. RESULTS: A total of 623 patients were included. Mean age was 68.3?±?9.7 years and 81% were males. AKI was observed in 198 patients (32%). Mean arterial pressure was 47?±?6?mmHg and 45?±?6?mmHg (P?=?0.008) in the AKI and no-AKI group, respectively. Norepinephrine was used more frequently and in...

  6. Healing of ulcers on the feet correlated with distal blood pressure measurements in occlusive arterial disease

    DEFF Research Database (Denmark)

    Holstein, P; Lassen, N A

    1980-01-01

    The frequency of healing in subchronic ulcers in 66 feet in 62 patients with arterial occlusive disease was correlated with the systolic digital blood pressure (SDBP) and the systolic ankle blood pressure (SABP), both measured with a strain gauge, and with the skin perfusion pressure on the heel ...... and peripheral neuropathy were frequent in the diabetic group. The data show that the systolic digital blood pressure is a particularly valuable prognostic parameter....

  7. Hubungan Kadar Apelin dengan Disfungsi Diastol pada Penderita Gagal Jantung dengan Fraksi Ejeksi Normal

    Directory of Open Access Journals (Sweden)

    Dini Rostiati

    2015-06-01

    Full Text Available Apelin ia a novel multifunction peptide implicated in cardiovascular performance regulation in chronic pressure overload. Plasma apelin level and its correlation to diastolic dysfunction in patient heart failure with preserved ejection fraction were investigated. Hypertensive patients with heart failure but without coronary artery disease, atrial fibrillation, obese, and diabetes mellitus were enrolled in this study. Each patients underwent plasma apelin measurement and echocardiographic assessment of left ventricular diastolic function. Statistical analysis was conducted using Spearman Rank. Fifty patients, 24 males (48% and 26 females (52%, met the inclusion criteria. The mean age of the participants was 58.72 (11.02 years with a duration of hypertension between 1–30 years, median 5 year. Mean body mass index was 24.13 kg/m2. Systolic blood pressure median was 130 (120–180mmHg while the diastolic blood pressure median was 90 (70–110mmHg. Left ventricular ejection fraction median was 65 (49–77%, treatment with Angiotensin converting enzyme inhibitor (ACEI was 48%, calcium channel blocker (CCB was 27%, beta blocker was 6%, angiotensin receptor blocker (ARB was 3%, and diuretic was 1%. Diastolic function assessment with tissue doppler imaging (TDI resulted in a mean of 10.32, deceleration time mean of 228.2, E/A (early/atrial (late filling velocities ratio median of 0.77 (0.43–1.53,and IVRT (isovolumic relaxation time median of 92 (59–177. Plasma apelin measurement median was 1080.5 (993.2–11 pg/mL. In conclusion, there is a positive correlation between plasma apelin level and diastolic function (TDI (R=0.3445, p=0.014. There is no significant correlation between plasma apelin level and diastolic function using other criteria. In conclusion, apelin can be used for assessing symptoms and prognosis of heart failure patients with preserved ejection fraction because apelin level is upregulated when pressure overload occurs with less fibrosis and down-regulated when pressure overload occurs with marked fibrosis.

  8. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series

    Directory of Open Access Journals (Sweden)

    Papoulidis Pavlos

    2011-04-01

    Full Text Available Abstract Introduction Pulmonary artery aneurysm is an uncommon disorder with severe complications. The diagnosis is often difficult, since the clinical manifestations are non-specific and the treatment is controversial, as the natural history of the disease is not completely understood. Case presentation We describe the cases of two patients with pulmonary artery aneurysms. The first patient was a 68-year-old Caucasian man with an idiopathic low-pressure pulmonary artery aneurysm together with a pulmonary embolism. The patient preferred a conservative approach and was stable at the 10-month follow-up visit after being placed on anti-coagulant treatment. The second patient was a 66-year-old Caucasian woman with a low-pressure pulmonary artery aneurysm also presented together with a pulmonary embolism. The aneurysm was secondary to pulmonary valve stenosis. She received anti-coagulants and, after stabilization, underwent percutaneous balloon valvuloplasty. Conclusion Pulmonary embolism may be the initial presentation of a low-pressure pulmonary artery aneurysm. No underlying cause for pulmonary embolism was found in either of our patients, suggesting a causal association with low-pressure pulmonary artery aneurysm.

  9. Basis of monitoring central blood pressure and hemodynamic parameters by peripheral arterial pulse waveform analyses.

    Science.gov (United States)

    Miyashita, Hiroshi; Katsuda, Shin-ichiro

    2013-01-01

    In hypertension clinics, central blood pressure (CBP) should be estimated, instead of directly measured, by the "signal processing" of a noninvasive peripheral pressure waveform. This paper deals with the data obtained in our three separate studies focusing on a major estimation method, i.e., radial artery late systolic shoulder pressure (rSBP2)-based CBP estimation. Study 1: Using a wave separation analysis of precise animal data of pressure wave transmission along the upper-limb arteries, we first demonstrate that pulse pressure amplification is largely attributable to local wave reflection alone. Study 2: A frequency component analysis of simultaneously recorded human central and radial artery pressure waveforms showed a predominance of lower (1st+2nd) harmonic components in determining the central augmentation peak amplitude. The features of a central pressure waveform, including its phase property, may contribute to the less-altered transmission of augmentation peak pressure to rSBP2. Study 3: Comparisons of noninvasive rSBP2 with direct or estimated central systolic blood pressure (cSBP) revealed broad agreement but also augmentation-dependent biases. Based on the features of the biases as well as the counterbalanced relationship between pulse pressure amplification and the transmission-induced alterations of augmentation peak amplitude observed in Study 2, we propose an improved cSBP estimate, SBPm, the simple arithmetic mean of rSBP2 and peripheral systolic blood pressure. PMID:24109664

  10. Diastolic dysfunction in Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Nikhil M Dikshit

    2013-06-01

    Conclusion: Echocardiography is a sensitive method to investigate for diastolic dysfunction. There is a high prevalence of diastolic dysfunction in diabetes, which is an early marker of diabetic cardiomyopathy. [Natl J Med Res 2013; 3(3.000: 249-252

  11. Protein losing enteropathy secondary to a pulmonary artery stent

    International Nuclear Information System (INIS)

    A 2-year-old patient with hypoplastic left heart syndrome presented 6 months following Fontan completion with protein-losing enteropathy (PLE). He had undergone stent implantation in the left pulmonary artery after the Norwood procedure, followed by redilation of the stent prior to Fontan completion. Combined bronchoscopic and catheterization studies during spontaneous breathing confirmed left bronchial stenosis behind the stent, and diastolic systemic ventricular pressure during expiration of 25 mm Hg. We postulate that the stent acts as a valve, against which the patient generates high expiratory pressures, which are reflected in the ventricular diastolic pressure. This may be the cause of PLE

  12. Protein losing enteropathy secondary to a pulmonary artery stent

    Directory of Open Access Journals (Sweden)

    Narayanswami Sreeram

    2012-01-01

    Full Text Available A 2-year-old patient with hypoplastic left heart syndrome presented 6 months following Fontan completion with protein-losing enteropathy (PLE. He had undergone stent implantation in the left pulmonary artery after the Norwood procedure, followed by redilation of the stent prior to Fontan completion. Combined bronchoscopic and catheterization studies during spontaneous breathing confirmed left bronchial stenosis behind the stent, and diastolic systemic ventricular pressure during expiration of 25 mm Hg. We postulate that the stent acts as a valve, against which the patient generates high expiratory pressures, which are reflected in the ventricular diastolic pressure. This may be the cause of PLE.

  13. Test of a novel miniature blood pressure sensor in the coronary arteries of a swine model

    Science.gov (United States)

    Wu, Nan; Sun, Kai; Zou, Xiaotian; Barringhaus, Kurt; Wang, Xingwei

    2011-06-01

    Fractional flow reserve (FFR) has proven to be very useful in diagnosis of narrowed coronary arteries. It is a technique that is used in coronary catheterization to measure blood pressure difference across a coronary artery stenosis in maximal flow. In-vivo blood pressure measurement is critical in FFR diagnosis. This paper presents a novel miniature all-optical fiber blood pressure sensor. It is based on Fabry-Perot (FP) interferometry principle. The FP cavity was fabricated by directly wet etching the fiber tip. Then, a diaphragm with well-controlled thickness was bonded to the end face of the fiber using the thermal bonding technique. Finally, the sensor was packaged with a bio-compatible and flexible coil for animal tests. A 25-50 kg Yorkshire swine model was introduced as the animal test target. The left anterior descending coronary artery (LAD) was exposed, and beyond the takeoff of the largest diagonal branch, a 3.0 mm vascular occluder was secured. Firstly, standard invasive manometry was used to obtain the blood pressure as baseline. Next, a guiding catheter was introduced into the ostium of the left main coronary artery, and the miniature blood pressure sensor was advanced into the LAD at a point beyond the vascular occlude. The blood pressure beyond the vascular occlude was recorded. The sensor successfully recorded the blood pressure at both near-end and far-end of the vascular occluder.

  14. Elevated Plasma Endothelin-1 and Pulmonary Arterial Pressure in Children Exposed to Air Pollution

    OpenAIRE

    Calderón-Garcidueñas, Lilian; Vincent, Renaud; Mora-Tiscareño, Antonieta; Franco-Lira, Maricela; Henríquez-Roldán, Carlos; Barragán-Mejía, Gerardo; Garrido-García, Luis; Camacho-Reyes, Laura; Valencia-Salazar, Gildardo; Paredes, Rogelio; Romero, Lina; Osnaya, Hector; Villarreal-Calderón, Rafael; Torres-Jardón, Ricardo; Hazucha, Milan J

    2007-01-01

    Background Controlled exposures of animals and humans to particulate matter (PM) or ozone air pollution cause an increase in plasma levels of endothelin-1, a potent vasoconstrictor that regulates pulmonary arterial pressure. Objectives The primary objective of this field study was to determine whether Mexico City children, who are chronically exposed to levels of PM and O3 that exceed the United States air quality standards, have elevated plasma endothelin-1 levels and pulmonary arterial pres...

  15. HISTOLOGICAL STUDY OF MEDIUM SIZED ARTERIES OF NECK IN RELATION WITH THEIR PULSE PRESSURE AND PULSATORY POWER

    Directory of Open Access Journals (Sweden)

    Prerana

    2014-11-01

    Full Text Available : INTRODUCTION: There are several studies on the microstructure of main arteries of the body but limited have been dealt with the neck arteries. It has been mentioned that the vascular pathologies like the thrombo-embolism, atherosclerosis and infarction are common in the branches of vertebral and internal carotid artery as compared to the branches of external carotid artery. OBJECTIVE: To study the histological structure of the 3 medium sized arteries of neck namely external carotid, internal carotid and vertebral artery, calculation of their mean pulse pressure and pulsatory power and to find any association between them if present. METHOD: Fresh samples of external carotid, internal carotid and vertebral artery each measuring 10mm in length were taken from five cadavers and prepared for histological examination under microscope using orcein and H&E stain. The mean pressure and pulsatory power of these arteries were calculated by taking the measurements such as wall thickness, lumen circumference, arterial wall area, and smooth muscle fibre density in tunica media in that arterial segment. RESULT: The pulsatory power of external carotid artery, internal carotid artery and vertebral artery is found to be 120, 273.3, 400 Joules /heart beat and the mean pressure is 17.1 mm Hg, 27.3 mm Hg and 33.3 mm Hg respectively. CONCLUSION: The thickness of tunica media of an artery is directly proportional to its pulsatory power. The mean pulse pressure, pulsatory power as well the number of smooth muscles fibres in tunica media are more in internal carotid artery and vertebral artery in comparison to external carotid artery. It may be a very important reason why vascular pathologies are less common in branches of external carotid as compare to internal carotid and vertebral artery.

  16. Echocardiographic evaluation of the arterial stiffness in healthy subjects and hypertensive patients under 60 years

    International Nuclear Information System (INIS)

    We conducted a cross-sectional study that included 83 patients (healthy, n=43; hypertensive, n=40) assisted in the external consultation of the National Cardiology and Cardiovascular Surgery Institute, from April to October, 2009. We included clinical (age, sex, personal antecedents of smoking habit, obesity, hypercholesterolemia, arterial hypertension) and echocardiographic (diastolic function, arterial stiffness index [β], pressure strain elastic modulus [Ep], arterial compliance, local pulse wave velocity [LPWV]) variables

  17. Pressão arterial elevada em adolescentes: prevalência e fatores associados / High blood pressure in adolescents: prevalence and associated factors

    Scientific Electronic Library Online (English)

    Diego Augusto Santos, Silva; Luiz Rodrigo Augustemak de, Lima; Rodolfo André, Dellagrana; Eliane Denise Araújo, Bacil; Cassiano Ricardo, Rech.

    2013-11-01

    Full Text Available Objetivou-se verificar a prevalência e os fatores associados à pressão arterial (PA) elevada em adolescentes de um município Brasileiro. Estudo transversal, conduzido em 653 adolescentes (57,9% do sexo feminino) de 14 a 19 anos de idade, estudantes do ensino médio. A Pressão arterial sistólica (PAS) [...] e a diastólica (PAD) foram mensuradas em todos os sujeitos. Variáveis sociodemográficas, do estilo de vida e índice de massa corporal foram obtidas. Regressão logística binária, bruta e ajustada, foi empregada com nível de significância de 5%. A média da PAS e PAD foi de 111,9 mmHg e 69,9 mmHg, respectivamente. A prevalência de PA elevada foi de 12,4%. Na análise multivariável foi identificado que jovens do sexo masculino (OR: 2,37; IC95%: 1,45-3,90), com escolaridade materna de até oito anos (OR: 1,84; IC95%: 1,03-3,30) e com excesso de peso (OR: 3,79; IC95%: 2,23-6,43), apresentaram maiores chances de PA elevada. O termo de interação entre sexo masculino e excesso de peso representou o subgrupo com maiores chances de PA elevada (OR: 6,41; IC95%: 3,00-13,16). Níveis pressóricos elevados acometem adolescentes da cidade de Ponta Grossa, Paraná, e os grupos com maiores chances de PA elevada foram os do sexo masculino, com escolaridade materna baixa e com excesso de peso. Abstract in english The aim of this study was to assess the prevalence and associated factors of high Blood Pressure (BP) among adolescents in a Brazilian city. A cross-sectional study was conducted with 653 adolescents (57.9% female) of high school level between 14 and 19 years of age. Systolic blood pressure (SBP) an [...] d diastolic blood pressure (DBP) of all subjects were measured. Social and demographic variables and lifestyle factors and body mass index were obtained. Binary logistic regression, crude and adjusted, was employed with a significance level of 5%. The mean SBP and DBP were 111.9 mmHg and 69.9 mmHg, respectively. The prevalence of high BP levels was 12.4%. The multivariable analysis revealed that males (OR: 2.37, 95% CI: 1.45, 3.90), adolescents with maternal education

  18. Heart rate and blood pressure during initial LBNP do not discriminate higher and lower orthostatic tolerant men

    DEFF Research Database (Denmark)

    Simonson, Shawn R; Norsk, Peter; Greenleaf, John E

    2003-01-01

    between the higher and lower tolerance men. Central venous pressure (CVP), HR, and systolic (SBP) and diastolic (DBP) blood pressures measured before and at 15-s intervals during LBNP and calculated mean arterial pressure (MAP), pulse pressure (PP), and work of the heart (HW) were analyzed using ANOVA (p...

  19. Dietary sodium and arterial blood pressure: evidence against genetic susceptibility.

    OpenAIRE

    Watt, G. C.; Foy, C. J.; Hart, J T; Bingham, G.; Edwards, C.; Hart, M; Thomas, E(European Organization for Nuclear Research (CERN), Geneva, Switzerland); Walton, P.

    1985-01-01

    Thirty five subjects with both parents in the top third of their age specific blood pressure distributions and 31 subjects with both parents in the bottom third of their blood pressure distributions restricted their intake of sodium for eight weeks while taking part in a double blind, randomised crossover trial of supplements of sodium and placebo. A comparison of two periods of four weeks at different intakes of sodium showed no differences in blood pressure in either the groups as a whole o...

  20. A pitfall in the measurement of arterial blood pressure in the ischaemic limb during elevation

    DEFF Research Database (Denmark)

    Bülow, J; Jelnes, Rolf

    1987-01-01

    In order to evaluate if elevation of the ischaemic limb above heart level is an alternative to the conventionally applied method with external counterpressure for estimation of skin perfusion pressure, femoral and popliteal artery pressures were measured directly in eight patients with occlusion of...... the superficial femoral artery. The measurements were done in the horizontal position and during elevation of the calf above heart level. During elevation relative blood flow, measured by arterio-venous oxygen saturation differences, decreased compared with the horizontal position. In contrast the...... popliteal arterial pressure decreased only by 20% of the value expected from the degree of elevation of the calf above the level of the heart. Thus, it could be calculated that calf vascular resistance increased two- to three-fold on average during elevation. Four patients were reexamined with the venous...

  1. The vibration plethysmographic method of arterial compliance analysis in dependence on transmural pressure.

    Science.gov (United States)

    Moudr, J; Svačinová, J; Závodná, E; Honzíková, N

    2014-01-01

    The aim of this study was to obtain a detailed analysis of the relationship between the finger arterial compliance C [ml/mm Hg] and the arterial transmural pressure P(t) [mm Hg]. We constructed a dynamic plethysmograph enabling us to set up a constant pressure P(css) [mm Hg] and a superimposed fast pressure vibration in the finger cuff (equipped with a source of infra-red light and a photoelectric sensor for the measurement of arterial volume). P(css) could be set on the required time interval in steps ranging between 30 and 170 mm Hg, and on sinusoidal pressure oscillation with an amplitude P(ca) (2 mm Hg) and a frequency f (20, 25, 30, 35, 40 Hz). At the same time continuous blood pressure BP was measured on the adjacent finger (Portapres). We described the volume dependence of a unitary arterial length on the time-varying transmural pressure acting on the arterial wall (externally P(css)+P(ca).sin(2pif), internally BP) by a second-order differential equation for volume. This equation was linearized within a small range of selected BP. In the next step, a Fourier transform was applied to obtain the frequency characteristic in analytic form of a complex linear combination of frequency functions. While series of oscillations [P(ca), f] were applied for each P(css), the corresponding response of the plethysmogram was measured. Amplitude spectra were obtained to estimate coefficients of the frequency characteristic by regression analysis. We determined the absolute value: elastance E, and its inverse value: compliance (C=1/E). Then, C=C(P(t)) was acquired by applying sequences of oscillations for different P(css) (and thus P(t)) by the above-described procedure. This methodology will be used for the study of finger arterial compliance in different physiological and pathological conditions. PMID:25669680

  2. Indirect measurement of arterial blood pressure: physiotherapists’ theoretical knowledge

    Directory of Open Access Journals (Sweden)

    Marcelle Morgana Vieira de Assis

    2003-12-01

    Full Text Available Blood pressure checking and its theoretical knowledge are crucial to obtain reliable data in clinical examination. Although it is considered a simple technique to be learned and applied, it is not fully dealt with at physiotherapy university courses. Therefore, a wide range of mistakes and misinterpretations are likely to threaten treatment quality. This work aims to evaluate the theory background of physiotherapists for blood pressure measurement. From June to October 2002, 55 physiotherapists answered a 20- question multiple-choice questionnaire on general knowledge related to concepts, anatomy and physiology, suitable equipment, indirect measurement, blood pressure values, mistakes and misinterpretation factors related to blood pressure measurement. The results disclose faulty theory concepts in the sample studied, indicating the need of deeper approach to this complex theme during course and ongoing updating of professionals.

  3. Diastolic Function in Heart Failure

    OpenAIRE

    Kovács, Sándor J

    2015-01-01

    Heart failure has reached epidemic proportions, and diastolic heart failure or heart failure with preserved ejection fraction (HFpEF) constitutes about 50% of all heart failure admissions. Long-term prognosis of both reduced ejection fraction heart failure and HFpEF are similarly dismal. No pharmacologic agent has been developed that actually treats or repairs the physiologic deficit(s) responsible for HFpEF. Because the physiology of diastole is both subtle and counterintuitive, its role in ...

  4. Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

    International Nuclear Information System (INIS)

    Purpose: To use feed-forward active contours (snakes) to track and measure brachial artery vasomotion on ultrasound images recorded in both transverse and longitudinal views; and to compare the algorithm's performance in each view. Methods: Longitudinal and transverse view ultrasound image sequences of 45 brachial arteries were segmented by feed-forward active contour (FFAC). The segmented regions were used to measure vasomotion artery diameter, cross-sectional area, and distention both as peak-to-peak diameter and as area. ECG waveforms were also simultaneously extracted frame-by-frame by thresholding a running finite-difference image between consecutive images. The arterial and ECG waveforms were compared as they traced each phase of the cardiac cycle. Results: FFAC successfully segmented arteries in longitudinal and transverse views in all 45 cases. The automated analysis took significantly less time than manual tracing, but produced superior, well-behaved arterial waveforms. Automated arterial measurements also had lower interobserver variability as measured by correlation, difference in mean values, and coefficient of variation. Although FFAC successfully segmented both the longitudinal and transverse images, transverse measurements were less variable. The cross-sectional area computed from the longitudinal images was 27% lower than the area measured from transverse images, possibly due to the compression of the artery along the image depth by transducer pressure. Conclusions: FFAC is a robust and sensitive vasomotion segmentation algorithm in both transverse and longitudinal views. Transverse imaging may offer advantages over longitudinal imaging: transverse measurements are more consistent, possibly because the method is less sensitive to variations in transducer pressure during imaging

  5. Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Cary, Theodore W.; Sultan, Laith R.; Sehgal, Chandra M., E-mail: sehgalc@uphs.upenn.edu [Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Reamer, Courtney B.; Mohler, Emile R. [Department of Medicine, Division of Cardiovascular Medicine, Section of Vascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States)

    2014-02-15

    Purpose: To use feed-forward active contours (snakes) to track and measure brachial artery vasomotion on ultrasound images recorded in both transverse and longitudinal views; and to compare the algorithm's performance in each view. Methods: Longitudinal and transverse view ultrasound image sequences of 45 brachial arteries were segmented by feed-forward active contour (FFAC). The segmented regions were used to measure vasomotion artery diameter, cross-sectional area, and distention both as peak-to-peak diameter and as area. ECG waveforms were also simultaneously extracted frame-by-frame by thresholding a running finite-difference image between consecutive images. The arterial and ECG waveforms were compared as they traced each phase of the cardiac cycle. Results: FFAC successfully segmented arteries in longitudinal and transverse views in all 45 cases. The automated analysis took significantly less time than manual tracing, but produced superior, well-behaved arterial waveforms. Automated arterial measurements also had lower interobserver variability as measured by correlation, difference in mean values, and coefficient of variation. Although FFAC successfully segmented both the longitudinal and transverse images, transverse measurements were less variable. The cross-sectional area computed from the longitudinal images was 27% lower than the area measured from transverse images, possibly due to the compression of the artery along the image depth by transducer pressure. Conclusions: FFAC is a robust and sensitive vasomotion segmentation algorithm in both transverse and longitudinal views. Transverse imaging may offer advantages over longitudinal imaging: transverse measurements are more consistent, possibly because the method is less sensitive to variations in transducer pressure during imaging.

  6. Relationship between pulmonary artery volumes at computed tomography and pulmonary artery pressures in patients with- and without pulmonary hypertension

    International Nuclear Information System (INIS)

    Objectives: This study was designed to determine the relationship between pulmonary artery (PA) volumes at computed tomography (CT) and PA pressures at right-sided heart catheterization in patients with and without pulmonary hypertension (PAH) to develop a noninvasive CT method of PA pressure quantification. Materials and methods: Sixteen patients with chronic sleep apnea syndrome underwent contrast enhanced helical CT (slice thickness 3 mm; pitch 2; increment 2 mm) at inspiration. Eight patients had PAH while cardiopulmonary disease has been excluded in eight other patients. Vascular volumes were determined using a 3D technique (threshold seeded vascular tracing algorithm; thresholds -600 H [lower] and 3000 H [upper]). Right-sided heart catheterization measurements were available for linear regression analysis of PA volumes and pressures. Results: Correlation between PA pressures and volumes (normalized for BMI), was high in both groups (without PAH: r = .85; with PAH .90, Pearson). Compared to elevated PA pressures in patients with pulmonary hypertension (p < .005), PA volumes also were significantly increased (p < .05) among the groups. Conclusions: High correlation was found between PA volumes and mean PA pressures in patients with- and without PAH. Significant differences in PA volumes at CT-volumetry may admit non-invasive determination of pulmonary hypertension

  7. Relationship between pulmonary artery volumes at computed tomography and pulmonary artery pressures in patients with- and without pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Froelich, Jens J. [Department of Radiology, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg (Germany)], E-mail: jens.froelich@klinikum-hef.de; Koenig, Helmut [Department of Radiology, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg (Germany)], E-mail: helmut.koenig@siemens.com; Knaak, Lennard [Department of Medicine, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg (Germany)], E-mail: froehlic@staff.uni-marburg.de; Krass, Stefan [MeVis Research, Universitaetsallee 29, 28359 Bremen (Germany)], E-mail: krass@mevis.de; Klose, Klaus J. [Department of Radiology, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg (Germany)], E-mail: klose@med.uni-marburg.de

    2008-09-15

    Objectives: This study was designed to determine the relationship between pulmonary artery (PA) volumes at computed tomography (CT) and PA pressures at right-sided heart catheterization in patients with and without pulmonary hypertension (PAH) to develop a noninvasive CT method of PA pressure quantification. Materials and methods: Sixteen patients with chronic sleep apnea syndrome underwent contrast enhanced helical CT (slice thickness 3 mm; pitch 2; increment 2 mm) at inspiration. Eight patients had PAH while cardiopulmonary disease has been excluded in eight other patients. Vascular volumes were determined using a 3D technique (threshold seeded vascular tracing algorithm; thresholds -600 H [lower] and 3000 H [upper]). Right-sided heart catheterization measurements were available for linear regression analysis of PA volumes and pressures. Results: Correlation between PA pressures and volumes (normalized for BMI), was high in both groups (without PAH: r = .85; with PAH .90, Pearson). Compared to elevated PA pressures in patients with pulmonary hypertension (p < .005), PA volumes also were significantly increased (p < .05) among the groups. Conclusions: High correlation was found between PA volumes and mean PA pressures in patients with- and without PAH. Significant differences in PA volumes at CT-volumetry may admit non-invasive determination of pulmonary hypertension.

  8. The origin of mean arterial and jugular venous blood pressures in giraffes.

    Science.gov (United States)

    Mitchell, Graham; Maloney, Shane K; Mitchell, Duncan; Keegan, D James

    2006-07-01

    Using a mechanical model of the giraffe neck and head circulation consisting of a rigid, ascending, 'carotid' limb, a 'cranial' circulation that could be rigid or collapsible, and a descending, 'jugular' limb that also could be rigid or collapsible, we have analyzed the origin of the high arterial and venous pressures in giraffe, and whether blood flow is assisted by a siphon. When the tubes were rigid and the 'jugular' limb exit was lower than the 'carotid' limb entrance a siphon operated, 'carotid' hydrostatic pressures became more negative, and flow was 3.3 l min(-1) but ceased when the 'cranial' and 'jugular' limbs were collapsible or when the 'jugular' limb was opened to the atmosphere. Pumping water through the model produced positive pressures in the 'carotid' limb similar to those found in giraffe. Applying an external 'tissue' pressure to the 'jugular' tube during pump flow produced the typical pressures found in the jugular vein in giraffe. Constriction of the lowest, 'jugular cuff', portion of the 'jugular' limb showed that the cuff may augment the orthostatic reflex during head raising. Except when all tubes were rigid, pressures were unaffected by a siphon. We conclude that mean arterial blood pressure in giraffes is a consequence of the hydrostatic pressure generated by the column of blood in the neck, that tissue pressure around the collapsible jugular vein produces the known jugular pressures, and that a siphon does not assist flow through the cranial circulation. PMID:16788035

  9. Noninvasive assessment of arterial compliance of human cerebral arteries with short inversion time arterial spin labeling.

    Science.gov (United States)

    Warnert, Esther A H; Murphy, Kevin; Hall, Judith E; Wise, Richard G

    2015-03-01

    A noninvasive method of assessing cerebral arterial compliance (AC) is introduced in which arterial spin labeling (ASL) is used to measure changes in arterial blood volume (aBV) occurring within the cardiac cycle. Short inversion time pulsed ASL (PASL) was performed in healthy volunteers with inversion times ranging from 250 to 850?ms. A model of the arterial input function was used to obtain the cerebral aBV. Results indicate that aBV depends on the cardiac phase of the arteries in the imaging volume. Cerebral AC, estimated from aBV and brachial blood pressure measured noninvasively in systole and diastole, was assessed in the flow territories of the basal cerebral arteries originating from the circle of Willis: right and left middle cerebral arteries (RMCA and LMCA), right and left posterior cerebral arteries (RPCA and LPCA), and the anterior cerebral artery (ACA). Group average AC values calculated for the RMCA, LMCA, ACA, RPCA, and LPCA were 0.56%±0.2%, 0.50%±0.3%, 0.4%±0.2%, 1.1%±0.5%, and 1.1%±0.3% per mm?Hg, respectively. The current experiment has shown the feasibility of measuring AC of cerebral arteries with short inversion time PASL. PMID:25515216

  10. Heterozygous disruption of activin receptor-like kinase 1 is associated with increased arterial pressure in mice

    Science.gov (United States)

    González-Núñez, María; Riolobos, Adela S.; Castellano, Orlando; Fuentes-Calvo, Isabel; de los Ángeles Sevilla, María; Oujo, Bárbara; Pericacho, Miguel; Cruz-Gonzalez, Ignacio; Pérez-Barriocanal, Fernando; ten Dijke, Peter; López-Novoa, Jose M.

    2015-01-01

    ABSTRACT The activin receptor-like kinase 1 (ALK-1) is a type I cell-surface receptor for the transforming growth factor-? (TGF-?) family of proteins. Hypertension is related to TGF-?1, because increased TGF-?1 expression is correlated with an elevation in arterial pressure (AP) and TGF-? expression is upregulated by the renin-angiotensin-aldosterone system. The purpose of this study was to assess the role of ALK-1 in regulation of AP using Alk1 haploinsufficient mice (Alk1+/?). We observed that systolic and diastolic AP were significantly higher in Alk1+/? than in Alk1+/+ mice, and all functional and structural cardiac parameters (echocardiography and electrocardiography) were similar in both groups. Alk1+/? mice showed alterations in the circadian rhythm of AP, with higher AP than Alk1+/+ mice during most of the light period. Higher AP in Alk1+/? mice is not a result of a reduction in the NO-dependent vasodilator response or of overactivation of the peripheral renin-angiotensin system. However, intracerebroventricular administration of losartan had a hypotensive effect in Alk1+/? and not in Alk1+/+ mice. Alk1+/? mice showed a greater hypotensive response to the ?-adrenergic antagonist atenolol and higher concentrations of epinephrine and norepinephrine in plasma than Alk1+/+ mice. The number of brain cholinergic neurons in the anterior basal forebrain was reduced in Alk1+/? mice. Thus, we concluded that the ALK-1 receptor is involved in the control of AP, and the high AP of Alk1+/? mice is explained mainly by the sympathetic overactivation shown by these animals, which is probably related to the decreased number of cholinergic neurons. PMID:26398936

  11. EFFECT OF MORNING AND EVENING RAMIPRIL TAKING ON AMBULATORY BLOOD PRESSURE PROFILE IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    V. M. Gorbunov

    2016-01-01

    Full Text Available Aim. To compare antihypertensive effect of ramipril monotherapy at morning and evening taking.Material and methods. 22 patients (10 men, 12 women; aged 62,1±1,9 y.o. with arterial hypertension of 1-2 stage were involved into the open randomized crossover study. Patients were randomized into 2 groups depending on ramipril taking time (morning or evening. Ambulatory blood pressure (BP monitoring (ABPM was performed. Patients of both groups were comparable in basic clinical characteristics and initial ABPM indices. Analysis of peak and phase characteristics of 24 hour BP profile was used as well as standard evaluation. Treatment duration was 3 weeks. Ramipril dose titration was made in 1,5 weeks. The average daily dose of ramipril was 6,1 mg in the morning taking, and 5,0 mg in the evening taking.Results. 20 patients finished study completely. 24 hour initial level of systolic (SBP and diastolic BP (DBP was 141,5±1,6/85,3±1,1 mm Hg. After ramipril monotherapy with evening taking BP reduced to 132,6±1,6/79,8±1,1 mm Hg (p<0,001 and with morning taking – to 131,8±1,6/79,2±1,1 mm Hg (p<0,001. Evening ramipril taking led to significant improvement of 24 hour BP profile. Night SBP/DBP reduction became deeper from 7,7±1,2/11,5±1,3% to 12,5±1,2/19,1±1,3 % (p<0,01. Morning taking did not have significant influence on these indices. Ramipril did not result in clinically significant hypotension including night one.Conclusion. Evening ramipril taking is effective and safe. It can be recommended to patients with insufficient night BP dipping (non dippers. 

  12. A micromechanical device that monitors arterial pressure during general anesthesia and in intensive care units

    Science.gov (United States)

    Andreeva, A. V.; Luchinin, V. V.; Kuzmina, K. A.; Klyavinek, A. S.; Karelov, A. E.

    2015-12-01

    A vibroacoustic fiber optic system that consists of micromechanical components designated for use in medicine and biology is reviewed. A theoretical analysis of a fiber optic microphone is done and its optimal construction parameters are determined. The possibility of using the developed system with magnetic resonance tomography to noninvasively measure man's arterial pressure is specified.

  13. Association of vitamin D status with arterial blood pressure and hypertension risk

    DEFF Research Database (Denmark)

    Vimaleswaran, Karani S; Cavadino, Alana; Berry, Diane J; Jorde, Rolf; Dieffenbach, Aida Karina; Lu, Chen; Alves, Alexessander Couto; Heerspink, Hiddo J Lambers; Tikkanen, Emmi; Eriksson, Joel; Wong, Andrew; Mangino, Massimo; Jablonski, Kathleen A; Nolte, Ilja M; Houston, Denise K; Ahluwalia, Tarunveer Singh; van der Most, Peter J; Pasko, Dorota; Zgaga, Lina; Thiering, Elisabeth; Vitart, Veronique; Fraser, Ross M; Huffman, Jennifer E; de Boer, Rudolf A; Schöttker, Ben; Saum, Kai-Uwe; McCarthy, Mark I; Dupuis, Josée; Herzig, Karl-Heinz; Sebert, Sylvain; Pouta, Anneli; Laitinen, Jaana; Kleber, Marcus E; Navis, Gerjan; Lorentzon, Mattias; Jameson, Karen; Arden, Nigel; Cooper, Jackie A; Acharya, Jayshree; Hardy, Rebecca; Raitakari, Olli; Ripatti, Samuli; Billings, Liana K; Lahti, Jari; Osmond, Clive; Penninx, Brenda W; Rejnmark, Lars; Lohman, Kurt K; Paternoster, Lavinia; Stolk, Ronald P; Hernandez, Dena G; Byberg, Liisa; Hagström, Emil; Melhus, Håkan; Ingelsson, Erik; Mellström, Dan; Ljunggren, Osten; Tzoulaki, Ioanna; McLachlan, Stela; Theodoratou, Evropi; Tiesler, Carla M T; Jula, Antti; Navarro, Pau; Wright, Alan F; Polasek, Ozren; Wilson, James F; Rudan, Igor; Salomaa, Veikko; Heinrich, Joachim; Campbell, Harry; Price, Jacqueline F; Karlsson, Magnus; Lind, Lars; Michaëlsson, Karl; Bandinelli, Stefania; Frayling, Timothy M; Hartman, Catharina A; Sørensen, Thorkild I A; Kritchevsky, Stephen B; Langdahl, Bente Lomholt; Eriksson, Johan G; Florez, Jose C; Spector, Tim D; Lehtimäki, Terho; Kuh, Diana; Humphries, Steve E; Cooper, Cyrus; Ohlsson, Claes; März, Winfried; de Borst, Martin H; Kumari, Meena; Kivimaki, Mika; Wang, Thomas J; Power, Chris; Brenner, Hermann; Grimnes, Guri; van der Harst, Pim; Snieder, Harold; Hingorani, Aroon D; Pilz, Stefan; Whittaker, John C; Järvelin, Marjo-Riitta; Hyppönen, Elina

    2014-01-01

    BACKGROUND: Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated with...

  14. Effect of an iso-osmolar contrast medium on pulmonary arterial pressure at pulmonary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Tajima, H.; Kumazaki, T.; Ito, K.; Tajima, N.; Gemma, K.; Ebata, K. (Nippon Medical School, Tokyo (Japan). Dept. of Radiology)

    1991-03-01

    A clinical comparison of the effects on pulmonary arterial pressure induced by contrast media with various osmolalities, iohexol 140 mg I/ml (300 mosm/kg H{sub 2}O), iohexol 300 mg I/ml (690 mosm/kg H{sub 2}O), and diatrizoate 292 mg I/ml (1480 mosm/kg H{sub 2}O) following selective pulmonary angiography was made in 12 patients with normal pulmonary arterial pressure. A double-blind crossover study was performed and the contrast media were administered in random order. The pulmonary arterial pressure was recorded continuously before, during, and for 3 min after the injection. The effect of iohexol 140 on the pulmonary arterial pressure was significantly less marked than that of diatrizoate 292, whereas no statistical significance was shown between iohexol 140 and iohexol 300. These results indicate that iso-osmolar contrast medium (iohexol 140), as well as iohexol 300, would be better tolerated than diatrizoate 292, and is therefore a safer contrast medium for selective pulmonary angiography. (orig.).

  15. Small artery structure adapts to vasodilatation rather than to blood pressure during antihypertensive treatment

    DEFF Research Database (Denmark)

    Mathiassen, Ole N; Buus, Niels H; Larsen, Mogens L; Mulvany, Michael J; Christensen, Kent L

    2007-01-01

    OBJECTIVE: Correction of the abnormal structure of resistance arteries in essential hypertension may be an important treatment goal in addition to blood pressure (BP) reduction. We investigated how this may be achieved in a prospective clinical study. METHODS: Plethysmography was used to measure ...

  16. Renal blood flow regulation and arterial pressure fluctuations: a case study in nonlinear dynamics

    DEFF Research Database (Denmark)

    Holstein-Rathlou, N H; Marsh, D J

    1994-01-01

    The arterial blood pressure, a physiological variable on which all renal excretory processes depend, fluctuates over a wide range of amplitudes and frequencies. Much of this variation originates in nonrenal vascular beds to support nonrenal tasks, and the fluctuations provide a noisy environment in...... itself to experimental discovery.(ABSTRACT TRUNCATED AT 400 WORDS)...

  17. Noninvasive arterial blood pressure waveform monitoring using two- element ultrasound system.

    Science.gov (United States)

    Seo, Joohyun; Pietrangelo, Sabino J; Lee, Hae-Seung; Sodini, Charles G

    2015-04-01

    This work details noninvasive arterial blood pressure (ABP) waveform estimation based on an arterial vessel cross-sectional area measurement combined with an elasticity measurement of the vessel, represented by pulse wave velocity (PWV), using a two-element ultrasound system. The overall ABP waveform estimation is validated in a custom-designed experimental setup mimicking the heart and an arterial vessel segment with two single element transducers, assuming a constant hemodynamic system. The estimation of local PWV using the flow-area method produces unbiased elasticity estimation of the tube in a pressure waveform comparison. The measured PWV using 16 cardiac cycles of data is 8.47 + 0.63 m/s with an associated scaling error of -1.56 + 14.0% in a direct pressure waveform comparison, showing negligible bias error on average. The distension waveform obtained from a complex cross-correlation model estimator (C3M) reliably traces small pressure changes reflected by the diameter change. The excellent agreement of an estimated pressure waveform to the reference pressure waveform suggests the promising potential of a readily available, inexpensive, and portable ABP waveform monitoring device. PMID:25881355

  18. A new non-invasive method using pulse oximetry for the assessment of arterial toe pressure.

    Science.gov (United States)

    Samuelsson, P; Blohmé, G; Fowelin, J; Eriksson, J W

    1996-07-01

    We evaluated a novel, simple non-invasive method to assess systolic arterial toe pressures (ATP). It was employed in 63 subjects, of which 37 had suspected or established lower extremity arterial disease (LEAD) and 26 did not. 48 of the subjects had diabetes and 15 were non-diabetic. Pulsatile toe blood flow was monitored with a regular pulse oximeter (Biox 3700TM, BOC Ohmeda, Helsingborg, Sweden) (POX) with the sensor on the tip of the great toe. A small blood pressure cuff was placed around the proximal part of the toe and was connected to a sphygmomanometer (TycosTM, Levimed AB, Höganäs, Sweden). Systolic pressure was estimated as the cuff pressure at which pulsatile blood flow ceased during cuff inflation. Toe pressure measurement was obtained, in parallel, using the established strain gauge plethysmographic technique. There was a good concordance between the two methods (linear regression: r = 0.93; y = 1.1 x x-6.4; y = pressure obtained with the pulse oximeter, x = pressure obtained with strain gauge, in mmHg). However, patients with very low systolic toe pressures, < 20 mmHg, could not be reproducibly assessed using the POX method. In conclusion, the POX method was found to be a simple and reliable method for the estimation of systolic toe pressures, at least for those above the severely ischemic level. It may provide an easily accessible and cost-effective means of vascular assessment at the bedside, as well as for out-patients. PMID:8842580

  19. Elevated Plasma Endothelin-1 and Pulmonary Arterial Pressure in Children Exposed to Air Pollution

    Science.gov (United States)

    Calderón-Garcidueñas, Lilian; Vincent, Renaud; Mora-Tiscareño, Antonieta; Franco-Lira, Maricela; Henríquez-Roldán, Carlos; Barragán-Mejía, Gerardo; Garrido-García, Luis; Camacho-Reyes, Laura; Valencia-Salazar, Gildardo; Paredes, Rogelio; Romero, Lina; Osnaya, Hector; Villarreal-Calderón, Rafael; Torres-Jardón, Ricardo; Hazucha, Milan J.; Reed, William

    2007-01-01

    Background Controlled exposures of animals and humans to particulate matter (PM) or ozone air pollution cause an increase in plasma levels of endothelin-1, a potent vasoconstrictor that regulates pulmonary arterial pressure. Objectives The primary objective of this field study was to determine whether Mexico City children, who are chronically exposed to levels of PM and O3 that exceed the United States air quality standards, have elevated plasma endothelin-1 levels and pulmonary arterial pressures. Methods We conducted a study of 81 children, 7.9 ± 1.3 years of age, lifelong residents of either northeast (n = 19) or southwest (n = 40) Mexico City or Polotitlán (n = 22), a control city with PM and O3 levels below the U.S. air quality standards. Clinical histories, physical examinations, and complete blood counts were done. Plasma endothelin-1 concentrations were determined by immunoassay, and pulmonary arterial pressures were measured by Doppler echocardiography. Results Mexico City children had higher plasma endothelin-1 concentrations compared with controls (p < 0.001). Mean pulmonary arterial pressure was elevated in children from both northeast (p < 0.001) and southwest (p < 0.05) Mexico City compared with controls. Endothelin-1 levels in Mexico City children were positively correlated with daily outdoor hours (p = 0.012), and 7-day cumulative levels of PM air pollution < 2.5 ?m in aerodynamic diameter (PM2.5) before endothelin-1 measurement (p = 0.03). Conclusions Chronic exposure of children to PM2.5 is associated with increased levels of circulating endothelin-1 and elevated mean pulmonary arterial pressure. PMID:17687455

  20. Prediction of pressure difference and velocity profile in steady flow through axi-symmetric deposited arteries

    International Nuclear Information System (INIS)

    Numerical simulations of blood flow through plaque deposited arteries at different Reynolds numbers have been performed to investigate the impact of atherosclerosis on pressure drop and velocity profile at down stream. The predicated results are presented in terms of non-dimensional pressure isobars and velocity profiles at distinct Reynolds numbers and various levels of deposition at downstream of the artery segment. The scaled non-dimensional graph of pressure drop is also illustrated. The incompressible Navier-Stokes equation in the axi-symmetric frame of reference is solved numerically by employing FEM (Finite Element Method). Semi-implicit Taylor-Galerkin/pressure-correction scheme has been utilized to obtain steady state solutions. The effects of atherosclerosis on hemodynamic factors have been investigated. The results show that blockage disturbs the flow field in the wake of plaque deposited arteries and the trend of pressure and velocity is increasing as level of deposition or Reynolds number increases. The application of this research work can be utilised in the field of cardio vascular disease, design of device and further planning towards treatment. (author)

  1. Evaluation of accuracy of invasive and non-invasive blood pressure monitoring in relation to carotid artery pressure in anaesthetised ponies

    OpenAIRE

    Gent, Thomas C.; Schwarz, Andrea; Hatz, Lea-Annina; Gozalo-Marcilla, Miguel; Stijn, Schauvliege; Gasthuys, Frank; Bettschart-Wolfensberger, Regula

    2015-01-01

    Invasive blood pressure measurement (IBP) using peripheral arteries is a commonly used technique in equine anaesthesia, although the accuracy has not been demonstrated. Non-invasive blood pressure monitoring (NIBP) may be indicated for field anesthesia, short procedures and foal anaesthesia. In the present report, the agreement of various IBP and NIBP measuring sites compared to carotid artery pressure was tested in anaesthetised experimental ponies. Six ponies were anaesthetised in lateral r...

  2. Transpulmonary pressure gradient verifies pulmonary hypertension is initiated by increased arterial resistance in broilers.

    Science.gov (United States)

    Lorenzoni, A G; Anthony, N B; Wideman, R F

    2008-01-01

    Previous hemodynamic evaluations demonstrated that pulmonary arterial pressure (PAP) is higher in broilers that are susceptible to pulmonary hypertension syndrome (PHS, ascites) than in broilers that are resistant to PHS. We compared key pulmonary hemodynamic parameters in broilers from PHS-susceptible and PHS-resistant lines (selected for 12 generations under hypobaric hypoxia) and in broilers from a relaxed (control) line. In experiment 1 the PAP was measured in male broilers in which a flow probe positioned on one pulmonary artery permitted the determination of cardiac output and pulmonary vascular resistance (PVR). The PAP and relative PVR were higher in susceptible broilers than in relaxed and resistant broilers, whereas absolute and relative cardiac output did not differ between lines. In experiment 2 male and female broilers from the 3 lines were catheterized to measure pressures in the wing vein, right atrium, right ventricle, pulmonary artery, and pulmonary veins (WP, wedge pressure). The transpulmonary pressure gradient (TPG) was calculated as (PAP-WP), with PAP quantifying precapillary pressure and WP approximating postcapillary pulmonary venous pressure. When compared with resistant and relaxed broilers, PAP values in susceptible broilers were > or =10 mmHg higher, TPG values were > or =8 mmHg higher, and WP values were < or =2 mmHg higher, regardless of sex. The combined hemodynamic criteria (elevated PAP and PVR combined with a proportionally elevated TPG) demonstrate that susceptibility to PHS can be attributed primarily to pulmonary arterial hypertension associated with increased precapillary (arteriole) resistance rather than to pulmonary venous hypertension caused by elevated postcapillary (venous and left atrial) resistance. PMID:18079461

  3. Variations in Arterial Blood Pressure after Kidney Transplantation

    Science.gov (United States)

    Popovtzer, Mordecai M.; Pinnggera, Wulf; Katz, Fred H.; Corman, Jacques L.; Robinette, John; Lanois, Bernard; Halgrimson, Charles G.; Starzl, Thomas E.

    2010-01-01

    SUMMARY The course of hypertension within the first 2 months after kidney transplantation was correlated with renal function, plasma renin activity (PRA), and the daily maintenance dose of prednisone in 18 homograft recipients. During acute rejection blood pressure (BP) closely correlated with PRA. Patients with normal homograft function showed an increase in BP early after transplantation which in most returned to normal 3–8 weeks later. In the latter group no correlation could be found between the level of BP and PRA, however the BP correlated closely with the dose of prednisone. These observations suggest that during acute rejection the increase in BP may at least partly be mediated by a renal pressor mechanism, whereas with normal renal function the high dose of glucocorticoids may play an important role in the development of hypertension. PMID:4581920

  4. Current clinical applications of spectral tissue Doppler echocardiography (E/E' ratio as a noninvasive surrogate for left ventricular diastolic pressures in the diagnosis of heart failure with preserved left ventricular systolic function

    Directory of Open Access Journals (Sweden)

    Roux Emmanuel

    2007-03-01

    Full Text Available Abstract Congestive heart failure with preserved left ventricular systolic function has emerged as a growing epidemic medical syndrome in developed countries, which is characterized by high morbidity and mortality rates. Rapid and accurate diagnosis of this condition is essential for optimizing the therapeutic management. The diagnosis of congestive heart failure is challenging in patients presenting without obvious left ventricular systolic dysfunction and additional diagnostic information is most commonly required in this setting. Comprehensive Doppler echocardiography is the single most useful diagnostic test recommended by the ESC and ACC/AHA guidelines for assessing left ventricular ejection fraction and cardiac abnormalities in patients with suspected congestive heart failure, and non-invasively determined basal or exercise-induced pulmonary capillary hypertension is likely to become a hallmark of congestive heart failure in symptomatic patients with preserved left ventricular systolic function. The present review will focus on the current clinical applications of spectral tissue Doppler echocardiography used as a reliable noninvasive surrogate for left ventricular diastolic pressures at rest as well as during exercise in the diagnosis of heart failure with preserved left ventricular systolic function. Chronic congestive heart failure, a disease of exercise, and acute heart failure syndromes are characterized by specific pathophysiologic and diagnostic issues, and these two clinical presentations will be discussed separately.

  5. Associação entre a Incisura Diastólica das Artérias Uterinas e a Histologia do Leito Placentário em Grávidas com Pré-eclâmpsia Association between Diastolic Notch of Uterine Artery and the Histology of the Placental Bed in Pregnant Women with Preeclampsia

    Directory of Open Access Journals (Sweden)

    Regina Amélia Lopes Pessoa de Aguiar

    2001-08-01

    Full Text Available Objetivo: avaliar a associação entre a presença da incisura diastólica nas artérias uterinas maternas e as alterações histopatológicas dos vasos útero-placentários. Métodos: estudo transversal incluindo 144 pacientes com gestação única interrompida por via abdominal entre a 27ª e a 41ª semana. Destas, 84 gestações estavam associadas à pré-eclâmpsia e 60 não apresentaram intercorrências clínicas. Neste grupo realizou-se dopplerfluxometria de ambas as artérias uterinas e biópsia do leito placentário. Resultados: das 144 pacientes, 88 (61% tiveram o fragmento da biópsia considerado representativo do leito placentário. A incisura diastólica estava presente em 40 (70% dos casos de alterações fisiológicas inadequadas e ausente em 28 (90% dos casos de alterações fisiológicas presentes (p=0,05. A dopplerfluxometria apresentou sensibilidade de 70%, especificidade de 90% e valores preditivos positivo e negativo de 44 e 97%, respectivamente. A associação entre a presença de incisura diastólica bilateral das artérias uterinas e arteriopatia decidual também foi significativa (dos 25 casos de arteriopatia decidual a incisura estava presente em 24, p=0,05. A sensibilidade da dopplerfluxometria foi de 96%, especificidade de 70% e valores preditivos positivo e negativo de 26 e 99%, respectivamente, ao passo que para a arteriolosclerose a dopplerfluxometria apresentou sensibilidade de 80%, especificidade de 55% e valores preditivos positivo e negativo de 17 e 96%, respectivamente. Conclusões: a incisura diastólica nas artérias uterinas maternas é indicador seguro de vasculopatia no leito placentário. A adequada invasão trofoblástica do leito placentário, revelada por histologia típica de alterações fisiológicas, resulta na ausência de incisura diastólica bilateral das artérias uterinas maternas.Purpose: to evaluate the association between the presence of diastolic notch in the maternal uterine arteries, and the histopathological changes of the uteroplacental vessels. Methods: transversal study of 144 women with single pregnancy interrupted by cesarean section between 27 and 41 weeks. In this sample, 84 had pregnancies complicated by preeclampsia and the other 60 were normal. In this group, Doppler study of both uterine arteries and placental bed biopsy was performed. Results: of the total of 144 patients, 88 patients (61% had a biopsy fragment that was considered representative of the placental bed. The diastolic notch was present in 40 patients (70% of the total of cases with inadequate physiologic alterations and absent in 28 patients (90% of the total of cases with physiologic alterations (p=0.0000. The Doppler study showed 70% sensitivity, 90% specificity, 44% positive predictive value and 97% negative predictive value. The association between bilateral diastolic notch of uterine arteries and acute atherosis in the placental bed was also significant (24 out of 25 cases -- p=0.000. The Doppler study showed 96% sensitivity, 70% specificity, 26% positive predictive value and 99% negative predictive value, while for arteriolosclerosis its results were 80% sensitivity, 55% specificity, 17% positive predictive value and 96% negative predictive value. Conclusions: the diastolic notch in the maternal uterine is a safe indicator of pathological vessel alteration in the placental bed. The adequate trophoblast migration into the myometrium, revealed by physiologic changes, results in the absence of bilateral diastolic notch of the maternal uterine arteries.

  6. Speed Modulation of the Continuous-Flow Total Artificial Heart to Simulate a Physiologic Arterial Pressure Waveform

    OpenAIRE

    Shiose, Akira; Nowak, Kathleen; Horvath, David J.; Massiello, Alex L.; Leonard A. R. Golding; Fukamachi, Kiyotaka

    2010-01-01

    This study demonstrated the concept of using speed modulation in a continuous-flow total artificial heart (CFTAH) to shape arterial pressure waveforms and to adjust pressure pulsatility. A programmable function generator was used to determine the optimum pulsatile speed profile. Three speed profiles (sinusoidal, rectangular, and optimized [a profile optimized for generation of a physiologic arterial pressure waveform]) were evaluated using the CFTAH mock circulatory loop. Hemodynamic paramete...

  7. Pressure profile and morphology of the arteries along the giraffe limb

    DEFF Research Database (Denmark)

    Østergaard, Kristine Hovkjær; Bertelsen, Mads Frost; Brøndum, Emil Toft; Aalkjær, Christian; Hasenkam, Michael; Smerup, Morten Holdgaard; Nielsen, Tobias Wang; Nyengaard, Jens Randel; Baandrup, Ulrik

    2011-01-01

    Giraffes are the tallest animals on earth and the effects of gravity on their cardiovascular system have puzzled physiologists for centuries. The authors measured arterial and venous pressure in the foreleg of anesthetized giraffes, suspended in upright standing position, and determined the ratio...... artery and vein along the foreleg was not significantly different from what was expected on basis of gravity. The area of the arterial lumen in the hindleg decreased towards the hoof from 11.2 ± 4.2 to 0.6 ± 0.5 mm(2) (n = 10, P = 0.001), but most of this narrowing occurred within 2-4 cm immediately...

  8. Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Kyriacou, P A [School of Engineering and Mathematical Sciences, City University, London EC1V 0HB (United Kingdom); Shafqat, K [School of Engineering and Mathematical Sciences, City University, London EC1V 0HB (United Kingdom); Pal, S K [St Andrew' s Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, CM1 7ET (United Kingdom)

    2007-10-15

    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO{sub 2}) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO{sub 2}) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO{sub 2} sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures. Both pulse oximeters showed gradual decrease of saturations during induced hypoperfusion which demonstrate the direct relation between blood volumes (PPG amplitudes), arterial vessel stenosis and blood oxygen saturation. The custom made pulse oximeter was found to be more sensitive to SpO{sub 2} changes than the commercial pulse oximeter especially at high occluding pressures.

  9. Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion

    Science.gov (United States)

    Kyriacou, P. A.; Shafqat, K.; Pal, S. K.

    2007-10-01

    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO2) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO2) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO2 sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures. Both pulse oximeters showed gradual decrease of saturations during induced hypoperfusion which demonstrate the direct relation between blood volumes (PPG amplitudes), arterial vessel stenosis and blood oxygen saturation. The custom made pulse oximeter was found to be more sensitive to SpO2 changes than the commercial pulse oximeter especially at high occluding pressures.

  10. Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion

    International Nuclear Information System (INIS)

    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO2) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO2) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO2 sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures. Both pulse oximeters showed gradual decrease of saturations during induced hypoperfusion which demonstrate the direct relation between blood volumes (PPG amplitudes), arterial vessel stenosis and blood oxygen saturation. The custom made pulse oximeter was found to be more sensitive to SpO2 changes than the commercial pulse oximeter especially at high occluding pressures

  11. Body height and arterial pressure in seated and supine young males during +2 G centrifugation.

    Science.gov (United States)

    Arvedsen, Sine K; Eiken, Ola; Kölegård, Roger; Petersen, Lonnie G; Norsk, Peter; Damgaard, Morten

    2015-11-01

    It is known that arterial pressure correlates positively with body height in males, and it has been suggested that this is due to the increasing vertical hydrostatic gradient from the heart to the carotid baroreceptors. Therefore, we tested the hypothesis that a higher gravito-inertial stress induced by the use of a human centrifuge would increase mean arterial pressure (MAP) more in tall than in short males in the seated position. In short (162-171 cm; n = 8) and tall (194-203 cm; n = 10) healthy males (18-41 yr), brachial arterial pressure, heart rate (HR), and cardiac output were measured during +2G centrifugation, while they were seated upright with the legs kept horizontal (+2Gz). In a separate experiment, the same measurements were done with the subjects supine (+2Gx). During +2Gz MAP increased in the short (22 ± 2 mmHg, P < 0.0001) and tall (23 ± 2 mmHg, P < 0.0001) males, with no significant difference between the groups. HR increased more (P < 0.05) in the tall than in the short group (14 ± 2 vs. 7 ± 2 bpm). Stroke volume (SV) decreased in the short group (26 ± 4 ml, P = 0.001) and more so in the tall group (39 ± 5 ml, P < 0.0001; short vs. tall, P = 0.047). During +2Gx, systolic arterial pressure increased (P < 0.001) and SV (P = 0.012) decreased in the tall group only. In conclusion, during +2Gz, MAP increased in both short and tall males, with no difference between the groups. However, in the tall group, HR increased more during +2Gz, which could be caused by a larger hydrostatic pressure gradient from heart to head, leading to greater inhibition of the carotid baroreceptors. PMID:26290109

  12. Skin perfusion pressure measured with a photo sensor in an air-filled plastic balloon: validity and reproducibility on the lower leg in normal subjects and patients suspected of obliterative arterial disease

    International Nuclear Information System (INIS)

    An inflatable small plastic bag including a photo sensor was constructed for measurement of skin perfusion pressure avoiding the rim of the photo sensor over bony and tendineous surfaces of the tibia below the knee, at the ankle, and on the dorsal forefoot. Compression was obtained using a conical blood pressure cuff with continuous decrease from suprasystolic arm pressure. The validity of skin perfusion pressure with the new device was compared to that of isotope washout below the knee in normal subjects and in patients with an ischemic forefoot with acceptable agreement. The method had a high reproducibility within and between days in normal subjects. Compared to systolic arterial pressure measured using a strain gauge with a cuff on the ankle in normal subjects and patients with intermittent claudication the new device showed blood pressure in the skin closer to the diastolic pressure. The new pressure device thus had acceptable validity and reproducibility for estimation of the skin perfusion pressure and can be used on bony and tendineous sites on the lower limb in regions where critical wound healing is frequent, e.g. ankle and forefoot

  13. Atrial distension, arterial pulsation, and vasopressin release during negative pressure breathing in humans

    DEFF Research Database (Denmark)

    Pump, B; Damgaard, M; Gabrielsen, A; Bie, P; Christensen, N J; Norsk, P

    2001-01-01

    During an antiorthostatic posture change, left atrial (LA) diameter and arterial pulse pressure (PP) increase, and plasma arginine vasopressin (AVP) is suppressed. By comparing the effects of a 15-min posture change from seated to supine with those of 15-min seated negative pressure breathing in...... eight healthy males, we tested the hypothesis that with similar increases in LA diameter, suppression of AVP release is dependent on the degree of increase in PP. LA diameter increased similarly during the posture change and negative pressure breathing (-9 to -24 mmHg) from between 30 and 31 +/- 1 to 34...... +/- 1 mm (P <0.05). The increase in PP from 38 +/- 2 to 44 +/- 2 mmHg (P <0.05) was sustained during the posture change but only increased during the initial 5 min of negative pressure breathing from 36 +/- 3 to 42 +/- 3 mmHg (P <0.05). Aortic transmural pressure decreased during the posture change and...

  14. Diferencia elevada de presión arterial interbraquial: Frecuencia y factores clínicos y demográficos / High difference of inter-arm blood pressure measurements: frequency and clinical and demographic factors

    Scientific Electronic Library Online (English)

    David, Hurtado de Mendoza; Roberto, Pineda-Reyes; Jacsel, Suárez; Wilfredo, Mormontoy; Félix, Medina.

    2015-01-01

    Full Text Available La diferencia elevada de presión arterial interbraquial (DEPAI) podría predecir eventos cardiovasculares adversos. Objetivos: Conocer la frecuencia de DEPAI y describir factores clínicos y demográficos relacionados. Material y métodos: Estudio descriptivo transversal. Muestra aleatoria de 211 pacien [...] tes de un hospital público de Lima. Se tomó la presión arterial tres veces, de forma simultánea en ambos brazos, con dos tensiómetros automáticos OMROM HEM-705CP propiamente calibrados, estando el paciente en posición sentada, con un reposo previo de cinco minutos. Se recolectaron datos demográficos y clínicos. Se estableció la DEPAI sistólica (?10 mm Hg y ? 20 mm Hg) y diastólica (? 10 mm Hg). Se consideró las tres tomas y sólo las dos últimas. Se empleó las pruebas de Chi Cuadrado o Exacta de Fisher y el coeficiente de correlación puntual biserial para variables cualitativas y cuantitativas, respectivamente. Resultados: La edad promedio fue 48,92 ± 16,75 años. El 67,3% fue de sexo femenino. 23,08% de los participantes fueron obesos; 19,23%, hipertensos y 13,42%, fumadores. Según los punto de corte y cantidad de medidas consideradas, las frecuencias de DEPAI sistólica fueron 40,38%, 30,29%, 15,88% y12,98%; y las de DEPAI diastólica 13% y 10,1%. Hubo correlación entre DEPAI y HTA e IMC (p Abstract in english High difference of inter-arm blood pressure (HDIABP) measurements could predict adverse cardiovascular events. Objectives: To determine the frequency of HDIABP and to describe clinical and demographic factors related to it. Methods: Cross sectional study. A random sample of 211 patients from a publi [...] c hospital in Lima was taken. Blood pressure was measured three times, simultaneously in both arms with two automated sphygmomanometers OMROM HEM705CP properly calibrated, with the patient seated with at least 5 minutes of previous resting. Clinical and demographic data were collected. Systolic HDIABP was defined as ? 10 mmHg and ? 20 mmHg, and diastolic HDIABP as ? 10 mmHg. Chi square test and Fisher´s exact test were used, as well as the correlation coefficient for qualitative and quantitative data. Results: Mean age was 48.92 ± 16.75 years; 67.3% were females; 23.08% were obese; 19.23% had blood hypertension and 13.42% were smokers. The frequencies of systolic and diastolic HDIABP were 40.38%, 30.29%, 15.88%, 12.98% and 13%, 10.1%. There was correlation between HDIABP and body mass index (p

  15. The mobility analog for modeling the intra-arterial pressure wave parameters.

    Science.gov (United States)

    Ferris, C D; Stinnett, H O

    1995-01-01

    To assist in the identification of physical/physiological parameters obtained from in vivo rat aortic artery dynamic pressure data, the natural (mobility) mechanical circuit model was constructed. The direct electrical analog of the model thus obtained was then analyzed using SPICE. The experimental data were obtained using a Multifunction Pressure Generator (MPG), appropriate pressure probes, and a high-speed video camera. Two 486 computers were used for system control and data recording and computation. Transfer functions in rational form of the ratio of the MPG input pressure (Pi) to the intra-arterial pressure (Po) were then generated in the s-domain. The mechanical circuit described by these rational functions was then constructed and transformed into its equivalent electrical model for analysis. On this basis, physiological pressures are represented by electrical currents, and volume flow rates by electrical voltages. The results obtained through steady-state (Bode plot) and transient analysis of the model developed suggest a compartmental model that explains the experimental observations. The mobility model is an improvement over previous models in that the mass element is referred to a single frame of reference, which agrees with the physical property that mass is a one-terminal device. PMID:7654985

  16. The giraffe kidney tolerates high arterial blood pressure by high renal interstitial pressure and low glomerular filtration rate

    DEFF Research Database (Denmark)

    Damkjær, Mads; Wang, T; Brøndum, E; Østergaard, Kristine Hovkjær; Baandrup, Ulrik; Hørlyck, A; Hasenkam, J M; Smerup, Morten Holdgaard; Funder, J; Marcussen, Niels; Danielsen, Carl Christian; Bertelsen, Mads F.; Grøndahl, Carsten; Pedersen, Michael; Agger, P; Candy, G; Aalkjær, Christian; Bie, Peter

    2015-01-01

    cava generated a pressure drop of 12 ± 2 mmHg. RI was 0.27. The renal capsule was durable with a calculated burst pressure of 600 mmHg. Plasma renin and AngII were 2.6 ± 0.5 mIU L(-1) and 9.1 ± 1.5 pg mL(-1) respectively. CONCLUSION: In giraffes, GFR, ERPF and RI appear much lower than expected based...... adaption in the giraffe kidney allows normal for size renal haemodynamics and glomerular filtration rate (GFR) despite a MAP double that of other mammals. METHODS: Fourteen anaesthetized giraffes were instrumented with vascular and bladder catheters to measure glomerular filtration rate (GFR) and effective...... renal plasma flow (ERPF). Renal interstitial hydrostatic pressure (RIHP) was assessed by inserting a needle into the medullary parenchyma. Doppler ultrasound measurements provided renal artery resistive index (RI). Hormone concentrations as well as biomechanical, structural and histological...

  17. Percutaneous renal artery stenting reduces arterial blood pressure, but what about renal function? A single-center experience

    Directory of Open Access Journals (Sweden)

    Erkan Dervişoğlu

    2010-02-01

    Full Text Available Objective: To assess the effects of percutaneous transluminal angioplasty and stenting (PTRA/S on arterial blood pressure and renal function.Methods: A retrospective chart review of patients undergoing PTRA/S at our institution between December 2003 and September 2006 was done. Follow-up data were derived from hospital records. Estimated glomerular filtration rate (EGFR was used as the marker of renal function. To evaluate the pre- and post-procedure values in individual patients the paired t test and Wilcoxon signed-rank tests were used.Results: Thirty-six patients (16 women, 30 men; mean age 59±15 years, range: 25-83 years underwent 43 PTRA/S interventions at our institution. The mean duration of follow-up was 9.3±8.6 (range 2-28 months. We observed no significant change in EGFR from pre-procedure to that obtained at follow-up (71.4±40.2 mL/min vs.73.3±39.0 mL/min; p=0.483. Mean arterial blood pressure (MABP, however, was reduced significantly: pre-procedure MABP-123±22 mmHg; post-procedure follow-up value of 101±14 mmHg (p <0.001. The mean number of antihypertensive medications used at the time of intervention was 2.1±1.0 (range: 0-4, whereas at follow-up, this number had decreased to 1.3±1.0 (range: 0-4; p<0.001. In patients with renal impairment (EGFR ≤59 mL/min, 41% showed improvement, 29% showed no change and 29% demonstrated deterioration in EGFR. Conclusion: PTRA/S may preserve renal function, especially in patients with pre-procedural impaired renal function.

  18. Combination Proximal Pulmonary Artery Coiling and Distal Embolization Induces Chronic Elevations in Pulmonary Artery Pressure in Swine

    Science.gov (United States)

    Aguero, Jaume; Ishikawa, Kiyotake; Fish, Kenneth M.; Hammoudi, Nadjib; Hadri, Lahouaria; Garcia-Alvarez, Ana; Ibanez, Borja; Fuster, Valentin; Hajjar, Roger J.; Leopold, Jane A.

    2015-01-01

    Pulmonary hypertension (PH) is associated with aberrant vascular remodeling and right ventricular (RV) dysfunction that contribute to early mortality. Large animal models that recapitulate human PH are essential for mechanistic studies and evaluating novel therapies; however, these models are not readily accessible to the field owing to the need for advanced surgical techniques or hypoxia. In this study, we present a novel swine model that develops cardiopulmonary hemodynamics and structural changes characteristic of chronic PH. This percutaneous model was created in swine (n=6) by combining distal embolization of dextran beads with selective coiling of the lobar pulmonary arteries (2 procedures per lung over 4 weeks). As controls, findings from this model were compared with those from a standard weekly distal embolization model (n=6) and sham animals (n=4). Survival with the combined embolization model was 100%. At 8 weeks after the index procedure, combined embolization procedure animals had increased mean pulmonary artery pressure (mPA) and pulmonary vascular resistance (PVR) compared to the controls with no effect on left heart or systemic pressures. RV remodeling and RV dysfunction were also present with a decrease in the RV ejection fraction, increase in the myocardial performance index, impaired longitudinal function, as well as cardiomyocyte hypertrophy, and interstitial fibrosis, which were not present in the controls. Pulmonary vascular remodeling occurred in both embolization models, although only the combination embolization model had a decrease in pulmonary capacitance. Taken together, these cardiopulmonary hemodynamic and structural findings identify the novel combination embolization swine model as a valuable tool for future studies of chronic PH. PMID:25923775

  19. Model Predictive Control of Drug Infusion System for Mean Arterial Pressure Regulation of Critical Care Patients

    Directory of Open Access Journals (Sweden)

    S.A. Nirmala

    2014-05-01

    Full Text Available Patients recovering in critical care units are continuously monitored for their hemodynamic states and accordingly given proper medication. The widely monitored hemodynamic variable is the Mean Arterial Pressure (MAP, which is regulated by infusion of vasoactive drugs like Sodium Nitroprusside (SNP. Presently, physicians check the patients’ MAP at regular intervals. This task is time-consuming and if automated, allows the physicians to attend to other critical parameters, which cannot be measured. Automation of the drug infusion based on the MAP would lead to continuous regulation of the hemodynamic variable enabling speedier recovery. This study attempts to automate the regulation of the drug infusion system using a model predictive controller. The controller’s performance was tested for three types of patient models. The controller tracks the set point changes and maintains the mean arterial pressure within the required values.

  20. Body height and arterial pressure in seated and supine young males during +2 G centrifugation

    DEFF Research Database (Denmark)

    Arvedsen, Sine Kongsbak; Eiken, Ola; Kölegård, Roger; Petersen, Lonnie Grove; Norsk, Peter

    2015-01-01

    by the use of a human centrifuge would increase mean arterial pressure (MAP) more in tall than in short males in the seated position. In short (162-171cm, n=8) and tall (194-203cm, n=10) healthy males (18-41y), brachial arterial pressure, heart rate (HR) and cardiac output were measured during +2G...... centrifugation, while they were seated upright with the legs kept horizontal (+2Gz). In a separate experiment, the same measurements were done with the subjects supine (+2Gx). During +2Gz MAP increased in the short (22±2 mmHg, p<0.0001) and tall (23±2 mmHg, p<0.0001) males, with no significant difference between...

  1. Leave-one-out prediction error of systolic arterial pressure time series under paced breathing

    CERN Document Server

    Ancona, N; Marinazzo, D; Nitti, L; Pellicoro, M; Pinna, G D; Stramaglia, S

    2004-01-01

    In this paper we show that different physiological states and pathological conditions may be characterized in terms of predictability of time series signals from the underlying biological system. In particular we consider systolic arterial pressure time series from healthy subjects and Chronic Heart Failure patients, undergoing paced respiration. We model time series by the regularized least squares approach and quantify predictability by the leave-one-out error. We find that the entrainment mechanism connected to paced breath, that renders the arterial blood pressure signal more regular, thus more predictable, is less effective in patients, and this effect correlates with the seriousness of the heart failure. The leave-one-out error separates controls from patients and, when all orders of nonlinearity are taken into account, alive patients from patients for which cardiac death occurred.

  2. The arterial load in pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    A. Vonk-Noordegraaf

    2010-09-01

    Full Text Available The anatomical differences between the pulmonary and systemic arterial system are the main cause of the difference in distribution of compliance. In the pulmonary arterial system compliance is distributed over the entire arterial system, and stands at the basis of the constancy of the RC-time. This distribution depends on the number of peripheral vessels, which is ∼8–10 times more in the pulmonary system than the systemic tree. In the systemic arterial tree the compliance is mainly located in the aorta (80% of total compliance in thoracic-abdominal aorta. The constant RC-time in the pulmonary bed results in proportionality of systolic and diastolic pressure with mean pressure and, in turn, in the constant ratio of oscillatory and mean power.

  3. Fourier Analysis of Peripheral Blood Pressure and Flow in Intraoperative Assessment of Infrainguinal Arterial Reconstructions

    Directory of Open Access Journals (Sweden)

    Cheshmedzhiev Mihail V.

    2014-08-01

    Full Text Available AIM: To assess infrainguinal arterial reconstructions by intraoperative flowmetry under the distal anastomosis using a fast Fourier transformation; calculate and compare the amplitude ratios of peripheral arterial blood pressure and volume flow before and after drug-induced vasodilation of occluded bypass grafts and bypass grafts that have been patent at least for 1 year. To find what magnitude of the change of these ratios indicate a long-term patency of the bypass grafting. PATIENTS AND METHODS: We compared the results of the intraoperative flowmetry tests of 97 patients with infrainguinal arterial reconstructions. The patients were divided into two groups based on the graft status: the grafts in 49 patients were patent for at least a year, and 48 patients had failed bypass. We used a fast Fourier transform (FFT of the pressure and blood flow waves and compared the ratios of their amplitudes before and after administration of a vasodilator drug into the graft. Comparing the ratios obtained before and those after administration of the drug we quantified their change in each group and analysed them. RESULTS: After a drug-induced vasodilation, the blood pressure and flow amplitude ratios for the group with compromised reconstructions were less than 1.9 times smaller than those before drug infusion, while for the group with bypass grafts that had been functional for at least 12 months the ratios declined by more than 1.9≈2 times. CONCLUSION: The magnitude of the change of amplitude ratios of the peripheral pressure and volume flow after drug-induced vasodilation can be used to make an assessment of the bypass graft and the distal arterial segment.

  4. Body height and arterial pressure in seated and supine young males during +2 G centrifugation

    DEFF Research Database (Denmark)

    Arvedsen, Sine Kongsbak; Eiken, Ola; Kölegård, Roger; Petersen, Lonnie Grove; Norsk, Peter

    2015-01-01

    the groups. HR increased more (p<0.05) in the tall than in the short group (14±2 versus 7±2 bpm). Stroke volume (SV) decreased in the short group (26±4 mL, p=0.001) and more so in the tall group (39±5 mL, p<0.0001; short vs tall p=0.047). During +2GX, systolic arterial pressure increased (p<0.001) and...

  5. Methodological aspects of toe blood pressure measurements for evaluation of arterial insuffiency in patients with diabetes

    OpenAIRE

    PÃ¥hlsson, Hans-Ivar

    2007-01-01

    Diabetes mellitus (DM) is a growing health problem in the aging population of the western world with prevalence figures around 6-7%, which are increasing fast. Treatment of this disease is complex and expensive for society. One of the most feared DM complications is foot ulcerations. As a causative factor for this complication peripheral arterial disease (PAD) is second only to neuropathy in importance, and screening for PAD is vital to prevent amputation. Toe blood pressure...

  6. The association between arterial stiffness and left ventricular filling pressure in an apparently healthy Korean population

    OpenAIRE

    Kim Hack-Lyoung; Im Moon-Sun; Seo Jae-Bin; Chung Woo-Young; Kim Sang-Hyun; Kim Myung-A; Zo Joo-Hee

    2013-01-01

    Abstract Background The aim of this study is to investigate the association between arterial stiffness and left ventricular filling pressure in an apparently healthy Korean population. Methods A total of 115 healthy subjects without known cardiovascular risk factors or overt heart disease who underwent both transthoracic echocardiography and brachial-ankle pulse wave velocity (baPWV) measurement at the same day during their routine check-ups were analyzed. Results The mean age of study subjec...

  7. Simultaneous measurement of arterial and left ventricular pressure in conscious freely moving rats by telemetry.

    Science.gov (United States)

    Segreti, Jason A; Polakowski, James S; Blomme, Eric A; King, Andrew J

    2016-01-01

    Comprehensive cardiovascular assessment in conscious rodents by utilizing telemetry has been limited by the restriction of current devices to one pressure channel. The purpose of this study was to test and validate a dual pressure transmitter that allows the simultaneous measurement of arterial pressure (AP) and left ventricular pressure (LVP) in conscious freely moving rats. Six rats were surgically implanted with dual pressure transmitters. Baseline hemodynamics and circadian rhythm were observed to return within 7days. AP, heart rate (HR), LVP and indices of left ventricular contractility were stable and demonstrated a prominent circadian rhythm over a two-week period of uninterrupted recordings. Administration of the vasodilator nifedipine produced the anticipated dose-dependent decrease in AP which was accompanied by a baroreflex mediated increase in HR and cardiac contractility. The negative inotrope verapamil produced the expected dose-dependent decreases in AP and cardiac contractility. Finally, a terminal validation of the dual pressure transmitter was performed under anesthesia by measuring AP and LVP simultaneously via telemetry and from a fluid filled arterial catheter and an intraventricular Millar catheter, respectively. A range of pressures and cardiac contractility were studied by administering sequential intravenous infusions of the positive inotrope dobutamine followed by verapamil. Linear regression analysis revealed a high level of agreement between pressures measured by the dual pressure transmitter and the exteriorized catheters. Histopathologic analysis of the heart revealed mild peri-catheter fibrosis. In conclusion, the simultaneous measurement of AP and LVP offers the potential for more detailed cardiovascular assessment in conscious rats. PMID:26778372

  8. Re-evaluation of Pre-pump Arterial Pressure to Avoid Inadequate Dialysis and Hemolysis: Importance of Prepump Arterial Pressure Monitoring in Hemodialysis Patients.

    Science.gov (United States)

    Shibata, Eriko; Nagai, Kojiro; Takeuchi, Risa; Noda, Yasuhiro; Makino, Tomomi; Chikata, Yusuke; Hann, Michael; Yoshimoto, Sakiya; Ono, Hiroyuki; Ueda, Sayo; Tamaki, Masanori; Murakami, Taichi; Matsuura, Motokazu; Abe, Hideharu; Doi, Toshio

    2015-07-01

    Prepump arterial pressure (PreAP) is monitored to avoid generating excessive negative pressure. The National Kidney Foundation K/DOQI clinical practice guidelines for vascular access recommend that PreAP should not fall below -250 mm Hg because excessive negative PreAP can lead to a decrease in the delivery of blood flow, inadequate dialysis, and hemolysis. Nonetheless, these recommendations are consistently disregarded in clinical practice and pressure sensors are often removed from the dialysis circuit. Thus far, delivered blood flow has been reported to decrease at values more negative than -150 mm Hg of PreAP. These values have been analyzed by an ultrasonic flowmeter and not directly measured. Furthermore, no known group has evaluated whether PreAP-induced hemolysis occurs at a particular threshold. Therefore, the aim of this study was to clarify the importance of PreAP in the prediction of inadequate dialysis and hemolysis. By using different diameter needles, human blood samples from healthy volunteers were circulated in a closed dialysis circuit. The relationship between PreAP and delivered blood flow or PreAP and hemolysis was investigated. We also investigated the optimal value for PreAP using several empirical monitoring methods, such as a pressure pillow. Our investigation indicated that PreAP is a critical factor in the determination of delivered blood flow and hemolysis, both of which occured at pressure values more negative than -150 mm Hg. With the exception of direct pressure monitoring, commonly used monitoring methods for PreAP were determined to be ineffective. We propose that the use of a vacuum monitor would permit regular measurement of PreAP. PMID:25940509

  9. The origin of Korotkoff sounds and the accuracy of auscultatory blood pressure measurements.

    Science.gov (United States)

    Babbs, Charles F

    2015-12-01

    This study explores the hypothesis that the sharper, high frequency Korotkoff sounds come from resonant motion of the arterial wall, which begins after the artery transitions from a buckled state to an expanding state. The motions of one mass, two nonlinear springs, and one damper, driven by transmural pressure under the cuff, are used to model and compute the Korotkoff sounds according to principles of classical Newtonian physics. The natural resonance of this spring-mass-damper system provides a concise, yet rigorous, explanation for the origin of Korotkoff sounds. Fundamentally, wall stretching in expansion requires more force than wall bending in buckling. At cuff pressures between systolic and diastolic arterial pressure, audible vibrations (> 40 Hz) occur during early expansion of the artery wall beyond its zero pressure radius after the outward moving mass of tissue experiences sudden deceleration, caused by the discontinuity in stiffness between bucked and expanded states. The idealized spring-mass-damper model faithfully reproduces the time-domain waveforms of actual Korotkoff sounds in humans. Appearance of arterial sounds occurs at or just above the level of systolic pressure. Disappearance of arterial sounds occurs at or just above the level of diastolic pressure. Muffling of the sounds is explained by increased resistance of the artery to collapse, caused by downstream venous engorgement. A simple analytical model can define the physical origin of Korotkoff sounds, suggesting improved mechanical or electronic filters for their selective detection and confirming the disappearance of the Korotkoff sounds as the optimal diastolic end point. PMID:26553392

  10. Concurrent determinants of blood pressure among adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil birth cohort study Determinantes contemporâneos da pressão arterial em adolescentes: a visita de 11 anos da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 1993

    Directory of Open Access Journals (Sweden)

    Ana M. B. Menezes

    2010-10-01

    Full Text Available The aim of this study was to evaluate concurrent risk factors for high blood pressure in adolescents. This is a prospective cohort study including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. Blood pressure was measured before and after the interview, and the mean value was used in the analyses. Mean systolic blood pressure was 101.9mmHg (SD = 12.3 and mean diastolic pressure was 63.4mmHg (SD = 9.9. Adolescents with black skin had higher blood pressure than those with white skin. Mean systolic pressure among subjects in the top quartile of body mass index (BMI was 11.6mmHg higher than among those in the lowest quartile. Mean systolic pressure among postmenarcheal girls was 5.4mmHg higher than among premenarcheal girls. Similar trends were found for diastolic arterial pressure. Our findings suggest that blood pressure control must begin already in childhood and adolescence.O objetivo do presente artigo foi avaliar fatores associados com a pressão arterial de adolescentes. Trata-se de estudo de coorte prospectivo, incluindo 4.452 adolescentes nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1993. A pressão arterial foi medida no início e final da entrevista com aparelho digital, sendo o valor médio utilizado nas análises. A pressão arterial sistólica média foi de 101,9mmHg (DP = 12,3 e a diastólica foi de 63,4mmHg (DP = 9,9. Adolescentes com pele preta apresentaram valores mais elevados de pressão arterial sistólica do que os de pele branca. Adolescentes no quartil superior do índice de massa corporal (IMC apresentaram uma pressão sistólica média 11,6mmHg maior do que aqueles no quartil inferior. Meninas que já menstruaram apresentaram uma pressão sistólica média 5,4mmHg maior em comparação às demais. Os resultados foram similares para a pressão arterial diastólica. O controle da pressão arterial elevada deve ser iniciado desde a infância e adolescência.

  11. Similarities and Differences between the Pathogenesis and Pathophysiology of Diastolic and Systolic Heart Failure

    OpenAIRE

    Kazuo Komamura

    2013-01-01

    Pathophysiology of heart failure has been considered to be a damaged state of systolic function of the heart followed by a state of low cardiac output that is, systolic heart failure. Even if systolic function is preserved, left ventricular filling in diastole can be impeded and resulted in elevation of filling pressure and symptoms of heart failure. This kind of heart failure is called diastolic heart failure. Nowadays, diastolic heart failure is referred to as heart failure with preserved e...

  12. Hydrostatic Pressure Independently Increases Elastin and Collagen Co-expression in Small-diameter Engineered Arterial Constructs

    OpenAIRE

    Crapo, Peter M.; Wang, Yadong

    2011-01-01

    Prior studies have demonstrated that smooth muscle cell (SMC) proliferation, migration, and extracellular matrix production increase with hydrostatic pressure in vitro. We have engineered highly compliant small-diameter arterial constructs by culturing primary adult arterial SMCs under pulsatile perfusion on tubular, porous, elastomeric scaffolds composed of poly(glycerol sebacate) (PGS). This study investigates the effect of hydrostatic pressure on the biological and mechanical properties of...

  13. A RETROSPECTIVE STUDY OF THE IMPACT OF MEAN ARTERIAL PRESSURE ON ESTIMATED BLOOD LOSS DURING ENDOSCOPIC SINUS SURGERY

    OpenAIRE

    Williams, George W.; Aanchal Sharma; Chunyan Cai

    2014-01-01

    The current practice of lowering mean arterial pressure (MAP) during endoscopic sinus surgery (ESS) is common, but unproven with regard to peer reviewed literature. The controlled hypotension induced is aimed for improved surgical field and lower the blood loss. Lower mean arterial pressures especially for prolonged surgeries may result in end organ hypoperfusion. The authors reviewed all patients who underwent outpatient endoscopic sinus surgery for the diagnosis of chronic sinusitis f...

  14. Effects of simulated microgravity on circadian rhythm of caudal arterial pressure and heart rate in rats and their underlying mechanism

    OpenAIRE

    Chen, Li; Zhang, Bin; Yang, Lu; Xie, Man-Jiang

    2016-01-01

    Objective  To explore the effects of simulated microgravity on the circadian rhythm of rats' caudal arterial pressure and heart rate, and their underlying mechanism. Methods  Eighteen male SD rats (aged 8 weeks) were randomly assigned to control (CON) and tail suspension (SUS) group (9 each). Rats with tail suspension for 28 days were adopted as the animal model to simulate microgravity. Caudal arterial pressure and heart rate of rats were measured every 3 hours. The circadian difference of a...

  15. Reverse end-diastolic flow in a fetus with a rare liver malformation: a case report

    Directory of Open Access Journals (Sweden)

    La Torre Renato

    2011-01-01

    Full Text Available Abstract Introduction We describe a case of early and persistent reverse end-diastolic flow in the middle cerebral artery in a fetus with severe ascites. These features are associated with a rare liver malformation known as ductal plate malformation. Case presentation A 28-year-old Caucasian woman was referred to our high-risk obstetric unit at 24 weeks' gestation for fetal ascites detected during a routine ultrasound examination. During her hospitalization we performed medical investigations, including a fetal paracentesis, to detect the etiology of fetal ascites. The cause of fetal ascites (then considered non-immune or idiopathic was not evident, but a subsequent ultrasound examination at 27 weeks' gestation showed a reverse end-diastolic flow in the middle cerebral artery without any other Doppler abnormalities. A cesarean section was performed at 28 weeks' gestation because of the compromised fetal condition. An autopsy revealed a rare malformation of intrahepatic bile ducts known as ductal plate malformation. Conclusion Persistent reverse flow in the middle cerebral artery should be considered a marker of adverse pregnancy outcome. We recommend careful ultrasound monitoring in the presence of this ultrasonographic sign to exclude any other cause of increased intracranial pressure. To better understand the nature of these ultrasonographic signs, additional reports are deemed necessary. In fact in our case, as confirmed by histopathological examination, the fetal condition was extremely compromised due to failure of the fetal liver. Ductal plate malformation altered the liver structures causing hypoproteinemia and probably portal hypertension. These two conditions therefore explain the severe hydrops that compromised the fetal situation.

  16. Sensitivity of rapidly acting arterial pressure control system in conscious adult rabbits at different ages.

    Science.gov (United States)

    Hosomi, H; Katsuda, S; Motochigawa, H; Morita, H; Hayashida, Y

    1984-01-01

    Changes in sensitivity of the rapidly acting arterial pressure control (AP) system with aging were investigated. Two catheters, one for pressure measurement and the other for inducing hemorrhage from the aorta, were chronically implanted in 25 rabbits from the same colony (aged 6 to 30 months). A few days after the operations, each animal was quickly bled (2 ml/kg body weight) while it was conscious. The hemorrhage experiment was repeated 16 times and the mean arterial pressure responses were sampled with an A/D-converter and stored in a digital computer, the 16 strings of data being pooled for each animal. The overall open-loop gain (G) of the AP-system was estimated from the individually pooled responses. In the present study, aging exerted no significant effect on the value of G (7.1) as evaluated by Kruskal-Wallis' non-parametric one criterion variance analysis (p greater than 0.05). The reflex sensitivity of the AP-system over the pressure ranges used in this experiment thus appears to be unaffected by aging over the range from 6 to 30 months. PMID:6533380

  17. Profunda Femoris Artery Perforator Propeller Flap: A Valid Method to Cover Complicated Ischiatic Pressure Sores

    Science.gov (United States)

    Tartaglione, Caterina; Bolletta, Elisa; Pierangeli, Marina; Di Benedetto, Giovanni

    2015-01-01

    Summary: We report the case of a 50-year-old paraplegic man with a complicated grade III/IV ischiatic pressure sore treated with a propeller flap based on the first perforator of the profunda femoris artery. Our aim was to surgically reconstruct an ischiatic pressure sore in a patient with ankylosis using a fasciocutaneous perforator propeller flap obtained from the posterior region of the thigh. Our decision to perform a profunda femoris artery perforator propeller flap reconstruction was mainly due to the anatomical contiguity of the flap with the site of the lesion and the good quality of the skin harvested from the posterior region of the thigh. The use of the perforator fasciocutaneous flap represents a muscle-sparing technique, providing a better long-term result in surgical reconstruction. The choice of the 180-degree propeller flap was due to its ability to provide a good repair of the pressure ulcer and to pass over the ischiatic prominence in the patient in the forced decubitus position. The operatory course did not present any kind of complication. Using this reconstructive treatment, we have obtained complete coverage of the ischiatic pressure sore. PMID:26495200

  18. Influence of physical exercise and sodium intake on arterial pressure and cardiac hypertrophy in rats

    Directory of Open Access Journals (Sweden)

    Santos Bruno Mello Rodrigues dos

    1999-01-01

    Full Text Available Evidence shows that cardiac hypertrophy (CH is a risk factor for many cardiovascular diseases. Several stimuli may cause CH-like manifestations and promote volume or pressure overload. Exercise-induced cardiac hypertrophy is an expected adaptation to regular exercise training. Salt intake has been shown to be the most important determinant of blood pressure in different populations. The purpose of the present work was to verify the influence of physical exercise and sodium intake on the blood pressure and myocardium. The study was performed on 36 rats divided into six groups: Group I (diet without salt overload, Group II (diet without salt overload and swimming, Group III (diet with 2.5% NaCl solution and swimming, Group IV (diet with 5% NaCl solution and swimming, Group V (diet with 2.5% NaCl solution without exercise, Group VI (diet with 5% NaCl solution without exercise. The arterial pressure was significantly lower in Group I when compared with Group IV. The ratio of cardiac mass/body mass was increased in Groups III and IV. In conclusion, there was evidence that exercise training and NaCl intake promotes arterial hypertension and cardiac hypertrophy.

  19. Amino Acid Intakes Are Inversely Associated with Arterial Stiffness and Central Blood Pressure in Women12

    Science.gov (United States)

    Jennings, Amy; MacGregor, Alex; Welch, Ailsa; Chowienczyk, Phil; Spector, Tim; Cassidy, Aedín

    2015-01-01

    Background: Although data suggest that intakes of total protein and specific amino acids (AAs) reduce blood pressure, data on other cardiovascular disease risk factors are limited. Objective: We examined associations between intakes of AAs with known mechanistic links to cardiovascular health and direct measures of arterial stiffness, central blood pressure, and atherosclerosis. Methods: In a cross-sectional study of 1898 female twins aged 18–75 y from the TwinsUK registry, intakes of 7 cardioprotective AAs (arginine, cysteine, glutamic acid, glycine, histidine, leucine, and tyrosine) were calculated from food-frequency questionnaires. Direct measures of arterial stiffness and atherosclerosis included central systolic blood pressure (cSBP), mean arterial pressure (MAP), augmentation index (AI), pulse wave velocity (PWV), and intima–media thickness (IMT). ANCOVA was used to assess the associations between endpoints of arterial stiffness and intake (per quintile), adjusting for potential confounders. Results: In multivariable analyses, higher intakes of total protein and 7 potentially cardioprotective AAs were associated with lower cSBP, MAP, and PWV. Higher intakes of glutamic acid, leucine, and tyrosine were most strongly associated with PWV, with respective differences of ?0.4 ± 0.2 m/s (P-trend = 0.02), ?0.4 ± 0.2 m/s (P-trend = 0.03), and ?0.4 ± 0.2 m/s (P-trend = 0.03), comparing extreme quintiles. There was a significant interaction between AA intakes and protein source, and higher intakes of AAs from vegetable sources were associated with lower central blood pressure and AI. Higher intakes of glutamic acid, leucine, and tyrosine from animal sources were associated with lower PWV. Conclusions: These data provide evidence to suggest that intakes of several AAs are associated with cardiovascular benefits beyond blood pressure reduction in healthy women. The magnitude of the observed associations was similar to those previously reported for other lifestyle factors. Increasing intakes of these AAs could be an important and readily achievable way to reduce cardiovascular disease risk. PMID:26203100

  20. Assesment of Right Ventricular Diastolic Function in Chronic Obstructive Lung Disease

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    Hasibe Yemenici

    2012-12-01

    Full Text Available Objective: Chronic obstructive lung disease (COPD is a systemic disease characterised by airflow limitation that is not fully reversible. Right ventricular diastolic function (rvdf was investigated in COPD.Material and Methods: Study groups consisted of 40 patients with COPD and 24 healthy controls. All subjects performed respiratory function test and doppler echocardiography. Results: There was no statistical difference between patient and control groups with respect to tricuspid annular systolic velocity (S, tricuspid annulus early diastolic filling velocity (E and tricuspid annulus late diastolic velocity (A (p>0.05. For E/A ratio and İVRT, there was a statistical difference between groups (p=0.05, p=0.0001. There was a positive correlation between FEV1 and E/A ratio (r=0.409, p=0.009. There was no statistically significant correlation between other parameters of Echocardiography (Echo, RFT and arterial blood gas (ABG analysis comparisons. Decrease in E and E/A ratio in COPD whose SatO2≤%90 was statistically significant compared to patients with SatO2>%90 (p=0.002. Decreases in E and E/A rates were significant between COPD cases with PH (pulmonary artery pressure PABsis>30 mmHg, and those without PH (p=0.016, p=0.01. There was no statistically significant correlation between PABsis and FEV1 and FEV1/FVC. There was a negative correlation between PABsis and pO2, and positive correlation between PABsis and pCO2 (p=0.006, p=0.029. There was a positive correlation between FEV1, pO2 and satO2 (p=0.018, p=0.001. Conclusion: As a result, we concluded that, in order to evulate right ventricular functions in COPD cases, we must not only consider systolic functions but also examining the diastolic functions is important. Doppler-Echo proved to be favorable in evaluating rvdf in all COPD patients.

  1. A STUDY OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN HYPERTENSION

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    Ravi Keerthy

    2015-03-01

    Full Text Available INTRTODUCTION: Hypertension is one of the major non communica b le disease among the adult population . Hypertension is the leading cause of morbidity and mortality in both developed and developing countries . Hypertension is the leading cause of ischemic heart disease , heart failure and stroke . (1 In spite of having target organ damage , hypertens ion remains asymptomatic in majority of population . Diastolic dysfunction and left ventricular hypertrophy are the early evidence of hypertensive heart disease , both of which may remain silent . (2 Heart failure is a common and often lethal complication of chronic hypertension . Based on extensive research , it has become possible to focus on individual factors that cause or contribute to the syndrome of chronic heart failure . OBJECTIVE: Main objective of the study of to find out the incidence of left ventricu lar diastolic dysfunction . METERIALS AND METHODS: All hypertensive patient with systolic blood pressure of more than 140 and or diastolic blood pressure of more than 90 are included in the study . Data was collected from history , clinical examination , ECG , Echo . Coronary angiogram was done in few patients to rule out ischemic heart disease . LV dime n sions were obtained by M - mode echo from apical and parasternal windows . Diastolic dysfunction was measured by Doppler echo . RESULTS: 85patients were considered fo r the study . 62 patients had diastolic dysfunction , 40 patients had LVH . Of the 62 patients , 28 had isolated diastolic dysfunction and 34 patients had both systolic and diastolic dysfunction . Ejection fraction was ranging from 50 - 77% . Early peak velocity r anged from40cms/secto 120cms/sec with a mean of 71 . 21+/ - 16 . 81cms/sec in patients with diastolicdys function , l ate atrial velocity ranged from 50cms/sec to 150cms/sec with a mean of102 . 66cmd/sec+/ - 19 . 13cms/sec . E/A ratio ranged from 0 . 41 to 1 . 8 with a mean of 0 . 69+/ - 0 . 14 . CONCLUSION: Since in the introduction of non - invasive methods such as radionuclide vetriculogram and doppler echocardiography , these techniques have become the modalities of choice for the assessment of left ventricular diastolic dy sfunction . These have advantages of ease of performance repeatability ( 4 , 5 , 6 , 7 , 8 It was concluded from the study that incidence of diastolic d ysfunction is72% . 32% had isolated Diastolicdys function and the rest had LVH along with diastolic dysfunction . LV diastolic dysfunction can manifest both as backward failure and forward failure . Diastolicdys function correlated well with the severity of diastolic blood pressure as well as with the duration of hypertension . Doppler echocardiography is an easily avai lable non - invasive technique today , can utilized for early detection of LV diastolic dysfunction . Early detection and more aggressive management of hypertension prevents the long term complications .

  2. Monounsaturated fatty acid, carbohydrate intake, and diabetes status are associated with arterial pulse pressure

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    Vaccaro Joan A

    2011-11-01

    Full Text Available Abstract Background Diabetes is a global epidemic. Cardiovascular disease (CVD is one of the most prevalent consequences of diabetes. Nutrition is considered a modifiable risk factor for CVD, particularly for individuals with diabetes; albeit, there is little consensus on the role of carbohydrates, proteins and fats for arterial health for persons with or without diabetes. In this study, we examined the association of macronutrients with arterial pulse pressure (APP, a surrogate measure of arterial health by diabetes status and race. Methods Participants were 892 Mexican Americans (MA, 1059 Black, non-Hispanics (BNH and 2473 White, non-Hispanics (WNH with and without diabetes of a weighted sample from the National Nutrition and Health Examination Survey (NHANES 2007-2008. The cross-sectional analysis was performed with IBM-SPSS version 18 with the complex sample analysis module. The two-year sample weight for the sub-sample with laboratory values was applied to reduce bias and approximate a nationally, representative sample. Arterial stiffness was assessed by arterial pulse pressure (APP. Results APP was higher for MA [B = 0.063 (95% CI 0.015 to 0.111, p = 0.013] and BNH [B = 0.044 (95% CI 0.006 to 0.082, p = 0.018] than WNH, controlling for diabetes, age, gender, body mass index (BMI, fiber intake, energy intake (Kcal and smoking. A two-way interaction of diabetes by carbohydrate intake (grams was inversely associated with APP [B = -1.18 (95% CI -0.178 to -0.058, p = 0.001], controlling for race, age, gender, BMI, Kcal and smoking. BNH with diabetes who consumed more mono-unsaturated fatty acids (MUFA than WNH with diabetes had lower APP [B = -0.112 (95%CI-0.179 to -0.045, p = 0.003] adjusting for saturated fatty acids, Kcal, age, gender, BMI and smoking. Conclusion Higher MUFA and carbohydrate intake for persons with diabetes reflecting lower APP may be due to replacement of saturated fats with CHO and MUFA. The associations of APP with diabetes, race and dietary intake need to be confirmed with intervention and prospective studies. Confirmation of these results would suggest that dietary interventions for minorities with diabetes may improve arterial health.

  3. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

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    Amann Matthias

    2007-11-01

    Full Text Available Abstract Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC measurement by the pulmonary artery catheter (PAC. However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA only requires access to the radial or femoral artery using a standard arterial catheter and does not need an external calibration. We validated this technique in critically ill patients in the intensive care unit (ICU using COPAC as the method of reference. Methods We studied 20 critically ill patients, aged 16 to 74 years (mean, 55.5 ± 18.8 years, who required both arterial and pulmonary artery pressure monitoring. COPAC measurements were performed at least every 4 hours and calculated as the average of 3 measurements, while COAP values were taken immediately at the end of bolus determinations. Accuracy of measurements was assessed by calculating the bias and limits of agreement using the method described by Bland and Altman. Results A total of 164 coupled measurements were obtained. Absolute values of COPAC ranged from 2.80 to 10.80 l/min (mean 5.93 ± 1.55 l/min. The bias and limits of agreement between COPAC and COAP for unequal numbers of replicates was 0.02 ± 2.92 l/min. The percentage error between COPAC and COAP was 49.3%. The bias between percentage changes in COPAC (ΔCOPAC and percentage changes in COAP (ΔCOAP for consecutive measurements was -0.70% ± 32.28%. COPAC and COAP showed a Pearson correlation coefficient of 0.58 (p PAC and ΔCOAP was 0.46 (p Conclusion Although the COAP algorithm shows a minimal bias with COPAC over a wide range of values in an inhomogeneous group of critically ill patients, the scattering of the data remains relative wide. Therefore, the used algorithm (V 1.03 failed to demonstrate an acceptable accuracy in comparison to the clinical standard of cardiac output determination.

  4. Selective Heart Rate Reduction With Ivabradine Increases Central Blood Pressure in Stable Coronary Artery Disease.

    Science.gov (United States)

    Rimoldi, Stefano F; Messerli, Franz H; Cerny, David; Gloekler, Steffen; Traupe, Tobias; Laurent, Stéphane; Seiler, Christian

    2016-06-01

    Heart rate (HR) lowering by β-blockade was shown to be beneficial after myocardial infarction. In contrast, HR lowering with ivabradine was found to confer no benefits in 2 prospective randomized trials in patients with coronary artery disease. We hypothesized that this inefficacy could be in part related to ivabradine's effect on central (aortic) pressure. Our study included 46 patients with chronic stable coronary artery disease who were randomly allocated to placebo (n=23) or ivabradine (n=23) in a single-blinded fashion for 6 months. Concomitant baseline medication was continued unchanged throughout the study except for β-blockers, which were stopped during the study period. Central blood pressure and stroke volume were measured directly by left heart catheterization at baseline and after 6 months. For the determination of resting HR at baseline and at follow-up, 24-hour ECG monitoring was performed. Patients on ivabradine showed an increase of 11 mm Hg in central systolic pressure from 129±22 mm Hg to 140±26 mm Hg (P=0.02) and in stroke volume by 86±21.8 to 107.2±30.0 mL (P=0.002). In the placebo group, central systolic pressure and stroke volume remained unchanged. Estimates of myocardial oxygen consumption (HR×systolic pressure and time-tension index) remained unchanged with ivabradine.The decrease in HR from baseline to follow-up correlated with the concomitant increase in central systolic pressure (r=-0.41, P=0.009) and in stroke volume (r=-0.61, Phttp://www.clinicaltrials.gov. Unique identifier NCT01039389. PMID:27091900

  5. Impact of low-grade albuminuria on left ventricular diastolic dysfunction

    OpenAIRE

    Hiroaki Nagai; Susumu Suzuki; Hideki Ishii; Yohei Shibata; Shingo Harata; Yohei Takayama; Yosuke Tatami; Yusaku Shimbo; Naohiro Osugi; Tomoyuki Ota; Yoshihiro Kawamura; Akihito Tanaka; Kyosuke Takeshita; Toyoaki Murohara

    2015-01-01

    Background: Albuminuria is an established risk factor for mortality and cardiovascular events in high-risk populations. However, few studies have evaluated the relationship between normoalbuminuria and left ventricular (LV) diastolic function. The present study evaluated the impact of the low-grade albuminuria on LV diastolic function in patients with coronary artery disease (CAD). Methods: A cross-sectional study was conducted in 202 chronic CAD patients with normal urinary albumin levels...

  6. [Effect of the type of diabetes on the prognosis over 4 years of arterial blood pressure].

    Science.gov (United States)

    Mayaudon, H; Dupuy, O; Belmejdoub, G; Bredin, C; Rivetta, F; Avaro, J F; Bauduceau, B

    2000-08-01

    The aim of this study was to analyse over a four years period the blood pressure rise according to the type of diabetes. The study population was composed of 79 diabetic patients (type 1: 36; type 2: 43). An evaluation of diabetes mellitus is undertaken at a four years interval (A0, A4). In the same time, blood pressure level is assessed using clinic BP and 24 h-ambulatory blood pressure monitoring (ABPM). Type 2 diabetic patients were older than type 1 (60.9 +/- 9.5 vs 43.5 +/- 12.5 years, p < 0.001). The two groups did not differ in body mass index, tobacco consumption, diabetes duration, glycemic control and serum creatinine. Hypertension was more frequent in type 2 diabetes (46.5 vs 11.1%, p < 0.01) and baseline systolic but not diastolic casual BP was significantly higher in type 2 diabetes compared with type 1 (142 +/- 14 vs 132 +/- 15 mmHg, p < 0.01). Between A0 and A4 the increase in type 1 and type 2 diabetics casual BP was not significant. Type 1 diabetic patients 24 h-ABPM did not differ from significant manner at A0 and at A4. Type 2 diabetic subjects had an increase in 24 h and night time SBP (24 h: 123 +/- 14 at A0 vs 130 +/- 16 mmHg at A4, p < 0.05; night time: 116 +/- 15 at A0 vs 125 +/- 17 mmHg at A4, p < 0.02). This reduction in nocturnal BP fall was not associated with an increase in diabetes complications frequency. BP evolution seems to be closely linked to the type of diabetes and to patients age. In this study, frequency of diabetes complications does not increase when BP level is lower than references values for ABPM. PMID:10989751

  7. DIURNAL VARIATION IN THE CARDIOVASCULAR INDICES AND INTRAOCULAR PRESSURE

    OpenAIRE

    R. B. PATIL; Doddamani, B. R.; Mohammed Ehtesham Ali Farooqui

    2012-01-01

    Introduction: Intra ocular pressure is an essential entity in maintaining the structural and functional integrity of eye ball. It varies in regular cycle in the normal eye for 24hour.  In the present study, the diurnal variation of Heart rate, intra ocular pressure, systolic, diastolic, pulse and mean arterial pressures from 6AM to 6PM with every 2 hour interval was investigated. Methodology: The present study included 100 normal male healthy subjects from the Gulbarga city, recruited after ...

  8. Variaciones de riesgo en valores de tensión arterial en pacientes hipertensos durante procedimientos odontológicos / Risk changes in blood pressure in hypertensive patients during dental procedures

    Scientific Electronic Library Online (English)

    Gloria C, Aranzazu-Moya; Ronald Y, Delgado-Jaimes; María P, Pieschacón-Gutierrez.

    2014-08-01

    Full Text Available Introducción: Las variaciones de Tensión Arterial (TA) de origen fisiológico son frecuentes; sin embargo, los procedimientos durante la consulta odontológica podrían generar variaciones a valores de riesgo de TA que pueden alterar el estado sistémico, o generar complicaciones médicas que comprometen [...] la integridad del paciente. Objetivo: Identificar factores que generan variaciones de riesgo de la Tensión Arterial durante los procedimientos odontológicos en pacientes hipertensos y no hipertensos. Materiales y métodos: Se diseñó un estudio observacional descriptivo, en 108 pacientes. Se evaluaron tanto hipertensos como no hipertensos, incluidos por un muestreo probabilístico por conglomerados; se evaluaron variables sociodemográficas, presión arterial antes, durante y después del procedimiento, factores de riesgo cardiovascular y aquellas dependientes del procedimiento. Los datos se procesaron en el programa SPSS 21, utilizando medidas de tendencia central y dispersión, desviación estándar (DE) e intervalos de confianza (IC), frecuencias, chi 2, T test, diferencia de medias, ANOVA de una vía y medidas repetidas. Resultados: La edad media fue 62,3 años con DE 12,5 años; 42(38,9%) fueron no hipertensos y 66(61,1%) hipertensos. Las variaciones de presión sistólica mayor a 20mmHg y diastólica mayor a 10mmHg se presentaron en mayor porcentaje en los hipertensos con control errático. Así mismo las variaciones fueron superiores en mujeres y en procedimientos sin uso de anestésico. Según el tipo de hipertensión, se encontraron diferencias entre el grupo de sanos con los grupos control errático, mal control y sin control. Al aplicar un modelo lineal de medidas repetidas, se encontraron diferencias en las tres mediciones en los diferentes tipos de hipertensión. Conclusiones: Los factores relacionados a variaciones de riesgo fueron el control errático, sexo femenino y duración del procedimiento. Abstract in english Introduction: Physiologic changes in blood pressure are frequent, nevertheless dental procedures could trigger an increase in blood pressure, which may alter the state or even generate systemic vascular injury or medical complications, that compromise patient integrity. Objectives: To identify facto [...] rs, which produce risk variations of blood pressure levels during dental procedures in hypertensive and no hypertensive patients. Materials and Methods: A descriptive study was made in 108 patients; including hypertensive and non-hypertensive patients. Sociodemographic variables were assessed, blood pressure values; before, during and after procedure, cardiovascular risk factors and those dependent of the procedure. Patients were selected using the cluster probability method. The data were processed at SPSS 21, using central tendency measures and dispersion, standard deviation and confidence interval, frequencies, chi2, T test, mean difference, one-way ANOVA and repeated measures. Results: The mean age was 62.3 years with SD 12,5 years, 42 (38.9%) without hypertension and 66(61.1%) hypertensive patients. Changes in systolic pressure greater than 20mmHg in systolic and 10mmHg in diastolic, was present in greater percentage of hypertensive patients with erratic control, in women and procedures without the use of anesthetic. Depending on the type of hypertension, differences were found between the group of healthy control, erratic control group, poorly controlled and uncontrolled group. By applying a linear model repeated measures, we found differences in the measurements of arterial pressure in different types of hypertension. Conclusions The factors related with risk variations in blood pressure occurred in erratic control hypertension patients, women and duration of the procedure.

  9. Influência do índice de massa corporal e da circunferência abdominal na pressão arterial sistêmica de crianças Influence of body mass index and abdominal circumference on children's systemic blood pressure

    Directory of Open Access Journals (Sweden)

    Marcelo Nunes Iampolsky

    2010-06-01

    Full Text Available OBJETIVO: Avaliar os níveis pressóricos em crianças e relacioná-los ao índice de massa corporal e à circunferência abdominal. MÉTODOS: Por meio de estudo prospectivo e transversal, avaliaram-se 1.408 escolares com idade entre cinco anos e dez anos e 11 meses, matriculados em escolas públicas do Município de Santo André. Foram coletados: peso ao nascer; peso e estatura, expressos como escore Z do índice de massa corporal (ZIMC e estatura para idade (ZEI. A pressão arterial (medida única foi aferida pelo mesmo examinador. Considerou-se: desnutrição quando ZIMC+2, baixa estatura se ZEIP90 para sexo e idade e pressão arterial elevada quando superior ao percentil 90 para sexo, idade e estatura. A análise estatística incluiu o teste do qui-quadrado e o cálculo da Odds Ratio, adotando-se como significante o valor de pOBJECTIVE: To evaluate blood pressure levels in children, relating them to body mass index and abdominal circumference. METHODS: This cross-sectional prospective study enrolled 1.408 school children, aged between five and ten years and 11 months, in the municipality of Santo Andre, São Paulo, Brazil. The following variables were evaluated: birth weight, weight and height, expressed as body mass index Z score (ZBMI and height to age Z score (ZH, and waist circumference (WC. Blood pressure was measured once by the same physician. Malnutrition was considered when ZBMI +2, short stature when ZH P90 for age and gender, and increased blood pressure when >P90 for age, gender and height. Statistical analysis included chi-square test and Odds Ratio, being significant p<0.05. RESULTS: Mean age was seven years old, and 51% were females. High systolic blood pressure levels were observed in 19% and elevated diastolic blood pressure in 12%. Short stature, malnutrition, obesity and increased abdominal circumference were diagnosed in 2.6%, 3.1%, 7.3% and 13.4%, respectively, of the studied population. The presence of obesity was strongly associated with high systolic (OR 2.1, 95%IC 1.3-3.3; p<0.001 and diastolic blood pressure (OR 2.6, 95%IC 1.6-4.3; p<0.001. Increased abdominal circumference was also an important risk factor for high systolic blood pressure (OR 1.6; 95%IC 1.0-2.5; p=0.027. CONCLUSIONS: High blood pressure in children is associated with obesity and increased abdominal circumference.

  10. A computational study of pressure wave reflections in the pulmonary arteries.

    Science.gov (United States)

    Qureshi, M Umar; Hill, N A

    2015-12-01

    Experiments using wave intensity analysis suggest that the pulmonary circulation in sheep and dogs is characterized by negative or open-end type wave reflections, that reduce the systolic pressure. Since the pulmonary physiology is similar in most mammals, including humans, we test and verify this hypothesis by using a subject specific one-dimensional model of the human pulmonary circulation and a conventional wave intensity analysis. Using the simulated pressure and velocity, we also analyse the performance of the P-U loop and sum of squares techniques for estimating the local pulse wave velocity in the pulmonary arteries, and then analyse the effects of these methods on linear wave separation in the main pulmonary artery. P-U loops are found to provide much better estimates than the sum of squares technique at proximal locations, but both techniques accumulate progressive error at distal locations away from heart, particularly near junctions. The pulse wave velocity estimated using the sum of squares method also gives rise to an artificial early systolic backward compression wave. Finally, we study the influence of three types of pulmonary hypertension viz. pulmonary arterial hypertension, chronic thromboembolic pulmonary hypertension and pulmonary hypertension associated with hypoxic lung disease. Simulating these conditions by changing the relevant parameters in the model and then applying the wave intensity analysis, we observe that for each group the early systolic backward decompression wave reflected from proximal junctions is maintained, whilst the initial forward compression and the late systolic backward compression waves amplify with increasing pathology and contribute significantly to increases in systolic pressure. PMID:25754476

  11. Ex Vivo and in Silico Study of Human Common Carotid Arteries Pressure Response in Physiological and Inverted State

    Science.gov (United States)

    Piechna, A.; Cieślicki, K.; Lombarski, L.; Ciszek, B.

    2015-02-01

    Arterial walls are a multilayer structures with nonlinear material characteristics. Furthermore, residual stresses exist in unloaded state (zero-pressure condition) and they affect arterial behavior. To investigate these phenomena a number of theoretical and numerical studies were performed, however no experimental validation was proposed and realized yet. We cannot get rid of residual stresses without damaging the arterial segment. In this paper we propose a novel experiment to validate a numerical model of artery with residual stresses. The inspiration for our study originates from experiments made by Dobrin on dogs' arteries (1999). We applied the idea of turning the artery inside out. After such an operation the sequence of layer is reversed and the residual stresses are re-ordered. We performed several pressure-inflation tests on human Common Carotid Arteries (CCA) in normal and inverted configurations. The nonlinear responses of arterial behavior were obtained and compared to the numerical model. Computer simulations were carried out using the commercial software which applied the finite element method (FEM). Then, these results were discussed.

  12. Relation between arterial pressure, dietary sodium intake, and renin system in essential hypertension.

    OpenAIRE

    Parfrey, P. S.; Markandu, N D; Roulston, J. E.; JONES, B. E.; Jones, J. C.; MacGregor, G. A.

    1981-01-01

    Forty-one patients with mild essential hypertension, 36 patients with severe hypertension, and 28 normotensive subjects were studied on a high sodium intake of 350 mmol/day for five days and low sodium intake of 10 mmol/day for five days. The fall in mean arterial pressure on changing from the high-sodium to the low-sodium diet was 0.7 +/- 1.7 mm Hg in normotensive subjects, 8 +/- 1.4 mm Hg in patients with mild hypertension, and 14.5 +/- 1.4 mm Hg in patients with severe hypertension. The fa...

  13. The influence of balneotherapy on spa truskavets’ on arterial pressure and its regulation at children

    OpenAIRE

    Vovchyna, Yu V; W Zukow

    2014-01-01

    Vovchyna YuV, Zukow W. The influence of balneotherapy on spa truskavets’ on arterial pressure and its regulation at children. Journal of Health Sciences. 2014;4(10):151-162. ISSN 1429-9623 / 2300-665X. Retrieved from http://journal.rsw.edu.pl/index.php/JHS/article/view/2014%3B4%2810%29%3A151-162. DOI: 10.13140/2.1.4378.3688 http://dx.doi.org/10.13140/2.1.4378.3688 The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1107. (...

  14. Finding events of electrocardiogram and arterial blood pressure signals via discrete wavelet transform with modified scales.

    Science.gov (United States)

    Ghaffari, A; Homaeinezhad, M R; Akraminia, M; Davaeeha, M

    2010-01-01

    A robust electrocardiogram (ECG) wave detection-delineation algorithm that can be applied to all ECG leads is developed in this study on the basis of discrete wavelet transform (DWT). By applying a new simple approach to a selected scale obtained from DWT, this method is capable of detecting the QRS complex, P-wave, and T-wave as well as determining parameters such as start time, end time, and wave sign (upward or downward). In the proposed method, the selected scale is processed by a sliding rectangular window of length n and the curve length in each window is multiplied by the area under the absolute value of the curve. In the next step, an adaptive thresholding criterion is conducted on the resulted signal. The presented algorithm is applied to various databases including the MIT-BIH arrhythmia database, European ST-T database, QT database, CinC Challenge 2008 database as well as high-resolution Holter data gathered in the DAY Hospital. As a result, the average values of sensitivity and positive prediction Se = 99.84 per cent and P+ = 99.80 per cent were obtained for the detection of QRS complexes with an average maximum delineation error of 13.7, 11.3, and 14.0 ms for the P-wave, QRS complex, and T-wave respectively. The presented algorithm has considerable capability in cases of a low signal-to-noise ratio, high baseline wander, and in cases where QRS complexes and T-waves appear with abnormal morphologies. Especially, the high capability of the algorithm in the detection of the critical points of the ECG signal, i.e. the beginning and end of the T-wave and the end of the QRS complex was validated by the cardiologist and the maximum values of 16.4 and 15.9 ms were recognized as absolute offset error of localization respectively. Finally, in order to illustrate an alternative capability of the algorithm, it is applied to all 18 subjects of the MIT-BIH polysomnographic database and the end-systolic and end-diastolic points of the blood pressure waveform were extracted and values of sensitivity and positive prediction Se = 99.80 per cent and P+ = 99.86 per cent were obtained for the detection of end-systolic, end-diastolic pulses. PMID:20225455

  15. Diagnóstico y prevalencia de hipertensión arterial en menores de 19 años en la ciudad de Colima Diagnosis and prevalence of high blood pressure in children aged under 19 in Colima City

    Directory of Open Access Journals (Sweden)

    Javier Cervantes

    2000-11-01

    Full Text Available OBJETIVO: Estimar la prevalencia de hipertensión arterial en menores de 19 años de Colima, Colima, México. MATERIAL Y MÉTODOS: Estudio transversal realizado en 1992 a partir de las mediciones de la tensión arterial (TA de 400 menores, distribuidos por sexo y edad. Se calcularon: promedio, varianza y Anova por edad; coeficientes de correlación y determinación entre edad y TA; se compararon los grupos con pruebas t de Student, F y U de Mann-Whitney con Z para sexos seleccionados según la curva de distribución; asimismo, se calculó percentil 95 para definir cifras anormales. RESULTADOS: El coeficiente de correlación es lineal, el de determinación lo confirma, se distinguen con pOBJECTIVE: To assess the prevalence of high blood pressure among young children. MATERIAL AND METHODS: This is a cross-sectional study, conducted in 1992 in Colima City, Mexico. Blood pressure readings were obtained from 400 children aged under 19. Statistical analysis consisted of calculation of means, variance, and Anova by group age. Association between age and blood pressure was assessed with correlation and determination coefficients. Comparisons by sex were made using Student's t, F, Mann-Whitney's U, and Z tests. Percentile 95th was used to define normal figures. RESULTS: A lineal correlation coefficient was found and confirmed by the determination coefficient. Groups where this association was statistically significant at p<0.01 were: a children aged under 2; b children from 2 to 13 years of age; and c those over 13 years of age. High blood pressure figures for each group were: a 92/50 mm/Hg; 110/70 mm/Hg; and 133/84 mm/Hg, respectively. CONCLUSIONS: The prevalence of high blood pressure in younger children may be 8% for systolic pressure and 9% for diastolic pressure.

  16. Effect of beta-1-blocker, nebivolol, on central aortic pressure and arterial stiffness in patients with essential hypertension

    Directory of Open Access Journals (Sweden)

    Radhika Soanker

    2012-01-01

    Conclusion: Nebivolol 5 mg demonstrated antihypertensive efficacy in patients with essential hypertension by reducing not only peripheral brachial pressures, but also significantly reducing central aortic pressures, augmentation index, and carotid femoral pulse wave velocity, which is the marker of arterial stiffness.

  17. Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries' Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration

    Science.gov (United States)

    García-Espinosa, Victoria; Curcio, Santiago; Castro, Juan Manuel; Arana, Maite; Giachetto, Gustavo; Chiesa, Pedro; Zócalo, Yanina

    2016-01-01

    Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries' stiffness. Methods. 221 subjects (4–15 years, 92 females) were assigned to normal weight (NW, n = 137) or obesity (OB, n = 84) groups, considering their body mass index z-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP) levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus), BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial) stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children.

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

    Directory of Open Access Journals (Sweden)

    Dursunoglu Nese

    2007-01-01

    Full Text Available 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 ventilation (NPPV treatment is increasingly used for the treatment of acute and chronic respiratory failure in patients with COPD. NPPV can increase PaO2 and decrease PaCO2 by correcting the gas exchange in such patients. The acute effect of NPPV on decreasing PAP is seen in patients with respiratory failure, probably due to the effect on cardiac output. Here, a case with COPD whose respiratory acidosis and PAH rapidly improved by NPPV was presented and therefore we suggested to perform an echocardiographic assessment to reveal an improvement of PAH as well as respiratory acidosis, hypercapnia and hypoxemia with that treatment.

  19. Monitorização ambulatorial da pressão arterial e diabete melito tipo 2 Ambulatory blood pressure monitoring and type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Cristiane Bauermann Leitão

    2007-11-01

    Full Text Available A hipertensão arterial sistêmica (HAS é um dos principais fatores de risco para a instalação e progressão das complicações crônicas do diabetes melito (DM tipo 2. A medida da pressão arterial (PA através da monitorização ambulatorial da PA (MAPA apresenta melhor correlação com o desenvolvimento de lesões em órgãos-alvo do que a medida no consultório. Além disso, permite a avaliação de parâmetros pressóricos distintos como as médias das PAs sistólica e diastólica das 24 h, do dia e da noite, cargas pressóricas e ausência do descenso noturno, além da identificação de pacientes com HAS do avental branco e mascarada. Os pacientes com DM apresentam maiores médias de PA diurna e noturna do que os sem DM. Além disso, um terço do pacientes normotensos com DM tipo 2 apresentam HAS mascarada, que está associada a um aumento da albuminúria e da espessura das paredes do ventrículo esquerdo. Por outro lado, a prevalência e o efeito da HAS do avental branco nos pacientes com DM ainda não foram adequadamente avaliados. A determinação da ausência do descenso noturno da PA não acrescenta informação às medidas da PA nas 24 h, no dia ou na noite, mas a medida da PA noturna parece ser relevante na retinopatia do DM. Em conclusão, a determinação da PA através da MAPA é capaz de estratificar de forma mais adequada os pacientes em risco para o desenvolvimento das complicações crônicas do DM e tornou-se um instrumento indispensável para o controle efetivo da PA nestes pacientes.Hypertension is one of the main risk factors for the onset and progression of chronic complications in type 2 diabetes mellitus (DM. Ambulatory blood pressure (BP monitoring (ABPM provides a better correlation with target organ lesions than BP obtained in the office. Furthermore, it allows the evaluation of distinct BP parameters such as the 24-h, daytime and nighttime systolic and diastolic BP means, BP loads and the absence of nocturnal drop of BP, as well as the identification of white-coat and masked hypertension. DM patients have higher daytime and nighttime BP means than non-DM patients. In addition, one third of normotensive type 2 DM patients have masked hypertension, which is associated with an increase in albuminuria and in left ventricle wall thickness. On the other hand, the prevalence and effect of white-coat hypertension in type 2 DM patients have not yet been properly evaluated. The absence of nocturnal drop of BP does not add information to the 24 h, daytime or nighttime BP measurements, but the nighttime BP means seem to be relevant in DM retinopathy. In conclusion, BP determination by ABPM allows better patient risk stratification for the development of DM chronic complications and is an essential instrument for effective BP control in these patients.

  20. Application of Static Pressure Change in Estimation of Elastic Parameters of Rabbit’s Artery by Doppler Ultrasound

    Directory of Open Access Journals (Sweden)

    N. Nikanjam

    2005-06-01

    Full Text Available Backgrounds/Objectives : Noninvasive evaluation of elastic properties of vessel wall is hampered by the absence of methods to directly asse ss local elasticity. In order to invasively record the static pressure of carotid artery dur ing cardiac cycle in rabbit s and compare it with noninvasive technique, T–shaped tubes have been designed and constructed and calibrated. A noninvasive method to measure static pressure in arteries and finally estimate the elasticity of vessels is provided. Materials and Methods: In male white rabbits, we estimated the static pressure changes in carotid artery noninvasively by measuring blood flow velocities throughout cardiac cycle using Color Doppler Ultrasound. The blood flow ve locities were converted to static pressure changes by using energy conservation low. The st atic pressure changes of arterial wall were estimated. These parameters were compared wi th measured actual static pressure changes using a T-shaped tube, that was inserted into the carotid artery and the static pressure change was measured in the side br anch of the tube. The elastic parameters in both methods were calculated and compared by pa ired t-test statistical analysis. Results: Statistical analysis of static pressure c hanges and elastic parameters in both methods showed that there was no significant difference between the two methods. Conclusion: By applying this noninvasive approach, we can estimate elastic parameters in arteries of normal people and patients with, or at risk of developing atherosclerosis for determination of disease extent. We propose this noninvasive method as an accurate and safe way suitable for screening of large popula tions of young and symptom-free individuals.

  1. [Clinical- functional assessment of organoprotective efficacy of enalapril and telmisartan in patients with arterial hypertension].

    Science.gov (United States)

    Tatarchenko, I P; Pozdniakova, N V; Morozova, O I; Petrushin, I A; Sekerko, S A

    2011-01-01

    Effect of enalapril and telmisartan on hemodynamic indices, structural-functional parameters of the left ventricle, and vasomotor function of arterial endothelium was studied in 49 patients (mean age 48.3+/-3.2 years) with 1-2 degree arterial hypertension (AH) and abnormal relaxation type of left ventricular diastolic dysfunction. Enalapril was given to 24 and telmisartan to 25 patients. Examination included 24-hour arterial pressure monitoring, echocardiography, duplex scanning of the left brachial artery. At the background of therapy with enalapril target levels of systolic and diastolic arterial pressure (AP) were achieved in 79.2 and 70.85% of patients. This was associated with 54.2% reduction of number of non-dippers and night peakers. Therapy with telmisartan (30 weeks) besides effective AP control provided normalization of 24-hour AP profile in 90% of patients with pathological circadian rhythm. This was accompanied by improvement of vasomotor endothelial function of arteries, positive dynamics of structural-functional parameters of the left heart chambers, improvement of indices of left ventricular diastolic function. PMID:21623715

  2. Patient Directed Perfusion Pressure on Bypass, an Analogy from Electrical Engineering—A New Concept

    OpenAIRE

    Warwick, Richard; Poole,Robert; Palmer, Kenneth; Johnson, Ian; Poullis, Michael

    2010-01-01

    Organ ischemia, particularly mesenteric and renal, can occur despite a seemingly adequate perfusion flow and pressure during a period of cardiopulmonary bypass. The blood pressure to run bypass at remains a contentious issue. We present the concept that perfusion pressure during cardiopulmonary bypass should be patient specific, depending on an individual’s resting pre-procedural blood pressure. Four simulated arterial traces with variable morphology, but identical systolic and diastolic bloo...

  3. Effects of physical training on pulmonary arterial pressure during exercise under hypobaric hypoxia in rats

    Science.gov (United States)

    Kashimura, Osamu; Sakai, Akio

    1991-12-01

    In this investigation, we assessed the effects of physical training on exercise-induced systemic and pulmonary hemodynamic changes under hypobaric hypoxia in catheter-implanted rats. We made continuous measurements of pulmonary and systemic arterial pressures during progressive treadmill exercises under hypobaric hypoxia (equivalent to altitudes of 2500 and 5500 m) in 46 control and 41 trained rats. Trained rats were exercised on two running schedules: 4 weeks (4-trained) and 6 weeks (6-trained). Both these groups of trained rats were exercised for the same length of running time each day. The increase in resting mean pulmonary arterial pressure(overline {P_{pa} } ) with increasing equivalent altitude was lower in the two trained groups than in the control group. The increase in(overline {P_{pa} } ) with progressive intensity of exercise was lower in the 6-trained than in the 4-trained and control groups at 610 and 2500 m. The 6-trained rats showed higher pH, P a CO 2 and O2 saturation in their blood than did the control group, whereas the P a O 2 was less. Lung tissue cyclic AMP concentration at rest was higher in the 6-trained than in the control group. Finally, it may be noted that exercise-induced lung tissue vasodilator responses seem to be enhanced in well-trained rats under both normobaric normoxia and hypobaric hypoxia. This study indicates that exercise training may be useful in preventing pulmonary hypertension resulting from both hypoxia and exercise.

  4. Moderately elevated intracranial pressure produces greater cross-filling of the anterior communicating artery.

    Science.gov (United States)

    Zhang, Yi C; Young, Robert J; Jones, Kevin; Koh, Elsie; Lien, Ruby J; Kagetsu, Nolan J

    2014-09-01

    This study aimed to investigate whether moderately elevated intracranial pressure is associated with greater cross-filling of the anterior communicating artery on diagnostic cerebral angiography. A retrospective study of 12 patients with subarachnoid hemorrhage was performed. Data on sequential cerebral angiograms and clinical data were used to indirectly estimate intracranial pressure (ICP). Cross-filling of the anterior communicating artery (ACom) was recorded according to our scoring system. Our study included 12 patients with mean age 43 ± 11 yrs. Six patients demonstrated greater ICP associated with greater cross-filling of the ACom on initial angiogram. One patient had greater ICP with greater cross-filling on follow-up angiogram secondary to infarction and midline shift. Two patients had lower ICP yet greater cross-filling on follow-up angiogram due to higher injection rate and volume. One patient with no change in ICP demonstrated the same degree of cross-filling. A markedly elevated ICP is traditionally associated with no cross-filling across the ACom. We propose a counter-intuitive model in which moderately elevated ICP produces greater cross-filling of the ACom. This diagnostic angiographic finding should make the angiographer consider that the patient has moderately elevated ICP, and facilitate more timely clinical management. PMID:25196611

  5. Comparison of Doppler ultrasonography and high-definition oscillometry for blood pressure measurements in healthy awake dogs.

    OpenAIRE

    Chetboul, Valérie; Tissier, Renaud; Gouni, Vassiliki; De Almeida, Virginie; Lefebvre, Hervé; Concordet, Didier; Jamet, Nathalie; Sampedrano, Carolina Carlos; Serres, François; Pouchelon, Jean-Louis

    2010-01-01

    OBJECTIVE: To determine the intra- and interobserver variability of systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) measurements obtained with 2 indirect methods in awake dogs and percentage of successful measurements. ANIMALS: 6 healthy conscious adult dogs. PROCEDURES: 4 observers with different levels of training measured SAP and DAP on 4 days by use of Doppler ultrasonography (DU) and high-definition oscillometry (HDO). The examinations were randomized. Measurements...

  6. Left and right ventricular diastolic function in hemodialysis patients

    International Nuclear Information System (INIS)

    The aim of this prospective study was the assessment of left ventricular and right ventricular diastolic function in patients on hemodialysis (HD) and the correlation of this function with the duration of HD. The study included 42 patients (22 females and 20 males) with chronic renal failure (CRF), treated with HD, and 40 healthy subjects (24 females and 16 males) with no history of cardiovascular disease and with normal renal function, who constituted the control group. The groups were matched for age and sex. All study patients and control subjects unde went detailed history taking and physical examination. They also underwent electrocardiogram, echocardiography and biochemical and hematological blood analyses. Significant differences were noted between the two groups in the two-dimensional and M-mode echocardiography findings concerning aortic root dimension, transverse diameter of the left atrium, thickness of the inter-ventricular septum, thickness of the left ventricular posterior wall, left ventricular diastolic diameter, left ventricular systolic diameter, shortening fraction, ejection fraction as well as findings from the pulse Doppler study, including E wave, A wave, E/A ratio, deceleration time of E wave (DT-E), acceleration time of E wave (AT-E), tricuspid E and A waves (E tr and A tr ) and E tr /A tr , ratio. There were significant changes in HD patients without arterial hypertension as well in the control group subjects. Our study suggests that the left ventricular and left atrial dimensions as well as the left ventricular wall thickness are augmented in patients with CRF treated with HD compared with the control group. Additionally, the left and right ventricular diastolic function is also reduced in these patients. These differences were also noted in patients with CRF without arterial hypertension. Left ventricular diastolic dysfunction had no correlation with the duration of HD (Author).

  7. Measuring Partial Pressure of Ammonia in Arterial or Venous Blood VS total Ammonia Levels in Hepatic Encephalopathy

    OpenAIRE

    Mohammad Asif Mehmood; Tariq Waseem; Malik Asif Humayun; Farina Zia Ahmad

    2013-01-01

    AIM: To find out the correlation between clinical grade of hepaticencephalopathy and different serum ammonia levels, namely,serum arterial ammonia, serum venous ammonia, partial pressureof ammonia in arterial plasma and partial pressure of ammonia invenous plasma.METHODS: After informed consent from patients or their relatives,100 patients in hepatic encephalopathy due to advanced liver disease,were examined for their clinical grade of hepatic encephalopathywithin 24 hours of admission. Fasti...

  8. Concordance between side-stream end-tidal carbon dioxide and arterial carbon dioxide partial pressure in respiratory service setting

    OpenAIRE

    Law, GTS; Wong, CY; Kwan, CW; Wong, FP; Tse, HN; Wong, KY

    2009-01-01

    OBJECTIVE: To explore the correlation and concordance between end-tidal carbon dioxide and arterial carbon dioxide partial pressure, and confirm the experience of the general consensus among service environments. DESIGN: A prospective cross-sectional analysis. SETTING: Two respiratory service units in Hong Kong. PARTICIPANTS: Two hundred respiratory patients were recruited, in whom 219 sets of observations were recorded. Patients deemed to require arterial blood gas determination also had the...

  9. Effects of Age on Arterial Stiffness and Blood Pressure Variables in Patients with Newly Diagnosed Untreated Hypertension

    OpenAIRE

    Cho, Soo Kyung; Cho, Sang Ki; KIM, KYE HUN; Cho, Jae Yeong; YOON, HYUN JU; Yoon, Nam Sik; Hong, Young Joon; Park, Hyung Wook; Kim*, Ju Han; AHN, YOUNGKEUN; Jeong, Myung Ho; CHO, JEONG GWAN; Park, Jong Chun

    2015-01-01

    Background and Objectives To investigate the impact of age on arterial stiffness and blood pressure (BP) variables in newly diagnosed untreated hypertension (HT). Subjects and Methods A total of 144 patients with newly diagnosed untreated HT were divided into two groups: young group (age ≤50 years, n=71), and old group (age >50 years, n=73). BP variables were measured on office or 24 hours ambulatory BP monitoring (ABPM). Parameters of arterial stiffness were measured on pulse wave velocity (...

  10. Neural reflex regulation of arterial pressure in pathophysiological conditions: interplay among the baroreflex, the cardiopulmonary reflexes and the chemoreflex

    Directory of Open Access Journals (Sweden)

    E.C. Vasquez

    1997-04-01

    Full Text Available The maintenance of arterial pressure at levels adequate to perfuse the tissues is a basic requirement for the constancy of the internal environment and survival. The objective of the present review was to provide information about the basic reflex mechanisms that are responsible for the moment-to-moment regulation of the cardiovascular system. We demonstrate that this control is largely provided by the action of arterial and non-arterial reflexes that detect and correct changes in arterial pressure (baroreflex, blood volume or chemical composition (mechano- and chemosensitive cardiopulmonary reflexes, and changes in blood-gas composition (chemoreceptor reflex. The importance of the integration of these cardiovascular reflexes is well understood and it is clear that processing mainly occurs in the nucleus tractus solitarii, although the mechanism is poorly understood. There are several indications that the interactions of baroreflex, chemoreflex and Bezold-Jarisch reflex inputs, and the central nervous system control the activity of autonomic preganglionic neurons through parallel afferent and efferent pathways to achieve cardiovascular homeostasis. It is surprising that so little appears in the literature about the integration of these neural reflexes in cardiovascular function. Thus, our purpose was to review the interplay between peripheral neural reflex mechanisms of arterial blood pressure and blood volume regulation in physiological and pathophysiological states. Special emphasis is placed on the experimental model of arterial hypertension induced by N-nitro-L-arginine methyl ester (L-NAME in which the interplay of these three reflexes is demonstrable

  11. Fatores Prognósticos para o Óbito Perinatal em Gestações com Diástole Zero ou Reversa na Dopplervelocimetria das Artérias Umbilicais Prognostic Parameters for Perinatal Death in Pregnancies with Absent or Reversed End-Diastolic Flow Velocity in the Umbilical Arteries

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto

    2000-01-01

    Full Text Available Objetivos: estudar os fatores prognósticos para o óbito perinatal em gestações com diagnóstico de diástole zero (DZ ou reversa (DR na dopplervelocimetria das artérias umbilicais. Métodos: foram analisadas retrospectivamente 204 gestantes com DZ ou DR, sendo realizados os exames de cardiotocografia, perfil biofísico fetal, índice do líquido amniótico e dopplervelocimetria do ducto venoso e das artérias umbilicais, uterinas, aorta e cerebral média. Em 170 casos foi aplicado o modelo de regressão logística para determinar a variável com melhor acurácia na predição do óbito perinatal. Resultados: a mortalidade foi de 28 casos de óbito fetal (13,7% e 45 de óbito pós-natal (22,1%. Houve correlação significativa entre os óbitos e as variáveis analisadas. A proporção de óbitos no grupo com recém-nascidos de peso inferior a 1.000 g foi de 74,7% e no grupo com idade gestacional inferior a 31 semanas, de 66,3%. Na regressão logística, o peso do recém-nascido foi a melhor variável capaz de predizer o óbito perinatal (pPurpose: to study the prognostic parameters for perinatal death in pregnancies with absent or reversed end-diastolic flow velocity on umbilical artery dopplervelocimetry. Methods: two hundred and four pregnancies were retrospectively reviewed. The methods used were cardiotocography, fetal biophysical profile, amniotic fluid index and dopplervelocimetry of ductus venosus, fetal aorta, middle cerebral artery, umbilical arteries and uterine artery. The logistic regression model was applied to one hundred and seventy cases in order to determine the most accurate variable for predicting perinatal death. Results: the mortality rates were: 28 cases of intrauterine fetal death (13.7% and 45 neonatal deaths (22.1%. A statistically significant correlation was found between death and the studied variables. The perinatal death rate in the group with birth weight below 1,000 g was 74.7%, and in the group with gestational age at delivery below 31 weeks it was 66.3%. By logistic regression, birth weight was the most accurate variable for predicting perinatal death, and a probability curve for death according to this variable was obtained. Conclusions: absent or reversed end-diastolic flow velocity in the umbilical arteries is a severe fetal condition, where the risk of perinatal death is mainly related to birth weight and a gestational age at delivery below 31 weeks.

  12. Pharmacodynamic and pharmacoeconomic aspects of application of antihypertensive preparations of various groups in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Kurkina T.V.

    2010-09-01

    Full Text Available At the background of the therapy for 3 months with Perindopril, Telmisartan and Bisoprolol, the patients with arterial hypertension were noted to decrease systolic and diastolic arterial pressure. The preparations under investigation had different effects on electrolyte metabolism. Therapy with Telmisartan turned out to have the least effect on electrolyte metabolism. Microalbuminuria is a risk factor in patients with arterial hypertension and may influence on the basic blood electrolyte balance. Bisoprolol should be recommended as the most preferable therapy for arterial hypertension from the pharmacoeconomic point of view. In order to control morning systolic arterial pressure the preference should be given to Perindopril, while for controlling evening systolic arterial pressure the preference should be given to Telmisartan

  13. Pressão diastólica final do ventrículo esquerdo e síndromes coronarianas agudas / Left ventricular end diastolic pressure and acute coronary syndromes / Presión diastólica final del ventrículo izquierdo y síndromes coronarios agudos

    Scientific Electronic Library Online (English)

    Rogério, Teixeira; Carolina, Lourenço; Rui, Baptista; Elisabete, Jorge; Paulo, Mendes; Fátima, Saraiva; Silvia, Monteiro; Francisco, Gonçalves; Pedro, Monteiro; Maria J., Ferreira; Mário, Freitas; Luís, Providência.

    2011-08-01

    Full Text Available FUNDAMENTO: Há falta de dados sobre o impacto prognóstico da pressão diastólica final do ventrículo esquerdo (PDFVE) sobre as síndromes coronarianas agudas (SCA). OBJETIVO: Avaliar a PDFVE e suas implicações prognósticas em pacientes com SCA. MÉTODOS: Estudo prospectivo, longitudinal e contínuo de 1 [...] .329 pacientes com SCA de um único centro, realizado entre 2004 e 2006. A função diastólica foi determinada através da PDFVE. A população foi dividida em dois grupos: Grupo A - PDFVE 26,5 mmHg (n = 226). RESULTADOS: Não houve diferenças significantes entre os grupos em relação aos fatores de risco para doença cardiovascular, histórico médico e terapia médica durante a admissão. Nos pacientes do grupo A, a SCA sem elevação do segmento ST foi mais frequente, bem como angiogramas coronários normais. A mortalidade hospitalar foi similar entre os grupos, mas a sobrevida de um ano foi maior entre os pacientes do grupo A (96,9 vs 91,2%, log rank p = 0,002). Em um modelo multivariado de regressão de Cox, uma PDFVE > 26,5 mmHg (RR 2,45, IC95% 1,05 - 5,74) permaneceu um preditor independente para mortalidade de um ano, quando ajustado para idade, fração de ejeção sistólica do VE, SCA com elevação do segmento ST, pico da troponina, glicemia na admissão hospitalar e diuréticos após 24 horas. Além disso, uma PDFVE > 26,5 mmHg foi um preditor independente de uma futura rehospitalização por IC congestiva (RR 6,65 IC95% 1,74 - 25,5). CONCLUSÃO: Em nossa população selecionada, a PDFVE apresentou uma influência prognóstica significante. Abstract in spanish FUNDAMENTO: Hay falta de datos sobre el impacto pronóstico de la presión diastólica final del ventrículo izquierdo (PDFVI) sobre los síndromes coronarios agudos (SCA). OBJETIVO: Evaluar la PDFVI y sus implicaciones pronósticas en pacientes con SCA. MÉTODOS: Estudio prospectivo, longitudinal y contin [...] uo de 1.329 pacientes con SCA de un único centro, realizado entre 2004 y 2006. La función diastólica fue determinada a través de la PDFVI. La población fue dividida en dos grupos: Grupo A - PDFVI 26,5 mmHg (n = 226). RESULTADOS: No hubo diferencias significativas entre los grupos en relación a los factores de riesgo para enfermedad cardiovascular, historia médica y terapia médica durante la admisión. En los pacientes del grupo A, la SCA sin elevación del segmento ST fue más frecuente, así como angiogramas coronarios normales. La mortalidad hospitalaria fue similar entre los grupos, pero la sobrevida de un año fue mayor entre los pacientes del grupo A (96,9 vs 91,2%, log rank p = 0,002). En un modelo multivariado de regresión de Cox, una PDFVI > 26,5 mmHg (RR 2,45, IC95% 1,05 -5,74) permaneció un predictor independiente para mortalidad de un año, cuando fue ajustado para edad, fracción de eyección sistólica del VI, SCA con elevación del segmento ST, pico de la troponina, glicemia en la admisión hospitalaria y diuréticos después de 24 horas. Además de eso, una PDFVI > 26,5 mmHg fue un predictor independiente de una futura rehospitalización por IC congestiva (RR 6,65 IC95% 1,74 - 25,5). CONCLUSIÓN: En nuestra población seleccionada, la PDFVI presentó una influencia pronóstica significativa. Abstract in english BACKGROUND: Data is lacking in the literature regarding the prognostic impact of left ventricular-end diastolic pressure (LVEDP) across acute coronary syndromes (ACS). OBJECTIVE: To assess LVEDP and its prognostic implications in ACS patients. METHODS: Prospective, longitudinal and continuous study [...] of 1329 ACS patients from a single center between 2004 and 2006. Diastolic function was determined by LVEDP. Population was divided in two groups: A - LVEDP 26.5 mmHg (n = 226). RESULTS: There were no significant differences between groups with respect to risk factors for cardiovascular disease, medical history and medical therapy during admission. In group A, patients with non-ST elevation ACS were more frequent, as well as normal coronary angiograms. In-hospital mortality was

  14. A prospective study of glomerular filtration rate and arterial blood pressure in insulin-dependent diabetics with diabetic nephropathy

    DEFF Research Database (Denmark)

    Parving, H H; Smidt, U M; Friisberg, B; Bonnevie-Nielsen, V; Andersen, A R

    1981-01-01

    /min/month (range 0.1 to 1.5 ml/min/month). The decrease in GFR did not correlate wih sex, age at onset, duration of diabetes, arterial blood pressure, proteinuria, insulin requirement, postprandial blood glucose or the initial GFR in each individual was constant, but varied considerably between patients. Increase......Glomerular filtration rate (GFR, single bolus 51Cr-EDTA technique), serum creatinine, proteinuria and arterial blood pressure have been measured prospectively in 14 young onset insulin-dependent diabetics selected by of persistent proteinuria (greater than 0.5 g/day) secondary to diabetic...... in arterial blood pressure to a hypertensive level is an early feature of diabetic nephropathy in young insulin-dependent diabetics....

  15. Control neural de la circulación periférica y de la presión arterial / Neural control of the peripheral circulation and blood pressure

    Scientific Electronic Library Online (English)

    Bruno, Estañol; Manuel, Porras-Betancourt; Gustavo, Sánchez-Torres; Raúl, Martínez-Memije; Oscar, Infante; Horacio, Sentíes-Madrid.

    2009-12-01

    Full Text Available En el siglo XIX, Claude Bernard descubrió la acción del sistema nervioso sobre el control de la circulación periférica. A principios del siglo XX, Ewald Hering descubrió el barorreceptor arterial y estudió el control reflejo de la frecuencia cardiaca y de la tensión arterial. Cowley y Guyton demostr [...] aron que la denervación de los barorreceptores de la carótida y de la aorta produce cambios persistentes en la tensión arterial en el animal experimental. El sistema nervioso autónomo es el principal regulador neural de la circulación y de la tensión arterial a corto plazo y latido a latido y ejerce su función mediante diversos reflejos que regulan el tono vasomotor, la frecuencia cardiaca y el gasto cardiaco. Con los nuevos métodos no invasivos que miden la tensión arterial latido a latido como el Finapres y con los métodos de medición de la variabilidad espectral de la frecuencia cardiaca y la tensión arterial, es posible en la actualidad medir muchas de las variables que regulan la circulación periférica y la tensión arterial. En este trabajo se presenta una revisión del control neural de la tensión arterial y de la frecuencia cardiaca, una breve reseña histórica y datos obtenidos con la medición de la tensión arterial latido a latido de manera no invasiva utilizando el sistema conocido como Finapres. Abstract in english In the XIX century Claude Bernard discovered the action of the nervous system on the peripheral circulation. In the first half of the XX century Ewald Hering discovered the baro-receptor and the reflex control of the heart rate and blood pressure. Cowley and Guyton demonstrated that that sino-aortic [...] denervation induces persistent changes in the blood pressure in the dog. The autonomic nervous system is mainly responsible for the regulation of the circulation and blood pressure in the short term on a beat to beat basis. It controls the vasomotor tone, the heart rate and the cardiac output. With the advent of non invasive methods that measure the blood pressure on a beat to beat basis (Finapres) and with the methods of measurement of the variability of the blood pressure in the frequency domain (spectral analysis) we can currently measure many variables including heart rate, blood pressure, stroke volume, peripheral resistances and the baroreceptor sensitivity and make some inferences about their control mechanisms. These variables can be measured at rest in the supine position, standing up, during rhythmic breathing and during the Valsalva maneuver. In this article we present a review of the neural control of the blood pressure and heart rate.

  16. Relação da temperatura da solução de diálise e a hipotensão arterial sintomática observada durante sessões de hemodiálise em pacientes com insuficiência renal crônica Relación de la temperatura de la solution de diálisis y la hipotensión arterial sintomática observada durante sesiones de hemodialisis en pacientes con insuficiencia renal crónica Relationship between dialysis solution temperature and symptomatic low blood pressure during hemodialysis for end stage renal disease patients

    Directory of Open Access Journals (Sweden)

    Clélia Beltrame Soares

    2001-12-01

    Full Text Available Realizado estudo prospectivo em um grupo de 21 pacientes portadores de insuficiência renal crônica que apresentavam hipotensão arterial no decorrer da hemodiálise. Avaliada a pressão arterial durante duas sessões com dialisato a 35(9C e duas a 37°C, observou-se que as pressões sistólica e diastólica, nas temperaturas estudadas, mostraram diferenças estatisticamente significativas quando comparadas aos valores iniciais pré-diálise, queda progressiva das pressões com prevalência de episódios hipotensivos na 3(5 e 4(5 horas de tratamento em ambas temperaturas, diminuição de 7,69% das hipotensões com dialisato a 35ºC e importante queixa de sensação de frio, tornando o tratamento desconfortável.Realizado estudio prospectivo en un grupo de 21 pacientes portadores de insuficiencia renal crónica que presentaban hipotensión arterial en el decorrer de la hemodiálisis. Evaluada la presión arterial durante dos sesiones con dialisato a 35° C y dos a 37° C se observó que las presiones sistolica y diastólica, en las temperaturas estudiadas, mostraron diferencias estadisticamente significativas cuando comparadas a los valores iniciales predialisis, caída progresiva de las presiones con prevalencia de episodios hipotensivos en la 3(9 y 4(5 horas de tratamiento en ambas temperaturas. Disminuición de 7,69% de las hipotensiones con dialisato a 35°C e importante queja de sensación de frio, tornando el tratamiento desconfortable.This prospective study was designed to evaluate hypotension in a group of 21 end stage renal disease patients (ESRD on hemodialysis, with syntomatic low blood pressure. The arterial blood pressure was recorded at 4 consecutive dialysis sessions, two at 35°C and two at 37°C dialysate temperature. In both situations, systolic and diastolic pressures, measured during dialysis, were different from the pre-dialysis value, with progressive lowering up to the end of the procedure. Cold dialysis did not protect from lowering the blood pressure in an amount similar to that occuring at 37°C.

  17. [Case of renal artery stenosis in an elderly patient after nephrectomy diagnosed by ultrasound sonography, showing improvement of blood pressure and renal dysfunction after renal artery stenting].

    Science.gov (United States)

    Nagai, Kojiro; Kusunose, Kenya; Nishio, Susumu; Taketani, Yoshio; Yamada, Hirotsugu; Sata, Masataka; Kondo, Naoki; Kishi, Fumi; Kishi, Seiji; Araoka, Toshikazu; Matsuura, Motokazu; Mima, Akira; Abe, Hideharu; Murakami, Taichi; Nakamura, Masayuki; Doi, Toshio

    2011-01-01

    Arteriosclerotic renal artery stenosis is one of the increasingly common diseases that affects many aged patients. There are various non-invasive methods to diagnose renal artery stenosis, such as contrast enhanced CT or MRI. However, these methods are not appropriate for patients with renal dysfunction. Ultrasound sonography is becoming one of the promising methods to diagnose artery stenosis because of photographic improvements. In this case, a 72-year-old woman was hospitalized 7 months after nephrectomy because of severe hypertension, heart failure and kidney dysfunction. The heart failure was quite uncontrollable in spite of massive administration of diuretics, and finally, hemodialysis was started to control her volume status. In consideration of her past history and abdominal bruit, we evaluated the renal artery stenosis by ultrasound sonography and confirmed the diagnosis by renal angiography. To improve hypertension control, we performed renal artery stenting, which resulted in an impressive improvement of her blood pressure and renal function. We recognized the importance of careful causal evaluation of renal dysfunction, even though it is difficult to apply invasive therapy to patients after nephrectomy. PMID:21370580

  18. Sustained Improvement of Arterial Stiffness and Blood Pressure after Long-Term Rosuvastatin Treatment in Patients with Inflammatory Joint Diseases: Results from the RORA-AS Study

    Science.gov (United States)

    Ikdahl, Eirik; Rollefstad, Silvia; Hisdal, Jonny; Olsen, Inge C.; Pedersen, Terje R.; Kvien, Tore K.; Semb, Anne Grete

    2016-01-01

    Objective Patients with inflammatory joint diseases (IJD) have a high prevalence of hypertension and increased arterial stiffness. The aim of the present study was to evaluate the effect of long-term rosuvastatin treatment on arterial stiffness, measured by augmentation index (AIx) and aortic pulse wave velocity (aPWV), and blood pressure (BP) in IJD patients with established atherosclerosis. Methods Eighty-nine statin naïve IJD patients with carotid atherosclerotic plaque(s) (rheumatoid arthritis n = 55, ankylosing spondylitis n = 23, psoriatic arthritis n = 11) received rosuvastatin for 18 months to achieve low-density lipoprotein cholesterol goal ≤1.8 mmol/L. Change in AIx (ΔAIx), aPWV (ΔaPWV), systolic BP (ΔsBP) and diastolic BP (ΔdBP) from baseline to study end was assessed by paired samples t-tests. Linear regression was applied to evaluate associations between cardiovascular disease (CVD) risk factors, rheumatic disease specific variables and medication, and ΔAIx, ΔaPWV, ΔsBP and ΔdBP. Results AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end. The mean (95%CI) changes were: ΔAIx: -0.34 (-0.03, -0.65)% (p = 0.03), ΔaPWV: -1.69 (-0.21, -3.17)m/s2 (p = 0.03), ΔsBP: -5.27 (-1.61, -8.93)mmHg (p = 0.004) and ΔdBP -2.93 (-0.86, -5.00)mmHg (p = 0.01). In linear regression models, ∆aPWV was significantly correlated with ΔsBP and ΔdBP (for all: p<0.001). Conclusions There is an unmet need of studies evaluating CVD prevention in IJD patients. We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD. These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins. Trial Registration ClinicalTrials.gov NCT01389388 PMID:27093159

  19. The vascular Ca2+-sensing receptor regulates blood vessel tone and blood pressure

    DEFF Research Database (Denmark)

    Schepelmann, Martin; Yarova, Polina L; Lopez-Fernandez, Irene; Davies, Thomas S; Brennan, Sarah C; Edwards, Peter J; Aggarwal, Abhishek; Graca, Joao; Rietdorf, Katja; Matchkov, Vladimir V; Fenton, Robert A; Chang, Wenhan; Krssak, Martin; Stewart, Andrew; Broadley, Kenneth J; Ward, Donald T; Price, Sally A; Edwards, D H; Kemp, Paul J; Riccardi, Daniela

    2015-01-01

    aortae. Accordingly, diastolic and mean arterial blood pressures of KO animals were significantly reduced compared to WT, as measured by both tail cuff and radiotelemetry. This hypotension was mostly pronounced during the animals' active phase and was not rescued by either NO-synthase inhibition with L...

  20. Serum Endoglin Levels in Patients Suffering from Systemic Sclerosis and Elevated Systolic Pulmonary Arterial Pressure

    Directory of Open Access Journals (Sweden)

    Paola Ximena Coral-Alvarado

    2010-01-01

    Full Text Available Background. Pulmonary arterial hypertension (PAH is the main cause of morbimortality in systemic sclerosis (SSc. Increased Eng expression has been demonstrated in SSc patients. Objective. Ascertaining serum levels of Eng in SSc patients with and without elevated systolic pulmonary arterial pressure (sPAP and comparing them with that of healthy volunteers. Methods. A cross-sectional study was carried out. A commercial ELISA kit was used for measuring serum concentrations of Eng in 60 subjects: 40 patients with SSc with and without elevated sPAP, compared to 20 healthy control subjects. Elevated sPAP was detected by echocardiogram. Results. No association between positive Eng and elevated sPAP was found when compared to the SSc without elevated sPAP group (OR=2.85; 0.65–12.88 95% CI; P=.11; however, an association was found between positive Eng and elevated sPAP compared to healthy controls (OR=23.22; 2.46–1050.33 95% CI; P=.001, and weak association was found between the positive Eng with SSc without elevated sPAP group compared to healthy controls (OR=8.14, 0.8–393.74 95% CI; P=.046. Conclusion. Raised serum levels of Eng in SSc patients compared to healthy controls were found, suggesting a role for Eng in SSc vasculopathy and not just in elevated sPAP. However, prospective studies are needed to verify such observations.

  1. Effects of Blood Pressure and Sex on the Change of Wave Reflection: Evidence from Gaussian Fitting Method for Radial Artery Pressure Waveform

    OpenAIRE

    Liu, Chengyu; Zhao, Lina; Liu, Changchun

    2014-01-01

    An early return of the reflected component in the arterial pulse has been recognized as an important indicator of cardiovascular risk. This study aimed to determine the effects of blood pressure and sex factor on the change of wave reflection using Gaussian fitting method. One hundred and ninety subjects were enrolled. They were classified into four blood pressure categories based on the systolic blood pressures (i.e., ≤110, 111–120, 121–130 and ≥131 mmHg). Each blood pressure category was al...

  2. Clinical significance of inter-arm pressure difference and ankle-brachial pressure index in patients with suspected coronary artery disease

    International Nuclear Information System (INIS)

    Although measuring blood pressure at the bilateral brachia is common in medical practice, its clinical significance in patients with suspected coronary artery disease (CAD) has not been fully clarified. The method of this study was to define the significance of inter-arm systolic blood pressure difference in patients with suspected CAD, and to assess the relationship between inter-arm pressure difference and CAD, simultaneous brachial and ankle blood pressure measurements and stress myocardial single-photon emission computed tomography (SPECT) were performed in 386 consecutive patients with suspected CAD, excluding those with previous myocardial infarction or coronary revascularization. Subclavian artery stenosis, defined as ≥15 mmHg inter-arm systolic blood pressure difference, was found in 27 patients (7%). Age (65±12 vs 65±11 years), male sex (21/27 vs 244/359), prevalence of hypertension (63% vs 56%), hypercholesterolemia (63% vs 62%), diabetes mellitus (33% vs 38%), cigarette smoking (44% vs 41%) and family history of CAD (15% vs 12%) were similar between patients with subclavian artery stenosis and those without. The incidence of decreased ankle-brachial pressure index (ABI) was higher (37% vs 12%, p=0.001), and percentage ischemic myocardium as assessed by SPECT was greater (9.0±8.5% vs 5.6±6.6%, p=0.05) in patients with subclavian artery stenosis than in those without. Furthermore, significant correlations were observed between inter-arm pressure difference and percentage ischemic myocardium (r=0.13; p=0.01), and ABI (r=-0.26, p<0.0001). Among 386 patients, 283 underwent coronary angiography, and 63% of those who had inter-arm blood pressure difference had CAD. Furthermore, 83% of those CAD patients had multi-vessel CAD, which is regarded as a high-risk subset for subsequent cardiac events. Inter-arm pressure difference is often found in patients with suspected CAD, and is associated with significant CAD and peripheral artery disease. Thus, inter-arm pressure difference may be regarded as a simple marker for coronary and peripheral artery diseases. (author)

  3. On the Effect of Apex Geometry on Wall Shear Stress and Pressure in a 2-D Arterial Bifurcation

    Science.gov (United States)

    Robertson, Anne; Haljasmaa, Igor; Galdi, Giovanni

    2000-11-01

    There is strong evidence to support the hypothesis that vascular geometry plays an important role in the initiation and development of cerebral aneurysms as well as other vascular diseases through its influence on hemodynamics. Cerebral aneurysms are nearly always found at arterial bifurcations in and near the Circle of Willis. It is commonly believed that the cause of initiation and development of cerebral aneurysms is at least indirectly related to the effect of hemodynamic wall pressure and shear stress on the arterial tissue at arterial bifurcations. In this work, we use analytical and numerical approaches to investigate the hypothesis that local geometric factors can have a significant impact on the magnitude and spatial gradients of wall pressure and shear stress at the apex of arterial bifurcations. We find that sharp corners such as those at arterial bifurcations and the juncture between grafted vessels can be a source of localized high wall pressure and shear stress. In fact, it can be shown analytically that perfectly sharp corners (zero radius of curvature) will lead to unbounded magnitudes of shear stress and pressure . As the radius of curvature is increased (the corner is rounded), the maximum in magnitude in wall shear stress shifts away from the apex to the lateral sides of the bifurcation. Significantly, the unbounded pressure and shear stress at perfectly sharp corners are unrelated to the fluid inertia. As shown here, the large values of pressure and shear stress which have previously been reported in studies in sharp corner models (zero radius of curvature) are grid dependent approximations for unbounded pressure and shear stress.

  4. A simple model of cerebral blood flow dependence on arterial blood pressure

    CERN Document Server

    Gersten, Alexander

    2011-01-01

    It is shown that the dependence of the cerebral blood flow (CBF) on mean arterial blood pressure (MABP) can be described with a simple model having the following assumptions. Below certain MABP (denoted as MABP1) there are no autoregulatory or feedback mechanisms influencing CBF. Between MABP1 and MABP2 (MABP at which breakthrough accurs) there is a linear (on MABP) dependent feedback with a sloap depending very much on the individual considered. The classical autoregulation model with a plateau in between MABP1 and MABP2 is a particular case of this model. The model describes well the experiments performed on dogs (Harper 1966), for which the individual feedback sloap parameter varied to great extent, indicating the importance of mesurments on individuals against averaged mesurments (or measurments on diffent individuals) which superficially support the classical autoregulation. New effect of decreased CBF, while increasing MABP, was observed.

  5. Arterial pressure and cerebral blood flow variability: friend or foe? A review

    Directory of Open Access Journals (Sweden)

    CarolineAliceRickards

    2014-04-01

    Full Text Available Variability in arterial pressure and cerebral blood flow has traditionally been interpreted as a marker of cardiovascular decompensation, and has been associated with negative clinical outcomes across varying time scales, from impending orthostatic syncope to an increased risk of stroke. Emerging evidence, however, suggests that increased hemodynamic variability may, in fact, be protective in the face of acute challenges to perfusion, including significant central hypovolemia and hypotension (including hemorrhage, and during cardiac bypass surgery. This review presents the dichotomous views on the role of hemodynamic variability on clinical outcome, including the physiological mechanisms underlying these patterns, and the potential impact of increased and decreased variability on cerebral perfusion and oxygenation. We suggest that reconciliation of these two apparently discrepant views may lie in the time scale of hemodynamic variability; short time scale variability appears to be cerebroprotective, while mid to longer term fluctuations are associated with primary and secondary end-organ dysfunction.

  6. 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)

    Cláudio Corrêa Natalini

    2000-06-01

    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.

  7. Effect of continuous positive airway pressure on blood pressure in hypertensive patients with coronary artery bypass grafting and obstructive sleep apnea

    OpenAIRE

    Dong, Yumei; Dai, Yingnan; Wei, Guoqian; Cha, Li; Li, Xueqi

    2014-01-01

    Background: Previous studies have documented that obstructive sleep apnea (OSA) increases the incidence of hypertension, respiratory failure and unexpected post-operative deaths during night in coronary artery bypass grafting (CABG) patients. We hypothesized that continuous positive airway pressure (CPAP) reduces blood pressure in these patients. Methods: We conducted a prospective, controlled study in 51 patients. The subjects received CPAP treatment were defined as CPAP group, whereas those...

  8. Continuous estimates of dynamic cerebral autoregulation: influence of non-invasive arterial blood pressure measurements

    International Nuclear Information System (INIS)

    Temporal variability of parameters which describe dynamic cerebral autoregulation (CA), usually quantified by the short-term relationship between arterial blood pressure (BP) and cerebral blood flow velocity (CBFV), could result from continuous adjustments in physiological regulatory mechanisms or could be the result of artefacts in methods of measurement, such as the use of non-invasive measurements of BP in the finger. In 27 subjects (61 ± 11 years old) undergoing coronary artery angioplasty, BP was continuously recorded at rest with the Finapres device and in the ascending aorta (Millar catheter, BPAO), together with bilateral transcranial Doppler ultrasound in the middle cerebral artery, surface ECG and transcutaneous CO2. Dynamic CA was expressed by the autoregulation index (ARI), ranging from 0 (absence of CA) to 9 (best CA). Time-varying, continuous estimates of ARI (ARI(t)) were obtained with an autoregressive moving-average (ARMA) model applied to a 60 s sliding data window. No significant differences were observed in the accuracy and precision of ARI(t) between estimates derived from the Finapres and BPAO. Highly significant correlations were obtained between ARI(t) estimates from the right and left middle cerebral artery (MCA) (Finapres r = 0.60 ± 0.20; BPAO r = 0.56 ± 0.22) and also between the ARI(t) estimates from the Finapres and BPAO (right MCA r = 0.70 ± 0.22; left MCA r = 0.74 ± 0.22). Surrogate data showed that ARI(t) was highly sensitive to the presence of noise in the CBFV signal, with both the bias and dispersion of estimates increasing for lower values of ARI(t). This effect could explain the sudden drops of ARI(t) to zero as reported previously. Simulated sudden changes in ARI(t) can be detected by the Finapres, but the bias and variability of estimates also increase for lower values of ARI. In summary, the Finapres does not distort time-varying estimates of dynamic CA obtained with a sliding window combined with an ARMA model, but further research is needed to confirm these findings in healthy subjects and to assess the influence of different physiological manoeuvres

  9. Incidence of chronic heart failure with preserved left ventricular ejection fraction in patients with hypertension and isolated mild diastolic dysfunction.

    Science.gov (United States)

    Brzy?kiewicz, Halina; Konduracka, Ewa; Gajos, Grzegorz; Janion, Marianna

    2016-02-01

    INTRODUCTION    Heart failure (HF) with preserved ejection fraction (HFPEF) is still a challenge in clinical practice. The prognosis of patients with HFPEF is similar to or only slightly better than that of patients with HF with reduced ejection fraction (HFREF). Impaired relaxation is the mildest form of diastolic dysfunction, which should not be accompanied by symptoms of HFPEF. OBJECTIVES    The aim of the study was to assess the incidence of chronic HFPEF in patients with hypertension and isolated mild diastolic dysfunction. PATIENTS AND METHODS    It was a cross-sectional study including 210 patients (mean age, 56.11 ±6.24 years; women, 58%) with isolated abnormalities of left ventricular relaxation and arterial hypertension. In addition, we identified patients with type 2 diabetes to compare the incidence of HFPEF between patients with and without diabetes. HFPEF was diagnosed when clinical symptoms of HF were present simultaneously with echocardiographic markers of elevated left ventricular diastolic pressure, pulmonary congestion on chest X-ray, or elevated serum brain natriuretic peptide (BNP) levels. RESULTS    HFPEF was diagnosed in 42% of the patients with impaired relaxation. An elevated left atrial volume index (>34 ml/m²) was observed in 38% of the patients; E/e' ratio exceeding 8, in 37%; elevated BNP levels, in 39%; and pulmonary congestion on chest X-ray, in 41%. Independent predictors of HFPEF were age, systolic blood pressure of 140 mmHg or higher, type 2 diabetes, coronary artery disease, and an estimated glomerular filtration rate of less than 60 ml/min/1.73 m². In diabetic patients, a positive correlation was found between an insulin dose (>80 units/day) and BNP levels. CONCLUSIONS    Patients with isolated relaxation abnormalities constitute a clinically heterogeneous group because some of these individuals present with symptoms of HFPEF and a simultaneous increase in BNP levels. Therefore, the question of whether diastolic dysfunction is mild should be readdressed, and it should be emphasized that these patients have a serious prognosis with the risk of HF. In diabetic patients, a positive correlation between high insulin doses and BNP levels requires further research. PMID:26810565

  10. Neural set point for the control of arterial pressure: role of the nucleus tractus solitarius

    Directory of Open Access Journals (Sweden)

    Valentinuzzi Max E

    2010-01-01

    Full Text Available Abstract Background Physiological experiments have shown that the mean arterial blood pressure (MAP can not be regulated after chemo and cardiopulmonary receptor denervation. Neuro-physiological information suggests that the nucleus tractus solitarius (NTS is the only structure that receives information from its rostral neural nuclei and from the cardiovascular receptors and projects to nuclei that regulate the circulatory variables. Methods From a control theory perspective, to answer if the cardiovascular regulation has a set point, we should find out whether in the cardiovascular control there is something equivalent to a comparator evaluating the error signal (between the rostral projections to the NTS and the feedback inputs. The NTS would function as a comparator if: a its lesion suppresses cardiovascular regulation; b the negative feedback loop still responds normally to perturbations (such as mechanical or electrical after cutting the rostral afferent fibers to the NTS; c perturbation of rostral neural structures (RNS to the NTS modifies the set point without changing the dynamics of the elicited response; and d cardiovascular responses to perturbations on neural structures within the negative feedback loop compensate for much faster than perturbations on the NTS rostral structures. Results From the control theory framework, experimental evidence found currently in the literature plus experimental results from our group was put together showing that the above-mentioned conditions (to show that the NTS functions as a comparator are satisfied. Conclusions Physiological experiments suggest that long-term blood pressure is regulated by the nervous system. The NTS functions as a comparator (evaluating the error signal between its RNS and the cardiovascular receptor afferents and projects to nuclei that regulate the circulatory variables. The mean arterial pressure (MAP is regulated by the feedback of chemo and cardiopulmonary receptors and the baroreflex would stabilize the short term pressure value to the prevailing carotid MAP. The discharge rates of rostral neural projections to the NTS would function as the set point of the closed and open loops of cardiovascular control. No doubt, then, the RNS play a functional role not only under steady-state conditions, but also in different behaviors and pathologies.

  11. Avaliação de fatores de risco associados com elevação da pressão arterial em crianças Evaluation of risk factors associated with increased blood pressure in children

    Directory of Open Access Journals (Sweden)

    Frederico D Garcia

    2006-10-01

    Full Text Available Objetivos: Identificar fatores associados a níveis elevados de pressão arterial em crianças. Métodos: Estudo transversal da pressão arterial de 672 crianças entre 2 e 11 anos de idade em duas instituições de ensino de Belo Horizonte, entre setembro e dezembro de 2001. A pressão arterial foi mensurada seguindo os parámetros estabelecidos pelo relatório do Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents. As seguintes variáveis foram estudadas: idade, sexo, cor da pele, índice de qualidade de vida urbana, estatura e índice de massa corporal. Para a comparação das médias, foi utilizada a análise de variãncia, e para a comparação de proporções, o teste quiquadrado. As variãveis associadas a níveis mais elevados de pressão arterial foram incluídas em análise de regressão linear múltipla. Resultados: Na análise univariada, níveis mais elevados de pressão arterial sistólica e diastólica estiveram associados com crianças de cor branca, crianças da região com alto índice de qualidade de vida urbana e com elevado índice de massa corporal. Na análise multivariada, apenas o índice de massa corporal, o índice de qualidade de vida urbana e a estatura mantiveram-se associados com níveis elevados de pressão sistólica. Em relação aos níveis mais elevados de pressão arterial diastólica, apenas as variáveis índice de qualidade de vida urbana e idade foram mantidas no modelo após o ajustamento. Conclusão: O sobrepeso e a obesidade estiveram associados com níveis mais elevados de pressão arterial sistólica. Outros fatores, não identificados, foram parcialmente associados a níveis mais elevados de pressão arterial de crianças do estabelecimento privado do ensinoTo identify factors associated with increased arterial blood pressure in children. Methods: In this cross-sectional study, arterial blood pressure was measured in 672 children between 2 and 11 years of age from two schools in the city of Belo Horizonte, Brazil. After providing informed consent, all children had their blood pressure and anthropometric parameters measured. Blood pressure was measured based on the recommendations of the Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents. The following variables were assessed: age, sex, race, urban life quality index, weight, height, and body mass index. Analysis of variance was used for comparison of means and the chi-square was used for comparison of proportions. Variables associated with increased blood pressure were included in a multiple regression model. Results: According to univariate analysis, increased systolic and diastolic blood pressure were associated with high urban life quality index, white race and high body mass index. On multivariate analysis, body mass index, urban life quality index and height remained associated with increased systolic blood pressure; urban life quality index and age were associated with increased diastolic blood pressure. Conclusion: In this study, excess weight and obesity were associated with increased systolic blood pressure. Other unidentified factors were partially associated with increased blood pressure in children from the school with elevated urban life quality index

  12. Effect of magnesium on blood pressure.

    OpenAIRE

    Dyckner, Thomas; Wester, P O

    1983-01-01

    Twenty patients receiving long term diuretic treatment for arterial hypertension (18 patients) or congestive heart failure (two patients) received magnesium supplementation as aspartate hydrochloride 15 mmol/day for six months. Both systolic and diastolic pressures decreased significantly, by a mean of 12/8 mm Hg. No significant changes were recorded in plasma or urinary electrolytes except for magnesium, 24 hour urinary volumes, or body weight after treatment. The effect of magnesium on bloo...

  13. [Synchonization of the blood flow rate in arterial with the changing rate of space of blood pressure with time].

    Science.gov (United States)

    Zhang, Shenghua; Qin, Renjia

    2012-10-01

    In physiology-related books, there are many relationship curves about blood flow rate in arteries and blood pressure changes with time, but there are not much explanation about such relationship. This is the very the question that the present article tries to answer. We clarified the relations between blood flow rate and blood pressure gradient using the experimental curves as the basis, using Poiseuille Law and relative knowledge of phisics and mathematics, and using analysis and reasoning. Based on the study, it can be concluded that in every course of cardiac cycle, the blood flow rate of any section in artery blood vessel is roughly synchronized with changing rate of space and time of the blood pressure, but blood flow rate is not synchronized with blood pressure. PMID:23198422

  14. A pharmacologic activator of endothelial KCa channels increases systemic conductance and reduces arterial pressure in an anesthetized pig model.

    Science.gov (United States)

    Mishra, Ramesh C; Mitchell, Jamie R; Gibbons-Kroeker, Carol; Wulff, Heike; Belenkie, Israel; Tyberg, John V; Braun, Andrew P

    2016-04-01

    SKA-31, an activator of endothelial KCa2.3 and KCa3.1 channels, reduces systemic blood pressure in mice and dogs, however, its effects in larger mammals are not well known. We therefore examined the hemodynamic effects of SKA-31, along with sodium nitroprusside (SNP), in anesthetized, juvenile male domestic pigs. Experimentally, continuous measurements of left ventricular (LV), aortic and inferior vena cava (IVC) pressures, along with flows in the ascending aorta, carotid artery, left anterior descending coronary artery and renal artery, were performed during acute administration of SKA-31 (0.1, 0.3, 1.0, 3.0 and 5.0mg/ml/kg) and a single dose of SNP (5.0?g/ml/kg). SKA-31 dose-dependently reduced mean aortic pressure (mPAO), with the highest dose decreasing mPAO to a similar extent as SNP (-23±3 and -28±4mmHg, respectively). IVC pressure did not change. Systemic conductance and conductance in coronary and carotid arteries increased in response to SKA-31 and SNP, but renal artery conductance was unaffected. There was no change in either LV stroke volume (SV) or heart rate (versus the preceding control) for any infusion. With no change in SV, drug-evoked decreases in LV stroke work (SW) were attributed to reductions in mPAO (SW vs. mPAO, r(2)=0.82, P<0.001). In summary, SKA-31 dose-dependently reduced mPAO by increasing systemic and arterial conductances. Primary reductions in mPAO by SKA-31 largely account for associated decreases in SW, implying that SKA-31 does not directly impair cardiac contractility. PMID:26239885

  15. Arterial to end-tidal carbon dioxide pressure gradient increases with age in the steep Trendelenburg position with pneumoperitoneum

    OpenAIRE

    Choi, Dae-Kee; Lee, In-Gyu; Hwang, Jai-Hyun

    2012-01-01

    Background Several factors affect the end-tidal carbon dioxide pressure (PETCO2) and increase the arterial to end-tidal carbon dioxide pressure gradient (Pa-ETCO2) during general anesthesia. We evaluated the relationship between age and Pa-ETCO2 during pneumoperitoneum in the steep Trendelenburg position in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). Methods Ninety-two consecutive patients undergoing RALP were divided by age into a middle-aged (45-65 years) and an el...

  16. Flavonoid metabolite 3-(3-hydroxyphenyl)propionic acid formed by human microflora decreases arterial blood pressure in rats.

    Science.gov (United States)

    Najmanová, Iveta; Pourová, Jana; Vopršalová, Marie; Pilařová, Veronika; Semecký, Vladimír; Nováková, Lucie; Mladěnka, Přemysl

    2016-05-01

    There are reports of positive effects of quercetin on cardiovascular pathologies, however, mainly due to its low biovailability, the mechanism remains elusive. Here, we report that one metabolite formed by human microflora (3-(3-hydroxyphenyl)propionic acid)relaxed isolated rat aorta and decreased arterial blood pressure in rats. PMID:26790841

  17. Chronic hypoxia increases arterial blood pressure and reduces adenosine and ATP induced vasodilatation in skeletal muscle in healthy humans

    DEFF Research Database (Denmark)

    Calbet, J A L; Boushel, Robert Christopher; Robach, P; Hellsten, Ylva; Saltin, Bengt; Lundby, Carsten

    2014-01-01

    protein expression was determined in muscle biopsies after 4 weeks at 3454 m by Western blot. RESULTS: At altitude, mean arterial blood pressure was 13% higher (91 ± 2 vs. 102 ± 3 mmHg, P < 0.05) than at sea level and was unaltered by hyperoxic breathing. Baseline leg vascular conductance was 25% lower at...

  18. Pressão arterial entre trabalhadores de curtume Blood pressure among tannery workers

    Directory of Open Access Journals (Sweden)

    Ricardo Cordeiro

    1998-10-01

    Full Text Available INTRODUÇÃO: O grupo das doenças cardiovasculares tem sido apontado como a principal causa de óbito no Brasil desde os anos 70, sendo a hipertensão arterial sistêmica (HAS o fator de risco mais importante para esse grupo. Entre os trabalhadores observa-se correlação negativa entre o status ocupacional e a pressão arterial. Tais fatos ressaltam a importância do conhecimento da distribuição da pressão arterial sistêmica entre os distintos grupos profissionais. Assim, foi realizado estudo para descrever o status pressórico de uma população homogênea e estável de trabalhadores do setor secundário da economia, pouco especializados e que ganham baixos salários, estabelecendo a prevalência da HAS nesse grupo específico, relacionando-a com algumas covariáveis biológicas e socioeconômicas, e comparando-a com a prevalência de HAS em outros grupos profissionais no Brasil. MÉTODO: Foram estudados 73 trabalhadores regularmente empregados em julho de 1993 em um curtume situado no Município de Botucatu, cidade de médio porte da região Centro-Oeste do Estado de São Paulo, os quais foram submetidos a exame antropométrico, aferição de pressão arterial, anamnese e exame clínico. Os resultados foram comparados com os obtidos em estudos semelhantes, controlando-se o confundimento da idade por intermédio de diferentes técnicas. RESULTADOS: A prevalência bruta da HAS encontrada foi de 56,1%, sendo 15,8% a prevalência de hipertensão sistólica isolada. Ambas se associaram ao etilismo e ao tabagismo na população estudada. DISCUSSÃO: A prevalência da hipertensão foi consideravelmente alta e significativamente maior do que a encontrada em outros grupos de trabalhadores estudados no Brasil. Tal achado ressalta a necessidade da continuidade da investigação, objetivando o isolamento dos fatores implicados na elevação pressórica do grupo estudado.INTRODUCTION: Cardiovascular diseases have been shown to be the leading cause of death in Brazil since the 1970s. High blood pressure has been the major risk factor among the above mentioned diseases. A negative correlation between occupational qualification and blood pressure has been observed among workers. The above mentioned facts bring out the importance of the knowledge of high blood pressure distribution among the different occupational groups. The aim of the present study was to describe the distribution of blood pressure in stable and homogeneous population of unskilled, low wage larning industrial workers. The Prevalence of high blood pressure was established for this specific group. This prevalence was also related to some biological and socio-economical covariates as compared with that among other occupational groups in Brazil. METHOD: The subjects were 73 active employees at a tannery in Botucatu, state of S.Paulo, Brazil, in July 1993. These subjects underwent blood pressure measurements, anamnesis and clinical examination. The results were compared with those of similar studies carried out in elsewhere Brazil. Age confounding was controlled by different techniques. RESULT: The crude prevalence of high blood pressure detected in this group of workers was of 56.1%, with 15.8% of isolated systolic hypertension. Alcohol abuse and smoking were associated with high blood pressure and isolated systolic hypertension in the population studied. DISCUSSION: Prevalence of hypertension in the group studied is significantly higher than that observed in other groups of workers studied in Brazil. Such a finding points to the need for further investigation so as to isolate those factors involved in the increased blood pressure found in this group.

  19. Blood pressure and heart rate variability and baroreflex sensitivity before and after brain death

    OpenAIRE

    Conci, F.; Di, R; Castiglioni, P

    2001-01-01

    OBJECTIVES—To evaluate spontaneous blood pressure and heart rate variability and spontaneous baroreflex sensitivity before and after brain death.
METHODS—Spontaneous variability of arterial blood pressure and heart rate—estimated by power spectra of systolic (SBP) and diastolic blood pressure (DBP) and pulse interval (PI)—and spontaneous baroreflex sensitivity (BRS)—estimated by the alpha index and the sequence technique—were evaluated in 11 patients twice: shortly before...

  20. Loci influencing blood pressure identified using a cardiovascular gene-centric array

    OpenAIRE

    Ganesh, S.K.; Tragante, V.; Guo, W.; Guo, Y.; Lanktree, M. B.; Smith, E N; Johnson, T; Castillo, B. A.; J Barnard; J. Baumert; Chang, Y.-P. C.; C.C. Elbers; Farrall, M; Fischer, M.E.; Franceschini, N.

    2013-01-01

    Blood pressure (BP) is a heritable determinant of risk for cardiovascular disease (CVD). To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP), we genotyped ∼50 000 single-nucleotide polymorphisms (SNPs) that capture variation in ∼2100 candidate genes for cardiovascular phenotypes in 61 619 individuals of European ancestry from cohort studies in the USA and Europe. We identified novel associations between rs347591 ...

  1. Loci influencing blood pressure identified using a cardiovascular gene-centric array

    OpenAIRE

    Ganesh, Santhi K.; Tragante, Vinicius; Guo, Wei; Guo, Yiran; Lanktree, Matthew B; Smith, Erin N.; Johnson, Toby; Castillo, Berta Almoguera; Barnard, John; Baumert, Jens; Chang, Yen-Pei Christy; Elbers, Clara C.; Farrall, Martin; Fischer, Mary E; Franceschini, Nora

    2013-01-01

    Blood pressure (BP) is a heritable determinant of risk for cardiovascular disease (CVD). To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP), we genotyped 50 000 single-nucleotide polymorphisms (SNPs) that capture variation in 2100 candidate genes for cardiovascular phenotypes in 61 619 individuals of European ancestry from cohort studies in the USA and Europe. We identified novel associations between rs347591 an...

  2. Investigating complex patterns of blocked intestinal artery blood pressure signals by empirical mode decomposition and linguistic analysis

    International Nuclear Information System (INIS)

    In this investigation, surgical operations of blocked intestinal artery have been conducted on pigs to simulate the condition of acute mesenteric arterial occlusion. The empirical mode decomposition method and the algorithm of linguistic analysis were applied to verify the blood pressure signals in simulated situation. We assumed that there was some information hidden in the high-frequency part of the blood pressure signal when an intestinal artery is blocked. The empirical mode decomposition method (EMD) has been applied to decompose the intrinsic mode functions (IMF) from a complex time series. But, the end effects and phenomenon of intermittence damage the consistence of each IMF. Thus, we proposed the complementary ensemble empirical mode decomposition method (CEEMD) to solve the problems of end effects and the phenomenon of intermittence. The main wave of blood pressure signals can be reconstructed by the main components, identified by Monte Carlo verification, and removed from the original signal to derive a riding wave. Furthermore, the concept of linguistic analysis was applied to design the blocking index to verify the pattern of riding wave of blood pressure using the measurements of dissimilarity. Blocking index works well to identify the situation in which the sampled time series of blood pressure signal was recorded. Here, these two totally different algorithms are successfully integrated and the existence of the existence of information hidden in high-frequency part of blood pressure signal has been proven

  3. Arterial Wall Properties and Womersley Flow in Fabry Disease

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    Dimitriadis Emilios

    2002-01-01

    Full Text Available Abstract Background Fabry disease is an X-linked recessive lysosomal storage disease resulting in the cellular accumulation of globotriaosylceramide particularly globotriaosylceramide. The disease is characterized by a dilated vasculopathy with arterial ectasia in muscular arteries and arterioles. Previous venous plethysomographic studies suggest enhanced endothelium-dependent vasodilation in Fabry disease indicating a functional abnormality of resistance vessels. Methods We examined the mechanical properties of the radial artery in Fabry disease, a typical fibro-muscular artery. Eight control subjects and seven patients with Fabry disease had a right brachial arterial line placed allowing real time recording of intra-arterial blood pressure. Real time B-mode ultrasound recordings of the right radial artery were obtained simultaneously allowing calculation of the vessel wall internal and external diameter, the incremental Young's modulus and arterial wall thickness. By simultaneously measurement of the distal index finger-pulse oximetry the pulse wave speed was calculated. From the wave speed and the internal radial artery diameter the volume flow was calculated by Womersley analysis following truncation of the late diastolic phase. Results No significant difference was found between Fabry patients and controls for internal or external arterial diameters, the incremental Young's modulus, the arterial wall thickness, the pulse wave speed and the basal radial artery blood flow. Further, no significant difference was found for the radial artery blood flow in response to intra-arterial acetylcholine or sodium nitroprusside. Both drugs however, elevated the mean arterial flow. Conclusions The current study suggests that no structural or mechanical abnormality exists in the vessel wall of fibro-muscular arteries in Fabry disease. This may indicate that a functional abnormality downstream to the conductance vessels is the dominant feature in development Fabry vasculopathy.

  4. Eprosartan-based hypertension therapy, systolic arterial blood pressure and cognitive function: analysis of Middle East data from the OSCAR study

    Directory of Open Access Journals (Sweden)

    Radaideh G

    2011-08-01

    Full Text Available Ghazi Ahmad Radaideh1, Patrick Choueiry2, Amr Ismail2, Elie Eid3, Jean-Pascal Berrou4, Armand Sedefdjian5, Frank Sévenier6, Atul Pathak71Rashid Hospital of Dubai, Dubai, United Arab Emirates; 2Abbott Gulf – Levant; 3Division of Cardiology, American University of Beirut, Beirut, Lebanon; 4Abbott Products Operations AG, Allschwill, Switzerland; 5EvidenceBased Communication (EBC, Rueil-Malmaison, France; 6Fovéa Group, Rueil-Malmaison, France; 7Departments of Clinical Pharmacology and Cardiology, Institut National de la Santé et de la Recherche Médicale U1048, Université de Toulouse-UPS, Centre Hospitalier Universitaire de Toulouse, Toulouse, FranceBackground: Studies have indicated a relationship between hypertension and cognitive function. The possible effect of antihypertensive therapy on cognitive disorders is therefore a matter of interest.Materials and methods: The Observational Study on Cognitive function And SBP Reduction (OSCAR was an open-label, multinational trial designed to evaluate the impact of eprosartan-based antihypertensive therapy on cognitive function in patients with essential hypertension. Eprosartan 600 mg/day for 6 months (with provision for additional medication as needed was initiated in hypertensive subjects aged ≥50 years. A total of 853 patients in an intention-to-treat cohort from seven countries of the Middle East was identified for subgroup analysis.Results: Arterial blood pressure was reduced significantly (P < 0.001 during the study: At the end of 6 months of eprosartan-based therapy, the mean (±SD reduction from baseline was 32.1 ± 14.3/14.6.3 ± 8.6 mmHg (P < 0.001. Mean pulse pressure was reduced by 18.3 ± 13.1 mmHg (P < 0.0001 vs baseline. Blood pressure was normalized (systolic <140 mmHg and diastolic <90 mmHg in 68.2% of patients. The overall mean Mini-Mental State Examination (MMSE score after 6 months of eprosartan-based therapy was one-point higher than at baseline (P < 0.001. MMSE score on completion of 6 months’ follow-up was either unchanged or increased from baseline in 793 (93% individuals and decreased in 60 (7%. Factors associated with stability of or improvement in cognitive function included MMSE score at baseline, diastolic blood pressure (DBP at baseline, and treatment-induced change in DBP.Conclusion: Results from the Middle East subgroup of OSCAR are supportive of the hypothesis that antihypertensive therapy based on angiotensin-receptor blocker therapy with eprosartan may be associated with preservation or improvement of cognitive function.Keywords: hypertension, eprosartan, cognitive function, Middle East 

  5. Random perturbations of arterial blood pressure for the assessment of dynamic cerebral autoregulation

    International Nuclear Information System (INIS)

    The assessment of cerebral autoregulation (CA) relies mostly on methods that modulate arterial blood pressure (ABP). Despite advances, the gold standard of assessment remains elusive and clinical practicality is limited. We investigate a novel approach of assessing CA, consisting of the intermittent application of thigh cuffs using square wave sequences. Our aim was to increase ABP variability whilst minimizing volunteer discomfort, thus improving assessment acceptability. Two random square wave sequences and two maximum pressure settings (80 and 150 mmHg) were used, corresponding to four manoeuvres that were conducted in random order after a baseline recording. The intermittent application of thigh cuffs resulted in an amplitude dependent increase in ABP (p = 0.001) and cerebral blood flow velocity (CBFV) variability (p = 0.026) compared to baseline. No statistically significant differences in mean heart rate or heart rate variability were observed (p = 0.108 and p = 0.350, respectively), suggesting that no significant sympathetic response was elicited. No significant differences in the CBFV step response were observed, suggesting no distortion of autoregulatory parameters resulted from the use of thigh cuffs. We conclude that pseudorandom binary sequences are an effective and safe alternative for increasing ABP variability. This new approach shows great promise as a tool for the robust assessment of CA. (paper)

  6. High frequency of diastolic dysfunction in a population-based cohort of elderly women - but poor association with the symptom dyspnea

    Directory of Open Access Journals (Sweden)

    Krämer Ursula

    2011-11-01

    Full Text Available Abstract Background The European Society of Cardiology recently proposed a new algorithm "How to diagnose heart failure with normal ejection fraction". Central element of the diagnostic strategy is the demonstration of diastolic dysfunction, either by tissue Doppler-derived indices in first line, or in second line by a combination of elevated blood levels of natriuretic peptide with abnormal tissue Doppler findings. We thought to use this diagnostic flowchart in a population-based cohort of elderly women, in whom the prevalence of diastolic dysfunction and heart failure is believed to be high. The purpose was to evaluate the association of dyspnea with the presence of diastolic dysfunction. Methods The study cohort recruited from a cross-sectional follow-up examination of the SALIA cohort (study on the influence of air pollution on lung function, inflammation, and aging. Participants with cardiac or pulmonary disease were excluded, 291 participants formed the final study group (all women, age range 69 to 79 years, all in sinus rhythm, LV ejection fraction > 50%, LV enddiastolic volume index 2. Quality of life was assessed by the Minnesota living with heart failure questionnaire, and actual symptoms by a structural questionnaire; the examination consisted of a physical examination, measurement of B-type natriuretic peptide, ECG and tissue Doppler echocardiography. Diastolic dysfunction was assumed when the E/E' ratio exceeded 15 as derived from tissue Doppler. In case, tissue Doppler yielded an E/E' ratio ranging from 8 to 15, additional non-invasive parameters had to be fulfilled: left atrial volume index > 40 ml/m2 body surface, or left ventricular mass index > 122 g/m2 body surface, or transmitral E/A ratio 280 ms, or blood level of brain natriuretic peptide (BNP > 200 pg/mL. Results The examinations were concordant with the presence of diastolic dysfunction in 122/291 participants (41.9%. The diagnosis based in 94% of cases on two criteria: in 50 cases on the criterion "E/E' ratio > 15", and in 65 cases on the criterion "15 > E/E'>8 and LV mass index > 122 g/m2". The participants with diastolic dysfunction had on average a higher body mass index, more frequent a history of arterial hypertension and of hospitalization for congestive heart failure, poorer quality of life, and higher BNP blood levels as compared to those participants without signs of diastolic dysfunction. The number of participants complaining exertional dyspnea, however, was similar distributed among the subgroups with and without signs of diastolic dysfunction (40.2 vs 40.8%; p = n.s. In a logistic regression model, the symptom dyspnea was best predicted by systolic pulmonary artery pressure, followed by left atrial volume index, BNP, and body mass index. Conclusion The demonstration of diastolic dysfunction showed only a poor association with the symptom dyspnea in a cohort of elderly women with otherwise normal systolic function. Additional structural or hemodynamic changes are necessary to "explain" the symptom dyspnea. It is unclear whether these additional factors are secondary to a more advanced stage of diastolic dysfunction, or are related to cardiovascular co-morbidities, or both.

  7. Cambios en la presión arterial en un grupo de voluntarios normotensos después del consumo de diferentes dosis de café filtrado Changes in blood pressure in a group of normotense volunteers after consumption or different doses of filtered coffee

    Directory of Open Access Journals (Sweden)

    Gloria M Agudelo

    2008-12-01

    Full Text Available No es clara la asociación entre el consumo de café y los cambios en los niveles de presión arterial; si bien algunos estudios muestran una correlación positiva, otros no logran confirmarla. El objetivo de este estudio fue determinar el cambio en los niveles de presión arterial en un grupo de voluntarios normotensos sometidos al consumo de diferentes dosis de café filtrado. Se trata de un estudio prospectivo, clínico controlado, en el cual se conformaron cuatro grupos y se sometieron por un período de seis semanas al consumo de diferentes cantidades de café filtrado: el grupo uno no consumió café, el grupo dos consumió 200 mL, el tres 400 mL y el cuatro 600 mL. Antes y al final de la intervención, en cada sujeto se midieron los niveles de presión arterial; en el grupo control se midió la concentración de cafeína antes, durante y al final de la intervención. Los resultados mostraron grupos comparables por género, edad e índice de masa corporal, sin diferencias significativas en las condiciones basales. Después de la intervención, la presión arterial sistólica y diastólica no mostró diferencia intragrupos, excepto en el grupo cuatro en el cual disminuyó significativamente (p=0,006 la presión arterial diastólica. Entre grupos los cambios en los niveles de presión sistólica y diastólica no fueron significativos (p=0,510 y 0,430 respectivamente. En conclusión, el consumo de diferentes dosis de café filtrado no ocasionó en sujetos normotensos cambios significativos en los niveles de presión arterial; el grupo que se abstuvo de tomar café no mostró disminución significativa de la presión arterial.The association between coffee consumption and changes in blood pressure values is not clear yet. Although some studies show a positive correlation, others fail to confirm it. The aim of this study was to determine changes in blood pressure values in a group of normotense volunteers submitted to consumption of different doses of filtered coffee. This is a prospective clinical controlled study in which four groups were conformed and were submitted during a period of six weeks to consumption of different doses of filtered coffee: group one did not have coffee, group two consumed 200 mL, group three 400 mL and group four 600 mL. Blood pressure values were measured before and at the end of the intervention in each subject; in the control group coffeine concentration was measured before, during and at the end of the intervention. The results showed comparable groups by gender, age and body mass index, without significant differences in basal conditions. After the intervention, systolic and diastolic blood pressure did not show any difference between the groups, with the exception of group four in which diastolic blood pressure diminished significantly (p=0.006. Between the groups, the changes in systolic and diastolic blood pressure values were not significant (p=0.510 and 0.430 respectively. In conclusion, consumption of different doses of filtered coffee did not cause significant changes in blood pressure values; the group that did not have coffee did not show significant lowering of blood pressure values.

  8. Prognostic role of alveolar-arterial oxygen pressure difference in acute pulmonary embolism

    International Nuclear Information System (INIS)

    This study investigated the utility of the alveolar-arterial oxygen pressure difference (AaDO2) in predicting the short-term prognosis of acute pulmonary embolism (PE). This study retrospectively enrolled 114 consecutive patients with acute PE, diagnosed by either spiral computed tomography or high probability ventilation-perfusion lung scans. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Patient exclusion criteria were chronic lung disease, septic emboli, and moderate and low probability lung scans. Patients were assigned to 2 groups based on either 30-day death or a 30-day composite event. Receiver operating characteristic analyses was used to determine the AaDO2 cut-off value for predicting primary and composite endpoints. Statistical analysis demonstrated significant differences in AaDO2 between the 30-day composite endpoint group and the 30-day composite event-free survival group (p=0.012). The AaDO2 had a strong trend between the 30-day death group and the survival group (p=0.062). The best cut-off value for AaDO2 was 53 mmHg and using this, the positive predictive value for 30-day death was 25% and the negative predictive value was 92%. For the 30-day composite endpoint, the positive predictive value for AaDO2 was 35%, and the negative predictive value was 84%. In this study, thrombocytopenia was also an indicator of poor prognosis for patients with acute PE. The AaDO2 measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with acute PE. It has high negative predictive value and moderate positive predictive value for 30-day death and 30-day composite event. Aggressive thrombolytic treatment strategies should be considered for patients with an initial poor prognostic parameter (ie, AaDO2?53 mmHg). (author)

  9. Changes in intra-abdominal pressure in patients undergoing coronary artery bypass grafting and valve replacement

    Directory of Open Access Journals (Sweden)

    W. Dabrowski

    2008-04-01

    Full Text Available The aim of the present study was to analyze the changes in intra-abdominal pressure in patients undergoing different cardiac procedures with extracorporeal circulation (ECC. Patients and methods: IAP was measured in 100 patients undergoing CABG or valve replacement (VR with ECC. IAP was measured in the urinary bladder at six measurement points: 1/ just before anaesthesia, 2/ 10 minutes after ECC; 3/ just after surgery, 4/ one hour after the completed procedure, 5/ 6 hours after the completed procedure, 6/ 18 hours after the procedure. Additionally, IAP was correlated with heart rate (HR, mean artery pressure (MAP and central venous pressure (CVP. According to cardiac procedure, patients were divided into two groups: A/ CABG, B/ VR. Results: In all patients, ECC resulted in an increase in IAP from 2nd to 6th measurement points. There were significant correlations between: IAP and BMI (p < 0.001; R = 0.3487, IAP and the duration of: anaesthesia and surgery from 2nd to 6th, ECC from 4th to 6th and aorta clamping from 3rd to 6th measurement points. In groups A and B, IAP increased from 2nd to 6th measurement points. IAP correlated with a fluid balance, BMI, duration of anaesthesia, duration of ECC and aorta clamping time. Additionally, there were strong overall correlation between IAP and CVP. Conclusions: 1/ ECC resulted in increase in IAP; 2/ IAP correlated with BMI, 3/ IAP elevation depended on duration of: anaesthesia, surgery, ECC and aorta clamping, 4/ fluid balance had a strong impact on IAP, 5/ IAP correlated with CVP.

  10. Determinantes precoces da pressão arterial em adultos da coorte de nascimentos de 1982, Pelotas, RS Determinantes precoces de la presión arterial en adultos de la cohorte de nacimientos de 1982, Pelotas, Sur de Brasil Early determinants of blood pressure among adults of the 1982 birth cohort, Pelotas, Southern Brazil

    Directory of Open Access Journals (Sweden)

    Bernardo L Horta

    2008-12-01

    Full Text Available OBJETIVO: Avaliar os efeitos de exposições ocorridas na gestação ou nos primeiros anos de vida sobre a pressão arterial. MÉTODOS: Estudo de coorte com todas as crianças nascidas em 1982 nas maternidades da cidade de Pelotas, RS. As mães residentes em área urbana foram entrevistadas e as crianças, acompanhadas em diferentes ocasiões. Em 2004-5, buscou-se acompanhar todos os indivíduos da coorte. A pressão arterial foi medida duas vezes, no início e no final da entrevista, com esfigmomanômetro digital de pulso. Foi avaliada a associação entre pressão arterial e as seguintes variáveis: cor da pele; escolaridade materna; renda familiar ao nascer; mudança de renda entre o nascimento e os 23 anos de idade; peso ao nascer e duração da amamentação. A análise de variância foi utilizada para a comparação de médias e os modelos lineares generalizados na análise ajustada. RESULTADOS: Obteve-se a medida da pressão arterial para 4.291 indivíduos, 2.208 do sexo masculino e 2.083 do sexo feminino. A média das medidas da pressão arterial sistólica foi de 117,5±15,0 mmHg e da diastólica, de 73,6±11,5 mmHg. Entre os homens, a pressão arterial sistólica foi maior nos indivíduos de cor da pele preta ou parda e naqueles que nunca foram considerados pobres. A pressão diastólica esteve associada apenas com o peso ao nascer. Entre as mulheres, a pressão arterial sistólica foi maior nas de cor da pele preta ou parda, cuja escolaridade materna era maior ou igual a 12 anos ou com peso ao nascer menor do que 4.000 g. CONCLUSÕES:Para ambos os sexos apenas a cor da pele esteve associada com a pressão arterial. A amamentação não teve efeito em longo prazo sobre a pressão arterial, e para o peso ao nascer e o nível socioeconômico, as associações não foram consistentes.OBJETIVO: Evaluar los efectos de exposiciones ocurridas en la gestación o en los primeros años de vida sobre la presión arterial. MÉTODOS: Estudio de cohorte con todos los niños nacidos en 1982 en las maternidades de la ciudad de Pelotas (Sur de Brasil. Las madres residentes en área urbana fueron entrevistadas y los niños, acompañados en diferentes ocasiones. En 2004-5, se buscó acompañar todos los individuos de la cohorte. La presión arterial fue medida dos veces, en el inicio y al final de la entrevista, con esfigmomanómetro digital de pulso. Fue evaluada la asociación entre presión arterial y las siguientes variables: color de la piel, escolaridad materna, renta familiar al nacer, cambio de renta entre el nacimiento y los 23 años de edad, peso al nacer y duración del amamantamiento. El análisis de varianza fue utilizado para la comparación de promedio y los modelos lineares generalizados en el análisis ajustado. RESULTADOS: Se obtuvo la medida de presión arterial para 4.291 individuos, 2.208 del sexo masculino y 2.083 del sexo femenino. El promedio de las medidas de presión arterial sistólica fue de 117,5±15,0 mmHg y de la diastólica, de 73,6±11,5 mmHg. Entre los hombres, la presión arterial sistólica fue mayor en los individuos de color de piel negra o parda y en aquellos que nunca fueron considerados pobres. La presión diastólica estuvo asociada apenas con el peso al nacer. Entre las mujeres, la presión arterial sistólica fue mayor en las de color de piel negra o parda, cuya escolaridad materna era mayor o igual a 12 años o con peso al nacer menor de 4.000 g. CONCLUSIONES: Para ambos sexos apenas el color de la piel estuvo asociado con la presión arterial. El amamantamiento no tuvo efecto a largo plazo sobre la presión arterial, y para el peso al nacer y el nivel socioeconómico, las asociaciones no fueron consistentes.OBJECTIVE: To evaluate the effects of exposure occurring during pregnancy or the first years of life on blood pressure. METHODS: Cohort study on all children born in 1982 in maternity hospitals in the city of Pelotas, Southern Brazil. The mothers living in the urban area were interviewed and the children were followed up on different occasions. In 2004-5, all the individuals in the cohort were sought for monitoring. Their blood pressure was measured twice, at the start and end of the interview, using a digital wrist sphygmomanometer. Associations between blood pressure and the following variables were evaluated: skin color; maternal schooling level; family income at birth; change in income between birth and 23 years of age; birth weight; and duration of breastfeeding. Analysis of variance was used to compare the means and a generalized linear model was used in the adjusted analysis. RESULTS: Blood pressure measurements were obtained from 4,291 individuals: 2,208 males and 2,083 females. The mean systolic blood pressure was 117.5 ± 15.0 mmHg and the mean diastolic was 73.6 ± 11.5 mmHg. Among the men, systolic blood pressure was higher among those of black or brown skin color and among those who were never considered poor. Diastolic pressure was only associated with birth weight. Among the women, systolic blood pressure was greater among those of black or brown skin color whose mothers' schooling level was greater than or equal to 12 years or whose birth weight was less than 4,000 g. CONCLUSIONS: For both sexes, only skin color was associated with blood pressure. Breastfeeding did not have any long-term effect on blood pressure and the associations for birth weight and socioeconomic level were inconsistent.

  11. Algunas consideraciones sobre la hipertensión arterial en la diabetes mellitus tipo 2 Some considerations related to arterial high blood pressure in Type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Yanes Quesada

    2009-09-01

    Full Text Available Se realizó una revisión del tema relacionado con la hipertensión arterial en el paciente diabético tipo 2, con el objetivo de actualizar algunos elementos particulares en este grupo de pacientes. Se plantea que su prevalencia es considerablemente más alta que en la población no diabética, donde la hiperinsulinemia y la disfunción endotelial cobran un papel protagónico en su etiopatogenia. La hipertensión arterial en estos pacientes clínicamente se manifiesta como un patrón non dipper, lo que incrementa la morbimortalidad por esta entidad. El tratamiento medicamentoso es habitualmente necesario, y se usan como drogas de primera línea los inhibidores de la enzima convertidora, los antagonistas de los receptores de angiotensina ll y los calcioantagonistas, aunque se pueden utilizar también los diuréticos tiacídicos a dosis bajas.Authors made a review of the topic related to arterial high blood pressure in the patient presenting with Type 2 diabetes mellitus to update some particular elements in this group of patients. We propose that its prevalence is higher than that present in non-diabetic population, where the hyperinsulinism and the endothelial dysfunction have a leading role in its ethiopathogenesis. The arterial high blood pressure in these patients clinically is manifested as a non-dipper pattern increasing the morbidity and mortality. Drug therapy is commonly necessary and as first line-drugs are used the converting-enzyme inhibitors, the agiotensin-II receptors antagonists, and the antagonists-calcium, although the low-dose thiacidic diuretics.

  12. Effect of negative pressure ventilation on arterial blood gas pressures and inspiratory muscle strength during an exacerbation of chronic obstructive lung disease.

    Science.gov (United States)

    Montserrat, J. M.; Martos, J. A.; Alarcon, A.; Celis, R.; Plaza, V.; Picado, C.

    1991-01-01

    The effects of intermittent negative pressure ventilation have been studied in 20 patients with chronic obstructive pulmonary disease during an exacerbation of their disease. Measurements of arterial blood gas tensions and maximal inspiratory pressure (MIP) were performed before and after six hours of negative pressure ventilation or standard treatment (control day) given in random order on two consecutive days. After negative pressure ventilation the mean (SD) value of MIP increased from 68.1 (21.5) to 74.8 (20) cm H2O;* arterial oxygen tension (PaCO2) fell from 60.6 (12.2) to 50.9 (8.9) mm Hg* but PaO2 changed little (from 48.4 (7.4) to 47.6 (8.2) mm Hg). There were no significant changes on the control day in arterial blood gas tensions (PaO2 47.8 (8.1) and 48.9 (9.4) and Paco2 59.8 (10.9) and 57.5 (8.06) mm Hg) or in MIP (69.4 (22.4) and 70.9 (22.9) cm H2O). Six patients tolerated negative pressure ventilation poorly and these patients showed less improvement after negative pressure ventilation. Our results suggest that intermittent negative pressure ventilation can increase alveolar ventilation in patients with an exacerbation of chronic obstructive lung disease, particularly in those who tolerate the procedure well. Most subjects showed a fall in PaCO2 and an increase in MIP. The fact that PaO2 was unchanged despite the fall in PaCO2 suggests that gas exchange may deteriorate with negative pressure ventilation in these patients. PMID:1908138

  13. Prediction of Pressure Difference and Velocity Profile in Steady Flow through Axi-Symmetric Plaque Deposited Arteries

    Directory of Open Access Journals (Sweden)

    Muhammad AnwarSolangi

    2012-10-01

    Full Text Available Numerical simulations of blood flow through plaque deposited arteries at different Reynolds numbers have been performed to investigate the impact of atherosclerosis on pressure drop and velocity profile at down stream. The predicated results are presented in terms of non-dimensional pressure isobars and velocity profiles at distinct Reynolds numbers and various levels of deposition at downstream of the artery segment. The scaled non-dimensional graph of pressure drop is also illustrated. The incompressible Navier-Stokes equation in the axi-symmetric frame of reference is solved numerically by employing FEM (Finite Element Method. Semi-implicit Taylor-Galerkin/pressure-correction scheme has been utilised to obtain steady state solutions. The effects of atherosclerosis on hemodynamic factors have been investigated. The results show that blockage disturbs the flow field in the wake of plaque deposited arteries and the trend of pressure and velocity is increasing as level of deposition or Reynolds number increases. The application of this research work can be utilised in the field of cardio vascular disease, design of device and further planning towards treatment.

  14. Resposta da pressão arterial ao esforço em adolescentes: influência do sobrepeso e obesidade Blood pressure response to physical exertion in adolescents: influence of overweight and obesity

    Directory of Open Access Journals (Sweden)

    Luciana Carletti

    2008-07-01

    Full Text Available FUNDAMENTO: A resposta aguda da pressão arterial ao esforço tem sido utilizada como indicador de risco para o desenvolvimento de hipertensão arterial. Os fatores associados com essa resposta precisam ser esclarecidos a fim de se intervir na prevenção da doença hipertensiva. OBJETIVO: Descrever o comportamento das variáveis cardiovasculares ao esforço agudo em adolescentes com excesso de peso, por meio de teste cardiopulmonar. MÉTODOS: A amostra foi constituída de 104 adolescentes (56 meninos e 48 meninas, divididos nos grupos de sobrepeso/obesos (GSO e eutróficos (GE. Foram aferidas variáveis antropométricas (peso, estatura e IMC, de composição corporal (dobra cutânea e variáveis hemodinâmicas de pressão arterial sistólica (PAS e diastólica (PAD e freqüência cardíaca (FC, no repouso e no esforço máximo do teste cardiopulmonar. RESULTADOS: No grupo masculino, identificaram-se maiores valores de pressão arterial sistólica de repouso para o GSO, quando comparados com o GE (113 ± 13 vs 106 ± 8 mmHg; p = 0,009, a PAS pré-exercício (120 ± 14 vs 109 ± 10 mmHg; p = 0,003 e de PAS na carga máxima de trabalho (156 ± 20 vs 146 ± 14 mmHg; p = 0,03. No grupo feminino, apenas a PAS pré-exercício foi superior no grupo de sobrepeso, quando isso foi comparado com as eutróficas (114 ± 11 vs 106 ± 10 mmHg; p = 0,009. CONCLUSÃO: A resposta pressórica durante o exercício foi mais exacerbada em adolescentes obesos quando comparada com àquela obtida em eutróficos, o que indica maior reatividade ao estresse físico.BACKGROUND: The acute blood pressure response to physical exertion has been used as an indicator of the risk of developing hypertension. The factors associated with this response need to be clarified for timely intervention in preventing hypertensive disease. OBJECTIVE: To describe the response of cardiovascular variables to acute physical exertion in overweight adolescents using cardiopulmonary exercise testing. METHODS: The sample consisted of 104 adolescents (56 boys and 48 girls, divided into two groups: the obese/overweight group (OOG and the eutrophic group (EG. The following variables were measured: anthropometric (weight, height, and BMI, body composition (skin fold thickness, as well as hemodynamic variables such as systolic arterial pressure (SAP, diastolic arterial pressure (DAP, and heart rate (HR, at rest and at maximal physical exertion during the cardiopulmonary test. RESULTS: In the male group, the greatest values of systolic arterial pressure at rest were recorded in the OOG as compared to the EG (113 ± 13 vs 106 ± 8 mmHg; p = 0.009, pre-exertion SAP (120 ± 14 vs 109 ± 10 mmHg; p = 0.003, and SAP during maximal exertion conditions (156 ± 20 vs 146 ± 14 mmHg; p = 0.03. In the female group, only pre-exertion SAP was higher in the overweight group as compared to the eutrophic girls (114 ± 11 vs 106 ± 10 mmHg; p = 0.009. CONCLUSION: The response of arterial blood pressure during physical exercise was most exacerbated in obese adolescents as compared to eutrophic teens, suggesting greater reactivity to physical exertion.

  15. ORANGE JUICE AND BLOOD PRESSURE

    Directory of Open Access Journals (Sweden)

    M. F. VALIM

    2009-01-01

    Full Text Available

    Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mm Hg and recorded as two numbers: systolic pressure (as the heart contracts over diastolic pressure (as the heart relaxes between beats. High blood pressure (hypertension is defined as chronically elevated high blood pressure, with systolic blood pressure (SBP of 140 mm Hg or greater, and diastolic blood pressure (DBP of 90 mm Hg or greater. High blood pressure (HBP, smoking, abnormal blood lipid levels, obesity and diabetes are risk factors for coronary heart disease, the leading cause of death in the US. Lifestyle modifications such as engaging in regular physical activity, quitting smoking and eating a healthy diet (limiting intake of saturated fat and sodium and increasing consumption of fiber, fruits and vegetables are advocated for the prevention, treatment, and control of HBP. As multiple factors influence blood pressure, the effects of each factor are typically modest, particularly in normotensive subjects, yet the combined effects can be substantial. Nutrition plays an important role in influencing blood pressure. Orange juice should be included as part of any low sodium diet and/or any blood pressure reducing eating plan, as it is sodium free, fat-free and can help meet recommended levels of potassium intake that may contribute to lower BP.

  16. Pressão arterial de crianças e adolescentes de uma escola pública de Fortaleza - Ceará Presión arterial de niños y adolescentes de una escuela pública de Fortaleza-Ceará Blood pressure of children and teenagers from a public school in Fortaleza-Ceará

    Directory of Open Access Journals (Sweden)

    Thelma Leite de Araujo

    2007-12-01

    Full Text Available OBJETIVO: O objetivo do estudo foi analisar a evolução dos valores da pressão arterial sistólica (PAS, da pressão arterial diastólica (PAD e das medidas antropométricas de crianças e adolescentes que apresentaram alteração da pressão arterial em uma primeira avaliação. MÉTODOS: Estudo longitudinal, realizado nos meses de outubro de 2004 a dezembro de 2005, em uma escola pública de Fortaleza, Ceará. Cento e cinqüenta e um indivíduos com idades entre seis e dezessete anos foram avaliados e acompanhados por um período de um ano. RESULTADOS: As variáveis idade, escolaridade, peso, altura, índice de massa corporal, perímetro da cintura, perímetro do quadril, circunferência do braço e prega subescapular estiveram correlacionadas positiva e significativamente com os valores da PAS e da PAD. Houve diferença de mediana entre as variáveis: sexo, grau de parentesco para hipertensão arterial, fumante passivo com a PAS e com a PAD. CONCLUSÃO: Observou-se que a PAS e a PAD das crianças e dos adolescentes diminuíram ao longo das avaliações.OBJETIVO: En este estudio se tuvo como objetivo analizar la evolución de los valores de la presión arterial sistólica (PAS, de la presión arterial diastólica (PAD y de las medidas antropométricas de niños y adolescentes que presentaron alteración de la presión arterial en una primera evaluación. MÉTODOS: Se trata de un estudio longitudinal, realizado en los meses de octubre del 2004 a diciembre del 2005, en una escuela pública de Fortaleza, Ceará. Ciento cincuenta y un individuos con edades entre seis y diecisiete años fueron evaluados y acompañados por el período de un año. RESULTADOS: Las variables edad, escolaridad, peso, altura, índice de masa corporal, perímetro de la cintura, perímetro de la cadera, circunferencia del brazo y pliegue subescapular estuvieron correlacionadas positiva y significativamente con los valores de la PAS y de la PAD. Hubo diferencia de mediana entre las variables: sexo, grado de parentesco para hipertensión arterial, fumador pasivo con la PAS y con la PAD. CONCLUSIÓN: Se observó que la PAS y la PAD de los niños y adolescentes disminuyeron a lo largo de las evaluaciones.OBJECTIVE: To analyze the evolution of systolic blood pressure (SAP, diastolic blood pressure (DAP and anthropometric measurement values of children and teenagers who presented altered arterial pressure on a first evaluation. METHODS: Follow-up study, performed from October / 2004 to December / 2005, at a public school in Fortaleza. One hundred fifty-one subjects between six and seventeen years old were accompanied and evaluated for a period of one year. RESULTS: It was observed that the SAP and DAP of children and teenagers decreased along the evaluations. The variables age, education, weight, height, body mass index, waist perimeter, hip perimeter, arm and subscapular skin fold circumference were correlated positive and significantly with SAP and DAP values. There was a difference in median among the variables: Gender, kinship degree for arterial hypertension, passive smoker with SAP and DAP. CONCLUSION: It was observed that the SAP and DAP of children and adolescents decreased along the evaluations.

  17. Low pulmonary artery flush perfusion pressure combined with high positive end-expiratory pressure reduces oedema formation in isolated porcine lungs

    International Nuclear Information System (INIS)

    Flush perfusion of the pulmonary artery with organ protection solution is a standard procedure before lung explantation. However, rapid flush perfusion may cause pulmonary oedema which is deleterious in the lung transplantation setting. In this study we tested the hypotheses that high pulmonary perfusion pressure contributes to the development of pulmonary oedema and positive end-expiratory pressure (PEEP) counteracts oedema formation. We expected oedema formation to increase weight and decrease compliance of the lungs on the basis of a decrease in alveolar volume as fluid replaces alveolar air spaces. The pulmonary artery of 28 isolated porcine lungs was perfused with a low-potassium dextrane solution at low (mean 27 mmHg) or high (mean 40 mmHg) pulmonary artery pressure (PAP) during mechanical ventilation at low (4 cmH2O) or high (8 cmH2O) PEEP, respectively. Following perfusion and storage, relative increases in lung weight were smaller (p < 0.05) during perfusion at low PAP (62 ± 32% and 42 ± 26%, respectively) compared to perfusion at high PAP (133 ± 54% and 87 ± 30%, respectively). Compared to all other PAP–PEEP combinations, increases in lung weight were smallest (44 ± 9% and 27 ± 12%, respectively), nonlinear intratidal lung compliance was largest (46% and 17% respectively, both p < 0.05) and lung histology showed least infiltration of mononuclear cells in the alveolar septa, and least alveolar destruction during the combination of low perfusion pressure and high PEEP. The findings suggest that oedema formation during pulmonary artery flush perfusion in isolated and ventilated lungs can be reduced by choosing low perfusion pressure and high PEEP. PAP–PEEP titration to minimize pulmonary oedema should be based on lung mechanics and PAP monitoring

  18. Kinks of the Transplant Renal Artery Without Accompanying Intraarterial Pressure Gradient Do Not Require Correction: Five-Year Outcome Study

    International Nuclear Information System (INIS)

    Significant transplant renal artery stenosis (TRAS) results in an intraarterial pressure gradient and increasing graft dysfunction correctable by endovascular therapy. Kinks of the transplant artery cause velocity gradients on Doppler ultrasound, but some will have no intraarterial pressure gradient across the kink. It is not known whether these nonflow limiting kinks progress further to threaten graft function and should undergo endovascular correction. This is a longitudinal study of conservatively managed arterial kinks to define their natural history. Fourteen patients who had undergone angiography over a 5-year period for suspected TRAS had kinks of the renal artery. True intraarterial pressures were measured in all cases by slow withdrawal of an end-hole catheter after intraarterial injection of a vasodilator. Those with a significant pressure change (≥10% change in peak systolic pressure across the area of suspicion) underwent endovascular treatment. The rest were managed conservatively, with maximal antihypertensive therapy. Outcome of all 14 cases was determined by follow-up of creatinine levels, blood pressure (BP) control and graft outcome over a 3-5-year period (median 4 years). Of the 14 patients with kinks, 10 were male and 4 female; age range 23-67 years (mean 47 years). Eleven had received cadaveric transplants and 3 were allografts; 12 had end-to-side and 2 end-to-end anastomosis, 11/14 cases had an intraarterial pressure ratio of <10% and at median 4 years follow-up on conservative treatment, the serum creatinine of these 11 patients did not differ significantly from those who underwent successful endovascular treatment (mean 118 μmol/l versus 149 μmol/l; p = 0.30, Mann Whitney test). Mean blood pressure was 137/82 mmHg, with a range of 124-155/56-95 mmHg. Only one patient has required an unexplainable increase in antihypertensive medication. Grafts (2/11) were lost and both had chronic rejection on histology. There were no unexplained graft failures. Kinks of the renal transplant artery with normal intraarterial pressures do not appear to progress and threaten renal graft function. Satisfactory graft outcome was seen on 5-year follow-up with conservative therapy alone

  19. Effect of amiloride and spironolactone on renal tubular function and central blood pressure in patients with arterial hypertension during baseline conditions and after furosemide: a double-blinded, randomized, placebo-controlled crossover trial.

    Science.gov (United States)

    Matthesen, Solveig K; Larsen, Thomas; Vase, Henrik; Lauridsen, Thomas G; Jensen, Janni M; Pedersen, Erling B

    2013-01-01

    This study demonstrates that the increased potassium content in the body seems to change both the blood pressure and renal tubular function. We wanted to test the hypotheses that amiloride and spironolactone induced potassium retention reduces ambulatory blood pressure (ABP) and central blood pressure (CBP) during baseline conditions and after furosemide and that the tubular transport via the epithelial sodium channels (ENaCs) and aquaporin-2 (AQP2) water channels was increased by furosemide in arterial hypertension. Each of three 28-day treatment periods (placebo, amiloride, and spironolactone) was completed by a 4-day period with standardized diet regarding calories and sodium and water intake. At the end of each period, we measured pulse wave velocity (PWV), central systolic blood pressure (CSBP), central diastolic blood pressure (CDBP), glomerular filtration rate (GFR), free water clearance (CH2O), fractional excretion of sodium (FENa) and potassium (FEK), urinary excretion of AQP2 (u-AQP2), urinary excretion of ?-fraction of the ENaC (u-ENaC?), and plasma concentrations of renin (PRC), angiotensin II (p-Ang II), and aldosterone (p-Aldo) at baseline conditions and after furosemide bolus. Ambulatory blood pressure and CBP were significantly lowered by amiloride and spironolactone. During 24-hour urine collection and at baseline, GFR, CH2O, FENa, FEK, u-AQP2 and u-ENaC? were the same. After furosemide, CH2O, FENa, FEK, u-AQP2, u-ENaC?, PRC, p-Ang II, p-Aldo, PWV and CDBP increased after all treatments. However, during amiloride treatment, FEK increased to a larger extent than after spironolactone and during placebo after furosemide, and CSBP was not significantly reduced. The increases in water and sodium absorption via AQP2 and ENaC after furosemide most likely are compensatory phenomena to antagonize water and sodium depletion. Amiloride is less effective than spironolactone to reduce renal potassium excretion. PMID:22966789

  20. Beneficial effects of elevating cardiac preload on left-ventricular diastolic function and volume during heat stress

    DEFF Research Database (Denmark)

    Brothers, R M; Pecini, Redi; Dalsgaard, Morten; Bundgaard-Nielsen, Morten; Wilson, Thad E; Secher, Niels H; Crandall, Craig G

    2014-01-01

    Volume loading normalizes tolerance to a simulated hemorrhagic challenge in heat-stressed individuals, relative to when these individuals are thermoneutral. The mechanism(s) by which this occurs is unknown. This project tested two unique hypotheses; that is, the elevation of central blood volume...... via volume loading while heat stressed would 1) increase indices of left ventricular diastolic function, and 2) preserve left ventricular end-diastolic volume (LVEDV) during a subsequent simulated hemorrhagic challenge induced by lower-body negative pressure (LBNP). Indices of left ventricular...... conditions prior to and during a simulated hemorrhagic challenge. Heat stress did not change indices of diastolic function. Subsequent volume infusion elevated indices of diastolic function, specifically early diastolic mitral annular tissue velocity (E') and early diastolic propagation velocity (E) relative...

  1. Effect of Stent Geometry on Phase Shift between Pressure and Flow Waveforms in Stented Human Coronary Artery

    Directory of Open Access Journals (Sweden)

    Vahab Dehlaghi

    2008-01-01

    Full Text Available Shear stress is known to play a central role in restenosis formation and is sensitive to stent geometry. Alterations of the phase shift between pressure and flow waveform created by a different stents were studied to compare the hemodynamic effects of stent design properties on restenosis in stented human coronary artery. Blood pressure waveforms were computed in three different sites, pre-stent, middle of stented arterial segment, and post-stent regions using computational fluid dynamics. Blood flow was assumed as pulsatile, incompressible, and Newtonian flow. Rigid boundary conditions were assumed for all models. The governing Navier-Stokes equations were solved using commercial software package (Fluent V6.0.12. Stents were assumed with real structure and modeled using the commercial software package (Gambit, V2.0. The alterations of the phase shift between pressure and flow waveform created by a different stents were investigated in three major regions using commercial software package (Matlab, V7.0. It is concluded that stent geometry changes the phase shift between pressure and flow waveforms in stented human coronary artery, and wall shear stress between stent struts was sensitive to these variations. The results show that variation in the phase shift is sensitive to stent geometry.

  2. Changes in arterial blood pressure of a soluble cocoa fiber product in spontaneously hypertensive rats.

    Science.gov (United States)

    Sánchez, D; Quiñones, M; Moulay, L; Muguerza, B; Miguel, M; Aleixandre, A

    2010-02-10

    The effect produced by long-term intake of a soluble cocoa fiber product (SCFP) on the development of hypertension of spontaneously hypertensive rats (SHR) was evaluated. Twenty male 3-week-old SHR were divided into two groups of 10 animals that drank either tap water (control) or a solution of SCFP (0.75 g/day SCFP) until the 20th week of life. Five 20-week-old rats of each group were sacrificed. Tap water as drinking fluid was given to all the animals from the 20th to 24th week of life. The 24-week-old rats were also sacrificed. Body weight, liquid and dry food intake, and arterial blood pressure (tail cuff) were recorded weekly. Malondialdehyde (MDA), glucose and angiotensin converting enzyme (ACE) activity in the plasma from the sacrificed rats were also obtained, and we evaluated the relaxation caused by acetylcholine in the aorta from these animals. SCFP attenuated the development of hypertension in SHR; however, the withdrawal of SCFP caused an increase in blood pressure in the rats. Body weight gain was slower in the group treated with SCFP. SCFP increased liquid intake but decreased dry food intake in the rats. SCFP decreased plasma MDA concentrations and slightly decreased plasma ACE activity, but no differences were observed in plasma glucose and in the aorta responses to acetylcholine in both groups of 20-week-old SHR. We have demonstrated the antihypertensive and antioxidant properties of SCFP. The control of body weight and the control of increased angiotensin II may be involved in the antihypertensive effect of this product. PMID:20050664

  3. The association between arterial stiffness and left ventricular filling pressure in an apparently healthy Korean population

    Directory of Open Access Journals (Sweden)

    Kim Hack-Lyoung

    2013-01-01

    Full Text Available Abstract Background The aim of this study is to investigate the association between arterial stiffness and left ventricular filling pressure in an apparently healthy Korean population. Methods A total of 115 healthy subjects without known cardiovascular risk factors or overt heart disease who underwent both transthoracic echocardiography and brachial-ankle pulse wave velocity (baPWV measurement at the same day during their routine check-ups were analyzed. Results The mean age of study subjects was 52.8 ± 8.4 years, and 78 (67.8% were men. The mean baPWV value was 1,325 ± 185 cm/s. Study subjects were divided into 3 groups according to E/E’ value: subjects with E/E’ p β = 0.371, p after controlling confounders including age, sex and body mass index. In receiver-operating characteristic (ROC curve analysis, the sensitivity and specificity for detection of E/E’ ≥ 10 were 78.6% and 59.8%, respectively with mean baPWV of 1,282 cm/s as the cut off value. The discriminatory capacity for predicting E/E’ ≥ 10 was improved from an area under the ROC curve of 0.646 with age alone to 0.734 when baPWV was added (p Conclusions There is a significant association between baPWV and E/E’ in an apparently healthy Korean population. BaPWV is useful as a simple and non-invasive method for early detection of increased LV filling pressure among these people.

  4. Respiratory nitric oxide and pulmonary artery pressure in children of aymara and European ancestry at high altitude.

    Science.gov (United States)

    Stuber, Thomas; Sartori, Claudio; Salmòn, Carlos Salinas; Hutter, Damian; Thalmann, Sébastien; Turini, Pierre; Jayet, Pierre-Yves; Schwab, Marcos; Sartori-Cucchia, Céline; Villena, Mercedes; Scherrer, Urs; Allemann, Yves

    2008-11-01

    Invasive studies suggest that healthy children living at high altitude display pulmonary hypertension, but the data to support this assumption are sparse. Nitric oxide (NO) synthesized by the respiratory epithelium regulates pulmonary artery pressure, and its synthesis was reported to be increased in Aymara high-altitude dwellers. We hypothesized that pulmonary artery pressure will be lower in Aymara children than in children of European ancestry at high altitude, and that this will be related to increased respiratory NO. We therefore compared pulmonary artery pressure and exhaled NO (a marker of respiratory epithelial NO synthesis) between large groups of healthy children of Aymara (n = 200; mean +/- SD age, 9.5 +/- 3.6 years) and European ancestry (n = 77) living at high altitude (3,600 to 4,000 m). We also studied a group of European children (n = 29) living at low altitude. The systolic right ventricular to right atrial pressure gradient in the Aymara children was normal, even though significantly higher than the gradient measured in European children at low altitude (22.5 +/- 6.1 mm Hg vs 17.7 +/- 3.1 mm Hg, p Aymara children (30.0 +/- 5.3 mm Hg vs 22.5 +/- 6.1 mm Hg, p Aymara children than in European children living at the same altitude (12.4 +/- 8.8 parts per billion [ppb] vs 16.1 +/- 11.1 ppb, p = 0.06) and was not related to pulmonary artery pressure in either group. Aymara children are protected from hypoxic pulmonary hypertension at high altitude. This protection does not appear to be related to increased respiratory NO synthesis. PMID:18641102

  5. Changes in pulmonary artery pressures during ethanol sclerotherapy for arteriovenous malformations: identifying the most vulnerable period

    International Nuclear Information System (INIS)

    Aim: To evaluate the changes in pulmonary artery pressure (PAP) during ethanol embolization and to identify the most vulnerable period associated with cardiovascular collapse in patients with arteriovenous malformations (AVMs). Materials and methods: Twenty-three patients (30 sessions) with AVMs were enrolled. PAP was measured at the following times: baseline (Tbaseline); immediately before (Tpre), and after (Tpost) bolus injection of absolute ethanol; at the time of maximum mean PAP value during a session (Thighest-ethanol); 10 min after final injection (Tfinal); after restoration of spontaneous breathing (Tresp); at extubation (Textubation); 30 min after extubation (Textubation-30min); and at the time of maximum mean PAP after patient resumed spontaneous respiration (Thighest-resp). Nitroglycerin was infused (range 0.5-3 μg/kg/min) in all patients to attenuate the effect of ethanol on pulmonary vasoconstriction. Results: The PAPs of Thighest-ethanol, Tresp, Textubation, and Thighest-resp were significantly higher than the corresponding values for Tbaseline and Tfinal (all p highest-resp were significantly higher than those at Thighest-ethanol (both p < 0.05). In 24 sessions (80%), the highest mean PAP was detected during the recovery period. Conclusion: The greatest rise in PAP was noted during the recovery period in patients undergoing ethanol embolotherapy. Therefore, PAP monitoring and nitroglycerin infusions are recommended during the recovery period because early detection of an increase in PAP and prompt management may prevent detrimental complications.

  6. Arterial line pressure control enhanced extracorporeal blood flow prescription in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rosales Laura

    2008-11-01

    Full Text Available Abstract Background In hemodialysis, extracorporeal blood flow (Qb recommendation is 300–500 mL/min. To achieve the best Qb, we based our prescription on dynamic arterial line pressure (DALP. Methods This prospective study included 72 patients with catheter Group 1 (G1, 1877 treatments and 35 arterio-venous (AV fistulae Group 2 (G2, 1868 treatments. The dialysis staff was trained to prescribe Qb sufficient to obtain DALP between -200 to -250 mmHg. We measured ionic clearance (IK: mL/min, access recirculation, DALP (mmHg and Qb (mL/min. Six prescription zones were identified: from an optimal A zone (Qb > 400, DALP -200 to -250 to zones with lower Qb E (Qb -199. Results Treatments distribution in A was 695 (37% in G1 vs. 704 (37.7% in G2 (P = 0.7. In B 150 (8% in G1 vs. 458 (24.5% in G2 (P P = 0.62. IK in A was 214 ± 34 (G1 vs. 213 ± 35 (G2 (P = 0.65. IK Anova between G2 zones was: A vs. C and D (P P = 0.02. Conclusion In conclusion, an optimal Qb can de prescribed with DALP of -200 mmHg. Staff adherence to DLAP treatment prescription could be reached up to 81.3% in catheters and 84.1% in AV fistulae.

  7. [Trial of typological classification of the blood pressure profile over 24 hours in aged patients by Fourier analysis].

    Science.gov (United States)

    Bousquet, F; Chau, N P; Poncelet, P; Warembourg, A; Carre, A

    1988-06-01

    The profiles of 24-hour systolic and diastolic arterial pressures and heart rates obtained with the Bard-Sentron system were studied in 36 untreated subjects (24 women and 12 men, aged from 65 to 89 years) with normal or borderline blood pressure. Each profile was modelized by a Fourier's serie. Multivariate analysis showed that 4 first harmonics were sufficient for a good description of the values observed. A programme of redistribution in subgroups, using McQueen's reallocation method and based on diastolic pressure spectrum, divided the subjects into two groups (A and B) such that the diastolic pressure spectrum of subjects in the same group were "similar" and those of subjects in different groups were "dissimilar". Subjects in both groups were of the same age and had the same man/woman ratio. The diastolic profile of group A showed marked day-night variations, while that of group B had almost the same level day and night. The same method can be applied to systolic pressure. Although the exact role of ambulatory blood pressure as a risk factor remains to be determined, a strong day-night variation of pressure observed in a given subject ought to be closely watched by the clinician. This study suggests a method to evaluate the different types of arterial pressure and heart rate profiles in any population of subjects and to identify a group at higher cardiovascular risk, if it is present. PMID:3142418

  8. Pregnancy Downregulates Actin Polymerization and Pressure-Dependent Myogenic Tone in Ovine Uterine Arteries

    OpenAIRE

    Xiao, DaLiao; Huang, Xiaohui; Yang, Shumei; Longo, Lawrence D.; Zhang, Lubo

    2010-01-01

    Pregnancy is associated with significantly decreased uterine vascular tone and increased uterine blood flow. The present study tested the hypothesis that the downregulation of actin polymerization plays a key role in reduced vascular tone of uterine arteries in the pregnant state. Uterine arteries were isolated from nonpregnant and near-term pregnant sheep. Activation of protein kinase C significantly increased the filamentous:globular actin ratio and contractions in the uterine arteries, whi...

  9. A novel photoplethysmography technique to derive normalized arterial stiffness as a blood pressure independent measure in the finger vascular bed

    International Nuclear Information System (INIS)

    Stiffening of the small artery may be the earliest sign of arteriosclerosis. However, there is no adequate method for directly assessing small arterial stiffness. In this study, the finger arterial elasticity index (FEI) was defined as the parameter n which denotes the curvilinearity of an exponential model of pressure (P)–volume (Va) relationship (Va = a − b exp (−nP)). For the original estimation, the FEI was calculated from a compliance index from the finger photoplethysmogram whilst occluding the finger. A simple estimation of the FEI was devised by utilizing normalized pulse volume instead of the compliance index. Both estimations yielded close agreement with the exponential model in healthy young participants (study 1: n = 19). Since the FEI was dependent on finger mean blood pressure, normalized finger arterial stiffness index (FSI) was defined as standardized residual from their relationship: mean and standard deviation (SD) of the FSI were 50 ± 10 (study 2: n = 174). The mean coefficient of variation of the FSI for four measurements was 5.72% (study 3: n = 6). The mean and SD of the FSI in seven arteriosclerotic patients were 100.0 ± 13.5. In conclusion, the FEI and FSI by simple estimation are valid and useful for arteriosclerosis research

  10. Outflow boundary conditions for 3D simulations of non-periodic blood flow and pressure fields in deformable arteries

    CERN Document Server

    Vignon-Clementel, Irene; Jansen, K E; Taylor, C A; 10.1080/10255840903413565

    2010-01-01

    The simulation of blood flow and pressure in arteries requires outflow boundary conditions that incorporate models of downstream domains. We previously described a coupled multidomain method to couple analytical models of the downstream domains with 3D numerical models of the upstream vasculature. This prior work either included pure resistance boundary conditions or impedance boundary conditions based on assumed periodicity of the solution. However, flow and pressure in arteries are not necessarily periodic in time due to heart rate variability, respiration, complex transitional flow or acute physiological changes. We present herein an approach for prescribing lumped parameter outflow boundary conditions that accommodate transient phenomena. We have applied this method to compute haemodynamic quantities in different physiologically relevant cardiovascular models, including patient-specific examples, to study non-periodic flow phenomena often observed in normal subjects and in patients with acquired or congen...

  11. Prevalence of peripheral arterial occlusive disease and associated risk factors in a sample of southern Sardinian population.

    Science.gov (United States)

    Binaghi, F; Fronteddu, P F; Cannas, F; Caredda, E; Uras, A; Garau, P; Pitzus, F

    1994-09-01

    We studied a sample of adult population over 20 years old of Donori (totally 2049 inhabitants), a small town near Cagliari, South Sardinia, to: (1) Evaluate the prevalence of peripheral arterial occlusive disease of lower limbs (PAOD) diagnosed by standard questionnaire and US CW Doppler examination and associated risk factors in South Sardinia. (2) Compare the reliability of these two diagnostic methods. Our study included the answers to a standard anamnestic questionnaire (according to the WHO recommendations), physical examination and CW Doppler study of the lower limb arteries, the determination of the arterial systolic and diastolic pressure, ankle/arm pressure ratio, Body Mass Index, blood glucose, total and HDL-cholesterol, triglycerides and fibrinogen (the hematochemical examination only on 50% of the sample). The surveyed sample was of 577 subjects (37.96% of 1520, the eligible subjects over 20 years old), 237 males and 340 females. An arteriopathy was diagnosed by means of CW Doppler in 27 subjects, 20 M and 7 F. The overall prevalence of PAOD was 4.67% of the sample (2.06% of females, 8.43% of males). Prevalence steadily increased with age, and, surprisingly, the disease was not absent in young people (2 cases within males with age < or = 40 years). Conversely only 18.5% of PAOD patients were symptomatic. The overall prevalence of associated risk factors was: diabetes 3.6%, hypercholesterolaemia 59.1%, smoking 21.3%, arterial hypertension 21.6%, obesity 17.9%, hypertriglyceridaemia 9.3%, hyperfibrinogenaemia 4.67%. Among the males a significant correlation has been found, among the values of BMI vs age and total cholesterol, age vs total cholesterol, systolic blood pressure, diastolic pressure, fibrinogenaemia. Among the females, the systolic and diastolic pressure, BMI, total cholesterol, LDL-cholesterol, triglycerides and fibrinogen are significantly correlated with age; BMI correlates with systolic and diastolic blood pressure, fibrinogen; a nearly significant correlation has been found between BMI and triglycerides. PMID:7822900

  12. Automedida da pressão arterial para o controle das cifras tensionais e para a adesão ao tratamento / Self measurement of blood pressure for control of blood pressure levels and adherence to treatment

    Scientific Electronic Library Online (English)

    Weimar Kunz Sebba Barroso, Souza; Paulo César Brandão Veiga, Jardim; Ludmila Porto, Brito; Fabrício Alves, Araújo; Ana Luíza Lima, Sousa.

    2012-02-01

    Full Text Available FUNDAMENTO: A medida da pressão arterial (PA) pelo próprio paciente, sem protocolos rígidos, com treinamento adequado, aparelhos validados e no próprio domicílio, é definida como automedida da pressão arterial (AMPA). OBJETIVO: Avaliar a interferência da AMPA na adesão ao tratamento e no controle pr [...] essórico. MÉTODOS: Participaram do estudo 57 pacientes, 38 no grupo de estudo (GE) e 19 no grupo de controle (GC). Esses pacientes foram seguidos por 12 meses e avaliados na randomização (V1), bem como no sexto (V2) e no décimo segundo mês (V3). Comparadas as médias da PA pela medida casual, pela AMPA e pela monitorização ambulatorial da pressão arterial (MAPA), exames laboratoriais e as respostas ao questionário sobre o estilo de vida. Os aparelhos utilizados foram: OMRON HEM 714, para a AMPA; OMRON 705 CP, para a medida casual; e Monitor SPACELABS 9002, para a MAPA. RESULTADOS: A idade média em anos foi de 62,05 ± 10,78 e de 55,42 ± 11,87 no GE e no GC (p = 0,03), respectivamente. Os valores da pressão arterial sistólica (PAS) pela medida casual no GE e no GC foram: 140,01 ± 16,73 mmHg e 141,79 ± 23,21 mmHg em V1 (p = 0,72); 135,49 ± 12,73 mmHg e 145,69 ± 19,31 mmHg em V2 (p = 0,02); 131,64 ± 19,28 mmHg e 134,88 ± 23,21 mmHg em V3 (p = 0,59). Os valores da pressão arterial diastólica (PAD) foram: 84,13 ± 10,71 mmHg e 86,29 ± 10,35 mmHg em V1 (p = 0,47); 81,69 ± 10,88 mmHg e 89,61 ± 11,58 mmHg em V2 (p = 0,02); 80,31 ± 11,83 mmHg e 86 ± 13,38 mmHg em V3 (p = 0,12). CONCLUSÃO: Os pacientes do GE apresentaram adesão ao tratamento não farmacológico semelhante ao GC, mas tiveram maior adesão ao tratamento medicamentoso e utilizaram menor número de drogas anti-hipertensivas. Não houve diferença entre os grupos na comparação do perfil metabólico e da função renal. (Arq Bras Cardiol. 2011; [online].ahead print, PP.0-0) Abstract in english BACKGROUND: The measurement of blood pressure (BP) by the patient himself without strict protocols, adequate training, and validated equipment at their own household is defined as self measured blood pressure (SMBP). OBJECTIVE: To evaluate the interference of the SMBP in treatment adherence and bloo [...] d pressure control. METHODS: The study included 57 patients, 38 in the study group (SG) and 19 in the control group (CG). These patients were followed for 12 months and assessed at randomization (V1) as well as in the sixth (V2) and the twelfth month (V3). Compare the mean blood pressure by casual measurement, by SMBP and by ambulatory monitoring of blood pressure (AMBP), laboratory tests and the answers to the questionnaire on lifestyle. The instruments used were: OMRON HEM 714, for SMBP; OMRON 705 CP, for the casual measurement, and Monitor SPACELABS 9002 for the AMBP. RESULTS: The average age was 62.05 ± 10.78 in the SG and 55.42 ± 11.87 in the CG (p = 0.03). The values of systolic blood pressure (SBP) by casual measurement in the SG and CG were: 140.01 ± 16.73 mmHg and 141.79 ± 23.21 mmHg in V1 (p = 0.72), 135.49 ± 12.73 mmHg and 145.69 ± 19.31 mmHg in V2 (p = 0.02), 131.64 ± 19.28 mmHg and 134.88 ± 23.21 mmHg at V3 (p = 0.59). The values of diastolic blood pressure (DBP) were: 84.13 ± 10.71 mmHg and 86.29 ± 10.35 mmHg in V1 (p = 0.47), 81.69 ± 10.88 mmHg and 89.61 V2 ± 11.58 mmHg (p = 0.02), 80.31 ± 11.83 mmHg and 86 ± 13.38 mmHg in V3 (p = 0.12). CONCLUSION: Patients in the SG had adherence to non-pharmacological treatment similar to the CG, but they had greater adherence to drug treatment and used fewer antihypertensive drugs. There was no difference between groups when comparing the metabolic profile and renal function. (Arq Bras Cardiol. 2011; [online].ahead print, PP.0-0)

  13. Automedida da pressão arterial para o controle das cifras tensionais e para a adesão ao tratamento Self measurement of blood pressure for control of blood pressure levels and adherence to treatment

    Directory of Open Access Journals (Sweden)

    Weimar Kunz Sebba Barroso Souza

    2012-02-01

    Full Text Available FUNDAMENTO: A medida da pressão arterial (PA pelo próprio paciente, sem protocolos rígidos, com treinamento adequado, aparelhos validados e no próprio domicílio, é definida como automedida da pressão arterial (AMPA. OBJETIVO: Avaliar a interferência da AMPA na adesão ao tratamento e no controle pressórico. MÉTODOS: Participaram do estudo 57 pacientes, 38 no grupo de estudo (GE e 19 no grupo de controle (GC. Esses pacientes foram seguidos por 12 meses e avaliados na randomização (V1, bem como no sexto (V2 e no décimo segundo mês (V3. Comparadas as médias da PA pela medida casual, pela AMPA e pela monitorização ambulatorial da pressão arterial (MAPA, exames laboratoriais e as respostas ao questionário sobre o estilo de vida. Os aparelhos utilizados foram: OMRON HEM 714, para a AMPA; OMRON 705 CP, para a medida casual; e Monitor SPACELABS 9002, para a MAPA. RESULTADOS: A idade média em anos foi de 62,05 ± 10,78 e de 55,42 ± 11,87 no GE e no GC (p = 0,03, respectivamente. Os valores da pressão arterial sistólica (PAS pela medida casual no GE e no GC foram: 140,01 ± 16,73 mmHg e 141,79 ± 23,21 mmHg em V1 (p = 0,72; 135,49 ± 12,73 mmHg e 145,69 ± 19,31 mmHg em V2 (p = 0,02; 131,64 ± 19,28 mmHg e 134,88 ± 23,21 mmHg em V3 (p = 0,59. Os valores da pressão arterial diastólica (PAD foram: 84,13 ± 10,71 mmHg e 86,29 ± 10,35 mmHg em V1 (p = 0,47; 81,69 ± 10,88 mmHg e 89,61 ± 11,58 mmHg em V2 (p = 0,02; 80,31 ± 11,83 mmHg e 86 ± 13,38 mmHg em V3 (p = 0,12. CONCLUSÃO: Os pacientes do GE apresentaram adesão ao tratamento não farmacológico semelhante ao GC, mas tiveram maior adesão ao tratamento medicamentoso e utilizaram menor número de drogas anti-hipertensivas. Não houve diferença entre os grupos na comparação do perfil metabólico e da função renal. (Arq Bras Cardiol. 2011; [online].ahead print, PP.0-0BACKGROUND: The measurement of blood pressure (BP by the patient himself without strict protocols, adequate training, and validated equipment at their own household is defined as self measured blood pressure (SMBP. OBJECTIVE: To evaluate the interference of the SMBP in treatment adherence and blood pressure control. METHODS: The study included 57 patients, 38 in the study group (SG and 19 in the control group (CG. These patients were followed for 12 months and assessed at randomization (V1 as well as in the sixth (V2 and the twelfth month (V3. Compare the mean blood pressure by casual measurement, by SMBP and by ambulatory monitoring of blood pressure (AMBP, laboratory tests and the answers to the questionnaire on lifestyle. The instruments used were: OMRON HEM 714, for SMBP; OMRON 705 CP, for the casual measurement, and Monitor SPACELABS 9002 for the AMBP. RESULTS: The average age was 62.05 ± 10.78 in the SG and 55.42 ± 11.87 in the CG (p = 0.03. The values of systolic blood pressure (SBP by casual measurement in the SG and CG were: 140.01 ± 16.73 mmHg and 141.79 ± 23.21 mmHg in V1 (p = 0.72, 135.49 ± 12.73 mmHg and 145.69 ± 19.31 mmHg in V2 (p = 0.02, 131.64 ± 19.28 mmHg and 134.88 ± 23.21 mmHg at V3 (p = 0.59. The values of diastolic blood pressure (DBP were: 84.13 ± 10.71 mmHg and 86.29 ± 10.35 mmHg in V1 (p = 0.47, 81.69 ± 10.88 mmHg and 89.61 V2 ± 11.58 mmHg (p = 0.02, 80.31 ± 11.83 mmHg and 86 ± 13.38 mmHg in V3 (p = 0.12. CONCLUSION: Patients in the SG had adherence to non-pharmacological treatment similar to the CG, but they had greater adherence to drug treatment and used fewer antihypertensive drugs. There was no difference between groups when comparing the metabolic profile and renal function. (Arq Bras Cardiol. 2011; [online].ahead print, PP.0-0

  14. Sedentary Behavior and Light Physical Activity Are Associated with Brachial and Central Blood Pressure in Hypertensive Patients

    DEFF Research Database (Denmark)

    Gerage, A. M.; Benedetti, T. R. B.; Farah, B. Q.; Santana, F. D.; Ohara, D.; Andersen, Lars Bo; Ritti-Dias, R. M.

    2015-01-01

    pressure. Arterial stiffness parameters (augmentation index and pulse wave velocity) and cardiac autonomic modulation (sympathetic and parasympathetic modulation in the heart) were also obtained as secondary outcomes. Results Sedentary activities and light physical activities were positively and inversely...... associated, respectively, with brachial systolic (r = 0.56; P <0.01), central systolic (r = 0.51; P <0.05), brachial diastolic (r = 0.45; P <0.01) and central diastolic (r = 0.42; P <0.05) blood pressures, after adjustment for sex, age, trunk fat, number of antihypertensive drugs, accelerometer wear time and...

  15. NT-proBNP in Isolated Diastolic Dysfunction

    Directory of Open Access Journals (Sweden)

    Kenan ?ltümür

    2005-01-01

    Full Text Available B-type natriuretic peptide (BNP is a neurohormone secreted mainly in the cardiac ventricles in response to volume expansion and pressure overload. This peptide, which is diagnostic and prognostic, has been known as a diagnosis toll in distinguishing diagnosis of dispnea.This study aimed the search of the relation between NT-proBNP and diastolic parameters in hypertensive patients whose systolic dysfunction does not develop.This study included 31 healthy individuals (18 M, age; 44? 9 and 51 hypertensive patients (29 M, age; 48 ? 9 who had hypertension diagnosis for the first time and were free of cardiovascular disease. NT-proBNP was measured with immünoassey method. Tissue doppler was also measured in addition to the standard echocardiography. In hypertensive group plasma NT-proBNP level was significantly higher than control group. (56? 44 and 32 ? 22 p=0,003. Left ventricular ejection fraction (LVEF was normal in both groups (p>0,05. However, in 23 (45% of the hipertensive patients diastolic dysfunction (DDF was found. At the same time left ventricular mass index (LVMI of the patients had increased. It was found that NT-proBNP was significantly higher in patients with left ventricular DDF than those without (66,1? 44,3 ve 38,4 ? 33,2 p=0,003. There was a significant correlation between NT-proBNP and LVMI (r=0,32 p=0,003 and diastolic function parameters (for mitral E/A; r= -0,3 p=0,006 and for mitral tissue E/A ; r= -0,22 p<0,05.As a result, in isolated diastolic dysfunction NT-proBNP level increases. Especially the correlation between NT-proBNP and LVMI and DDF can reflect the increase of afterload in hypertension.

  16. Closure of digital arteries in high vascular tone states as demonstrated by measurement of systolic blood pressure in the fingers

    DEFF Research Database (Denmark)

    Krähenbühl, B; Nielsen, S L; Lassen, N A

    1977-01-01

    Finger systolic blood pressure (FSP) was measured indirectly in normal subjects and patients with primary Raynaud phenomenon by applying a thin-walled plastic cuff around the finger and a strain gauge more distally to detect volume changes. Inducing a high vascular tone in one or more fingers by...... vasospastic arterial disease. It implies an underestimation of palmar arch systolic pressure measured indirectly on the fingers. FSP measured under these circumstances may be taken as an estimate of the vascular tone, and can be employed in diagnosis and quantification of vasospastic disorders....

  17. Low Blood Pressure

    Science.gov (United States)

    ... blood pressure is less than 120/80 mm Hg (systolic pressure is 120 AND diastolic pressure is ... pressure --- even a change of just 20 mm Hg --- can cause dizziness or fainting. Sometimes a rapid ...

  18. Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Raul G. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurosurgery, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurology, Neurocritical Care and Vascular Neurology Section, Boston, MA (United States); Massachusetts General Hospital, Boston, MA (United States); Schwamm, Lee H.; Buonanno, Ferdinando S.; Koroshetz, Walter J. [Massachusetts General Hospital, Harvard Medical School, Department of Neurology, Neurocritical Care and Vascular Neurology Section, Boston, MA (United States); Yoo, Albert J.; Rabinov, James D.; Pryor, Johnny C.; Hirsch, Joshua A. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurosurgery, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States)

    2008-04-15

    The use of coronary balloons in the cerebral vasculature is limited due to their poor trackability and increased risk of vessel injury. We report our experience using more compliant elastomer balloons for thrombus resistant to intraarterial (IA) pharmacological and mechanical thrombolysis in acute stroke. We retrospectively analyzed 12 consecutive patients with an occluded intracranial artery treated with angioplasty using a low-pressure elastomer balloon. Angiograms were graded according to the Thrombolysis in Cerebral Infarction (TICI) and Qureshi grading systems. Outcomes were categorized as independent (modified Rankin scale, mRS, score {<=}2), dependent (mRS score 3-5), or dead (mRS score 6). Included in the study were 12 patients (mean age 66{+-}17 years, range 31-88 years; mean baseline National Institutes of Health stroke scale score 17{+-}3, range 12-23). The occlusion sites were: internal carotid artery (ICA) terminus (five patients, including two concomitant cervical ICA occlusions), M1 segment (two patients), and basilar artery (two patients). Pharmacological treatment included intravenous (IV) t-PA only (two patients), IA urokinase only (nine patients), both IV t-PA and IA urokinase (one patient), and IV and/or IA eptifibatide (eight patients). Mean time to treatment was 5.9{+-}3.9 h (anterior circulation) and 11.0{+-}7.2 h (posterior circulation). Overall recanalization rate (TICI grade 2/3) was 91.6%. Procedure-related morbidity occurred in one patient (distal posterior inferior cerebellar artery embolus). There were no symptomatic hemorrhages. Outcomes at 90 days were independent (five patients), dependent (three patients) and dead (four patients, all due to progression of stroke with withdrawal of care). Angioplasty of acutely occluded intracranial arteries with low-pressure elastomer balloons results in high recanalization rates with an acceptable degree of safety. Prior use of thrombolytics may increase the chances of recanalization, and glycoprotein IIb-IIIa inhibitors may be helpful in preventing reocclusion and in increasing patency rates. (orig.)

  19. Pressão arterial elevada em escolares de Santos: relação com a obesidade High arterial pressure in school children in Santos: relationship to obesity

    Directory of Open Access Journals (Sweden)

    Paulo César Koch Nogueira

    2007-10-01

    Full Text Available OBJETIVO: O crescimento na prevalência da obesidade aumentou a freqüência de pressão elevada em crianças. O objetivo do presente trabalho é avaliar a relação da pressão arterial com a obesidade em escolares do município de Santos. MÉTODOS: Realizamos estudo transversal em duas etapas, sendo uma fase de triagem, envolvendo avaliação antropométrica e medida de pressão em 7.440 crianças (9,0 ± 1,1 anos, 3.891 ou 52% de meninas. Uma amostra de 1.713 indivíduos (9,7 ± 1,1 anos, 826 ou 48% de meninas dentre os que, na triagem, apresentaram a pressão arterial em nível igual ou superior ao percentil 90 foi revisitada um ano mais tarde e novas medidas foram realizadas. Nas duas fases do estudo, consideramos pressão elevada os valores iguais ou maiores que o percentil 95 de pressão para o sexo e a estatura. RESULTADOS: Na triagem 1.123/7.440 (15% crianças apresentaram pressão elevada; crianças obesas apresentaram pressão elevada mais freqüentemente (OR = 3,7 95% IC=3,2 a 4,3. Na segunda fase, 43/1.713 (2,7% apresentaram pressão elevada e novamente a presença de obesidade conferiu maior risco para pressão elevada (OR=1,5 95% IC=1,2 a 1,8. Além disso, observamos aumento da PA sistólica de acordo com a massa corporal na totalidade dos intervalos de IMC estudados e não apenas após a instalação da obesidade. CONCLUSÃO: Nosso estudo reforça os dados que sugerem aumento no risco de pressão elevada em crianças obesas. Para a pressão sistólica, o incremento de pressão parece ser cumulativo de acordo com o aumento do IMC, mesmo em crianças não obesas.OBJECTIVE: The escalating prevalence of obesity has led to an increase in the blood pressure of children and adolescents. This works aims to assess the relation between blood pressure and obesity in school children of Santos. METHODS: We performed a cross-sectional study in two phases. In a first screening we measured blood pressure and performed anthropometric evaluation of 7.440 children (9.0 ± 1.1 years, 3891 or 52% of girls. Then a sample, including 1.713 children (9.7 ± 1.1 years, 826 or 48% of girls, among those who presented with blood pressure equal to or above the 90 percentile in the screening phase was selected and visited again for new blood pressure and anthropometric measurements. In both phases of the study we considered as high blood pressure those values equal to or higher than the 95 percentile for the gender and stature of each individual. RESULTS: In the screening phase 1.123/7.440 (15% of children presented high blood pressure; obese children presented an increased frequency of high blood pressure (OR = 3.7 95% CI=3.2 4.3. In the second phase 43/1.713 (2.7% presented high blood pressure; obese children again presented an increased frequency of high blood pressure (OR = 1.5 95% CI=1.2 1.8. Moreover we observed a progressive rise of systolic blood pressure parallel to the BMI at all intervals of BMI and not only in obese children. CONCLUSION: Our work reinforces data in literature suggesting increased risk of high blood pressure among obese children. Increase in blood pressure may be cumulative with BMI rise, not only in obese children.

  20. A STUDY OF EFFECT OF SMOKING ON BLOOD PRESSURE IN HEALTHY YOUNG ADULTS

    OpenAIRE

    Prashanth Babu; Mallikarjuna; Arun Kumar; Prashanth

    2014-01-01

    BACKGROUND: Smoking now is identified as a major cause of respiratory diseases, heart related ailments, cancer and a wide variety of other health problems. It is well known that the acute effects of smoking produce an increase in systolic and diastolic blood pressure, tachycardia, vasoconstriction, increase in carotid artery occlusion, and sometimes instantaneous Myocardial infarction. The present study was undertaken to study the effects of smoking on blood pressure in young apparently healt...

  1. Changes in pulmonary artery pressures during ethanol sclerotherapy for arteriovenous malformations: identifying the most vulnerable period

    Energy Technology Data Exchange (ETDEWEB)

    Ko, J.S. [Department of Anaesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul (Korea, Republic of); Kim, C.S., E-mail: kem99@skku.edu [Department of Anaesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul (Korea, Republic of); Shin, B.S.; Kim, M.J.; Lee, J.H. [Department of Anaesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul (Korea, Republic of); Kim, K.H.; Do, Y.S. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul (Korea, Republic of)

    2011-07-15

    Aim: To evaluate the changes in pulmonary artery pressure (PAP) during ethanol embolization and to identify the most vulnerable period associated with cardiovascular collapse in patients with arteriovenous malformations (AVMs). Materials and methods: Twenty-three patients (30 sessions) with AVMs were enrolled. PAP was measured at the following times: baseline (T{sub baseline}); immediately before (T{sub pre}), and after (T{sub post}) bolus injection of absolute ethanol; at the time of maximum mean PAP value during a session (T{sub highest-ethanol}); 10 min after final injection (T{sub final}); after restoration of spontaneous breathing (T{sub resp}); at extubation (T{sub extubation}); 30 min after extubation (T{sub extubation-30} {sub min}); and at the time of maximum mean PAP after patient resumed spontaneous respiration (T{sub highest-resp}). Nitroglycerin was infused (range 0.5-3 {mu}g/kg/min) in all patients to attenuate the effect of ethanol on pulmonary vasoconstriction. Results: The PAPs of T{sub highest-ethanol}, T{sub resp}, T{sub extubation}, and T{sub highest-resp} were significantly higher than the corresponding values for T{sub baseline} and T{sub final} (all p < 0.05). The systolic and mean PAPs of T{sub highest-resp} were significantly higher than those at T{sub highest-ethanol} (both p < 0.05). In 24 sessions (80%), the highest mean PAP was detected during the recovery period. Conclusion: The greatest rise in PAP was noted during the recovery period in patients undergoing ethanol embolotherapy. Therefore, PAP monitoring and nitroglycerin infusions are recommended during the recovery period because early detection of an increase in PAP and prompt management may prevent detrimental complications.

  2. Gene Variant of the Bradykinin B2 Receptor Influences Pulmonary Arterial Pressures in Heart Failure Patients

    Directory of Open Access Journals (Sweden)

    Thomas P. Olson

    2009-01-01

    Full Text Available Background: Pulmonary arterial pressure (PAP varies considerably in heart failure (HF despite similar degrees of left ventricular (LV dysfunction. Bradykinin alters vascular tone and common variations in the kinin B2 receptor (BDKRB2 gene exists. We hypothesized that genetic variation in this receptor would influence PAP in HF.Methods: 131 HF patients ( >1yr history systolic HF, without COPD, not currently smoking, BMI < 40, without atrial fibrillation completed the study which included a blood draw for genotyping and neurohormones (ACE, A-II, Bradykinin, ANP, BNP, and catecholamines, an echocardiogram for cardiac function and systolic PAP (PAPsys.Results: Mean LVEF was 29% ± 12%, NYHA class 2 ± 1, age 56 ± 12 yr, BMI 28 ± 5 kg/m2. Forty-six patients (35% were homozygous for the +9 allele, 58 (44% were heterozygous (+9/?9 and 27 (21% were homozygous for the ?9 allele of the BDKRB2. PAPsys averaged 42 ± 13, 38 ± 12, and 35 ± 11 mmHg for +9/+9, +9/?9 and ?9/?9, respectively (p = 0.03. There was a trend towards gene effect for plasma ACE with the highest values in +9/+9 and lowest in ?9/?9 patients (9.5 ± 10.7, 7.1 ± 8.7, and 5.4 ± 6.4 U/L, respectively, p = 0.06. There were no differences in plasma bradykinin or A-II, LVEF, or NYHA across genotypes.Conclusion: These data suggest the +9/+9 polymorphism of the BDKRB2 receptor influences pulmonary vascular tone in stable HF.

  3. Peripheral arterial line (image)

    Science.gov (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of blood pressure ...

  4. Color Doppler imaging of the ophthalmic artery in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Daniela B. Almeida-Freitas

    2011-10-01

    Full Text Available Purpose: To evaluate the ophthalmic artery hemodynamics in patients with chronic heart failure. Methods: Doppler parameters of ophthalmic artery of 18 patients with chronic heart failure in different stages of the disease were compared with 21 healthy volunteers (control group. These parameters were also correlated with echocardiographic assessments and clinical cardiologic status. Results: Mean diastolic velocity was 5.14 ± 2.4 cm/s in the chronic heart failure group and 7.44 ± 3.5 cm/s in the control group (p=0.007. Mean resistance index of the ophthalmic artery was 0.76 ± 0.08 in the chronic heart failure group and 0.70 ± 0.08 in the control group (p=0.04. Mean systolic velocity of the ophthalmic artery was 22.03 ± 7.7 cm/s in the chronic heart failure group and 25.32 ± 9.2 cm/s in the control group (p=0.24. There was a negative correlation between the resistance index of the ophthalmic artery and systemic blood pressure of patients with chronic heart failure (r= -0.47, p=0.007. Diastolic velocity of the ophthalmic artery correlated positively with systemic blood pressure (r=0.44, p=0.02. Conclusion: Lower diastolic velocity and higher resistance index were observed in the ophthalmic artery of chronic heart failure patients when compared to the control group, which probably reflects the presence of orbital vasoconstriction in response to low cardiac output. Therefore, the influence of these findings on the structure and function of the optic nerve head deserves investigation.

  5. Preeclampsia Is Associated with Increased Central Aortic Pressure, Elastic Arteries Stiffness and Wave Reflections, and Resting and Recruitable Endothelial Dysfunction.

    Science.gov (United States)

    Torrado, Juan; Farro, Ignacio; Zócalo, Yanina; Farro, Federico; Sosa, Claudio; Scasso, Santiago; Alonso, Justo; Bia, Daniel

    2015-01-01

    Introduction. An altered endothelial function (EF) could be associated with preeclampsia (PE). However, more specific and complementary analyses are required to confirm this topic. Flow-mediated dilation (FMD), low-flow-mediated constriction (L-FMC), and hyperemic-related changes in carotid-radial pulse wave velocity (PWVcr) offer complementary information about "recruitability" of EF. Objectives. To evaluate, in healthy and hypertensive pregnant women (with and without PE), central arterial parameters in conjunction with "basal and recruitable" EF. Methods. Nonhypertensive (HP) and hypertensive pregnant women (gestational hypertension, GH; preeclampsia, PE) were included. Aortic blood pressure (BP), wave reflection parameters (AIx@75), aortic pulse wave velocity (PWVcf) and PWVcr, and brachial and common carotid stiffness and intima-media thickness were measured. Brachial FMD and L-FMC and hyperemic-related change in PWVcr were measured. Results. Aortic BP and AIx@75 were elevated in PE. PE showed stiffer elastic but not muscular arteries. After cuff deflation, PWVcr decreased in HP, while GH showed a blunted PWVcr response and PE showed a tendency to increase. Maximal FMD and L-FMC were observed in HP followed by GH; PE did not reach significant arterial constriction. Conclusion. Aortic BP and wave reflections as well as elastic arteries stiffness are increased in PE. PE showed both "resting and recruitable" endothelial dysfunctions. PMID:26351578

  6. Gene-centric Meta-analysis in 87,736 Individuals of European Ancestry Identifies Multiple Blood-Pressure-Related Loci

    OpenAIRE

    Tragante, Vinicius; Barnes, Michael R.; Ganesh, Santhi K.; Lanktree, Matthew B.; Guo, Wei; Franceschini, Nora; Smith, Erin N.; Johnson, Toby; Holmes, Michael V.; Padmanabhan, Sandosh; Karczewski, Konrad J.; Almoguera, Berta; Barnard, John; Baumert, Jens; Chang, Yen-Pei Christy

    2014-01-01

    Blood pressure (BP) is a heritable risk factor for cardiovascular disease. To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP), we genotyped ∼50,000 SNPs in up to 87,736 individuals of European ancestry and combined these in a meta-analysis. We replicated findings in an independent set of 68,368 individuals of European ancestry. Our analyses identified 11 previously undescribed associations in independent loci c...

  7. Epidemiology of high blood pressure among the Kaingang people on the Xapecó Indigenous Land in Santa Catarina State, Brazil, 2013

    OpenAIRE

    Deise Bresan; João Luiz Bastos; Maurício Soares Leite

    2015-01-01

    This cross-sectional study describes the prevalence of high blood pressure (HBP; measured at one setting, and suggestive of a clinical diagnosis of arterial hypertension) and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) and their associations with socio-demographic and anthropometric variables among 355 Kaingang adults (≥ 20 years) on the Xapecó Indigenous Land in Brazil. Weight, height, waist circumference (WC), SBP, and DBP were measured and socio-demographic data w...

  8. Sildenafil and diastolic dysfunction after acute myocardial infarction in patients with preserved ejection fraction

    DEFF Research Database (Denmark)

    Andersen, Mads J; Ersbøll, Mads; Axelsson, Anna; Gustafsson, Finn; Hassager, Christian; Køber, Lars; Borlaug, Barry A; Boesgaard, Søren; Skovgaard, Lene T; Møller, Jacob E

    2013-01-01

    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. 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...

  9. Numerical and analytical assessment of the influence of blood flow through arterial perforators on the pulse pressure shape

    Science.gov (United States)

    Pieniak, Marcin; Piechna, Adam; Cie?licki, Krzysztof

    2015-09-01

    Most of the existing models of cardiovascular system do not take into account the leakage of blood through a number of small vessels branching the main arterial trunks and called perforators. Therefore, the aim of this study is to investigate their influence on the pulse pressure waveform. Linearized, 1D computer model of a minute part of the cardiovascular system has been designed and series of simulations with and without leakage have been conducted. Blood flow in a single segment of the arterial system and pressure in vascular nodes were described by the two first order partial differential equations. A set of boundary conditions on both ends of a single vascular segment and at nodal point have been formulated. To solve the linear set of above equations, a numerical method of characteristic has been used. It was shown that the leakage reduces reflection from the peripheral resistance. The simulations have also shown a decrease of the average pressure value with increase of leakage and modification of the pulse pressure waveform. All these effects depended strongly on the assumed leakage value and practically died out when its value was reduced to about 10% of the main flow.

  10. Efeito do sulfato de magnésio sobre o índice de pulsatilidade das artérias uterinas, umbilical e cerebral média fetal de acordo com a persistência da incisura protodiastólica da artéria uterina na pré-eclâmpsia grave 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

    Directory of Open Access Journals (Sweden)

    Alex Sandro Rolland Souza

    2009-02-01

    Full Text Available OBJETIVO: avaliar o efeito do sulfato de magnésio sobre o índice de pulsatilidade (IP das artérias uterinas, umbilicais e cerebral média fetal, de acordo com a persistência ou não da incisura protodiastólica bilateral das artérias uterinas na pré-eclâmpsia grave. MÉTODOS: foi desenvolvido um estudo do tipo coorte, incluindo 40 gestantes com pré-eclâmpsia grave, das quais 23 apresentavam incisura protodiastólica bilateral e 17, incisura ausente/unilateral. As pacientes foram submetidas a doplervelocimetria antes e depois de 20 minutos da administração intravenosa de 6 g do sulfato de magnésio. O exame foi realizado com a paciente em posição semi-Fowler, obtendo-se os sonogramas durante a inatividade fetal, em períodos de apneia e ausência de contrações uterinas. Todos os exames foram realizados por dois pesquisadores, considerando a média como resultado final. A comparação dos IP antes e depois do sulfato de magnésio em cada grupo foi realizada pelo teste de Wilcoxon. A diferença das duas medidas (antes e depois do sulfato de magnésio foi comparada entre os grupos (incisura bilateral e incisura ausente/unilateral utilizando-se o teste de Mann-Whitney. RESULTADOS: houve um aumento significativo da frequência cardíaca materna e uma diminuição da pressão arterial materna e da mediana dos IP das duas artérias uterinas e da artéria cerebral média fetal depois da utilização do sulfato de magnésio em ambos os grupos. Houve redução significativa do IP da artéria uterina esquerda e da artéria umbilical apenas no grupo com incisura protodiastólica unilateral/ausente. No entanto, não foram encontradas diferenças significativas em relação ao IP da artéria uterina direita e relação umbilical/cerebral antes e depois do sulfato de magnésio em cada grupo. Não se encontrou diferença entre os grupos, antes e depois do sulfato de magnésio, para nenhum dos desfechos estudados. CONCLUSÕES: após a administração intravenosa de 6 g do sulfato de magnésio nas pacientes com pré-eclâmpsia grave, ocorre uma diminuição da pressão arterial e do IP das artérias uterinas, umbilicais e cerebral média fetal, além de aumento da frequência cardíaca materna, não influenciada pela presença de incisura protodiastólica bilateral nas artérias uterinas.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 differ

  11. Intensidades de treinamento resistido e pressão arterial de idosas hipertensas - um estudo piloto Resistance training intensities and blood pressure of hypertensive older women - a pilot study

    Directory of Open Access Journals (Sweden)

    Eline Silva da Cunha

    2012-12-01

    Full Text Available INTRODUÇÃO: Observa-se que a literatura apresenta uma lacuna acerca da intensidade ideal de treinamento resistido para idosos hipertensos, os poucos estudos existentes utilizam treinamentos com diferentes intensidades. OBJETIVO: Verificar o efeito de duas intensidades de treinamento resistido sobre a pressão arterial de idosas hipertensas controladas. Métodos: Dezesseis idosas hipertensas, controladas por medicação anti-hipertensiva, foram divididas em dois grupos através de sorteio. Nove pacientes foram submetidas a treinamento resistido moderado (G1 e sete, a treinamento resistido leve (G2. As pacientes realizaram oito semanas de treinamento resistido, com frequência de três vezes por semana em dias alternados, no período vespertino. Os exercícios realizados foram respectivamente: leg press, supino reto, extensão de joelhos, puxada frontal, flexão de joelhos, abdução de ombro, abdução unilateral de quadril com cross over e rosca direta com barra. RESULTADOS: As pacientes do G1 apresentaram redução tanto nos valores de repouso da pressão arterial diastólica (PAD p BACKGROUND: The optimum intensity of resistance training for hypertensive elderly has not been studied yet and the few studies in the literature used training with distinct intensities. Objective: To verify the effect of two resistance training intensities on blood pressure (BP of elderly women with controlled hypertension. METHODS: Sixteen older women with hypertension controlled by anti-hypertensive drug were randomly divided into two groups. Nine patients were submitted to moderate resistance training (G1 and seven patients were submitted to mild resistance training (G2. The patients underwent eight weeks of resistance training, with frequency of three times per week on alternate days in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. RESULTS: G1 patients presented reduction in both resting values in diastolic blood pressure (DBP p<0.03 and mean arterial pressure (MAP p<0.03. G2 presented decrease in resting values of MAP (p<0.03 and a tendency to decrease in DBP (p<0.06. Magnitude of values decrease in both groups was higher than the ones reported in the literature. CONCLUSION: Both light and moderate training promoted cardiovascular benefits, even when initiated at old age. Moreover, both can be indicated as supporting treatment for older women with hypertension controlled by medication.

  12. VARIATION IN THE SYSTOLIC ARTERIAL PRESSURE WITH THE CHANGES OF POSITION, AS PREDICTOR OF POSTANESTHETIC HYPOTENSION IN ELECTIVE CESAREAN (IN SPANISH

    Directory of Open Access Journals (Sweden)

    De la Peña-Martínez Michael

    2014-01-01

    Full Text Available Introduction: It is important to identify to those pregnant women with risk to present postanesthetic arterial hypotension, when they are submitted to cesarean under spinal anesthesia. Objective: to identify if the variability in the systolic arterial pressure (SAP with the preoperative changes of position is predictor of postanesthetic arterial hypotension in elective cesarean. Methods: 244 women with pregnancy at term, programmed for elective cesarean were studied. Preanesthetic measures of the SAP in supine decubitus and in left lateral decubitus position were carried out, estimating the difference between the two measures. Postanesthetic arterial hypotension was defined as SAP lower than 90 mmHg or reduction higher to 30% of the SAP in supine decubitus position. Results: postanesthetic arterial hypotension was presented in 107 (43.8% of the pregnant women. The variation of the SAP in the group that presented postanesthetic arterial hypotension was 10.5 [2.0 to 16.5] Vs 2.5 [-6.5 to 6.0] between those who did not present it (P<0,0001. It was estimated that variability higher to 11 mmHg of the SAP predicted postanesthetic arterial hypotension with sensibility: 47.6%, specificity: 93.4%, LR (+: 7.26, LR (-: 0.58 and area under the curve of 0.737 (CI 95%: 0.677-0.791, (p=0.0001. In turn such a variation was significant risk factor for the decrease of the arterial pressure. RR: 2.79 (CI95%: 2.19-3.56. Conclusion: the preanesthetic variation of the SAP with the change of position from supine decubitus to lateral decubitus position was predictor of arterial hypotension subsequent to the use of spinal anesthesia in pregnant women submitted to elective cesareans. Rev.Cienc.Biomed. 2014;5(1:29-34 KEYWORDS Arterial Pressure; Blood Pressure; Cesarean Section; Anesthesia, Obstetric.

  13. EFFECT OF SYSTEMIC ADMINISTRATION OF HMG Co A REDUCTASE INHIBITOR ATORVASTATIN ON CENTRAL RETINAL ARTERY FLOW DYNAMICS, INTRA OCULAR PRESSURE AND VISUAL FIELD CHANGES IN PRIMARY OPEN ANGLE GLAUCOMA AND NORMAL TENSION GLAUCOMA PATIENTS

    Directory of Open Access Journals (Sweden)

    Deepak Kumar

    2015-12-01

    Full Text Available PURPOSE To study the effect of systemic administration of HMG CoA reductase inhibitor Atorvastatin on Central Retinal Artery (CRA flow dynamics, Intraocular Pressure (IOP and Visual Field (VF changes in Primary Open Angle Glaucoma (POAG and Normal Tension Glaucoma (NTG patients. MATERIALS AND METHODS Prospective randomized placebo controlled double blind parallel group study consisting of 80 eyes of 40 patients suffering from POAG and NTG was conducted. After baseline clinical evaluation and Color Doppler Imaging (CDI of CRA subjects were randomized to receive 40mg/day of Atorvastatin (Tonact or matching Placebo for 3 months and followed at two weeks, one month and three months. Main outcome measures were Peak Systolic Velocity (PSV, End Diastolic Velocity (EDV, Resistive Index (RI, IOP and Mean Deviation (MD in VF. RESULTS Atorvastatin group showed decrease in IOP (P=0.0009 in right eye and P=0.0049 in left eye and in RI (P=0.0005 in right eye and P=0.0008 in left eye, while there was increase in RI in the placebo group (P=0.0006 in right eye and P=0.0007 in left eye after 3 months. No significant change in MD of VF was noticed in both groups. CONCLUSION Atorvastatin has favorable effect in POAG and NTG patients causing decrease in IOP and resistance of CRA with increase in CRA flow dynamics.

  14. Pressão arterial e discriminação interpessoal: revisão sistemática de estudos epidemiológicos / Blood pressure and interpersonal discrimination: systematic review of epidemiologic studies

    Scientific Electronic Library Online (English)

    Paulo Francisco, Couto; Janaina Brugnera, Goto; João Luiz, Bastos.

    2012-10-01

    Full Text Available A relação entre pressão arterial e discriminação tem sido investigada recentemente, havendo intensos debates na literatura sobre o tema. Este trabalho objetivou atualizar as revisões de literatura sobre discriminação e pressão arterial ou hipertensão. Foi conduzida pesquisa no PubMed, entre janeiro/ [...] 2000 e dezembro/2010, incluindo estudos epidemiológicos, que avaliaram a discriminação interpessoal e sua relação com pressão arterial/hipertensão. Os 22 estudos identificados originaram-se dos Estados Unidos; 96% deles empregaram o delineamento transversal, com amostras de conveniência e compostas, em 59% dos casos, exclusivamente por negros. Os instrumentos mais utilizados para aferir discriminação foram Everyday Discrimination Scale e Perceived Racism Scale, enfatizando a discriminação étnico-racial, ocorrida ao longo da vida ou cotidianamente. Nos 22 estudos avaliados, a relação entre discriminação e os desfechos foi analisada 50 vezes. Em 20 (40%) resultados, não foi encontrada qualquer associação e, em apenas 15 (30%), observaram-se associações positivas globais, sendo 67% destas estatisticamente significativas. Foram também observadas oito associações inversas, sugerindo que maior exposição à discriminação estaria associada com menor pressão arterial/hipertensão. Os estudos não permitiram apoiar consistentemente a hipótese de que a discriminação está associada à maior pressão arterial. Isto pode ser atribuído, em parte, às limitações dos estudos, relacionadas à mensuração da discriminação e de eventos que podem modificar sua associação com os desfechos. Para consolidar a discriminação como um fator de risco epidemiológico, é necessário utilizar estratégias metodológicas mais rigorosas e revisar os marcos teóricos que propõem relações de causa e efeito entre discriminação e pressão arterial. Abstract in english The relationship between blood pressure and discrimination has been recently investigated, and there are conflicting debates in literature devoted to the topic. The objective of this study was to update previous literature reviews on discrimination and blood pressure. A bibliographic search was cond [...] ucted in PubMed between January/2000 and December/2010, including epidemiological studies, assessing the relationship between interpersonal discrimination and blood pressure/hypertension. The 22 studies included originated from the United States; 96% of them used the cross-sectional design with convenience sample, comprising, in 59% of the studies, exclusively Black participants. The Everyday Discrimination Scale and the Perceived Racism Scale were the most frequently used instruments, emphasizing lifetime or chronic/everyday racial/ethnic discrimination. In the 22 studies assessed, the association between discrimination and blood pressure/hypertension was assessed 50 times. Twenty results (40%) showed no association between them, and only 15 (30%) revealed global positive associations, of which 67% were statistically significant. Eight negative associations were also observed, suggesting that higher exposure to discrimination would be associated with lower blood pressure/hypertension. The studies did not consistently support the hypothesis that discrimination is associated with higher blood pressure. These findings can be partially attributed to the limitations of the studies, especially those related to the measurement of discrimination and of factors that might modify its association with outcomes. To establish discrimination as an epidemiological risk factor, more rigorous methodological strategies should be used, and the theoretical frameworks that postulate causal relationships between discrimination and blood pressure should be reviewed.

  15. Peripheral and central arterial pressure and its relationship to vascular target organ damage in carotid artery, retina and arterial stiffness. Development and validation of a tool. The Vaso risk study

    Directory of Open Access Journals (Sweden)

    Patino-Alonso Maria C

    2011-04-01

    Full Text Available Abstract Background Ambulatory blood pressure monitoring (ABPM shows a better correlation to target organ damage and cardiovascular morbidity-mortality than office blood pressure. A loss of arterial elasticity and an increase in carotid artery intima-media thickness (IMT has been associated with increased cardiovascular morbidity-mortality. Tools have been developed that allow estimation of the retinal arteriovenous index but not all studies coincide and there are contradictory results in relation to the evolution of the arteriosclerotic lesions and the caliber of the retinal vessels. The purpose of this study is to analyze the relationship between peripheral and central arterial pressure (clinic and ambulatory and vascular structure and function as evaluated by the carotid artery intima-media thickness, retina arteriovenous index, pulse wave velocity (PWV and ankle-brachial index in patients with and without type 2 diabetes. In turn, software is developed and validated for measuring retinal vessel thickness and automatically estimating the arteriovenous index. Methods/Design A cross-sectional study involving a control group will be made, with a posterior 4-year follow-up period in primary care. The study patients will be type 2 diabetics, with a control group of non-diabetic individuals. Consecutive sampling will be used to include 300 patients between 34-75 years of age and no previous cardiovascular disease, one-half being assigned to each group. Main measurements: age, gender, height, weight and abdominal circumference. Lipids, creatinine, microalbuminuria, blood glucose, HbA1c, blood insulin, high sensitivity C-reactive protein and endothelial dysfunction markers. Clinic and ambulatory blood pressure monitoring. Carotid ultrasound to evaluate IMT, and retinography to evaluate the arteriovenous index. ECG to assess left ventricle hypertrophy, ankle-brachial index, and pulse wave analysis (PWA and pulse wave velocity (PWV with the Sphigmocor System. Discussion We hope to obtain information on the correlation of different ABPM-derived parameters and PWA to organ target damage - particularly vascular structure and function evaluated from the IMT and PWV - and endothelial dysfunction in patients with and without type 2 diabetes. We also hope to demonstrate the usefulness of the instrument developed for the automated evaluation of retinal vascularization in the early detection of alterations in vascular structure and function and in the prognosis of middle-term cardiovascular morbidity. Trial Registration Clinical Trials.gov Identifier: NCT01325064

  16. Mesenteric artery response to head-up tilt-induced central hypovolaemia and hypotension

    DEFF Research Database (Denmark)

    Perko, M J; Madsen, P; Perko, Grazyna; Schroeder, T V; Secher, N H

    1997-01-01

    Superior mesenteric artery (SMA) blood flow and impedance were evaluated by duplex ultrasound during head-up tilt (HUT)-induced central hypovolaemia and hypotension in eight healthy volunteers. HUT induced a reduction in cardiac stroke volume from 88.8 +/- 6.3 to 64.7 +/- 6.3 ml (mean +/- SEM; P <0....... During both the normotensive and the hypotensive phase of HUT, the SMA diameter (5.7 +/- 0.03 mm) and blood flow (514 +/- 75 ml min-1) did not change significantly, although the end-diastolic velocity increased from 9.7 +/- 4.8 to 39.7 +/- 4.0 cm s-1 (P <0.01). The increase in diastolic velocity, despite...... a maintained or reduced arterial pressure, supports a reduction in the SMA impedance as it was reproduced during a meal test when a moderate reduction in mean arterial pressure (87 +/- 4 to 80 +/- 4 mm Hg; P = 0.04) was accompanied by a ninefold increase in the end-diastolic velocity (P <0.01). The...

  17. Blood-Pressure Measuring System Gives Accurate Graphic Output

    Science.gov (United States)

    1965-01-01

    The problem: To develop an instrument that will provide an external (indirect) measurement of arterial blood pressure in the form of an easily interpreted graphic trace that can be correlated with standard clinical blood-pressure measurements. From sphygmograms produced by conventional sphygmographs, it is very difficult to differentiate the systolic and diastolic blood-pressure pulses and to correlate these indices with the standard clinical values. It is nearly impossible to determine these indices when the subject is under physical or emotional stress. The solution: An electronic blood-pressure system, basically similar to conventional ausculatory sphygmomanometers, employing a standard occluding cuff, a gas-pressure source, and a gas-pressure regulator and valve. An electrical output transducer senses cuff pressure, and a microphone positioned on the brachial artery under the occluding cuff monitors the Korotkoff sounds from this artery. The output signals present the conventional systolic and diastolic indices in a clear, graphical display. The complete system also includes an electronic timer and cycle-control circuit.

  18. Validação do monitor de medida de pressão arterial Omron HEM 742 em adolescentes Validación del monitor de medida de presión arterial Omron HEM 742 en adolescentes Validation of the omron HEM 742 blood pressure monitoring device in adolescents

    Directory of Open Access Journals (Sweden)

    Diego Giulliano Destro Christofaro

    2009-01-01

    Full Text Available FUNDAMENTO: A medida precisa da pressão arterial é fundamental para a investigação científica ou decisão clínica. Nesse sentido, é importante verificar valores fornecidos por equipamentos eletrônicos. OBJETIVO: Validar o monitor Omron HEM 742 de medida de pressão arterial em adolescentes, segundo os critérios sugeridos pela British Hypertension Society. MÉTODOS: Participaram do estudo 150 adolescentes com idades entre 10 e 16 anos. O monitor automático Omron HEM 742 foi conectado em Y com equipamento auscultatório de coluna de mercúrio, e realizaram-se três avaliações simultâneas, calculando-se as diferenças entre os dois equipamentos. Para verificar a relação entre ambos, utilizaram-se o coeficiente de correlação intraclasse e a plotagem de Bland-Altman (concordância. A especificidade e a sensibilidade do aparelho foram determinadas pela curva ROC. RESULTADOS: A comparação entre as medidas acusou uma diferença menor ou igual a 5 mmHg em 67,3% dos valores sistólicos e 69,3% dos valores diastólicos; uma diferença menor ou igual a 10 mmHg ocorreu em 87,3% e 90,6% dos valores sistólicos e diastólicos, respectivamente; e uma diferença menor ou igual a 15 mmHg em 96,6% dos valores sistólicos e 97,3% dos diastólicos. Esses resultados indicam grau A segundo o protocolo da British Hypertension Society. Observou-se ainda elevada concordância nos valores obtidos por meio do monitor automático, e verificou-se que esse equipamento é capaz de identificar a presença ou a ausência da pressão arterial elevada. CONCLUSÃO: O monitor Omron HEM 742 mostrou-se válido para medidas de pressão arterial em adolescentes, conforme os critérios sugeridos pela British Hypertension Society.FUNDAMENTO: La medida precisa de la presión arterial es fundamental para la investigación científica o decisión clínica. En este sentido, es importante que se verifique valores provenientes de equipos electrónicos. OBJETIVO: Validar el monitor Omron HEM 742 de medida de presión arterial en adolescentes, de acuerdo con los criterios sugeridos por British Hypertension Society. MÉTODOS: Participaron del estudio 150 adolescentes con edades entre 10 y 16 años. Se conectó el monitor automático Omron HEM 742 en Y con equipo de auscultación de columna de mercurio, y se realizaron tres evaluaciones simultáneas, calculándose las diferencias entre los dos equipos. Para verificarse la relación entre ambos, se utilizó el coeficiente de correlación intraclase y el método de Bland-Altman (concordancia. Se determinó la especificidad y la sensibilidad del aparato por medio de la curva ROC. RESULTADOS: La comparación entre las medidas evidenció una diferencia menor o igual a 5 mmHg en el 67,3% de los valores sistólicos y el 69,3% de los valores diastólicos; una diferencia BACKGROUND: Accurate blood pressure measurement is fundamental for scientific investigation or clinical decision-making. In this sense, it is important to verify the values provided by electronic devices. OBJECTIVE: To validate the Omron HEM 742 blood pressure monitoring device in adolescents according to criteria suggested by the British Hypertension Society. METHODS: A total of 150 adolescents aged between 10 and 16 years participated in the study. The automated Omron HEM 742 monitor was connected in Y to the mercury column auscultatory device, then three simultaneous measurements were taken, and the differences between the readings of the two devices were calculated. The intraclass correlation coefficient and Bland-Altman plot (agreement were used to verify the relationship between both devices. Specificity and sensitivity of the device were determined by using the ROC curve. RESULTS: The comparison between the measurements showed an equal to or lower than 5mmHg difference in 67.3% of the systolic values, and 69.3% of the diastolic values; an equal to or lower than 10mmHg difference occurred in 87.3% and 90.6% of the systolic and diastolic values, respectively; an equal to or lower than 15mmHg difference was found in 96.6% of the systolic values and 97.3% of the diastolic values. These findings are consistent with a grade A according to the British Hypertension Society protocol. A marked consonance was observed between the values obtained by the automated monitor and this device was proven to be capable of identifying the presence or absence of high blood pressure. CONCLUSION: The Omron HEM 742 monitor was proved valid for blood pressure measurement in adolescents according to the criteria suggested by the British Hypertension Society.

  19. Comparison of Telemetry and High-Definition Oscillometry for Blood Pressure Measurements in Conscious Dogs: Effects of Torcetrapib

    OpenAIRE

    Meyer, Olivier; Jenni, Roland; Greiter-Wilke, Andrea; Breidenbach, Alexander; Holzgrefe, Henry H

    2010-01-01

    This study compared torcetrapib-induced blood pressure (BP) changes simultaneously obtained by high-definition oscillometry (HDO) and telemetry. Male beagles (n = 6) received single oral doses of vehicle or torcetrapib at 10 or 30 mg/kg; BP were acquired simultaneously by HDO and telemetry from 2 h before dosage until 7 h afterward. Systolic, diastolic, and mean arterial pressures (MAP) and heart rate were compared by using Altman-Bland agreement analysis. Dogs were allocated into subgroups a...

  20. Reproducibility of the ambulatory arterial stiffness index in hypertensive patients

    DEFF Research Database (Denmark)

    Dechering, D.G.; Steen, M.S. van der; Adiyaman, A.; Thijs, L.; Deinum, J.; Li, Y.; Dolan, E.; Akkermans, R.P.; Richart, T.; Kikuya, M.; Wang, J.; O'Brien, E.; Thien, T.; Staessen, J.A.; Hansen, Tine Willum

    2008-01-01

    BACKGROUND: We studied the repeatability of the ambulatory arterial stiffness index (AASI), which can be computed from 24-h blood pressure (BP) recordings as unity minus the regression slope of diastolic on systolic BP. METHODS: One hundred and fifty-two hypertensive outpatients recruited in...... Nijmegen (mean age = 46.2 years; 76.3% with systolic and diastolic hypertension) and 145 patients enrolled in the Systolic Hypertension in Europe (Syst-Eur) trial (71.0 years) underwent 24-h BP monitoring at a median interval of 8 and 31 days, respectively. We used the repeatability coefficient, which is...... were approximately 30%. Differences in AASI between paired recordings were correlated with differences in the goodness of fit (r2) of the AASI regression line as well as with differences in the night-to-day BP ratio. However, in sensitivity analyses stratified for type of hypertension, r2, or dipping...

  1. Early detection of acute transmural myocardial ischemia by the phasic systolic-diastolic changes of local tissue electrical impedance.

    Science.gov (United States)

    Jorge, Esther; Amorós-Figueras, Gerard; García-Sánchez, Tomás; Bragós, Ramón; Rosell-Ferrer, Javier; Cinca, Juan

    2016-02-01

    Myocardial electrical impedance is influenced by the mechanical activity of the heart. Therefore, the ischemia-induced mechanical dysfunction may cause specific changes in the systolic-diastolic pattern of myocardial impedance, but this is not known. This study aimed to analyze the phasic changes of myocardial resistivity in normal and ischemic conditions. Myocardial resistivity was measured continuously during the cardiac cycle using 26 different simultaneous excitation frequencies (1 kHz-1 MHz) in 7 anesthetized open-chest pigs. Animals were submitted to 30 min regional ischemia by acute left anterior descending coronary artery occlusion. The electrocardiogram, left ventricular (LV) pressure, LV dP/dt, and aortic blood flow were recorded simultaneously. Baseline myocardial resistivity depicted a phasic pattern during the cardiac cycle with higher values at the preejection period (4.19 ± 1.09% increase above the mean, P < 0.001) and lower values during relaxation phase (5.01 ± 0.85% below the mean, P < 0.001). Acute coronary occlusion induced two effects on the phasic resistivity curve: 1) a prompt (5 min ischemia) holosystolic resistivity rise leading to a bell-shaped waveform and to a reduction of the area under the LV pressure-impedance curve (1,427 ± 335 vs. 757 ± 266 ?·cm·mmHg, P < 0.01, 41 kHz) and 2) a subsequent (5-10 min ischemia) progressive mean resistivity rise (325 ± 23 vs. 438 ± 37 ?·cm at 30 min, P < 0.01, 1 kHz). The structural and mechanical myocardial dysfunction induced by acute coronary occlusion can be recognized by specific changes in the systolic-diastolic myocardial resistivity curve. Therefore these changes may become a new indicator (surrogate) of evolving acute myocardial ischemia. PMID:26608340

  2. Minimal distal pressure rise after reconstructive arterial surgery in patients with multiple obstructive arteriosclerosis

    DEFF Research Database (Denmark)

    Noer, Ivan; Tønnesen, K H; Sager, P

    1980-01-01

    fifteen had ischemic ulcers. The preoperative median pressure index (per cent of arm systolic pressure) was 10% on the 1st toe. At the 10th postoperative day the median toe pressure rose to 25%. A further rise took place at the one month control to 30% which was unchanged throughout the study. All...... patients with a persistent postoperative toe pressure above 20% of arm systolic pressure were ultimately relieved from rest pain and chronic ulcers....

  3. Effects of β-adrenergic receptor agonists on drinking and arterial blood pressure in young and old rats

    OpenAIRE

    Thunhorst, Robert L.; Grobe, Connie L.; Beltz, Terry G.; Johnson, Alan Kim

    2011-01-01

    These experiments examined water-drinking and arterial blood pressure responses to β-adrenergic receptor activation in young (4 mo), “middle-aged” adult (12 mo), and old (29 mo) male rats of the Brown-Norway strain. We used isoproterenol to simultaneously activate β1- and β2-adrenergic receptors, salbutamol to selectively activate β2-adrenergic receptors, and the combination of isoproterenol and the β2-adrenergic receptor antagonist ICI 118,551 to stimulate only β1-adrenergic receptors. Anima...

  4. Pulse wave analysis in a 180-degree curved artery model: Implications under physiological and non-physiological inflows

    Science.gov (United States)

    Bulusu, Kartik V.; Plesniak, Michael W.

    2013-11-01

    Systolic and diastolic blood pressures, pulse pressures, and left ventricular hypertrophy contribute to cardiovascular risks. Increase of arterial stiffness due to aging and hypertension is an important factor in cardiovascular, chronic kidney and end-stage-renal-diseases. Pulse wave analysis (PWA) based on arterial pressure wave characteristics, is well established in clinical practice for evaluation of arterial distensibility and hypertension. The objective of our exploratory study in a rigid 180-degree curved artery model was to evaluate arterial pressure waveforms. Bend upstream conditions were measured using a two-component, two-dimensional, particle image velocimeter (2C-2D PIV). An ultrasonic transit-time flow meter and a catheter with a MEMS-based solid state pressure sensor, capable of measuring up to 20 harmonics of the observed pressure waveform, monitored flow conditions downstream of the bend. Our novel continuous wavelet transform algorithm (PIVlet 1.2), in addition to detecting coherent secondary flow structures is used to evaluate arterial pulse wave characteristics subjected to physiological and non-physiological inflows. Results of this study will elucidate the utility of wavelet transforms in arterial function evaluation and pulse wave speed. Supported by NSF Grant No. CBET- 0828903 and GW Center for Biomimetics and Bioinspired Engineering.

  5. Understanding Blood Pressure Readings

    Science.gov (United States)

    ... American Heart Association. Blood Pressure Category Systolic mm Hg (upper #) Diastolic mm Hg (lower #) Normal less than 120 and less than ... blood pressure is less than 120/80 mm Hg. Your blood pressure rises with each heartbeat and ...

  6. Diastolic Dysfunction Is a Contributing Factor to Exercise Intolerance in COPD.

    Science.gov (United States)

    Faludi, Réka; Hajdu, Máté; Vértes, Vivien; Nógrádi, Ágnes; Varga, Noémi; Illés, Miklós Balázs; Sárosi, Veronika; Alexy, György; Komócsi, András

    2016-06-01

    Right ventricular (RV) systolic failure is rare in patients with COPD, but they often develop RV diastolic dysfunction. Left ventricular (LV) diastolic dysfunction is also common in this population. Nevertheless, data are scarce regarding the effect of diastolic dysfunction on the functional capacity in patients with COPD. We investigated the correlation between echocardiographic parameters of RV and LV diastolic function and the exercise capacity in COPD, by using conventional echocardiographic methods and tissue Doppler imaging. 65 patients with COPD (61 ± 9 years) in stages GOLD II-IV were investigated. Functional capacity was measured with 6-minute walk test (6MWT). Right (RA) and left atrial (LA) area index were measured; collapsibility index inferior vena cava was calculated. Parameters of the mitral and tricuspid inflow (E, A) as well as annular systolic (S), early- (e') and late- (a') diastolic myocardial longitudinal velocities were measured. E/A, E/e' and e'/a' ratios were calculated. 6MWT distance was 330 ± 76 m. LV diastolic dysfunction was found in 48 (74%) patients. LV and RV filling pressures were elevated in 28 (43%) and in 29 (45%) patients, respectively. In the left heart, LA area index showed significant correlation with the functional capacity (r = -0.319; p = 0.011). In stepwise multiple linear regression analysis tricuspid e'/a' (r = 0.611; p = 0.000), collapsibility index (r = 0.505; p = 0.000), RA area index (r = -0.445; p = 0.000) and body surface area (r = 0.314; p = 0.011) were independent predictors of 6MWT distance. Right ventricular diastolic function and filling pressure have strong influence on the functional capacity in patients with COPD. PMID:26682932

  7. Oxidative stress mediated arterial dysfunction in patients with obstructive sleep apnoea and the effect of continuous positive airway pressure treatment

    Directory of Open Access Journals (Sweden)

    Del Ben Maria

    2012-07-01

    Full Text Available Abstract Background Several studies suggest an increase of oxidative stress and a reduction of endothelial function in obstructive sleep apnoea syndrome (OSAS. We assessed the association between OSAS, endothelial dysfunction and oxidative stress. Further aim was to evaluate the effect of nasal continuous positive airway pressure (nCPAP on oxidative stress and arterial dysfunction. Methods We studied 138 consecutive patients with heavy snoring and possible OSAS. Patients underwent unattended overnight home polysomnography. Ten patients with severe OSAS were revaluated after 6 months of nCPAP therapy. To assess oxidative stress in vivo, we measured urinary 8-iso-PGF2α and serum levels of soluble NOX2-derived peptide (sNOX2-dp. Serum levels of nitrite/nitrate (NOx were also determined. Flow-mediated brachial artery dilation (FMD was measured to asses endothelial function. Results Patients with severe OSAS had higher urinary 8-iso-PGF2α (p Conclusions The results of our study indicate that patients with OSAS and cardiometabolic comorbidities have increased oxidative stress and arterial dysfunction that are partially reversed by nCPAP treatment.

  8. Factores asociados al no control de la presión arterial en pacientes inscritos al programa de hipertensión de una Entidad Promotora de Salud en Cali-Colombia, 2004 Factors associated with lack of blood pressure control in patients enrolled in a hypertension control program of a private primary Health Care Organization in Cali, Colombia, in 2004

    Directory of Open Access Journals (Sweden)

    Rodolfo Herrera

    2009-08-01

    Full Text Available Objetivos: determinar los factores asociados al no control de la presión arterial en pacientes inscritos al programa de control de la hipertensión de una Entidad Promotora de Salud en Cali-Colombia, en el año 2004. Métodos: estudio descriptivo de corte transversal, en el que se seleccionaron de manera aleatoria 356 pacientes mayores de 18 años de los inscritos en el programa de control de la hipertensión arterial. Se clasificó como paciente no controlado en hipertensión arterial a quien presentó presión arterial sistólica superior a 139 mm Hg o presión arterial diastólica superior a 89 mm Hg. Se consideraron como variables independientes: factores de riesgo no modificables, comportamentales, biológicos y administrativos. Mediante un análisis bivariado y multivariado se identificaron factores asociados al no control de la presión arterial. Resultados: la prevalencia del no control fue 30,1% (IC 95% 25,3-34,8, siendo mayor en el género masculino (c2= 9,368; p=0,002. La adherencia al tratamiento farmacológico fue 56,2% (IC 95%: 51,0% - 61,3%. El riesgo relativo indirecto (OR de no control de la tensión arterial ajustada por género y según el uso de inhibidores de la enzima convertidora de angiotensina solos o en combinación con medicamentos hipolipemiantes, fue de 1,71 (IC 95%: 1,0-2,94; según el tipo de Institución Prestadora de Salud donde se lleva a cabo el programa de hipertensión arterial adscrita a la Entidad Promotora de Salud en comparación con los que asisten a Instituciones Prestadoras de Salud propias, el OR fue 2,13 (IC 95%: 1,3- 3,5. Conclusiones: la prevalencia de hipertensión arterial no controlada en un programa de una Entidad Promotora de Salud fue de 30,1%. Los factores asociados fueron: tipo de Institución Prestadora de Salud, género masculino y uso de inhibidores de la enzima convertidora de angiotensina y la interacción del medicamento con antecedentes de dislipidemia.Objectives: to determine the factors associated to the lack of control of arterial blood pressure in patients enrolled in a hypertension control program of a private primary health care organization in Cali, Colombia in 2004. Methods: descriptive cross-sectional study. 356 patients >18 years were randomly chosen from the hypertension control program. Those patients with systolic blood pressure >139 mm Hg or diastolic blood pressure >89 mm Hg were classified as patients with lack of blood pressure control. Risk factors that could not be modified, behavioral, biological and administrative factors, were considered independent variables. Through a bivariate and multivariate analysis, factors associated to lack of blood pressure control were identified. Results: the prevalence of lack of blood pressure control in this health care organization was 30,1% (95% CI, 25,3-34,8, being higher in males (c2= 9,368; p=0,002. Adherence to pharmacological treatment was 56,2% (95% CI: 51,0% - 61,3%. Odds ratio (OR for lack of blood pressure control adjusted by gender and according to hypolipemic drugs combination was 1,71 (95% CI: 1,0-2,94; OR according to the contracted health care organization in comparison with the institutional health care was 2.13 (95% CI: 1.3 - 3.5. Conclusions: the prevalence of lack of blood pressure control in a hypertension control program of a private health care organization was 30,1%. Associated factors were: type of health care organization, male gender, use of inhibitors on angiotensing-converting enzyme and drug interaction with concomitant use of hypolipemis.

  9. Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions

    International Nuclear Information System (INIS)

    The use of coronary balloons in the cerebral vasculature is limited due to their poor trackability and increased risk of vessel injury. We report our experience using more compliant elastomer balloons for thrombus resistant to intraarterial (IA) pharmacological and mechanical thrombolysis in acute stroke. We retrospectively analyzed 12 consecutive patients with an occluded intracranial artery treated with angioplasty using a low-pressure elastomer balloon. Angiograms were graded according to the Thrombolysis in Cerebral Infarction (TICI) and Qureshi grading systems. Outcomes were categorized as independent (modified Rankin scale, mRS, score ≤2), dependent (mRS score 3-5), or dead (mRS score 6). Included in the study were 12 patients (mean age 66±17 years, range 31-88 years; mean baseline National Institutes of Health stroke scale score 17±3, range 12-23). The occlusion sites were: internal carotid artery (ICA) terminus (five patients, including two concomitant cervical ICA occlusions), M1 segment (two patients), and basilar artery (two patients). Pharmacological treatment included intravenous (IV) t-PA only (two patients), IA urokinase only (nine patients), both IV t-PA and IA urokinase (one patient), and IV and/or IA eptifibatide (eight patients). Mean time to treatment was 5.9±3.9 h (anterior circulation) and 11.0±7.2 h (posterior circulation). Overall recanalization rate (TICI grade 2/3) was 91.6%. Procedure-related morbidity occurred in one patient (distal posterior inferior cerebellar artery embolus). There were no symptomatic hemorrhages. Outcomes at 90 days were independent (five patients), dependent (three patients) and dead (four patients, all due to progression of stroke with withdrawal of care). Angioplasty of acutely occluded intracranial arteries with low-pressure elastomer balloons results in high recanalization rates with an acceptable degree of safety. Prior use of thrombolytics may increase the chances of recanalization, and glycoprotein IIb-IIIa inhibitors may be helpful in preventing reocclusion and in increasing patency rates. (orig.)

  10. Diastolic and autonomic dysfunction in early cirrhosis

    DEFF Research Database (Denmark)

    Dahl, Emilie Kristine; Møller, Søren; Kjær, Andreas; Petersen, Claus Leth; Bendtsen, Flemming; Krag, Aleksander

    2014-01-01

    cirrhosis during maximal β-adrenergic drive. MATERIAL AND METHODS. Nineteen patients with Child A (n = 12) and Child B cirrhosis (n = 7) and seven matched controls were studied during cardiac stress induced by increasing dosages of dobutamine and atropine. RESULTS. Pharmacological responsiveness was similar...... fraction was similar in patients and controls. Peak filling rate was longer in cirrhosis compared to controls (1.8 ± 0.4 and 1.4 ± 0.2 end-diastolic volume/s, p < 0.01). Pro-ANP was higher in cirrhosis and increased during stress by 13% compared to 0% in controls, p < 0.01. CONCLUSIONS. These findings...... indicate that patients with early stage cirrhosis exhibit early diastolic and autonomic dysfunction as well as elevated pro-ANP. However, the cardiac chronotropic and inotropic responses to dobutamine stress were normal. The dynamics of ventricular repolarization appears normal in patients with early stage...

  11. COPD advances in left ventricular diastolic dysfunction

    OpenAIRE

    Kubota Y; Asai K; Murai K; Tsukada YT; Hayashi H; Saito Y; Azuma A; Gemma A; Shimizu W

    2016-01-01

    Yoshiaki Kubota,1 Kuniya Asai,1 Koji Murai,1 Yayoi Tetsuou Tsukada,1 Hiroki Hayashi,2 Yoshinobu Saito,2 Arata Azuma,2 Akihiko Gemma,2 Wataru Shimizu1 1Department of Cardiovascular Medicine, 2Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan Background: COPD is concomitantly present in ~30% of patients with heart failure. Here, we investigated the pulmonary function test parameters for left ventricular (LV) diastolic dysfunction a...

  12. Oscillometric continuous blood pressure sensing for wearable health monitoring system

    CERN Document Server

    Gelao, Gennaro; Passaro, Vittorio M N; Perri, Anna Gina

    2015-01-01

    In this paper we present an acquisition chain for the measurement of blood arterial pressure based on the oscillometric method. This method does not suffer from any limitation as the well-known auscultatory method and it is suited for wearable health monitoring systems. The device uses a pressure sensor whose signal is filtered, digitalized and analyzed by a microcontroller. Local analysis allows the evaluation of the systolic and diastolic pressure values which can be used for local alarms, data collection and remote monitoring.

  13. Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure

    DEFF Research Database (Denmark)

    Holstein, P; Trap-Jensen, J; Bagger, H; Larsen, B

    1983-01-01

    The skin perfusion pressure (SPP) measured as the isotope washout cessation external pressure is valuable in selection of major amputation level. Five methodological investigations important to clinical use were carried out: (1) In five normal legs and 10 legs with arterial occlusive disease (AOD...... digit (strain gauge technique). The two different methods correlated statistically significant at all four levels, but the systolic blood pressures were higher than the SPP in particular in diabetic legs; (3) Angiograms in 35 legs with AOD showed that the SPP on the ankle was only consistently decreased...... concluded that 99Tcm is as suitable as the 131I- -labelled tracers in estimating the SPP. The SPP is significantly correlated to skin blood flow, to systolic blood pressure, to tc pO2 and to angiographic findings. Correction of SPP for systemic blood pressure changes can be made in proportion with the...

  14. Angiographic diagnosis of fibromuscular dysplasia of the renal arteries

    Energy Technology Data Exchange (ETDEWEB)

    Petkov, B.; Grigorov, G.; Nedelkov, G. (Meditsinska Akademiya, Sofia (Bulgaria). Nauchen Inst. po Rentgenologiya i Radiobiologiya)

    1982-01-01

    In the nosological structure of renovascular hypertensions fibromuscular dysplasia of the renal arteries by incidence ranks second after atherosclerosis. The illness affects mainly women, more frequently young and having borne a child. Hypertension in such patients is usually characterized by high values of the diastolic pressure, and leads to early neurologic complaints such as headache, sight impairment, vertigo and Meniere-like syndromes. Morphological and functional changes are likewise described. Some of the literature statements concerning the etiopathogenesis and classification of fibromuscular dysplasia are critically assayed. The success of the surgical management depends on the timely established exact diagnosis, and angiography appears to be the only method of primary importance in this respect.

  15. Number of distal limb and brachial pressure measurements required when diagnosing peripheral arterial disease by laser Doppler flowmetry

    International Nuclear Information System (INIS)

    We examine the reliability of single and repeated blood pressure measurements at ankle, toe, and arm levels for the diagnosis of peripheral arterial disease (PAD) by laser Doppler flowmetry. Segmental pressures were measured in 200 patients with known or suspected PAD. Segmental indices were calculated using (1) one measurement [M-1], two measurements [M-2], or by a predefined reproducibility criterion (RC) as well as (2) by using one brachial blood-pressure (BBP-one) or correspondent to each segmental pressure (BBP-all) as reference. The agreement in diagnosis of PAD by Cohen's Kappa was κ = 0.930 when comparing RC to M-1, and κ = 0.977 when comparing RC to M-2. The same comparison showed excellent relative reliability for segmental indices (all intra-class correlation coefficients (ICC) ≥ 0.980). Diagnostic classification agreement for BBP-all versus BBP-one were κ = 0.831 for RC, κ = 0.804 for M-1, and κ = 0.847 for M-2. The relative reliability analysis showed excellent correlation in segmental indices (all ICC ≥ 0.957). The study shows minimal difference in segmental indices and diagnostic classification when comparing calculations based on the listed strategies. However, the study indicated that it is important to measure BBPs correspondent to each segmental pressure. (paper)

  16. Quantitative 3D pulmonary MR-perfusion in patients with pulmonary arterial hypertension: Correlation with invasive pressure measurements

    Energy Technology Data Exchange (ETDEWEB)

    Ley, Sebastian [Department of Pediatric Radiology, Children' s Hospital University Heidelberg, Im Neuenheimer Feld 153, 69120 Heidelberg (Germany) and Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)]. E-mail: ley@gmx.net; Mereles, Derliz [Internal Medicine III, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Risse, Frank [Medical Physics in Radiology (E020), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Gruenig, Ekkehard [Internal Medicine III, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Ley-Zaporozhan, Julia [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Tecer, Zueleyha [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Puderbach, Michael [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Fink, Christian [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Clinical Radiology, University Medical Center Grosshadern, Ludwigs-Maximilians-University, Munich (Germany); Kauczor, Hans-Ulrich [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

    2007-02-15

    Purpose: Pathological changes of the peripheral pulmonary arteries induce pulmonary arterial hypertension (PAH). Aim of this study was to quantitatively assess the effect of PAH on pulmonary perfusion by 3D-MR-perfusion techniques and to compare findings to healthy controls. Furthermore, quantitative perfusion data were correlated with invasive pressure measurements. Material and methods: Five volunteers and 20 PAH patients (WHO class II or III) were examined using a 1.5 T MR scanner. Measurement of pulmonary perfusion was done in an inspiratory breathhold (FLASH3D; 3.5 mm x 1.9 mm x 4 mm; TA per 3D dataset 1.5 s). Injection of contrast media (0.1 mmol Gd-DTPA/kg BW) and image acquisition were started simultaneously. Evaluation of 3D perfusion was done using singular value decomposition. Lung borders were outlined manually. Each lung volume was divided into three regions (anterior, middle, posterior), and the following parameters were assessed: Time-to-Peak (TTP), blood flow (PBF), blood volume (PBV), and mean transit time (MTT). In 10 patients invasive pulmonary artery pressure measurements were available and correlated to the perfusion measurements. Results: In both, controls and patients, an anterior-to-posterior gradient with higher PBF and PBV posterior was observed. In the posterior lung region, a significant difference (p < 0.05) was found for TTP (12 s versus 16 s) and MTT (4 s versus 6 s) between volunteers and patients. PBF and PBV were lower in patients than in volunteers (i.e. dorsal regions: 124 versus 180 ml/100 ml/min and 10 versus 12 ml/100 ml), but the difference failed to be significant. The ratio of PBF and PBV between the posterior and the middle or ventral regions showed no difference between both groups. A moderate linear correlation between mean pulmonary arterial pressure (mPAP) and PBV (r = 0.51) and MTT (r = 0.56) was found. Conclusion: The only measurable effect of PAH on pulmonary perfusion is a prolonging of the MTT. There is only a moderate linear correlation of invasive mPAP with PBV and MTT.

  17. End-tidal arterial CO2 partial pressure gradient in patients with severe hypercapnia undergoing noninvasive ventilation

    Directory of Open Access Journals (Sweden)

    Defilippis V

    2013-06-01

    Full Text Available Vito Defilippis,1 Davide D’Antini,2 Gilda Cinnella,2 Michele Dambrosio,2 Fernando Schiraldi,3 Vito Procacci1 1Emergency Department, Riuniti Hospital, 2Department of Anaesthesiology and Intensive Care, University of Foggia, Foggia, 3Emergency Department, San Paolo Hospital, Naples, Italy Background: Patients with severe hypercapnia represent a particularly serious condition in an emergency department (ED, requiring immediate attention. Noninvasive ventilation (NIV is an integral part of the treatment for acute respiratory failure. The present study aimed to validate the measurement of end-tidal CO2 (EtCO2 as a noninvasive technique to evaluate the effectiveness of NIV in acute hypercapnic respiratory failure. Methods: Twenty consecutive patients admitted to the ED with severe dyspnea were enrolled in the study. NIV by means of bilevel positive airway pressure, was applied to the patients simultaneously with standard medical therapy and continued for 12 hours; the arterial blood gases and side-stream nasal/oral EtCO2 were measured at subsequent times: T0 (admission to the ED, T1h (after 1 hour, T6h (after 6 hours, and T12h (after 12 hours during NIV treatment. Results: The arterial CO2 partial pressure (PaCO2–EtCO2 gradient decreased progressively, reaching at T6h and T12h values lower than baseline (P < 0.001, while arterial pH increased during the observation period (P < 0.001. A positive correlation was found between EtCO2 and PaCO2 values (r = 0.89, P < 0.001 at the end of the observation period. Conclusion: In our hypercapnic patients, the effectiveness of the NIV was evidenced by the progressive reduction of the PaCO2–EtCO2 gradient. The measurement of the CO2 gradient could be a reliable method in monitoring the effectiveness of NIV in acute hypercapnic respiratory failure in the ED. Keywords: arterial end-tidal CO2 gradient, noninvasive ventilation, bilevel positive airway pressure, acute respiratory failure

  18. Consumo de fibra dietética, sodio, potasio y calcio y su relación con la presión arterial en hombres adultos normotensos Dietary fiber, energy, sodium, potassium and calcium intake and its relationship to blood pressure in normotensive male adults

    Directory of Open Access Journals (Sweden)

    Martha Nydia Ballesteros-Vásquez

    1998-05-01

    Full Text Available Objetivo. Evaluar el efecto del consumo de fibra dietética, energía, sodio, potasio y calcio sobre la presión arterial de un grupo de adultos normotensos, tomando en cuenta indicadores tales como la edad, el sexo, la actividad física y la obesidad. Material y métodos. Se evaluaron 38 sujetos del sexo masculino de 30 a 45 años de edad, normotensos, aparentemente sanos y residentes de la ciudad de Hermosillo, Sonora, México. Se midió la presión arterial y se realizó una evaluación dietética, antropométrica y de actividad física. Resultados. La dieta resultó ser alta en fibra y en grasa. El sodio estaba 56% por arriba de la recomendación en 87% de los casos y fue la variable que más efecto mostró sobre la presión diastólica. De los sujetos estudiados, 36.9% tenían sobrepeso y obesidad, y se encontró una asociación significativa entre el índice de masa corporal y la presión diastólica y sistólica. Conclusiones. Existe una asociación significativa entre la hipertensión arterial y el alto consumo de sodio, el sobrepeso y la obesidad en sujetos normotensos.Objective. To evaluate the effect of dietary fiber, energy, sodium, calcium and potassium intake on the blood pressure of a group of normotensive adults. Material and methods. Subjects were 38 healthy normotensive adult males aged 30-45 years, resident of Hermosillo, Sonora, Mexico. Blood pressure, diet, anthropometric data and physical activity were recorded. Results. Their diet was high in fiber and fat. Sodium intake was 56% above the recommended values in 87% of the subjects, and the variable with the highest correlation to diastolic blood pressure. Of the subjects, 36.9% were overweight and obese, and a significant statistic association was found between BMI and diastolic and systolic blood pressure. Conclusions. A significant relationship was found between hypertension and high consumption of sodium, overweight and obesity in healthy adult normotensive males.

  19. A computational analysis of the long-term regulation of arterial pressure [v2; ref status: indexed, http://f1000r.es/2hm

    Directory of Open Access Journals (Sweden)

    Daniel A. Beard

    2013-12-01

    Full Text Available The asserted dominant role of the kidneys in the chronic regulation of blood pressure and in the etiology of hypertension has been debated since the 1970s. At the center of the theory is the observation that the acute relationships between arterial pressure and urine production—the acute pressure-diuresis and pressure-natriuresis curves—physiologically adapt to perturbations in pressure and/or changes in the rate of salt and volume intake. These adaptations, modulated by various interacting neurohumoral mechanisms, result in chronic relationships between water and salt excretion and pressure that are much steeper than the acute relationships. While the view that renal function is the dominant controller of arterial pressure has been supported by computer models of the cardiovascular system known as the “Guyton-Coleman model”, no unambiguous description of a computer model capturing chronic adaptation of acute renal function in blood pressure control has been presented. Here, such a model is developed with the goals of: 1. representing the relevant mechanisms in an identifiable mathematical model; 2. identifying model parameters using appropriate data; 3. validating model predictions in comparison to data; and 4. probing hypotheses regarding the long-term control of arterial pressure and the etiology of primary hypertension. The developed model reveals: long-term control of arterial blood pressure is primarily through the baroreflex arc and the renin-angiotensin system; and arterial stiffening provides a sufficient explanation for the etiology of primary hypertension associated with ageing. Furthermore, the model provides the first consistent explanation of the physiological response to chronic stimulation of the baroreflex.

  20. A computational analysis of the long-term regulation of arterial pressure [v1; ref status: indexed, http://f1000r.es/1xq

    Directory of Open Access Journals (Sweden)

    Daniel A. Beard

    2013-10-01

    Full Text Available The asserted dominant role of the kidneys in the chronic regulation of blood pressure and in the etiology of hypertension has been debated since the 1970s. At the center of the theory is the observation that the acute relationships between arterial pressure and urine production—the acute pressure-diuresis and pressure-natriuresis curves—physiologically adapt to perturbations in pressure and/or changes in the rate of salt and volume intake. These adaptations, modulated by various interacting neurohumoral mechanisms, result in chronic relationships between water and salt excretion and pressure that are much steeper than the acute relationships. While the view that renal function is the dominant controller of arterial pressure has been supported by computer models of the cardiovascular system known as the “Guyton-Coleman model”, no unambiguous description of a computer model capturing chronic adaptation of acute renal function in blood pressure control has been presented. Here, such a model is developed with the goals of: 1. capturing the relevant mechanisms in an identifiable mathematical model; 2. identifying model parameters using appropriate data; 3. validating model predictions in comparison to data; and 4. probing hypotheses regarding the long-term control of arterial pressure and the etiology of primary hypertension. The developed model reveals: long-term control of arterial blood pressure is primarily through the baroreflex arc and the renin-angiotensin system; and arterial stiffening provides a sufficient explanation for the etiology of primary hypertension associated with ageing. Furthermore, the model provides the first consistent explanation of the physiological response to chronic stimulation of the baroreflex.

  1. Cardiac magnetic resonance imaging for myocardial perfusion and diastolic function-reference control values for women.

    Science.gov (United States)

    Bakir, May; Wei, Janet; Nelson, Michael D; Mehta, Puja K; Haftbaradaran, Afsaneh; Jones, Erika; Gill, Edward; Sharif, Behzad; Slomka, Piotr J; Li, Debiao; Shufelt, Chrisandra L; Minissian, Margo; Berman, Daniel S; Bairey Merz, C Noel; Thomson, Louise E J

    2016-02-01

    Angina, heart failure with preserved ejection fraction (HFpEF) and coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease (CAD) are more common in women and are associated with adverse cardiovascular prognosis. Cardiac magnetic resonance imaging (CMRI) is established for assessment of left ventricular (LV) morphology and systolic function and is increasingly used to assess myocardial perfusion and diastolic function. Indeed, stress CMRI allows measurement of myocardial perfusion reserve index (MPRI) using semi-quantitative techniques, and quantification of LV volumetric filling patterns provides valuable insight into LV diastolic function. The utility of these two techniques remains limited, because reference control values for MPRI and LV diastolic function in asymptomatic middle-aged, women have not previously been established. To address this limitation, we recruited twenty women, without clinical cardiovascular disease or cardiovascular risk factors, with normal maximal Bruce protocol exercise treadmill testing. Subjects underwent CMRI (1.5 tesla) using a standardized protocol of adenosine stress and rest perfusion and LV cinematic imaging. Commercially available with automated CMRI segmentation was used for calculation of MPRI, LV filling profiles, and ejection fraction. Mean age was 54±9 years and mean body mass index was 25±4 kg/m(3). The exercise treadmill testing results demonstrated a normotensive group with normal functional capacity and hemodynamic response. We report reference control values for semi-quantitative MPRI as well as measures of LV systolic and diastolic function including ejection fraction, stroke volume, peak filling rate (PFR), PFR adjusted for end-diastolic volume (EDV) and stroke volume, time to PFR, and EDV index. The data herein provide reference values for MPRI and diastolic function in a cohort of healthy, middle-aged of women. These reference values may be used for comparison with a variety of patient populations, including women with CMD and HFpEF. PMID:26885495

  2. Cardiac magnetic resonance imaging for myocardial perfusion and diastolic function—reference control values for women

    Science.gov (United States)

    Bakir, May; Wei, Janet; Nelson, Michael D.; Mehta, Puja K.; Haftbaradaran, Afsaneh; Jones, Erika; Gill, Edward; Sharif, Behzad; Slomka, Piotr J.; Li, Debiao; Shufelt, Chrisandra L.; Minissian, Margo; Berman, Daniel S.; Bairey Merz, C. Noel

    2016-01-01

    Angina, heart failure with preserved ejection fraction (HFpEF) and coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease (CAD) are more common in women and are associated with adverse cardiovascular prognosis. Cardiac magnetic resonance imaging (CMRI) is established for assessment of left ventricular (LV) morphology and systolic function and is increasingly used to assess myocardial perfusion and diastolic function. Indeed, stress CMRI allows measurement of myocardial perfusion reserve index (MPRI) using semi-quantitative techniques, and quantification of LV volumetric filling patterns provides valuable insight into LV diastolic function. The utility of these two techniques remains limited, because reference control values for MPRI and LV diastolic function in asymptomatic middle-aged, women have not previously been established. To address this limitation, we recruited twenty women, without clinical cardiovascular disease or cardiovascular risk factors, with normal maximal Bruce protocol exercise treadmill testing. Subjects underwent CMRI (1.5 tesla) using a standardized protocol of adenosine stress and rest perfusion and LV cinematic imaging. Commercially available with automated CMRI segmentation was used for calculation of MPRI, LV filling profiles, and ejection fraction. Mean age was 54±9 years and mean body mass index was 25±4 kg/m3. The exercise treadmill testing results demonstrated a normotensive group with normal functional capacity and hemodynamic response. We report reference control values for semi-quantitative MPRI as well as measures of LV systolic and diastolic function including ejection fraction, stroke volume, peak filling rate (PFR), PFR adjusted for end-diastolic volume (EDV) and stroke volume, time to PFR, and EDV index. The data herein provide reference values for MPRI and diastolic function in a cohort of healthy, middle-aged of women. These reference values may be used for comparison with a variety of patient populations, including women with CMD and HFpEF. PMID:26885495

  3. Effects of Everolimus-Eluting Stents on the Left Ventricular Systolic and Diastolic Functions

    Directory of Open Access Journals (Sweden)

    MohammadSadegh Parsaee

    2015-10-01

    Full Text Available Background: The drug-eluting stent (DES decreases the rate of coronary restenosis and re-obstruction. The aim of this study was to assess prospectively the effectiveness of the new generation DES on the left ventricular (LV systolic and diastolic functions in patients with isolated severe proximal left anterior descending (LAD coronary artery stenosis.Methods: A prospective study was conducted on 50 patients with isolated severe proximal LAD stenosis. Successful percutaneous coronary intervention (PCI with Everolimus-eluting stents was performed for the whole study population. All the patients underwent transthoracic echocardiography within 24 hours before and one month after PCI, and LV systolic and diastolic parameters were compared before and after PCI using the paired samples t-test.Results: The mean age of the study population was 57.68 ± 8.82 years. Within the study population, 26 (52% patients were male and 24 (48% were female. There was a significant 10.6% and 5.2% increase in the early diastolic mitral annular motion (e' and the LV ejection fraction following PCI, respectively (p value = 0.005 and p value = 0.044, respectively. Before PCI, wall motion abnormality was seen in 2.21 ± 2.91 segments, which significantly decreased to 1.49 ± 2.58 segments (p value = 0.04 after the procedure. Also, the wall motion score index was 1.18 ± 0.26 before PCI, which significantly decreased to 1.13 ± 0.23 after PCI (p value < 0.001.Also, there was a trend toward a higher ratio of transmitral peak early diastolic velocity to peak late diastolic velocity after PCI (p value = 0.068.Conclusion: Our study showed that the use of the Everolimus-eluting stents improved the LV systolic and diastolic functions in patients with isolated severe LAD stenosis.

  4. A RETROSPECTIVE STUDY OF THE IMPACT OF MEAN ARTERIAL PRESSURE ON ESTIMATED BLOOD LOSS DURING ENDOSCOPIC SINUS SURGERY

    Directory of Open Access Journals (Sweden)

    George W Williams

    2014-10-01

    Full Text Available The current practice of lowering mean arterial pressure (MAP during endoscopic sinus surgery (ESS is common, but unproven with regard to peer reviewed literature. The controlled hypotension induced is aimed for improved surgical field and lower the blood loss. Lower mean arterial pressures especially for prolonged surgeries may result in end organ hypoperfusion. The authors reviewed all patients who underwent outpatient endoscopic sinus surgery for the diagnosis of chronic sinusitis from January 1, 2012 to December 31, 2012 at Memorial Hermann Hospital – Texas Medical Centre. We individually reviewed case sheets of every patient and documented blood loss as recorded on the anaesthesia record or in the surgical procedure note, among other variables. A total of 326 patients were included in this study. The median estimated blood loss (EBL was found to be 50 ml. The multivariate regression analysis between these three groups showed that EBL was higher in MAP 75 group. The average of EBL in MAP75 group and the average of EBL in MAP 65-70 group is 42% higher than that in MAP>75 group when other variables were fixed. Hence we found the trend toward higher blood loss with lower MAP. The authors conclude that lower MAP does not result in lower EBL in endoscopic sinus surgery. Furthermore, increases in BMI and crystalloid administered during an aesthetic management of these cases correlates with increased estimate blood loss.

  5. Temporal changes in clinic and ambulatory blood pressure during cyclic post-menopausal hormone replacement therapy

    DEFF Research Database (Denmark)

    Sørensen, M B; Rasmussen, Verner; Jensen, Gorm Boje; Ottesen, B

    2000-01-01

    , diastolic blood pressure was again reduced (-3.6 mmHg, P= 0.037). Mean 24 h ambulatory systolic and diastolic blood pressures were significantly lower than clinic measurements (-15.7 and -5.9 mmHg, P < 0.001) but were unaffected by HRT. CONCLUSIONS: Clinic blood pressure is reduced during a cyclic HRT...... regimen but the reduction varies with the HRT regimen, which might explain the diversity in previous BP findings during HRT. Norethisterone acetate might possess additive blood pressure-lowering effects in postmenopausal women.......OBJECTIVE: Post-menopausal hormone replacement (HRT) might protect against cardiovascular disease, possibly by arterial vasodilation and reduced blood pressure. Progestogens are needed to avoid endometrial disease but vascular effects are controversial. The objective was to assess temporal changes...

  6. Functional electrical stimulation training on functional capacity and blood pressure variability in a centenarian woman: case study Treinamento com estimulação elétrica funcional sobre a capacidade funcional e a variabilidade da pressão arterial em uma idosa centenária: estudo de caso

    Directory of Open Access Journals (Sweden)

    Bruna Eibel

    2011-08-01

    Full Text Available BACKGROUND: Functional electrical stimulation (FES is a rehabilitation method that can revert alterations provoked by aging, such as reductions in functional capacity and modifications on blood pressure variability (BPV. OBJECTIVES: To evaluate the training effects of FES on functional capacity and BPV in a centenarian woman. METHODS: A 101-year-old woman without previous disease underwent FES training for 12 weeks, with three 40 min sessions/week. FES was applied at a frequency of 20 Hz with a 0.5 ms pulse, 5 s contraction time, 10 s relaxation time, the maximum tolerable intensity and with progressive overload. Functional capacity was assessed with a six-minute walk test (6MWT and proximal lower limb strength was assessed with a sit-and-stand test (STST. BPV was measured by continuous recording of pulse pressure and calculated by spectral analysis. All variables were measured before and after FES training. RESULTS: After training there was a 70% increase in distance walked in the 6MWT, a 300% increase in the number of STST repetitions, an 8 mmHg reduction in systolic blood pressure (SBP and a 4 mmHg reduction in diastolic blood pressure (DBP and mean blood pressure (MBP. Reductions in SBP (11.8 mmHg², DBP (2.3 mmHg² and MBP (6.0 mmHg² variability were also observed. CONCLUSIONS: Three months of FES training improved functional capacity and BPV in a centenarian woman.CONTEXTUALIZAÇÃO: A estimulação elétrica funcional (EEF é uma forma de reabilitação que pode reverter alterações provocadas pelo envelhecimento, como diminuição da capacidade funcional e modificações na variabilidade da pressão arterial (VPA. OBJETIVOS: Avaliar os efeitos do treinamento com EEF sobre a capacidade funcional e a VPA em uma idosa centenária. MÉTODOS: Paciente do sexo feminino, 101 anos e sem patologia prévia. O treinamento com EEF foi realizado durante 12 semanas, sendo três sessões/semana e tempo máximo de aplicação de 40 min/sessão. A EEF foi aplicada com frequência de 20 Hz, largura de pulso de 0,5 ms, tempo de contração de 5 s, tempo de repouso de 10 s, intensidade máxima tolerável e aplicação de sobrecarga progressiva. A capacidade funcional foi avaliada por meio do teste de caminhada de 6 minutos (TC6 e do teste de sentar e levantar (TSL. A VPA foi mensurada pelo registro contínuo da pressão de pulso e calculada pela análise espectral. Todas as variáveis foram mensuradas pré e pós-treinamento. RESULTADOS: Após treinamento, houve um aumento de 70% na distância percorrida no TC6 e aumento de 300% no número de repetições no TSL. Observou-se redução de 8 mmHg na pressão arterial sistólica (PAS e de 4 mmHg na pressão arterial diastólica (PAD e na pressão arterial média (PAM, havendo ainda uma redução na variabilidade da PAS (11,8 mmHg², da PAD (2,3 mmHg² e da PAM (6,0 mmHg². CONCLUSÕES: O treinamento com EEF durante três meses proporcionou aumento da capacidade funcional e melhora da VPA em uma idosa centenária.

  7. Medida da pressão arterial em crianças e adolescentes: recomendações das diretrizes de hipertensão arterial e prática médica atual Blood pressure measurement in children and adolescents: guidelines of high blood pressure recommendations and current clinical practice

    Directory of Open Access Journals (Sweden)

    Maria Alayde Mendonça da Silva

    2007-04-01

    Full Text Available OBJETIVO: Identificar, em crianças e adolescentes (7 a 17 anos, rede pública e privada de ensino, a freqüência de indivíduos já submetidos à medida da pressão arterial (MPA, o número de vezes, os locais em que foi realizada a aferição e o resultado informado. MÉTODOS: Estudo transversal. Amostragem por conglomerados em 40 escolas, nível fundamental e médio, sorteadas. Cálculo da amostra baseado na prevalência esperada de HAS em crianças e adolescentes. Protocolo: questionário sobre realização prévia de MPA (em caso afirmativo, quantas vezes, quando foi a última medida, o local e o resultado da medida e duas MPA. Variáveis independentes: sexo, faixa etária, classe econômica, escola pública ou privada. RESULTADOS: Amostra constituída de 1253 estudantes 1215 responderam ao questionário (97% 531 do sexo masculino média de 12,4 ± 3 anos. Prevalência de HAS: 7,7% 348 estudantes (29% já haviam medido a PA (54% 1 vez 35% 2 a 4 vezes 11% 5 ou mais 53% há menos de 1 ano. Posto de Saúde, residência, hospital e consultório foram os locais mais mencionados (27%, 16%, 15% e 14%, respectivamente. Houve associação significante entre prévia MPA com faixa etária de 15 a 17 anos, classes econômicas A e B e ser estudante de escola privada. CONCLUSÃO: Apesar das recomendações, há baixa freqüência de MPA (29% em crianças e adolescentes, demonstrando que a mesma não foi ainda incorporada na prática clínica.OBJECTIVE: To determine, in a school-based sample of children and adolescents, aged from 7 to 17 years, of both gender, in public and private schools, the frequency of students already submitted to blood pressure measure. METHODS: A cross-sectional study was carried out, sampling from a population pool of elementary and middle schools, randomly selected. The sample was calculated based on the expected prevalence of hypertension for the age group. Data were collected through a questionnaire. Blood pressure was measured twice and hypertension was defined as mean systolic and/or diastolic blood pressure over the 95th percentile. Independent variables studied: sex; age groups; economic status; public/private school. RESULTS: The final sample included 1253 students. The response rate was 97%: 1215 students; 531 males; mean age 12,4±3 years (236 from 7 to 9 years; 638 from 10 to 14 years; 341 from 15 to 17 years. Prevalence of hypertension was 7.7%; 348 students (29% were already submitted to blood pressure measures (54% once; 35% 2 to 4 times; 11% 5 or more times. High economic status, private school and adolescent group were significantly associated to previous blood pressure measure. CONCLUSION: Despite of pediatric consensus statements and guidelines recommendations about importance of blood pressure measure at every examination after age 3 years, there is a very low frequency of this practice (29% in children and adolescents.

  8. Diabetes and diastolic function: stiffness and relaxation from transmitral flow.

    Science.gov (United States)

    Riordan, Matt M; Chung, Charles S; Kovács, Sándor J

    2005-12-01

    To characterize the mechanism by which diabetes affects the heart in diabetic (n = 15) and age-matched control subjects (n = 15), we quantified and compared diastolic function (DF) in terms of chamber stiffness and viscosity/relaxation by analyzing Doppler E- and E'-waves and simultaneous (high-fidelity) hemodynamic data. We compared tau, standard Doppler indexes and indexes of stiffness and viscosity/relaxation computed via the parameterized diastolic filling (PDF) formalism. Three PDF parameters uniquely characterize each E-wave in terms of load (x(o)), viscoelasticity or viscosity/relaxation (c) and stiffness (k). Significant differences for c (p = 0.00004), the peak atrioventricular pressure gradient (kx(o)) (p = 0.02) and the stored elastic energy available for early filling (1/2kx(o)2) (p = 0.04) were found. The only conventional index attaining significance was E-wave acceleration time (p = 0.007). Neither time constant of isovolumic relaxation (tau) nor E-wave deceleration time, E', k or x(o) differentiated between groups. We conclude that PDF based DF assessment differentiates between diabetic and nondiabetic controls better than conventional echo- or cath-based indexes. Our results in humans agree with published results from animal studies. We conclude that diabetes affects the heart via a quantifiable increase in chamber viscoelasticity (c) rather than an increase in chamber stiffness (k) and that phenotypic characterization of diabetic cardiomyopathy is facilitated by DF assessment via the PDF formalism. PMID:16344121

  9. Indexing Guidelines: Applications in Use of Pulmonary Artery Catheters and Pressure Ulcer Prevention

    OpenAIRE

    Jenders, Robert A.; Estey, Greg; Martin, Martha; Hamilton, Glenys; Ford-Carleton, Penny; Thompson, B Taylor; Oliver, Diane E.; Eccles, Randy; Barnett, G. Octo; Zielstorff, Rita D.; Fitzmaurice, Joan B.

    1994-01-01

    In a busy clinical environment, access to knowledge must be rapid and specific to the clinical query at hand. This requires indices which support easy navigation within a knowledge source. We have developed a computer-based tool for trouble-shooting pulmonary artery waveforms using a graphical index. Preliminary results of domain knowledge tests for a group of clinicians exposed to the system (N=33) show a mean improvement on a 30-point test of 5.33 (p

  10. Pressure and Flow Wave Propagation in Patient-Specific Models of the Arterial Tree

    OpenAIRE

    Reymond, Philippe

    2011-01-01

    Blood flow in the arterial circulation induces hemodynamic forces that play an important role in various forms of vascular diseases. Temporal variation of the wall shear stress seems to play a significant role in atherogenesis and plaque stability. Flow induced wall shear stress has been linked to growth and possibly rupture of the aneurysm wall. Hemodynamic forces are patient-specific and difficult to assess in the clinic. At present, there is no in ...

  11. Vital Signs – Presión arterial alta (High Blood Pressure)

    Centers for Disease Control (CDC) Podcasts

    2012-10-02

    En los EE. UU. casi un tercio de la población adulta tiene presión arterial alta, el principal factor de riesgo de enfermedades cardiacas y accidentes cerebrovasculares, dos de las principales causas de muerte en el país.  Created: 10/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/17/2012.

  12. A study of arterial pressure in medical personnel working with sources of ionizing radiation

    International Nuclear Information System (INIS)

    A total of 1283 persons, working at medical institutions and professionally exposed to the effects of ionizing radiation, were included in the study. The data of the individual film dosimetry in these persons showed values of radiation doses below the threshold ones for a year. A statistically significant increase in cases of arterial hypotonia was recorded, especially in persons just started work. This may be attributed to the altered reactivity of the organism at the onset of its contact with ionizing radiation. (author)

  13. Identification of the in vivo elastic properties of common carotid arteries from MRI: a study on subjects with and without atherosclerosis.

    Science.gov (United States)

    Franquet, A; Avril, S; Le Riche, R; Badel, P; Schneider, F C; Boissier, C; Favre, J-P

    2013-11-01

    The stiffness of the arterial wall, which is modified by many cardiovascular diseases such as atherosclerosis, is known to be an indicator of vulnerability. This work focuses on the in vivo quantification of the stiffness of the common carotid artery (CCA) by applying the Magnitude Based Finite Element Model Updating (MB-FEMU) method to 13 healthy and diseased volunteers aged from 24 to 76 years old. The MB-FEMU method is based on the minimisation of the deviation between the image of a deformed artery and a registered image of this artery deformed by means of a finite elements analysis. Cross sections of the neck of each subject at different times of the cardiac cycle are recorded using a Phase Contrast cine-MRI. Applanation tonometry is then performed to obtain the blood pressure variations in the CCA throughout a heart beat. First, a time averaged elastic modulus of each CCA between diastole and systole is identified and a stiffening of the artery with age and disease is observed. Second, four elastic moduli are identified during a single heart beat for each artery, highlighting the nonlinear mechanical behaviour of the artery. A stiffening of the artery is observed and quantified at systole in comparison to diastole. PMID:23706824

  14. Segmental wall motion abnormalities alter vulnerability to ventricular ectopic beats associated with acute increases in aortic pressure in patients with underlying coronary artery disease

    OpenAIRE

    Siogas, K; Pappas, S; Graekas, G; Goudevenos, J; Liapi, G.; Sideris, D

    1998-01-01

    Objective—To evaluate whether patients with coronary artery disease are susceptible to pressure related ventricular arrhythmias, and if so to identify possible risk factors.
Design—Interventional study.
Methods—Metaraminol was given to 43 patients undergoing coronary arteriography for ischaemic heart disease to increase their aortic pressure, provided their systolic blood pressure was  100%) in 13/43 patients. Ventricular ectopy was not related to age, sex, presence of hypertension, history o...

  15. Efeitos da suplementação de potássio via sal de cozinha sobre a pressão arterial e a resistência à insulina em pacientes obesos hipertensos em uso de diuréticos Effects of potassium supplementation by salt on arterial blood pressure and insulin resistance in hypertensive obese patients on diuretic therapy

    Directory of Open Access Journals (Sweden)

    Maria Alice de Gouveia Pereira

    2005-02-01

    Full Text Available OBJETIVO: Avaliar os efeitos da suplementação de potássio, por intermédio do sal de cozinha contendo cloreto de potássio, associada à dieta hipocalórica e à atividade física aeróbica, sobre a pressão arterial e índices de resistência à insulina em pacientes hipertensos com obesidade abdominal. MÉTODOS: Estudo prospectivo duplo-cego, randomizado, em 22 pacientes hipertensos com excesso de peso (índice de massa corporal >27kg/m² e controle insatisfatório da pressão arterial durante o uso de diuréticos pressão arterial sistólica >140 e 90 e OBJECTIVE: The objectives of the present study were to evaluate the effects of oral potassium supplementation, associated with a hypocaloric diet and aerobic exercises, on plasma potassium levels, blood pressure and insulin resistance, in centrally obese, not well controlled hypertensive patients on diuretic therapy; waist to hip ratio >0.85 in women, and >0.95 in men; systolic blood pressure >140mmHg and 90mmHg and <105mmHg. METHODS: This was a prospective double-blind randomized study including 22 patients divided in 2 groups: sodium chloride n=10, and potassium chloride n=12. For 12 weeks, each group received cooking salt containing, either 100% sodium chloride, or 50% sodium chloride and 50% potassium chloride. All patients were submitted to a hypocaloric diet and advised to increase their physical activity; a 40-minute walk three times a week. Before and after the study period, all patients were submitted to determinations of body mass index, body composition, waist circumference, sodium and potassium urinary excretions, sodium and potassium serum levels, 24h ambulatory blood pressure monitoring, oral glucose tolerance test with serum insulin measurements at fasting and 120 minutes after glucose load, and serum lipid profile. RESULTS: In both groups, no changes were observed in serum sodium and potassium levels, in blood glucose and insulin levels, insulin resistance indexes and serum lipid profile. The body mass index decreased similarly in both groups; 3.5±2.0% in sodium Chloride, and 2.7±3.2% in Potassium Chloride, as well as 24 h systolic ambulatory blood pressure monitoring mean; from 134.7 ±14.8 to 130.2±12.6mmHg (p<0.05 in group sodium chloride, and from 128.2±7.4 to 122.9±5.7mmHg (p<0.05 in potassium, and 24h diastolic ambulatory blood pressure monitoring from 84.4±10.2 to 81.4 ± 8.9mmHg in sodium chloride, and from 84.0±5.7 to 79.5±3.9mmHg (p<0.05 in group potassium (p<0.05. Changes in 24h systolic ambulatory blood pressure monitoring correlated with changes in the waist circumference, but not with changes in bory mass index when all patients were analyzed together. Serum lipid profile, blood glucose levels and insulin resistance indexes did not differ between groups and did not change during the study. CONCLUSION: Weight reduction induced by life style changes, promotes reductions in blood pressure, which are proportional to reductions in abdominal fat. Potassium supplementation through cooking salt was insufficient to avoid serum potassium falling during diuretic therapy and did not show any additional beneficial effect on blood pressure or insulin resistance in hypertensive patients with central obesity.

  16. AMLODIPINE ADVANTAGES IN ARTERIAL HYPERTENSION THERAPY

    Directory of Open Access Journals (Sweden)

    V. M. Tsareva

    2016-01-01

    Full Text Available Aim. To study effects of calcium channel blocker, amlodipine on indices of ambulatory blood pressure monitoring (ABPM, heart rate variability, corrected QT-interval and its dispersion, structural and functional heart indices, microcirculation in patients with arterial hypertension (HT.Material and methods. 48 patients with HT of 1-2 stages were involved in the study. After 2 week wash-out period amlodipine (5-10 mg/day therapy was started. ABPM, 24 hour electrocardiogram monitoring, echocardiography, laser Doppler flowmetry was performed initially and in 24 weeks of therapy.Results. Amlodipine therapy increased microcirculation efficacy, reduced repolarization nonhomogeneity, contributed to myocardial electrophysiological stability. Besides it improved structural and functional heart indices, decreased systolic and diastolic blood pressure (BP, reduced indices of BP load during a day.Conclusion. Amlodipine is effective antihypertensive medicine, having prominent cardio- and vasoprotective effects and good tolerability.

  17. Broncoscopia y tensión arterial en un grupo de pacientes sometidos a este estudio

    Directory of Open Access Journals (Sweden)

    Pedro Pablo Pino Alfonso

    2001-09-01

    Full Text Available Teniendo como base lo descrito en la literatura acerca de la elevación de la frecuencia cardíaca, de la respiración y de la tensión arterial durante la broncoscopia, se realizó un estudio prospectivo que incluyó 84 pacientes a los cuales se les midió la tensión arterial antes y durante ese proceder. Se estudiaron las variables edad, sexo, raza, tensión arterial sistólica, diastólica y media. Se obtuvieron los resultados siguientes: la elevación promedio de la tensión arterial sistólica, diastólica y media, tanto en normotensos como en hipertensos, fue estadísticamente significativa, lo mismo ocurrió cuando se comparó el grupo de normotensos con el de los hipertensos, tanto antes de la prueba como durante su realización. Al analizar las variables sexo, edad y raza en relación con el comportamiento de la tensión arterial no se encontraron diferencias significativasTaking as a basis what is described in literature about the elevation of heart rate, of respiration and of the arterial pressure during bronchoscopy, a prospective study was conducted among 84 patients whose arterial pressure was measured before and during that procedure. Variables such as age, sex, race, systolic, diastolic and mean arterial pressure were studied. The following results were obtained: the average elevation of the systolic, dyastolic and mean arterial pressure, both in the normotensive and in the hypertensive was statistically significant. The same happened when the group of normotensive was compared with the hypertensive before and during the test. On analyzing the variables sex, age and race in relation to the behavior of the arterial pressure no significant differences were found

  18. Right ventricular systolic and diastolic functions assessed by 81mKr scintigraphy and relation to ventricular septal ischemia

    International Nuclear Information System (INIS)

    Right ventricular (RV) systolic and diastolic functions were assessed in patients with previous anteroseptal myocardial infarction to ascertain the influence of interventricular septal ischemia on RV function. Gated right ventriculography with continuous infusion of krypton-81 m was performed in 12 normal subjects and 28 patients with infarction but without significant stenosis of the right coronary artery. Furthermore, RV contractile reserve by postextrasystolic potentiation was evaluated by gated radionuclide ventriculography with 99mTc-HSA. The patients with anteroseptal infarction were divided into two groups by the presence or absence of three hours' redistribution in the septal region on exercise thallium-201 myocardial scintigraphy. Two indices of systolic function (ejection fraction and the peak ejection rate) and three indices of diastolic function (1/3 diastolic filling rate, the peak filling rate and time to the peak filling rate) were derived from the right ventricular time-activity curve and its derivative curve. There was no difference in systolic function among normal subjects and patients with or without redistribution. However, diastolic function was impaired only in the patients without redistribution. The RV contractile reserve in the patients without redistribution was less than in those with it. Thus, RV systolic function was maintained in the patients with anteroseptal infarction, but contractile reserve deteriorated only in severe septal ischemia. Similarly, diastolic function was maintained in mild septal ischemia, but impaired in severe septal ischemia. We concluded that RV systolic and diastolic functions are closely related to interventricular septal ischemia. (author)

  19. Relación entre perímetro abdominal, nivel socioeconómico y presión arterial Relation of abdominal circumference and socio-economic status to blood pressure

    Directory of Open Access Journals (Sweden)

    Eduardo Fasce H

    2010-01-01

    Full Text Available Objetivos: Relacionar perímetro abdominal y condición socioeconómica con presión arterial (PA en comunidad urbana de Concepción. Métodos: Se midió el perímetro abdominal (PeA de 8472 residentes mayores de 15 años de edad, proporcionados por edad, género y nivel socioeconómico. La PA fue medida con normas estandarizadas, realizando dos visitas en diferentes días, la segunda si la PA era mayor de 140/90 mm Hg. Los Pe A se distribuyeron en cuartiles, relacionando cada cuartil con los respectivos promedios de presión sistólica y diastólica y se establecieron coeficientes de correlación lineal mediante "r" de Pearson entre PeA y PA. Además, se estableció la frecuencia de cada cuartil de Pe A por nivel socioeconómico. Resultados: Los Pea tuvieron la siguiente distribución (cm: 1er cuartil, 96. La prevalencia de hipertensión para niveles socioeconómicos alto, medio y bajo fue 17,9%, 19,5% y 24,5%, respectivamente. La PA promedio (mmHg en hombres y en mujeres del 1er cuartil de PeA fue 112 y 109; en el 2º cuartil 118 y 118; en el 3er cuartil 123 y 122 y en el 4º cuartil 129 y 129, respectivamente. Los coeficientes de correlación entre PeA y presión sistólica y presión diastólica resultaron significativos en ambos géneros: r = 0,343, pAim: To correlate abdominal circumference (AC and socio-economic status with blood pressure( BP in an urban community of Concepción, Chile Methods: AC was measured in 8472 subjects above 15years of age, stratified by age, gender and socio-economic status. BP was measured by standard procedures, with a repeat recording when the initial valué was > 140/90mmHg. BP was compared in quartiles of abdominal circumference and according to socio-economic status. Pearson "r" was used to correlate BP and AC Results: Cut points for quartiles of AC were 78, 87, and 96 cm. Prevalence of hypertension in high, médium and low socio-economic status was 17.9%, 19.5% and 24.5%, respectively Mean systolic BP was 112 - 109 mmHg (males - females in the first AC quartile, 118 - 118, 123-122 and 129-129 in the second, third and fourth quartiles, respectively. A significant correlation between AC and BP (systolic and diastolic was observed in both genders (r 0.345 and 0.281 for males and females, respectively, p<0.00001. 22% of low socio-economic subjects belonged in the first AC quartile compared to 28.8% in the 4th quartile. In contrast 38.9% of high socio-economic subjects belonged in the first AC quartile while 15.5% did so in the 4th quartile (p<0001. Conclusion: A positive correlation ofAC and blood pressure was shown in both genders. A greater AC in low socio-economic subjects maybe related to a higher prevalence of hypertension in this group.

  20. The effects of venous cannulation technique and cardioplegia type on plasma potassium concentration and arterial blood pressure during cardiopulmonary bypass.

    LENUS (Irish Health Repository)

    Coleman, E T

    2012-02-03

    The cannulation method and cardioplegia solution used during cardiopulmonary bypass (CPB) may both influence plasma potassium concentrations ([K+]) and mean arterial blood pressure (MAP). Bi-caval or right atrial cannulation methods are routinely used in conjunction with crystalloid or blood cardioplegia. We investigated the influence of cannulation method and cardioplegia solutions on plasma [K+] and MAP during cardiopulmonary bypass. Sixty consecutive patients undergoing elective coronary artery bypass grafting (CABG) using CPB were studied. They were randomly divided into three groups of 20 patients. Patients in Group A underwent bi-caval venous cannulation and received crystalloid cardioplegia. Group B patients underwent right atrial cannulation and received crystalloid cardioplegia. Group C patients underwent right atrial cannulation and received blood cardioplegia. In each case. cardioplegia was administered antegrade via the aortic root. Plasma [K+], MAP. and hemoglobin concentration (Hb) were measured over an 8-min period following cardioplegia administration (pilot studies indicated pressure changes occuring post cardioplegia administration up to this time). The combination of bi-caval cannulation and crystalloid cardioplegia (Group A) was associated with the least increase in plasma [K+] and no decrease in MAP. The maximum [K+] for this Group was 4.2 mmol\\/L (4.6% increase). The minimum mean pressure was 57 mmHg (13.6% increase). Both right atrial cannulation groups (B and C) showed a large rise in plasma [K+] and a decrease in MAP. Group B maximum [K+] was 5.2 mmol\\/L (27.5% increase). Group C was also 5.2 mmol\\/L (26.0% increase). Group C showed the largest pressure decrease, the minimum mean pressure was 45 mmHg (21.3% decrease). The Group B minimum mean pressure was 45 mmHg (8.7% decrease). Our results show that patients undergoing CPB operations who are deemed to be at increased risk of suffering adverse effects from hypotensive episodes may benefit from bicaval cannulation and caval snaring, in preference to right atrial cannulation. Crystalloid cardioplegia may be preferable to blood cardioplegia in these cases to maintain the MAP.

  1. Changes in Doppler waveforms can predict pressure reduction across internal carotid artery stenoses

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T

    1988-01-01

    perfusion pressure. Forty-nine patients were examined consecutively with ultrasound Doppler prior to carotid endarterectomy. Pulsatility index (PI), pulse rise-time (RT), and systolic width (SW) were related to angiographic degree of stenosis and the ratio of distal ICA blood pressure to common carotid...

  2. A variedade da dieta é fator protetor para a pressão arterial sistólica elevada Dietary variety is a protective factor for elevated systolic blood pressure

    Directory of Open Access Journals (Sweden)

    Erick Prado de Oliveira

    2012-04-01

    Full Text Available FUNDAMENTO: A dieta influencia diretamente a hipertensão arterial (HAS, que é um dos principais fatores de risco da doença cardiovascular. OBJETIVO: Associar a HAS com fatores dietéticos de adultos clinicamente selecionados para programa de mudança de estilo de vida. MÉTODOS: Estudo transversal composto por 335 indivíduos, com idade entre 44 e 65 anos, clinicamente selecionados para um programa de mudança de estilo de vida. Foram avaliados os dados antropométricos (IMC, % de gordura e circunferência abdominal, os componentes bioquímicos (concentrações plasmáticas de glicose, triglicerídeos, colesterol total, HDL-c e LDL-c e a dieta, por meio do recordatório de 24 horas. A qualidade da dieta foi avaliada pelo Índice de Alimentação Saudável. A pressão arterial foi mensurada de acordo com a V Diretriz Brasileira de Hipertensão Arterial e classificada de acordo com o NCEP-ATPIII. A regressão logística foi realizada para determinar a probabilidade de alterações na PAS e PAD de acordo com a ingestão dietética. Adotou-se como significante o valor de p BACKGROUND: Diet directly influences systemic arterial hypertension (SAH, which is one of the main risk factors for cardiovascular disease. OBJECTIVE: To associate hypertension with dietary factors in adults clinically selected for a change-of-lifestyle program. METHODS: Cross-sectional study comprising 335 individuals, aged between 44 and 65 years, clinically selected for a change-of-lifestyle program. We evaluated anthropometric data (BMI, %body fat and waist circumference, biochemical components (plasma glucose, triglycerides, total cholesterol, HDL-C and LDL-c and diet, through the 24-hour recall method. The quality of the diet was assessed by the Healthy Eating Index. Blood pressure was measured according to the V Brazilian Guidelines on Hypertension and classified according to NCEP-ATPIII. Logistic regression was performed to determine the likelihood of changes in SBP and DBP according to dietary intake. The level of significance was set at p <0.05. RESULTS: There was a positive correlation between diastolic blood pressure and sugar and cholesterol intake, and a negative one with intake of fiber, portions of oil and fats and diet quality. Dietary variety with ≥ 8 food items showed a protective effect for alterations in systolic blood pressure, OR = 0.361 (0.148 to 0.878. CONCLUSION: A greater dietary variety had a protective effect on the systolic blood pressure.

  3. Blood Pressure and Hemodynamic Adaptations after a Training Program in Young Individuals with Down Syndrome / Pressão Arterial e Adaptações Hemodinâmicas após Programa de Treinamento em Jovens com Síndrome de Down

    Scientific Electronic Library Online (English)

    Bruna Barboza, Seron; Karla Fabiana, Goessler; Everaldo Lambert, Modesto; Eloise Werle, Almeida; Márcia, Greguol.

    2015-06-01

    Full Text Available Fundamento: As doenças cardiovasculares atingem as pessoas em todo o mundo. Pessoas com Síndrome de Down (SD) apresentam um risco até dezesseis vezes maior de mortalidade por doenças cardiovasculares. Objetivo: Avaliar os efeitos do exercício aeróbio e resistido na pressão arterial e variáveis hemo [...] dinâmicas de jovens com SD. Métodos: Participaram do estudo 29 jovens com SD, divididos em dois grupos: (TA) Treinamento Aeróbio (n = 14) e (TR) Treinamento Resistido (n = 15), idade 15,7 ± 2,82 anos. O programa de treinamento teve doze semanas, frequência de três vezes por semana para TA, e duas vezes, para TR. TA foi realizado com esteira/bicicleta, intensidade entre 50%-70% da FC de reserva. TR teve nove exercícios com três séries de doze repetições máximas. Avaliações de Pressão Arterial Sistólica (PAS), Pressão Arterial Diastólica PAD), Pressão Arterial Média (PAM) e variáveis hemodinâmicas foram realizadas batimento a batimento por meio do Finometer antes/após o programa de treinamento. Foram usados estatística descritiva, teste de Shapiro-Wilk para verificação da normalidade dos dados e teste ANOVA two-way para medidas repetidas para a comparação das variáveis pré e pós-treinamento. Para correlacionar as variáveis hemodinâmicas, foi calculado o coeficiente de correlação de Pearson. Utilizou-se o programa estatístico SPSS versão 18.0, adotando nível de significância (p Abstract in english Background: Cardiovascular diseases affect people worldwide. Individuals with Down Syndrome (DS) have an up to sixteen-time greater risk of mortality from cardiovascular diseases. Objective: To evaluate the effects of aerobic and resistance exercises on blood pressure and hemodynamic variables of y [...] oung individuals with DS. Methods: A total of 29 young individuals with DS participated in the study. They were divided into two groups: aerobic training (AT) (n = 14), and resistance training (TR) (n = 15). Their mean age was 15.7 ± 2.82 years. The training program lasted 12 weeks, and had a frequency of three times a week for AT and twice a week for RT. AT was performed in treadmill/ bicycle ergometer, at an intensity between 50%-70% of the HR reserve. RT comprised nine exercises with three sets of 12 repetition-maximum. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and hemodynamic variables were assessed beat-to-beat using the Finometer device before/after the training program. Descriptive analysis, the Shapiro-Wilk test to check the normality of data, and the two-way ANOVA for repeated measures were used to compare pre- and post-training variables. The Pearson’s correlation coefficient was calculated to correlate hemodynamic variables. The SPSS version 18.0 was used with the significance level set at p

  4. Blood Pressure and Hemodynamic Adaptations after a Training Program in Young Individuals with Down Syndrome / Pressão Arterial e Adaptações Hemodinâmicas após Programa de Treinamento em Jovens com Síndrome de Down

    Scientific Electronic Library Online (English)

    Bruna Barboza, Seron; Karla Fabiana, Goessler; Everaldo Lambert, Modesto; Eloise Werle, Almeida; Márcia, Greguol.

    Full Text Available Fundamento: As doenças cardiovasculares atingem as pessoas em todo o mundo. Pessoas com Síndrome de Down (SD) apresentam um risco até dezesseis vezes maior de mortalidade por doenças cardiovasculares. Objetivo: Avaliar os efeitos do exercício aeróbio e resistido na pressão arterial e variáveis hemo [...] dinâmicas de jovens com SD. Métodos: Participaram do estudo 29 jovens com SD, divididos em dois grupos: (TA) Treinamento Aeróbio (n = 14) e (TR) Treinamento Resistido (n = 15), idade 15,7 ± 2,82 anos. O programa de treinamento teve doze semanas, frequência de três vezes por semana para TA, e duas vezes, para TR. TA foi realizado com esteira/bicicleta, intensidade entre 50%-70% da FC de reserva. TR teve nove exercícios com três séries de doze repetições máximas. Avaliações de Pressão Arterial Sistólica (PAS), Pressão Arterial Diastólica PAD), Pressão Arterial Média (PAM) e variáveis hemodinâmicas foram realizadas batimento a batimento por meio do Finometer antes/após o programa de treinamento. Foram usados estatística descritiva, teste de Shapiro-Wilk para verificação da normalidade dos dados e teste ANOVA two-way para medidas repetidas para a comparação das variáveis pré e pós-treinamento. Para correlacionar as variáveis hemodinâmicas, foi calculado o coeficiente de correlação de Pearson. Utilizou-se o programa estatístico SPSS versão 18.0, adotando nível de significância (p Abstract in english Background: Cardiovascular diseases affect people worldwide. Individuals with Down Syndrome (DS) have an up to sixteen-time greater risk of mortality from cardiovascular diseases. Objective: To evaluate the effects of aerobic and resistance exercises on blood pressure and hemodynamic variables of y [...] oung individuals with DS. Methods: A total of 29 young individuals with DS participated in the study. They were divided into two groups: aerobic training (AT) (n = 14), and resistance training (TR) (n = 15). Their mean age was 15.7 ± 2.82 years. The training program lasted 12 weeks, and had a frequency of three times a week for AT and twice a week for RT. AT was performed in treadmill/ bicycle ergometer, at an intensity between 50%-70% of the HR reserve. RT comprised nine exercises with three sets of 12 repetition-maximum. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and hemodynamic variables were assessed beat-to-beat using the Finometer device before/after the training program. Descriptive analysis, the Shapiro-Wilk test to check the normality of data, and the two-way ANOVA for repeated measures were used to compare pre- and post-training variables. The Pearson’s correlation coefficient was calculated to correlate hemodynamic variables. The SPSS version 18.0 was used with the significance level set at p

  5. Renal artery stent angioplasty for renovascular hypertension

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic results of expandable stent for treatment of atherosclerotic renovascular obstructive disease. Methods: 15 patients (10 men and 5 women, 41-75 years old; mean age, 52 years) with renal arterial hypertension underwent renal stent angioplasty including renal arterial stenosis 89%(n=13) and fully obstruction without function in 2, of which 2 patients had bilateral involvement. The stenotic range of all arterial segments showed 60% to 90% width of the normal arterial diameter. 16 stents were implanted under the guidance of fluoroscopy. The most of stents implanted were Palmaz (n=12, 75%) with regular clinical and angiographic follow up. Results: Technical success (residual stenosis <30%) was achieved in all patients without serious complication. During the follow-up (6-15 months; mean, 8 ± 4 months), hypertension was improved in 9 patients and cured in 4 patients with a total benefit of 86% and no efficacy in 2(13%). The average systolic blood pressure decreased from 27.12 ± 3.09 kPa to 18.62 ± 3.12 kPa and the average diastolic blood pressure decreased from 17.73 ± 1.92 kPa to 11.12 ± 2.43 kPa after stent treatment (P<0.05). Serum creatinine remained stable in 60% (n=9) patients with improvement in 33% (n=5) and worsened in 6% (n=1) patients. Follow-up angiography was performed in all patients with 1 case of a restenosis. 6 months after expanding through stent by using balloon, the two follow up angiographies showed a stable restenosis about 20%. Conclusions: Percutaneous transluminal stent placement is highly beneficial for patients who had renal arterial obstructive disease. The success of stent angioplasty of complete obstructive renal arteries reveals wide prospects for interventional method. (authors)

  6. 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)

    José Marconi Almeida de Sousa

    2004-05-01

    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.

  7. Arterial pressure variations as parameters of brain perfusion in response to central blood volume depletion and repletion

    Directory of Open Access Journals (Sweden)

    Anne-SophieG.T.Bronzwaer

    2014-04-01

    Full Text Available Rationale:\tA critical reduction in central blood volume (CBV is often characterized by hemodynamic instability. Restoration of a volume deficit may be established by goal-directed fluid therapy guided by respiration-related variation in systolic- and pulse pressure (SPV and PPV. Stroke volume index (SVI serves as a surrogate end-point of a fluid challenge but tissue perfusion itself has not been addressed. Objective: To delineate the relationship between arterial pressure variations, SVI and regional brain perfusion during CBV depletion and repletion in spontaneously breathing volunteers. Methods: This study quantified in 14 healthy subjects (11 male the effects of CBV depletion (by 30 and 70 degrees passive head-up tilt (HUT and a fluid challenge (by tilt back on CBV (thoracic admittance, mean middle cerebral artery (MCA blood flow velocity (Vmean, SVI, cardiac index (CI , PPV and SPV. Results: PPV (103±89%, p< 0.05 and SPV (136±117%, p< 0.05 increased with progression of central hypovolemia manifested by a reduction in thoracic admittance (11±5%, p< 0.001, SVI (28±6%, p< 0.001, CI (6±8%, p< 0.001 and MCAVmean (17±7%, p< 0.05 but not in arterial pressure. The reduction in MCAVmean correlated to the fall in SVI (R2=0.52, p< 0.0001 and inversely to PPV and SPV (R2=0.46 (p< 0.0001 and R2=0.45 (p< 0.0001, respectively. PPV and SPV predicted a ≥15% reduction in MCAVmean and SVI with comparable sensitivity (67%/ 67% vs. 63%/ 68% respectively and specificity (89%/94% vs. 89%/94%, respectively. A rapid fluid challenge by tilt-back restored all parameters to baseline values within one minute. Conclusion: In spontaneously breathing subjects, a reduction in MCAVmean was related to an increase in PPV and SPV during graded CBV depletion and repletion. Specifically, PPV and SPV predicted changes in both SVI and MCAVmean with comparable sensitivity and specificity, however the predictive value is limited in spontaneously breathing subjects.

  8. High estimated pulmonary artery systolic pressure predicts adverse cardiovascular outcomes in stage 2-4 chronic kidney disease.

    Science.gov (United States)

    Bolignano, Davide; Lennartz, Simone; Leonardis, Daniela; D'Arrigo, Graziella; Tripepi, Rocco; Emrich, Insa E; Mallamaci, Francesca; Fliser, Danilo; Heine, Gunnar; Zoccali, Carmine

    2015-07-01

    High estimated pulmonary artery systolic pressure (ePASP) is an established risk factor for mortality and cardiovascular (CV) events in the general population. High ePASP predicts mortality in dialysis patients but such a relationship has not been tested in patients with early CKD. Here we estimated the prevalence and the risk factors of high ePASP in 468 patients with CKD stage 2-4 and determined its prognostic power for a combined end point including cardiovascular death, acute heart failure, coronary artery disease, and cerebrovascular and peripheral artery events. High ePASP (35?mm?Hg and above) was present in 108 CKD patients. In a multivariate logistic regression model adjusted for age, diabetes, hemoglobin, left atrial volume (LAV/BSA), left ventricular mass (LVM/BSA), and history of CV disease, age (OR, 1.06; 95% CI, 12 1.04-1.09) and LAV/BSA (OR, 1.05; 95% CI, 1.03-1.07) were the sole significant independent predictors of high ePASP. Elevated ePASP predicted a significantly high risk for the combined cardiovascular end point both in unadjusted analyses (HR, 2.70; 95% CI, 1.68-4.32) and in analyses adjusting for age, eGFR, hemoglobin, LAV/BSA, LVM/BSA, and the presence of diabetes and CV disease (HR, 1.75; 95% CI, 1.05-2.91). High ePASP is relatively common in patients with stage 2-4 CKD and predicts adverse CV outcomes independent of established classical and CKD-specific risk factors. Whether high ePASP is a modifiable risk factor in patients with CKD remains to be determined in randomized clinical trials. PMID:25692957

  9. Blood Pressure, Internal Carotid Atery Flow Parameters and Age-Related White Matter Hyperintensities

    Science.gov (United States)

    Aribisala, Benjamin S; Morris, Zoe; Eadie, Elizabeth; Thomas, Avril; Gow, Alan; Hernández, Maria C Valdés; Royle, Nataile A; Bastin, Mark E; Starr, John; Deary, Ian J; Wardlaw, Joanna M

    2014-01-01

    White matter hyperintensities (WMH) are associated with hypertension. We examined interactions between blood pressure (BP), internal carotid artery (ICA) flow velocity parameters and WMH. We obtained BP measurements from 694 community-dwelling subjects at mean ages 69.6 (±0.8) and again at 72.6 (±0.7) years, plus brain MRI and ICA ultrasound at age 73±1 years. Diastolic and mean BP decreased and pulse pressure increased but systolic BP did not change between 70 and 73 years. Multiple linear regression, corrected for vascular disease and risk factors, showed that WMH at age 73 were associated with history of hypertension (β=0.13, p<0.001) and with BP at age 70 (systolic β=0.08, mean β=0.09, diastolic β=0.08, all p<0.05); similar but attenuated associations were seen for BP at age 73. Lower diastolic BP and higher pulse pressure were associated with higher ICA pulsatility index at age 73 (diastolic BP: standardized β, age 70=−0.24, p<0.001; pulse pressure age 70 β=0.19, p<0.001). WMH were associated with higher ICA pulsatility index (β=0.13, p=0.002) after adjusting for BP and correction for multiple testing. Therefore falling diastolic BP and increased pulse pressure are associated with increased ICA pulsatility index, which in turn is associated with WMH. This suggests that hypertension and WMH may either associate indirectly because hypertension increases arterial stiffness which leads to WMH over time, or co-associate through advancing age and stiffer vessels, or both. Reducing vascular stiffness may reduce WMH progression and should be tested in randomised trials, in addition to testing antihypertensive therapy. PMID:24470459

  10. Exercise training does not improve myocardial diastolic tissue velocities in Type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Nenonen Arja

    2007-09-01

    Full Text Available Abstract Background Myocardial diastolic tissue velocities are reduced already in newly onset Type 2 diabetes mellitus (T2D. Poor disease control may lead to left ventricular (LV systolic dysfunction and heart failure. The aim of this study was to assess the effects of exercise training on myocardial diastolic function in T2D patients without ischemic heart disease. Methods 48 men (52.3 ± 5.6 yrs with T2D were randomized to supervised training four times a week and standard therapy (E, or standard treatment alone (C for 12 months. Glycated hemoglobin (HbA1c, oxygen consumption (VO2max, and muscle strength (Sit-up were measured. Tissue Doppler Imaging (TDI was used to determine the average maximal mitral annular early (Ea and late (Aa diastolic as well as systolic (Sa velocities, systolic strain (ε and strain rate (έ from the septum, and an estimation of left ventricular end diastolic pressure (E/Ea. Results Exercise capacity (VO2max, E 32.0 to 34.7 vs. C 32.6 to 31.5 ml/kg/min, p = .001, muscle strength (E 12.7 to 18.3 times vs. C 14.6 to 14.7 times, p 1c (E 8.2 to 7.5% vs. C 8.0 to 8.4%, p = .006 improved significantly in the exercise group compared to the controls (ANOVA. Systolic blood pressure decreased in the E group (E 144 to 138 mmHg vs. C 146 to 144 mmHg, p = .04. Contrary to risk factor changes diastolic long axis relaxation did not improve significantly, early diastolic velocity Ea from 8.1 to 7.9 cm/s for the E group vs. C 7.4 to 7.8 cm/s (p = .85, ANOVA. Likewise, after 12 months the mitral annular systolic velocity, systolic strain and strain rate, as well as E/Ea were unchanged. Conclusion Exercise training improves endurance and muscle fitness in T2D, resulting in better glycemic control and reduced blood pressure. However, myocardial diastolic tissue velocities did not change significantly. Our data suggest that a much longer exercise intervention may be needed in order to reverse diastolic impairment in diabetics, if at all possible.

  11. Exhaled and arterial levels of endothelin-1 are increased and correlate with pulmonary systolic pressure in COPD with pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Dragonieri Silvano

    2008-09-01

    Full Text Available Abstract Background Endothelin-1 (ET-1 and Nitric Oxide (NO are crucial mediators for establishing pulmonary artery hypertension (PAH. We tested the hypothesis that their imbalance might also occur in COPD patients with PAH. Methods The aims of the study were to measure exhaled breath condensate (EBC and circulating levels of ET-1, as well as exhaled NO (FENO levels by, respectively, a specific enzyme immunoassay kit, and by chemiluminescence analysis in 3 groups of subjects: COPD with PAH (12, COPD only (36, and healthy individuals (15. In order to evaluate pulmonary-artery systolic pressure (PaPs, all COPD patients underwent Echo-Doppler assessment. Results Significantly increased exhaled and circulating levels of ET-1 were found in COPD with PAH compared to both COPD (p 1%, (r = -0.59, p = 0.043, and PaPs negatively correlated to PaO2 (r = -0.618; p = 0.032. Significantly reduced levels of FENO were found in COPD associated with PAH, compared to COPD only (22.92 ± 11.38 vs.35.07 ± 17.53 ppb; p = 0.03. Thus, we observed an imbalanced output in the breath between ET-1 and NO, as expression of pulmonary endothelium and epithelium impairment, in COPD with PAH compared to COPD only. Whether this imbalance is an early cause or result of PAH due to COPD is still unknown and deserves further investigations.

  12. Elevated Blood Pressure and Obesity in Childhood: A Cross-Sectional Evaluation of 4,609 Schoolchildren / Aumento da Pressão Arterial e Obesidade na Infância: Uma Avaliação Transversal de 4.609 Escolares

    Scientific Electronic Library Online (English)

    Caroline Filla, Rosaneli; Cristina Pellegrio, Baena; Flavia, Auler; Alika Terumi Arasaki, Nakashima; Edna Regina, Netto-Oliveira; Amauri Bássoli, Oliveira; Luiz César, Guarita-Souza; Marcia, Olandoski; José Rocha, Faria-Neto.

    2014-09-01

    Full Text Available Introdução: A incidência de obesidade em crianças está aumentando em todo o mundo, principalmente em países industrializados de alta renda, e o desenvolvimento de hipertensão é um efeito negativo desse problema. Objetivo: O presente estudo transversal objetivou determinar a prevalência de obesida [...] de e sua associação com o aumento da pressão arterial em escolares. Métodos: Neste estudo transversal foram avaliadas 4.609 crianças de ambos os sexos, com idade entre 6 e 11 anos, pertencentes a 24 escolas públicas e particulares de Maringá, Brasil. O estado nutricional foi avaliado pelo índice de massa corporal (IMC) de acordo com pontos de corte ajustados para sexo e idade. Valores de pressão arterial (PA) acima do 90º percentil para gênero, idade e percentil da altura foram considerados elevados. Resultados: A prevalência de excesso de peso entre os escolares foi de 24,5%, sendo que 16,9% apresentaram sobrepeso e 7,6% apresentaram obesidade. O gênero e as condições socioeconômicas não apresentaram correlação com o aumento da pressão arterial. Em todas as faixas etárias, a PA sistólica e diastólica tiveram correlação com o IMC, medida da cintura, medida do quadril, mas não com a relação cintura-quadril. A prevalência de PA elevada foi de 11,2% em crianças eutróficas, 20,6% nas com sobrepeso (OR = 1,99, IC 95% = 1,61-2,45) e 39,7% nas obesas (OR = 5,4, IC 95% = 4,23-6,89). Conclusão: As crianças obesas e com sobrepeso apresentaram maior prevalência de pressão arterial elevada. Nossos dados confirmam que a crescente prevalência de excesso de peso e pressão arterial elevada em escolares observado mundialmente também pode estar ocorrendo no Brasil. Abstract in english Background: The incidence of obesity in children is increasing worldwide, primarily in urbanized, high-income countries, and hypertension development is a detrimental effect of this phenomenon. Objective: In this cross-sectional study, we evaluated the prevalence of excess weight and its associat [...] ion with high blood pressure (BP) in schoolchildren. Methods: Here 4,609 male and female children, aged 6 to 11 years, from 24 public and private schools in Maringa, Brazil, were evaluated. Nutritional status was assessed by body mass index (BMI) according to cutoff points adjusted for sex and age. Blood pressure (BP) levels above 90th percentile for gender, age and height percentile were considered elevated. Results: The prevalence of excess weight among the schoolchildren was 24.5%; 16.9% were overweight, and 7.6% were obese. Sex and socioeconomic characteristics were not associated with elevated BP. In all age groups, systolic and diastolic BP correlated with BMI and waist and hip measurements, but not with waist-hip ratio. The prevalence of elevated BP was 11.2% in eutrophic children, 20.6% in overweight children [odds ratio (OR), 1.99; 95% confidence interval (CI), 1.61-2.45], and 39.7% in obese children (OR, 5.4; 95% CI, 4.23-6.89). Conclusion: Obese and overweight children had a higher prevalence of elevated BP than normal-weight children. Our data confirm that the growing worldwide epidemic of excess weight and elevated BP in schoolchildren may also be ongoing in Brazil.

  13. Standardized Peridialytic Blood Pressures for Diagnosing Arterial Hypertension in Patients on Chronic Hemodialysis

    OpenAIRE

    Raluca Moldovan; Mirela Gherman-Căprioară

    2014-01-01

    Background. The relevance of peridialytic blood pressures for diagnosing hypertension is controversial. Standardized peridialytic BPs have not yet been evaluated for the positive diagnosis and evaluation of hypertension severity in chronic hemodialysis patients.Aim. To evaluate the utility of standardized peridialytic BP for diagnosing hypertension, defined according to the results of 24-hour ambulatory blood pressure monitoring(ABPM).Methods. Thirty-five chronic hemodialysis patients with a ...

  14. Effect of isosorbide-5-mononitrate on the mean pulmonary artery pressure and parameters of endocardial scintigraphy following uncomplicated myocardial infarction

    International Nuclear Information System (INIS)

    It was the aim of the study described here to find out whether it would be possible to validate the effects that isosorbide-5-mononitrate has on patients having suffered uncomplicated myocardial infarction, when given shortly after continuous infusions of glycerol trinitrate, which are generally withdrawn just before the infarct patient is transferred from the intensive care unit to a peripheral ward. In this connection it was also of interest, if an effect would be detectable after three to four weeks of treatment using a 3x20 mg regimen or if the effects of continuous treatment would be abolished by the development of tachyphylaxis. An unbiased evaluation of efficacy was achieved on the basis of determinations of the mean pulmonary artery pressure, of the enddiastolic volume of the left ventricle using technetium-99m and of the left-ventricular ejection fraction at rest. (Vhe)

  15. Clinical significance of ankle systolic blood pressure following exercise in assessing calf muscle tissue ischemia in peripheral artery disease.

    Science.gov (United States)

    Khurana, Aman; Stoner, Julie A; Whitsett, Thomas L; Rathbun, Suman; Montgomery, Polly S; Gardner, Andrew W

    2013-07-01

    Our primary objective assessed whether a decline in ankle systolic blood pressure (SBP) to less than 50 mm Hg after treadmill exercise is associated with lower extremity ischemia, as measured by calf muscle hemoglobin oxygen saturation (StO(2)). Eighty-four patients with peripheral artery disease (PAD) completed a treadmill test. Ankle SBP exercise was observed in only 49% (group 1), whereas 51% had ankle SBP ?50 mm Hg (group 2). No group differences were observed for the decline in calf muscle StO(2) to a minimum value (group 1: 18 ± 21%, group 2: 20 ± 20%; P = .60) and for the time to reach minimum StO(2) (group 1: 224 ± 251 seconds, group 2: 284 ± 283 seconds; P = .30). Requirement of ankle SBP to decrease below 50 mm Hg after exercise has little clinical significance for assessing ischemia in calf muscle of patients with PAD limited by intermittent claudication. PMID:22609542

  16. An improved baseline model for a human arterial network to study the impact of aneurysms on pressure-flow waveforms.

    Science.gov (United States)

    Low, K; van Loon, R; Sazonov, I; Bevan, R L T; Nithiarasu, P

    2012-12-01

    In this study, an improved and robust one-dimensional human arterial network model is presented. The one-dimensional blood flow equations are solved using the Taylor-locally conservative Galerkin finite element method. The model improvements are carried out by adopting parts of the physical models from different authors to establish an accurate baseline model. The predicted pressure-flow waveforms at various monitoring positions are compared against in vivo measurements from published works. The results obtained show that wave shapes predicted are similar to that of the experimental data and exhibit a good overall agreement with measured waveforms. Finally, computational studies on the influence of an abdominal aortic aneurysm are presented. The presence of aneurysms results in a significant change in the waveforms throughout the network. PMID:23212798

  17. Role of Left Ventricular Diastolic Dysfunction in Predicting Atrial Fibrillation Recurrence after Successful Electrical Cardioversion

    Directory of Open Access Journals (Sweden)

    Rowlens M. Melduni, M.D., M.P.H

    2012-12-01

    Full Text Available The role of left ventricular (LV diastolic dysfunction in predicting atrial fibrillation (AF recurrence after successful electrical cardioversion is largely unknown. Studies suggest that there may be a link between abnormal LV compliance and the initial development, and recurrence of AF after electrical cardioversion. Although direct-current cardioversion (DCCV is a well-established and highly effective method to convert AF to sinus rhythm, it offers little else beyond immediate rate control because it does not address the underlying cause of AF. Preservation of sinus rhythm after successful cardioversion still remains a challenge for clinicians. Despite the use of antiarrhythmic drugs and serial cardioversions, the rate of AF recurrence remains high in the first year. Current evidence suggests that diastolic dysfunction, which is associated with atrial volume and pressure overload, may be a mechanism underlying the perpetuating cycle of AF recurrence following successful electrical cardioversion. Diastolic dysfunction is considered to be a defect in the ability of the myofibrils, which have shortened against a load in systole to eject blood into the high-pressure aorta, to rapidly or completely return to their resting length. Consequently, LV filling is impaired and the non-compliant left ventricle is unable to fill at low pressures. As a result, left atrial and pulmonary vein pressure rises, and electrical and structural remodeling of the atrial myocardium ensues, creating a vulnerable substrate for AF. In this article, we review the current evidence highlighting the association of LV diastolic dysfunction with AF recurrence after successful electrical cardioversion and provide an approach to the management of LV diastolic dysfunction to prevent AF recurrence.

  18. Anticoncepcionais orais e pressão arterial: pesquisa epidemiológica de hipertensão arterial no Rio Grande do Sul

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    Célia L. Szwarcwald

    1985-06-01

    Full Text Available O presente trabalho teve por objetivo descrever a relação entre o uso de anticoncepcionais orais e a pressão arterial em mulheres residentes nas áreas urbana, rural e metropolitana no Rio Grande do Sul situado no extremo sul do Brasil Os dados utilizados nesta análise provêm de um inquérito de hipertensão arterial conduzido neste Estado, em 1978. Através de uma análise de covariâncias, controlando-se idade e índice de Quetelet, as médias de pressão sistólica e diastólica das mulheres usuárias e ex-usuárias de pílulas, foram comparadas com as médias de pressão das mulheres que nunca tomaram anticoncepcionais. Observou-se que, para a pressão sistólica, houve, sistematicamente, nos quatro estratos considerados na pesquisa (Interior Rural, Interior Urbano, Cinturão Metropolitano e Porto Alegre, uma diferença positiva para as mulheres que estão tomando pílula atualmente. Esta diferença mostrou-se significativa (p The present paper describes the relationship between the use of oral contraceptives and arterial blood pressure among women residing in rural, urban and metropolitan areas of Rio Grande do Sul, the southernmost state of Brazil. The analysis is based on data from a cross-sectional survey of blood pressure carried out in Rio Grande do Sul, in 1978. In an analysis ofcovariance, controlling forage and Quetelet Index, the average systolic and diastolic pressures of oral contraceptive users or ex-users were compared to the average pressure of never-users. A positive difference in systolic pressure was observed systematically for all four study strata (Rural Interior, Urban Interior, Capital and its Metropolitan Belt, among women using oral contraceptives at the time of interview. The difference was found to be significant (p < 1% for women residing in the Metropolitan Belt using oral contraceptives for more than 2 y ears. The effect on diastolic pressure, although generally positive, were smaller and not significant. The research methodology allowed for the association between the use of oral contraceptives and other risk factors to be evaluated. The effect on blood pressure was found to be most intense for women of the lowest educational status residing in the Metropolitan belt. For the group of women with a history of hypertension during pregnancy or classified as hypertensive (criteria 140/90 the effect of oral contraceptives was also found to be highly significant (p <1% - an alteration of over IQmmHg on the average systolic pressure. These results suggest that the use of oral contraceptives brings about a greater increase in systolic pressure in groups of women with normally higher levels of pressure.

  19. Avaliação do monitor de medida de pressão arterial 0mron 705-CP para uso em adolescentes e adultos jovens Evaluation of the Omron 705-CP blood pressure measuring device for use in adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Erika Arai Furusawa

    2005-05-01

    Full Text Available OBJETIVO: Avaliar o monitor OMRON 705-CP de medida de pressão arterial em adolescentes e adultos jovens. MÉTODOS: De acordo com o protocolo da British Hypertension Society e da Association for the Advancement of Medical Instrumentation, realizamos a validação do aparelho em 60 adolescentes. O monitor foi conectado em Y com a coluna de mercúrio e foram realizadas 4 medidas consecutivas e simultâneas, analisadas as independentes e calculadas as diferenças médias entre as pressões e o desvio padrão dessas diferenças. Os resultados foram analisados de acordo com o sistema de grau do protocolo utilizado. RESULTADOS: Foram avaliadas 240 medidas. A idade média dos pacientes foi 16,3 anos. Quando comparada a medida realizada pela coluna de mercúrio com o aparelho houve uma diferença OBJECTIVE: To assess the Omron 705-CP monitor for measuring blood pressure in adolescents and young adults. METHODS: According to the protocols of the British Hypertension Society and the Association for the Advancement of Medical Instrumentation, we performed validation of the device in 60 adolescents. The Omron monitor was connected in Y to a mercury column. Four consecutive and simultaneous measurements were taken with the mercury column sphygmomanometer and the test device, were independently analyzed, and the mean differences between the blood pressure measurements and the standard deviations of those differences were calculated. The results were analyzed according to the grading system of the protocol used. RESULTS: Two hundred and forty measurements were evaluated. The mean age of the patients was 16.3 years. When the measurement performed with the mercury column sphygmomanometer was compared with that taken with the device, a difference < 15 mmHg was observed in 97.9% of the systolic and 98.8% of the diastolic blood pressure measurements; a difference < 10 mmHg was observed in 86.3% of the systolic and 90.4% of the diastolic blood pressure measurements, which was classified as grade A; a difference < 5 mmHg was observed in 59.1% of the systolic and 67% of the diastolic blood pressure measurements, and was classified as grade A/B. The mean difference and the standard deviation of that difference for the systolic blood pressure was 2.91±6.42 mmHg, and, for the diastolic blood pressure, it was 1.16±5.79 mmHg. CONCLUSION: The Omron 705-CP monitor proved to be useful for measuring blood pressure in adolescents according to the protocol used.

  20. Estudo comparativo da pressão arterial e da prevalência de hipertensão arterial em duas coortes sucessivas (1975-1976 de estudantes de 16 a 25 anos, Botucatu, SP, Brasil Blood pressure levels and hipertension prevalence in 16 to 25 year-old students in Botucatu, S. Paulo, Brazil. A comparative study of two successive cohorts, 1975-1976

    Directory of Open Access Journals (Sweden)

    Dináh Borges de Almeida

    1978-12-01

    Full Text Available Com o objetivo de determinar os níveis de pressão arterial e a prevalência de hipertensão arterial em uma população jovem, foram realizados pesquisas em dois anos sucessivos em 1.288 e 736 estudantes de Botucatu, SP (Brasil tendo sido comparados os resultados obtidos. As médias das pressões sistólicas da população estudada e dos dois grupos etários desta população (16 a 20 anos e 21 a 25 anos foram idênticas em ambos os anos, tendo as médias das pressões diastólicas diferido de no máximo 2 mmHg; as médias, tanto sistólicas quanto diastólicas, dos dois sexos e da parcela branca da população estudada quanto à idade e sexo também diferiram de no máximo 2 mmHg. As médias da população estudada e sua parcela branca, em ambos os anos, foram superiores no sexo masculino e no grupo etário de 21 a 25 anos. Na população negra e amarela houve disparidade de resultados entre 1975 e 1976, indicando influência da exiguidade do tamanho dos contigentes negro e amarelo desta população. A prevalência de hipertensão arterial (pressão sistólica igual ou maior que 140 mmHg e diastólica igual ou maior que 90 mmHg foi de 5,04% em 1975 e 6,22% em 1976, tendo sido em ambos os anos maior no sexo masculino do que no feminino e no grupo de 21 a 25 do que no de 16 a 20 anos.To determine the prevalence of hypertension and blood pressure levels in a young population group, two groups, one of 1288 students and another of 736, all from Botucatu, were investigated during two consecutive years, and the results were then compared. The mean values for systolic readings of the whole population, as for the two age groups (16 to 20 and 21 to 25 years old, were identical for both years studied; the diastolic mean values differed by 2 mmHg at most. The mean systolic and diastolic reading for both sexes and among the whites also differed by 2 mmHg at most. The mean values for the whole population and among the white population were higher for males than for females, and also higher in the 21 to 25 age group than in the 16 to 20 group. The 1975 and 1976 results for the black and yellow population were inconsistent, reflecting the influence of the small size of these groups. The prevalence of arterial hypertension (systolic readings equal to or higher than 140 mmHg and diastolic readings equal to or higher than 90 mmHg was 5.04% in 1975 and 6.22% in 1976, being higher in the males than in the females and higher in the 21 to 25 age group than in the 16 to 20 year-old group.

  1. Noninvasive assessment of pulmonary arterial pressure by krypton-81m right cardiac ventriculography in patients with chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Yamaoka, Shimpachi; Kuriyama, Takanobu; Hirai, Masashi; Nishimura, Kouichi; Kuno, Kenshi; Yonekura, Yoshiharu

    1987-10-01

    In twenty patients with COPD, the following pulmonary function test values were obtained (mean +- SD): FEV/sub 1.0/ = 1070 +- 490 ml;FEV/sub 1.0/ % = 47.7 +- 8.9 %;PaO/sub 2/ = 65.8 +- 8.4 torr;PaCO/sub 2/ = 39.7 +- 4.4 torr. All patients underwent right heart catheterization and pulmonary arterial mean pressures (PAMP) were obtained. The PAMP value was 20.2 +- 4.1 torr (range 12 - 28), RVEF was 52.2 +- 8.4 % (range 31 - 63) and RVRFR was 25.5 +- 4.7 %100 msec (range 18 - 34). The PAMP negatively correlated with the RVEF (r = -0.69, p < 0.001) and RVRFR (r = -0.82, p < 0.001). In ten healthy male subjects, the RVEF was 56.6 +- 5.1 % (range 50 - 64) and RVRFR was 37.7 +- 3.0 %100 msec (range 33 - 42). The lower limit of normal for the RVEF was regarded as 46.4 % and that of the RVRFR as 31.7 %100 msec;these are the values two standard deviations below the means. Nine of the twenty patients has a PAMP value of more than 20 torr (the sine qua non of cor pulmonale). Five of these nine patients had RVEF values less than 46.4 % and all of them had RVRFR values of less than 31.7 %100 msec. On the other hand, all of the remaining eleven patients (PAMP 20 torr or less) had RVEF values within the normal range, but ten of the eleven had RVRFR values of less than 31.7 %100 msec. Therefore, the RVRFR value, which showed excellent correlation with the PAMP, provided a noninvasive assessment of pulmonary arterial pressure with good sensitivity in detecting elevated pressure. The RVEF value supplemented the RVRFR with good specificity for detection of elevation of pressure;that is, it eliminated false positive results. (J.P.N.)

  2. Noninvasive assessment of pulmonary arterial pressure by krypton-81m right cardiac ventriculography in patients with chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    In twenty patients with COPD, the following pulmonary function test values were obtained (mean ± SD): FEV1.0 = 1070 ± 490 ml; FEV1.0 % = 47.7 ± 8.9 %; PaO2 = 65.8 ± 8.4 torr; PaCO2 = 39.7 ± 4.4 torr. All patients underwent right heart catheterization and pulmonary arterial mean pressures (PAMP) were obtained. The PAMP value was 20.2 ± 4.1 torr (range 12 - 28), RVEF was 52.2 ± 8.4 % (range 31 - 63) and RVRFR was 25.5 ± 4.7 %/100 msec (range 18 - 34). The PAMP negatively correlated with the RVEF (r = -0.69, p < 0.001) and RVRFR (r = -0.82, p < 0.001). In ten healthy male subjects, the RVEF was 56.6 ± 5.1 % (range 50 - 64) and RVRFR was 37.7 ± 3.0 %/100 msec (range 33 - 42). The lower limit of normal for the RVEF was regarded as 46.4 % and that of the RVRFR as 31.7 %/100 msec; these are the values two standard deviations below the means. Nine of the twenty patients has a PAMP value of more than 20 torr (the sine qua non of cor pulmonale). Five of these nine patients had RVEF values less than 46.4 % and all of them had RVRFR values of less than 31.7 %/100 msec. On the other hand, all of the remaining eleven patients (PAMP 20 torr or less) had RVEF values within the normal range, but ten of the eleven had RVRFR values of less than 31.7 %/100 msec. Therefore, the RVRFR value, which showed excellent correlation with the PAMP, provided a noninvasive assessment of pulmonary arterial pressure with good sensitivity in detecting elevated pressure. The RVEF value supplemented the RVRFR with good specificity for detection of elevation of pressure; that is, it eliminated false positive results. (J.P.N.)

  3. Considerações sobre a medida da pressão arterial em exercícios contra-resistência Considerations on blood pressure assessment during resistive exercise

    Directory of Open Access Journals (Sweden)

    Marcos Doederlein Polito

    2003-02-01

    Full Text Available A pressão arterial (PA é uma variável cuja quantificação em sessões de treinamento é desejável, já que tem relação com as demandas cardiovasculares no esforço. No caso de exercícios contra-resistência (ECR, porém, os valores obtidos estão sujeitos a erros, dependendo da técnica de medida adotada. Este texto tem por objetivo revisar os métodos de medida da PA no ECR, sugerindo formas de reduzir as discrepâncias das medidas indiretas quando comparadas com o método direto. A medida direta da PA é feita por cateterismo intra-arterial (CI. Este método é tido como padrão-ouro mas, devido a sua natureza invasiva, é um procedimento pouco usual. Além disso, sua aplicação não seria indicada em indivíduos assintomáticos, uma vez associada a riscos de dor, espasmo e oclusão arterial, síncope vasovagal e sangramento. Dentre os métodos indiretos, destacam-se o fotoplestimográfico (Finapres e o auscultatório (MA. Poucos são os estudos comparativos entre esses procedimentos de medida durante ECR, a ênfase sendo maior em atividades aeróbias e no repouso. Dentre os estudos revisados, não foram localizados trabalhos comparando o CI com Finapres durante ECR e apenas três com o método auscultatório. Em suma, o CI parece pouco viável e ético para quantificar a PA em ECR. O Finapres é considerado o melhor procedimento indireto, mas depende de equipamento, cujo custo é elevado e a fabricação, suspensa. O MA pode subestimar o valor real da PA, em função de limitações inerentes à técnica e das características dos exercícios observados. No entanto, alguns procedimentos durante a mensuração podem reduzir essas diferenças, como realizá-la o mais tardiamente possível, antes do término do exercício. Enfim, apesar das discrepâncias referentes aos valores absolutos, as medidas obtidas pelo método auscultatório podem ser sensíveis para identificar tendências do impacto sobre a PA, decorrentes de diferentes situações de prescrição de ECR.Cardiovascular demands during exercise are related to arterial blood pressure (BP. However, BP assessment during resistive exercises (RE can be biased by limitations of measurement techniques. The purpose of this paper was to review the methods of BP assessment during RE, and to suggest ways to minimize differences between indirect and direct methods. Intra-arterial catheterism (IC is considered the gold-standard for BP assessment. However, its application is unusual and not recommended for healthy individuals, due to enhanced risk of pain, arterial spasm and occlusion, syncope, or blending. The most common indirect methods are the photoplethysmographic (Finapres and auscultation (AU techniques. There are few studies comparing these methods during RE. Only one paper was found comparing IC to Finapres, and three comparing IC to AU. In conclusion, despite its precision, IC utilization to assess BP during RE in healthy subjects seems not to be feasible nor ethical. Finapres is considered the best indirect procedure, but it relies on an expensive device which is no longer available, since its production was discontinued. On the other hand, AU can lead to important underestimation of the actual BP values, depending on the exercise characteristics. Some recommendations can be adopted to reduce these differences, such as making the measurement the latest possible before the end of the exercise. The absolute differences between AU and the other methods notwithstanding, it seems that it is adequate to identify trends of BP profile associated to different RE situations.

  4. Influence of a history of arterial hypertension and pretreatment blood pressure on the effect of angiotensin converting enzyme inhibition after acute myocardial infarction. Trandolapril Cardiac Evaluation Study

    DEFF Research Database (Denmark)

    Gustafsson, F; Køber, L; Torp-Pedersen, C; Per Hildebrand