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Sample records for artery diastolic pressure

  1. 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.

  2. 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.

  3. Left Ventricular Diastolic Function Assessment of a Heterogeneous Cohort of Pulmonary Arterial Hypertension Patients

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    Hernandez-Suarez, Dagmar F.; Lopez Menendez, Francisco R.; Palm, Denada; Lopez-Candales, Angel

    2017-01-01

    Background Pulmonary arterial hypertension (PAH) is known to trigger right ventricular (RV) remodeling that might compromise left ventricular (LV) filling due to inter-ventricular interdependence. In this study, we aimed to examine standard echocardiographic measurements of LV diastolic function in PAH patients. Methods In this retrospective study, we identified clinical as well as complete echocardiographic data from 128 chronic PAH patients to fully assess LV diastolic dysfunction (LVDD) using standard recommended Doppler guidelines. Accordingly, patients were divided into three groups: LVDD 0, LVDD 1 and LVDD 2. Results The mean age of the studied population was 57 ± 14 years with a mean pulmonary artery systolic pressure (PASP) of 55 ± 21 mm Hg. A total of 36% of the study patients had normal LV diastolic function. However, 64% had LVDD with LVDD stage 1 being the most common (48%). In terms of echocardiographic data, significant differences were found among the three LVDD groups in regards to PASP, LV end systolic and diastolic volumes, tricuspid annular plane systolic excursion, right ventricular fractional area change as well as many other tissue Doppler imaging parameters. Finally, just age and PASP were predictors of abnormal LV diastolic function (P < 0.05). Conclusions Impaired relaxation is a common abnormality in PAH patients. Additional studies are warranted to determine whether LVDD alters prognosis or is related to changes in the symptomatic profile of this group of patients. PMID:28270896

  4. Left Atrial Volume and Pulmonary Artery Diameter Are Noninvasive Measures of Age-Related Diastolic Dysfunction in Mice.

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    Medrano, Guillermo; Hermosillo-Rodriguez, Jesus; Pham, Thuy; Granillo, Alejandro; Hartley, Craig J; Reddy, Anilkumar; Osuna, Patricia Mejia; Entman, Mark L; Taffet, George E

    2016-09-01

    Impaired cardiac diastolic function occurs with aging in many species and may be difficult to measure noninvasively. In humans, left atrial (LA) volume is a robust measure of chronic diastolic function as the LA is exposed to increased left ventricular filling pressures. We hypothesized that LA volume would be a useful indicator of diastolic function in aging mice. Further, we asked whether pressures were propagated backwards affecting pulmonary arteries (PAs) and right ventricle (RV). We measured LA, PA, and RV infundibulum dimensions with echocardiography and used mouse-specific Doppler systems and pressure catheters for noninvasive and invasive measures. As C57BL/6 mice aged from 3 to 29-31 months, LA volume almost tripled. LA volume increases correlated with traditional diastolic function measures. Within groups of 14- and 31-month-old mice, LA volume correlated with diastolic function measured invasively. In serial studies, mice evaluated at 20 and 24 months showed monotonic increases in LA volume; other parameters changed less predictably. PA diameters, larger in 30-month-old mice than 6-month-old mice, correlated with LA volumes. Noninvasive LA volume and PA diameter assessments are useful and state independent measures of diastolic function in mice, correlating with other measures of diastolic dysfunction in aging. Furthermore, serial measurements over 4 months demonstrated consistent increases in LA volume suitable for longitudinal cardiac aging studies.

  5. Wave potential and the one-dimensional windkessel as a wave-based paradigm of diastolic arterial hemodynamics.

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    Mynard, Jonathan P; Smolich, Joseph J

    2014-08-01

    Controversy exists about whether one-dimensional wave theory can explain the "self-canceling" waves that accompany the diastolic pressure decay and discharge of the arterial reservoir. Although it has been proposed that reservoir and wave effects be treated as separate phenomena, thus avoiding the issue of self-canceling waves, we have argued that reservoir effects are a phenomenological and mathematical subset of wave effects. However, a complete wave-based explanation of self-canceling diastolic expansion (pressure-decreasing) waves has not yet been advanced. These waves are present in the forward and backward components of arterial pressure and flow (P ± and Q ±, respectively), which are calculated by integrating incremental pressure and flow changes (dP ± and dQ ±, respectively). While the integration constants for this calculation have previously been considered arbitrary, we showed that physiologically meaningful constants can be obtained by identifying "undisturbed pressure" as mean circulatory pressure. Using a series of numeric experiments, absolute P ± and Q ± values were shown to represent "wave potential," gradients of which produce propagating wavefronts. With the aid of a "one-dimensional windkessel," we showed how wave theory predicts discharge of the arterial reservoir. Simulated data, along with hemodynamic recordings in seven sheep, suggested that self-canceling diastolic waves arise from repeated and diffuse reflection of the late systolic forward expansion wave throughout the arterial system and at the closed aortic valve, along with progressive leakage of wave potential from the conduit arteries. The combination of wave and wave potential concepts leads to a comprehensive one-dimensional (i.e., wave-based) explanation of arterial hemodynamics, including the diastolic pressure decay.

  6. Clinical review: Interpretation of arterial pressure wave in shock states

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    Lamia, Bouchra; Chemla, Denis; Richard, Christian; Teboul, Jean-Louis

    2005-01-01

    In critically ill patients monitored with an arterial catheter, the arterial pressure signal provides two types of information that may help the clinician to interpret haemodynamic status better: the mean values of systolic, diastolic, mean and pulse pressures; and the magnitude of the respiratory variation in arterial pressure in patients undergoing mechanical ventilation. In this review we briefly discuss the physiological mechanisms responsible for arterial pressure generation, with specia...

  7. Clinical usefulness of carotid arterial wave intensity in assessing left ventricular systolic and early diastolic performance.

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    Ohte, Nobuyuki; Narita, Hitomi; Sugawara, Motoaki; Niki, Kiyomi; Okada, Takashi; Harada, Akimitsu; Hayano, Junichiro; Kimura, Genjiro

    2003-07-01

    Wave intensity (WI) is a novel hemodynamic index, which is defined as (d P/d t) x (d U/d t) at any site of the circulation, where d P/d t and d U/d t are the derivatives of blood pressure and velocity with respect to time, respectively. However, the pathophysiological meanings of this index have not been fully elucidated in the clinical setting. Accordingly, we investigated this issue in 64 patients who underwent invasive evaluation of left ventricular (LV) function. WI was obtained at the right carotid artery using a color Doppler system for blood velocity measurement combined with an echo-tracking method for detecting vessel diameter changes. The vessel diameter changes were automatically converted to pressure waveforms by calibrating its peak and minimum values by systolic and diastolic brachial blood pressures. The WI of the patients showed two sharp positive peaks. The first peak was found at the very early phase of LV ejection, while the second peak was observed near end-ejection. The magnitude of the first peak of WI significantly correlated with the maximum rate of LV pressure rise (LV max. d P/d t) (r = 0.74, P WI significantly correlated with the time constant of LV relaxation (r = -0.77, P WI reflects LV contractile performance, and the amplitude of the second peak of WI is determined by LV behavior during the period from late systole to isovolumic relaxation. WI is a noninvasively obtained, clinically useful parameter for the evaluation of LV systolic and early diastolic performance at the same time.

  8. High diastolic blood pressure is a risk factor for in-hospital mortality in complete MCA stroke patients.

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    Caso, Valeria; Agnelli, Giancarlo; Alberti, Andrea; Venti, Michele; Acciarresi, Monica; Palmerini, Francesco; Paciaroni, Maurizio

    2012-06-01

    Complete middle cerebral artery (MCA) stroke is a life-threatening condition, which can lead to death in the form of "malignant MCA syndrome"; characterized by massive brain edema and cerebral herniation. Moreover, patients with complete MCA infarct have high mortality due to complications. The aim of this study was to evaluate the clinical predictors of in-hospital mortality in patients with complete MCA stroke. Consecutive patients with complete MCA stroke were enrolled in a prospective single center in-hospital outcome study having mortality as its end point. Among 780 ischemic stroke patients, 125 had complete MCA strokes (16%) and 44 (35.2%) of these died in hospital. A high NIHSS-score (OR 1.17 95%CI 1.03-1.34, P=0.013) and high diastolic blood pressure on admission (OR 1.05 95%CI 1.01-1.09) resulted being independent predictors of in-hospital mortality in patients with complete MCA stroke. The median value of diastolic blood pressure at admission was 90 mmHg in patients who died and 80 mmHg in survivors (P=0.01). The risk of death increased by 5% for each mmHg increase in diastolic blood pressure on admission after adjusting for other risk factors. The rate of mortality was 22% in patients with diastolic blood pressure lower than 90 mmHg, 56% for those with diastolic blood pressure between 90 and 109 mmHg and 67% for those with diastolic blood pressure higher than 110 mmHg. This study suggests that high diastolic blood pressure on admission in acute MCA stroke patients is linearly correlated with in-hospital mortality.

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

    NARCIS (Netherlands)

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

    2011-01-01

    Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we ident

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

    NARCIS (Netherlands)

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

    2011-01-01

    Numerous genetic loci have been associated with 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

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

    NARCIS (Netherlands)

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

    2011-01-01

    textabstractNumerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,60

  12. 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;

    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...... model estimated (1) high genetic correlations for DBP with SBP (0.87), PP with SBP (0.75); (2) low-moderate genetic correlations between PP and DBP (0.32), each BP component and BMI (0.24-0.37); (3) moderate unique environmental correlation for PP with SBP (0.68) and SBP with DBP (0.63); (4...

  13. [Measurement of arterial pressure].

    Science.gov (United States)

    Rorive, G

    1998-03-01

    The casual determination of blood pressure remains the basis of the diagnosis of arterial hypertension and the criteria for usefulness of drug therapy. The reference values usually in use concern determinations by the doctor in very well defined conditions, rest, size of the bladder, etc.... The poor reproductibility of the determinations made by the doctor in casual conditions has produced a large interest for new approaches: autodetermination by the patient at home, and ambulatory blood pressure determinations using automatic devices. These new approaches have their own reference values, specific indications and limitations.

  14. Relationship among diastolic intraventricular pressure gradients, relaxation, and preload : impact of age and fitness

    NARCIS (Netherlands)

    Popovic, Z.B.; Prasad, A.; Garcia, M.J.; Arbab-Zadeh, A.; Borowski, A.; Dijk, E.; Greenberg, N.L.; Levine, B.D.; Thomas, J.D.

    2006-01-01

    Diastolic intraventricular pressure gradients (IVPGs) are a measure of the ability of the ventricle to facilitate its filling using diastolic suction. We assessed 15 healthy young but sedentary subjects, aged <50 yr (young subjects; age, 35 +/- 9 yr); 13 healthy but sedentary seniors, aged >65 yr wi

  15. Association between arterial stiffness and left ventricular diastolic function in relation to gender and age

    Science.gov (United States)

    Kim, Hack-Lyoung; Lim, Woo-Hyun; Seo, Jae-Bin; Chung, Woo-Young; Kim, Sang-Hyun; Kim, Myung-A.; Zo, Joo-Hee

    2017-01-01

    Abstract Left ventricular (LV) diastolic dysfunction and subsequent overt heart failure are more prevalent in elderly women. Close interaction between arterial stiffness and LV morphology/function has been reported. The aim of this study was to investigate whether there is an age- and gender-dependent relationship between arterial stiffness and LV diastolic function. A total of 819 subjects (58.6 ± 13.3 years, 50.2% men) without structural heart disease (LV ejection fraction ≥50%) were retrospectively analyzed. All participants underwent transthoracic echocardiography and brachial-ankle pulse wave velocity (baPWV) measurement on the same day. The association of baPWV with septal e′ velocity and average E/e′ was assessed. In the total study subjects, baPWV was negatively correlated with septal e′ velocity (r = 0.383, P  0.05 for each). In conclusion, baPWV was independently associated with septal e′ velocity and E/e′ in elderly women but not in younger women or men. The results of this study provide additional evidence that increased arterial stiffness plays an important role in the development of heart failure with preserved ejection fraction as well as LV diastolic dysfunction in elderly women. PMID:28072727

  16. A new technique for assessing arterial pressure wave forms and central pressure with tissue Doppler

    Science.gov (United States)

    Haluska, Brian A; Jeffriess, Leanne; Mottram, Phillip M; Carlier, Stephane G; Marwick, Thomas H

    2007-01-01

    Background Non-invasive assessment of arterial pressure wave forms using applanation tonometry of the radial or carotid arteries can be technically challenging and has not found wide clinical application. 2D imaging of the common carotid arteries is routinely used and we sought to determine whether arterial waveform measurements could be derived from tissue Doppler imaging (TDI) of the carotid artery. Methods We studied 91 subjects (52 men, age 52 ± 14 years) with and without cardiovascular disease. Tonometry was performed on the carotid artery simultaneously with pulsed wave Doppler of the LVOT and acquired digitally. Longitudinal 2D images of the common carotid artery with and without TDI were also acquired digitally and both TDI and tonometry were calibrated using mean and diastolic cuff pressure and analysed off line. Results Correlation between central pressure by TDI and tonometry was excellent for maximum pressure (r = 0.97, p < 0.0001). The mean differences between central pressures derived by TDI and tonometry were minimal (systolic 5.36 ± 5.5 mmHg; diastolic 1.2 ± 1.2 mmHg). Conclusion Imaging of the common carotid artery motion with tissue Doppler may permit acquisition of a waveform analogous to that from tonometry. This method may simplify estimation of central arterial pressure and calculation of total arterial compliance. PMID:17266772

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

    NARCIS (Netherlands)

    Wain, L.V.; Verwoert, G.C.; O'Reilly, P.F.; Shi, G.; Johnson, T.; Johnson, A.D.; Bochud, M.; Rice, K.M.; Henneman, P.; Smith, A.V.; Ehret, G.B.; Amin, N.; Larson, M.G.; Mooser, V.; Hadley, D.; Dorr, M.; Bis, J.C.; Aspelund, T.; Esko, T.; Janssens, A.C.J.W.; Zhao, J.H.; Heath, S.; Laan, M.; Fu, J.Y.; Pistis, G.; Luan, J.A.; Arora, P.; Lucas, G.; Pirastu, N.; Pichler, I.; Jackson, A.U.; Webster, R.J.; Zhang, F.; Peden, J.F.; Schmidt, H.; Tanaka, T.; Campbell, H.; Igl, W.; Milaneschi, Y.; Hottenga, J.J.; Vitart, V.; Chasman, D.I.; Trompet, S.; Bragg-Gresham, J.L.; Alizadeh, B.Z.; Chambers, J.C.; Guo, X.Q.; Lehtimaki, T.; Kuhnel, B.; Lopez, L.M.; Polasek, O.; Boban, M.; Nelson, C.P.; Morrison, A.C.; Pihur, V.; Ganesh, S.K.; Hofman, A.; Kundu, S.; Mattace-Raso, F.U.S.; Rivadeneira, F.; Sijbrands, E.J.G.; Uitterlinden, A.G.; Hwang, S.J.; Vasan, R.S.; Wang, T.J.; Bergmann, S.; Vollenweider, P.; Waeber, G.; Laitinen, J.; Pouta, A.; Zitting, P.; McArdle, W.L.; Kroemer, H.K.; Volker, U.; Volzke, H.; Glazer, N.L.; Taylor, K.D.; Harris, T.B.; Alavere, H.; Haller, T.; Keis, A.; Tammesoo, M.L.; Aulchenko, Y.; Barroso, I.; Khaw, K.T.; Galan, P.; Hercberg, S.; Lathrop, M.; Eyheramendy, S.; Org, E.; Sober, S.; Lu, X.W.; Nolte, I.M.; Penninx, B.W.; Corre, T.; Masciullo, C.; Sala, C.; Groop, L.; Voight, B.F.; Melander, O.; O'Donnell, C.J.; Salomaa, V.; d'Adamo, A.P.; Fabretto, A.; Faletra, F.; Ulivi, S.; Del Greco, M.F.; Facheris, M.; Collins, F.S.; Bergman, R.N.; Beilby, J.P.; Hung, J.; Musk, A.W.; Mangino, M.; Shin, S.Y.; Soranzo, N.; Watkins, H.; Goel, A.; Hamsten, A.; Gider, P.; Loitfelder, M.; Zeginigg, M.; Hernandez, D.; Najjar, S.S.; Navarro, P.; Wild, S.H.; Corsi, A.M.; Singleton, A.; de Geus, E.J.C.; Willemsen, G.; Parker, A.N.; Rose, L.M.; Buckley, B.; Stott, D.; Orru, M.; Uda, M.; van der Klauw, M.M.; Zhang, W.H.; Li, X.Z.; Scott, J.; Chen, Y.D.I.; Burke, G.L.; Kahonen, M.; Viikari, J.; Doring, A.; Meitinger, T.; Davies, G.; Starr, J.M.; Emilsson, V.; Plump, A.; Lindeman, J.H.; 'T Hoen, P.A.C.; Konig, I.R.; Felix, J.F.; Clarke, R.; Hopewell, J.C.; Ongen, H.; Breteler, M.; Debette, S.; DeStefano, A.L.; Fornage, M.; Mitchell, G.F.; Smith, N.L.; Holm, H.; Stefansson, K.; Thorleifsson, G.; Thorsteinsdottir, U.; Samani, N.J.; Preuss, M.; Rudan, I.; Hayward, C.; Deary, I.J.; Wichmann, H.E.; Raitakari, O.T.; Palmas, W.; Kooner, J.S.; Stolk, R.P.; Jukema, J.W.; Wright, A.F.; Boomsma, D.I.; Bandinelli, S.; Gyllensten, U.B.; Wilson, J.F.; Ferrucci, L.; Schmidt, R.; Farrall, M.; Spector, T.D.; Palmer, L.J.; Tuomilehto, J.; Pfeufer, A.; Gasparini, P.; Siscovick, D.; Altshuler, D.; Loos, R.J.F.; Toniolo, D.; Snieder, H.; Gieger, C.; Meneton, P.; Wareham, N.J.; Oostra, B.A.; Metspalu, A.; Launer, L.; Rettig, R.; Strachan, D.P.; Beckmann, J.S.; Witteman, J.C.M.; Erdmann, J.; van Dijk, K.W.; Boerwinkle, E.; Boehnke, M.; Ridker, P.M.; Jarvelin, M.R.; Chakravarti, A.; Abecasis, G.R.; Gudnason, V.; Newton-Cheh, C.; Levy, D.; Munroe, P.B.; Psaty, B.M.; Caulfield, M.J.; Rao, D.C.; Tobin, M.D.; Elliott, P.; van Duijn, C.M.

    2011-01-01

    Numerous genetic loci have been associated with 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

  18. Impact of Age on the Importance of Systolic and Diastolic Blood Pressures for Stroke Risk

    DEFF Research Database (Denmark)

    Vishram, Julie K K; Borglykke, Anders; Andreasen, Anne H;

    2012-01-01

    This study investigates age-related shifts in the relative importance of systolic (SBP) and diastolic (DBP) blood pressures as predictors of stroke and whether these relations are influenced by other cardiovascular risk factors. Using 34 European cohorts from the MOnica, Risk, Genetics, Archiving...

  19. 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.

  20. Association of arterial stiffness and electrocardiography-determined left ventricular hypertrophy with left ventricular diastolic dysfunction.

    Directory of Open Access Journals (Sweden)

    Po-Chao Hsu

    Full Text Available OBJECTIVES: Increased arterial stiffness is associated with left ventricular diastolic dysfunction (LVDD, but this association may be influenced by left ventricular (LV performance. Left ventricular hypertrophy (LVH is not only a significant determinant of LV performance, but is also correlated with LVDD. This study is designed to compare LV diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV and electrocardiography (ECG-determined LVH and to assess whether increased baPWV and ECG-determined LVH are independently associated with LVDD. METHODS: This cross-sectional study enrolled 270 patients and classified them into four groups according to the median value of baPWV and with/without ECG-determined LVH. The baPWV was measured using an ABI-form device. ECG-determined LVH was defined by Sokolow-Lyon criterion. LVDD was defined as impaired relaxation, pseudonormal, and restrictive mitral inflow patterns. Groups 1, 2, 3, and 4 were patients with lower baPWV and without ECG-determined LVH, lower baPWV but with ECG-determined LVH, higher baPWV but without ECG-determined LVH, and higher baPWV and with ECG-determined LVH respectively. RESULTS: Early diastolic mitral velocity (Ea was gradually decreased from group 1 to group 4 (p≦0.027. Patients in group 4 had the highest prevalence of LVDD (all p<0.001. After multivariate analysis, both baPWV and ECG-determined LVH were independent determinants of Ea (β = -0.02, P<0.001; β = -1.77, P<0.001 respectively and LVDD (odds ratio = 1.02, P = 0.011 and odds ratio = 3.53, P = 0.013 respectively. CONCLUSION: Our study showed the group with higher baPWV and ECG-determined LVH had the lowest Ea and highest prevalence of LVDD. In addition, both baPWV and ECG-determined LVH were independently associated with Ea and LVDD. Hence, assessment of arterial stiffness by baPWV and LVH by ECG may be useful in identifying the high risk group of LVDD.

  1. 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 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 blood pressure and HR from daytime...

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

    DEFF Research Database (Denmark)

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

    1995-01-01

    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 pressure and HR from daytime......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 pressures...

  3. Poor agreement between pulmonary capillary wedge pressure and left ventricular end-diastolic pressure in a veteran population.

    Directory of Open Access Journals (Sweden)

    Abbas Bitar

    Full Text Available BACKGROUND: Accurate determination of left ventricular filling pressure is essential for differentiation of pre-capillary pulmonary hypertension (PH from pulmonary venous hypertension (PVH. Previous data suggest only a poor correlation between left ventricular end-diastolic pressure (LVEDP and its commonly used surrogate, the pulmonary capillary wedge pressure (PCWP. However, no data exist on the diagnostic accuracy of PCWP in veterans. Furthermore, the effects of age and comorbidities on the PCWP-LVEDP relationship remain unknown. METHODS: We investigated the PCWP-LVEDP relationship in 101 patients undergoing simultaneous right and left heart catherization at a large VA hospital. PCWP performance was evaluated using correlation and Bland-Altman analyses. Area under Receiver Operating Characteristics curves (AUROC for PCWP were determined. RESULTS: PCWP-LVEDP correlation was moderate (r = 0.57. PCWP-LVEDP calibration was poor (Bland-Altman limits of agreement -17.2 to 11.4 mmHg; mean bias -2.87 mmHg. 59 patients (58.4% had pulmonary hypertension; 15 (25.4% of those met pre-capillary PH criteria based on PCWP. However, if LVEDP was used instead of PCWP, 7/15 patients (46.6% met criteria for PVH rather than pre-capillary PH. When restricting analysis to patients with a mean pulmonary artery pressure of ≥25 mmHg and pulmonary vascular resistance of >3 Wood units (n = 22, 10 patients (45.4% were classified as pre-capillary PH based on PCWP ≤15 mmHg. However, if LVEDP was used, 4/10 patients (40% were reclassified as PVH. Among patients with any type of pulmonary hypertension, PCWP discriminated moderately between high and normal LVEDP (AUROC, 0.81; 95%CI 0.69-0.94. PCWP-LVEDP correlation was particularly poor in patients with COPD or obesity. CONCLUSION: Reliance on PCWP rather than LVEDP results in misclassification of veterans as having pre-capillary PH rather than PVH in almost 50% of cases. This is clinically relevant, as

  4. Correlation of invasive central arterial pressure with peripheral arterial pressure and coronary sclerosis

    Institute of Scientific and Technical Information of China (English)

    吴琪

    2013-01-01

    Objective To study the consistency among non-invasive and invasive brachial artery pressure,radial artery pressure and invasive central arterial pressure,and to explore the correlation between the severe degree of coronary artery disease and invasive central aortic pressure.

  5. Coronary Flow Reserve Predicts Cardiopulmonary Fitness in Patients with Coronary Artery Disease Independently of Systolic and Diastolic Function

    DEFF Research Database (Denmark)

    Snoer, Martin; Olsen, Rasmus Huan; Monk-Hansen, Tea

    2014-01-01

    Aims Despite revascularization and optimal medical treatment, patients with coronary artery disease (CAD) have reduced exercise capacity. In the absence of coronary artery stenosis, coronary flow reserve (CFR) is a measure of coronary microvascular function, and a marker of future poor outcome...... early (E) and late (A) inflow velocities, and tissue Doppler diastolic (e′) and systolic (s′) velocities. Peak coronary flow velocity (CFV) was measured in the LAD using pulse-wave Doppler. CFR was calculated as the ratio between peak CFV at rest and during vasodilator stress. Median CFR was 2.22 (1....... Conclusions Coronary flow reserve measured noninvasively predicts cardiopulmonary fitness independently of resting systolic and diastolic function in CAD patients, indicating that cardiac output during maximal exercise is dependent on the ability of the coronary circulation to adapt to the higher metabolic...

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

    Science.gov (United States)

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

    2007-11-01

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

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

    DEFF Research Database (Denmark)

    Bogert, Lysander W J; Harms, Mark P M; Pott, Frank;

    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...

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

    DEFF Research Database (Denmark)

    Bogert, Lysander W J; Harms, Mark P M; Pott, Frank

    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 (Fi...

  9. Daily liquorice consumption for two weeks increases augmentation index and central systolic and diastolic blood pressure.

    Directory of Open Access Journals (Sweden)

    Miia H Leskinen

    Full Text Available 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.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.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<0.05, and increased extracellular volume by 0.5 litres (P<0.05 versus controls. Also augmentation index adjusted to heart rate 75/min (from 7% to 11%, 95% CI for change 0.3-7.5, P<0.05 and aortic pulse pressure (by 4 mmHg, 95% CI 1-7, P<0.05 were elevated indicating increased wave reflection from the periphery. In contrast, peripheral (-3/-0.3 mmHg and central blood pressure (-2/-0.5 mmHg, aortic pulse pressure (-1 mmHg, and augmentation index adjusted to heart rate 75/min (from 9% to 7% decreased numerically but not statistically significantly without changes in extracellular volume in the control group. Heart rate, systemic vascular resistance, cardiac output, and pulse wave velocity did not differ between the groups.Two weeks of daily liquorice consumption increased extracellular volume, amplified pressure wave reflection from the periphery, and elevated central systolic and diastolic blood pressure.EU Clinical Trials Register EudraCT 2006-002065-39 ClinicalTrials.gov NCT01742702.

  10. Sex Differences in Peripheral Augmentation Index and Arterial Reservoir Pressure during Upper Limb Postural Shifts

    Directory of Open Access Journals (Sweden)

    Kevin S. Heffernan

    2014-01-01

    Full Text Available We examined the peripheral hemodynamic response to passive arm postural changes in young men and women. Radial artery pulse waveforms were captured using applanation tonometry in 20 men (age 27 ± 2 yrs, BMI 25 ± 1 kg/m2 and 20 women (age 27 ± 2 yrs, BMI 23±1 kg/m2. Arm position was maintained at either heart level or supported 14 cm above/below heart level in a randomized fashion. Systolic augmentation index (sAIx and diastolic augmentation index (dAIx were used as estimates of pressure from wave reflections arriving in systole and diastole, respectively. A novel reservoir-wave separation technique was used to obtain arterial reservoir pressure (pressure generated by arterial capacitance. Women showed a significant reduction in radial diastolic pressure-time integral (DPTI (P0.05 or dAIx (P>0.05 when moving the arm from below to above heart level. Conversely, men showed an attenuated change in radial DPTI (P>0.05 concomitant with significant increases in reservoir pressure (P<0.05, sAIx (P<0.05, and dAIx (P<0.05. Gravity-mediated changes in regional hemodynamics produced by passive arm postural shifts are sex specific. Men demonstrate less change in regional diastolic pressure concomitant with increased augmentation index and arterial reservoir pressure.

  11. [Features of arterial blood pressure in elderly persons of different ethnic groups in Yakutsk].

    Science.gov (United States)

    Nikitin, Iu P; Tatarinova, O V; Neustroeva, V N; Shcherbakova, L V; Sidorov, A S

    2013-01-01

    The differences in arterial blood pressure in the sample of population in the age of 60 and older of different ethnic groups in Yakutsk, as well as its connection with the other cardiovascular diseases risk factors have been analyzed. It was shown that the average values of systolic and diastolic blood pressure in subsample of the Yakuts appeared to be lower than in Caucasoid gerontic persons. The average values of systolic arterial blood pressure both in the Yakuts and in the Caucasoids were detected higher than normal values in all age-dependent subgroups. The average values of diastolic blood pressure in both ethnic groups were within the limits of high normal level. From 60 to 90 years and older the decrease in systolic and diastolic arterial blood pressure was detected; it was more marked in Caucasoid gerontic persons. The average values of pulse pressure in the Yakuts and in the Caucasoids appeared to be higher than the existing standard and didn't have any differences in ethnic groups. In both ethnical subsamples, pulse pressure values increase was observed in persons of 60-89 years old and its decrease after 90. Persons with overweight, obesity, central (abdominal) obesity, dyslypoproteidemias irrespective of belonging to ethnical group were characterized as having higher levels of arterial blood pressure. Statistically significant differences in the levels of arterial blood pressure in the Yakuts and in the Caucasoids depending on hyperglycemia, smoking, the presence of burdened anamnesis, educational level, marital status was not detected.

  12. Arterial Pulse Pressure and Its Association With Reduced Stroke Volume During Progressive Central Hypovolemia

    Science.gov (United States)

    2006-09-01

    Measurement of Stroke Volume Stroke volume (SV) was measured noninvasively using thoracic electrical bioimpedance (TEB). TEB was measured using four...tients who did not die. For the current study, we measured mean arterial blood pressure (MAP), pulse pressure (PP), SV, and muscle sympathetic nerve...hemorrhagic shock. The vital sign monitors placed in emergency transport vehicles provide the medic with routine measures of arterial systolic, diastolic and

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

    OpenAIRE

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

    2007-01-01

    The severity of left ventricular (LV) dysfunction in rats with myocardial infarction (MI) varies widely. Because homogeneity in baseline parameters is essential for experimental investigations, a study was conducted to establish whether Doppler echocardiography (DE) could accurately identify animals with high LV end-diastolic pressure as a marker of LV dysfunction soon after MI. Direct measurements of LV end-diastolic pressure were made and DE was performed simultaneously 1 week after surgica...

  14. Association of target organ damage with 24-hour systolic and diastolic blood pressure levels and hypertension subtypes in untreated Chinese.

    Science.gov (United States)

    Wei, Fang-Fei; Li, Yan; Zhang, Lu; Xu, Ting-Yan; Ding, Feng-Hua; Staessen, Jan A; Wang, Ji-Guang

    2014-02-01

    The association of target organ damage with 24-hour systolic and diastolic blood pressure levels and ambulatory hypertension subtypes has not yet been examined in untreated Chinese patients. We measured left ventricular mass index by echocardiography (n=619), the urinary albumin:creatinine ratio (n=1047), and aortic pulse wave velocity by tonometry (n=1013) in 1047 untreated subjects (mean age, 50.6 years; 48.9% women). Normotension was a 24-hour systolic/diastolic blood pressure Hypertension subtypes were isolated diastolic hypertension and mixed systolic plus diastolic hypertension. We assessed associations of interest by multivariable-adjusted linear models. Using normotension as reference, mixed hypertension was associated with higher (P≤0.003) left ventricular mass index (+4.31 g/m(2)), urinary albumin:creatinine ratio (+1.63 mg/mmol), and pulse wave velocity (+0.76 m/s); and isolated diastolic hypertension was associated with similar left ventricular mass index and pulse wave velocity (P≥0.39), but higher urinary albumin:creatinine ratio (+1.24 mg/mmol; P=0.002). In younger participants (hypertension are major determinants of target organ damage irrespective of age and target organ, whereas 24-hour diastolic blood pressure and isolated diastolic hypertension only relate to the urinary albumin:creatinine ratio below middle age.

  15. Effect of transcatheter aortic valve implantation on intraoperative left ventricular end-diastolic pressure.

    Science.gov (United States)

    Toyota, Kosaku; Ota, Takashi; Nagamine, Katsutoshi; Koide, Yasuhiro; Nomura, Takeshi; Yamanaka, Futoshi; Shishido, Koki; Tanaka, Masashi; Saito, Shigeru

    2016-12-01

    Transcatheter aortic valve implantation (TAVI) for patients with aortic stenosis is a less invasive alternative to surgical aortic valve replacement. Despite this, careful anesthetic management, especially strict control of blood pressure and fluid management, is necessary. During TAVI, normalization of left ventricular afterload due to aortic balloon valvuloplasty and prosthetic valve deployment is expected to result in rapid improvement of systolic function and consequent improvement in diastolic function. However, the early effect of TAVI on left ventricular diastolic function is less clear. We hypothesized that TAVI induces a rapid decrease in left ventricular end-diastolic pressure (LVEDP) after valve deployment. This retrospective observational study included 71 patients who had undergone TAVI using the transfemoral approach with a balloon-expandable valve under general anesthesia. Intraoperative LVEDP was measured using an intracardiac catheter. The severity of residual aortic regurgitation (AR) was assessed using the Sellers criteria. The mean (SD) LVEDP was 17.8 (5.3) mmHg just before TAVI and increased significantly to 27.3 (8.2) mmHg immediately after prosthetic valve deployment (p < 0.0001). The change in LVEDP was 8.7 (8.6) mmHg in patients with low residual AR (Sellers ≤1) and 11.0 (7.1) mmHg in those with high residual AR (Sellers ≥2); however, this difference was not significant. No correlation was found between the LVEDP change and intraoperative fluid balance. In conclusion, LVEDP increased significantly in the early period after valve deployment during TAVI, regardless of residual AR severity. It was suggested that the tolerability of fluid load could be reduced at that time.

  16. Prognostic value of echocardiographic right/left ventricular end-diastolic diameter ratio in idiopathic pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    ZENG Wei-jie; SUN Yun-juan; XIONG Chang-ming; GU Qing; HE Jian-guo

    2011-01-01

    Background An echocardiographic right/left ventricular end-diastolic diameter ratio (RV/LV ratio) ≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. Right ventricular dilation is a common characteristic of both acute pulmonary embolism and idiopathic pulmonary arterial hypertension (IPAH).However, the prognostic value of the RV/LV ratio in patients with IPAH is unknown.Methods Ninety-five consecutive patients with newly diagnosed IPAH were included, 17 were re-evaluated by echocardiography after 3-12 months of targeted therapy. Follow-up data were obtained by telephone interviews and review of the patients' records.Results Higher RV/LV ratios were associated with greater functional impairment and with a higher mean right atrial pressure.The RV/LV ratio was positively correlated with pulmonary vascular resistance (r=0.549, P <0.001) and plasma N-terminal pro-brain natriuretic peptide level (r=0.575, P <0.001), but negatively correlated with cardiac output (r= -0.517, P <0.001) and mixed venous oxygen saturation (r= -0.599, P <0.001). During a follow-up period of (21 ± 15) months, 27 patients died.Sensitivity and specificity of an RV/LV ratio ≥0.84 for predicting death were 85.2% and 51.5%, respectively. The RV/LV ratio and body mass index were independent predictors of death by multivariate Cox analysis (P <0.01). A baseline RV/LV ratio ≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis (P <0.01).Conclusion The RV/LV ratio helps to assess the severity of IPAH and may serve as an independent predictor of prognosis in patients with IPAH.

  17. 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....

  18. [Impact of periodontal disease on arterial pressure in diabetic mice].

    Science.gov (United States)

    Blasco-Baque, V; Kémoun, P; Loubieres, P; Roumieux, M; Heymes, C; Serino, M; Sixou, M; Burcelin, R

    2012-06-01

    Diabetes-driven cardiovascular diseases represent a high challenge for developed countries. Periodontal disease is strictly linked to the aforementioned diseases, due to its Gram negative-driven inflammation. Thus, we investigated the effects of periodontal disease on arterial pressure during the development of diabetes in mice. To this aim, C57BL/6 female mice were colonized with pathogens of periodontal tissue (Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucleatum) for 1month, whereas another group of mice did not undergo the colonization. Subsequently, all mice were fed a high-fat carbohydrate-free diet for 3months. Then, arterial pressure was measured in vivo and a tomodensitometric analysis of mandibles was realized as well. Our results show increased mandibular bone-loss induced by colonization with periopathogens. In addition, periodontal infection augmented glucose-intolerance and systolic and diastolic arterial pressure, parameters already known to be affected by a fat-diet. In conclusion, we show here that periodontal disease amplifies metabolic troubles and deregulates arterial pressure, emerging as a new axis of metabolic investigation.

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

    Science.gov (United States)

    Zheng, Dingchang; Murray, Alan

    2011-05-01

    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 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 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.

  20. Calpain-5 gene variants are associated with diastolic blood pressure and cholesterol levels

    Directory of Open Access Journals (Sweden)

    Morón Francisco J

    2007-01-01

    Full Text Available Abstract Background Genes implicated in common complex disorders such as obesity, type 2 diabetes mellitus (T2DM or cardiovascular diseases are not disease specific, since clinically related disorders also share genetic components. Cysteine protease Calpain 10 (CAPN10 has been associated with T2DM, hypertension, hypercholesterolemia, increased body mass index (BMI and polycystic ovary syndrome (PCOS, a reproductive disorder of women in which isunlin resistance seems to play a pathogenic role. The calpain 5 gene (CAPN5 encodes a protein homologue of CAPN10. CAPN5 has been previously associated with PCOS by our group. In this new study, we have analysed the association of four CAPN5 gene variants(rs948976A>G, rs4945140G>A, rs2233546C>T and rs2233549G>A with several cardiovascular risk factors related to metabolic syndrome in general population. Methods Anthropometric measurements, blood pressure, insulin, glucose and lipid profiles were determined in 606 individuals randomly chosen from a cross-sectional population-based epidemiological survey in the province of Segovia in Central Spain (Castille, recruited to investigate the prevalence of anthropometric and physiological parameters related to obesity and other components of the metabolic syndrome. Genotypes at the four polymorphic loci in CAPN5 gene were detected by polymerase chain reaction (PCR. Results Genotype association analysis was significant for BMI (p ≤ 0.041, diastolic blood pressure (p = 0.015 and HDL-cholesterol levels (p = 0.025. Different CAPN5 haplotypes were also associated with diastolic blood pressure (DBP (0.0005 ≤ p ≤ 0.006 and total cholesterol levels (0.001 ≤ p ≤ 0.029. In addition, the AACA haplotype, over-represented in obese individuals, is also more frequent in individuals with metabolic syndrome defined by ATPIII criteria (p = 0.029. Conclusion As its homologue CAPN10, CAPN5 seems to influence traits related to increased risk for cardiovascular diseases. Our

  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.

    2013-01-01

    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......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...

  2. Effect of tender coconut water on systolic and diastolic blood pressure in prehypertensive women

    Directory of Open Access Journals (Sweden)

    Farapti Farapti

    2014-02-01

    . Dietary intakes of high potassium will decrease blood pressure (BP. Tender coconut water (TCW is a typical drink high in potassium. This study aimed to investigate the effect of TCW on BP in female teachers and employees prehypertension. Methods: The research was a parallel single blind randomized clinical trial. A total of 32 female prehypertension subjects aged 25-44 years. The subjects were selected using certain criteria and randomly allocated to one of two groups using block randomized, 16 subjects each. The treatment group received TCW 300 ml twice daily for 14 days and nutritional counseling, and the control group received water 300 ml twice daily for 14 days and nutritional counseling. Assessment of BP was done on day 0, day 8, and day 15. Statistical analysis were done using t-test and Mann-Whitney test. Results: Mean dietary intakes of potassium were 1420.28±405.54 mg/day or 30.22±8.63% compared to Recommended Dietary Allowance (RDA. During treatment period, potassium intake increased significantly in the treatment group. There were decreased BP in both groups, which were greater in the treatment group, but not statistically significant different (P > 0.05. The mean decrease of systolic BP was significant in treatment group (P = 0.031, meanwhile the mean decrease of diastolic BP was not significant (P=0.134. Conclusion: Tender coconut water 300 ml twice daily for 14 consecutive days has tendency to decrease systolic BP, but not diastolic blood pressure. (Health Science Indones 2013;2: 64-8Key words: coconut water, systolic and diastolic blood pressure

  3. 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.

  4. Diastolic function and functional capacity after a single session of continuous positive airway pressure in patients with compensated heart failure

    Directory of Open Access Journals (Sweden)

    Marjory Fernanda Bussoni

    2014-01-01

    Full Text Available OBJECTIVE: The effects of acute continuous positive airway pressure therapy on left ventricular diastolic function and functional capacity in patients with compensated systolic heart failure remain unclear. METHODS: This randomized, double-blind, placebo-controlled clinical trial included 43 patients with heart failure and a left ventricular ejection fraction <0.50 who were in functional classes I-III according to the New York Heart Association criteria. Twenty-three patients were assigned to continuous positive airway pressure therapy (10 cmH2O, while 20 patients received placebo with null pressure for 30 minutes. All patients underwent a 6-minute walk test (6MWT and Doppler echocardiography before and immediately after intervention. Clinicaltrials.gov: NCT01088854. RESULTS: The groups had similar clinical and echocardiographic baseline variables. Variation in the diastolic function index (e′ after intervention was associated with differences in the distance walked in both groups. However, in the continuous positive airway pressure group, this difference was greater (continuous positive airway pressure group: Δ6MWT = 9.44+16.05×Δe′, p = 0.002; sham group: Δ6MWT = 7.49+5.38×Δe′; p = 0.015. There was a statistically significant interaction between e′ index variation and continuous positive airway pressure for the improvement of functional capacity (p = 0.020. CONCLUSIONS: Continuous positive airway pressure does not acurately change the echocardiographic indexes of left ventricle systolic or diastolic function in patients with compensated systolic heart failure. However, 30-minute continuous positive airway pressure therapy appears to have an effect on left ventricular diastolic function by increasing functional capacity.

  5. The association between paired basic amino acid cleaving enzyme 4 gene haplotype and diastolic blood pressure

    Institute of Scientific and Technical Information of China (English)

    李建平; 王晓滨; 陈常忠; 徐新; 洪雪梅; 徐希平; 高炜; 霍勇

    2004-01-01

    Background In a previously identified locus linked to hypertension on chromosome 15q, we identified three blood pressure candidate genes: insulin-like growth factor 1 receptor gene (IGF1R), myocyte specific enhancer factor 2A gene (MEF2A), and paired basic amino acid cleaving enzyme 4 gene (PACE4). In this study, we tested their associations with hypertension using haplotype analysis.Methods A total of 288 unrelated individuals, including 163 high diastolic blood pressure (DBP) subjects and 125 normal DBP subjects were enrolled in this case-control study. Twenty single nucleotide polymorphisms (SNPs) in the three genes were genotyped using polymerase chain reaction followed by restriction enzyme digestion. Haplotype analysis was accomplished in the following stages: (1) pair-wise linkage disequilibrium test among SNPs on the same gene was performed to explore blocks in which recombination is very unlikely to happen; (2) Estimation-Maximization algorithm was applied to estimate haplotype frequencies in each block; (3) the chi-square test was used to examine the specific haplotype difference, and a permutation test was used to examine the overall haplotype profile difference between cases and controls in each block.Results An estimated haplotype "CCCCG" frequency in the haplotype block on the PACE4 gene was significantly higher in high DBP cases than in controls (P<0.01). The overall estimated haplotype profile in this block was also significantly different between the cases and the controls (P<0.001). This association indicates. Conclusions This study for the first time demonstrated that PACE4 gene may play an important role in the regulation of DBP. This association indicates that variations influencing DBP resides in or near this genomic region.

  6. Renal evaluation in patients with type 2 diabetes mellitus and its association with diastolic blood pressure

    Directory of Open Access Journals (Sweden)

    Fokine D. Anna

    2016-04-01

    Full Text Available Background: HbA1c is correlated with the estimated glomerular filtration rate (eGFR and diastolic blood pressure (DBP. Our main objective was to evaluate the trend of biochemical and clinical variables, in relation to the eGFR in patients with type 2 diabetes mellitus (T2DM.Methods: This was a retrospective, longitudinal, and descriptive study, including patients with T2DM, who were cared for from January 2014 until December 2014, at the Clínica de Diabetes, Hospital Regional “Gral. Ignacio Zaragoza", ISSSTE, Mexico City, Mexico. eGFR was calculated using three formulas: the chronic kidney disease – epidemiology collaboration (CKD-EPI, Cockcroft-Gault, and modification of diet in renal disease (MDRD, during two periods of observation, 3 and 6 months. The results were compared by Student t tests or Wilcoxon-Mann-Whitney test depending on the variable distribution. Pearson correlation was employed to determine the relation between the eGFR determined with each formula and the analyzed variables.Results: The mean age was 56.5±11.3 years in the group of 3 months’ follow-up (n=110 and 57.1±13.8 years in the group of 6 months’ follow-up (n=47. In both groups, the formula with the lowest percentages of cases of CKD was CKD-EPI and the difference of this formula had a basal and final significant positive correlation with the DBP.Conclusion: The CKD-EPI formula showed the lowest percentages of cases of CKD in a short follow-up period, and its difference is consistently associated with the DBP, confirming the importance of controlling the later to mitigate the evolution to CKD.

  7. 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

  8. Comparison of noninvasive blood pressure measurement techniques via the coccygeal artery in anesthetized cheetahs (Acinonyx jubatus).

    Science.gov (United States)

    Sadler, Ryan A; Hall, Natalie H; Kass, Philip H; Citino, Scott B

    2013-12-01

    Two indirect blood pressure measurement techniques, Doppler (DOP) sphygmomanometry and oscillometry, applied at the ventral coccygeal artery were compared with simultaneous direct blood pressure measurements at the dorsal pedal artery in 10 anesthetized, captive cheetahs (Acinonyx jubatus). The DOP method was moderately accurate, with relatively little bias (mean difference 3.8 mmHg) and 88.6% of the DOP systolic arterial pressure measurements being within 10 mmHg of the direct systolic arterial measurement. With the oscillometric (OM) method, 89.2% of the mean arterial pressure measurements were within 10 mmHg of the direct measurement and had the least bias (mean difference 2.3 mmHg), 80.7% of the systolic measurements were within 10 mmHg of the direct measurement and had the second least bias (mean difference 2.3 mmHg), and 59% of the diastolic measurements were within 10 mmHg of the direct measurement and had significant bias (mean difference 7.3 mmHg). However, DOP showed relatively poor precision (SD 11.2 mmHg) compared with OM systolic (SD 8.0 mmHg), diastolic (SD 8.6 mmHg), and mean (SD 5.7 mmHg). Both techniques showed a linear relationship with the direct technique measurements over a wide range of blood pressures. The DOP method tended to underestimate systolic measurements below 160 mmHg and overestimate systolic measurements above 160 mmHg. The OM method tended to underestimate mean pressures below 160 mm Hg, overestimate mean pressures above 160 mmHg, underestimate systolic pressures below 170 mmHg, overestimate systolic pressures above 170 mmHg, and underestimate diastolic pressures throughout the measured blood pressure range. Indirect blood pressure measurement using the ventral coccygeal artery, particularly when using an OM device for mean and systolic arterial pressure, may be useful in the clinical assessment of cheetahs when monitoring trends over time, but caution should be taken when interpreting individual values.

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

    Directory of Open Access Journals (Sweden)

    Peter Juhl-Olsen

    2012-01-01

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

  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. Characterization and calibration of the central arterial pressure waveform obtained from vibrocardiographic signal

    Science.gov (United States)

    Casacanditella, L.; Cosoli, G.; Casaccia, S.; Rohrbaugh, J. W.; Scalise, L.; Tomasini, E. P.

    2016-06-01

    Laser Doppler Vibrometry (LDV) has been demonstrated to be a non-contact technique with high sensitivity, able to measure the skin vibrations related to cardiac activity. The obtainable mechanical signal (i.e. a velocity signal), VibroCardioGram (VCG), is able to provide significant physiological parameters, such as Heart Rate (HR). In this work, the authors aim to present a non-contact measurement method to obtain the arterial blood pressure signal from the mechanical vibrations assessed by LDV, in a central district of the arterial tree, such as carotid artery. In fact, in this way it is possible to indirectly assess Central Arterial Blood Pressure (CABP), which indicates the hemodynamic load on the heart, so that it is considered an important index predicting the cardiac risk of a subject. The measurement setup involves the use of an oscillometric cuff, to measure peripheral blood pressure at the radial artery level. Diastolic and Mean Arterial Pressure (MAP) at radial level were used to calibrate the integrated LDV signal (i.e. a displacement signal). As regard calibration, an exponential mathematical model was adopted to derive the pressure waveform from the displacement of the vessel detected by LDV. Results show an average difference of around 20% between systolic pressure measured at brachial level (i.e. peripheral pressure value) and systolic pressure derived from VCG signal measured over the carotid artery (i.e. central pressure). This is a physiological difference, consistent with the literature about the physiological increase of Systolic Blood Pressure (SBP) and Pressure Pulse (PP) at increased distances from the heart. However, this non-contact technique is affected by movement artifacts and by reflection phenomena not related to the studied vessel and so it is necessary to account of such issues in the results.

  12. Acute lead exposure increases arterial pressure: role of the renin-angiotensin system.

    Directory of Open Access Journals (Sweden)

    Maylla Ronacher Simões

    Full Text Available BACKGROUND: Chronic lead exposure causes hypertension and cardiovascular disease. Our purpose was to evaluate the effects of acute exposure to lead on arterial pressure and elucidate the early mechanisms involved in the development of lead-induced hypertension. METHODOLOGY/PRINCIPAL FINDINGS: Wistar rats were treated with lead acetate (i.v. bolus dose of 320 µg/Kg, and systolic arterial pressure, diastolic arterial pressure and heart rate were measured during 120 min. An increase in arterial pressure was found, and potential roles of the renin-angiotensin system, Na(+,K(+-ATPase and the autonomic reflexes in this change in the increase of arterial pressure found were evaluated. In anesthetized rats, lead exposure: 1 produced blood lead levels of 37±1.7 µg/dL, which is below the reference blood concentration (60 µg/dL; 2 increased systolic arterial pressure (Ct: 109±3 mmHg vs Pb: 120±4 mmHg; 3 increased ACE activity (27% compared to Ct and Na(+,K(+-ATPase activity (125% compared to Ct; and 4 did not change the protein expression of the α1-subunit of Na(+,K(+-ATPase, AT(1 and AT(2. Pre-treatment with an AT(1 receptor blocker (losartan, 10 mg/Kg or an ACE inhibitor (enalapril, 5 mg/Kg blocked the lead-induced increase of arterial pressure. However, a ganglionic blockade (hexamethonium, 20 mg/Kg did not prevent lead's hypertensive effect. CONCLUSION: Acute exposure to lead below the reference blood concentration increases systolic arterial pressure by increasing angiotensin II levels due to ACE activation. These findings offer further evidence that acute exposure to lead can trigger early mechanisms of hypertension development and might be an environmental risk factor for cardiovascular disease.

  13. Effects of percutaneous transluminal septal myocardial ablation for obstructive hypertrophic cardiomyopathy on systolic and diastolic left ventricular function assessed by pressure-volume loops.

    Science.gov (United States)

    Meliga, Emanuele; Steendijk, Paul; Valgimigli, Marco; Ten Cate, Folkert J; Serruys, Patrick W

    2008-04-15

    The aim of the present study was to determine the long-term effects of percutaneous transluminal septal myocardial ablation (PTSMA) on systolic and diastolic left ventricular (LV) functions in patients with obstructive hypertrophic cardiomyopathy (HC). Ten consecutive patients with symptomatic HC despite optimal medical treatment were referred for PTSMA at our center. LV systolic and diastolic functions were assessed by online LV pressure-volume loops obtained by conductance catheter at baseline and at 6 months after the procedure. At follow-up, the mean gradients at rest and after extrasystole were significantly decreased compared with baseline (88 +/- 29 to 21 +/- 11 mm Hg and 130 +/- 50 to 35 +/- 22 mm Hg, respectively, p <0.01 for the 2 comparisons). End-systolic and end-diastolic pressures significantly decreased (p <0.01), whereas end-systolic and end-diastolic LV volumes significantly increased (p <0.01 for the 2 comparisons). Cardiac output and stroke volume were unchanged, as were ejection fraction (p = 0.25) and maximum dP/dt (p = 0.13). The slope of the end-systolic pressure-volume relation was not decreased, indicating a preserved contractility. The relaxation constant time, end-diastolic stiffness, projected volume of the end-diastolic pressure-volume relation at 30 mm Hg, and diastolic stiffness constant showed a significant improvement of active and passive myocardial diastolic properties. In conclusion, PTSMA is an effective method in the treatment of symptomatic patients with HC. At 6-month follow-up, the LV-aortic gradient was decreased and active and passive LV diastolic properties were increased. Myocardial contractility was not decreased and general hemodynamics was maintained.

  14. Retrograde arterial leg blood flow during tilt-back from a head-up posture: importance of capacitive flows when arterial pressure changes.

    Science.gov (United States)

    Sheriff, Don D; Nådland, Inger Helene; Toska, Karin

    2010-03-01

    The windkessel function of the arterial system converts the intermittent action of the heart into more continuous microcirculatory blood flow during diastole via the return of elastic energy stored in the walls of the arteries during systole. Might the same phenomenon occur regionally within the arterial system during tilting owing to regional differences in local arterial pressure imposed by gravity? We sought to test the hypothesis that during tilt-back from a head-up posture, the return of stored elastic energy in leg arteries would work to slow, or perhaps transiently reverse, the flow of blood in the femoral artery. Femoral artery blood flow and arterial pressure were recorded during tilt back from a 30 degrees head-up posture to supine (approximately 0.5 G) in young, healthy subjects (n = 7 males and 3 females) before and during clonidine infusion. During control (no drug) conditions femoral artery blood flow ceased for an entire heart beat during tilt-back. During clonidine infusion femoral artery blood flow reversed for at least one entire heart beat during tilt-back, i.e., blood flow in the retrograde direction in the femoral artery from the leg into the abdomen. Thus substantial capacitive effects of tilting on leg blood flow occur in humans during mild changes in posture.

  15. Comparison of how well conscious cats tolerate blood pressure measurement from the radial and coccygeal arteries.

    Science.gov (United States)

    Cannon, Martha J; Brett, Jo

    2012-12-01

    Hypertension is a common condition of older cats and acquiring clinically relevant and repeatable blood pressure (BP) measurements in conscious cats is important in its diagnosis and management. The most common sites for indirect BP measurement in the cat are the radial artery (RA) and the coccygeal artery (CA) but, to date, there are no published data comparing how conscious cats tolerate BP measurements from these sites. A high-definition oscillometric BP monitor was used to measure BP in 30 cats admitted to a cat-only veterinary clinic for reasons other than hypertension. Systolic arterial pressure (SAP), mean arterial pressure (MAP) and diastolic arterial pressure (DAP) were measured using the RA and CA, alternating which site was used first. The number of failed attempts and total time to achieve six measurements was recorded. Measurement of BP using the CA was better tolerated than the RA, resulting in fewer failures and shorter total time required. SAP measurements were slightly higher from the CA compared with the RA, irrespective of which site was used first. There were no significant differences in MAP and DAP. The coccygeal artery appears to be the more appropriate site to use when measuring BP in conscious cats using this oscillometric machine. Further studies are required using alternative BP monitors, including Doppler machines, to establish whether this is a consistent finding. When measuring BP in cats the site used should be recorded and the same site used for all subsequent measurements from the same cat.

  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. Long-term oral calcium supplementation reduces diastolic blood pressure in end stage renal disease. A randomized, double-blind, placebo controlled study.

    Science.gov (United States)

    Petersen, L J; Rudnicki, M; Højsted, J

    1994-01-01

    Previous studies suggest that oral calcium supply reduces blood pressure in patients with mild to moderate hypertension. The aim of this study was to determine whether oral calcium supply reduces blood pressure in patients undergoing haemodialysis. The study was randomized, double-blind, and placebo controlled. Eleven patients received two grams of calcium per day and 12 patients received placebo. Three patients (one from the calcium group and two from the placebo group) dropped out within the first month. The groups were comparable at inclusion regarding blood pressure, weight, and serum values. Blood pressure measurements were auscultatory with a mercury manometer and diastolic blood pressure was measured as Korotkoff phase V. At inclusion a significant positive correlation between serum phosphate and blood pressure was found. After a study period of six months a significant reduction in diastolic blood pressure was found between the two groups (p < 0.05), but no difference was found in systolic blood pressure. The reduction in diastolic blood pressure was 6.9 mmHg of the pretreatment level in the calcium group. In conclusion, the treatment of secondary hyperparathyroidism with oral calcium gives good benefits in the regulation of diastolic blood pressure. A well controlled phosphate homeostasis may also be of importance for the control of blood pressure in haemodialysis patients.

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

    Science.gov (United States)

    Hobbs, Ditte A; Goulding, Marie G; Nguyen, Annie; Malaver, Thomas; Walker, Claire F; George, Trevor W; Methven, Lisa; Lovegrove, Julie A

    2013-09-01

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

  19. 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...

  20. Influence of geomagnetic activity and atmospheric pressure on human arterial pressure during the solar cycle 24

    Science.gov (United States)

    Azcárate, T.; Mendoza, B.; Levi, J. R.

    2016-11-01

    We performed a study of the systolic (SBP) and diastolic (DBP) arterial blood pressure behavior under natural variables such as the atmospheric pressure (AtmP) and the horizontal geomagnetic field component (H). We worked with a sample of 304 healthy normotense volunteers, 152 men and 152 women, with ages between 18 and 84 years in Mexico City during the period 2008-2014, corresponding to the minimum, ascending and maximum phases of the solar cycle 24. The data was divided by gender, age and day/night cycle. We studied the time series using three methods: Correlations, bivariate and superposed epochs (within a window of three days around the day of occurrence of a geomagnetic storm) analysis, between the SBP and DBP and the natural variables (AtmP and H). The correlation analysis indicated correlation between the SBP and DBP and AtmP and H, being the largest during the night. Furthermore, the correlation and bivariate analysis showed that the largest correlations are between the SBP and DBP and the AtmP. The superposed epoch analysis found that the largest number of significant SBP and DBP changes occurred for women. Finally, the blood pressure changes are larger during the solar minimum and ascending solar cycle phases than during the solar maximum; the storms of the minimum were more intense than those of the maximum and this could be the reason of behavior of the blood pressure changes along the solar cycle.

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

    Science.gov (United States)

    Mackenzie, Isla S; McEniery, Carmel M; Dhakam, Zahid; Brown, Morris J; Cockcroft, John R; Wilkinson, Ian B

    2009-08-01

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

  2. Plasma sE-selectin level is positively correlated with neutrophil count and diastolic blood pressure in Japanese men.

    Science.gov (United States)

    Mochizuki, Kazuki; Inoue, Seiya; Miyauchi, Rie; Misaki, Yasumi; Shimada, Masaya; Kasezawa, Nobuhiko; Tohyama, Kazushige; Goda, Toshinao

    2013-01-01

    Increased levels of circulating soluble type of E-selectin (sE-selectin), neutrophil counts and blood pressure are associated with the development of cardiovascular diseases (CVD). In this study, we conducted a cross-sectional study of men who participated in health check-ups, and selected those who were not diagnosed with or being treated for metabolic diseases such as diabetes, hypertension and lipid abnormality according to the health check-ups. We measured their basic clinical parameters including blood pressure and neutrophil count, plasma sE-selectin concentration and lifestyle factors, and assessed their interrelations by multivariate linear regression (MLR) analysis. A total of 351 subjects aged 47.5±8.41 (range, 30-64) y were recruited. Significantly correlated with sE-selectin concentration were neutrophil count, diastolic blood pressure (DBP), and systolic blood pressure (SBP) (Pearson's correlation coefficient, 0.194, 0.220 and 0.175, respectively). MLR analysis showed that sE-selectin concentration was independently positively related with DBP and neutrophil count, whereas neutrophil count was positively associated with sE-selectin concentration but not DBP. DBP, but not SBP, was independently positively correlated with sE-selectin concentration but not neutrophil count. These results indicate that circulating sE-selectin concentration may be a biomarker for indicating subsequent development of metabolic diseases, in particular CVD, from a healthy state.

  3. 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.

  4. 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

  5. A system for the automatic measurement and digital display of systolic and diastolic blood pressures

    Science.gov (United States)

    Schulze, A. E.

    1971-01-01

    Basic components of system are - occluding cuff with mounted cuff microscope, cuff pump deflator, pressure transducer, preamplifier unit, electrocardiograph machine, an analog to digital convertor unit, and digital display unit. System utilizes indirect auscultatory method, based on Korotkoff sounds, for measurement.

  6. 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;

    2014-01-01

    BACKGROUND: Data on risk associated with 24-hour ambulatory diastolic (DBP24) versus systolic (SBP24) blood pressure are scarce. METHODS AND RESULTS: We recorded 24-hour blood pressure and health outcomes in 8341 untreated people (mean age, 50.8 years; 46.6% women) randomly recruited from 12...... populations. We computed hazard ratios (HRs) using multivariable-adjusted Cox regression. Over 11.2 years (median), 927 (11.1%) participants died, 356 (4.3%) from cardiovascular causes, and 744 (8.9%) experienced a fatal or nonfatal cardiovascular event. Isolated diastolic hypertension (DBP24≥80 mm Hg) did...

  7. 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

  8. Porcine radial artery decellularization by high hydrostatic pressure.

    Science.gov (United States)

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

    2015-11-01

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

  9. Phylloquinone (vitamin K₁) intake and pulse pressure as a measure of arterial stiffness in older adults.

    Science.gov (United States)

    Vaccaro, Joan A; Huffman, Fatma G

    2013-01-01

    This study examined the relationships among ethnicity/race, lifestyle factors, phylloquinone (vitamin K₁) intake, and arterial pulse pressure in a nationally representative sample of older adults from four ethnic/racial groups: non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, and other Hispanics. This was a cross-sectional study of U.S. representative sample with data from the National Health and Nutrition Examination Surveys, 2007-2008 and 2009-2010 of adults aged 50 years and older (N = 5296). Vitamin K intake was determined by 24-hour recall. Pulse pressure was calculated as the difference between the averages of systolic blood pressure and diastolic blood pressure. Compared to White non-Hispanics, the other ethnic/racial groups were more likely to have inadequate vitamin K₁ intake. Inadequate vitamin K₁ intake was an independent predictor of high arterial pulse pressure. This was the first study that compared vitamin K₁ inadequacy with arterial pulse pressure across ethnicities/races in U.S. older adults. These findings suggest that vitamin K screening may be a beneficial marker for the health of older adults.

  10. 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;

    2013-01-01

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

  11. 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)

    Marjanović 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.

  12. [Monitoring myocardial performance after open heart surgery by calculation of diastolic and systolic pressure time index (author's transl)].

    Science.gov (United States)

    Seybold-Epting, W; Fenchel, G; Stunkat, R; Seboldt, H; Hoffmeister, H E

    1978-10-01

    In order to determine the incidence of subendocardial ischemia after open heart surgery, subendocardial blood flow was monitored in 171 patients subjected to mitral and/or aortic valve replacement or coronary revascularization by on-line calculation of Diastolic (DPTI) and Systolic Pressure Time Index (TTI). Body hypothermia with an esophageal temperature of 25 degrees C and magnesium-aspartate-procaine cardioplegia were applied for myocardial protection. Ten patients developed low cardiac output state with two early deaths. In the two patients with fatal low cardiac output DPTI/TTI remained below 0.8. In the remaining 8 patients DPTI/TTI rose to 1.4 after a mean recovery time of 36 hours. In 161 patients (94%) no low cardiac output state evolved and DPTI/TTI rose to 1.3 within 60 min. after termination of cardiopulmonary bypass. Our results indicate that body hypothermia of 25 degrees C combined with magnesium-aspartate-procaine cardioplegia can reduce the incidence of subendocardial ischemia, but does not prevent this complication completely after anoxic times beyond 60-70 minutes.

  13. [Left ventricular relaxation and ambulatory blood pressure in mild, untreated arterial hypertension].

    Science.gov (United States)

    Herpin, D; Raynier, P; Ciber, M; Amiel, A; Boutaud, P; Demange, J

    1989-03-01

    Twenty patients with mild, untreated arterial hypertension had ambulatory blood pressure recordings and a digitized echocardiographic study of the left ventricle with measurement of its mass (LVM) and of relaxation parameters. A significant correlation was found between LVM and ambulatory systolic pressure during daytime (r = 0.64; p less than 0.01; n = 20) and during 24 hours (r = 0.79; p less than 0.001; n = 16). One of the relaxation parameters studied, the time taken to reach maximal speed of left ventricular enlargement, was closely related to the diurnal diastolic blood pressure (r = 0.58; p less than 0.01; n = 20), whereas in this population with mild arterial blood pressure none of the parameters was related to the amount of increase of LVM. One may therefore consider the abnormalities of left ventricular relaxation as likely to appear at an early stage of arterial hypertension; their discovery may antedate that of LVM and confirm that the hypertensive disease is real. However, the methodological problems encountered with type of exploration ought to be stressed: left ventricular relaxation is a multifactorial phenomenon, and its echocardiographic approach is subject to many hazards.

  14. Effect of Algerian Varieties Dates on Glycemic, Arterial Blood Pressure and Satiety Responses

    Directory of Open Access Journals (Sweden)

    Gourchala Freha, Mihoub Fatma, Derradj Meriem,\tHenchiri Cherifa

    2016-04-01

    Full Text Available The purpose of our study is to determine the Glycemic Indexes (GIsof three Algerians varieties of dates in healthy subjects, evaluate the satiety and effect on arterial pressure after their consumption. We have first documented the chemical composition of the dates. 10 healthy subjects consumed the dates (carbohydrates content of 50 g in order to determine the GIs. The responses of glycaemia were monitored during two hours after the dates taking and compared to the reference glucose. In a randomized trial, 20 healthy adults consumed the dates after 12h of fast. We reported the level of satiety on a Visual Analog Scale for 2h further to the ingestion of the dates. Furthermore, 28 normotensive and 45 hypertensive individuals ingested the three varieties in randomized order during 21 days to assess their impact on the Pressure Arterial Systolic (PAS and Pressure Arterial Diastolic (PAD. We noted significant differences (p<0.05 for the different fractions of sugars, soluble fibers, polyphenols, K+, Mg2+. The low GIs are denoted among 44.31-52.35, deducting a moderate impact on blood glucose level. The dates reduced hunger and increased satiety. Our varieties studied following their ingestion induced a significant hypotensive activity (p<0.05on the PAS and, PAD from hypertensive subjects.

  15. Harmonics tracking of intracranial and arterial blood pressure waves.

    Science.gov (United States)

    Shahsavari, Sima; McKelvey, Tomas

    2008-01-01

    Considering cardiorespiratory interaction and heart rate variability, a new approach is proposed to decompose intracranial pressure and arterial blood pressure to their different harmonics. The method is based on tracking the amplitudes of the harmonics by a Kalman filter based tracking algorithm. The algorithm takes benefit of combined frequency estimation technique which uses both Fast Fourier Transform and RR-interval detection. The result would be of use in intracranial pressure and arterial blood pressure waveform analysis as well as other investigations which need to estimate contribution of specific harmonic in above mentioned signals such as Pressure-Volume Compensatory Reserve assessment.

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

    Directory of Open Access Journals (Sweden)

    Mojtaba Salarifar

    2010-08-01

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

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

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    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.

  18. Normalisation of a severely abnormal ductus venosus Doppler flow velocity waveform in a growth-retarded fetus with absent end-diastolic flow in the umbilical artery and congenital anomalies.

    Science.gov (United States)

    Müller, T; Rehn, M; Girschick, G; Kristen, P; Dietl, J

    2001-01-01

    Doppler recordings of fetal venous blood flow seem to be superior to arterial velocimetry and CTG concerning the prediction of fetal outcome and optimal time of delivery in pregnancies with fetal growth retardation and AREDV. An improvement of arterial Doppler flow velocities has been described. We report the reappearance of a normal end-diastolic flow velocity in a ductus venosus temporarily showing reversed end-diastolic flow in a growth-retarded fetus with congenital anomalies. This normalization was accompanied by an improvement of the CTG, a loss of umbilical vein pulsations, a reappearance of umbilical diastolic flow and a progressive return of cerebral and venous blood flow into the 'normal' range. Improvement of fetal condition may be the explanation for our observation.

  19. 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.

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

    Science.gov (United States)

    Posadzy-Małaczyńska, Anna; Kosch, Marcus; Hausberg, Martin; Rahn, Karl H; Małaczyński, Paweł; Głuszek, Jerzy; Tykarski, Andrzej

    2004-01-01

    Structural and mechanical properties of the arterial wall are altered in patients with renal failure. Age and hypertension are known to affect the vessel wall structure. Aging process of arterial wall appears to be accelerated in patients with end-stage renal failure. The mechanisms responsible for reduced arterial compliance and distensibility in dialyse patients and renal transplant recipients without hypertension remain to be evaluated. 20 normotensive dialyse patients (D), 20 normotensive renal transplant recipients (T) and 20 healthy volunteers (N) matched for age, sex and blood pressure as controls were enrolled in to the study. Patients with cardiovascular risk factors and diabetes were excluded. The arterial blood pressure of all patients placed below 140/90 mmHg. The dialyse patients and renal transplant recipients were eligible for the study if the serum creatinine level was below 2 mg/dl. In all subjects, fasting concentrations of serum creatinine, total cholesterol, HDL-cholesterol, LDL-cholesterol, hemoglobin and glucose were determined at enrollment to the study. Long-term immunosuppression consisted of cyclosporine and prednisolone. Blood pressure was measured using an automatic sphygmomanometer (Criticon Dinamap model 1846 SX). Pulse wave velocity (PWV) was evaluated using non-invasive automatic Complior device. The vessel wall properties of the left common carotid artery were studied using multigate pulsed Doppler's system (Pie Medical Equipment BV Maastricht, The Netherlands). The frequency of transducer used was 7.5 MHz. With this non-invasive method, the end-diastolic diameter (d) and the systolic increase of vessel diameter (distension delta d) were measured using ECG trigger. From these data relative systolic increase of vessel diameter (delta d/d) and arterial wall distensibility coefficient (DC) were calculated. Simultaneously with the ultrasound measurements at the left common carotid artery carotid pulse waveforms are recorded using

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

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    Udompunturak Suthipol

    2008-09-01

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

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

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    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.

  3. 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;

    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 femoral artery segments. Rest pain or gangrene was present in 74 limbs. In 26 other limbs simultaneous aortoiliac and femoral artery reconstructions were performed. The changes in both toe and ankle pressures could be confidently predicted from the preoperative data. A predicted toe pressure of lower than...... 25 mm Hg was associated with a high probability that amputation would be required. The chances of an amputation were less than 3% if a toe pressure higher than 40 mm Hg was predicted. If the predicted ankle pressure index was lower than 0.56, there was a 90% chance that intermittent claudication...

  4. 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

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    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 [Chronobiology of blood pressure and chronopharmacotherapy of arterial hypertension].

    Science.gov (United States)

    Schmieder, R E; Bramlage, P; Schunkert, H

    2012-02-01

    Arterial blood pressure is subject to a circadian rhythm that results in a fall of blood pressure during the night. In patients with diabetes, renal insufficiency, left-ventricular hypertrophy, sleep apnea, hypertension of pregnancy, and different forms of secondary hypertension a nocturnal fall of blood pressure is even abandoned or reverted. Diagnosis is made using 24-h blood pressure measurement, which is however used not frequently enough for a clinical assessment or adjustment of therapy. An adaption of the selection or the time of administration of antihypertensive drugs with respect to the circadian rhythm is beneficial to control blood pressure and reduce cardiovascular morbidity. This is particularly true for patients with an a non- or inverted dipping blood pressure pattern, in which the bedtime dosing may result in a normalization of blood pressure and restoration of a normal circadian rhythm. The present manuscript reviews the chronopharmacotherapy of arterial hypertension and grant practical recommendations for their translation into clinical practice.

  5. Arterial blood pressure is closely related to ascites development in compensated HCV-related cirrhosis.

    Directory of Open Access Journals (Sweden)

    Eduardo Vilar Gomez

    Full Text Available BACKGROUND: Arterial blood pressure (BP is a reliable marker of circulatory dysfunction in cirrhotic patients. There are no prospective studies evaluating the association between different levels of arterial BP and ascites development in compensated cirrhotic patients. Therefore, we evaluated the relationship between arterial BP and ascites development in compensated cirrhotic patients. MATERIALS AND METHODS: A total of 402 patients with compensated HCV-related cirrhosis were prospectively followed during 6 years to identify ascites development. At baseline, patients underwent systolic, diastolic and mean arterial pressure (MAP measurements. Any history of arterial hypertension was also recorded. The occurrence of events such as bleeding, hepatocellular carcinoma, death and liver transplantation prior to ascites development were considered as competing risk events. RESULTS: Over a median of 156 weeks, ascites occurred in 54 patients (13%. At baseline, MAP was significantly lower in patients with ascites development (75.9 mm/Hg [95%CI, 70.3-84.3] than those without ascites (93.6 mm/Hg [95% CI: 86.6-102.3]. After adjusting for covariates, the 6-year cumulative incidence of ascites was 40% (95%CI, 34%-48% for patients with MAP<83.32 mm/Hg. In contrast, cumulative incidences of ascites were almost similar among patients with MAP values between 83.32 mm/Hg and 93.32 mm/Hg (7% [95% CI: 4%-12%], between 93.32 mm/Hg and 100.31 mm/Hg (5% [95% CI: 4%-11%] or higher than 100.31 mm/Hg (3% [95% CI: 1%-6%]. The MAP was an independent predictor of ascites development. CONCLUSIONS: The MAP is closely related to the development of ascites in compensated HCV-related cirrhosis. The risk of ascites development increases in 4.4 fold for subjects with MAP values <83.32 mm/Hg.

  6. Heart and Artery Damage and High Blood Pressure

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More How High Blood Pressure Can Lead to a Heart Attack Updated:Dec ... sheet This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Central arterial pressure assessment with intensity POF sensor

    Science.gov (United States)

    Leitão, Cátia; Gonçalves, Steve; Antunes, Paulo; Bastos, José M.; Pinto, João. L.; André, Paulo

    2015-09-01

    The central pressure monitoring is considered a new key factor in hypertension assessment and cardiovascular prevention. In this work, it is presented the central arterial systolic pressure assessment with an intensity based POF sensor. The device was tested in four subjects, and stable pulse waves were obtained, allowing the calculation of the central pressure for all the subjects. The results shown that the sensor performs reliably, being a simple and low-cost solution to the intended application.

  9. Distal shift of arterial pressure wave reflection sites with aging.

    Science.gov (United States)

    Sugawara, Jun; Hayashi, Koichiro; Tanaka, Hirofumi

    2010-11-01

    An early return of reflected waves, the backward propagation of the arterial pressure wave from the periphery to the heart, is associated with the augmentation of central pulse pressure and cardiovascular risks. The locations of arterial pressure wave reflection, along with arterial stiffening, have a major influence on the timing of the reflected wave. To determine the influence of aging on the location of a major reflection site, arterial length (via 3D artery tracing of MRI) and central (carotid-femoral) and peripheral (femoral-ankle) pulse wave velocities were measured in 208 adults varying in age. The major reflection site was detected by carotid-femoral pulse wave velocity and the reflected wave transit time (via carotid arterial pressure wave analysis). The length from the aortic valve to the major reflection site (eg, effective reflecting length) significantly increased with aging. The effective reflecting length normalized by the arterial length demonstrated that the major reflection sites were located between the aortic bifurcation and femoral site in most of the subjects. The normalized effective reflecting length did not alter with aging until 65 years of age and increased remarkably thereafter in men and women. The effective reflecting length was significantly and positively associated with the difference between central and peripheral pulse wave velocities (r=0.76). This correlation remained significant even when the influence of aortic pulse wave velocity was partial out (r=0.35). These results suggest that the major reflection site shifts distally with aging partly because of the closer matching of impedance provided by central and peripheral arterial stiffness.

  10. Impact of mitral E/A ratio on the accuracy of different echocardiographic indices to estimate left ventricular end-diastolic pressure.

    Science.gov (United States)

    Poerner, Tudor C; Goebel, Björn; Kralev, Stefan; Kaden, Jens J; Süselbeck, Tim; Haase, Karl K; Borggrefe, Martin; Haghi, Dariusch

    2007-05-01

    The objective was to determine the influence of left ventricular (LV) inflow pattern on the accuracy of different echocardiographic indices for estimation of LV end-diastolic pressure (LVEDP). Echocardiography with color tissue Doppler imaging (TDI) and LVEDP measurements using fluid-filled catheters were performed in 176 consecutive patients on the same day. Mitral peak diastolic velocities (E, A) and the difference in duration between pulmonary venous retrograde velocity and mitral A-velocity (PV(R)-A) were recorded by pulsed Doppler. Propagation velocity of the early mitral inflow (V(P)) was assessed using color M-mode. Early diastolic longitudinal (E'(lat)) and radial (E'(radial)) velocities of mitral annulus were measured by TDI. Area under ROC curve (AUC) for prediction of elevated LVEDP (> or =15 mm Hg) was computed for each parameter. For E/A > or =1 (98 patients, 46 with elevated LVEDP), the AUC values were: PV(R)-A: 0.914; E/E'(lat): 0.780; E/E'(radial): 0.729; E/V(P): 0.712 (p PV(R)-A reached statistical significance (AUC = 0.893, p PV(R)-A enabled the most accurate noninvasive estimation of LVEDP irrespective of LV filling profile and combined indices E/V(P), E/E'(lat) and E/E'(radial) represent more feasible alternatives for patients with mitral E/A-1.

  11. Implantable blood pressure sensor for analyzing elasticity in arteries

    Science.gov (United States)

    Franco-Ayala, Marco; Martínez-Piñón, Fernando; Reyes-Barranca, Alfredo; Sánchez de la Peña, Salvador; Álvarez-Chavez, José A.

    2009-03-01

    MEMS technology could be an option for the development of a pressure sensor which allows the monitoring of several electronic signals in humans. In this work, a comparison is made between the typical elasticity curves of several arteries in the human body and the elasticity obtained for MEMS silicon microstructures such as membranes and cantilevers employing Finite Element analysis tools. The purpose is to identify which types of microstructures are mechanically compatible with human arteries. The goal is to integrate a blood pressure sensor which can be implanted in proximity with an artery. The expected benefits for this type of sensor are mainly to reduce the problems associated with the use of bulk devices through the day and during several days. Such a sensor could give precise blood pressure readings in a continuous or periodic form, i.e. information that is especially important for some critical cases of hypertension patients.

  12. 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.

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

    Science.gov (United States)

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

    2015-07-09

    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.

  14. Ambulatory instrument for monitoring indirect beat-to-beat blood pressure in superficial temporal artery using volume-compensation method.

    Science.gov (United States)

    Tanaka, S; Yamakoshi, K

    1996-11-01

    A portable instrument, based on a volume-compensation technique, is designed for ambulatory monitoring of indirect beat-to-beat blood pressure (BP) in the superficial temporal artery. The instrument consists of a small disc-type cuff and a portable unit carried by the subject. Several components are integrated in the cuff for applying counter-pressure to the artery, i.e. a reflectance-type photo-plethysmographic sensor for arterial volume detection, a pressure sensor for cuff pressure Pc measurement and a nozzle flapper-type- electro-pneumatic convertor for controlling Pc. The portable unit includes volume servo control circuitry and a microprocessor-based signal-processing and recording unit. This automatically performs all the necessary measurement procedures and stores into a memory IC element the processed systolic, mean and diastolic blood pressure data, together with pulse intervals on a beat-to-beat basis from the servo-controlled Pc (indirectly measured BP waveform). With this instrument, momentary changes in BP during ambulatory situations such as bicycle ergometer exercise and daily activities including motorway driving are successfully recorded. From the results of simultaneous measurement of the subject's posture changes, the effect of posture change on blood pressure, e.g. baroreceptor-cardiac reflex, is also clearly demonstrated.

  15. Arterial blood pressure oscillation after active standing up in kidney transplant recipients.

    Science.gov (United States)

    Gerhardt, U; Schäfer, M; Hohage, H

    2000-04-12

    Dynamic arterial blood pressure (FINAPRES) response to active standing up, normally consisting of initial rise, fall and recovery above the baseline (overshoot), was compared with the early steady-state arterial blood pressure level to measure sympathetic vasomotor function in healthy subjects [group 1: n=50, 10 female subjects, age 51+/-2.5 years; weight 78+/-2.3 kg; height 174+/-1.4 cm (mean+/-standard error of the mean)] and in kidney transplant recipients under basal (group 2a: n=50, age 51.7+/-1.7 years; weight 77+/-2.1 kg; height 174+/-1.5 cm) and under high (group 2b: same subjects as in group 2a) cyclosporine A whole blood levels. Furthermore, baroreflex sensitivity and the activity of the generating compounds of the sympathetic nervous systems (Mayer waves) were measured. Systolic and diastolic overshoot values did not differ statistically significant in the present study. In the control subjects, a systolic overshoot of 15.4+/-2.7 mmHg and a diastolic overshoot of 15.2+/-2 mmHg was detected. The systolic overshoot disappeared in 57% of group 2a (-7.1+/-2.7 mmHg; P<0.001) and in 50% of group 2b recipients (-8.0+/-2.7 mmHg; P<0.001). Systolic early steady-state level was not lower in kidney transplant recipients before cyclosporine (baseline+2 mmHg) intake, but after cyclosporine administration (baseline-3 mmHg; controls: baseline+3 mmHg; P<0.05). There was a strong association between the overshoot and steady-state levels (P for chi(2)<0.001, n=150). Overshoot of group 1 levels (r=0.428; P<0.01) and group 2 levels (r=0.714; P<0. 001) correlated to their respective steady-state blood pressure. Furthermore, recipients had reduced baroreceptor sensitivities estimated by sequence analysis as compared to controls (10+/-1 ms/mmHg vs. 7.5+/-1.4 ms/mmHg; P<0.05). Mayer waves amplitudes of the heart rate spectrum were elevated statistically significant in renal transplant recipients (44.4+/-0.2 vs. 43.8+/-2.2 A.U.). In conclusion, baroreceptor reflex

  16. Longitudinal perspective on the conundrum of central arterial stiffness, blood pressure, and aging.

    Science.gov (United States)

    Scuteri, Angelo; Morrell, Christopher H; Orrù, Marco; Strait, James B; Tarasov, Kirill V; Ferreli, Liana Anna Pina; Loi, Francesco; Pilia, Maria Grazia; Delitala, Alessandro; Spurgeon, Harold; Najjar, Samer S; AlGhatrif, Majd; Lakatta, Edward G

    2014-12-01

    The age-associated increase in arterial stiffness has long been considered to parallel or to cause the age-associated increase in blood pressure (BP). Yet, the rates at which pulse wave velocity (PWV), a measure of arterial stiffness, and BP trajectories change over time within individuals who differ by age and sex have not been assessed and compared. This study determined the evolution of BP and aortic PWV trajectories during a 9.4-year follow-up in >4000 community-dwelling men and women of 20 to 100 years of age at entry into the SardiNIA Study. Linear mixed effects model analyses revealed that PWV accelerates with time during the observation period, at about the same rate over the entire age range in both men and women. In men, the longitudinal rate at which BP changed over time, however, did not generally parallel that of PWV acceleration: at ages>40 years the rates of change in systolic BP (SBP) and pulse pressure (PP) increase plateaued and then declined so that SBP, itself, also declined at older ages, whereas PP plateaued. In women, SBP, diastolic BP, and mean BP increased at constant rates across all ages, producing an increasing rate of increase in PP. Therefore, increased aortic stiffness is implicated in the age-associated increase in SBP and PP. These findings indicate that PWV is not a surrogate for BP and that arterial properties other than arterial wall stiffness that vary by age and sex also modulate the BP trajectories during aging and lead to the dissociation of PWV, PP, and SBP trajectories in men.

  17. Effects of renal artery stenting on renal function and blood pressure in patients with atherosclerotic renovascular disease

    Institute of Scientific and Technical Information of China (English)

    张奇; 沈卫峰; 张瑞岩; 张建盛; 胡健; 张宪

    2003-01-01

    Objective To study the effects of percutaneous renal artery intervention on renal function and blood pressure in patients with renal artery stenosis. Methods Eighty-seven patients with severe uni- or bi-lateral renal artery stenosis (luminal diameter narrowing ≥70%) and clinical hypertension received renal artery stenting between January 2002 and December 2002. The changes in blood pressure and serum creatinine level and creatinine clearance (CCr) 48 hours after intervention and during 6 months of follow-up were assessed.Results Renal stenting was performed in 98 stenotic arteries of 87 patients, and the procedural success rate was 100%. Serum creatinine level was slightly elevated from (176±21) μmol/L to (179±11) μmol/L (P=0.15) 48 hours after the procedure, but significantly decreased to (149±15) μmol/L at 6 months (P<0.001). CCr was also greatly improved [(37±11) ml/min before versus (51±8) ml/min at 6 months, P<0.001]. During follow-up, 61% of the patients experienced a normal renal function. Despite conventional medical treatment, systolic and diastolic blood pressures were also significantly decreased after stenting [(163±23)/(96±13) mm Hg before versus (148±12)/(79±15) mm Hg at 6 months, all P<0.001], and hypertension was well controlled in 67% of the patients at 6 months ' follow-up.Conclusion Renal artery stenting has a high success rate and is effective in improving renal function and blood pressure for patients with severe renal artery stenosis.

  18. Blood Pressure Control in Smokers with Arterial Hypertension Who Switched to Electronic Cigarettes

    Directory of Open Access Journals (Sweden)

    Riccardo Polosa

    2016-11-01

    Full Text Available Electronic cigarettes (ECs are battery-operated devices designed to vaporise nicotine, which may help smokers with quitting or reducing their tobacco consumption. No data is available regarding the health effects of ECs use among smokers with arterial hypertension and whether regular use results in blood pressure (BP changes. We investigated long-term changes in resting BP and level of BP control in hypertensive smokers who quit or reduced substantially their tobacco consumption by switching to ECs. A medical records review of patients with hypertension was conducted to identify patients reporting regular daily use of ECs on at least two consecutive follow-up visits. Regularly smoking hypertensive patients were included as a reference group. A marked reduction in cigarette consumption was observed in ECs users (n = 43 though consumption remained unchanged in the control group (n = 46. Compared to baseline, at 12 months (follow-up visit 2 decline in cigarette consumption was associated with significant reductions in median (25th-, 75th-centile systolic BP (140 (134.5, 144 to 130 (123.5, 138.5 mmHg; p < 0.001 and diastolic BP (86 (78, 90 to 80 (74.5, 90 mmHg; p = 0.006. No significant changes were observed in the control group. As expected, decline in cigarette consumption in the ECs users was also associated with improved BP control. The study concludes that regular ECs use may aid smokers with arterial hypertension reduce or abstain from cigarette smoking, with only trivial post-cessation weight gain. This resulted in improvements in systolic and diastolic BP as well as better BP control.

  19. Blood Pressure Control in Smokers with Arterial Hypertension Who Switched to Electronic Cigarettes

    Science.gov (United States)

    Polosa, Riccardo; Morjaria, Jaymin B.; Caponnetto, Pasquale; Battaglia, Eliana; Russo, Cristina; Ciampi, Claudio; Adams, George; Bruno, Cosimo M.

    2016-01-01

    Electronic cigarettes (ECs) are battery-operated devices designed to vaporise nicotine, which may help smokers with quitting or reducing their tobacco consumption. No data is available regarding the health effects of ECs use among smokers with arterial hypertension and whether regular use results in blood pressure (BP) changes. We investigated long-term changes in resting BP and level of BP control in hypertensive smokers who quit or reduced substantially their tobacco consumption by switching to ECs. A medical records review of patients with hypertension was conducted to identify patients reporting regular daily use of ECs on at least two consecutive follow-up visits. Regularly smoking hypertensive patients were included as a reference group. A marked reduction in cigarette consumption was observed in ECs users (n = 43) though consumption remained unchanged in the control group (n = 46). Compared to baseline, at 12 months (follow-up visit 2) decline in cigarette consumption was associated with significant reductions in median (25th-, 75th-centile) systolic BP (140 (134.5, 144) to 130 (123.5, 138.5) mmHg; p < 0.001) and diastolic BP (86 (78, 90) to 80 (74.5, 90) mmHg; p = 0.006). No significant changes were observed in the control group. As expected, decline in cigarette consumption in the ECs users was also associated with improved BP control. The study concludes that regular ECs use may aid smokers with arterial hypertension reduce or abstain from cigarette smoking, with only trivial post-cessation weight gain. This resulted in improvements in systolic and diastolic BP as well as better BP control. PMID:27845734

  1. Magnetic sensor for arterial distension and blood pressure monitoring.

    Science.gov (United States)

    Ruhhammer, Johannes; Herbstritt, Tamara; Ruh, Dominic; Foerster, Katharina; Heilmann, Claudia; Beyersdorf, Friedhelm; Goldschmidtboeing, Frank; Seifert, Andreas; Woias, Peter

    2014-12-01

    A novel sensor for measuring arterial distension, pulse and pressure waveform is developed and evaluated. The system consists of a magnetic sensor which is applied and fixed to arterial vessels without any blood vessel constriction, hence avoiding stenosis. The measurement principle could be validated by in vitro experiments on silicone tubes, and by in vivo experiments in an animal model, thereby indicating the non-linear viscoelastic characteristics of real blood vessels. The sensor is capable to provide absolute measurements of the dynamically varying arterial diameter. By calibrating the sensor, a long-term monitoring system for continuously measuring blood pressure and other cardiovascular parameters could be developed based on the method described. This will improve diagnostics for high risk patients and enable a better, specific treatment.

  2. AGE, ARTERIAL STIFFNESS AND CARDIOVASCULAR RISK

    Institute of Scientific and Technical Information of China (English)

    蒋雄京; 刘国仗; 刘力生

    2001-01-01

    The recent researches on the structure and function of large artery find that increasing pulse pressure is associated with greater cardiovascular risk, especially risk of coronary events. Such risk is not explicable on the basis of increasing systolic pressure with age, and is apparent even when the major reason for increased pulse pressure is a relative decrease of diastolic pressure. The finding challenges the conventional approach to arterial pressure where diastolic pressure is traditionally viewed as the most robust indicator of caridovascular risk. An explanation is available. This is based on the perception of Harriet Dustan that hypertension in the older popula-

  3. 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.

  4. Peripheral arterial blood pressure monitoring adequately tracks central arterial blood pressure in critically ill patients: an observational study

    OpenAIRE

    Mignini, Mariano Alejandro; Piacentini, Enrique; Dubin,Arnaldo

    2006-01-01

    Introduction Invasive arterial blood pressure monitoring is a common practice in intensive care units (ICUs). Accuracy of invasive blood pressure monitoring is crucial in evaluating the cardiocirculatory system and adjusting drug therapy for hemodynamic support. However, the best site for catheter insertion is controversial. Lack of definitive information in critically ill patients makes it difficult to establish guidelines for daily practice in intensive care. We hypothesize that peripheral ...

  5. Left Ventricular Mass index and Pulmonary Artery Pressure in Patients with the Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Seyed Hashem Sezavar

    2016-07-01

    Full Text Available Background: Sleep apnea is accompanied by some cardiovascular complications. It has even been hypothesized that sleep apnea, itself, can induce some of these complications. Given such controversies, we assessed the left ventricular mass index (LVMI and systolic pulmonary artery pressure in patients with sleep apnea.Methods: Through convenience sampling, 56 patients with the obstructive sleep apnea syndrome (OSAS were included in the present descriptive cross-sectional study. Patients with any past history of hypertension and diabetes mellitus were excluded. The apnea severity was assessed via the polysomnography-derived apnea-hypopnea index (AHI. All the patients underwent transthoracic echocardiography. In this cross-sectional study - data regarding age, gender, smoking, systolic and diastolic blood pressures, polysomnographic parameters (AHI, severity of disease, mean heart rate, mean oxygen saturation [SaO2], lowest SaO2, and duration of SaO2 below 90% [d.SaO2 < 90%], and  echocardiographic parameters (systolic pulmonary artery pressure and LVMI were accumulated and processed.Results: Fifty-two men and 14 women at a mean age of 49.29 ± 11.79 years participated in this study. Systolic and was significantly high in the severe group compared with the mild group (128.21 ± 9.73 mmHg vs. 119.23 ± 12.5 mmHg; p value = 0.007. The LVMI was increased parallel to an increase in the severity of the OSAS, but that increase was not statistically significant (p value = 0.161. The d.SaO2 < 90% was positively correlated with the LVMI, and this relationship remained true after adjustment for the body mass index (r = 0.27; p value = 0.042.Conclusion: Severe OSAS was accompanied by a higher blood pressure. The LVMI did not differ significantly between the patients with the OSAS and those who did not suffer from other risk factors of cardiac diseases.

  6. Early diastolic filling dynamics in diastolic dysfunction

    Directory of Open Access Journals (Sweden)

    Crean Peter A

    2003-07-01

    Full Text Available Abstract Background The aim of the study was to determine the relationship between the rate of peak early mitral inflow velocity and the peak early diastolic mitral annular tissue velocities in normal controls and to compare them with subjects with diastolic dysfunction. Methods The relationship between early passive diastolic transmitral flow and peak early mitral annular velocity in the normal and in diastolic dysfunction was studied. Two groups comprising 22 normal controls and 25 patients with diastolic dysfunction were studied. Results Compared with the normal group, those with diastolic dysfunction had a lower E/A ratio (0.7 ± 0.2 vs. 1.9 ± 0.5, p 2 vs. 871 ± 128.1 cm/sec2, p Conclusions This investigation provides information on the acceleration of early diastolic filling and its relationship to mitral annular peak tissue velocity (Ea recorded by Doppler tissue imaging. It supports not only the premise that recoil is an important mechanism for rapid early diastolic filling but also the existence of an early diastolic mechanism in normal.

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

    DEFF Research Database (Denmark)

    Vimaleswaran, Karani S; Cavadino, Alana; Berry, Diane J

    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 blood pressure and hypertension risk. METHODS: In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta......, -0·12 mm Hg, 95% CI -0·20 to -0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97-0·99; p=0·0003), but not with decreased diastolic blood pressure (β per 10% increase, -0·02 mm Hg, -0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D...

  8. Myocardial steatosis as a possible mechanistic link between diastolic dysfunction and coronary microvascular dysfunction in women.

    Science.gov (United States)

    Wei, Janet; Nelson, Michael D; Szczepaniak, Edward W; Smith, Laura; Mehta, Puja K; Thomson, Louise E J; Berman, Daniel S; Li, Debiao; Bairey Merz, C Noel; Szczepaniak, Lidia S

    2016-01-01

    Women with coronary microvascular dysfunction (CMD) and no obstructive coronary artery disease (CAD) have increased rates of heart failure with preserved ejection fraction (HFpEF). The mechanisms of HFpEF are not well understood. Ectopic fat deposition in the myocardium, termed myocardial steatosis, is frequently associated with diastolic dysfunction in other metabolic diseases. We investigated the prevalence of myocardial steatosis and diastolic dysfunction in women with CMD and subclinical HFpEF. In 13 women, including eight reference controls and five women with CMD and evidence of subclinical HFpEF (left ventricular end-diastolic pressure >12 mmHg), we measured myocardial triglyceride content (TG) and diastolic function, by proton magnetic resonance spectroscopy and magnetic resonance tissue tagging, respectively. When compared with reference controls, women with CMD had higher myocardial TG content (0.83 ± 0.12% vs. 0.43 ± 0.06%; P = 0.025) and lower diastolic circumferential strain rate (168 ± 12 vs. 217 ± 15%/s; P = 0.012), with myocardial TG content correlating inversely with diastolic circumferential strain rate (r = -0.779; P = 0.002). This study provides proof-of-concept that myocardial steatosis may play an important mechanistic role in the development of diastolic dysfunction in women with CMD and no obstructive CAD. Detailed longitudinal studies are warranted to explore specific treatment strategies targeting myocardial steatosis and its effect on diastolic function.

  9. Systolic Pressure in Different Percents of Stenosis at Major Arteries

    CERN Document Server

    Mirzaee, Mohammad Reza; Firoozabadi, Bahar; Dandaneband, Meitham

    2016-01-01

    - Modeling Human cardiovascular system is always an important issue. One of the most effective methods is using lumped model to reach to a complete model of human cardiovascular system. Such modeling with advanced considerations is used in this paper. Some of these considerations are as follow: Exact simulating of ventricles as pressure suppliers, peristaltic motion of descending arteries as additional suppliers, and dividing each vessel into more than one compartment to reach more accurate answers. Finally a circuit with more than 150 RLC segments and different elements is made. Then the verification of our complex circuit is done and at the end, obstruction as an important abnormality is investigated. For this aim different percents of obstruction in vital arteries are considered and the results are brought as different graphs at the end. According to physiological texts the citation of our simulation and its results are obvious. To earn productive information about arteries characteristics a 36-vessels mod...

  10. Associations of blood pressure and arterial compliance with occupational noise exposure in female workers of textile mill

    Institute of Scientific and Technical Information of China (English)

    NI Chun-hui; ZHANG Yu-jun; CHEN Zhi-yong; ZHOU Yin; ZHOU Jian-wei; Pan Jing-jing; LIU Nian; WANG Jun; LIANG Chen-ke; ZHANG Zhi-zhong

    2007-01-01

    Background There are few studies on the arterial compliance of noise exposure. The purpose of this study was to understand the relationship between hearing loss, blood pressure and arterial compliance of female workers who exposed to occupational noise in a textile mill.Methods The noise levels in the workplace were measured with a HS6288 sound level meter. Cumulated noise exposure (CNE) was calculated according to the noise intensity and the exposure period. Hearing ability and arterial compliance were measured in 618 noise exposed workers. The database was set up with EpiData and the statistical analysis was performed with SAS software 9.1.3.Results The noise levels were 80.1dB(A) to 113.5dB(A), of which the levels at 92.5% of the noise monitoring sites were over the national standard. The incidence of high frequency hearing loss (HFHL) was 24.43% and language frequency hearing impairment (LFHI) was 0.81%. The incidence of hypertension was 7.93%. Both systolic blood pressure (SBP)and diastolic blood pressure (DBP) in the high frequency hearing loss group were significantly higher than those in the normal hearing group (P<0.05), while C1 (large artery compliance) and C2 (small artery compliance) were significantly lower (P<0.05). The high frequency hearing threshold (HFHT) of the hypertension group was significantly higher than in the normal blood pressure group (P<0.05), while C1 and C2 were significantly lower (P<0.05). C1 and C2 had a negative correlation with HFHT, SBP, DBP, mean of arterial pressure (MAP), pulse pressure (PP) and pulse rate (PR) (P<0.05).The multiple regression analyses showed that blood pressure and PR were the main influencing factors on C1 and C2.LFHT was an influence on C2 and HFHT on C1.Conclusions Textile mill noise pollution is very serious and has an obvious influence on worker's auditory function. The female workers with Iow artery compliance or with high blood pressure might be suffering from hearing loss; those with noise

  11. Determinants of an elevated pulmonary arterial pressure in patients with pulmonary arterial hypertension.

    Science.gov (United States)

    Sakao, Seiichiro; Voelkel, Norbert F; Tanabe, Nobuhiro; Tatsumi, Koichiro

    2015-01-01

    Given the difficulty of diagnosing early-stage pulmonary arterial hypertension (PAH) due to the lack of signs and symptoms, and the risk of an open lung biopsy, the precise pathological features of presymptomatic stage lung tissue remain unknown. It has been suggested that the maximum elevation of the mean pulmonary arterial pressure (P pa) is achieved during the early symptomatic stage, indicating that the elevation of the mean P pa is primarily driven by the pulmonary vascular tone and/or some degree of pulmonary vascular remodeling completed during this stage. Recently, the examination of a rat model of severe PAH suggested that the severe PAH may be primarily determined by the presence of intimal lesions and/or the vascular tone in the early stage. Human data seem to indicate that intimal lesions are essential for the severely increased pulmonary arterial blood pressure in the late stage of the disease.However, many questions remain. For instance, how does the pulmonary hemodynamics change during the course of the disease, and what drives the development of severe PAH? Although it is generally acknowledged that both pulmonary vascular remodeling and the vascular tone are important determinants of an elevated pulmonary arterial pressure, which is the root cause of the time-dependent progression of the disease? Here we review the recent histopathological concepts of PAH with respect to the progression of the lung vascular disease.

  12. 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

    1998-01-01

    inhibition after AMI complicated by left ventricular dysfunction may be of particular importance in patients with a history of arterial hypertension or a relatively high pretreatment blood pressure. However, further investigations are necessary to establish the clinical impact of these results.......OBJECTIVE: To evaluate the influence of a history of arterial hypertension and the level of pretreatment blood pressure on the efficacy of the angiotensin converting enzyme (ACE) inhibitor trandolapril on mortality and morbidity in patients with acute myocardial infarction (AMI) and left...... for a broad spectrum of potential confounders. Also, benefit from ACE inhibition increased with increasing blood pressure at the time of randomization. Significant interactions between benefit from ACE inhibition and hypertension history, and systolic and diastolic blood pressure were found. CONCLUSION: ACE...

  13. Pulmonary Hypertension in Elderly Patients with Diastolic Dysfunction and Preserved Ejection Fraction

    Science.gov (United States)

    Afshar, Majid; Collado, Fareed; Doukky, Rami

    2012-01-01

    Purpose: Patients with diastolic dysfunction may have a disproportionate degree of elevation in pulmonary pressure, particularly in the elderly. Higher pulmonary vascular resistance in the elderly patients with heart failure but preserved ejection fraction suggests that beyond the post-capillary contribution of pulmonary venous congestion, a pre-capillary component of pulmonary arterial hypertension occurs. We aim to identify if pulmonary vascular resistance in elderly patients with diastolic dysfunction is disproportionately higher than patients with systolic dysfunction independent of filling pressures. Methods: 389 patients identified retrospectively between 2003- 2010; elderly with preserved ejection fraction, elderly with depressed ejection fraction, and primary arterial hypertension who underwent right-heart catheterization at Rush University. Results: No significant difference in pulmonary vascular resistance between systolic and diastolic dysfunction. The mean difference in pulmonary vascular resistance was not statistically significant at 0.40 mmHg·min/l (95% CI -3.03 to 3.83) with similar left ventricular filling pressures with mean difference of 3.38 mmHg (95% CI, -1.27 to 8.02). When adjusted for filling pressures, there remained no difference in pulmonary vascular resistance for systolic and diastolic dysfunction. The mean pulmonary vascular resistance is more elevated in systolic heart failure compared to diastolic heart failure with means 3.13 mmHg·min/l and 3.52 mmHg·min/l, respectively. Conclusion: There was no other association identified for secondary pulmonary hypertension other than diastolic dysfunction and chronic venous pulmonary hypertension. Our results argue against any significant arterial remodeling that would lead to disproportionate pre-capillary hypertension, and implies that treatment should focus on lowering filling pressure rather than treating the pulmonary vascular tree. PMID:22282715

  14. Carotid artery disease and low cerebral perfusion pressure

    DEFF Research Database (Denmark)

    Schroeder, T; Utzon, N P; Aabech, J

    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...

  15. Activity of the positive and negative reinforcement motivation systems and baseline arterial blood pressure in humans.

    Science.gov (United States)

    Aftanas, L I; Sidorova, P V; Pavlov, S V; Makhnev, V P; Korenek, V V; Reva, N V; Amstislavskaya, T G

    2008-10-01

    The aim of the present work was to identify possible associations between individual balances in the activity of the positive and negative reinforcement motivation systems using a method based on emotional modulation of the startle reaction (EMSR) by motivationally significant emotionally positive and negative contextual visual stimuli and measures of cardiovascular system activity. Studies were performed using healthy males (mean age 30.29 +/- 9.8 years) with normal and first-episode excessive increases in arterial blood pressure (systolic blood pressure to greater than 140 mmHg, diastolic to greater than 90 mmHg). Cluster analysis of EMSR data identified groups of individuals with different activity profiles for the positive and negative reinforcement systems. Groups of subjects with changes in the balance of activity towards a lower level of positive reinforcement system activity (smaller startle reflexes to positive contextual stimuli) or a higher level of negative reinforcement system activity (larger startle reactions to threatening contextual stimuli) showed significantly greater baseline SBP and DBP. The possible mechanisms of the modulatory influences of the balance of system activities on autonomic vascular regulatory processes are discussed.

  16. 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

  17. Comparison of two methods of dental prophylaxis: evaluation of arterial pressure and patient comfort in a clinical randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Camila Lopes FERREIRA

    Full Text Available Abstract Introduction The number of hypertensive patients is increasing and prophylaxis with bicarbonate jet are widely performed in clinical practice using large amounts of this substance in a short period of time, which may lead to increased arterial pressure. In the literature there are several studies that analyze the effect of sodium bicarbonate jet on the biofilm and dental structures, but not report the effect on arterial pressure. Aim Evaluated the change in arterial pressure before and after two procedures of dental prophylaxis, jet baking soda application and conventional prophylaxis, and patient opinion of the comfort of each system was obtained. Material and method We selected 20 patients aged 18 to 30 in need of prophylaxis to remove biofilm. The patients were placed into three different treatment groups: sodium bicarbonate jet (G1, conventional prophylaxis (G2 and control (G3, with a one month interval between treatments. Patients were divided into groups randomly. Measurements were performed immediately before and after the procedure, 15 and 30 minutes after the end of treatment. Patient comfort was measured using a Visual Analog Scale (VAS at the end of each treatment. Data were analyzed by analysis of variance. Result There was a statistically significant difference in the comfort of the procedures, with G2 and G3 being better than G1. Additionally, an increase in the diastolic blood pressure was observed in sodium bicarbonate jet group evaluated just after the procedure. Conclusion The conventional prophylaxis is more comfortable from the patient stand point and does not alter arterial pressure.

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

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    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

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

    NARCIS (Netherlands)

    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

    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 unkno

  20. 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

    2014-01-01

    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:10.1038/hr.2014.95....

  1. The diastolic flow velocity-pressure gradient relation and dpv50 to assess the hemodynamic significance of coronary stenoses.

    Science.gov (United States)

    Marques, Koen M J; van Eenige, Machiel J; Spruijt, Hugo J; Westerhof, Nico; Twisk, Jos; Visser, Cees A; Visser, Frans C

    2006-12-01

    To evaluate the hemodynamic impact of coronary stenoses, the fractional (FFR) or coronary flow velocity reserve (CFVR) usually is measured. The combined measurement of instantaneous flow velocity and pressure gradient (v-dp relation) is rarely used in humans. We derived from the v-dp relation a new index, dp(v50) (pressure gradient at flow velocity of 50 cm/s), and compared the diagnostic performance of dp(v50), CFVR, and FFR. Before coronary angiography was performed, patients underwent noninvasive stress testing. In all coronary vessels with an intermediate or severe stenosis, the flow velocity, aortic, and distal coronary pressure were measured simultaneously with a Doppler and pressure guidewire after induction of hyperemia. After regression analysis of all middiastolic flow velocity and pressure gradient data, the dp(v50) was calculated. With the use of the results of noninvasive stress testing, the dp(v50) cutoff value was established at 22.4 mmHg. In 77 patients, 124 coronary vessels with a mean 39% (SD 19) diameter stenosis were analyzed. In 43 stenoses, ischemia was detected. We found a sensitivity, specificity, and accuracy of 56%, 86%, and 76% for CFVR; 77%, 99%, and 91% for FFR; and 95%, 95%, and 95% for dp(v50). To establish that dp(v50) is not dependent on maximal hyperemia, dp(v50) was recalculated after omission of the highest quartile of flow velocity data, showing a difference of 3%. We found that dp(v50) provided the highest sensitivity and accuracy compared with FFR and CFVR in the assessment of coronary stenoses. In contrast to CFVR and FFR, assessment of dp(v50) is not dependent on maximal hyperemia.

  2. Increased Systolic and Diastolic Blood Pressure Is Associated With Altered Gut Microbiota Composition and Butyrate Production in Early Pregnancy.

    Science.gov (United States)

    Gomez-Arango, Luisa F; Barrett, Helen L; McIntyre, H David; Callaway, Leonie K; Morrison, Mark; Dekker Nitert, Marloes

    2016-10-01

    The risk of developing pregnancy-induced hypertension and preeclampsia is higher in obese pregnant women. In obesity, the composition of the gut microbiota is altered. Obesity is also associated with low-grade inflammation. Metabolites from the gut microbiota may contribute to both hypertension and inflammation. The aim of this study is to investigate whether the composition of the gut microbiota in overweight and obese pregnant women is associated with blood pressure and levels of plasminogen activator inhibitor-1. The composition of the gut microbiota was determined with 16S ribosomal RNA sequencing in 205 women at 16 weeks gestation from the SPRING study (the Study of Probiotics in Gestational Diabetes). Expression of butyrate-producing genes in the gut microbiota was assessed by real-time polymerase chain reaction. Plasminogen activator inhibitor-1 levels were measured in fasting serum of a subset of 70 women. Blood pressure was slightly but significantly higher in obese compared with overweight women. The abundance of the butyrate-producing genus Odoribacter was inversely correlated with systolic blood pressure. Butyrate production capacity was decreased, but plasminogen activator inhibitor-1 concentrations increased in obese pregnant women. Plasminogen activator inhibitor-1 levels were inversely correlated with expression of butyrate kinase and Odoribacter abundance. This study shows that in overweight and obese pregnant women at 16 weeks gestation, the abundance of butyrate-producing bacteria and butyrate production in the gut microbiota is significantly negatively associated with blood pressure and with plasminogen activator inhibitor-1 levels. Increasing butyrate-producing capacity may contribute to maintenance of normal blood pressure in obese pregnant women.

  3. Sarcoplasmic reticulum calcium mobilization in right ventricular pressure-overload hypertrophy in the ferret: relationships to diastolic dysfunction and a negative treppe.

    Science.gov (United States)

    Gwathmey, J K; Morgan, J P

    1993-03-01

    In a model of right-ventricular pressure-overload hypertrophy (POH) in the ferret, action potential duration (to 90% repolarization) was found to be significantly longer (228 +/- 11 vs 314 +/- 12 ms) with no change in amplitude (85 +/- 3 vs 85 +/- 2 mV) or resting membrane potential (-79 +/- 1.5 vs -79 +/- 1 mV) for control and POH, respectively. Peak sarcoplasmic reticulum Ca2+ release (expressed as the logarithm of the fractional luminescence, -4.2 +/- 0.1 vs -4.4 +/- 0.3) and resting calcium concentrations (-5.5 +/- 0.1 vs -5.7 +/- 0.1) were not different between the two groups (control vs POH respectively). Muscles from control and POH animals demonstrated a positive force/interval relationship in the presence of physiological extracellular [Ca2+]. However, unlike muscles from control animals, muscles from animals with POH subjected to increasing frequencies of contraction in the presence of increased extracellular [Ca2+] demonstrated further impairment of diastolic relaxation and a negative treppe. Exposure of muscles from POH animals to isoproterenol returned the slowed Ca2+ uptake by the sarcoplasmic reticulum as detected with aequorin to control values, although the relaxation phase of the isometric twitch remained prolonged compared to non-hypertrophied muscles. Exposure to milrinone also abbreviated the time course of the intracellular Ca2+ transient, but did not return it to that seen in normal myocardium. The exposure of non-hypertrophied isolated muscles to caffeine resulted in similar prolongation of the isometric twitch duration to that seen in hypertrophied myocardium. Results of these experiments suggest that impaired muscle relaxation in POH reflects changes at the level of the myofilaments. Thus, although slowed intracellular calcium mobilization contributes to diastolic relaxation abnormalities, it can not be the sole factor responsible for the slowed relaxation as has been suggested.

  4. Dopplerfluxometria das artérias renais: valores normais das velocidades sistólica e diastólica e do índice resistivo nas artérias renais principais Renal arteries Dopplerfluxometry: normal systolic and diastolic flow velocities and resistive index values in the main renal arteries

    Directory of Open Access Journals (Sweden)

    M.B. Melo

    2006-08-01

    Full Text Available Dopplerfluxometry of renal arteries has been used to estimate renal perfusion in humans. The aim of this study was to use Dopplerfluxometry technique to calculate the resistive index of main renal arteries in dogs, measuring their systolic and diastolic blood flow velocities. Twenty (10 males, 10 females, adult mongrel dogs, were used in this study. The dogs were submitted to Doppler sonographic evaluation of left and right main renal arteries. The systolic and diastolic blood flow velocities, expressed (in centimeters per second as mean and standard deviation were 79.96± 8.82 and 28.86± 5.11 in the right main renal artery and 80.22± 6.99 and 29.62± 4.14 in the left main renal artery. The value of resistive index expressed as mean ± standard deviation was 0.64± 0.04 for the right main renal artery and 0.63± 0.028 in the left main renal artery.

  5. Non-invasive quantification of peripheral arterial volume distensibility and its non-linear relationship with arterial pressure.

    Science.gov (United States)

    Zheng, Dingchang; Murray, Alan

    2009-05-29

    Arterial wall function is associated with different physiological and clinical factors. Changes in arterial pressure cause major changes in the arterial wall. This study presents a simple non-invasive method to quantify arterial volume distensibility changes with different arterial pressures. The electrocardiogram, finger and ear photoplethysmogram were recorded from 15 subjects with the right arm at five different positions (90 degrees , 45 degrees , 0 degrees , -45 degrees and -90 degrees referred to the horizontal level). Arm pulse propagation time was determined by subtracting ear pulse transit time from finger pulse transit time, and was used to obtain arterial volume distensibility. The mean arterial blood pressure with the arm at the horizontal level was acquired, and changes with position were calculated using the hydrostatic principle that blood pressure in the arm is linearly related to its vertical distance from the horizontal level. The mean arm pulse propagation times for the five different positions were 88, 72, 57, 54 and 52ms, with the corresponding mean arterial volume distensibility of 0.234%, 0.158%, 0.099%, 0.088% and 0.083% per mmHg. For all consecutive changes in arm position, arm pulse propagation time and arterial volume distensibility, were significantly different (all probability Ppressure decreased significantly between each consecutive arm position from 90 degrees to -45 degrees (all Ppressure changes from 101 to 58mmHg. In conclusion, the inverse and non-linear relationship between arterial volume distensibility and arterial pressure has been quantified using a simple arm positioning procedure, with the greatest effect at low pressures. This work is an important step in developing a simple non-invasive technique for assessing peripheral arterial volume distensibility.

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

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    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.

  7. A Neural Network for Estimation of Aortic Pressure from the Radial Artery Pressure Pulse

    Science.gov (United States)

    2001-10-25

    from periphery to artery: a model based study, American Journal of Physiology, 1998,274:43, pp H1386-92 [9] C. Chen, E. Nevo , B Fetics, P Pak, F, Yin, L...36. [10] B Fetics, E Nevo , C. Chen, D Kass, Parametric model derivation of transfer function for noninvasive estimation of aortic pressure by radial

  8. The effect of septoplasty on pulmonary artery pressure and right ventricular function in nasal septum deviation.

    Science.gov (United States)

    Ozkececi, Gulay; Akci, Onder; Bucak, Abdulkadir; Ulu, Sahin; Yalım, Zafer; Aycicek, Abdullah; Onrat, Ersel; Avsar, Alaettin

    2016-11-01

    Nasal septum deviation (NSD) can cause obstruction of the upper airway, which may lead to increased pulmonary artery pressure (PAP) and right ventricle dysfunction. The aim of the present study was to evaluate the effect of septoplasty on right ventricular function and mean PAP of patients with marked NSD. 25 patients with marked NSD (mean age = 31.8 ± 12.3 years) and 27 healthy volunteers (mean age = 34.5 ± 10.8 years) were enrolled. Echocardiography was performed for all subjects and right ventricular function and mean PAP were evaluated before and 3 months after septoplasty. Tricuspid annular plane systolic excursion (TAPSE) and tricuspid annulus early diastolic myocardial velocity (E') were significantly lower in patients with NSD than control subjects, while right ventricle myocardial performance index (RVMPI) and mean PAP were significantly higher (respectively, p = 0.006, 0.037, 0.049, 0.046). When preoperative and postoperative findings were compared, the mean PAP decreased whereas TAPSE increased significantly (respectively, p = 0.007, 0.03). The results of the present study demonstrated that mean PAP increased and right ventricular function worsened in patients with NSD. However, mean PAP decreased and right ventricular function tended to recover after septoplasty.

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

    Science.gov (United States)

    Pillar, Roberta; G Lopes, Miriam Ghedini; Rocha, Lillian Andrade; Cuppari, Lilian; Carvalho, Aluízio B; Draibe, Sérgio A; Canziani, Maria Eugênia F

    2013-05-01

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

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

    Directory of Open Access Journals (Sweden)

    R.R. Cabral

    2010-02-01

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

  11. The relationship of pulmonary vascular resistance and compliance to pulmonary artery wedge pressure during submaximal exercise in healthy older adults

    Science.gov (United States)

    Wright, Stephen P.; Granton, John T.; Esfandiari, Sam; Goodman, Jack M.

    2016-01-01

    Key points A consistent inverse hyperbolic relationship has been observed between pulmonary vascular resistance and compliance, although changes in pulmonary artery wedge pressure (PAWP) may modify this relationship.This relationship predicts that pulmonary artery systolic, diastolic and mean pressure maintain a consistent relationship relative to the PAWP.We show that, in healthy exercising human adults, both pulmonary vascular resistance and compliance decrease in relation to exercise‐associated increases in PAWP.Pulmonary artery systolic, diastolic and mean pressures maintain a consistent relationship with one another, increasing linearly with increasing PAWP.Increases in PAWP in the setting of exercise are directly related to a decrease in pulmonary vascular compliance, despite small decreases in pulmonary vascular resistance, thereby increasing the pulsatile afterload to the right ventricle. Abstract The resistive and pulsatile components of right ventricular afterload (pulmonary vascular resistance, Rp; compliance, Cp) are related by an inverse hyperbolic function, expressed as their product known as RpCp‐time. The RpCp‐time exhibits a narrow range, although it may be altered by the pulmonary artery wedge pressure (PAWP). Identifying the determinants of RpCp‐time should improve our understanding of the physiological behaviour of pulmonary arterial systolic (PASP), diastolic (PADP) and mean (mPAP) pressures in response to perturbations. We examined the effect of exercise in 28 healthy non‐athletic adults (55 ± 6 years) who underwent right heart catheterization to assess haemodynamics and calculate Rp and Cp. Measurements were made at rest and during two consecutive 8–10 min stages of cycle ergometry, at targeted heart‐rates of 100 beats min–1 (Light) and 120 beats min–1 (Moderate). Cardiac output increased progressively during exercise. PASP, PADP, mPAP and PAWP increased for Light exercise, without any further rise for Moderate

  12. 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.

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

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    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. Systolic and diastolic changes in human coronary blood flow during Valsalva manoeuvre.

    Science.gov (United States)

    Federici, A; Ciccone, M; Gattullo, D; Losano, G

    2000-01-01

    Valsalva manoeuvre is reported to be sometimes successful for the relief of angina pectoris. The present study investigated how haemodynamic changes produced by Valsalva manoeuvre can interact to improve the relationship between cardiac work and coronary blood flow. Ten male subjects aged 53 +/- 12 years (SD) were considered. Blood velocity in the internal mammary artery, previously anastomosed to the left descending coronary artery, was studied with Doppler technique. The subjects performed Valsalva manoeuvres by expiring into a tube connected to a mercury manometer, to develop a pressure of 40 mmHg. The arterial blood pressure curve was continuously monitored with a Finapres device from a finger of the left hand. During expiratory effort, an increase in heart rate and a decrease in arterial pulse pressure were followed by a more delayed and progressive increase in mean and diastolic pressures. Systolic blood velocity markedly decreased along with the reduction in pulse pressure and increase in heart rate. By contrast, diastolic and mean coronary blood velocities did not show any significant change. Since it is known that the Valsalva manoeuvre strongly reduces stroke volume and cardiac output, it is likely that a reduction in cardiac work also takes place. Since in diastole, i.e. when the myocardial wall is better perfused, coronary blood velocity did not show any significant reduction, it is likely that unchanged perfusion in the presence of reduced cardiac work is responsible for the relief from angina sometimes observed during Valsalva manoeuvre. It is also likely that the increase in heart rate prevents the diastolic and mean blood coronary velocity from decreasing during the expiratory strain, when an increased sympathetic discharge could cause vasoconstriction through the stimulation of the coronary alpha-receptors.

  15. Sleep Bruxism Is Associated with a Rise in Arterial Blood Pressure

    Science.gov (United States)

    Nashed, Angela; Lanfranchi, Paola; Rompré, Pierre; Carra, Maria Clotilde; Mayer, Pierre; Colombo, Roberto; Huynh, Nelly; Lavigne, Gilles

    2012-01-01

    Study Objectives: Sleep bruxism (SB) is a movement disorder identified by grinding of teeth and rhythmic masticatory muscle activity (RMMA). RMMA is associated with body movements and cortical arousals. Increases in autonomic sympathetic activities that characterize sleep cortical arousal precede RMMA/SB. Based on these findings, this study examined whether RMMA/SB episodes are also associated with significant changes in arterial blood pressure (BP). Design: Participants underwent 3 nights of full polysomnography that included noninvasive beat-to-beat BP recording. Single RMMA/SB episodes and arousal episodes were analyzed in stage 2 sleep and categorized as: (i) RMMA/SB + arousal; (ii) RMMA/SB + body movement; (iii) RMMA/SB + arousal + body movement; or (iv) arousal alone. Sleep and RMMA/SB data were compared to a Non SB group. RMMA/SB clusters (RMMA/SB episodes ≤ 30 sec apart) were also analyzed. Setting: Sleep Laboratory at l'Hôpital du Sacré-Coeur de Montréal. Participants: Ten young, healthy participants with SB (mean age = 26 ± 1.8 years) and 9 without SB (mean age = 29 ± 1.2 years). Interventions: N/A Measurements and Results: BP increased with all RMMA/SB and arousal episodes (P ≤ 0.05). The average maximum BP surges (systolic/diastolic ± SE mm Hg) were: 25.6 ± 3.3/12.6 ± 2.0 for RMMA/SB + arousal; 30.1 ± 1.7/19.1 ± 1.9 for RMMA/SB + body movement; 26.0 ± 2.8/15.1 ± 2.0 for RMMA/SB + arousal + body movement; 19.4 ± 2.3/8.9 ± 1.2 for arousal alone; and for RMMA/SB clusters: Episode: 1: 26.2 ± 8.7/16.4 ± 5.7; Episode 2: 21.1 ± 7.9/12.6 ± 6.4. Conclusion: Rhythmic masticatory muscle activity/sleep bruxism (RMMA/SB) is associated with blood pressure fluctuations during sleep. Arousals and body movements often occur with RMMA/SB and can impact the magnitude of this BP surge. Citation: Nashed A; Lanfranchi P; Rompré P; Carra MC; Mayer P; Colombo R; Huynh N; Lavigne G. Sleep bruxism is associated with a rise in arterial blood pressure. SLEEP

  16. Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

    DEFF Research Database (Denmark)

    Fuglsang, S; Bendtsen, F; Christensen, E

    2001-01-01

    Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40%...... predictors of SV/PP (P abnormalities in the arterial compliance of these patients....

  17. 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.

  18. Intraspecific scaling of arterial blood pressure in the Burmese python.

    Science.gov (United States)

    Enok, Sanne; Slay, Christopher; Abe, Augusto S; Hicks, James W; Wang, Tobias

    2014-07-01

    Interspecific allometric analyses indicate that mean arterial blood pressure (MAP) increases with body mass of snakes and mammals. In snakes, MAP increases in proportion to the increased distance between the heart and the head, when the heart-head vertical distance is expressed as ρgh (where ρ is the density of blood, G: is acceleration due to gravity and h is the vertical distance above the heart), and the rise in MAP is associated with a larger heart to normalize wall stress in the ventricular wall. Based on measurements of MAP in Burmese pythons ranging from 0.9 to 3.7 m in length (0.20-27 kg), we demonstrate that although MAP increases with body mass, the rise in MAP is merely half of that predicted by heart-head distance. Scaling relationships within individual species, therefore, may not be accurately predicted by existing interspecific analyses.

  19. [Acute Postoperative Negative Pressure Pulmonary Edema Caused by the Compression of Brachiocephalic Artery].

    Science.gov (United States)

    Tagawa, Miki; Iwai, Hidetaka; Fukatsu, Ken; Shimada, Mami; Hirabayashi, Yoshihiro

    2016-06-01

    We report a case of negative-pressure pulmonary edema occurring by tracheal obstruction caused by the brachiocephalic artery. The patient had deformed thorax with cerebral palsy, which deformed thorax placing the brachiocephalic artery high over the trachea, resulting in close and tight contact between the artery and trachea. Additional deformity of the thorax associated with myotonic attacks after general anesthesia might shorten the distance between the sternal notch and the vertebral body, resulting in the tracheal obstruction by the artery.

  20. Impact of age on the importance of systolic and diastolic blood pressures for stroke risk: the MOnica, Risk, Genetics, Archiving, and Monograph (MORGAM) Project.

    Science.gov (United States)

    Vishram, Julie K K; Borglykke, Anders; Andreasen, Anne H; Jeppesen, Jørgen; Ibsen, Hans; Jørgensen, Torben; Broda, Grazyna; Palmieri, Luigi; Giampaoli, Simona; Donfrancesco, Chiara; Kee, Frank; Mancia, Giuseppe; Cesana, Giancarlo; Kuulasmaa, Kari; Sans, Susana; Olsen, Michael H

    2012-11-01

    This study investigates age-related shifts in the relative importance of systolic (SBP) and diastolic (DBP) blood pressures as predictors of stroke and whether these relations are influenced by other cardiovascular risk factors. Using 34 European cohorts from the MOnica, Risk, Genetics, Archiving, and Monograph (MORGAM) Project with baseline between 1982 and 1997, 68 551 subjects aged 19 to 78 years, without cardiovascular disease and not receiving antihypertensive treatment, were included. During a mean of 13.2 years of follow-up, stroke incidence was 2.8%. Stroke risk was analyzed using hazard ratios per 10-mm Hg/5-mm Hg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, DBP was analyzed separately for DBP ≥ 71 mm Hg and DBP <71 mm Hg. Stroke risk was associated positively with SBP and DBP ≥ 71 mm Hg (SBP/DBP ≥ 71 mm Hg; hazard ratios: 1.15/1.06 [95% CI: 1.12-1.18/1.03-1.09]) and negatively with DBP <71 mm Hg (0.88[0.79-0.98]). The hazard ratio for DBP decreased with age (P<0.001) and was not influenced by other cardiovascular risk factors. Taking into account the age × DBP interaction, both SBP and DBP ≥ 71 mm Hg were significantly associated with stroke risk until age 62 years, but in subjects older than 46 years the superiority of SBP for stroke risk exceeded that of DBP ≥ 71 mm Hg and remained significant until age 78 years. DBP <71 mm Hg became significant at age 50 years with an inverse relation to stroke risk. In Europeans, stroke risk should be assessed by both SBP and DBP until age 62 years with increased focus on SBP from age 47 years. From age 62 years, emphasis should be on SBP without neglecting the potential harm of very low DBP.

  1. Blood amyloid beta levels in healthy, mild cognitive impairment and Alzheimer's disease individuals: replication of diastolic blood pressure correlations and analysis of critical covariates.

    Directory of Open Access Journals (Sweden)

    Agustín Ruiz

    Full Text Available Plasma amyloid beta (Aβ levels are being investigated as potential biomarkers for Alzheimer's disease. In AB128 cross-sectional study, a number of medical relevant correlates of blood Aβ40 or Aβ42 were analyzed in 140 subjects (51 Alzheimer's disease patients, 53 healthy controls and 36 individuals diagnosed with mild cognitive impairment. We determined the association between multiple variables with Aβ40 and Aβ42 levels measured in three different blood compartments called i Aβ directly accessible (DA in the plasma, ii Aβ recovered from the plasma matrix (RP after diluting the plasma sample in a formulated buffer, and iii associated with the remaining cellular pellet (CP. We confirmed that diastolic blood pressure (DBP is consistently correlated with blood DA Aβ40 levels (r=-0.19, P=0.032. These results were consistent in the three phenotypic groups studied. Importantly, the observation resisted covariation with age, gender or creatinine levels. Observed effect size and direction of Aβ40 levels/DBP correlation are in accordance with previous reports. Of note, DA Aβ40 and the RP Aβ40 were also strongly associated with creatinine levels (r=0.599, P<<0.001 and to a lesser extent to urea, age, hematocrit, uric acid and homocysteine (p<0.001. DBP and the rest of statistical significant correlates identified should be considered as potential confounder factors in studies investigating blood Aβ levels as potential AD biomarker. Remarkably, the factors affecting Aβ levels in plasma (DA, RP and blood cell compartments (CP seem completely different.

  2. 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...

  3. 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

    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...

  4. Arterial blood-pressure change and endogenous circulating substance P in man

    DEFF Research Database (Denmark)

    Henriksen, J H; Kastrup, J; Schaffalitzky De Muckadell, O B

    1985-01-01

    Substance P (SP) is a powerful vasodilator and this peptide is today considered to be a chemical messenger. The potential effects on circulating SP of acute changes in arterial blood-pressure was investigated in nine subjects. An increase in arterial mean blood-pressure (+33%, P less than 0.001, ...

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

    DEFF Research Database (Denmark)

    Arvedsen, Sine K.; Eiken, Ola; Kölegård, Roger;

    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 (18-41yr), brachial arterial pressure, heart rate (HR) and cardiac output were measured during +2G...

  6. Phytoestrogen genistein decreases contractile response of aortic artery in vitro and arterial blood pressure in vivo

    Institute of Scientific and Technical Information of China (English)

    Hong-fang LI; Long-de WANG; Song-yi QU

    2004-01-01

    AIM: To determine the mechanisms of effects of phytoestrogen genistein on the contracted rabbit aortic arteries in vitro, and observe the effect of genistein and 17-β estradiol on mean arterial pressure (MAP) in ovariectomized (OVX) rats. METHODS: (1) Strips of rabbit aortic smooth muscle were suspended in organ baths containing Kreb's solution, and then isometric tension was measured. (2) Female mature Wistar rats underwent a bilateral ovariectomy (OVX). Sham-operated rats (SHAM) were used as controls. After administration of genistein (0.4(1) Similar to 17-β estradiol, genistein could dose-dependently relax 40 mmol/L KCl-precontracted arterial strips.Incubation with Nω-L-nitro-arginine (L-NNA), methylene blue (MB), indomethacin, propranolol or endothelium removal did not affect relaxation induced by genistein. In calcium-free solution containing 0.01mmol/L egtazic acid (EGTA), genistein inhibited not only the first phase contraction induced by noradrenaline (NA), but also the second contraction induced by CaCl2. In addition, genistein could reduce the contractile responses of NA, KCl and CaCl2,and shift their cumulative concentration-response curves rightward. (2) MAP in OVX rats was significantly higher compared with that of SHAM rats. However, after chronically treatment with genistein or 17-β estradiol for 21 d the baseline MAP in OVX rats was reduced significantly. CONCLUSIONS: (1) The vasodilator effect of genistein in vitro is endothelium independent and not related to the nitric oxide, its mechanisms being probably due to inhibition of Ca2+ influx through calcium channels in a noncompetitive manner and Ca2+ release from intracellular store induced by NA. (2) Administration of genistein or 17-β estradiol can chronically decrease MAP in OVX rats.

  7. Variation of left ventricular diastolic function indexes in coronary artery disease during dobutamine stress echocardiography%多巴酚丁胺负荷试验中冠心病患者左室舒张功能的参数变化

    Institute of Scientific and Technical Information of China (English)

    吴巧英; 钱蕴秋; 张军; 周晓东; 朱永胜; 李楠; 李寰

    2001-01-01

    目的:探讨多巴酚丁胺负荷试验中左室舒张功能的参数变化及其在冠心病诊断中的意义。方法:对18例正常人和30例冠心病患者进行多巴酚丁胺负荷超声心动图检查,分析比较静息状态与峰值负荷状态下两组左室舒张功能各参数的变化情况。结果:多巴酚丁胺负荷后,两组心率、收缩压均明显增加,组间比较有明显差异;左室舒张早期峰值血流速度(E)和左室舒张早期血流传播速度(RFP)在对照组表现为增加,在冠心病组为减低;冠心病组出现局部室壁运动异常(RWMA)25例,对照组有1例出现RWMA。结论:多巴酚丁胺负荷试验中左室舒张功能的参数变化是反映冠心病心肌缺血的敏感指标,可为冠心病诊断提供有力帮助。%AIM:To investigate the variation of left ventricular diastolic function indexes during dobutamine stress echocardiography. METHODS:Changes of left ventricular diastolic function indexes were observed in 18 normal subjects and 30 patients with coronary artery stenosis. RESULTS:In both groups dobutamine induced similar increases in heart rate and systolic blood pressure;dobutamine caused increases in control subjects and decreases in patients in peak early filling velocity(E) and rate of flow propagation (RFP);during the test,25 patients had wall motion abnormalities,and ischemia occurred to one of the control subjects. CONCLUSION:During dobutamine stress test,an abnormal response of left ventricular diastolic function is a sensitive index for myocardial ischemia and of high value in detecting coronary artery diseases.

  8. Percutaneous transluminal renal angioplasty with stent is effective for blood pressure control and renal function improvement in atherosclerotic renal artery stenosis patients

    Institute of Scientific and Technical Information of China (English)

    LIAO Chuan-jun; YANG Bao-zhong; WANG Zhong-gao

    2012-01-01

    Background Percutaneous transluminal renal angioplasty with stent is an effective procedure for atherosclerotic renal artery stenosis.However,the decision to perform this procedure has recently raised considerable debate.The aim of this study was to assess the effects of percutaneous transluminal renal angioplasty with stent in atherosclerotic renal artery stenosis patients,especially as it relates to blood pressure control and renal function improvement.Methods A retrospective analysis was made of the clinical data from 125 atherosclerotic renal artery stenosis patients who underwent percutaneous transluminal renal angioplasty from July 2004 to June 2008 in the Department of Vascular Surgery of Beijing Chaoyang Hospital.We compared blood pressure,number of oral antihypertensive medications,and renal function changes pre and post-procedure at 24 months follow-up.Results A total of 125 atherosclerotic renal artery stenosis patients underwent percutaneous transluminal renal angioplasty and 143 stents were placed.At 24 months follow-up,both systolic and diastolic blood pressure and the number of oral antihypertensive medications were significantly reduced (P <0.05).Overall,the estimated glomerular filtration rate did not change significantly (P >0.05); however,a significant increase in estimated glomerular filtration rate was observed in the subgroup of patients with a lower baseline estimated glomerular filtration rate and in the subgroup of patients with bilateral renal artery stenosis (P <0.05).Conclusion Percutaneous transluminal renal angioplasty is a safe procedure for atherosclerotic renal artery stenosis patients,providing a significant improvement in blood pressure control and reduction in the number of oral antihypertensive medications.

  9. [Pulmonary artery wedge pressure and heart rate measurement during pharmacological stress induction for left cardial function diagnosis in horses with and without heart disease].

    Science.gov (United States)

    Gehlen, H; Groner, U; Rohn, K; Stadler, P

    2006-07-01

    diastole (p = 0.001) between healthy horses and horses with heart diseases. All horses showed a positive correlation between the pulmonary artery wedge pressure and the left atrial size (r = 0.8), as well as between the left ventricular systolic (r = 0.6) and the diastolic diameter (r = 0.6). The correlation between the pulmonary artery wedge pressure and the left atrial size was nearly the same in the healthy horses (r = 0.74) and in the horses with heart diseases (r = 0.76). Regarding the training level, all untrained horses had a significantly higher correlation between the pulmonary artery wedge pressure and the left atrial size (r = 0.87) in comparison to the trained horses (r = 0.74). Particularly in the untrained horses with heart diseases, this correlation was remarcable (r = 0.99).

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

    Institute of Scientific and Technical Information of China (English)

    Sang-Hyun Ihm; Hui-Kyung Jeon; Shung Chull Chae; Do-Sun Lim; Kee-Sik Kim; Dong-Ju Choi; Jong-Won Ha

    2013-01-01

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

  11. DIASTOLIC DYSFUNCTION: A REVIEW

    Directory of Open Access Journals (Sweden)

    Rajat

    2016-01-01

    Full Text Available INTRODUCTION Diastolic heart failure is an underestimated pathology. Epidemiological and clinical studies suggest that HF with a preserved ejection fraction will become the more common form of HF which clinicians will encounter. Symptomatic treatment focuses on the reduction in pulmonary congestion and the improvement in LV filling. Specific treatment is actually lacking, but encouraging data are emerging concerning the use of renin–angiotensin–aldosterone axis blockers, nitric oxide donors, or, very recently, new agents specifically targeting actin–myosin cross-bridges. It is generally considered to have a somewhat better prognosis than systolic HF, but frequency of hospitalizations is comparable in systolic and diastolic HF. 1 Despite the recognition of its importance, definition and diagnostic criteria of diastolic dysfunction and diastolic HF remain controversial. AIMS AND OBJECTIVES This review focus of definition, diagnosis and management of diastolic heart failure with it prognosis. MATERIAL AND METHODS We have studied various guidelines, articles, reviews using given keywords, along with our experience in management of diastolic heart failure in 2015. The articles and the references were reviewed keeping in mind about the simplified management offered to the patient.

  12. Low frequency component in systolic arterial pressure variability in patients with persistent atrial fibrillation.

    Science.gov (United States)

    Mainardi, Luca; Corino, Valentina; Belletti, Sebastiano; Terranova, Paolo; Lombardi, Federico

    2009-12-03

    Atrial fibrillation (AF) is a common arrhythmia characterized by irregular ventricular response. During AF, beat-to-beat variability of arterial pressure (AP) is increased because of continuous changes in filling time, stroke volume and contractility. Only a few studies have analyzed short-term AP variability during AF but they were mainly focused on the effects of respiration. We therefore analyzed short-term systolic (S), diastolic (D) and mean (M) AP variability by autoregressive method and an FFT-based spectral estimation (Welch periodogram) in 26 patients with persistent AF before and after restoration of sinus rhythm by electrical cardioversion. A low frequency (LF) component (central frequency 0.07+/-0.02 Hz, mean+/-standard deviation) of SAP variability was observed in 23 out of 26 patients during AF. Frequency analysis of DAP and MAP also showed a LF component with a central frequency of 0.08+/-0.03 Hz (20 patients) and 0.07+/-0.03 Hz (25 patients), respectively. After recovery of sinus rhythm, we found significant reduction in mean SAP, DAP and MAP variability in all frequency bands. Squared coherence between SAP and heart rate variability after recovery of sinus rhythm revealed a weak and strong coupling within, respectively, LF and HF frequency bands. These data indicate that in patients with AF, in spite of an absence of rhythmical oscillation in RR interval time series, it is possible to observe a LF component in SAP, DAP and MAP variability signals. These 0.1 Hz fluctuations reflect the influence of the sympathetic fibres acting on the cardiovascular system.

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

    Directory of Open Access Journals (Sweden)

    Đorđević Dragan

    2008-01-01

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

  14. Blood pressure and arterial stiffness in obese children and adolescents.

    Science.gov (United States)

    Hvidt, Kristian Nebelin

    2015-03-01

    Obesity, elevated blood pressure (BP) and arterial stiffness are risk factors for cardiovascular disease. A strong relationship exists between obesity and elevated BP in both children and adults. Obesity and elevated BP in childhood track into adult life increasing the risk of cardiovascular disease in adulthood. Ambulatory BP is the most precise measure to evaluate the BP burden, whereas carotid-femoral pulse wave velocity (cfPWV) is regarded as the gold standard for evaluating arterial (i.e. aortic) stiffness. These measures might contribute to a better understanding of obesity's adverse impact on the cardiovascular system, and ultimately a better prevention and treatment of childhood obesity. The overall aim of the present PhD thesis is to investigate arterial stiffness and 24-hour BP in obese children and adolescents, and evaluate whether these measures are influenced by weight reduction. The present PhD thesis is based on four scientific papers.  In a cross-sectional design, 104 severe obese children and adolescents with an age of 10-18 years were recruited when newly referred to the Children's Obesity Clinic, Holbæk University Hospital, and compared to 50 normal weighted age and gender matched control individuals. Ambulatory BP was measured, and cfPWV was investigated in two ways in respect to the distance measure of aorta; the previously recommended length - the so called subtracted distance, and the currently recommended length - the direct distance. In a longitudinal design, the obese patients were re-investigated after one-year of lifestyle intervention at the Children's Obesity Clinic in purpose of reducing the degree of obesity. In the cross-sectional design, the obese group had higher measures of obesity, while matched for age, gender and height, when compared to the control group. In the longitudinal design, 74% of the 72 followed up obese patients experienced a significant weight reduction. CfPWV was dependent on the method used to measure the

  15. NONLINEAR DYNAMICS MODFLING OF MECHANICAL PERIODICITY OF END DIASTOLIC VOLUME OF LEFT VENTRICLE

    Institute of Scientific and Technical Information of China (English)

    许世雄; 毛晓春

    2001-01-01

    The cardiovascular system with a lumped parameter model is treated, in which the Starling model is used to simulate left ventricle and the four-element Burattini & Gnudi model is used in the description of arterial system. Moreover, the feedback action of arterial pressure on cardiac cycle is taken into account. The phenomenon of mechanical periodicity (MP) of end diastolic volume (EDV) of left ventricle is successfully simulated by solving a series of one-dimensional discrete nonlinear dynamical equations. The effects of cardiovascular parameters on MP is also discussed.

  16. Mean arterial pressure following prolonged exercise in the heat

    DEFF Research Database (Denmark)

    Gagnon, D; Lynn, A G; Binder, K

    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......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.......36 °C, P = 0.941) and body weight losses (T: 3.4 ± 1.2% vs UT: 2.7 ± 0.9%, P = 0.332), which did not differ between groups. Although MAP was equally reduced 5 min into the post-exercise period of DEHY (T: -20 ± 11 mmHg vs UT: -22 ± 13 mmHg, P = 0.800), its subsequent recovery was significantly different...

  17. 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.

  18. 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.;

    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...

  19. Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

    DEFF Research Database (Denmark)

    Henriksen, J H; Fuglsang, Stefan; Bendtsen, Flemming;

    2001-01-01

    Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40...... predictors of SV/PP (P index seems to reflect abnormalities in the arterial compliance of these patients....

  20. Validation of continuous noninvasive arterial blood pressure measurements during general anesthesia

    NARCIS (Netherlands)

    Kalmar, A.F.; Vos, Jaap Jan; Weening, M.; Mooyaart, E.A.; Poterman, Marieke; Struys, Michel; Scheeren, Thomas

    2012-01-01

    Background:  Continuous invasive arterial blood pressure (IBP) monitoring remains the accepted gold standard for blood pressure monitoring because of its high accuracy. Several disadvantages of this method motivate the use of noninvasive intermittent blood pressure (NIBP) in most anesthesia cases de

  1. 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;

    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...

  2. 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 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.

  3. 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;

    2004-01-01

    in 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 decreased...

  4. Effects of three days of dry immersion on muscle sympathetic nerve activity and arterial blood pressure in humans.

    Science.gov (United States)

    Iwase, S; Sugiyama, Y; Miwa, C; Kamiya, A; Mano, T; Ohira, Y; Shenkman, B; Egorov, A I; Kozlovskaya, I B

    2000-03-15

    The present study was performed to determine how sympathetic function is altered by simulated microgravity, dry immersion for 3 days, and to elucidate the mechanism of post-spaceflight orthostatic intolerance in humans. Six healthy men aged 21-36 years old participated in the study. Before and after the dry immersion, subjects performed head-up tilt (HUT) test to 30 degrees and 60 degrees (5 min each) with recordings of muscle sympathetic nerve activity (MSNA, by microneurography), electrocardiogram, and arterial blood pressure (Finapres). Resting MSNA was increased after dry immersion from 23.7+/-3.2 to 40.9+/-3.0 bursts/min (p<0.005) without significant changes in resting heart rate (HR). MSNA responsiveness to orthostasis showed no significant difference but HR response was significantly augmented after dry immersion (p<0. 005). A significant diastolic blood pressure fall at 5th min of 60 degrees HUT was observed in five orthostatic tolerant subjects despite enough MSNA discharge after dry immersion. A subject suffered from presyncope at 2 min after 60 degrees HUT. He showed gradual blood pressure fall 10 s after 60 degrees HUT with initially well-maintained MSNA response and then with a gradually attenuated MSNA, followed by a sudden MSNA withdrawal and abrupt blood pressure drop. In conclusion, dry immersion increased MSNA without changing MSNA response to orthostasis, and resting HR, while increasing the HR response to orthostasis. Analyses of MSNA and blood pressure changes in orthostatic tolerant subjects and a subject with presyncope suggested that not only insufficient vasoconstriction to sympathetic stimuli, but also a central mechanism to induce a sympathetic withdrawal might play a role in the development of orthostatic intolerance after microgravity exposure.

  5. Diastolic dysfunction in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiese, Signe; Halgreen, Hanne;

    2016-01-01

    between DD and the severity of liver dysfunction and the presence of ascites. After liver transplantation, DD worsens the prognosis and increases the risk of graft rejection, but DD improves after few months. Insertion of a transjugular intrahepatic portosystemic shunt increases left ventricular diastolic...

  6. 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.

  7. Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects

    Directory of Open Access Journals (Sweden)

    Galderisi Maurizio

    2005-04-01

    Full Text Available Abstract Left ventricular (LV diastolic dysfunction (DD and diastolic heart failure (HF, that is symptomatic DD, are due to alterations of myocardial diastolic properties. These alterations involve relaxation and/or filling and/or distensibility. Arterial hypertension associated to LV concentric remodelling is the main determinant of DD but several other cardiac diseases, including myocardial ischemia, and extra-cardiac pathologies involving the heart are other possible causes. In the majority of the studies, isolated diastolic HF has been made equal to HF with preserved systolic function (= normal ejection fraction but the true definition of this condition needs a quantitative estimation of LV diastolic properties. According to the position of the European Society of Cardiology and subsequent research refinements the use of Doppler echocardiography (transmitral inflow and pulmonary venous flow and the new ultrasound tools has to be encouraged for diagnosis of DD. In relation to uncertain definitions, both prevalence and prognosis of diastolic heart failure are very variable. Despite an apparent lower death rate in comparison with LV systolic HF, long-term follow-up (more than 5 years show similar mortality between the two kinds of HF. Recent studies performed by Doppler diastolic indexes have identified the prognostic power of both transmitral E/A ratio 1.5 (restrictive patterns. The therapy of LV DD and HF is not well established but ACE-inhibitors, angiotensin inhibitors, aldosterone antagonists and β-blockers show potential beneficial effect on diastolic properties. Several trials, completed or ongoing, have been planned to treat DD and diastolic HF.

  8. Non-invasive assessment of pulmonary arterial pressure in healthy neonates.

    OpenAIRE

    Skinner, J. R.; Boys, R J; Hunter, S; Hey, E N

    1991-01-01

    Doppler echocardiograms were carried out on 51 healthy babies three times during the first 72 hours of life to estimate pulmonary arterial systolic pressure by measuring regurgitant tricuspid jet velocity and applying the Bernoulli equation. Tricuspid regurgitation was detected at some stage in all preterm babies and most of those born at full term. Pulmonary arterial pressure could be measured from peak regurgitant velocity in babies with pansystolic regurgitation. The incidence of pansystol...

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

    Energy Technology Data Exchange (ETDEWEB)

    Manning, R.D. Jr.

    1987-01-01

    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 (/sup 125/I)iothalamate and (/sup 131/I)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.

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

    OpenAIRE

    Della Rocca, Giorgio; Cecconi, Maurizio; Costa, Maria Gabriella

    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...

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

    Directory of Open Access Journals (Sweden)

    Ayslan Jorge Santos de Araujo

    2013-04-01

    -NAME (40 mg/Kg to the drinking water for four weeks. Arterial pressure was evaluated before and after RT. RT was performed using 50% of 1RM, 3 sets of 10 repetitions, 3 times per week for four weeks. Vascular reactivity was measured in rat mesenteric artery rings by concentration-response curves to sodium nitroprusside (SNP; phenylephrine (PHE was also used for histological and stereological analysis. RESULTS: Resistance training inhibited the increase in mean and diastolic arterial pressures. Significant reduction was observed in Rmax (maximal response and pD2 (potency of PHE between SH and TH groups. Arteries demonstrated normal intima, media and adventitia layers in all groups. Stereological analysis demonstrated no significant difference in luminal, tunica media, and total areas of arteries in the SH and TH groups when compared to the SN group. Wall-to-lumen ratio of SH arteries was significantly different compared to SN arteries (p<0.05 but there was no difference when compared to TH arteries. CONCLUSIONS: RT was able to prevent an increase in blood pressure under the conditions in this study. This appears to involve a vasoconstrictor regulation mechanism and maintenance of luminal diameter in L-NAME induced hypertensive rats.

  12. 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

    kept at 10 mmHg during elevation. In these patients, the increase in vascular resistance was significantly less compared with the situation in which venous pressure was 0 mmHg during elevation. The arterial pressure still did not decrease. It is concluded that perfusion pressure in the ischaemic lower......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...

  13. A comparison of the indirect estimate of mean arterial pressure calculated by the conventional equation and calculated to compensate for a change in heart rate.

    Science.gov (United States)

    Rogers, G; Oosthuyse, T

    2000-02-01

    The standard equation used to calculate mean arterial pressure (MAP) assumes that diastole persists for 2/3 and systole for 1/3 of each cardiac cycle. This ratio is altered when heart rate increases, and therefore we investigated the efficacy of predicting MAP during exercise using non-invasive indirect methods. Eight subjects exercised on a cycle ergometer for 3 minute intervals to elicit heart rates between 100-110, 120-130, 140-150, 160-170, and 180-190 beats/min. In the last minute of each 3 min interval an ECG recording was taken and systolic (SP) and diastolic (DP) blood pressure was measured by manual auscultation. MAP was calculated for each heart rate interval by: MAP=DP+1/3(SP-DP) (method A), and MAP= DP + Fs(SP- DP) (method B), where Fs is the fraction of the cardiac cycle comprising systole, measured from the ECG. Fs increased from 0.35+/-0.049 at rest to 0.47+/-0.039 at a heart rate of 180-190 beats/min. MAP measured by method B was consistently greater than MAP calculated by method A at all heart rates greater than resting heart rate (pequation (method A) to derive MAP during exercise (measured as the percentage difference between method A and B) increased linearly with heart rate (r=0.98). The standard MAP equation should not be applied during exercise, as it does not account for the change in the systolic: diastolic period ratio as heart rate increases.

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

    Directory of Open Access Journals (Sweden)

    Polyana Carina Viana da Silva

    2010-01-01

    blood pressure of adolescents in private schools in the city of Fortaleza-CE. METHODS: This is a cross-sectional and quantitative study in which 794 adolescents were surveyed - between 12 and 17 years of age - from 14 private schools of that city, in the period from March to September 2007. It was used a questionnaire that contemplated the following characteristics: socio-demographic, blood pressure, body mass index (BMI, physical activity and capillary glucose. RESULTS: It was found that 19.7% of young people had high blood pressure. The male participants had systolic blood pressure (SBP and diastolic blood pressure (DBP higher than females (p=0.0001. The investigation found higher values of SBP and DBP in those who were overweight (p=0.0001. CONCLUSION: The blood pressure was influenced mainly by gender and BMI.

  15. A longitudinal study of arterial blood pressure in chronic haemodialysis patients with different levels of plasma renin concentration.

    Science.gov (United States)

    Kornerup, H J; Fredsted, B; Pedersen, R S

    1978-01-01

    The purpose of the study was to examine the value of regular measurements of plasma renin concentration (PRC) in selecting those chronic haemodialysis patients suitable for bilateral nephrectomy to prevent development of uncontrollable hypertension. Regular measurements of arterial blood pressure (BP) and PRC were performed during one year in 31 patients undergoing regular haemodialysis because of end-stage renal disease. Among 18 patients with PRC greater than or equal to 100 micro Goldblatt units per ml plasma (microGU/ml) systolic and/or diastolic hypertension persisted or developed in 12. In contrast, among 13 patients with PRC greater than 100microGU/ml, BP became normal in all but one, who had a slightly increased systolic BP. However, hypertension was mild and easily controlled by conventional therapy in all except one, who probably had an overlying volume-dependent hypertension. Therefore, bilateral nephrectomy was not necessary in any case. The results indicate that hypertension in the majority of chronic haemodialysis patients with high PRC can be adequately controlled without surgical intervention and that regular measurements of PRC have no practical value in forecasting the development of uncontrollable hypertension in chronic haemodialysis patients.

  16. Fluid input control in burned patients with the aid of ultrasonic arterial blood pressure monitoring.

    Science.gov (United States)

    Banssillon, V; Latarjet, J

    1975-01-01

    Arterial blood pressure is nowadays easily and reliably measured with ultrasonic equipment. It correlates well with blood volume, and may therefore be used to guide fluid infusion in burned patients. Monitoring of blood pressure, instead of application of old-fashioned recipes, helps to avoid dangerous situations of hypovolemia or overload.

  17. 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...... artery (CCA) blood pressure (ICA/CCA pressure ratio). The latter was determined during surgery. All three waveform parameters were significantly correlated with the ICA/CCA pressure ratio when calculated from the mean frequency curve (p less than 0.001). A reduction in ICA pressure of 20% could...

  18. 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.

  19. 柚皮素舒张大鼠肾动脉及其机制研究%Study on naringenin for renal artery diastole in rats and its mechanisms

    Institute of Scientific and Technical Information of China (English)

    侯晓敏; 秦小江

    2014-01-01

    Obj ective:To probe into the vasodilation effect of naringenin for rat renal artery rings and its mechanism.Methods:DMT capillary tension recorder and Powerlab tension transducer were used to record its changes of tension.The renal artery rings received pre contraction treatment with potassium chloride (60 mmol/L)or phenylephrine (10-5 mol/L)reached to the platform,and the concentration dependent vaso-dilation was implemented in the renal arteries by using naringenin (10-6 mol/L~10-4 mol/L),then to measure the vasodilation percentage of pre contracted renal artery.Before and after naringenin pre incubation (selected concentration was RC50 values calculated in diastole experi-ments )contraction amplitude changes of the renal arteries were ob-served after treatment with 60 mmol/L KCl or 10-5 mol/L phenyleph-rine.After potassium chloride or phenylephrine were used for pre con-striction of renal artery up to the platform,and incubation reached the platform with Kir channel inhibitor barium chloride (BaCl2 10-4 mol/L) and KCa channel inhibitor tetraethylammonium (TEA,10-3 mol/L)for 1 5 min,then in turn the different concentrations of naringenin (1 0-6 mol/L~1 0-4 mol/L)was added for relaxing the renal artery and then to observe the influence of BaCl2 and TEA on vasodilation of renal artery by naringenin.Results:Naringenin within 1 0-6 mol/L~1 0-4 mol/L had a concentration dependent vasodilation for KCl or phenylephrine pre constricted isolated rat renal artery rings;naringenin incubation in ad-vance can reduce contraction amplitude of rat kidney artery rings by KCl or phenylephrine to some extent,and it decreased by (53.10±2.43)%and (46.39±3.24)% respectively;Kir channel inhibitor barium chloride (1 0-4 mol/L)didn’t have significant influence on vasodilation effect of naringenin for 60 mmol/L KCl or 10-5 mol/L phenylephrine pre con-stricted renal artery rings,and KCa channel inhibitor tetraethylammoni-um (TEA,10-3 mol/L)had a certain degree of inhibition for maximum

  20. Effect of treatment temperature on collagen structures of the decellularized carotid artery using high hydrostatic pressure.

    Science.gov (United States)

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

    2011-09-01

    Decellularized tissues have attracted a great deal of attention as regenerating transplantation materials. A decellularizing method based on high hydrostatic pressure (HHP) has been developed, and the preparation of many types of decellularized tissues has been investigated, including aorta, cornea, and dermis. The preparation of a small-diameter vascular graft was studied using a carotid artery from the viewpoint of collagen denaturation and leakage. After HHP, the carotid artery was washed at two washing temperatures (37 and 4°C). Histological evaluation, collagen content measurement and circular dichroism (CD) measurement indicated that the washing temperatures clearly affected the collagen structure of the decellularized carotid artery. The amount of collagen decreased in the carotid artery decellularized by HHP washed at 37°C (HHP/37°C). On the other hand, the amount and structure of collagen were preserved in the carotid artery washed at 4°C after HHP (HHP/4°C). In rat carotid artery syngeneic transplantation, the HHP/37°C decellularized carotid artery occluded after 2 weeks, but the HHP/4°C decellularized one did not. These results indicate that collagen denaturation and leakage of the decellularized carotid artery affect the in vivo performance of the carotid artery.

  1. A computational analysis of the long-term regulation of arterial pressure.

    Science.gov (United States)

    Beard, Daniel A; Pettersen, Klas H; Carlson, Brian E; Omholt, Stig W; Bugenhagen, Scott M

    2013-01-01

    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.

  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

    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 (cfPWV). RESULTS...... analyses, the higher nighttime BP in the obese group was independent of logHOMA and cfPWV. CONCLUSIONS: Obese children had a higher nighttime BP when compared with the control group independently of insulin resistance and arterial stiffness. No relationship was found between insulin resistance and arterial...

  3. Effect of coronary occlusion during percutaneous transluminal angioplasty in humans on left ventricular chamber stiffness and regional diastolic pressure-radius relations

    NARCIS (Netherlands)

    W. Wijns (William); P.W.J.C. Serruys (Patrick); C.J. Slager (Cornelis); J. Grimm; H.P. Krayenbuehl; P.G. Hugenholtz (Paul); O.M. Hess (Otto)

    1986-01-01

    textabstractThe effect of repeated (3 to 10 second) and transient (15 to 75 second) abrupt coronary occlusion on the global and regional chamber stiffness was studied in nine patients undergoing angioplasty of a single proximal left anterior descending coronary artery stenosis. The left ventricular

  4. Arterial dysfunction but maintained systemic blood pressure in cavin-1-deficient mice.

    Directory of Open Access Journals (Sweden)

    Karl Swärd

    Full Text Available Caveolae are omega-shaped plasma membrane micro-domains that are abundant in cells of the vascular system. Formation of caveolae depends on caveolin-1 and cavin-1 and lack of either protein leads to loss of caveolae. Mice with caveolin-1 deficiency have dysfunctional blood vessels, but whether absence of cavin-1 similarly leads to vascular dysfunction is not known. Here we addressed this hypothesis using small mesenteric arteries from cavin-1-deficient mice. Cavin-1-reporter staining was intense in mesenteric arteries, brain arterioles and elsewhere in the vascular system, with positive staining of both endothelial and smooth muscle cells. Arterial expression of cavin-1, -2 and -3 was reduced in knockout (KO arteries as was expression of caveolin-1, -2 and -3. Caveolae were absent in the endothelial and smooth muscle layers of small mesenteric arteries as determined by electron microscopy. Arginase, a negative regulator of nitric oxide production, was elevated in cavin-1 deficient arteries as was contraction in response to the α1-adrenergic agonist cirazoline. Detailed assessment of vascular dimensions revealed increased media thickness and reduced distensibility, arguing that enhanced contraction was due to increased muscle mass. Contrasting with increased α1-adrenergic contraction, myogenic tone was essentially absent and this appeared to be due in part to increased nitric oxide production. Vasomotion was less frequent in the knock-out vessels. In keeping with the opposing influences on arterial resistance of increased agonist-induced contractility and reduced myogenic tone, arterial blood pressure was unchanged in vivo. We conclude that deficiency of cavin-1 affects the function of small arteries, but that opposing influences on arterial resistance balance each other such that systemic blood pressure in unstressed mice is well maintained.

  5. Increased concentration of serum TNF alpha and its correlations with arterial blood pressure and indices of renal damage in dogs infected with Babesia canis.

    Science.gov (United States)

    Zygner, Wojciech; Gójska-Zygner, Olga; Bąska, Piotr; Długosz, Ewa

    2014-04-01

    Canine babesiosis is a tick-borne disease caused by parasites of the genus Babesia. Tumour necrosis factor alpha (TNF-α) is a cytokine that plays a role in the pathogenesis of canine babesiosis. In this study, the authors determined the concentration of serum TNF-α in 11 dogs infected with Babesia canis and calculated Spearman's rank correlations between the concentration of TNF-α and blood pressure, and between TNF-α and indices of renal damage such as: fractional excretion of sodium (FE(Na(+))), urinary creatinine to serum creatinine ratio (UCr/SCr), renal failure index (RFI), urine specific gravity (USG) and urinary protein to urinary creatinine ratio (UPC). The results demonstrated statistically significant strong negative correlations between TNF-α and systolic arterial pressure (r = -0.7246), diastolic arterial pressure (r = -0.6642) and mean arterial pressure (r = -0.7151). Serum TNF-α concentration was also statistically significantly correlated with FE(Na(+)) (r = 0.7056), UCr/SCr (r = -0.8199), USG (r = -0.8075) and duration of the disease (r = 0.6767). The results of this study show there is an increase of serum TNF-α concentration during canine babesiosis, and the increased TNF-α concentration has an influence on the development of hypotension and renal failure in canine babesiosis. This probably results from the fact that TNF-α is involved in the production of nitric oxide and induction of vasodilation and hypotension, which may cause renal ischaemia and hypoxia, and finally acute tubular necrosis and renal failure.

  6. 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.

  7. Advanced glycation end-products, anti-hypertensive treatment and diastolic function in patients with hypertension and diastolic dysfunction

    NARCIS (Netherlands)

    Hartog, Jasper W. L.; van de Wal, Ruud M.; Schalkwijk, Casper G.; Miyata, Toshio; Jaarsma, Wybren; Plokker, H. W. Thijs; van Wijk, Leen M.; Smit, Andries J.; van Veldhuisen, Dirk J.; Voors, Adriaan A.

    2010-01-01

    Aims To investigate the relationship between advanced glycation end-products (AGEs) and diastolic function and the response to blood pressure treatment in patients with hypertension and diastolic dysfunction. Methods and results Data were analysed from 97 patients (aged 65 +/- 10 years, 36% male) wh

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

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Aparecida Bronzo

    2012-08-01

    Full Text Available FUNDAMENTO: A felipressina foi adicionada ao anestésico local para aumentar a duração do efeito anestésico e reduzir a toxicidade nos procedimentos dentários. No entanto, o efeito sobre a pressão arterial é incerta, e isso pode ser altamente relevante no tratamento dentário de pacientes hipertensos. OBJETIVO: Investigar o efeito da felipressina sobre a pressão arterial em pacientes hipertensos com pressão arterial controlada. MÉTODOS: Foram estudados 71 indivíduos com essas características e com necessidade de tratamento periodontal. Após 10 minutos de repouso, a anestesia local (prilocaína foi infiltrada com e sem adição de felipressina. Em seguida, uma raspagem subgengival profunda foi realizada. A pressão arterial foi medida por um equipamento oscilométrico automático (DIXTAL DX2010. Dez minutos após a administração do anestésico, o pico de ação anestésica foi gravado. O Inventário de Ansiedade Traço-Estado (IDATE foi utilizado para avaliar o traço de ansiedade nos pacientes. RESULTADOS: A pressão arterial sistólica aumentou após a anestesia, independentemente da associação com felipressina, durante todo o procedimento dentário (p BACKGROUND: Felypressin has been added to local anesthetic to increase the length of the anesthetic effect and reduce toxicity during dental procedures. However, the effect on blood pressure remains uncertain, and this may be highly relevant in the dental treatment of hypertensive patients. OBJECTIVE: To investigate the effect of felypressin on blood pressure in hypertensive patients with controlled BP. METHODS: 71 subjects with these characteristics and in need of periodontal treatment were studied. After 10 minutes of rest, local anesthesia (prilocaine was infiltrated with and without addition of felypressin. Then, a deep subgingival scaling was performed. Blood pressure was measured by an automated oscillometric device (DIXTAL DX2010. Ten minutes after the administration of the

  9. 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

    2015-01-01

    BACKGROUND: The tallest animal on earth, the giraffe (Giraffa camelopardalis) is endowed with a mean arterial blood pressure (MAP) twice that of other mammals. The kidneys reside at heart level and show no sign of hypertension-related damage. We hypothesized that a species-specific evolutionary...... on body mass. A strong renal capsule supports a RIHP, which is >10-fold that of other mammals effectively reducing the net filtration pressure and protecting against the high MAP....... 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...

  10. ASSESSMENT OF THE CHANGES IN BLOOD PRESSURE CIRCADIAN PROFILE AND VARIABILITY IN PATIENTS WITH CHRONIC HEART FAILURE AND ARTERIAL HYPERTENSION DURING COMBINED THERAPY INCLUDING IVABRADINE

    Directory of Open Access Journals (Sweden)

    M. V. Surovtseva

    2015-12-01

    Full Text Available Aim. To assess the changes in blood pressure (BP circadian profile and variability in patients with chronic heart failure (CHF of ischemic etiology and arterial hypertension (HT due to the complex therapy including ivabradine. Material and methods. Patients (n=90 with CHF class II–III NYHA associated with stable angina II-III class and HT were examined. The patients were randomized into 3 groups depending on received drugs: perindopril and ivabradine - group 1; perindopril, bisoprolol and ivabradine - group 2; perindopril and bisoprolol - group 3. The duration of therapy was 6 months. Ambulatory BP monitoring (ABPM was assessed at baseline and after treatment. Results. More significant reduction in average 24-hours systolic BP was found in groups 1 and 2 compared to group 3 (Δ%: -19.4±0,4; -21.1±0.4 and -11.8±0.6, respectively as well as diastolic BP (Δ%: -10.6±0.6; -12.9±0.4 and -4,3±0.3, respectively and other ABPM indicators. Improvement of BP circadian rhythm was found due to increase in the number of «Dipper» patients (p=0.016. More significant reduction in average daily and night systolic and diastolic BP (p=0.001, as well as daily and night BP variability (p=0.001 was also found in patients of group 2 compared to these of group 1. Conclusion. Moderate antihypertensive effect (in respect of both diastolic and systolic BP was shown when ivabradine was included into the complex therapy of patients with ischemic CHF and HT. The effect was more pronounced when ivabradine was combined with perindopril and bisoprolol. This was accompanied by reduction in high BP daily variability and improvement of the BP circadian rhythm. 

  11. ASSESSMENT OF THE CHANGES IN BLOOD PRESSURE CIRCADIAN PROFILE AND VARIABILITY IN PATIENTS WITH CHRONIC HEART FAILURE AND ARTERIAL HYPERTENSION DURING COMBINED THERAPY INCLUDING IVABRADINE

    Directory of Open Access Journals (Sweden)

    M. V. Surovtseva

    2012-01-01

    Full Text Available Aim. To assess the changes in blood pressure (BP circadian profile and variability in patients with chronic heart failure (CHF of ischemic etiology and arterial hypertension (HT due to the complex therapy including ivabradine. Material and methods. Patients (n=90 with CHF class II–III NYHA associated with stable angina II-III class and HT were examined. The patients were randomized into 3 groups depending on received drugs: perindopril and ivabradine - group 1; perindopril, bisoprolol and ivabradine - group 2; perindopril and bisoprolol - group 3. The duration of therapy was 6 months. Ambulatory BP monitoring (ABPM was assessed at baseline and after treatment. Results. More significant reduction in average 24-hours systolic BP was found in groups 1 and 2 compared to group 3 (Δ%: -19.4±0,4; -21.1±0.4 and -11.8±0.6, respectively as well as diastolic BP (Δ%: -10.6±0.6; -12.9±0.4 and -4,3±0.3, respectively and other ABPM indicators. Improvement of BP circadian rhythm was found due to increase in the number of «Dipper» patients (p=0.016. More significant reduction in average daily and night systolic and diastolic BP (p=0.001, as well as daily and night BP variability (p=0.001 was also found in patients of group 2 compared to these of group 1. Conclusion. Moderate antihypertensive effect (in respect of both diastolic and systolic BP was shown when ivabradine was included into the complex therapy of patients with ischemic CHF and HT. The effect was more pronounced when ivabradine was combined with perindopril and bisoprolol. This was accompanied by reduction in high BP daily variability and improvement of the BP circadian rhythm. 

  12. Predictors of Subclinical Cardiovascular Disease in Women with Polycystic Ovary Syndrome: Interrelationship of Dyslipidemia and Arterial Blood Pressure

    Directory of Open Access Journals (Sweden)

    Djuro Macut

    2015-01-01

    Full Text Available Background. Women with polycystic ovary syndrome (PCOS could develop subclinical atherosclerosis during life. Purpose. To analyze cardiovascular risk (CVR factors and their relation to clinical markers of cardiovascular disease (CVD in respect to their age. Material and Methods. One hundred women with PCOS (26.32±5.26 years, BMI: 24.98±6.38 kg/m2 were compared to 50 respective controls. In all subjects, total cholesterol (TC, HDL-C, LDL-C, triglycerides, TC/HDL-C and TG/HDL-C ratios, glucose, insulin and HOMA index, waist-to-hip ratio (WHR, systolic and diastolic blood pressure (SBP and DBP, resp., and carotid intima-media thickness (CIMT were analyzed in respect to their age and level of androgens. Results. PCOS over 30 years had higher WHR (P=0.008, SBP (P<0.001, DBP (P<0.001, TC (P=0.028, HDL-C (P=0.028, LDL-C (P=0.045, triglycerides (P<0.001, TC/HDL-C (P<0.001, and triglycerides/HDL-C (P<0.001 and had more prevalent hypertension and pronounced CIMT on common carotid arteries even after adjustment for BMI (P=0.005 and 0.036, resp.. TC/HDL-C and TG/HDL-C were higher in PCOS with the highest quintile of FAI in comparison to those with lower FAI (P=0.045 and 0.034, resp.. Conclusions. PCOS women older than 30 years irrespective of BMI have the potential for early atherosclerosis mirrored through the elevated lipids/lipid ratios and through changes in blood pressure.

  13. Altered diastolic function and aortic stiffness in Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Çalık AN

    2014-07-01

    Full Text Available Ali Nazmi Çalik,3 Kazim Serhan Özcan,4 Gülbün Yüksel,2 Baris Güngör,1 Emre Arugarslan,1 Figen Varlibas,2 Ahmet Ekmekci,1 Damirbek Osmonov,1 Mustafa Adem Tatlisu,1 Mehmet Karaca,1 Osman Bolca,1 Izzet Erdinler1 1Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey; 2Department of Neurology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey; 3Department of Cardiology, Yozgat State Hospital, Yozgat, Turkey; 4Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey Background: Alzheimer’s disease (AD is closely linked to cardiovascular risk factors.Methods: Echocardiographic studies were performed, including left ventricular diastolic functions, left and right atrial conduction times, and arterial stiffness parameters, namely stiffness index, pressure-strain elastic modulus, and distensibility, on 29 patients with AD and 24 age-matched individuals with normal cognitive function.Results: The peak mitral flow velocity of the early rapid filling wave (E was lower, and the peak velocity of the late filling wave caused by atrial contraction (A, deceleration time of peak E velocity, and isovolumetric relaxation time were higher in the AD group. The early myocardial peak (Ea velocity was significantly lower in AD patients, whereas the late diastolic (Aa velocity and E/Ea ratio were similar between the two groups. In Alzheimer patients, stiffness index and pressure-strain elastic modulus were higher, and distensibility was significantly lower in the AD group compared to the control. Interatrial electromechanical delay was significantly longer in the AD group.Conclusion: Our findings suggest that patients with AD are more likely to have diastolic dysfunction, higher atrial conduction times, and increased arterial stiffness compared to the controls of same sex and similar age. Keywords: diastolic dysfunction, atrial conduction timeA Letter to the Editor has been

  14. Evaluation of restenosis, renal function and blood pressure after the renal artery stenting in patients with atherosclerosis renovascular disease

    Institute of Scientific and Technical Information of China (English)

    王焱

    2006-01-01

    Objective To evaluate the restenosis, renal function and blood pressure after renal artery stenting in patients with atherosclerosis renovascular disease. Methods Percutaneous renal artery stent (PTRAS) was performed in 135 patients with single or bilateral renal artery stenosis (≥70%). Clinical data of above patients were studied during follow-up period. Results A total of 147

  15. Verapamil COER-24 180/240mg na hipertensão arterial leve a moderada em dose única diária avaliado pela monitorização ambulatorial da pressão arterial Single daily dose of verapamil (COER-24 180/240mg in mild and moderate hypertension evaluated by ambulatory blood pressure monitoring

    Directory of Open Access Journals (Sweden)

    Katia Coelho Ortega

    2000-03-01

    Full Text Available OBJETIVO: Avaliar a eficácia terapêutica do verapamil COER-24 180/240 mg, em dose única, ao deitar, como monoterapia para a hipertensão arterial leve a moderada. MÉTODOS: Estudo multicêntrico, aberto, não comparativo com 81 pacientes de ambos os sexos, com idade >20 anos e hipertensão arterial essencial leve e moderada. Medimos a pressão arterial no consultório e com a monitorização ambulatorial (MAPA durante 24h antes e ao final de 8 semanas do uso da medicação. RESULTADOS: Verificou-se diminuição (pOBJECTIVE: To evaluate the anti-hypertensive effecft of verapamil COER-24 180/240 mg in a single dose at bedtime as single therapy in mild to moderate hypertensives. METHODS: A multicentric, open, placebo controlled study of 81 hypertensive patients older than 20 years-old followed to 8 weeks. Blood pressure was measured in doctor's office and by 24h ambulatory monitoring (ABPM. RESULTS: We observed a decreased in systolic and diastolic blood pressure in doctor's office at 4th and 8th weeks. ABPM showed that both systolic, diastolic and mean blood pressure, heart rate and the mean 24-hour blood pressure load decreased after the 8-week treatment. In addition, there was a reduction of the double-product, especially in the morning and 68% of the patients didn't have any adverse events. CONCLUSION: The theraphy verapamil COER-24 180/240mg in a single dose is useful for mild and moderate hypertensive patients, with significant pressure decrease in both office blood pressure measurements and in the ABPM/24 hours, as well as showing good tolerability.

  16. Energy harvesting from arterial blood pressure for powering embedded brain sensors

    Science.gov (United States)

    Nanda, Aditya; Karami, M. Amin

    2016-04-01

    This paper investigates energy harvesting from arterial blood pressure via the piezoelectric effect by using a novel streaked cylinder geometry for the purpose of powering embedded micro-sensors in the brain. Initially, we look at the energy harvested by a piezoelectric cylinder placed inside an artery acted upon by blood pressure. Such an arrangement would be tantamount to constructing a stent out of piezoelectric materials. A stent is a cylinder placed in veins and arteries to prevent obstruction in blood flow. The governing equations of a conductor coated piezoelectric cylinder are obtained using Hamilton's principle. Pressure acting in arteries is radially directed and this is used to simplify the modal analysis and obtain the transfer function relating pressure to the induced voltage across the surface of the harvester. The power harvested by the cylindrical harvester is obtained for different shunt resistances. Radially directed pressure occurs elsewhere and we also look at harvesting energy from oil flow in pipelines. Although the energy harvested by the cylindrical energy harvester is significant at resonance, the natural frequency of the system is found to be very high. To decrease the natural frequency, we propose a novel streaked stent design by cutting it along the length, transforming it to a curved plate and decreasing the natural frequency. The governing equations corresponding to the new geometry are derived using Hamilton's principle and modal analysis is used to obtain the transfer function.

  17. Use of paravascular admittance waveforms to monitor relative change in arterial blood pressure

    Science.gov (United States)

    Zielinski, Todd M.; Hettrick, Doug; Cho, Yong

    2010-04-01

    Non-invasive methods to monitor ambulatory blood pressure often have limitations that can affect measurement accuracy and patient adherence [1]. Minimally invasive measurement of a relative blood pressure surrogate with an implantable device may provide a useful chronic diagnostic and monitoring tool. We assessed a technique that uses electrocardiogram and paravascular admittance waveform morphology analysis to one, measure a time duration (vascular tone index, VTI in milliseconds) change from the electrocardiogram R-wave to admittance waveform peak and two, measure the admittance waveform minimum, maximum and magnitude as indicators of change in arterial compliance/distensibility or pulse pressure secondary to change in afterload. Methods: Five anesthetized domestic pigs (32 ± 4.2 kg) were used to study the effects of phenylephrine (1-5 ug/kg/min) on femoral artery pressure and admittance waveform morphology measured with a quadrapolar electrode array catheter placed next to the femoral artery to assess the relative change in arterial compliance due to change in peripheral vascular tone. Results: Statistical difference was observed (p blood pressure may be suitable for implantable devices to detect progression of cardiovascular disease such as hypertension.

  18. Strophanthus hispidus attenuates the Ischemia-Reperfusion induced myocardial Infarction and reduces mean arterial pressure in renal artery occlusion

    Directory of Open Access Journals (Sweden)

    Rohit Gundamaraju

    2014-01-01

    Full Text Available Background: The myocardium is generally injured in the case of reperfusion injury and arterial damage is caused by hypertension. In reference to these statements, the present study was focused. Cardiac glycosides were said to have protective effects against myocardial infarction and hypertension. Strophanthus hispidus was thus incorporated in the study. Objective: The prime objective of the study was to investigate the protective effects of Strophanthus hispidus against ischemia-reperfusion myocardial Infarction and renal artery occluded hypertension in rats. Materials and Methods: The animal model adopted was surgically-induced myocardial ischemia, performed by means of left anterior descending coronary artery occlusion (LAD for 30 min followed by reperfusion for another 4 h. Infarct size was assessed by using the staining agent TTC (2,3,5-triphenyl tetrazolium chloride. Hypertension was induced by clamping the renal artery with renal bulldog clamp for 4 h. Results: The study was fruitful by the effect of Strophanthus hispidus on infarction size, which got reduced to 27.2 ± 0.5and 20.0 ± 0.2 by 500 mg/Kg and 1000 mg/Kg ethanolic extracts which was remarkably significant when compared with that of the control group 52.8 ± 4.6. The plant extract did reduce heart rate at various time intervals. There was also a protective effect in the case of mean arterial blood pressure were the 500 mg/Kg and 1000 mg/Kg of the plant extract did reduce the hypertension after 60 minutes was 60.0 ± 4.80 and 50.50 ± 6.80. Conclusion: The results suggest that 500 mg/Kg and 100 mg/Kg ethanolic extract of Strophanthus hispidus was found to possess significant cardiac protective and anti-hypertensive activity.

  19. Effects of barnidipine on blood pressure and left ventricular diastolic function in patients with hypertension and metabolic syndrome: A 12-week, open-label noncomparison study

    OpenAIRE

    Angeli, Fabio; Repaci, Salvatore; Borgioni, Claudia; Sardone, Mariagrazia; Scotti, Aurelio; Verdecchia, Paolo

    2008-01-01

    Background: Barnidipine is one of a new generation of dihydropyridine calcium-channel blockers. Despite evidence of favorable effects on blood pressure (BP) and insulin sensitivity, this drug has rarely been tested in hypertensive patients with metabolic syndrome (MS).

  20. Arterial pulse pressure amplification described by means of a nonlinear wave model: characterization of human aging

    Science.gov (United States)

    Alfonso, M.; Cymberknop, L.; Armentano, R.; Pessana, F.; Wray, S.; Legnani, W.

    2016-04-01

    The representation of blood pressure pulse as a combination of solitons captures many of the phenomena observed during its propagation along the systemic circulation. The aim of this work is to analyze the applicability of a compartmental model for propagation regarding the pressure pulse amplification associated with arterial aging. The model was applied to blood pressure waveforms that were synthesized using solitons, and then validated by waveforms obtained from individuals from differentiated age groups. Morphological changes were verified in the blood pressure waveform as a consequence of the aging process (i.e. due to the increase in arterial stiffness). These changes are the result of both a nonlinear interaction and the phenomena present in the propagation of nonlinear mechanic waves.

  1. Low-sodium dietary approaches to stop hypertension diet reduces blood pressure, arterial stiffness, and oxidative stress in hypertensive heart failure with preserved ejection fraction.

    Science.gov (United States)

    Hummel, Scott L; Seymour, E Mitchell; Brook, Robert D; Kolias, Theodore J; Sheth, Samar S; Rosenblum, Hannah R; Wells, Joanna M; Weder, Alan B

    2012-11-01

    Recent studies suggest that oxidative stress and vascular dysfunction contribute to heart failure with preserved ejection fraction (HFPEF). In salt-sensitive HFPEF animal models, diets low in sodium and high in potassium, calcium, magnesium, and antioxidants attenuate oxidative stress and cardiovascular damage. We hypothesized that the sodium-restricted Dietary Approaches to Stop Hypertension diet (DASH/SRD) would have similar effects in human hypertensive HFPEF. Thirteen patients with treated hypertension and compensated HFPEF consumed the DASH/SRD for 21 days (all food/most beverages provided). The DASH/SRD reduced clinic systolic (155-138 mm Hg; P=0.02) and diastolic blood pressure (79-72 mm Hg; P=0.04), 24-hour ambulatory systolic (130-123 mm Hg; P=0.02) and diastolic blood pressure (67-62 mm Hg; P=0.02), and carotid-femoral pulse wave velocity (12.4-11.0 m/s; P=0.03). Urinary F2-isoprostanes decreased by 31% (209-144 pmol/mmol Cr; P=0.02) despite increased urinary aldosterone excretion. The reduction in urinary F2-isoprostanes closely correlated with the reduction in urinary sodium excretion on the DASH/SRD. In this cohort of HFPEF patients with treated hypertension, the DASH/SRD reduced systemic blood pressure, arterial stiffness, and oxidative stress. These findings are characteristic of salt-sensitive hypertension, a phenotype present in many HFPEF animal models and suggest shared pathophysiological mechanisms linking these 2 conditions. Further dietary modification studies could provide insights into the development and progression of hypertensive HFPEF.

  2. Correlation of Global Strain Rate and Left Ventricular Filling Pressure in Patients with Coronary Artery Disease: A 2-D Speckle-Tracking Study.

    Science.gov (United States)

    Ma, Hong; Wu, Wei-Chun; Xie, Rong-Ai; Gao, Li-Jian; Wang, Hao

    2016-02-01

    The aim of the present study was to evaluate the role of 2-D speckle-tracking imaging in the prediction of left ventricular filling pressure in patients with coronary artery disease (CAD) and normal left ventricular ejection fraction (LVEF). Eighty-four patients with CAD and 30 healthy controls were recruited prospectively. The longitudinal strain rate (SR) curves were determined in three apical views of the left ventricle long axis. Circumferential and radial SR curves were determined in three short-axis views. Left ventricular end-diastolic pressure (LVEDP) was invasively obtained by left heart catheterization. Compared with the 30 controls, the patients with CAD had significantly lower global SR during early diastole (SRe) and higher E/SRe in three directions of myocardial deformation. CAD patients with elevated LVEDP had significantly lower SRe and higher E/SRe of three deformations. Pearson's correlation analysis revealed that LVEDP correlated positively with E/E' ratio, radial SRe and longitudinal and circumferential E/SRe. LVEDP correlated negatively with longitudinal and circumferential SRe and radial E/SRe. Receiver operating characteristic curve analysis revealed that these SR indexes predicted elevated LVEDP (areas under the curve: longitudinal E/SRe = 0.74, circumferential E/SRe = 0.74, circumferential SRe = 0.70, longitudinal SRe = 0.69, radial E/SRe = 0.68, radial SRe = 0.65), but neither was superior to the tissue Doppler imaging index E/E' (area under the curve = 0.84). The present study indicates that 2-D speckle-tracking imaging is a practical method for evaluating LV filling pressure, but it might not provide additional advantages compared with E/E' in CAD patients.

  3. 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.

  4. The mechanical properties of the systemic and pulmonary arteries of Python regius correlate with blood pressures.

    Science.gov (United States)

    van Soldt, Benjamin J; Danielsen, Carl Christian; Wang, Tobias

    2015-12-01

    Pythons are unique amongst snakes in having different pressures in the aortas and pulmonary arteries because of intraventricular pressure separation. In this study, we investigate whether this correlates with different blood vessel strength in the ball python Python regius. We excised segments from the left, right, and dorsal aortas, and from the two pulmonary arteries. These were subjected to tensile testing. We show that the aortic vessel wall is significantly stronger than the pulmonary artery wall in P. regius. Gross morphological characteristics (vessel wall thickness and correlated absolute amount of collagen content) are likely the most influential factors. Collagen fiber thickness and orientation are likely to have an effect, though the effect of collagen fiber type and cross-links between fibers will need further study.

  5. Fast and Accurate Pressure-Drop Prediction in Straightened Atherosclerotic Coronary Arteries

    NARCIS (Netherlands)

    J.T.C. Schrauwen (Jelle); D. Koeze (Dion); J.J. Wentzel (Jolanda); F.N. van de Vosse (Frans); A.F.W. van der Steen (Ton); F.J.H. Gijsen (Frank)

    2014-01-01

    textabstractAtherosclerotic disease progression in coronary arteries is influenced by wall shear stress. To compute patient-specific wall shear stress, computational fluid dynamics (CFD) is required. In this study we propose a method for computing the pressure-drop in regions proximal and distal to

  6. Geometry-based pressure drop prediction in mildly diseased human coronary arteries

    NARCIS (Netherlands)

    J.T.C. Schrauwen (Jelle); J.J. Wentzel (Jolanda); A.F.W. van der Steen (Ton); F.J.H. Gijsen (Frank)

    2014-01-01

    textabstractPressure drop (△. p) estimations in human coronary arteries have several important applications, including determination of appropriate boundary conditions for CFD and estimation of fractional flow reserve (FFR). In this study a △. p prediction was made based on geometrical features deri

  7. Increasing arterial blood pressure with norepinephrine does not improve microcirculatory blood flow: a prospective study

    NARCIS (Netherlands)

    A. Dubin; M.O. Pozo; C.A. Casabella; F.,Jr Pálizas; G. Murias; M.C. Moseinco; V.S. Kanoore Edul; F. Pálizas; E. Estenssoro; C. Ince

    2009-01-01

    Introduction Our goal was to assess the effects of titration of a norepinephrine infusion to increasing levels of mean arterial pressure (MAP) on sublingual microcirculation. Methods Twenty septic shock patients were prospectively studied in two teaching intensive care units. The patients were mecha

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

    DEFF Research Database (Denmark)

    Østergaard, Kristine Hovkjær; Bertelsen, Mads F.; Brøndum, Emil;

    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...

  9. Proprioceptive Neuromuscular Facilitation Flexibility Techniques: Acute Effects on Arterial Blood Pressure.

    Science.gov (United States)

    Cornelius, William L.; Craft-Hamm, Kelley

    1988-01-01

    The effects of stretching techniques on arterial blood pressure (ABP) were studied in three groups of 20 men each. Each group performed one of three proprioceptive neuromuscular facilitation (PNF) techniques. Results are presented. The study indicates that the benefits of stretching may outweigh the risk of elevated ABP. (JL)

  10. External iliac artery injury secondary to indirect pressure wave effect from gunshot wound

    OpenAIRE

    Ng, Eugene; Choong, Andrew MTL

    2016-01-01

    In patients presenting with gunshot wounds, a high clinical suspicion of injury to vasculature and viscera remote from the projectile track is paramount. We present a case of a 17 year old male who sustained a gunshot wound to his abdomen and subsequently developed a right external iliac artery contusion requiring surgery as an indirect effect of the pressure wave from the bullet.

  11. Long-term pressure monitoring with arterial applanation tonometry : a non-invasive alternative during clinical intervention?

    NARCIS (Netherlands)

    Matthys, Koen S; Kalmar, Alain F; Struys, Michel M R F; Mortier, Eric P; Avolio, Alberto P; Segers, Patrick; Verdonck, Pascal R

    2008-01-01

    Arterial tonometry is a non-invasive technique for continuous registration of arterial pressure waveforms. This study aims to assess tonometric blood pressure recording (TBP) as an alternative for invasive long-term bedside monitoring. A prospective study was set up where patients undergoing neurosu

  12. A comparison of pulmonary arterial occlusion algorithms for estimation of pulmonary capillary pressure.

    Science.gov (United States)

    Pellett, A A; Johnson, R W; Morrison, G G; Champagne, M S; deBoisblanc, B P; Levitzky, M G

    1999-07-01

    Using the arterial occlusion method, we compared five literature-based estimates of pulmonary capillary pressure (Ppc) with the corresponding double occlusion pressures (Pdo) in anesthetized dogs whose chests had been closed after sternotomy for instrumentation. Arterial occlusions were performed with a balloon-tipped pulmonary artery catheter that housed pressure transducers immediately proximal and distal to the balloon. Separation of the proximal and distal pressure waveforms during balloon inflation allowed us to precisely define the moment of occlusion. We fit a monoexponential curve to pressure data beginning 200 ms after the onset of occlusion and a biexponential curve to data beginning at the instant of occlusion, with data obtained over a range of vascular states (control, serotonin infusion, histamine infusion). In addition, we investigated the use of sampling of the raw data to estimate capillary pressure. Three of the five literature-based estimates of Ppc yielded values similar to Pdo. The optimal (least average difference from Pdo) interpolation/extrapolation time points of the curve fits varied, depending on the type of curve fitting and the state of the pulmonary vasculature. We also determined that a close approximation of Pdo may be derived from the raw data, as an alternative to exponential curve fitting.

  13. Acute nitric oxide synthase inhibition and endothelin-1-dependent arterial pressure elevation

    Directory of Open Access Journals (Sweden)

    Robert eRapoport

    2014-04-01

    Full Text Available Key evidence that endogenous nitric oxide (NO inhibits the continuous, endothelin (ET-1-mediated drive to elevate arterial pressure includes demonstrations that ET-1 mediates a significant component of the pressure elevated by acute exposure to NO synthase (NOS inhibitors. This review examines the characteristics of this pressure elevation in order to elucidate potential mechanisms associated with the negative regulation of ET-1 by NO and, thereby, provide potential insight into the vascular pathophysiology underlying NO dysregulation. We surmise that the magnitude of the ET-1-dependent component of the NOS inhibitor-elevated pressure is 1 independent of underlying arterial pressure and other pressor pathways activated by the NOS inhibitors and 2 dependent on relatively higher NOS inhibitor dose, release of stored and de novo synthesized ET-1, and ETA receptor-mediated increased vascular resistance. Major implications of these conclusions include: 1 the marked variation of the ET-1-dependent component, i.e., from 0-100% of the pressure elevation, reflects the NO-ET-1 regulatory pathway. Thus, NOS inhibitor-mediated, ET-1-dependent pressure elevation in vascular pathophysiologies is an indicator of the level of compromised/enhanced function of this pathway; 2 NO is a more potent inhibitor of ET-1-mediated elevated arterial pressure than other pressor pathways, due in part to inhibition of intravascular pressure-independent release of ET-1. Thus, the ET-1-dependent component of pressure elevation in vascular pathophysiologies associated with NO dysregulation is of greater magnitude at higher levels of compromised NO.

  14. Reproducibility of the ambulatory arterial stiffness index in hypertensive patients

    DEFF Research Database (Denmark)

    Dechering, D.G.; Steen, M.S. van der; Adiyaman, A.;

    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...

  15. Roles of Arterial Stiffness and Blood Pressure in Hypertension-Associated Cognitive Decline in Healthy Adults.

    Science.gov (United States)

    Hajjar, Ihab; Goldstein, Felicia C; Martin, Greg S; Quyyumi, Arshed A

    2016-01-01

    Although there is strong evidence that hypertension leads to cognitive decline, especially in the executive domain, the relationship between blood pressure and cognition has been conflicted. Hypertension is characterized by blood pressure elevation and increased arterial stiffness. We aimed at investigating whether arterial stiffness would be superior to blood pressure in predicting cognitive decline and explaining the hypertension-executive decline association. A randomly selected asymptomatic population (n=591, age=49.2 years, 70% women, 27% black, and education=18 years) underwent annual vascular and cognitive assessments. Cognition was assessed using computerized versions commonly used cognitive tests, and principal component analysis was used for deriving cognitive scores for executive function, memory, and working memory. Arterial stiffness was measured by carotid-femoral pulse wave velocity (PWV). Higher PWV, but not blood pressure, was associated with a steeper decline in executive (P=0.0002), memory (P=0.05), and working memory (P=0.02) scores after adjusting for demographics, education, and baseline cognitive performance. This remained true after adjusting for hypertension. Hypertension was associated with greater decline in executive score (P=0.0029) and those with combined hypertension and elevated PWV (>7 m/s) had the greatest decline in executive score (P value hypertension×PWV=0.02). PWV explained the association between hypertension and executive function (P value for hypertension=0.0029 versus 0.24 when adjusting for PWV). In healthy adults, increased arterial stiffness is superior to blood pressure in predicting cognitive decline in all domains and in explaining the hypertension-executive function association. Arterial stiffness, especially in hypertension, may be a target in the prevention of cognitive decline.

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

    Directory of Open Access Journals (Sweden)

    María González-Núñez

    2015-11-01

    Full Text Available The activin receptor-like kinase 1 (ALK-1 is a type I cell-surface receptor for the transforming growth factor-β (TGF-β family of proteins. Hypertension is related to TGF-β1, because increased TGF-β1 expression is correlated with an elevation in arterial pressure (AP and TGF-β 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 β-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.

  17. Exploring Arterial Smooth Muscle Kv7 Potassium Channel Function using Patch Clamp Electrophysiology and Pressure Myography

    Science.gov (United States)

    Brueggemann, Lioubov I.; Mani, Bharath K.; Haick, Jennifer; Byron, Kenneth L.

    2012-01-01

    Contraction or relaxation of smooth muscle cells within the walls of resistance arteries determines the artery diameter and thereby controls flow of blood through the vessel and contributes to systemic blood pressure. The contraction process is regulated primarily by cytosolic calcium concentration ([Ca2+]cyt), which is in turn controlled by a variety of ion transporters and channels. Ion channels are common intermediates in signal transduction pathways activated by vasoactive hormones to effect vasoconstriction or vasodilation. And ion channels are often targeted by therapeutic agents either intentionally (e.g. calcium channel blockers used to induce vasodilation and lower blood pressure) or unintentionally (e.g. to induce unwanted cardiovascular side effects). Kv7 (KCNQ) voltage-activated potassium channels have recently been implicated as important physiological and therapeutic targets for regulation of smooth muscle contraction. To elucidate the specific roles of Kv7 channels in both physiological signal transduction and in the actions of therapeutic agents, we need to study how their activity is modulated at the cellular level as well as evaluate their contribution in the context of the intact artery. The rat mesenteric arteries provide a useful model system. The arteries can be easily dissected, cleaned of connective tissue, and used to prepare isolated arterial myocytes for patch clamp electrophysiology, or cannulated and pressurized for measurements of vasoconstrictor/vasodilator responses under relatively physiological conditions. Here we describe the methods used for both types of measurements and provide some examples of how the experimental design can be integrated to provide a clearer understanding of the roles of these ion channels in the regulation of vascular tone. PMID:23007713

  18. Arterial blood-pressure change and endogenous circulating substance P in man

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Kastrup, J; Schaffalitzky De Muckadell, O B

    1985-01-01

    Substance P (SP) is a powerful vasodilator and this peptide is today considered to be a chemical messenger. The potential effects on circulating SP of acute changes in arterial blood-pressure was investigated in nine subjects. An increase in arterial mean blood-pressure (+33%, P less than 0.001, n...... = 9) was obtained by infusion of angiotensin II and a decrease in pressure (-10%, P less than 0.005, n = 6) was obtained by ganglionic blockade. The concentration of SP in plasma, from supine subjects in the normotensive condition, ranged from 3 to 13 pmol/l (with a mean of 5.6 pmol/l). SP was thus...

  19. Tea, but not coffee consumption, is associated with components of arterial pressure. The Observation of Cardiovascular Risk Factors study in Luxembourg.

    Science.gov (United States)

    Alkerwi, Ala'a; Sauvageot, Nicolas; Crichton, Georgina E; Elias, Merrill F

    2015-07-01

    There is uncertainty regarding the impact of tea and coffee consumption on arterial blood pressure. The present study aimed to examine the association between blood pressure (BP) components, namely, systolic BP (SBP), diastolic BP, mean arterial pressure, and pulse pressure (PP), and tea or coffee consumption, taking into account simultaneous consumption. The study population was derived from a national cross-sectional stratified sample of 1352 individuals aged 18 to 69 years, recruited between November 2007 and January 2009 to participate in the Observation of Cardiovascular Risk Factors in Luxembourg study. We hypothesized that greater tea consumption would be independently associated with lower BP. Tea and coffee consumptions in deciliters per day were obtained from a semiquantitative food frequency questionnaire. Participants were classified into 3 groups: nonconsumers, ≤3-dL/d consumers, and >3-dL/d consumers of each beverage separately. After exclusion of subjects taking antihypertensive medications, several general linear models were performed to investigate the independent relationship between tea/coffee consumption and BP components. Tea consumers (36.3%) were more likely to be younger women, nonsmokers, with better cardiometabolic profiles, and less frequent chronic pathologies, whereas the reverse was true for coffee consumers (88%). Greater tea consumption was associated with lower SBP and PP values, after adjustment for age, sex, education, lifestyle, and dietary confounding factors, including coffee drinking. No association between BP components and coffee consumption was observed. Daily consumption of 1 dL of tea was associated with a significant reduction of SBP by 0.6 mm Hg and PP by 0.5 mm Hg. Given the widespread consumption of tea and coffee throughout the world, together with the major cardiovascular disease risk, our findings have important implications for human health.

  20. Age, hypertension and arterial function.

    Science.gov (United States)

    McEniery, Carmel M; Wilkinson, Ian B; Avolio, Albert P

    2007-07-01

    1. Ageing exerts a marked effect on the cardiovascular system and, in particular, the large arteries. Using a variety of techniques to assess arterial stiffness, many cross-sectional studies have demonstrated a significant relationship between age and aortic stiffness, although the age-related changes observed in peripheral arteries appear to be less marked. 2. The relationship between arterial stiffness and hypertension is more complex. The distending, or mean arterial, pressure is an important confounder of measurements of arterial stiffness and, therefore, must be taken into consideration when assessing arterial stiffness in hypertensive subjects or investigating the effect of antihypertensive agents. Current methods for correcting for differences in distending pressure involve pharmacological manipulation, statistical correction or mathematical manipulation of stiffness indices. 3. Many studies have provided evidence that both peripheral (muscular) and central (elastic) arteries are stiffer in subjects with mixed (systolic/diastolic) hypertension compared with normotensive subjects. However, it is unclear to what extent differences in mean arterial pressure explain the observed differences in hypertensive subjects. In contrast, isolated systolic hypertension is associated with increased aortic, but not peripheral artery, stiffness, although the underlying mechanisms are somewhat unclear. 4. Traditional antihypertensive agents appear to reduce arterial stiffness, but mostly via an indirect effect of lowering mean pressure. Therefore, therapies that target the large arteries to reduce stiffness directly are urgently required. Agents such as nitric oxide donors and phosphodiesterase inhibitors may be useful in reducing stiffness via functional mechanisms. In addition, inhibitors or breakers of advanced glycation end-product cross-links between proteins, such as collagen and elastin, hold substantial promise.

  1. Assessment of Diastolic Function in Congenital Heart Disease

    Science.gov (United States)

    Panesar, Dilveer Kaur; Burch, Michael

    2017-01-01

    Diastolic function is an important component of left ventricular (LV) function which is often overlooked. It can cause symptoms of heart failure in patients even in the presence of normal systolic function. The parameters used to assess diastolic function often measure flow and are affected by the loading conditions of the heart. The interpretation of diastolic function in the context of congenital heart disease requires some understanding of the effects of the lesions themselves on these parameters. Individual congenital lesions will be discussed in this paper. Recently, load-independent techniques have led to more accurate measurements of ventricular compliance and remodeling in heart disease. The combination of inflow velocities and tissue Doppler measurements can be used to estimate diastolic function and LV filling pressures. This review focuses on diastolic function and assessment in congenital heart disease.

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

    DEFF Research Database (Denmark)

    Pump, B; Damgaard, M; Gabrielsen, A;

    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 breathing from 36 +/- 3 to 42 +/- 3 mmHg (P

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

    NARCIS (Netherlands)

    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; Gaunt, Tom R.; Gho, Johannes M. I. H.; Gieger, Christian; Gong, Yan; Isaacs, Aaron; Kleber, Marcus E.; Mateo Leach, Irene; McDonough, Caitrin W.; Meijs, Matthijs F. L.; Mellander, Olle; Molony, Cliona M.; Nolte, Ilja M.; Padmanabhan, Sandosh; Price, Tom S.; Rajagopalan, Ramakrishnan; Shaffer, Jonathan; Shah, Sonia; Shen, Haiqing; Soranzo, Nicole; van der Most, Peter; Van Iperen, Erik P. A.; Van Setten, Jessic A.; Vonk, Judith M.; Zhang, Li; Beitelshees, Amber L.; Berenson, Gerald S.; Bhatt, Deepak L.; Boer, Jolanda M. A.; Boerwinkle, Eric; Burkley, Ben; Burt, Amber; Chakravarti, Aravinda; Chen, Wei; Cooper-DeHoff, Rhonda M.; Curtis, Sean P.; Dreisbach, Albert; Duggan, David; Ehret, Georg B.; Fabsitz, Richard R.; Fornage, Myriam; Fox, Ervin; Furlong, Clement E.; Gansevoort, Ron T.; Hofker, Marten H.; Hovingh, G. Kees; Kirkland, Susan A.; Kottke-Marchant, Kandice; Kutlar, Abdullah; LaCroix, Andrea Z.; Langaee, Taimour Y.; Li, Yun R.; Lin, Honghuang; Liu, Kiang; Maiwald, Steffi; Malik, Rainer; Murugesan, Gurunathan; Newton-Cheh, Christopher; OConnell, Jeffery R.; Onland-Moret, N. Charlotte; Ouwehand, Willem H.; Palmas, Walter; Penninx, Brenda W.; Pepine, Carl J.; Pettinger, Mary; Polak, Joseph F.; Ramachandran, Vasan S.; Ranchalis, Jane; Redline, Susan; Ridker, Paul M.; Rose, Lynda M.; Scharnag, Hubert; Schork, Nicholas J.; Shimbo, Daichi; Shuldiner, Alan R.; Srinivasan, Sathanur R.; Stolk, Ronald P.; Taylor, Herman A.; Thorand, Barbara; Trip, Mieke D.; van Duijn, Cornelia M.; Verschuren, W. Monique; Wijmenga, Cisca; Winkelmann, Bernhard R.; Wyatt, Sharon; Young, J. Hunter; Boehm, Bernhard O.; Caulfield, Mark J.; Chasman, Daniel I.; Davidson, Karina W.; Doevendans, Pieter A.; FitzGerald, Garret A.; Gums, John G.; Hakonarson, Hakon; Hillege, Hans L.; Illig, Thomas; Jarvik, Gail P.; Johnson, Julie A.; Kastelein, John J. P.; Koenig, Wolfgang; Maerz, Winfried; Mitchell, Braxton D.; Murray, Sarah S.; Oldehinkel, Albertine J.; Rader, Daniel J.; Reilly, Muredach P.; Reiner, Alex P.; Schadt, Eric E.; Silverstein, Roy L.; Snieder, Harold; Stanton, Alice V.; Uitterlinden, Andre G.; van der Harst, Pim; van der Schouw, Yvonne T.; Samani, Nilesh J.; Johnson, Andrew D.; Munroe, Patricia B.; de Bakker, Paul I. W.; Zhu, Xiaofeng; Levy, Daniel; Keating, Brendan J.; Asselbergs, Folkert W.

    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 varia

  4. 连续无创血压监测系统在全身麻醉中的应用%Efficacy of a continuous non -invasive arterial pressure monitor system during general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李晶; 周婷; 田丽平; 徐世元; 张鸿飞

    2016-01-01

    目的:评价TL_300 tensymeter系统(TL_300)所测的连续无创血压(NIBP)在全身麻醉中的有效性及安全性。方法选择全身麻醉下行择期仰卧位手术的成年患者20例,ASAⅠ~Ⅲ级。麻醉诱导后无菌操作下左侧桡动脉穿刺置入动脉导管进行连续有创血压( IBP)监测,右侧手臂连接TL_300进行NIBP监测,稳定5 min后,同时测量IBP和NIBP,间隔3 min分别记录IBP监测及相应时点NIBP监测的收缩压、舒张压和平均压。术后监测与两种血压监测相关的并发症如肢体缺血、坏死、感觉异常。结果 NIBP监测与IBP监测所测收缩压、舒张压和平均压差值分别为(-0.086±9.59)、(3.203±7.11)、(2.60±6.76) mmHg,两种血压监测方法的收缩压、舒张压和平均压的决定系数分别为0.711、0.565和0.729,P值均小于0.001。所有患者均未发生肢体缺血、坏死、感觉异常。结论与IBP监测相比,NIBP监测在全身麻醉成年手术患者中,可提供连续、无创、准确、安全的血压监测。%Objective To investigate the accuracy, precision and safety of continuous non-invasive blood pres-sure( NIBP) monitoring delivered by TL_300 tensymeter system.Methods Twenty ASA classification of Ⅰ-Ⅲadult patients undergoing elective surgeries in a supine position under general anesthesia were included in the study.A catheter was placed into the left radial artery under local anesthesia before induction, with the TL_300 tensymeter system connected to the right arm.Continuous invasive blood pressure ( IBP) monitoring was derived from the invasive artery catheter while the NIBP was from TL_300 tensymeter system.Systolic, diastolic and mean arterial pressure were recorded every 3 mi-nutes simultaneously for both IBP and NIBP from 5 min after monitoring to the end of surgery.Complications associated with both pressure monitors including limb ischemia, necrosis and paresthesia were recorded

  5. Assessment of left ventricular diastolic deformation and untwist in patients with coronary artery disease using speckle tracking imaging%斑点追踪成像评价冠心病患者左心室张期形变及解旋运动

    Institute of Scientific and Technical Information of China (English)

    李翠玲; 林红; 范瑞; 姚凤娟; 陆堃

    2012-01-01

    目的 观察应用斑点追踪成像(STI)技术评价冠心病患者左心室舒张期形变及解旋运动的价值.方法 随机选择临床拟诊为冠心病患者117例,根据冠状动脉造影或冠状动脉CTA结果分成心肌梗死组(60例)、心肌缺血组(31例)及对照组(26例).常规测量二尖瓣口舒张期血流速度(E、A)及二尖瓣后瓣环的运动速度(E'、A'),计算E/E'.运用STI技术测量左心室舒张期各方向应变率、解旋率.结果 与心肌缺血组、对照组相比,心肌梗死组E/E'增大,纵向、径向、圆周方向舒张早期及晚期应变率、解旋率减低(P<0.001);与对照组比较,心肌缺血组仅解旋率、舒张早期纵向应变率、舒张早期与晚期圆周方向应变率减低,差异均有统计学意义(P均<0.05).结论 STI技术能有效评价冠心病患者左心室舒张期各方向的形变及解旋运动;与常规超声参数相比较,左心室舒张期径向、圆周方向应变率及解旋率能更早地反映心肌缺血患者左心室舒张功能的减低.%To observe the value of left ventricular (LV) deformation and untwist in patients with coronary artery disease (CAD) using speckle tracking imaging (STI). Methods Totally 117 patients were randomly selected and divided into three groups according to the extent of coronary artery stenosis, i. e. myocardial infarction group (60 patients), myocardial ischemia group (31 patients) and control group (26 patients). All patients were examined with STI, and the parameters of LV, including early and late diastolic global longitudinal, radial and circumferential strain rate, as well as untwisting rate were calculated. E/E (transmitral and mitral lateral annular early diastolic velocity ratio) was also measured and statistical analyzed. Results E/E increased obviously in myocardial infarction group (P<0.05). Global longitudinal strain rate in early diastole, circumferential strain rate in early and late diastole and untwisting rate

  6. Arterial pressure changes monitoring with a new precordial noninvasive sensor

    Directory of Open Access Journals (Sweden)

    Faita Francesco

    2008-08-01

    Full Text Available Abstract Background Recently, a cutaneous force-frequency relation recording system based on first heart sound amplitude vibrations has been validated. A further application is the assessment of Second Heart Sound (S2 amplitude variations at increasing heart rates. The aim of this study was to assess the relationship between second heart sound amplitude variations at increasing heart rates and hemodynamic changes. Methods The transcutaneous force sensor was positioned in the precordial region in 146 consecutive patients referred for exercise (n = 99, dipyridamole (n = 41, or pacing stress (n = 6. The curve of S2 peak amplitude variation as a function of heart rate was computed as the increment with respect to the resting value. Results A consistent S2 signal was obtained in all patients. Baseline S2 was 7.2 ± 3.3 mg, increasing to 12.7 ± 7.7 mg at peak stress. S2 percentage increase was + 133 ± 104% in the 99 exercise, + 2 ± 22% in the 41 dipyridamole, and + 31 ± 27% in the 6 pacing patients (p Conclusion S2 recording quantitatively documents systemic pressure changes.

  7. Adiponectin Genotype, Blood Pressures, and Arterial Stiffness: The Cardiometabolic Risk in Chinese (CRC) Study.

    Science.gov (United States)

    Liang, Jun; Qiu, Qinqin; Gong, Ying; Liu, Xuekui; Dou, Lianjun; Zou, Caiyan; Wang, Yu; Qi, Lu

    2015-05-01

    The authors examined whether the adiponectin gene (ADIPOQ) variant was associated with blood pressure and arterial stiffness in Chinese adults. A genome-wide association study of the adiponectin variant rs864265 in the ADIPOQ gene was genotyped in a total of 2364 participants. After adjustment for sex, age, body mass index (BMI), fasting glucose, and lipids, participants carrying the T allele of rs864265 showed a greater increase in carotid-femoral pulse wave velocity (cfPWV) and systolic blood pressure (SBP). Further adjustment for blood pressure did not appreciably change the association with cfPWV. The authors found significant interactions between rs864265 and BMI, waist circumference, body fat percentage, and SBP in relation to cfPWV (P for interaction = .035, .001, .003, .013, respectively). The T allele of rs864265 was associated with high blood pressure and arterial stiffness. BMI, body fat percentage, waist circumference, and SBP might modify the effects of genetic polymorphism on arterial stiffness.

  8. 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

  9. 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

  10. Microalbuminuria associated with systolic blood pressure and arterial compliance in Chinese metabolic syndrome patients

    Institute of Scientific and Technical Information of China (English)

    LI Xin-li; XU Qiong; TONG Min; LU Xin-zheng; ZHANG Hai-feng; ZHOU Yan-li; CAO Ke-jiang; HUANG Jun

    2007-01-01

    Background There is significant evidence showing that microalbuminuria and arterial compliance are sensitive markers for early cardiovascular diseases. However, whether microalbuminuria is associated with reduced arterial compliance in Chinese metabolic syndrome (MS) patients remains unknown.Methods According to the definition of MS proposed by ATPⅢ in 2001, USA, subjects (n=362) were divided into three groups according to the number of risk factors: group 1 (control), group 2 (medium, < 3 risk factors) and group 3 (MS, ≥ 3 risk factors). Both large artery compliance (C1) and small artery compliance (C2) were measured with the CVProfilor DO-2020 Cardiovascular Profiling System, and microalbuminuria was evaluated with the ratio of albumin to urine creatinine.Results (1) As C1 and C2 levels elasticity decreased, albumin creatinine ratio (ACR) and the prevalence of microalbuminuria increased within those groups with MS risk factors. C1 and C2 were negatively correlated with the ranking of MS risk factors, ACR was positively correlated with the ranking of MS risk factors (all P<0.05). (2) Subjects were also categorized into a microalbuminuria group and a normal group, C1 and C2 in the microalbuminuria group were lower than in the normal group. (3) Multivariate regression analysis showed that increased systolic blood pressure (SBP) and reduced arterial compliance were the main risk factors for microalbuminuria in the MS group.Conclusions The risk of developing microalbuminuria was higher in the subjects with multiple metabolic abnormalities.Increased systolic blood pressure and reduced arterial compliance may be the main predictors for microalbuminuria in MS.

  11. Comparison of arterial pressure and plethysmographic waveform-based dynamic preload variables in assessing fluid responsiveness and dynamic arterial tone in patients undergoing major hepatic resection

    NARCIS (Netherlands)

    Vos, J. J.; Kalmar, A. F.; Struys, M. M. R. F.; Wietasch, J. K. G.; Hendriks, H. G. D.; Scheeren, T. W. L.

    2013-01-01

    Dynamic preload variables to predict fluid responsiveness are based either on the arterial pressure waveform (APW) or on the plethysmographic waveform (PW). We compared the ability of APW-based variations in stroke volume (SVV) and pulse pressure (PPV) and of PW-based plethysmographic variability in

  12. Red wine, arterial stiffness and central hemodynamics.

    Science.gov (United States)

    Karatzi, Kalliopi; Papaioannou, Theodore G; Papamichael, Christos; Lekakis, John; Stefanadis, Christodoulos; Zampelas, Antonis

    2009-01-01

    Red wine is considered to reduce cardiovascular risk and decrease peripheral systolic and diastolic blood pressure. Central aortic pressures are often more sensitive clinical and prognostic factors than peripheral pressures, while arterial stiffness is an independent prognostic factor for cardiovascular events. Great efforts are being made to find natural sources of improving health. In order to clarify the mechanisms under which a widely used drink, like red wine, is affecting heart and vessels, we aimed to review the available data regarding the effects of red wine on arterial stiffness, wave reflections and central blood pressures. The effect of red wine on central hemodynamics has been poorly explored with divergent results. Possible consequences of acute and long-term intake on arterial stiffness, wave reflections and central pressures are not clear. This might make someone skeptical when suggesting the consumption of a glass of red wine, although its cardioprotective actions (when moderately consumed) are already shown from epidemiological studies.

  13. Future Treatment of Hypertension: Shifting the Focus from Blood Pressure Lowering to Arterial Stiffness Modulation?

    Science.gov (United States)

    Fok, Henry; Cruickshank, J Kennedy

    2015-08-01

    Isolated systolic hypertension is the commonest form of hypertension from middle age onwards. Achieving target systolic blood pressure (BP) control remains difficult in everyday clinical practice and even under clinical trial conditions. Most antihypertensive medicines were designed to lower peripheral vascular resistance, which was considered the haemodynamic determinant of hypertension; most are effective in reducing steady but not pulsatile components of BP. Arterial stiffness, defined via aortic length-specific pulse wave velocity (PWV), is thought to be an important determinant of pulse pressure widening through its effects on the timing and amplitude of pressure wave reflection, and/or the aorta's Windkessel function, or its excess 'reservoir' pressure. Whereas pulse pressure is neither an independent nor consistent cardiovascular risk factor, particularly below the age of about 60 years, PWV has become the most powerful predictor of cardiovascular outcomes including mortality, independent of systolic, pulse, mean or other BP components. PWV is therefore a more direct target for treatment. This review addresses the potential therapeutic options for targeting arterial stiffness and the role of pulse pressure.

  14. Predicting electrocardiogram and arterial blood pressure waveforms with different Echo State Network architectures.

    Science.gov (United States)

    Fong, Allan; Mittu, Ranjeev; Ratwani, Raj; Reggia, James

    2014-01-01

    Alarm fatigue caused by false alarms and alerts is an extremely important issue for the medical staff in Intensive Care Units. The ability to predict electrocardiogram and arterial blood pressure waveforms can potentially help the staff and hospital systems better classify a patient's waveforms and subsequent alarms. This paper explores the use of Echo State Networks, a specific type of neural network for mining, understanding, and predicting electrocardiogram and arterial blood pressure waveforms. Several network architectures are designed and evaluated. The results show the utility of these echo state networks, particularly ones with larger integrated reservoirs, for predicting electrocardiogram waveforms and the adaptability of such models across individuals. The work presented here offers a unique approach for understanding and predicting a patient's waveforms in order to potentially improve alarm generation. We conclude with a brief discussion of future extensions of this research.

  15. 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.

  16. Systolic and diastolic short-term blood pressure variability and its determinants in patients with controlled and uncontrolled hypertension: a retrospective cohort study.

    Science.gov (United States)

    Pengo, Martino F; Rossitto, Giacomo; Bisogni, Valeria; Piazza, Daniele; Frigo, Anna Chiara; Seccia, Teresa Maria; Maiolino, Giuseppe; Rossi, Gian Paolo; Pessina, Achille C; Calò, Lorenzo A

    2015-04-01

    Absolute blood pressure (BP) values are not the only causes of adverse cardiovascular consequences. BP variability (BPV) has also been demonstrated to be a predictor of mortality for cardiovascular events; however, its determinants are still unknown. This study considers 426 subjects with ambulatory BP monitoring (ABPM) measuring 24-h, diurnal and nocturnal absolute BP values and their standard deviations of the mean, along with nocturnal fall, age, sex and current treatment. Patients were divided in two subgroups, controlled and uncontrolled BP, and BPV of patients with "true" and "false" resistant hypertension was also analyzed. Nocturnal and 24-h BPV were higher in the group with uncontrolled hypertension. Multiple regression analysis showed that absolute BP, age, nocturnal fall, but not sex predicted BPV. Patients with "true" resistant hypertension had greater BPV than "false" resistant hypertension patients. Absolute BP resulted as the main determinant of 24-h and nocturnal BPV but not daytime BPV. Also nocturnal BP fall and age resulted as predictors of BPV in treated and untreated patients. Patients with "true" resistant hypertension have a higher BPV, suggesting a higher sympathetic activation. Evidence is still limited regarding the importance of short-term BPV as a prognostic factor and assessment of BPV cannot yet represent a parameter for routine use in clinical practice. Future prospective trials are necessary to define which targets of BPV can be achieved with antihypertensive drugs and whether treatment-induced reduction in BPV is accompanied by a corresponding reduction in cardiovascular events.

  17. [Does diastolic heart failure exist?].

    Science.gov (United States)

    Guadalajara Boo, José Fernando

    2003-01-01

    This paper reviews the concepts of systolic function, diastolic function, heart failure, diastolic dysfunction, and diastolic heart failure. We refer to the historic evolution of the concept of heart failure and the origin of the term diastolic heart failure. Based on the current concepts of the physiology of the heart and its pathophysiology, we discuss the inappropriateness of the term and to the confusion it has generated in clinical practice, treatment, and prognosis, as well as in numerous research papers (of which some examples are given) when terming as "heart failure" the diastolic dysfunction and using both terms indistinctively. We conclude that an increasing need has arisen, ever more imperative, to identify clearly the concepts of heart failure and diastolic dysfunction, emphasizing on their differences to recognize them as distinct clinical entities with their own personality and, hence, having different prognosis and treatment. This would be of great help to achieve more accuracy in the clinical guidelines, standards, and consensus, especially regarding treatment. Besides it would be useful to avoid, inconsistencies in the design of research, which appear in some of the publications just by the lack of a clear meaning of the terms. Finally, at present we have the necessary elements to conclude that the terms "diastolic heart failure" and "cardiac failure with preserved systolic function" are inexact, poorly gauged, and far away from the actual problem they try to define. Therefore, they should be substituted by the concept of Diastolic Dysfunction, which defines clearly the pathophysiology of the functional alteration, without having to state that "the heart is failing".

  18. Smoking and hyperlipidemia are important risk factors for coronary artery spasm

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Objective To investigate the role of coronary artery spasm in the etiology of chest pain lacking significant coronary stenosis and to identify the clinical risk factors related to coronary artery spasm. Methods Two hundred and seventy five patients with chest pain, but without significant coronary artery stenosis underwent the intracoronary acetylcholine test. Coronary artery spasm was diagnosed while coronary artery stenosis increased to 90% and was accompanied by the usual chest pain with or without ischemic changes on electrocardiogram. Logistic regression was employed to investigate the relationships between coronary artery spasm and sex, age, hypertension, diabetes mellitus, smoking, hyperlipidemia and results of electrocardiographic treadmill stress test. Left ventricular ejection fraction and end diastolic pressure were compared between spasm group and non-spasm group. Results Coronary artery spasm was detected in 103 out of 271 patients, a rate of 38%. Logistic regression analysis showed that smoking and hyperlipidemia increased the relative risk of coronary artery spasm 4.2 times and 2.3 times, respectively. There was a significantly negative relationship between diabetes mellitus and coronary artery spasm. Furthermore, there was no coronary artery spasm detected in left ventricular ejection fraction and end diastolic pressure. Conclusions Coronary artery spasm was one of the important etiological factors for patients with chest pain but no coronary artery stenosis. Smoking and hyperlipidemia were the main clinical risk factors for coronary artery spasm.

  19. The effects of epinine on arterial blood pressure and regional vascular resistances in anesthetized rats.

    Science.gov (United States)

    Martínez-Mir, I; Palop, V; Morales-Olivas, F J; Estañ, L; Rubio, E

    1998-07-01

    1. We carried out experiments in anesthetized rats to study the hemodynamic effects of intravenous injections of epinine. 2. Epinine (1-320 micrograms/kg) produced a biphasic effect on mean arterial blood pressure (n = 30). At doses lower than 40 micrograms/kg, arterial blood pressure decreased (by as much as 21.5 +/- 3.4%), though at higher doses it increased dose dependently (by as much as 73.2 +/- 14.5%). Epinine also produced bradicardia in a dose-dependent manner (by as much as 26.4 +/- 4.9%). Sulpiride (100 micrograms/kg) suppressed the hypotensive effect of epinine but did not change the hypertensive effect. In the presence of prazosin (1,000 micrograms/kg), arterial blood pressure remained significantly decreased at all doses of epinine. Neither sulpiride nor prazosin changed the bradycardic effect of epinine. 3. Prazosin produced a significant decrease in renal vascular resistance. Epinine (5 micrograms/kg) after prazosin reverted the effects of prazosin in renal vascular resistance, without any significant modification in the renal blood flows. However, 20 micrograms/kg epinine increased the renal vascular resistances and, moreover, produced a significant decrease in the blood flows of both kidneys. Neither prazosin nor epinine produced modifications in the intestinal vascular bed. 4. Although epinine possesses significant dopamine and alpha-adrenergic activities that are involved in the biphasic effect of the agent on mean arterial blood pressure in anesthetized rats, in the presence of prazosin, it is not possible to manifest dopaminergic activity involved in the increase in renal or mesenteric blood flow; this may be due to the low tone of the vascular wall induced by the alpha-adrenergic antagonist, though an alpha 2-activity cannot be discarded.

  20. Effect of Algerian Varieties Dates on Glycemic, Arterial Blood Pressure and Satiety Responses

    OpenAIRE

    Gourchala Freha, Mihoub Fatma, Derradj Meriem, Henchiri Cherifa

    2016-01-01

    The purpose of our study is to determine the Glycemic Indexes (GIs)of three Algerians varieties of dates in healthy subjects, evaluate the satiety and effect on arterial pressure after their consumption. We have first documented the chemical composition of the dates. 10 healthy subjects consumed the dates (carbohydrates content of 50 g) in order to determine the GIs. The responses of glycaemia were monitored during two hours after the dates taking and compared to the reference glucose. In a r...

  1. External iliac artery injury secondary to indirect pressure wave effect from gunshot wound

    Institute of Scientific and Technical Information of China (English)

    Eugene Ng; Andrew MTL.Choong

    2016-01-01

    In patients presenting with gunshot wounds,a high clinical suspicion of injury to vasculature and viscera remote from the projectile track is paramount.We present a case of a 17 year old male who sustained a gunshot wound to his abdomen and subsequently developed a right external iliac artery contusion requiring surgery as an indirect effect of the pressure wave from the bullet.

  2. 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.

  3. Effects of terlipressin on systolic pulmonary artery pressure of patients with liver cirrhosis:An echocardiographic assessment

    Institute of Scientific and Technical Information of China (English)

    Engin Altintas; Necdet Akkus; Ramazan Gen; M. Rami Helvaci; Orhan Sezgin; Dilek Oguz

    2004-01-01

    AIM: Portopulmonary hypertension is a serious complication of chronic liver disease. Our aim was to search into the effect of terlipressin on systolic pulmonary artery pressure among cirrhotic patients.METHODS: Twelve patients (6 males and 6 females) with liver cirrhosis were recruited in the study. Arterial blood gas samples were obtained in sitting position at rest. Contrast enhanced echocardiography and measurements of systolic pulmonary artery pressure were performed before and after the intravenous injection of 2 mg terlipressin.RESULTS: Of 12 patients studied, the contrast enhanced echocardiography was positive in 5, and the positive findings in contrast enhanced echocardiography were reversed to normal in two after terlipressin injection. The mean systolic pulmonary artery pressure was 25.5±3.6 mmHg before terlipressin injection, and was 22.5±2.5 mmHg after terlipressin (P=0.003). The systolic pulmonary artery pressure was above 25 mmHg in seven of these 12 patients.After the terlipressin injection, systolic pulmonary artery pressure was <25 mmHg in four of these cases (58.3% vs 25%, P=0.04).CONCLUSION: Terlipressin can decrease the systolic pulmonary artery pressure in patients with liver cirrhosis.

  4. Vasopressin contributes to maintenance of arterial blood pressure in dehydrated baboons.

    Science.gov (United States)

    Ryan, K L; Thornton, R M; Proppe, D W

    1989-02-01

    This study primarily sought to determine whether the role of vasopressin (VP) in maintenance of arterial blood pressure is enhanced in awake, chronically instrumented baboons after 68-72 h of dehydration. This question was approached by pharmacologically blocking vasopressin V1-receptors in euhydrated and dehydrated baboons with or without a normally functioning renin-angiotensin system (RAS). VP blockade during dehydration produced a rapidly occurring (within 5 min), statistically significant (P less than 0.05) decrease in mean arterial pressure (MAP) of 5 +/- 1 mmHg in the RAS-intact condition and an identical decline in MAP (5 +/- 1 mmHg) during blockade of the RAS by captopril, an angiotensin I-converting enzyme inhibitor. At 15 min after induction of VP blockade, heart rate was elevated by 9 +/- 2 beats/min in the RAS-intact condition and by 20 +/- 5 beats/min in the RAS-blocked condition. In addition, VP blockade in the dehydrated state produced small and equal increases in hindlimb vascular conductance in RAS-intact and RAS-blocked conditions. None of these cardiovascular changes were produced by VP blockade in the euhydrated state. RAS blockade produced modest declines in MAP in both hydration states, but the fall was larger by 7 +/- 4 mmHg in the dehydrated state. Thus both VP and the RAS contribute to the maintenance of arterial blood pressure during dehydration in the conscious baboon.

  5. Early Diastolic Strain Rate in Relation to Systolic and Diastolic Function and Prognosis in Aortic Stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Barros-Gomes, Sergio; Videbæk, Lars

    2016-01-01

    OBJECTIVES: This study examined the impact of early mitral inflow velocity-to-early diastolic strain rate (E/SRe) ratio on long-term outcome after aortic valve replacement (AVR) in aortic stenosis (AS). BACKGROUND: In AS, increased filling pressures are associated with a poor prognosis and can...... Aortic Stenosis; NCT00294775)....... be estimated using the early diastolic mitral inflow velocity-to-early diastolic velocity of the mitral annulus (E/e') ratio. Recent studies suggest that the E/SRe ratio surpasses the E/e' ratio in estimating outcome. METHODS: Pre-operative evaluation was performed in 121 patients with severe AS (aortic valve...

  6. Application of intraoperative arterial pressure-based cardiac output monitoring for patients undergoing coronary artery bypass grafting surgery

    Institute of Scientific and Technical Information of China (English)

    LU Jia-kai; ZHU Chen; JING He; WANG Yi-jun; QING En-ming

    2012-01-01

    Background For patients undergoing off-pump coronary artery bypass grafting (OPCABG),it is important to establish a hemodynamic monitoring system to obtain powerful parameters for better intraoperative treatment.This study aimed to observe the clinical feasibility of artedal pressure-based cardiac output (APCO) for cardiac output (CO) monitoring and to evaluate the correlation between APCO and pulmonary artery catheter (PAC) for CO measurement for patients undergoing OPCABG intraoperatively.Methods Fifty patients of Amedcan Society of Anaesthesiologists (ASA) classification Ⅱ-Ⅲ,undergoing elective OPCABG at Beijing Anzhen Hospital were randomly enrolled into this study.All patients were assigned to CO monitoring by PAC and APCO simultaneously.Patients with pacemaker,severe valvular heart disease,left ventdcular ejection fraction (EF) <40%,cardiac arrhythmias,peripheral vascular disease,application of intra-aortic balloon pump (IABP) and emergent diversion to cardiac pulmonary bypass were excluded.The radial artery wavaform was analyzed to estimate the stroke volume (SV) and heart rate (HR) continuously.CO was calculated as SV x HR; other derived parameters were cardiac index (CI),stroke volume index (SVI),systemic vascular resistance (SVR),and systemic vascular resistance index (SVRI).PAC was placed via right internal jugular vein and the correct position was confirmed by PAC waveforms.Continuous cardiac output (CCO),CI and other hemodynamic parameters were monitored at following 5 time points:immediate after anesthesia induction (baseline value),anastomosis of left intemal mammary artery to left anterior descending artery (LAD),anastomosis of left circumflex (LCX),anastomosis of posterior descending artery (PDA) and immediate after sternal closure.Results In the 50 patients,preoperative echocardiography measured left ventricular EF was (52.8±11.5)%,and 35 patients (70%) showed regional wall motion abnormalities.The correlation coefficient of CO

  7. 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...... of healing correlated significantly with the three distal blood pressure parameters investigated, the closest correlation being with the SDBP measured at the final examination, i.e. just after healing of the ulcer or just before an inevitable major amputation. Of the 22 cases with SDBP below 20 mmHg only two...... (SPPH) as measured with a photocell. Thirty-two patients (35 feet with ulcerations) had diabetes mellitus. The treatment was conservative. In 42 feet the ulcers healed after an average period of 5.8 months; in 24 feet major amputation became necessary after an average of 4.3 months. The frequency...

  8. Calculation and analysis of velocity and viscous drag in an artery with a periodic pressure gradient

    Science.gov (United States)

    Alizadeh, M.; Seyedpour, S. M.; Mozafari, V.; Babazadeh, Shayan S.

    2012-07-01

    Blood as a fluid that human and other living creatures are dependent on has been always considered by scientists and researchers. Any changes in blood pressure and its normal velocity can be a sign of a disease. Whatever significant in blood fluid's mechanics is Constitutive equations and finding some relations for analysis and description of drag, velocity and periodic blood pressure in vessels. In this paper, by considering available experimental quantities, for blood pressure and velocity in periodic time of a thigh artery of a living dog, at first it is written into Fourier series, then by solving Navier-Stokes equations, a relation for curve drawing of vessel blood pressure with rigid wall is obtained. Likewise in another part of this paper, vessel wall is taken in to consideration that vessel wall is elastic and its pressure and velocity are written into complex Fourier series. In this case, by solving Navier-Stokes equations, some relations for blood velocity, viscous drag on vessel wall and blood pressure are obtained. In this study by noting that vessel diameter is almost is large (3.7 mm), and blood is considered as a Newtonian fluid. Finally, available experimental quantities of pressure with obtained curve of solving Navier-Stokes equations are compared. In blood analysis in rigid vessel, existence of 48% variance in pressure curve systole peak caused vessel blood flow analysis with elastic wall, results in new relations for blood flow description. The Resultant curve is obtained from new relations holding 10% variance in systole peak.

  9. Effect of a single oral dose of milrinone on left ventricular diastolic performance in the failing human heart.

    Science.gov (United States)

    Piscione, F; Jaski, B E; Wenting, G J; Serruys, P W

    1987-12-01

    In 14 patients with severe congestive heart failure, left ventricular pressure (measured by tip manometer) and derived variables were measured before and every 10 minutes after administration of oral milrinone (10 mg) for 50 minutes along with measurements of coronary sinus blood flow and drug plasma levels. Arterial and coronary sinus catecholamines were measured only before and 50 minutes after milrinone. Left ventricular pressure, volume (as determined by angiography) and derived indexes were simultaneously assessed at matched atrial paced heart rate before and 60 minutes after milrinone. Three patients who did not achieve a therapeutic plasma level (less than 150 ng/ml) were excluded. Peak negative first derivative of left ventricular pressure (-dP/dt) progressively and significantly increased (10%) together with a decrease in the two exponential time constants of relaxation, namely, Tau 1 (19%) and Tau 2 (22%), which represent the fit for and after the first 40 ms, respectively. Coronary flow significantly increased by 43% within 30 minutes, whereas the decrease (-13%) in coronary vascular resistance failed to be statistically significant. No change occurred in catecholamine concentrations after milrinone. Peak filling rate significantly increased by 15%. Pressure-volume curves showed a leftward and, in four patients, a downward shift; a significant decrease in minimal left ventricular diastolic and end-diastolic pressures (by 55 and 38%, respectively) and in end-diastolic volume (18%) occurred. The constant of elastic chamber stiffness measured by the simple elastic model tended to decrease, but failed to achieve a statistically significant level. Thus, oral milrinone improved left ventricular early relaxation and filling as well as chamber distensibility. This global improvement of diastolic function makes milrinone a potentially useful drug in the oral treatment of heart failure.

  10. Isobolographic analysis of the interaction between fenoldopam and levodopa on arterial blood pressure of the rat.

    Science.gov (United States)

    Quevedo, M; Prieto, J C; Miranda, H F; Pinardi, G

    2000-09-01

    Fenoldopam (FD) and levodopa (LD) injected intravenously in rats in a noncumulative schedule induced dose-dependent reductions in mean arterial blood pressure. The doses that induced a 50% reduction in the initial control mean arterial pressure (referred as ED50) were calculated by linear regression analysis of the corresponding parallel dose-response curves and were 0.88 and 0.068 mg/kg, respectively. The interaction between the effects of FD and LD on pressure reduction was evaluated by simultaneous administration of different fixed ratios of FD and LD (16:1) and obtaining a dose-response curve. An isobolographic analysis was then performed, which showed that the experimental point for the effect of the simultaneous administration of FD and LD was significantly different from the theoretically calculated additive point, denoting supradditivity. It was concluded that the effect of the combination of FD and LD on mean blood pressure reduction was synergic and was probably due to an activation of D1 vascular receptors by both drugs, in conjunction with an activation of beta2 adrenoceptors by LD and a blocking action of FD on postsynaptic alpha1-adrenoceptors.

  11. PREDICTION OF BLOOD PATTERN IN S-SHAPED MODEL OF ARTERY UNDER NORMAL BLOOD PRESSURE

    Directory of Open Access Journals (Sweden)

    Mohd Azrul Hisham Mohd Adib

    2013-06-01

    Full Text Available Athletes are susceptible to a wide variety of traumatic and non-traumatic vascular injuries to the lower limb. This paper aims to predict the three-dimensional flow pattern of blood through an S-shaped geometrical artery model. This model has created by using Fluid Structure Interaction (FSI software. The modeling of the geometrical S-shaped artery is suitable for understanding the pattern of blood flow under constant normal blood pressure. In this study, a numerical method is used that works on the assumption that the blood is incompressible and Newtonian; thus, a laminar type of flow can be considered. The authors have compared the results with a previous study with FSI validation simulation. The validation and verification of the simulation studies is performed by comparing the maximum velocity at t = 0.4 s, because at this time, the blood accelerates rapidly. In addition, the resulting blood flow at various times, under the same boundary conditions in the S-shaped geometrical artery model, is presented. The graph shows that velocity increases linearly with time. Thus, it can be concluded that the flow of blood increases with respect to the pressure inside the body.

  12. Effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome

    Institute of Scientific and Technical Information of China (English)

    Mehri Najafi Sani; Hamid Reza Kianifar; Abdolrazagh Kianee; Gholamreza Khatami

    2006-01-01

    AIM: To study the effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome.METHODS: Garlic powder in a capsule form was given to 15 children with hepatopulmonary syndrome (confirmed by contrast echocardiography) at the dosage of 1g/1.73 m2 per day. Patients were evaluated clinically and by arterial blood gas every four weeks.RESULTS: The garlic capsule was administered to 15patients with hepatopulmonary syndrome. There were 10 boys and 5 girls with a mean age of 9.4±3.9 years.The underlying problems were biliary tract atresia (4patients), autoimmune hepatitis (4 patients), cryptogenic cirrhosis (4 patients) and presinusoidal portal hypertension (3 patients). Eight patients (53.3%) showed an increase of 10 mmHg in their mean arterial oxygen pressure. The baseline PaO2 was 65.6±12.1 mmHg in the responder group and 47.1±11.2 mmHg in nonresponder group. At the end of treatment the mean PaO2 in responders and non-responders was 92.2±7.75mmHg and 47.5±11.87 mmHg, respectively (P<0.01).CONCLUSION: Garlic may increase oxygenation and improve dyspnea in children with hepatopulmonary syndrome.

  13. Increased wall tension in response to vasoconstrictors in isolated mesenteric arterial rings from patients with high blood pressure.

    Science.gov (United States)

    Tahvanainen, Anna; Taurio, Jyrki; Mäki-Jouppi, Jenni; Kööbi, Peeter; Mustonen, Jukka; Kähönen, Mika; Sand, Juhani; Nordback, Isto; Pörsti, Ilkka

    2006-12-01

    Essential hypertension is associated with several alterations in arterial function. A wealth of information from animal models is available concerning hypertensive changes in the mesenteric circulation, while only few studies have examined human mesenteric arterial function. The tone of isolated mesenteric arterial segments (outer diameter 0.7-0.9 mm) was examined from individuals with high (n=17) or normal (n=22) blood pressure, grouped using the current definition of elevated blood pressure (140/90 mmHg). Since the majority of them were operated because of malignancies, we evaluated whether functional vascular properties provided information about patient prognosis. Wall tension development (mN/mm) in response to vasoconstrictors (noradrenaline, 5-hydroxy tryptamine, potassium chloride) was higher in mesenteric arterial rings from patients with high than normal blood pressure. There was no difference in vasoconstrictor sensitivity, or endothelium-dependent and endothelium-independent vasorelaxation. Arterial segment weight was higher in hypertensive subjects, suggesting vascular wall hypertrophy. The 10-year follow-up showed no differences in the control of arterial tone between the surviving (n=14) or deceased (n=25) patients. In conclusion, isolated mesenteric arterial segments from hypertensive patients showed increased wall tension in response to vasoconstrictors. Since the mesenteric circulation is an important regulator of peripheral arterial resistance, possible functional alterations in this vascular bed should be further investigated in hypertensive patients.

  14. Relationship between stroke volume and pulse pressure during blood volume perturbation: a mathematical analysis.

    Science.gov (United States)

    Bighamian, Ramin; Hahn, Jin-Oh

    2014-01-01

    Arterial pulse pressure has been widely used as surrogate of stroke volume, for example, in the guidance of fluid therapy. However, recent experimental investigations suggest that arterial pulse pressure is not linearly proportional to stroke volume. However, mechanisms underlying the relation between the two have not been clearly understood. The goal of this study was to elucidate how arterial pulse pressure and stroke volume respond to a perturbation in the left ventricular blood volume based on a systematic mathematical analysis. Both our mathematical analysis and experimental data showed that the relative change in arterial pulse pressure due to a left ventricular blood volume perturbation was consistently smaller than the corresponding relative change in stroke volume, due to the nonlinear left ventricular pressure-volume relation during diastole that reduces the sensitivity of arterial pulse pressure to perturbations in the left ventricular blood volume. Therefore, arterial pulse pressure must be used with care when used as surrogate of stroke volume in guiding fluid therapy.

  15. 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...... a relatively noise-free environment in which to work. Because of the time-varying nature of the blood pressure, we have concentrated in this review on the now substantial body of work on the dynamics of renal blood flow regulation and the underlying mechanisms. Renal vascular control mechanisms are not simply...... of experimental hypertension provide tubular pressure records that pass statistical tests for ordered structure and sensitive dependence on initial conditions in the reconstructed state space, two of the hallmarks of deterministic chaos. These records also pass recent more stringent tests for chaos...

  16. Arterial pressure and deltoid muscle gas tensions during cardiopulmonary bypass in man.

    Science.gov (United States)

    Stanley, T H

    1978-07-01

    The results of this study demonstrate that standard techniques of conducting cardiopulmonary bypass produce low muscle oxygen and high muscle carbon dioxide tensions and, thus, little perfusion of skeletal muscle. Our findings also show that PmO2 and PmCO2 do not return to pre-bypass levels until the mean arterial blood pressure exceeds 12 kPa (90 torr) during bypass and that utilization of vasopressor drugs during bypass maintains the pressure; but at the expense of muscle blood flow. The data indicate that both high mean blood pressure and high flow are necessary during bypass to ensure skeletal muscle perfusion and suggest, when combined with preliminary animal findings, that this type of bypass perfusion may prove to be superior to standard techniques in hastening recovery after cardio-pulmonary bypass.

  17. 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

  18. An innovative method to measure the peripheral arterial elasticity: spring constant modeling based on the arterial pressure wave with radial vibration.

    Science.gov (United States)

    Wei, Ching-Chuan

    2011-11-01

    In this study, we propose an innovative method for the direct measurement of the peripheral artery elasticity using a spring constant model, based on the arterial pressure wave equation, vibrating in a radial direction. By means of the boundary condition of the pressure wave equation at the maximum peak, we can derive the spring constant used for evaluating peripheral arterial elasticity. The calculated spring constants of six typical subjects show a coincidence with their proper arterial elasticities. Furthermore, the comparison between the spring constant method and pulse wave velocity (PWV) was investigated in 70 subjects (21-64 years, 47 normotensives and 23 hypertensives). The results reveal a significant negative correlation for the spring constant vs. PWV (correlation coefficient = -0.663, p constant method to assess the arterial elasticity is carefully verified, and it is shown to be effective as well as fast. This method should be useful for healthcare, not only in improving clinical diagnosis of arterial stiffness but also in screening subjects for early evidence of cardio-vascular diseases and in monitoring responses to therapy in the future.

  19. 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 direct cooling or intra-arterial noradrenaline infusion caused a marked drop in FSP in the exposed fingers, but not in the non-exposed fingers of the same hand. The fact that the non-exposed fingers retained the normal (arm systolic) pressure level is taken to indicate that palmar arch blood pressure...... also remained normal. In the high vascular tone state, a large transmural pressure difference must apparently be established before the digital arteries are forced open. The lowered opening pressure constitutes a manifestation of the closure phenomenon of the digital arteries described in patients...

  20. Relationship between pulmonary arterial pressure and pulmonary thromboembolism associated with dead worms in canine heartworm disease.

    Science.gov (United States)

    Hirano, Y; Kitagawa, H; Sasaki, Y

    1992-10-01

    To examine effects of thromboemboli due to dead worms on pulmonary arterial pressure (PAP), 20 to 50 dead heartworms were inserted into the pulmonary arteries of 4 heartworm uninfected dogs (uninfected group) and 11 dogs infected with heartworms (infected group). In the uninfected group, the mean PAP rose 1 week after worm insertion (10.9 to 166. mmHg), but it recovered by the 4th week. Clinical signs, hemodynamics and blood gas findings also deteriorated at the 1st week, but recovered at the 4th week. Angiographic and pathological findings indicated that blood flow recovered through the spaces between thromboemboli and vessel walls at the 4th week. The infected dogs were divided into three groups. In the infected-I group (5 dogs), the intimal lesions of the pulmonary arteries were slight, and clinical and laboratory findings showed changes similar to those of the uninfected group. In the infected-II group (4 dogs), the pulmonary arterial lesions were severe and the mean PAP was higher (25.7 mmHg) than in the uninfected group before worm insertion. An increase in PAP (34.1 mmHg) and worsening of clinical and laboratory findings were noticed till the 4th week. Thromboemboli adhered extensively to the vessel walls. Two dogs in the infected-III group died of severe dyspnea on the 9th and 10th day, and the mean PAP rose remarkably at the 1st week (from 19.4 to 28.2 mmHg). Severe pulmonary parenchymal lesions with edema or perforation were observed. From the above results, it was clarified that effects of dead worms on PAP and clinical signs depended on the severity of pulmonary arterial lesions before worm insertion.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Redox signaling via oxidative inactivation of PTEN modulates pressure-dependent myogenic tone in rat middle cerebral arteries.

    Directory of Open Access Journals (Sweden)

    Debebe Gebremedhin

    Full Text Available The present study examined the level of generation of reactive oxygen species (ROS and roles of inactivation of the phosphatase PTEN and the PI3K/Akt signaling pathway in response to an increase in intramural pressure-induced myogenic cerebral arterial constriction. Step increases in intraluminal pressure of cannulated cerebral arteries induced myogenic constriction and concomitant formation of superoxide (O2 (.- and its dismutation product hydrogen peroxide (H2O2 as determined by fluorescent HPLC analysis, microscopic analysis of intensity of dihydroethidium fluorescence and attenuation of pressure-induced myogenic constriction by pretreatment with the ROS scavenger 4,hydroxyl-2,2,6,6-tetramethylpiperidine1-oxyl (tempol or Mito-tempol or MitoQ in the presence or absence of PEG-catalase. An increase in intraluminal pressure induced oxidation of PTEN and activation of Akt. Pharmacological inhibition of endogenous PTEN activity potentiated pressure-dependent myogenic constriction and caused a reduction in NPo of a 238 pS arterial KCa channel current and an increase in [Ca(2+]i level in freshly isolated cerebral arterial muscle cells (CAMCs, responses that were attenuated by Inhibition of the PI3K/Akt pathway. These findings demonstrate an increase in intraluminal pressure induced increase in ROS production triggered redox-sensitive signaling mechanism emanating from the cross-talk between oxidative inactivation of PTEN and activation of the PI3K/Akt signaling pathway that involves in the regulation of pressure-dependent myogenic cerebral arterial constriction.

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

    Directory of Open Access Journals (Sweden)

    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

  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

  4. 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.

  5. Gene-centric meta-analysis in 87,736 individuals of European ancestry identifies multiple blood-pressure-related loci

    NARCIS (Netherlands)

    V. Tragante (Vinicius); M. Barnes (Michael); S.K. Ganesh (Santhi); M.B. Lanktree (Matthew); W. Guo (Weixiang); N. Franceschini (Nora); G.D. Smith; T. Johnson (Toby); M.V. Holmes (Michael); S. Padmanabhan (Sandosh); K.J. Karczewski (Konrad); B. Almoguera (Berta); J. Barnard (John); J. Baumert (Jens); Y.-P.C. Chang (Yen-Pei); C.C. Elbers (Clara); M. Farrall (Martin); M.E. Fischer (Mary); T.R. Gaunt (Tom); J.M.I.H. Gho (Johannes); C. Gieger (Christian); A. Goel (Anuj); Y. Gong (Yeming); A.J. Isaacs (Aaron); M.E. Kleber (Marcus); I.M. Leach (Irene Mateo); C.W. McDonough (Caitrin); M.F.L. Meijs (Matthijs); O. Melander (Olle); C.P. Nelson (Christopher P.); I.M. Nolte (Ilja); V.S. Pankratz (Shane); T.S. Price (Thomas); J. Shaffer (Jonathan); S. Shah (Sonia); M. Tomaszewski (Maciej); P.J. van der Most (Peter); E.P.A. van Iperen (Erik); J.M. Vonk (Judith); H.E. Witkowska (Ewa); C.O.L. Wong (Caroline); L. Zhang (Lingling); A.L. Beitelshees (Amber); G. Berenson (Gerald); D.L. Bhatt (Deepak); M.J. Brown (Morris); A.D. Burt (Alastair); R.M. Cooper-Dehoff (Rhonda); J. Connell (John); K.J. Cruickshanks (Karen); S.P. Curtis (Sean); G. Davey-Smith (George); C. Delles (Christian); R.T. Gansevoort (Ron); X. Guo (Xiuqing); S. Haiqing (Shen); C.E. Hastie (Claire); M.A. Hofker (Marten); G.K. Hovingh (Kees); D.S. Kim (Daniel); S.A. Kirkland (Susan); B.E.K. Klein (Barbara); B.E.K. Klein (Barbara); Y.R. Li (Yun); R. Maiwald (Robert); C. Newton-Cheh (Christopher); E. O'Brien (Eoin); N.C. Onland-Moret (Charlotte); W. Palmas (Walter); A. Parsa (Afshin); B.W.J.H. Penninx (Brenda); M. Pettinger (Mary); R.S. Vasan (Ramachandran Srini); J.E. Ranchalis (Jane); P. M Ridker (Paul); L.M. Rose (Lynda); P. Sever (Peter); D. Shimbo (Daichi); L. Steele (Linda); R.P. Stolk (Ronald); B. Thorand (Barbara); M.D. Trip (Mieke); C.M. van Duijn (Cock); W.M.M. Verschuren (W. M. Monique); C. Wijmenga (Cisca); S. Wyatt (Sally); J.C. Young (J. C.); A.H. Zwinderman (Ailko); C.R. Bezzina (Connie); E. Boerwinkle (Eric); J.P. Casas (Juan); M. Caulfield (Mark); A. Chakravarti (Aravinda); D.I. Chasman (Daniel); K.W. Davidson (Karina); P.A. Doevendans (Pieter); A. Dominiczak (Anna); G.A. Fitzgerald (Garret); J.G. Gums (John); M. Fornage (Myriam); H. Hakonarson (Hakon); H. van Halder (Han); H.L. Hillege (Hans); T. Illig (Thomas); G.P. Jarvik (Gail); J.A. Johnson (Jennifer ); J.J.P. Kastelein (John); W. Koenig (Wolfgang); M. Kumari (Meena); W. März (Winfried); S.S. Murray (Sarah); J.R. O'Connell (Jeffery); A.J. Oldehinkel (Albertine); J.S. Pankow (James); D.J. Rader (Daniel); S. Redline (Susan); M.P. Reilly (Muredach); E.E. Schadt (Eric); K. Kottke-Marchant (Kandice); H. Snieder (Harold); M. Snyder (Michael); A. Stanton (Alice); M.D. Tobin (Martin); A.G. Uitterlinden (André); P. van der Harst (Pim); Y.T. van der Schouw (Yvonne); N.J. Samani (Nilesh); H. Watkins (Hugh); A.D. Johnson (Andrew); A.P. Reiner (Alex); X. Zhu (Xiaofeng); P.I.W. de Bakker (Paul); D. Levy (Daniel); F.W. Asselbergs (Folkert); P. Munroe (Patricia); J. Keating (John)

    2014-01-01

    textabstractBlood 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

  6. Gene-centric meta-analysis in 87,736 individuals of European ancestry identifies multiple blood-pressure-related loci

    NARCIS (Netherlands)

    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; Elbers, Clara C; Farrall, Martin; Fischer, Mary E; Gaunt, Tom R; Gho, Johannes M I H; Gieger, Christian; Goel, Anuj; Gong, Yan; Isaacs, Aaron; Kleber, Marcus E; Mateo Leach, Irene; McDonough, Caitrin W; Meijs, Matthijs F L; Melander, Olle; Nelson, Christopher P; Nolte, Ilja M; Pankratz, Nathan; Price, Tom S; Shaffer, Jonathan; Shah, Sonia; Tomaszewski, Maciej; van der Most, Peter J; Van Iperen, Erik P A; Vonk, Judith M; Witkowska, Kate; Wong, Caroline O L; Zhang, Li; Beitelshees, Amber L; Berenson, Gerald S; Bhatt, Deepak L; Brown, Morris; Burt, Amber; Cooper-DeHoff, Rhonda M; Connell, John M; Cruickshanks, Karen J; Curtis, Sean P; Davey-Smith, George; Delles, Christian; Gansevoort, Ron T; Guo, Xiuqing; Haiqing, Shen; Hastie, Claire E; Hofker, Marten H; Hovingh, G Kees; Kim, Daniel S; Kirkland, Susan A; Klein, Barbara E; Klein, Ronald; Li, Yun R; Maiwald, Steffi; Newton-Cheh, Christopher; O'Brien, Eoin T; Onland-Moret, N Charlotte; Palmas, Walter; Parsa, Afshin; Penninx, Brenda W; Pettinger, Mary; Vasan, Ramachandran S; Ranchalis, Jane E; M Ridker, Paul; Rose, Lynda M; Sever, Peter; Shimbo, Daichi; Steele, Laura; Stolk, Ronald P; Thorand, Barbara; Trip, Mieke D; van Duijn, Cornelia M; Verschuren, W Monique; Wijmenga, Cisca; Wyatt, Sharon; Young, J Hunter; Zwinderman, Aeilko H; Bezzina, Connie R; Boerwinkle, Eric; Casas, Juan P; Caulfield, Mark J; Chakravarti, Aravinda; Chasman, Daniel I; Davidson, Karina W; Doevendans, Pieter A; Dominiczak, Anna F; FitzGerald, Garret A; Gums, John G; Fornage, Myriam; Hakonarson, Hakon; Halder, Indrani; Hillege, Hans L; Illig, Thomas; Jarvik, Gail P; Johnson, Julie A; Kastelein, John J P; Koenig, Wolfgang; Kumari, Meena; März, Winfried; Murray, Sarah S; O'Connell, Jeffery R; Oldehinkel, Albertine J; Pankow, James S; Rader, Daniel J; Redline, Susan; Reilly, Muredach P; Schadt, Eric E; Kottke-Marchant, Kandice; Snieder, Harold; Snyder, Michael; Stanton, Alice V; Tobin, Martin D; Uitterlinden, André G; van der Harst, Pim; van der Schouw, Yvonne T; Samani, Nilesh J; Watkins, Hugh; Johnson, Andrew D; Reiner, Alex P; Zhu, Xiaofeng; de Bakker, Paul I W; Levy, Daniel; Asselbergs, Folkert W; Munroe, Patricia B; Keating, Brendan J

    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 similar to 50,000 SNPs in up to 87,736 individuals of European ancestry and c

  7. Vitamin D induces increased systolic arterial pressure via vascular reactivity and mechanical properties.

    Directory of Open Access Journals (Sweden)

    Priscila Portugal Dos Santos

    Full Text Available The aim of this study was to evaluate whether supplementation of high doses of cholecalciferol for two months in normotensive rats results in increased systolic arterial pressure and which are the mechanisms involved. Specifically, this study assesses the potential effect on cardiac output as well as the changes in aortic structure and functional properties.Male Wistar rats were divided into three groups: 1 Control group (C, n = 20, with no supplementation of vitamin D, 2 VD3 (n = 19, supplemented with 3,000 IU vitamin D/kg of chow; 3 VD10 (n = 21, supplemented with 10,000 IU vitamin D/kg of chow. After two months, echocardiographic analyses, measurements of systolic arterial pressure (SAP, vascular reactivity, reactive oxygen species (ROS generation, mechanical properties, histological analysis and metalloproteinase-2 and -9 activity were performed.SAP was higher in VD3 and VD10 than in C rats (p = 0.001. Echocardiographic variables were not different among groups. Responses to phenylephrine in endothelium-denuded aortas was higher in VD3 compared to the C group (p = 0.041. Vascular relaxation induced by acetylcholine (p = 0.023 and sodium nitroprusside (p = 0.005 was impaired in both supplemented groups compared to the C group and apocynin treatment reversed impaired vasodilation. Collagen volume fraction (<0.001 and MMP-2 activity (p = 0.025 was higher in VD10 group compared to the VD3 group. Elastin volume fraction was lower in VD10 than in C and yield point was lower in VD3 than in C.Our findings support the view that vitamin D supplementation increases arterial pressure in normotensive rats and this is associated with structural and functional vascular changes, modulated by NADPH oxidase, nitric oxide, and extracellular matrix components.

  8. Dependency of cerebral blood flow upon mean arterial pressure in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Larsen, Fin Stolze; Qvist, Jesper;

    2000-01-01

    OBJECTIVE: Patients with acute bacterial meningitis are often treated with sympathomimetics to maintain an adequate mean arterial pressure (MAP). We studied the influence of such therapy on cerebral blood flow (CBF). DESIGN: Prospective physiologic trial. SETTING: The Department of Infectious...... Diseases, Copenhagen University Hospital, Denmark. PATIENTS: Sixteen adult patients with acute bacterial meningitis. INTERVENTION: Infusion of norepinephrine to increase MAP. MEASUREMENTS: During a rise in MAP induced by norepinephrine infusion, we measured relative changes in CBF by transcranial Doppler...... bacterial meningitis, CBF autoregulation is impaired. With recovery from meningitis, the cerebral vasculature regains the ability to maintain cerebral perfusion at a constant level despite variations in MAP....

  9. Arterial stiffness: pathophysiology and clinical impact.

    Science.gov (United States)

    London, Gérard M; Marchais, Sylvain J; Guerin, Alain P; Pannier, Bruno

    2004-01-01

    The ill effects of hypertension are usually attributed to a reduction in the caliber or the number of arterioles, resulting in an increase in total peripheral resistance (TPR). This definition does not take into account the fact that BP is a cyclic phenomenon with systolic and diastolic BP being the limits of these oscillations. The appropriate term to define the arterial factor(s) opposing LV ejection is aortic input impedance which depends on TPR, arterial distensibility (D), and wave reflections (WR). D defines the capacitive properties of arterial stiffness, whose role is to dampen pressure and flow oscillations and to transform pulsatile flow and pressure in arteries into a steady flow and pressure in peripheral tissues. Stiffness is the reciprocal value of D. These parameters are BP dependent, and arteries become stiffer at high pressure. In to D which provides information about the elasticity> of artery as a hollow structure, the elastic incremental modulus (Einc) characterizes the properties of the arterial wall biomaterials, independently of vessel geometry. As an alternative, arterial D can be evaluated by measuring the pulse wave velocity (PWV) which increases with the stiffening of arteries. Arterial stiffening increases left ventricular (LV) afterload and alters the coronary perfusion. With increased PWV, the WR impacts on the aorta during systole, increasing systolic pressures and myocardial oxygen consumption, and decreasing diastolic BP and coronary flow. The arterial stiffness is altered primarily in association with increased collagen content and alterations of extracellular matrix (arteriosclerosis) as classically observed during aging or in arterial hypertension. The arterial stiffening estimated by changes in aortic PWV and intensity of WR are independent predictors of survival in end stage renal disease (ESRD) and general population. Improvement of arterial stiffening could be obtained by antihypertensive treatmen as observed with the calcium

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Fabiane Rosa Rezende H. Marui

    2010-10-01

    ene/2007-set/2009. La medida de la presión arterial (PA casual de consultorio, MAPA de 24 horas y MRPA fueron realizadas según las directrices vigentes, con intervalo máximo de dos semanas entre los métodos. RESULTADOS: Al comparar la MAPA (media de vigilia y MRPA, fue obtenida buena correlación entre ambas, tanto para la presión arterial sistólica (PAS como para la diastólica (PAD: PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. La HAR fue confirmada por la MAPA en 33 pacientes y por la MRPA en 37 de esos, no habiendo diferencia significativa entre los dos métodos. CONCLUSIÓN: De acuerdo con los resultados obtenidos, se concluye que la MRPA es un examen que puede ser utilizado como alternativa a la MAPA para la confirmación diagnóstica de la HAR.BACKGROUND: Ambulatory blood pressure monitoring (ABPM is considered the gold standard for the diagnostic confirmation of resistant hypertension (RH. However, home blood pressure monitoring (HBPM has been considered an option, because of its lower cost and greater comfort. OBJECTIVE: To compare the values obtained by HBPM with those obtained by ABPM in the identification of patients with resistant hypertension. METHODS: A total of 51 consecutive patients with resistant hypertension were selected. All were adults of both genders and were undergoing treatment in an outpatient referral clinic from January 2007 to September 2009. Casual office blood pressure (BP, 24-hour ABPM, and HBPM were performed according to current guidelines, with a maximum two-week interval between the methods. RESULTS: The comparison of ABPM (mean daytime with HBPM showed a good correlation between them, both for systolic blood pressure (SBP and for diastolic blood pressure (DBP: SBP r = 0.70, CI = 0.51-0.82, DBP r = 0.69, CI = 0.52-0.81. RH was confirmed by ABPM in 33 patients and by HBPM in 37, with no significant difference between the methods. CONCLUSION: According to the results obtained, we conclude that HBPM is a method

  12. The assessment of diastolic function in patients with rheumatoid arthritis

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    Obradović-Tomašević Biljana

    2009-01-01

    Full Text Available Introduction. Rheumatoid arthritis (RA is a systemic inflammatory autoimmune chronic disease. In comparison with the overall population, mortality and morbidity of RA patients are increased due to cardiovascular diseases. There is increasing evidence that autoimmunity mechanisms are included in pathogenesis of cardiovascular diseases. Isolated disorder of diastolic function can, even with normal heart contractility, lead to heart failure. The aim of this study was to assess diastolic function in RA patients and determine factors causing diastolic dysfunction. Material and methods. The study included 88 patients with RA treated at Rheumatology Department, Clinical Hospital Centre, Zemun. All the patients were thoroughly examined (clinical findings, laboratory and echocardiographic examination. All parameters of diastolic function (mitral and pulmonary flow were measured. Results. In RA patients 98,9% had diastolic function disorder. This parameter had been changed prior to clinical signs of heart failure and decrease of ejection fraction. Indicators of diastolic function, velocities E, A and their ratio VE/VA, as well as velocities S, D and their ratio VS/VD were lower in patients with positive rheumatoid factor. The patients' age (p<0.01, duration of the disease (p<0.05, high level of cholesterol (p<0.05, triglycerides (p<0.05 and arterial hypertension (p<0.05 were significant factors considerably affecting diastolic function. Conclusion. These findings suggest subclinical myocardial disorder in a great number of RA patients. Apart from early and aggressive treatment of the chronic inflammatory process, it is also necessary to prevent further heart complications by timely recognition and treatment of 'standard' risk factors for cardiovascular diseases.

  13. 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.

  14. [Development of an automatic pneumatic tourniquet system that determines pressures in synchrony with systolic blood pressure].

    Science.gov (United States)

    Liu, Hongyun; Li, Kaiyuan; Zhang, Zhengbo; Guo, Junyan; Wang, Weidong

    2012-11-01

    The correlation coefficients between arterial occlusion pressure and systolic blood pressure, diastolic blood pressure, limb circumference, body mass etc were obtained through healthy volunteer experiments, in which tourniquet were applied on upper/lower extremities. The prediction equations were derived from the data of experiments by multiple regression analysis. Based on the microprocessor C8051F340, a new pneumatic tourniquet system that can determine tourniquet pressure in synchrony with systolic blood pressure was developed and verified the function and stability of designed system. Results showed that the pneumatic tourniquet which automatically adjusts occlusion pressure in accordance with systolic blood pressure could stop the flow of blood to get a bloodless field.

  15. Failure of unilateral carotid artery ligation to affect pressure-induced interruption of rapid axonal transport in primate optic nerves.

    Science.gov (United States)

    Radius, R L; Schwartz, E L; Anderson, D R

    1980-02-01

    Previous experiments showed that optic nerve axonal transport can be blocked at the level of the lamina cribrosa by elevated intraocular pressure. In an effort to discover if this blockage might be secondary to pressure-induced ischemia, we studied the effect of unilateral common carotid artery ligation upont the pressure-induced interruption of axonal transport. In 13 owl monkeys (Aotus trivirgatus), the right common carotid artery was ligated within the anterior cervical triangle. Three days later, ophtalmodynomometry was performed on all experimental eyes. In nine of the 13 animals, this estimate of ophthalmic artery pressure was 10 to 20 mm Hg less in the right compared to the left eye. Optic nerve axonal transport was studied in right and left eyes during 5 hours of increased intraocular pressure (ocular pressure 35 mm Hg less than mean femoral artery blood pressure). No significant difference in the extent to which the transport mechanisms were interrupted could be demonstrated when comparing right and left eyes of the experimental animals. These observations fail to support a vascular mechanism for this pressure-induced interruption of axonal transport.

  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. Oscillometric blood pressure measurement: a simple method in screening for peripheral arterial disease

    DEFF Research Database (Denmark)

    Mehlsen, Jesper; Wiinberg, Niels; Bruce, Christopher

    2008-01-01

    Blood pressure at the ankle level is a reliable indicator of peripheral arterial disease (PAD) and the ankle brachial index (ABI) is a useful non-invasive screening tool for the early detection of atherosclerosis. In the first part of the study, systolic blood pressures obtained by oscillometry......, the oscillometry showed a positive predictive value of 47%. The presence of PAD was significantly correlated to exercise related leg pain, a diagnosis of hypertension and smoking, whereas no correlation could be found with a diagnosis of heart disease, stroke, or with the presence of diabetes. The prevalence...... of PAD was sufficiently high in subjects over the age of 60 years to warrant screening. The ankle brachial index based on measurements with an oscillometric device was shown reliable in the exclusion of PAD, thereby fulfilling an important criterion for the use in screening....

  18. System identification of baroreflex response to mild lower body negative pressure.

    Science.gov (United States)

    Aletti, Federico; Ferrario, Manuela; Xu, Da; Greaves, Danielle K; Shoemaker, Kevin J; Arbeille, Philippe; Cerutti, Sergio; Hughson, Richard L; Baselli, Giuseppe

    2011-01-01

    The effect of mild lower body negative pressure (LBNP) on baroreflex control of arterial blood pressure (ABP) has long been thought to affect cardiopulmonary baroreflex only, although recent studies have pointed out that arterial baroreceptors may be transiently unloaded too after the rapid onset of mild LBNP. This paper presents a spectral decomposition method for the black box identification of the contribution of arterial and cardiopulmonary baroreflexes to beat-by-beat variability of ABP in response to mild LBNP levels. The significant decrease of mean and diastolic arterial pressure and of the arterial baroreflex mediated contribution to overall variability of ABP which was found, suggested that the unloading of arterial baroreceptors may be reflected by an altered dynamic response of arterial baroreflex, too. In addition, arterial baroreflex mediated modulations were found to be the main player in the modulation of beat-by-beat fluctuations of ABP, while the role of cardiopulmonary baroreflex mediated responses appeared to contribute very little.

  19. 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. PMID:27066273

  20. Noninvasively assessed pulsatility of ascending aortic pressure waveform is associated with the presence of coronary artery narrowing.

    Science.gov (United States)

    Wykretowicz, Andrzej; Metzler, Lidia; Milewska, Agata; Balinski, Marek; Rutkowska, Agnieszka; Adamska, Karolina; Krauze, Tomasz; Guzik, Przemysław; Dziarmaga, Mieczysław; Wysocki, Henryk

    2008-01-01

    Several hemodynamic indices, measured invasively in the ascending aorta during routine angiography, are related to the presence and severity of coronary atherosclerosis. Radial artery tonometry, when combined with a validated transfer function, offers the possibility of noninvasive assessment of central arterial pressure. We aim to evaluate the association between noninvasive indices of aortic or radial pressure waveforms and the presence of a significant coronary stenosis. Patients who underwent elective coronary angiography were studied (110 men, 91 women, mean age 53 +/- 0.9 years). Noninvasive measurement of their central hemodynamics was performed by analysis of the aortic pressure waveform derived from the radial artery. An increase in aortic fractional pulse pressure was associated with coronary artery narrowing or previous myocardial infarction. After multivariate adjustment, the odds ratio and confidence intervals (CI) of having a significant coronary aortic stenosis was 1.72 (95% CI, 1.1-2.7) and of previous myocardial infarction 1.6 (95% CI, 1.1-2.2). An increase in noninvasively assessed aortic fractional pulse pressure, but not of the peripheral index is significantly associated with the presence of coronary artery disease.

  1. A pressão arterial está sendo medida? Is the blood pressure being measured?

    Directory of Open Access Journals (Sweden)

    Débora C. Alavarce

    2000-03-01

    Full Text Available A medida da pressão arterial faz parte do exame físico e deve ser realizada em toda consulta médica. Para avaliar se a pressão arterial é medida nas consultas médicas, foram consultados 500 prontuários de pacientes de primeira consulta ambulatorial, sendo 335 (67% provenientes de clínicas médicas e cirúrgicas e 165 (33% das clínicas ginecológica e obstétrica. A pressão arterial foi anotada em 39% das consultas realizadas (135±32/85±19 mm Hg, sendo que em 11% destas anotações a pressão diastólica estava acima de 90 mm Hg. Em relação ao diagnóstico prévio de hipertensão arterial verificou-se que: a em 62% dos prontuários não havia esta informação; b 20% referiram ter hipertensão, e em 79% destes a pressão arterial foi anotada; e c 18% referiram não ter hipertensão e 46% destes tiveram registro da pressão arterial. Portanto, a maior parte dos pacientes não teve sua pressão arterial anotada.The blood pressure measure is part of the physical exam and it should be accomplished in every medical consultation. To verify the blood pressure measured in the accomplished medical consultations record of first they were consulted it consults 500 patient's ambulatorial being 335 (67% coming of medical and surgical clinics and 165 (33% of the gynecological and obstetric clinics. The blood pressure was written down in 39% of the accomplished consultations (135+32 mm Hg 85+19 mm Hg, and 11% of this annotations the pressure diastólica was above 90 mm Hg. In relation to the previous diagnosis of hypertension it was verified that: a in 62% of the records there was not this information; b 20% referred to have hypertension, and in 79% of these the arterial pressure was scored; and c 18% referred not to have hypertension and 46% of these had registration of the arterial pressure. Therefore, most of the patients didn't have its logged arterial pressure.

  2. Influence of changes in the pulmonary artery pressure on ventilation requirements in patients undergoing mitral valve replacement.

    Directory of Open Access Journals (Sweden)

    Muralidhar K

    2004-01-01

    Full Text Available The study was designed to evaluate the influence of changes in pulmonary artery pressure on the ventilation requirements in patients undergoing mitral valve surgery. Thirty patients with mitral valve disease with significant pulmonary arterial hypertension undergoing mitral valve replacement under cardiopulmonary bypass were included in this prospective study. All patients had a pulmonary artery catheter placed after the anaesthetic induction. The minute ventilation was adjusted to achieve an arterial carbon dioxide tension (PaCO2 of 35-40 mm Hg. After a stabilisation period of 15 minutes, the pulmonary artery pressure and the minute volume needed for maintaining a PaCO2 of 35-40 mm Hg in the precardiopulmonary bypass, post-cardiopulmonary bypass and six hours postoperatively were measured after ensuring stable haemodynamics and normothermia. There was a significant decrease in the mean pulmonary artery pressure from pre-cardiopulmonary bypass value of 41.3+/-15 mm Hg to 29.3+/-8 mm Hg in the postcardiopulmonary bypass period and subsequently to 25.5+/-7 mm Hg in the intensive care unit. There was a corresponding increase in the minute volume requirements from a pre-cardiopulmonary bypass value of 6.8+/-1 L/min to 8.0+/-1 L/min in the post cardiopulmonary bypass period and then to 9.4+/-1.2 L/min in the postoperative period. We conclude that there is a significant decrease in the pulmonary blood volume and a subsequent decrease in the pulmonary artery pressure after a successful mitral valve replacement in patients with pulmonary arterial hypertension. This is associated with a significant increase in the requirement of minute ventilation to maintain normocarbia.

  3. Decrease of blood pressure by community-based strategies Descenso de la presión arterial por estrategias comunitarias

    Directory of Open Access Journals (Sweden)

    Martín R. Salazar

    2005-12-01

    Full Text Available In a cross section study performed in Rauch in 1997 we found a high prevalence of hypertension and low levels of treatment and control. To evaluate the impact of the community-based intervention activities on blood pressure (BP, we made a cohort study in 1526 inhabitants aged between 15 and 75 years in 2003. The initial study, the advice to consult the family doctor when alterations were found, the free provision of antihypertensive drugs, the press diffusion of the study results and a healthy lifestyle were included among the intervention activities. BP was measured in the subjects' residence by especially trained nurses, considering systolic BP (SBP and diastolic BP (DBP as the average of three measurements in one occasion. A total of 1307 subjects (85.65% were re-interviewed. SBP decreased from 137.98 ± 0.57 to 132.49 ± 0.53 mm Hg (pLa ciudad de Rauch presentaba en 1997 alta prevalencia de hipertensión arterial (HA y bajos niveles de tratamiento y control. Para evaluar el impacto de actividades de intervención comunitarias sobre la presión arterial (PA reencuestamos en el año 2003 a una cohorte de 1526 habitantes de 15-75 años. Las actividades de intervención fueron el estudio inicial, la indicación de concurrir a su médico cuando se hallaban alteraciones, la provisión gratuita de antihipertensivos y la difusión por medios masivos de los resultados del estudio y de hábitos saludables de vida. La PA fue medida en el domicilio por enfermeras especialmente entrenadas, considerando PA sistólica y diastólica (PAS y PAD a los promedios de tres registros en una ocasión. Se reencuestaron 1307 individuos (85.65%. La PAS descendió de 137.98 ± 0.57 a 132.49 ± 0.53 mm Hg (p<0.01 y la PAD de 88.73 ± 0.38 a 81.87 ± 0.33 mm Hg (p<0.01. La PA disminuyó en ambos sexos, en todos los grupos etáreos y en el subgrupo sin antihipertensivos. El porcentaje de sujetos con antihipertensivos aumentó de 12.2 a 20.4 (p<0.01 y se observó una

  4. 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

  5. Earliest effects of sudden occlusions on pressure profiles in selected locations of the human systemic arterial system

    Science.gov (United States)

    Majka, Marcin; Gadda, Giacomo; Taibi, Angelo; Gałązka, Mirosław; Zieliński, Piotr

    2017-03-01

    We have developed a numerical simulation method for predicting the time dependence (wave form) of pressure at any location in the systemic arterial system in humans. The method uses the matlab-Simulink environment. The input data include explicitly the geometry of the arterial tree, treated up to an arbitrary bifurcation level, and the elastic properties of arteries as well as rheological parameters of blood. Thus, the impact of anatomic details of an individual subject can be studied. The method is applied here to reveal the earliest stages of mechanical reaction of the pressure profiles to sudden local blockages (thromboses or embolisms) of selected arteries. The results obtained with a purely passive model provide reference data indispensable for studies of longer-term effects due to neural and humoral mechanisms. The reliability of the results has been checked by comparison of two available sets of anatomic, elastic, and rheological data involving (i) 55 and (ii) 138 arterial segments. The remaining arteries have been replaced with the appropriate resistive elements. Both models are efficient in predicting an overall shift of pressure, whereas the accuracy of the 55-segment model in reproducing the detailed wave forms and stabilization times turns out dependent on the location of the blockage and the observation point.

  6. Subclavian steal syndrome presenting as recurrent pulmonary oedema associated with acute left ventricular diastolic dysfunction.

    Science.gov (United States)

    Mangialavori, Giuseppe; Ballo, Piercarlo; Michelagnoli, Stefano; Ercolini, Leonardo; Barbanti, Enrico; Passuello, Franco; Abbondanti, Alessandro; Consoli, Lorenzo; Chechi, Tania; Fibbi, Veronica; Nannini, Marco; Chiodi, Leandro; Zuppiroli, Alfredo

    2013-01-01

    Subclavian steal syndrome typically presents as angina in patients with internal mammary artery grafts. Atypical clinical presentations have been rarely described. We report an unusual case of subclavian steal syndrome presenting as pulmonary oedema with acute left ventricular diastolic dysfunction and preserved ejection fraction in a patient with internal mammary artery graft and severe stenosis of the proximal left subclavian artery. After successful angioplasty and stenting of subclavian artery, the patient remained asymptomatic for six months, but then experienced acute diastolic dysfunction and recurrent pulmonary oedema associated with critical subclavian in-stent restenosis with stent deformation. This report points out that, in patients with internal mammary-to-LAD grafts, subclavian steal syndrome may present as acute left ventricular diastolic dysfunction and pulmonary oedema even in the presence of normal ejection fraction.

  7. Continuous Non-Invasive Arterial Pressure Technique Improves Patient Monitoring during Interventional Endoscopy

    Directory of Open Access Journals (Sweden)

    Sylvia Siebig, Felix Rockmann, Karl Sabel, Ina Zuber-Jerger, Christine Dierkes, Tanja Brünnler, Christian E. Wrede

    2009-01-01

    Full Text Available Introduction: Close monitoring of arterial blood pressure (BP is a central part of cardiovascular surveillance of patients at risk for hypotension. Therefore, patients undergoing diagnostic and therapeutic procedures with the use of sedating agents are monitored by discontinuous non-invasive BP measurement (NIBP. Continuous non-invasive BP monitoring based on vascular unloading technique (CNAP®, CN Systems, Graz may improve patient safety in those settings. We investigated if this new technique improved monitoring of patients undergoing interventional endoscopy. Methods: 40 patients undergoing interventional endoscopy between April and December 2007 were prospectively studied with CNAP® in addition to standard monitoring (NIBP, ECG and oxygen saturation. All monitoring values were extracted from the surveillance network at one-second intervals, and clinical parameters were documented. The variance of CNAP® values were calculated for every interval between two NIBP measurements. Results: 2660 minutes of monitoring were recorded (mean 60.1±34.4 min/patient. All patients were analgosedated with midazolam and pethidine, and 24/40 had propofol infusion (mean 90.9±70.3 mg. The mean arterial pressure for CNAP® was 102.4±21.2 mmHg and 106.8±24.8 mmHg for NIBP. Based on the first NIBP value in an interval between two NIBP measurements, BP values determined by CNAP® showed a maximum increase of 30.8±21.7% and a maximum decrease of 22.4±28.3% (mean of all intervals. Discussion: Conventional intermittent blood pressure monitoring of patients receiving sedating agents failed to detect fast changes in BP. The new technique CNAP® improved the detection of rapid BP changes, and may contribute to a better patient safety for those undergoing interventional procedures.

  8. Dynamic Changes of Pulmonary Arterial Pressure and Ductus Arteriosus in Human Newborns From Birth to 72 Hours of Age

    OpenAIRE

    2016-01-01

    Abstract Normal pulmonary artery pressure and pulmonary hypertension assessment of newborns is rarely reported. The aim of the study is to explore dynamic changes of pulmonary arterial pressure and ductus arteriosus in human newborns from birth to 72 h of age with echocardiography. A total of 76 cases of normal newborns were prospectively detected by echocardiography after birth of 2 h, 6 h, 12 h, 24 h, 48 h, and 72 h, respectively. Ductus arteriosus diameter, blood shunt direction, blood flo...

  9. THE EFFECT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON THE PATHOGENESIS OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

    Objective. To investigate the effect of left ventricular diastohc dysfunction on the pathogenesis of angina decubitus (AD). Methods. The study population consisted of three groups: 20 individuals without cardiovascular disease were studied as group Ⅰ . Group Ⅱ included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction(EF) > 50% were studied as group Ⅲ. Group Ⅱ and Ⅲ were matched for age, EF and extent of coronary artery disease. Results. Left ventriculography (LVG) showed that left ventricular (LV) first 1/3 filling fraction(1/3FF) was significantly lower in group Ⅲ than in group Ⅱ and Ⅰ (both P < 0.001),but LV late 1/3 FF was much higher in group Ⅲ than in group Ⅱ and Ⅰ (P <0.05, P < 0.01). Left ventricular end-diastolic pressure(LVEDP)was markedly increased before and after LVG in group Ⅱ and Ⅲ as compared with group Ⅰ (bothP<0.05, both P< 0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD)before and after LVG was much higher in group Ⅲ than in group Ⅰ ( P <0.01, P < 0.001). Howevere,there were significant differences in LVEDP and in LACPD between before and after LVG only in group Ⅲ (both P < 0.01). Conclusion. The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogen esis of angina decubitus.

  10. On the reliability of frequency components in systolic arterial pressure in patients with atrial fibrillation.

    Science.gov (United States)

    Corino, Valentina D A; Lombardi, Federico; Mainardi, Luca T

    2010-04-01

    Atrial fibrillation (AF) is characterized by desynchronization of atrial electrical activity causing a consequent irregular ventricular response. In AF, the beat-to-beat variation of blood pressure is increased because of variations in filling time and contractility. However, only a few studies have analyzed short-term blood pressure variations in AF, and we have recently observed a harmonic low-frequency (LF) component in systolic arterial pressure (SAP) during AF. Aim of the present study is to propose a method to verify the reliability of the spectral component found in SAP series, based on the position of the poles of the autoregressive spectral decomposition in the z-plane. In particular, 1,000 random permutations of the series allowed the definition of an area in the z-plane where poles from random process are likely to occur. Poles lying outside this area are considered as reliable oscillations. We tested the method on 53 recordings obtained at rest from patients with persistent AF. LF component was found in, respectively, 51 and 43 recordings in SAP and RR series. High-frequency (HF) component was found in all the recordings for both SAP and RR series. Using the proposed test, the percentage of reliable components in LF and HF bands was 80 and 38 in SAP series, and 20 and 18 in RR series. We concluded that, at variance with RR ones, SAP LF components are likely to represent true physiological oscillations.

  11. Successful treatment of combined vaginal and broad ligament hematoma using pelvic pressure pack and arterial embolization

    Institute of Scientific and Technical Information of China (English)

    Ma Runmei; Lao Terence T; Feng Yukun; Zhao Wei; Huang Jianqiang; Liang GuoHua; Li Hongyu; Chen Zhuo

    2005-01-01

    Objective:To assess using the pelvic pressure pack as temporizing treatment for combined vaginal and broad ligament hematoma before selective arterial embolization could be undertaken.Methods:A 29-year-old woman was transferred because of a 10cm right upper vaginal hematoma found shortly after the spontaneous delivery of a 3400g infant at term.Following evacuation of the clots,the patient's condition deteriorated with the appearance of a painful right pelvic mass,displacing the uterus.At laparotomy,the hematoma extended between the folds of the broad ligament into the pelvic sidewall.After evacuation of the clots,hemostasis failed despite subtotal hysterectomy.Eventually a pressure pack created from joined gauze rolls was used to fill up the pelvic cavity and achieved hemostasis before abdominal closure.When the vaginal pack was removed 30 hours later,vaginal bleeding recurred,and bilateral hypogastric embolization was performed with Gianturco coils.Results:The patient was successfully treated by this way and discharged uneventfully.Conclusion:In combined vaginal and broad ligament hematoma,pelvic pressure pack can be used to ensure maternal survival until definitive treatment with angiographic embolization.

  12. Mean arterial pressure change associated with cerebral blood flow in healthy older adults.

    Science.gov (United States)

    Deverdun, Jeremy; Akbaraly, Tasnime N; Charroud, Celine; Abdennour, Meriem; Brickman, Adam M; Chemouny, Stephane; Steffener, Jason; Portet, Florence; Bonafe, Alain; Stern, Yaakov; Ritchie, Karen; Molino, François; Le Bars, Emmanuelle; Menjot de Champfleur, Nicolas

    2016-10-01

    We investigate over a 12-year period the association between regional cerebral blood flow (CBF) and cardiovascular risk factors in a prospective cohort of healthy older adults (81.96 ± 3.82 year-old) from the Cognitive REServe and Clinical ENDOphenotype (CRESCENDO) study. Cardiovascular risk factors were measured over 12 years, and gray matter CBF was measured at the end of the study from high-resolution magnetic resonance imaging using arterial spin labeling. The association between cardiovascular risk factors, their long-term change, and CBF was assessed using multivariate linear regression models. Women were observed to have higher CBF than men (p < 0.05). Increased mean arterial pressure (MAP) over the 12-year period was correlated with a low cerebral blood flow (p < 0.05, R(2) = 0.21), whereas no association was detected between CBF and MAP at the time of imaging. High levels of glycemia tended to be associated with low cerebral blood flow values (p < 0.05). Age, alcohol consumption, smoking status, body mass index, history of cardiovascular disease, and hypertension were not associated with CBF. Our main result suggests that change in MAP is the most significant predictor of future CBF in older adults.

  13. Ratio of exercise and recovery systolic blood pressure integrals in prediction of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Jure Mirat

    2009-02-01

    Full Text Available Aim This study was performed to determine whether the ratio (Q =A/B of area A under the curve of exercise systolic blood pressure(SBP increase and area B under curve of recovery SBP decreaseis predictive of angiographic coronary artery disease (CAD.Methods Patients who performed exercise testing and subsequentlyunderwent coronary angiography, within three months, wereanalyzed in this study. According to angiographic report, patientswere divided in three groups: without disease or with stenosis lessthan 50% (group 1, significant (group 2, and severe (group 3.Severe disease was defined as left main, three-vessel or two-vesseldisease with involvement of proximal left anterior descending artery.Results There were 137 patients included in this study (age 59 ±10, 70% male. Group 1 included 57%, group 2 included 30%,and group 3 included 13% of patients. Mean values of the Q ratiowere 2.72 ± 0.9, 1.74 ± 0.76, 1.01 ± 0.38 in groups 1, 2 and 3,respectively. By means of robust discrimination analysis, statisticallysignificant difference between groups 1, 2 and 3 in values ofthe ratio Q (p < 0.001 was found.Conclusion The ratio of exercise SBP increase and recovery SBPdecrease areas under the curve suggests severity of CAD.

  14. Multichannel Blind Deconvolution of the Arterial Pressure using Ito Calculus Method

    Directory of Open Access Journals (Sweden)

    M. El-Sayed Waheed

    2015-11-01

    Full Text Available Multichannel Blind Deconvolution (MBD is a powerful tool particularly for the identification and estimation of dynamical systems in which a sensor, for measuring the input, is difficult to place. This paper presents Ito calculus method for the estimation of the unknown time-varying coefficient. The arterial network is modelled as a Finite Impulse Response (FIR filter with unknown coefficients. A new tool for estimation of both the central arterial pressure and the unknown channel dynamics has been developed. The convolution process is modelled as a Finite Impulse Response (FIR filter with unknown coefficients. The source signal is also unknown. Assuming that one of the FIR filter coefficients are time varying, we have been able to get accurate estimation results for the source signal, even though the filter order is unknown. The time varying filter coefficients have been estimated through the SC algorithm, and we have been able to deconvolve the measurements and obtain both the source signal and the convolution path. The positive results demonstrate that the SC approach is superior to conventional methods.

  15. Raynaud's phenomenon is correlated with elevated systolic pulmonary arterial pressure in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Kasparian, A; Floros, A; Gialafos, E; Kanakis, M; Tassiopoulos, S; Kafasi, N; Vaiopoulos, G

    2007-01-01

    In patients with Systemic lupus erythematosus (SLE), Raynaud phenomenon (RP) is frequently present and associated with pulmonary hypertension (PHT). Elevated pulmonary artery systolic pressure (PASP) is an indicator of PHT and can be estimated noninvasively. We attempt to explore the significance of RP in SLE and to correlate it with clinical and serological parameters of the disease. The study population consisted of 34 patients (age, sex and disease duration matched) who fulfilled the revised SLE criteria of the American College of Rheumatology, and were categorized into two groups: Group 1 had patients having SLE and RP (2 males/15 females, mean age 45 +/- 18 years) and group 2 had patients with SLE but without RP (3 males/14 females, mean age 40 +/- 14 years. Detailed cardiac ultrasound was performed including measurement of PASP, while clinical and serological features of both groups were collected and correlated. Significant differences were shown in the presence of arterial hypertension (P < 0.05), arthralgias (P < 0.005), arthritis (P < 0.05), myalgias (P < 0.05), alopecia (P < 0.05) and PASP (P < 0.0001). No difference was observed among the cardiac ultrasound indices and the ejection fraction between the two groups. PASP was significantly correlated with RP, while no correlation was observed regarding the disease duration. In patients with SLE, the presence of RP was associated with elevation in PASP. Further investigation is needed to clarify the significance of this relation.

  16. Signal quality quantification and waveform reconstruction of arterial blood pressure recordings.

    Science.gov (United States)

    Fanelli, A; Heldt, T

    2014-01-01

    Arterial blood pressure (ABP) is an important vital sign of the cardiovascular system. As with other physiological signals, its measurement can be corrupted by different sources of noise, interference, and artifact. Here, we present an algorithm for the quantification of signal quality and for the reconstruction of the ABP waveform in noise-corrupted segments of the measurement. The algorithm quantifies the quality of the ABP signal on a beat-by-beat basis by computing the normalized mean of successive differences of the ABP amplitude over each beat. In segments of poor signal quality, the ABP wavelets are then reconstructed on the basis of the expected cycle duration and envelope information derived from neighboring ABP wavelet segments. The algorithm was tested on two datasets of ABP waveform signals containing both invasive radial artery ABP and noninvasive ABP waveforms. Our results show that the approach is efficient in identifying the noisy segments (accuracy, sensitivity and specificity over 95%) and reliable in reconstructing beats that were artificially corrupted.

  17. Wall shear stress and pressure distribution on aneurysms and infundibulae in the posterior communicating artery bifurcation.

    Science.gov (United States)

    Baek, Hyoungsu; Jayaraman, Mahesh V; Karniadakis, George Em

    2009-12-01

    A growing number of cases of rupture at an infundibulum, progression of infundibulum to a frank aneurysm, and subarachnoid hemorrhage (SAH) in the posterior communicating artery (PCoA) have been reported. Using patient-specific geometric models of the supraclinoid internal carotid artery (ICA) with PCoA infundibulum or aneurysm, high-resolution computational fluid dynamics simulations were performed by solving the Navier-Stokes equations with a spectral/hp element method. Simulation results show that the flow impinges at the distal wall of infundibulum near the outside of the ICA bend and creates a region of higher pressure (4-5 mmHg) surrounded by a band of a high wall shear stress (WSS) (20-30 N/m(2) on average). At the proximal end of the infundibulum, another stagnation area is formed characterized by low WSS (shear index. This impingement region seems to coincide with the locations of the rupture of infundibulae or progression to aneurysms. In addition, the pulsatile flow becomes unstable due to the presence of aneurysms or aneurysm-like infundibulae, and this leads to WSS temporal fluctuations inside the aneurysm, which may accelerate the degenerative processes in the vessel walls.

  18. The Correlation between Systolic Blood Pressure Measured by Return to Flow Versus Systolic Blood Pressure Measured by Arterial Catheter in the Adult Anesthetized Patient.

    Science.gov (United States)

    1986-12-01

    a U-tube and mercury manometer for other research, he did not use it to measure arterial blood pressure (30). It was almost a century 34 N N 35 later...use of this mercury manometer decreased the size of the measuring apparatus more than 27 times (30). Carl Ludwig made an important contribution to...direct measurement of blood pressure in 1847 when he added a i graphic recording device to the mercury manometer . This eliminated observer error and

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Caroline Alice Rickards

    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.

  1. Treatment of hypertension and metabolic syndrome: lowering blood pressure is not enough for organ protection, new approach-arterial destiffening.

    Science.gov (United States)

    Zimlichman, Reuven

    2014-10-01

    Cardiovascular risk factors (CVRFs) have been shown to induce end organ damage. Until now, the main approach to reduce CVRF-induced end organ damage was by normalization of CVRFs; this approach was found effective to reduce damage and cardiovascular (CV) events. However, a residual risk always remained even when CVRFs were optimally balanced. An additional risk factor which has an immense effect on the progression of end organ damage is aging. Aging is accompanied by gradual stiffening of the arteries which finally leads to CV events. Until recently, the process of arterial aging was considered as unmodifiable, but this has changed. Arterial stiffening caused by the aging process is similar to the changes seen as a result of CVRF-induced arterial damage. Actually, the presence of CVRFs causes faster arterial stiffening, and the extent of damage is proportional to the severity of the CVRF, the length of its existence, the patient's genetic factors, etc. Conventional treatments of osteoporosis and of hormonal decline at menopause are potential additional approaches to positively affect progression of arterial stiffening. The new approach to further decrease progression of arteriosclerosis, thus preventing events, is the prevention of age-associated arterial structural changes. This approach should further decrease age-associated arterial stiffening. A totally new promising approach is to study the possibility of affecting collagen, elastin, and other components of connective tissue that participate in the process of arterial stiffening. Reduction of pulse pressure by intervention in arterial stiffening process by novel methods as breaking collagen cross-links or preventing their formation is an example of future directions in treatment. This field is of enormous potential that might be revolutionary in inducing further significant reduction of cardiovascular events.

  2. Autoregulation of cerebral blood flow to changes in arterial pressure in mild Alzheimer's disease.

    Science.gov (United States)

    Zazulia, Allyson R; Videen, Tom O; Morris, John C; Powers, William J

    2010-11-01

    Studies in transgenic mice overexpressing amyloid precursor protein (APP) demonstrate impaired autoregulation of cerebral blood flow (CBF) to changes in arterial pressure and suggest that cerebrovascular dysfunction may be critically important in the development of pathological Alzheimer's disease (AD). Given the relevance of such a finding for guiding hypertension treatment in the elderly, we assessed autoregulation in individuals with AD. Twenty persons aged 75±6 years with very mild or mild symptomatic AD (Clinical Dementia Rating 0.5 or 1.0) underwent (15)O-positron emission tomography (PET) CBF measurements before and after mean arterial pressure (MAP) was lowered from 107±13 to 92±9 mm Hg with intravenous nicardipine; (11)C-PIB-PET imaging and magnetic resonance imaging (MRI) were also obtained. There were no significant differences in mean CBF before and after MAP reduction in the bilateral hemispheres (-0.9±5.2 mL per 100 g per minute, P=0.4, 95% confidence interval (CI)=-3.4 to 1.5), cortical borderzones (-1.9±5.0 mL per 100 g per minute, P=0.10, 95% CI=-4.3 to 0.4), regions of T2W-MRI-defined leukoaraiosis (-0.3±4.4 mL per 100 g per minute, P=0.85, 95% CI=-3.3 to 3.9), or regions of peak (11)C-PIB uptake (-2.5±7.7 mL per 100 g per minute, P=0.30, 95% CI=-7.7 to 2.7). The absence of significant change in CBF with a 10 to 15 mm Hg reduction in MAP within the normal autoregulatory range demonstrates that there is neither a generalized nor local defect of autoregulation in AD.

  3. Effects of Weather and Heliophysical Conditions on Emergency Ambulance Calls for Elevated Arterial Blood Pressure

    Directory of Open Access Journals (Sweden)

    Jone Vencloviene

    2015-02-01

    Full Text Available We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009–2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs, in which the conditions for the emergency calls were made coded I.10–I.15. The Kaunas Weather Station provided daily records of air temperature (T, wind speed (WS, relative humidity, and barometric pressure (BP. We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS > 600 km/s increased the daily number of elevated arterial blood pressure (EABP by 12% (RR = 1.12; 95% confidence interval (CI 1.04–1.21; and WS ≥ 3.5 knots during days of T < 1.5 °C and T ≥ 12.5 °C by 8% (RR = 1.08; CI 1.04–1.12. An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T ≥ 17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population’s sensitivity to different weather conditions.

  4. Role of pressor mechanisms from the NTS and CVLM in control of arterial pressure.

    Science.gov (United States)

    Moreira, Thiago Santos; Sato, Monica Akemi; Takakura, Ana Carolina Thomaz; Menani, José Vanderlei; Colombari, Eduardo

    2005-11-01

    In the present study, we investigated the effects of inhibition of the caudal ventrolateral medulla (CVLM) with the GABA(A) agonist muscimol combined with the blockade of glutamatergic mechanism in the nucleus of the solitary tract (NTS) with kynurenic acid (kyn) on mean arterial pressure (MAP), heart rate (HR), and regional vascular resistances. In male Holtzman rats anesthetized intravenously with urethane/chloralose, bilateral injections of muscimol (120 pmol) into the CVLM or bilateral injections of kyn (2.7 nmol) into the NTS alone increased MAP to 186 +/- 11 and to 142 +/- 6 mmHg, respectively, vs. control: 105 +/- 4 mmHg; HR to 407 +/- 15 and to 412 +/- 18 beats per minute (bpm), respectively, vs. control: 352 +/- 12 bpm; and renal, mesenteric and hindquarter vascular resistances. However, in rats with the CVLM bilaterally blocked by muscimol, additional injections of kyn into the NTS reduced MAP to 88 +/- 5 mmHg and mesenteric and hindquarter vascular resistances below control baseline levels. Moreover, in rats with the glutamatergic mechanisms of the NTS blocked by bilateral injections of kyn, additional injections of muscimol into the CVLM also reduced MAP to 92 +/- 2 mmHg and mesenteric and hindquarter vascular resistances below control baseline levels. Simultaneous blockade of NTS and CVLM did not modify the increase in HR but also abolished the increase in renal vascular resistance produced by each treatment alone. The results suggest that important pressor mechanisms arise from the NTS and CVLM to control vascular resistance and arterial pressure under the conditions of the present study.

  5. 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

    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...... in legs with arterial occlusions at two levels or more; (4) In 47 legs with AOD, the SPP on the calf or on the thigh was compared with transcutaneously measured pO2. The two different methods correlated statistically significant, but the scatter was great; (5) During induced variations in systemic blood...... pressure in seven patients (12 legs with AOD), the segmental SPP and the segmental systolic blood pressure were found on average to vary in proportion with intra-arterial mean and systolic pressure respectively; however, this proportional relationship was not valid for the individual leg. It is concluded...

  6. 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

  7. Pulmonary arterial hypertension secondary to chronic left-sided cardiac dysfunction in dogs.

    Science.gov (United States)

    Stepien, Rebecca L

    2009-09-01

    Pulmonary arterial hypertension is a description of a physiological finding rather than a diagnosis. Pulmonary arterial pressure is the result of interactions among pulmonary blood flow (right ventricular cardiac output), pulmonary vascular impedance and post-capillary pressure (typically reflecting left atrial pressure). When elevations in pulmonary arterial pressure (systolic/diastolic pulmonary arterial pressure > approximately 30/19 mmHg at rest) are accompanied by increased left atrial pressure, pulmonary arterial hypertension may be considered secondary to left-heart failure. Introduction of Doppler methods to diagnose pulmonary arterial hypertension has increased the awareness of the prevalence and importance of pulmonary arterial hypertension dogs with left-heart failure. Increasing understanding of the mechanism of development of pulmonary venous hypertension and reactive pulmonary arterial hypertension in dogs with left-heart disease has led to the development of successful additive therapies for progressive clinical signs in the setting of chronic therapy for congestive heart failure due to left-sided valvular and myocardial dysfunction. Because effective therapies for pulmonary arterial hypertension secondary to chronic left-sided cardiac dysfunction are now available, screening for pulmonary arterial hypertension should be a regular part of the Doppler echocardiographic examination in a clinical setting of chronic therapy for left-sided congestive heart failure due to valvular or myocardial disease.

  8. 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.

    Directory of Open Access Journals (Sweden)

    Eirik Ikdahl

    Full Text Available 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.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.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, -3.17m/s2 (p = 0.03, ΔsBP: -5.27 (-1.61, -8.93mmHg (p = 0.004 and ΔdBP -2.93 (-0.86, -5.00mmHg (p = 0.01. In linear regression models, ∆aPWV was significantly correlated with ΔsBP and ΔdBP (for all: p<0.001.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.ClinicalTrials.gov NCT01389388.

  9. Relation between central artery pressure and pulse wave conduction in aged patients with masked hypertension%老年隐性高血压患者中心动脉压与脉搏波传导速度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    寇学俊; 邢艳秋; 路方红; 刘振东; 胡小亮

    2012-01-01

    Objective To study the relation of central artery pressure and its augmentation index with pulse wave velocity(PWV) in aged patients with masked hypertension. Methods Two hundred and fifty individuals were divided into normal blood pressure group(? = 169) ,masked hypertension group(n = 81) ,and hypertension group(w=150) according to their blood pressure. Their 24 h dynamic blood pressure was monitored. Central artery pressure and its reflected wave were measured with a conductive artery device and carotid-radial pulse wave velocity (crPWV) was measured with a PWV device. Results The central artery systolic and diastolic pressure, central, pulse pressure(CPP) ,mean central systolic and diastolic pressure,end systolic pressure,augmented pressure and crPWV were significantly higher in masked hypertension group than in normal blood pressure group and significantly lower in masked hypertension group than in hypertension group(P<0. 05, P<0. 01). Multiple linear regression analysis showed that the central artery pressure,CPP,and LDL-C were the major risk factors for crPWV((3 = 0. 268,0. 313, 0. 311, P< 0. 01). Conclusion The central artery pressure and its augmentation index are significantly higher in aged patients with masked hypertension, indicating that decreased artery elasticity, central artery systolic pressure,CPP,and LDL-C are the major risk factors for arterial stiffness.%目的 探讨老年隐性高血压患者中心动脉压及增强指数与脉搏波传导速度(PWV)的相关性.方法 选择临床诊断血压正常者250例,根据血压诊断标准分为血压正常(正常组)169例和隐性高血压(隐性组)81例,及高血压患者(高血压组)150例.监测24 h动态血压.并采用大动脉测量仪测量中心动脉压及其反射波;采用PWV测定仪测量颈-桡动脉PWV(crPWV).结果 隐性组中心动脉收缩压、中心动脉舒张压、中心脉压、平均收缩压、平均舒张压、收缩末压、增强压、crPWV明显高于正常

  10. 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

  11. Effects of sodium and potassium supplementation on blood pressure and arterial stiffness : a fully controlled dietary intervention study

    NARCIS (Netherlands)

    Gijsbers, L.; Dower, J. I.; Mensink, M.; Siebelink, E.; Bakker, S. J. L.; Geleijnse, J. M.

    2015-01-01

    We performed a randomised, placebo-controlled, crossover study to examine the effects of sodium and potassium supplementation on blood pressure (BP) and arterial stiffness in untreated (pre) hypertensive individuals. During the study, subjects were on a fully controlled diet that was relatively low

  12. [Anesthesia management of geriatric patients with arterial pressure-based cardiac output monitoring FloTrac sensor for emergency surgery].

    Science.gov (United States)

    Yamamoto, Shunsuke; Goto, Koji; Yasuda, Norihisa; Kusaka, Junya; Hidaka, Seigo; Miyakawa, Hiroshi; Noguchi, Takayuki

    2009-06-01

    In cases of emergency surgery for geriatric patients, immediate anesthesia induction and careful intraoperative management is necessary without sufficient preoperative information. We report anesthesia management of a 96-year and a 90-year old patients with FloTrac sensor which is an arterial pressure-based cardiac output monitoring device and is able to manage critical patients effectively and safely during anesthesia.

  13. Finger arterial versus intrabrachial pressure and continuous cardiac output during head-up tilt testing in healthy subjects

    NARCIS (Netherlands)

    Jellema, W.T.; Imholz, B.P.M.; Goudoever, J. van; Wesseling, K.H.; Lieshout, J.J. van

    1996-01-01

    1. The aims of this study were to determine the clinical feasibility of continuous, non-invasive Finapres recordings as a replacement for intrabrachial pressure during a 30 min head-up tilt, and the reliability of continuous cardiac output computation by pulse contour analysis from the finger arteri

  14. Early detection and treatment of myocardial ischaemia after operation using continual ambulatory arterial pressure monitoring and ECG ST segment analysis.

    Science.gov (United States)

    Edwards, N D; Troy, G; Yeo, W; Jackson, P; Reilly, C S

    1995-10-01

    We report a case in which the use of continual ambulatory arterial pressure monitoring and ECG ST-segment analysis allowed early detection and treatment of myocardial ischaemia in the postoperative period. We believe that this case illustrates the potential value of ambulatory monitoring in the early postoperative period in high-risk patients.

  15. Early diastolic strain rate in relation to systolic and diastolic function and prognosis in acute myocardial infarction

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Andersen, Mads J; Valeur, Nana;

    2014-01-01

    AIMS: Diastolic dysfunction in acute myocardial infarction (MI) is associated with adverse outcome. Recently, the ratio of early mitral inflow velocity (E) to global diastolic strain rate (e'sr) has been proposed as a marker of elevated LV filling pressure. However, the prognostic value...... of this measure has not been demonstrated in a large-scale setting when existing parameters of diastolic function are known. We hypothesized that the E/e'sr ratio would be independently associated with an adverse outcome in patients with MI. METHODS AND RESULTS: We prospectively included patients with MI.......0001). CONCLUSION: Deformation-based E/e'sr contributes important information about global myocardial relaxation superior to velocity-based analysis and is independently associated with the outcome in acute MI....

  16. Velocidade da onda de pulso, pressão arterial e adipocitocinas em adultos jovens: estudo do Rio de Janeiro Pulse wave velocity, blood pressure and adipocytokines in young adults: the Rio de Janeiro study

    Directory of Open Access Journals (Sweden)

    Oswaldo Luiz Pizzi

    2012-01-01

    identificação do acometimento vascular nessa faixa etária.BACKGROUND: Data on noninvasive vascular assessment and their association with cardiovascular risk variables are scarce in young individuals. OBJECTIVE: To evaluate the association between pulse wave velocity and blood pressure, anthropometric and metabolic variables, including adipocytokines, in young adults. METHODS: A total of 96 individuals aged 26 to 35 years (mean 30.09 ± 1.92; 51 males were assessed in the Rio de Janeiro study. Pulse wave velocity (Complior method, blood pressure, body mass index, glucose, lipid profile, leptin, insulin, adiponectin and insulin resistance index (HOMA-IR were analyzed. Subjects were stratified into three groups according to the PWV tertile for each gender. RESULTS: The group with the highest pulse wave velocity (PWV tertile showed higher mean systolic and diastolic blood pressure, mean blood pressure, body mass index, insulin, and HOMA-IR, as well as lower mean adiponectin; higher prevalence of diabetes mellitus/glucose intolerance and hyperinsulinemia. There was a significant positive correlation of PWV with systolic blood pressure, diastolic blood pressure, pulse pressure and mean blood pressure, body mass index, and LDL-cholesterol, and a negative correlation with HDL-cholesterol and adiponectin. In the multiple regression model, after adjustment of HDL-cholesterol, LDL-cholesterol and adiponectin for gender, age, body mass index and mean blood pressure, only the male gender and mean blood pressure remained significantly correlated with PWV. CONCLUSION: PWV in young adults showed a significant association with cardiovascular risk variables, especially in the male gender, and mean blood pressure as important determinant variables. The findings suggest that PWV measurement can be useful for the identification of vascular impairment in this age group.

  17. Velocidade da onda de pulso, pressão arterial e adipocitocinas em adultos jovens: estudo do Rio de Janeiro Pulse wave velocity, blood pressure and adipocytokines in young adults: the Rio de Janeiro study

    Directory of Open Access Journals (Sweden)

    Oswaldo Luiz Pizzi

    2013-01-01

    identificação do acometimento vascular nessa faixa etária.BACKGROUND: Data on noninvasive vascular assessment and their association with cardiovascular risk variables are scarce in young individuals. OBJECTIVE: To evaluate the association between pulse wave velocity and blood pressure, anthropometric and metabolic variables, including adipocytokines, in young adults. METHODS: A total of 96 individuals aged 26 to 35 years (mean 30.09 ± 1.92; 51 males were assessed in the Rio de Janeiro study. Pulse wave velocity (Complior method, blood pressure, body mass index, glucose, lipid profile, leptin, insulin, adiponectin and insulin resistance index (HOMA-IR were analyzed. Subjects were stratified into three groups according to the PWV tertile for each gender. RESULTS: The group with the highest pulse wave velocity (PWV tertile showed higher mean systolic and diastolic blood pressure, mean blood pressure, body mass index, insulin, and HOMA-IR, as well as lower mean adiponectin; higher prevalence of diabetes mellitus/glucose intolerance and hyperinsulinemia. There was a significant positive correlation of PWV with systolic blood pressure, diastolic blood pressure, pulse pressure and mean blood pressure, body mass index, and LDL-cholesterol, and a negative correlation with HDL-cholesterol and adiponectin. In the multiple regression model, after adjustment of HDL-cholesterol, LDL-cholesterol and adiponectin for gender, age, body mass index and mean blood pressure, only the male gender and mean blood pressure remained significantly correlated with PWV. CONCLUSION: PWV in young adults showed a significant association with cardiovascular risk variables, especially in the male gender, and mean blood pressure as important determinant variables. The findings suggest that PWV measurement can be useful for the identification of vascular impairment in this age group.

  18. Hematocrit and mean arterial blood pressure in pre- and postmenopause women

    Directory of Open Access Journals (Sweden)

    Beatriz Y Salazar Vázquez

    2009-05-01

    Full Text Available Beatriz Y Salazar Vázquez1,2, Miguel A Salazar Vázquez3,4, Marcos Intaglietta2, Ulf de Faire5, Bengt Fagrell6, Pedro Cabrales21Facultad de Medicina, 3Department of Physical Chemistry, Universidad Juárez del estado de Durango, Durango, México; 2Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA; 4Department of Pediatrics, Instituto Mexicano del Seguro Social, Durango, México; 5Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Department of Cardiology, Karolinska Institutet, Solna, Stockholm, Sweden; 6Department of Medicine, Karolinska Institutet at Karolinska Hospital, Solna, Stockholm, SwedenAbstract: The relationship between mean arterial blood pressure (MAP and hematocrit (Hct was studied in pre- and postmenopause women in the city of Durango, Mexico. Premenopause women show a negative trend between parameters that is not statistically significant. MAP and Hct are directly related in postmenopause women (p < 0.01. It is proposed that that this MAP/Hct relationship is in part due to differences in endothelial function where menopause decreases the capacity of the endothelium to respond to increased blood viscosity and shears stress, leading to the increased production of vasodilator mediators to compensate for changes in blood viscosity due to changes in Hct. Comparison with a large group of postmenopause women in the city of Stockholm showed identical trends.Keywords: menopause, endothelial dysfunction, blood viscosity, blood pressure, hematocrit

  19. Evolution from electrophysiologic to hemodynamic monitoring: the story of left atrial and pulmonary artery pressure monitors

    Directory of Open Access Journals (Sweden)

    Deirdre M Mooney

    2015-10-01

    Full Text Available Heart failure (HF is a costly, challenging and highly prevalent medical condition. Hospitalization for acute decompensation is associated with high morbidity and mortality. Despite application of evidence-based medical therapies and technologies, HF remains a formidable challenge for virtually all healthcare systems. Repeat hospitalizations for acute decompensated HF (ADHF can have major financial impact on institutions and resources. Early and accurate identification of impending ADHF is of paramount importance yet there is limited high quality evidence or infrastructure to guide management in the outpatient setting. Historically, ADHF was identified by physical exam findings or invasive hemodynamic monitoring during a hospital admission; however, advances in medical microelectronics and the advent of device-based diagnostics have enabled long-term ambulatory monitoring of HF patients in the outpatient setting. These monitors have evolved from piggybacking on cardiac implantable electrophysiologic devices to standalone implantable hemodynamic monitors that transduce left atrial or pulmonary artery pressures as surrogate measures of left ventricular filling pressure. As technology evolves, devices will likely continue to miniaturize while their capabilities grow. An important, persistent challenge that remains is developing systems to translate the large volumes of real-time data, particularly data trends, into actionable information that leads to appropriate, safe and timely interventions without overwhelming outpatient cardiology and general medical practices. Future directions for implantable hemodynamic monitors beyond their utility in heart failure may include management of other major chronic diseases such as pulmonary hypertension, end stage renal disease and portal hypertension.

  20. Cardiovascular system identification: Simulation study using arterial and central venous pressures.

    Science.gov (United States)

    Karamolegkos, Nikolaos; Vicario, Francesco; Chbat, Nicolas W

    2015-08-01

    The paper presents a study of the identifiability of a lumped model of the cardiovascular system. The significance of this work from the existing literature is in the potential advantage of using both arterial and central venous (CVP) pressures, two signals that are frequently monitored in the critical care unit. The analysis is done on the system's state-space representation via control theory and system identification techniques. Non-parametric state-space identification is preferred over other identification techniques as it optimally assesses the order of a model, which best describes the input-output data, without any prior knowledge about the system. In particular, a recent system identification algorithm, namely Observer Kalman Filter Identification with Deterministic Projection, is used to identify a simplified version of an existing cardiopulmonary model. The outcome of the study highlights the following two facts. In the deterministic (noiseless) case, the theoretical indicators report that the model is fully identifiable, whereas the stochastic case reveals the difficulty in determining the complete system's dynamics. This suggests that even with the use of CVP as an additional pressure signal, the identification of a more detailed (high order) model of the circulatory system remains a challenging task.

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

    DEFF Research Database (Denmark)

    Andersen, Mads Jønsson; Ersboll, M; Axelsson, Anders

    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...... but was unchanged in the placebo group. CONCLUSIONS: Sildenafil did not decrease filling pressure at rest or during exercise in post-myocardial infarction patients with diastolic dysfunction. However, there were effects on secondary end points, which require further studies....

  2. 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

  3. Short-term effects of nitrate-rich green leafy vegetables on blood pressure and arterial stiffness in individuals with high-normal blood pressure.

    Science.gov (United States)

    Bondonno, Catherine P; Liu, Alex H; Croft, Kevin D; Ward, Natalie C; Yang, Xingbin; Considine, Michael J; Puddey, Ian B; Woodman, Richard J; Hodgson, Jonathan M

    2014-12-01

    Evidence for a beneficial effect of dietary nitrate, through the nitrate-nitrite-NO pathway, on measures of cardiovascular function in healthy individuals is accumulating. It is less clear whether increased dietary nitrate intake from green leafy vegetables would have similar beneficial vascular effects in those at increased risk of developing hypertension. Our aim was to assess the effects of short-term regular consumption of increased nitrate from green leafy vegetables on blood pressure and arterial stiffness in individuals with high-normal blood pressure. Thirty-eight men and women ages 30-70 years with systolic blood pressure 120 to 139 mm Hg were recruited to a randomized controlled crossover trial. The effects of a 7-day high-nitrate diet intervention (increased nitrate intake by at least 300 mg/day from green leafy vegetables) were compared to a 7-day low-nitrate diet intervention. Outcome measures included pre- and postintervention salivary and plasma nitrate and nitrite concentrations; ambulatory, home, and office blood pressure; augmentation index; and carotid-femoral pulse wave velocity. The high-nitrate diet intervention resulted in at least a fourfold increase in salivary and plasma nitrate and nitrite (Pblood pressure and arterial stiffness were not different between the high-nitrate diet and the low-nitrate diet. Increasing dietary nitrate intake in those with high-normal blood pressure and at increased risk of hypertension may not be an effective short-term strategy to lower blood pressure.

  4. 心外膜脂肪体积与冠状动脉粥样硬化及左心室舒张功能的相关性研究%Association of epicardial adipose tissue volume with coronary artery atherosclerosis and left ventricular diastolic function

    Institute of Scientific and Technical Information of China (English)

    张福庄; 赵怡; 陶红; 王永梅; 王文川; 高秀莹; 袁仙仙; 李彭; 张兆琪; 周迎生

    2012-01-01

    Objective;To measure epicardial adipose tissue (EAT) volume by the three-dimensional volume-rendering reconstruction technique of dual-source 64 slice computed tomography, and then explore the correlations of ETA volume with the severity of coronary artery atherosclerosis, the coronary artery vulnerable plaques and the diastolic function of left ventricular. Methods: Dual-source 64 slice computed tomography was performed in 131 consecutive patients with suspected coronary artery disease (CAD) (93 males and 38 females). The ages ranged from 37 to 79 years with a mean ± standard deviation (SD) of (56 ± 10) years. For each patient, body mass index ( BMI) , waist circumference (WC) and blood biochemical parameters were measured. Transthoracic echocardiographic examination was performed to assess the left ventricular diastolic function. EAT volume was determined by cardiac fat software on a workstation (Vitrea FX, Vital Images). Percutaneous coronary angiography was applied to confirm CAD in patients and assess the severity of coronary ath-erosclerosis. Results; (1) The volume of EAT in patients with CAD (n = 63) was higher than that in patients without CAD (n =68) (P =0. 003). (2) The volume of EAT was significantly higher in patients with three-vessel lesion (P<0.05). (3) EAT volume was significantly larger in patients with non-calcified plaque compared to that in those with calcified plaque or no plaque (all P <0. 001). (4) EAT volume was positively correlated with WC and BMI ( r = 0.475 ,P <0.001; r = 0. 386 ,P < 0. 001). After adjusting for confounding risk variables by logistic regression analysis, EAT volume was found as an independent predictor of CAD (odds ratio = 1.018,95% confidence interval 1.004-1.033, P=0.011). (5) EAT volume increased in patients with left ventricular diastolic dysfunction (P < 0. 05 ). EAT volume was positively correlated with left ventricular internal diameter in diastole ( LVIDd) and interventricular septum thickness (IVSDd

  5. Application of exercise transcutaneous oxygen pressure measurements for detection of proximal lower extremity arterial disease: a case report.

    Science.gov (United States)

    Mahe, Guillaume; Kalra, Manju; Abraham, Pierre; Liedl, David A; Wennberg, Paul W

    2015-06-01

    Proximal claudication is secondary to ischemia caused by peripheral artery disease (PAD), whereas proximal pseudo-claudication is secondary to other disease processes such as hip arthritis, spinal stenosis, neuropathy, and so forth. The differentiation between the two can be challenging. Exercise transcutaneous oxygen pressure measurement (exercise-TcPO2) allows noninvasive detection of flow-reducing lesions in the proximal arteries and tributaries of the lower extremity arterial tree. We present the first case report in the United States using an exercise-TcPO2 algorithm. A 71-year-old diabetic patient with proximal left-sided and right-calf claudication with indeterminate ankle-brachial indices underwent an exercise-TcPO2 study before and after endovascular intervention. Four TcPO2 probes were placed: one at chest level (reference probe), one on each buttock, and one on the symptomatic calf. The Delta from Resting Oxygen Pressure (DROP) index was calculated at each probe site using a previously validated protocol. Proximal left- and right-calf ischemia were confirmed by the initial exercise-TcPO2, and, after endovascular treatment of the left iliac artery lesion, improvements in proximal exercise-TcPO2 values were found. These data suggest that exercise-TcPO2 can be useful in PAD evaluation in patients with non-compressible arteries and/or proximal claudication.

  6. 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

  7. Relationship between left ventricular diastolic function and myocardial sympathetic denervation measured by {sup 123}I-meta-iodobenzylguanidine imaging in Anderson-Fabry disease

    Energy Technology Data Exchange (ETDEWEB)

    Spinelli, Letizia; Giudice, Caterina Anna; Imbriaco, Massimo; Trimarco, Bruno; Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Pellegrino, Teresa [Institute of Biostructure and Bioimaging, National Council of Research, Naples (Italy); Pisani, Antonio; Riccio, Eleonora [University Federico II, Department of Public Health, Naples (Italy); Salvatore, Marco [IRCCS SDN, Naples (Italy)

    2016-04-15

    Whether cardiac sympathetic nervous function abnormalities may be present in patients with Anderson-Fabry disease (AFD) remains unexplored. We investigated the relationship between left ventricular (LV) function and cardiac sympathetic nervous function in patients with AFD. Twenty-five patients (12 men, mean age 43 ± 13 years) with genetically proved AFD and preserved LV ejection fraction and ten age and gender-matched control subjects underwent speckle tracking echocardiography and {sup 123}I-meta-iodobenzylguanidine (MIBG) imaging from which early and late heart to mediastinum (H/M) ratios and myocardial washout rate values were calculated. In AFD patients, a significant correlation between late H/M ratio and LV mass index (r = -61, p = 0.001), left atrial volume (r = -0.72, p < 0.001), systolic pulmonary artery pressure (r = -0.75, p < 0.001), and early diastolic untwisting rate (r = -0.66, p < 0.001) was found. Ten AFD patients exhibited a late H/M ratio below two fold standard deviation of control subjects (≤1.75). Patients showing late H/M ratio ≤ 1.75 had significantly higher LV mass index, relative wall thickness, left atrial volume and systolic pulmonary artery pressure, lower systolic longitudinal strain and an early diastolic untwisting rate compared to patients with late H/M ratio > 1.75. At multivariable linear regression analysis, early diastolic untwisting rate was the only independent predictor of late H/M ratio ≤ 1.75 (odds ratio 1.15, 95 % confidence interval 1.07-1.31, p < 0.05). The present findings provide the first demonstration of a cardiac sympathetic derangement in AFD patients with preserved LV ejection fraction, which is mostly related to LV diastolic dysfunction. (orig.)

  8. Circulating ghrelin was negatively correlated with pulmonary arterial pressure in atrial septal defect patients

    Institute of Scientific and Technical Information of China (English)

    LI Zhao-feng; ZHOU Da-xin; PAN Wen-zhi; ZHANG Lei; GE Jun-bo

    2013-01-01

    Background Ghrelin was found to attenuate the magnitude of pulmonary arterial hypertension and pulmonary vascular remodeling in rats.The objective of this study was to explore the fasting plasma ghrelin level and the relationships between ghrelin and pulmonary arterial pressure (PAP) in atrial septal defect (ASD) patients with pulmonary arterial hypertension (PAH).Methods Fasting plasma ghrelin,obestatin,and insulin levels were measured by enzyme linked immunosorbent assay (ELISA) method in ASD patients with or without PAH according to the manufacturer's instructions.Insulin resistance was calculated by the homeostasis model of assessment for insulin resistance (HOMA-IR) approach,calculated as fasting insulin (microunits/ml)× fasting blood glucose (mmol/L)/22.5.Comparisons between the parameters of patients with PAH and those of patients with normal PAP were performed with an unpaired Student's t test.The relationships between ghrelin and various clinical parameters were examined by bivariate correlations and multiple regression analysis.Results We found that the fasting plasma ghrelin level and the ratio of ghrelin to obestatin were significantly lower in the PAH group compared with the control group ((582.4±12.8) pg/ml vs.(1045.2±95.5) pg/ml,P <0.05 and 30.5±4.9 vs.70.0±9.7,P <0.01).The fasting plasma obestatin level was higher in the PAH group compared with the control group,but the difference between them was not significant ((23.2±3.1) pg/ml vs.(16.3±1.6) pg/ml,P >0.05).In a multiple regression model analysis,only mean PAP was an independent predictor of ghrelin and the ratio of ghrelin to obestatin (standardized coefficient=0.737,P <0.001 and standardized coefficient=-0.588,P=0.006,respectively).Conclusion Ghrelin is negatively correlated with mean PAP and this suggests that circulating ghrelin might predict the severity of pulmonary hypertension in ASD patients with PAH.

  9. Left and right ventricular diastolic function in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rudhani Ibrahim

    2010-01-01

    Full Text Available 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 func-tion with the duration of HD. The study included 42 patients (22 females and 20 males with chro-nic 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 under-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.

  10. Left and right ventricular diastolic function in hemodialysis patients.

    Science.gov (United States)

    Rudhani, Ibrahim Destan; Bajraktari, Gani; Kryziu, Emrush; Zylfiu, Bejtush; Sadiku, Shemsedin; Elezi, Ymer; Rexhepaj, Nehat; Vitia, Arber; Emini, Merita; Abazi, Murat; Berbatovci-Ukimeraj, M; Kryeziu, Kaltrina; Hsanagjekaj, Venera; Korca, Hajrije; Ukimeri, Aferdita

    2010-11-01

    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 underwent 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 interventricular 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.

  11. Arterial blood pressure and renal sodium excretion in dopamine D3 receptor knockout mice.

    Science.gov (United States)

    Staudacher, Torsten; Pech, Bärbel; Tappe, Michael; Gross, Gerhard; Mühlbauer, Bernd; Luippold, Gerd

    2007-01-01

    Alterations in the dopaminergic system may contribute to the development of hypertension. Recently, it has been reported that pentobarbital-anesthetized mice with deficient dopamine D(3) receptors showed renin-dependent elevation in blood pressure. In a series of experiments, we evaluated the contribution of the dopamine D(3) receptor to the renal sodium excretion and arterial blood pressure behavior in conscious as well as anesthetized dopamine D(3) receptor knockout (-/-) mice. The blood pressure measuring study was designed as a cross-over trial to investigate the influence of different sodium loads. The animals were fed a normal salt diet (0.6% NaCl, NS) for 1 week and afterwards a low (0.2% NaCl, LS) or a high salt diet (4.6% NaCl, HS) for 2 weeks. After the third week, the animals were switched to the corresponding protocol. Systolic blood pressure in conscious (-/-) mice measured by tail-cuff plethysmography was not different from that of wild-type (+/+) animals, irrespective of the time course or the salt diet. In another experiment, challenge of an acute sodium loading per gavage in conscious D(3) receptor (-/-) and (+/+) animals on HS or NS diet did not show significant differences in renal sodium excretion between the two genotypes. Additionally, animals were fed an NS diet for 1 week and an HS diet for another week. As expected, sodium excretion significantly increased after the change from the NS to the HS diet. A slightly lower urinary sodium excretion was observed when comparing D(3) receptor (-/-) mice to their corresponding (+/+) mice, both on an HS diet. Clearance experiments with anesthetized D(3) receptor (-/-) and (+/+) mice were performed to investigate the renal sodium excretion capacity, when exposed to a moderate volume expansion (VE). Urinary sodium excretion increased in response to the VE; however, no difference were observed between the two genotypes. Taking these results together, we conclude that in the present animal model renal

  12. Noninvasive assessment of cardiac output from arterial pressure profiles during exercise.

    Science.gov (United States)

    Antonutto, G; Girardis, M; Tuniz, D; di Prampero, P E

    1995-01-01

    The stroke volume of the left ventricle (SV) was assessed in nine young men (mean age 22.2, ranging from 20 to 25 years) during cycle ergometer upright exercise at exercise intensities from 60 to 150 W (about 20% to 80% of individual maximal aerobic power). The SV was calculated from noninvasive tracings of the arterial blood pressure, determined from photoplethysmograph records and compared to the SV determined simultaneously by pulsed Doppler echocardiography (PDE). Given the relationship SV = As.Z-1 in which A(s) is the area underneath the systolic pressure profile (in millimetres of mercury and second), and Z (in millimetres of mercury and second per millilitre) is the apparent hydraulic impedance of the circulatory system, a prerequisite for the assessment of SV from the photoplethysmograph tracings is a knowledge of Z. The experimental value of Z (hereafter defined Z*) was calculated by dividing A(s) (from the finger photoplethysmograph) by SV as obtained by PDE. When the whole group of subjects was considered, Z* was not greatly affected by the exercise intensity: it amounted to 0.089 (SD 0.028; n = 36). The Z was also estimated independently of any parameter other than heart rate (HR), mean (MAP) and pulse (PP) arterial blood pressure obtained from the photoplethysmograph. A computerized statistical method allowed us to interpolate the experimental values of Z*, HR, PP and MAP by the equation Zm = a.(b + c.HR + d.PP + e.MAP)-1, thus obtaining the coefficients a to e. The mean percentage error between Zm (calculated from the coefficients obtained and Z* was 21.8 (SD 14.3)%. However, it was observed that, in a given subject, Z* was significantly affected by the exercise intensity. Therefore, to improve the estimate of Z a second algorithm was developed to update the experimental value of Z determined initially at rest (Zin). This updated value (Zcor) of Z was calculated as Zcor = Zin. [(f/(i + g.(HR/HRin) + h.(PP/PPin) + 1.(MAP/MAPin)], where HRin, PPin

  13. A method for the quantification of the pressure dependent 3D collagen configuration in the arterial adventitia.

    Science.gov (United States)

    Schrauwen, J T C; Vilanova, A; Rezakhaniha, R; Stergiopulos, N; van de Vosse, F N; Bovendeerd, P H M

    2012-11-01

    Collagen plays an important role in the response of the arterial wall to mechanical loading and presumably has a load-bearing function preventing overdistension. Collagen configuration is important for understanding this role, in particular in mathematical models of arterial wall mechanics. In this study a new method is presented to image and quantify this configuration. Collagen in the arterial adventitia is stained with CNA35, and imaged in situ at high resolution with confocal microscopy at luminal pressures from 0 to 140mm Hg. The images are processed with a new automatic approach, utilizing techniques intended for MRI-DTI data. Collagen configuration is quantified through three parameters: the waviness, the transmural angle and the helical angle. The method is demonstrated for the case of carotid arteries of the white New Zealand rabbit. The waviness indicated a gradual straightening between 40 and 80mm Hg. The transmural angle was about zero indicating that the fibers stayed within an axial-circumferential plane at all pressures. The helical angle was characterized by a symmetrical distribution around the axial direction, indicating a double symmetrical helix. The method is the first to combine high resolution imaging with a new automatic image processing approach to quantify the 3D configuration of collagen in the adventitia as a function of pressure.

  14. THE EFFECT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON THE PATHOGENESIS OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

    Objective. To investigate the effect of left veraricular diastolic dysfunction on the pathogenesis of angina decubitus (AD).Methods. The study population consisted of three groups: 20 individuals without cardiovascular disease were studied as group Ⅰ . Group Ⅱ included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction(EF) > 50% were studied as group Ⅲ. Group Ⅱ and Ⅲ were matched for age, EF and extent of coronary artery disease.Results. Left ventricnlography (LVG) showed that left ventricnlar (LV) first 1/3 filling fraction (1/3FF) was significantly lower in group Ⅲ than in group Ⅱ and Ⅰ (both P <0.001),but LV late 1/3 FF was much higher in group Ⅲ than in group Ⅱ and Ⅰ (P < 0.05, P < 0.01). Left ventricular end-diastohc presstrre(LVEDP) was markedly inereased before and after LVGin group Ⅱ and Ⅲ as compared with group Ⅰ (beth P<0.05, beth P<0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD) before and after LVG was much higher in group Ⅲ than in group Ⅰ ( P < 0.01, P < 0.001). Howevere, there were significant differences in LVEDP and in LACPD between before and after LVG only in group Ⅲ (both P < 0.01).Conclusion. The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogen-esis of angina decubitus.

  15. Blood pressure measurement

    Science.gov (United States)

    Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure ... or your health care provider will wrap the blood pressure cuff snugly around your upper arm. The lower ...

  16. Multiple level arterial occlusions of the leg. Reliability of indirect thigh pressures in the assessment of proximal arterial obstruction

    DEFF Research Database (Denmark)

    Noer, Ivan; Tønnesen, K H; Lassen, N A

    1981-01-01

    placed as proximally as possible on the thigh. The proximal pressures measured by the two techniques were found to correlate well. Thus, the atraumatic cuff pressure technique is validated which can be of use in evaluating multilevel occlusions and the associated run off problem involved in partial...

  17. Echocardiographic Assessment of Pulmonary Artery Systolic Pressure and Outcomes in Ambulatory Heart Failure Patients

    Science.gov (United States)

    Kalogeropoulos, Andreas P.; Siwamogsatham, Sarawut; Hayek, Salim; Li, Song; Deka, Anjan; Marti, Catherine N.; Georgiopoulou, Vasiliki V.; Butler, Javed

    2014-01-01

    Background Pulmonary hypertension (PH) in patients with heart failure (HF) is associated with worse outcomes and is rapidly being recognized as a therapeutic target. To facilitate pragmatic research efforts, data regarding the prognostic importance of noninvasively assessed pulmonary artery systolic pressure (PASP) in stable ambulatory patients with HF are needed. Methods and Results We examined the association between echocardiographic PASP and outcomes in 417 outpatients with HF (age, 54±13 years; 60.7% men; 50.4% whites; 24.9% with preserved ejection fraction). Median PASP was 36 mm Hg (interquartile range [IQR]: 29, 46). After a median follow‐up of 2.6 years (IQR: 1.7, 3.9) there were 72 major events (57 deaths; 9 urgent heart transplants; and 6 ventricular assist device implantations) and 431 hospitalizations for HF. In models adjusting for clinical risk factors and therapy, a 10‐mm Hg higher PASP was associated with 37% higher risk (95% CI: 18, 59; P<0.001) for major events, and 11% higher risk (95% CI: 1, 23; P=0.039) for major events or HF hospitalization. The threshold that maximized the likelihood ratio for both endpoints was 48 mm Hg; those with PASP ≥48 mm Hg (N=84; 20.1%) had an adjusted hazard ratio of 3.33 (95% CI: 1.96, 5.65; P<0.001) for major events and 1.47 (95% CI: 1.02, 2.11; P=0.037) for major events or HF hospitalization. Reduced right ventricular systolic function had independent prognostic utility over PASP for adverse outcomes. Right atrial pressure and transtricuspid gradient both contributed to risk. Conclusions Elevated PASP, determined by echocardiography, identifies ambulatory patients with HF at increased risk for adverse events. PMID:24492947

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

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    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.

  19. Increased pressure-induced tone in rat parenchymal arterioles vs. middle cerebral arteries: role of ion channels and calcium sensitivity.

    Science.gov (United States)

    Cipolla, Marilyn J; Sweet, Julie; Chan, Siu-Lung; Tavares, Matthew J; Gokina, Natalia; Brayden, Joseph E

    2014-07-01

    Brain parenchymal arterioles (PAs) are high-resistance vessels that branch off pial arteries and perfuse the brain parenchyma. PAs are the target of cerebral small vessel disease and have been shown to have greater pressure-induced tone at lower pressures than pial arteries. We investigated mechanisms by which brain PAs have increased myogenic tone compared with middle cerebral arteries (MCAs), focusing on differences in vascular smooth muscle (VSM) calcium and ion channel function. The amount of myogenic tone and VSM calcium was measured using Fura 2 in isolated and pressurized PAs and MCAs. Increases in intraluminal pressure caused larger increases in tone and cytosolic calcium in PAs compared with MCAs. At 50 mmHg, myogenic tone was 37 ± 5% for PAs vs. 6.5 ± 4% for MCAs (P channel (VDCC) inhibitor nifedipine than MCAs (EC50 for PAs was 3.5 ± 0.4 vs. 82.1 ± 2.1 nmol/l for MCAs;P channel inhibitor iberiotoxin, whereas MCAs constricted ∼15%. Thus increased myogenic tone in PAs appears related to differences in ion channel activity that promotes VSM membrane depolarization but not to a direct sensitization of the contractile apparatus to calcium.

  20. Membrane potential and Ca2+ concentration dependence on pressure and vasoactive agents in arterial smooth muscle: A model.

    Science.gov (United States)

    Karlin, Arthur

    2015-07-01

    Arterial smooth muscle (SM) cells respond autonomously to changes in intravascular pressure, adjusting tension to maintain vessel diameter. The values of membrane potential (Vm) and sarcoplasmic Ca(2+) concentration (Ca(in)) within minutes of a change in pressure are the results of two opposing pathways, both of which use Ca(2+) as a signal. This works because the two Ca(2+)-signaling pathways are confined to distinct microdomains in which the Ca(2+) concentrations needed to activate key channels are transiently higher than Ca(in). A mathematical model of an isolated arterial SM cell is presented that incorporates the two types of microdomains. The first type consists of junctions between cisternae of the peripheral sarcoplasmic reticulum (SR), containing ryanodine receptors (RyRs), and the sarcolemma, containing voltage- and Ca(2+)-activated K(+) (BK) channels. These junctional microdomains promote hyperpolarization, reduced Ca(in), and relaxation. The second type is postulated to form around stretch-activated nonspecific cation channels and neighboring Ca(2+)-activated Cl(-) channels, and promotes the opposite (depolarization, increased Ca(in), and contraction). The model includes three additional compartments: the sarcoplasm, the central SR lumen, and the peripheral SR lumen. It incorporates 37 protein components. In addition to pressure, the model accommodates inputs of α- and β-adrenergic agonists, ATP, 11,12-epoxyeicosatrienoic acid, and nitric oxide (NO). The parameters of the equations were adjusted to obtain a close fit to reported Vm and Ca(in) as functions of pressure, which have been determined in cerebral arteries. The simulations were insensitive to ± 10% changes in most of the parameters. The model also simulated the effects of inhibiting RyR, BK, or voltage-activated Ca(2+) channels on Vm and Ca(in). Deletion of BK β1 subunits is known to increase arterial-SM tension. In the model, deletion of β1 raised Ca(in) at all pressures, and these

  1. 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

    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

  2. ORANGE JUICE AND BLOOD PRESSURE

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    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.

  3. Perioperative management of left ventricular diastolic dysfunction and heart failure: an anesthesiologist's perspective

    Science.gov (United States)

    2017-01-01

    Anesthesiologists frequently see asymptomatic patients with diastolic dysfunction or heart failure for various surgeries. These patients typically show normal systolic function but abnormal diastolic parameters in their preoperative echocardiographic evaluations. The symptoms that are sometimes seen are similar to those of chronic obstructive pulmonary disease. Patients with diastolic dysfunction, and even with diastolic heart failure, have the potential to develop a hypertensive crisis or pulmonary congestion. Thus, in addition to conventional perioperative risk quantification, it may be important to consider the results of diastolic assessment for predicting the postoperative outcome and making better decisions. If anesthesiologists see female patients older than 70 years of age who have hypertension, diabetes, chronic renal disease, recent weight gain, or exercise intolerance, they should focus on the patient's diastologic echocardiography indicators such as left atrial enlargement or left ventricular hypertrophy. In addition, there is a need for perioperative strategies to mitigate diastolic dysfunction-related morbidity. Specifically, hypertension should be controlled, keeping pulse pressure below diastolic blood pressure, maintaining a sinus rhythm and normovolemia, and avoiding tachycardia and myocardial ischemia. There is no need to classify these diastolic dysfunction, but it is important to manage this condition to avoid worsening outcomes. PMID:28184260

  4. The Effect of High Dose Cholecalciferol on Arterial Stiffness and Peripheral and Central Blood Pressure in Healthy Humans

    DEFF Research Database (Denmark)

    Bressendorff, Iain; Brandi, Lisbet; Schou, Morten

    2016-01-01

    and blood pressure in healthy normotensive adults. METHODS: 40 healthy adults were randomised in this double-blinded study to either oral cholecalciferol 3000 IU/day or matching placebo and were followed for 16 weeks to examine any effects on pulse wave velocity (PWV), augmentation index (AIx), peripheral...... and central blood pressure and 24-hour ambulatory blood pressure. RESULTS: 22 subjects in the cholecalciferol arm and 18 subjects in the placebo arm completed the 16 weeks of follow-up. There was no difference in changes in PWV, AIx corrected for heart rate or central or peripheral blood pressure between...... the two groups. There was no correlation between serum 25-hydroxy vitamin D and any of these parameters. CONCLUSIONS: Oral cholecalciferol 3000 IU/day does not affect arterial stiffness or blood pressure after 16 weeks of treatment in healthy normotensive adults. TRIAL REGISTRATION: ClinicalTrials.gov NCT...

  5. Cardiac output in idiopathic normal pressure hydrocephalus: association with arterial blood pressure and intracranial pressure wave amplitudes and outcome of shunt surgery

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    Eide Per K

    2011-02-01

    Full Text Available Abstract Background In patients with idiopathic normal pressure hydrocephalus (iNPH responding to shunt surgery, we have consistently found elevated intracranial pressure (ICP wave amplitudes during diagnostic ICP monitoring prior to surgery. It remains unknown why ICP wave amplitudes are increased in these patients. Since iNPH is accompanied by a high incidence of vascular co-morbidity, a possible explanation is that there is reduced vascular compliance accompanied by elevated arterial blood pressure (ABP wave amplitudes and even altered cardiac output (CO. To investigate this possibility, the present study was undertaken to continuously monitor CO to determine if it is correlated to ABP and ICP wave amplitudes and the outcome of shunting in iNPH patients. It was specifically addressed whether the increased ICP wave amplitudes seen in iNPH shunt responders were accompanied by elevated CO and/or ABP wave amplitude levels. Methods Prospective iNPH patients (29 were clinically graded using an NPH grading scale. Continuous overnight minimally-invasive monitoring of CO and ABP was done simultaneously with ICP monitoring; the CO, ABP, and ICP parameters were parsed into 6-second time windows. Patients were assessed for shunt surgery on clinical grade, Evan's index, and ICP wave amplitude. Follow-up clinical grading was performed 12 months after surgery. Results ICP wave amplitudes but not CO or ABP wave amplitude, showed good correlation with the response to shunt treatment. The patients with high ICP wave amplitude did not have accompanying high levels of CO or ABP wave amplitude. Correlation analysis between CO and ICP wave amplitudes in individual patients showed different profiles [significantly positive in 10 (35% and significantly negative in 16 (55% of 29 recordings]. This depended on whether there was also a correlation between ABP and ICP wave amplitudes and on the average level of ICP wave amplitude. Conclusions These results gave no

  6. Acute effects of supramaximal exercise on carotid artery compliance and pulse pressure in young men and women.

    Science.gov (United States)

    Rossow, Lindy; Fahs, Christopher A; Guerra, Myriam; Jae, Sae Young; Heffernan, Kevin S; Fernhall, Bo

    2010-11-01

    The purpose of this study was to determine the cumulative effects of repeated cycling sprints (Wingate tests) on carotid compliance and blood pressure (BP). Fourteen young, healthy men and women completed this study. Vascular and hemodynamic measurements were taken at rest, 5 min following a first Wingate test, 25 min following the first Wingate test, 5 min following a second Wingate test, and 25 min following the second Wingate test. At each time point, the measurements taken included brachial and carotid pulse pressure (PP), heart rate, carotid artery maximum and minimum diameters, and carotid compliance. Carotid BP was obtained with applanation tonometry. Carotid diameters were obtained using ultrasonography and compliance was calculated from carotid diameters and BP. Carotid and brachial PP increased significantly (P sprint, carotid arterial compliance decreased significantly more than 5 min following the first sprint (P sprint reduces carotid artery compliance immediately after exercise. Performance of a second identical cycling sprint further compounds this vascular change, reducing carotid artery compliance beyond levels seen following a single cycling sprint.

  7. Influence of geomagnetic activity and atmospheric pressure in hypertensive adults.

    Science.gov (United States)

    Azcárate, T; Mendoza, B

    2017-03-30

    We performed a study of the systolic and diastolic arterial blood pressure behavior under natural variables such as the atmospheric pressure and the horizontal geomagnetic field component. We worked with a group of eight adult hypertensive volunteers, four men and four women, with ages between 18 and 27 years in Mexico City during a geomagnetic storm in 2014. The data was divided by gender, age, and day/night cycle. We studied the time series using three methods: correlations, bivariate analysis, and superposed epoch (within a window of 2 days around the day of occurrence of a geomagnetic storm) analysis, between the systolic and diastolic blood pressure and the natural variables. The correlation analysis indicated a correlation between the systolic and diastolic blood pressure and the atmospheric pressure and the horizontal geomagnetic field component, being the largest during the night. Furthermore, the correlation and bivariate analyses showed that the largest correlations are between the systolic and diastolic blood pressure and the horizontal geomagnetic field component. Finally, the superposed epoch analysis showed that the largest number of significant changes in the blood pressure under the influence of geomagnetic field occurred in the systolic blood pressure for men.

  8. Estimated aortic blood pressure based on radial artery tonometry underestimates directly measured aortic blood pressure in patients with advancing chronic kidney disease staging and increasing arterial stiffness

    DEFF Research Database (Denmark)

    Carlsen, Rasmus K; Peters, Christian D; Khatir, Dinah S;

    2016-01-01

    we compared invasive aortic systolic BP (SBP) with estimated central SBP obtained by radial artery tonometry and examined the influence of renal function and arterial stiffness on this relationship. We evaluated 83 patients with stage 3 to 5 CKD (mean estimated glomerular filtration rate [eGFR] 30 ml......% confidence interval -14.9 to -11.4) mm Hg. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cf-PWV) and was significantly increased in CKD patients compared with (versus) control patients (mean 10.7 vs. 9.3 m/s). The difference in BP significantly increased 1.0 mm Hg for every 10 ml....../min decrease in eGFR and by 1.6 mm Hg per 1 m/s increase in cfPWV. Using multivariate regression analysis including both eGFR and cfPWV, the difference between estimated central and invasive aortic SBP was significantly increased by 0.7 mm Hg. For the entire cohort brachial SBP significantly better reflected...

  9. 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

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    Thelma Leite de Araujo

    2007-12-01

    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.

  10. 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

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    Emilia Soares Chaves

    2010-03-01

    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.

  11. Tricuspid Regurgitation Improvement in Relation to the Amount of Pulmonary Artery Pressure Reduction

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    Mahmood Sheikhfathollahi

    2010-08-01

    Full Text Available Background: Given the common concomitance of tricuspid regurgitation (TR with significant mitral stenosis, we aimed at exploring the relation between TR severity and pulmonary artery hypertension (PAH in patients who underwent mitral balloon valvotomy (MBV.Methods: We analyzed the echocardiography data of 133 consecutive patients (82.0% female, mean age 44.68 ± 12.56 years with different degrees of TR severity that underwent MBV between April 2006 and March 2008. The pulmonary artery systolic pressure (PAPs > 35 mmHg was considered as PAH.Results: Before MBV, 36.20% of the patients had moderate to severe TR, 92.5% PAH, and 18.0% right ventricular (RVdilation (RV dimension ≥ 33 mm. After MBV, TR severity improved in 41.4%, worsened in 8.3%, and did not change in 50.4%. Before and after MBV, PAPs was significantly correlated with TR severity, and the mean PAPs change in patients with improved TR was significantly more than that of patients without TR improvement (p value = 0.042. Tricuspid regurgitation severity and mean PAPs (from 52.83 ± 18.82 to 35.89 ± 9.39 mmHg decreased significantly after MBV (both p values <0.001; this reduction was significantly correlated to the amount of PAPs decrease. A cut-off point of ≥ 19 mmHg reductionin PAPs had a specificity of 71.79% and sensitivity of 52.73% to show TR severity improvement (by Receiver-Operative-Characteristics analysis. The mean of RV dimension decreased from 28.94 ± 5.43 to 27.95 ± 4.67 mm (p value < 0.001. In contrast to patients with RV dilation, TR reduced significantly in patients without RV dilation (p value < 0.001.Conclusion: Improvement in TR severity was directly correlated with the amount of PAPs reduction after MBV. Morestudies are needed to better define a cut-off value for PAPs reduction related to TR severity improvement.

  12. 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

  13. The therapeutic implications of diastolic time changes in systemic hypertension.

    Science.gov (United States)

    Jawad, I A; Kinhal, V; Talmers, F; Weissler, A M; Boudoulas, H

    1985-06-01

    Twenty-five patients with chronic systemic hypertension were studied. Systolic time intervals and diastolic time were determined at baseline and after 12 weeks of therapy with nadolol, with or without bendroflumethiazide (treatment phase I), then after 12 weeks of therapy with hydralazine, bendroflumethiazide, or both (treatment phase II). Systolic, diastolic, and mean blood pressures were equally controlled after either treatment regimen. Heart rate was significantly slower after treatment phase I compared to baseline or after treatment phase II (p less than 0.001). Systolic time per minute was significantly shorter and diastolic time per beat and per minute were significantly longer after treatment phase I compared to baseline or after treatment phase II (p less than 0.001). Double and triple products decreased after either mode of therapy; however, these parameters were significantly lower after treatment phase I compared to treatment phase II (p less than 0.01). These changes in systolic and diastolic time and double and triple products may be of clinical significance during therapy of chronic systemic hypertension and may help explain the regression of left ventricular hypertrophy in patients with hypertension treated with sympathetic blocking agents.

  14. 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...

  15. 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

    1981-01-01

    nephropathy. Twelve of the 14 patients had normal serum creatinine levels. None of the patients received antihypertensive treatment. During the mean observation period of 26 months (range 23 to 33 months) GFR decreased from 107 to 87 ml/min/1.73 m2 (p less than 0.001), serum creatinine remained unchanged: 107...... in arterial blood pressure to a hypertensive level is an early feature of diabetic nephropathy in young insulin-dependent diabetics.......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...

  16. Rationale and methodology of monitoring ambulatory blood pressure and arterial compliance in the Hypertension in the Very Elderly Trial

    OpenAIRE

    2006-01-01

    OBJECTIVE: This article describes the rationale and methodology for the monitoring of ambulatory blood pressure and arterial compliance in hypertensive patients aged 80 years and above. This is a side project of the Hypertension in the Very Elderly Trial. METHODS: The hypertension in the Very Elderly Trial is a multicentre, double-blind, randomized, placebo-controlled trial aiming to investigate the effect of active treatment on cardiovascular and other outcomes in hypertensive patients aged ...

  17. Beneficial effects of prolonged blood pressure control after carotid artery stenting

    Directory of Open Access Journals (Sweden)

    Chang A

    2017-01-01

    Full Text Available Anna Chang,1 Huei-Fong Hung,2 Fang-I Hsieh,3 Wei-Hung Chen,1,4 Hsu-Ling Yeh,1,5 Jiann-Horng Yeh,1,6 Hou-Chang Chiu,1,6 Li-Ming Lien1,4 1Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 2Department of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 3School of Public Health, College of Public Health, Taipei Medical University, Taipei, 4School of Medicine, College of Medicine, Taipei Medical University, Taipei, 5Institute of Public Health, National Yang-Ming University, Taipei, 6School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan Objectives: The main purpose of this study was to investigate whether carotid artery stenting (CAS plus medicine in patients with severe carotid artery stenosis provide a better long-term blood pressure (BP control compared to other medical treatments alone. The other aim was to explore the correlation between post-CAS hypotension within 6 h and long-term BP reductions after CAS. Materials and methods: Patients with severe carotid stenosis were recruited either in the CAS group or in the medication group. BPs and the number of classes of antihypertensive agents were recorded at baseline, 6, and 12 months. Extra BP information was collected at 6 h, 3 days, and 1 month after CAS. Univariate and multivariate linear regressions were performed to test the relationship of BP changes among CAS and medication groups after 6 and 12 months of follow-up. Univariate linear regressions were also used to determine the correlations between the mean or maximal systolic BP (SBP reductions at 6 h and 1 year post-CAS. Results: In total, 72 members in the CAS group and 82 members in the medication group were recruited. Compared with the medication group, patients in the CAS group had greater BP reductions at 6 and 12 months of follow-up after adjusting for confounding factors (13.56 mmHg at 6 months, P=0.0002; 16.98 mmHg at 12 months, P<0.0001. This study also shows significant

  18. Inadvertent arterial insertion of a central venous catheter: delayed recognition with abrupt changes in pressure waveform during surgery -A case report-.

    Science.gov (United States)

    Choi, Yong Sun; Park, Ji Young; Kwak, Young Lan; Lee, Jong Wha

    2011-01-01

    We present a case of inadvertent arterial insertion of a central venous catheter, identified during a pericardiectomy procedure after observing abrupt changes in pressure waveform and confirmed via arterial blood gas analysis and transesophageal echocardiography. Central venous pressure measurement was initially 20 mmHg in supine, and then elevated to 30-40 mmHg in right lateral decubitus, presumably resulting from constrictive physiology of pericarditis. The pressure waveforms, however, abruptly changed from a venous to an arterial waveform during surgery. When visual discrimination between arterial and venous blood regurgitation is unreliable, anesthesiologists should confirm that using all the available methods one has on the scene, especially after at least two unsuccessful attempts or in patients with advanced age or clinical conditions resulting in jugular venous dilation. To prevent arterial catheterization, one should limit the leftward rotation of the head by <40° and consider using ultrasound-guided method after more than two unsuccessful attempts.

  19. 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;

    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...... in the placebo group. CONCLUSIONS: Sildenafil did not decrease filling pressure at rest or during exercise in post-myocardial infarction patients with diastolic dysfunction. However, there were effects on secondary end points, which require further studies....

  20. Study on the Correlation Between Absent End-diastolic Velocity in Fetal Umbilical Artery and Pregnancy Outcome%胎儿脐动脉舒张末期血流缺失与妊娠结局的相关性研究

    Institute of Scientific and Technical Information of China (English)

    孙江丽; 于海容

    2012-01-01

    [目的]探讨胎儿脐动脉舒张末期血流缺失(AEDV)与妊娠结局的关系.[方法]产前常规应用脉冲多普勒技术行胎儿脐动脉血流频谱检测,确诊为AEDV孕妇36例,分析AEDV与妊娠合并症、妊娠结局的关系.[结果]36例AEDV病例中,重度子痫前期69.4%(25/36),胎儿生长受限80.6%(29/36),羊水过少22.2%(8/36),妊娠期肝内胆管淤积症11.1%(4/36),妊娠期糖尿病8.3%(3/36);胎儿先天畸形发生率为16.7%(6 / 36),病死率55.6%(20 /36 ).[结论]脐动脉舒张末期血流缺失是脐动脉血流阻力增高的特有表现,表明胎儿-胎盘循环障碍,妊娠合并症增多,胎儿预后不良,临床应给予高度重视.%[Objective] To explore the relationship between absent end diastolic velocity (AEDV) in theumbilical artery and the pregnancy outcome. [Methods]Pulse Doppler was used to measure fetal umbilical ar tery flow. A total of 36 pregnant women were diagnosed as AEDV. The correlation of AEDV with pregnancy complications and pregnancy outcomes was analyzed. [Results] Among 36 AEDV cases, there were 25 cases of severe preeclampsia(69. 4%) , 29 cases of intrauterine growth retardation(IUGR) (80. 6%) , 8 cases of oli gohydramnios(22. 2%) , 4 cases of interahepatic cholestasis of pregnancy(ll. 1%) and 3 cases of gestational diabetes mellitus(8. 3%). The incident rate of fetal malformation was 16. 7% (6/36) and the mortality rate was 55. 6%(20/36). [Conclusion]AEDV in the umbilical artery is the unique performance of abnormally in creased resistance of blood flow in the umbilical artery, which suggests fetal placenta circulation barrier, more pregnancy complications and poor prognosis of fetus. Therefore AEDV should be paid attention.

  1. Acute effect of hydralazine administration on pulmonary artery hemodynamics in dogs with chronic heartworm disease.

    Science.gov (United States)

    Atkins, C E; Keene, B W; McGuirk, S M; Sato, T

    1994-02-01

    In an effort to better understand the role of vasodilators in the management of pulmonary hypertension associated with chronic heartworm disease (HWD), pulmonary hemodynamic measurements were obtained from 7 experimentally infected, anesthetized dogs before and after hydralazine administration (mean dose, 1.96 mg/kg of body weight). Five dogs were maintained on room air, while 2 were maintained on 100% oxygen during the hydralazine study. The hemodynamic effect of hydralazine in dogs with HWD was evaluated, using heart rate, cardiac index, mean pulmonary artery pressure, mean arterial pressure, total pulmonary resistance, total systemic resistance, total systemic resistance/total pulmonary resistance, left ventricular dP/dtmax, left ventricular end diastolic pressure, and left and right ventricular double products ([mean arterial pressure x heart rate] and [mean pulmonary artery pressure x heart rate], respectively). Responders were defined as those in which total pulmonary resistance decreased > or = 20% without an increase in mean pulmonary arterial pressure and in which heart rate increase was < or = 10%. Comparison was also made between maximal hemodynamic effect of hydralazine with that after 100% oxygen administration for 15 minutes to previously normoxemic dogs (n = 5). Significance was determined if P < 0.05, using the paired t-test. Hydralazine induced significant reductions in mean pulmonary and systemic arterial pressures and total pulmonary resistance, with no significant change in heart rate, cardiac index, total systemic resistance, left ventricular dP/dtmax, left ventricular end diastolic pressure, or right and left ventricular double products. Four (57%) of the 7 dogs studied were considered responders. Pretreatment cardiac index, mean pulmonary artery pressure, and total pulmonary resistance did not allow differentiation of responders from nonresponders.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Myosin heavy chain 15 is associated with bovine pulmonary arterial pressure

    Science.gov (United States)

    Neary, Joseph M.; Lund, Gretchen K.; Holt, Timothy N.; Garry, Franklyn B.; Mohun, Timothy J.; Breckenridge, Ross A.

    2014-01-01

    Abstract Bovine pulmonary hypertension, brisket disease, causes significant morbidity and mortality at elevations above 2,000 m. Mean pulmonary arterial pressure (mPAP) is moderately heritable, with inheritance estimated to lie within a few major genes. Invasive mPAP measurement is currently the only tool available to identify cattle at risk of hypoxia-induced pulmonary hypertension. A genetic test could allow selection of cattle suitable for high altitude without the need for invasive testing. In this study we evaluated three candidate genes (myosin heavy chain 15 [MYH15], NADH dehydrogenase flavoprotein 2, and FK binding protein 1A) for association with mPAP in 166 yearling Angus bulls grazing at 2,182 m. The T allele (rs29016420) of MYH15 was linked to lower mPAP in a dominant manner (CC 47.2 ± 1.6 mmHg [mean ± standard error of the mean]; CT/TT 42.8 ± 0.7 mmHg; P = 0.02). The proportions of cattle with MYH15 CC, CT, and TT genotypes were 55%, 41%, and 4%, respectively. Given the high frequency of the deleterious allele, it is likely that the relative contribution of MYH15 polymorphisms to pulmonary hypertension is small, supporting previous predictions that the disease is polygenic. We evaluated allelic frequency of MYH15 in the Himalayan yak (Bos grunniens), a closely related species adapted to high altitude, and found 100% prevalence of T allele homozygosity. In summary, we identified a polymorphism in MYH15 significantly associated with mPAP. This finding may aid selection of cattle suitable for high altitude and contribute to understanding human hypoxia-induced pulmonary hypertension. PMID:25621163

  3. Bilayered negative-pressure wound therapy preventing leg incision morbidity in coronary artery bypass graft patients

    Science.gov (United States)

    Yu, Yongchao; Song, Zhigang; Xu, Zhiyun; Ye, Xiaofei; Xue, Chunyu; Li, Junhui; Bi, Hongda

    2017-01-01

    Abstract Backgrounds: The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial. Methods: A single-center, pilot randomized controlled trial was conducted. From December 2013 to March 2014, a total of 72 coronary heart disease patients (48 men and 24 women) received CABG therapy, with great saphenous veins were selected as grafts. Patients were equally randomized into a treatment and a control group. After the harvesting of the great saphenous veins and direct closure of the wound with sutures, b-NPWT was used for the thigh incision in the treatment group for 5 days (treatment thigh). Traditional surgical pads were applied to both the shank incisions of the treatment group patients (treatment shank) and the entire incisions of the control group (control thigh, control shank). Postoperative complications were recorded and statistically analyzed based on outcomes of thigh treatment, shank treatment, thigh control, and shank control groups. Results: The incidence rates of early complications, such as lymphorrhagia, lymphoedema, infection, wound dehiscence, and skin flap necrosis, of the vascular donor site in the thigh treatment group was significantly lower than those in the 3 other groups. Conclusions: The self-designed b-NPWT can effectively reduce postoperative complications, such as lymphedema, incision infection, wound dehiscence, and skin flap necrosis, in CABG patients who underwent great saphenous veins harvesting. Trial registration: ClinicalTrials.gov. The unique registration number is NCT02010996. PMID:28099357

  4. Myosin heavy chain 15 is associated with bovine pulmonary arterial pressure.

    Science.gov (United States)

    Neary, Marianne T; Neary, Joseph M; Lund, Gretchen K; Holt, Timothy N; Garry, Franklyn B; Mohun, Timothy J; Breckenridge, Ross A

    2014-09-01

    Bovine pulmonary hypertension, brisket disease, causes significant morbidity and mortality at elevations above 2,000 m. Mean pulmonary arterial pressure (mPAP) is moderately heritable, with inheritance estimated to lie within a few major genes. Invasive mPAP measurement is currently the only tool available to identify cattle at risk of hypoxia-induced pulmonary hypertension. A genetic test could allow selection of cattle suitable for high altitude without the need for invasive testing. In this study we evaluated three candidate genes (myosin heavy chain 15 [MYH15], NADH dehydrogenase flavoprotein 2, and FK binding protein 1A) for association with mPAP in 166 yearling Angus bulls grazing at 2,182 m. The T allele (rs29016420) of MYH15 was linked to lower mPAP in a dominant manner (CC 47.2 ± 1.6 mmHg [mean ± standard error of the mean]; CT/TT 42.8 ± 0.7 mmHg; P = 0.02). The proportions of cattle with MYH15 CC, CT, and TT genotypes were 55%, 41%, and 4%, respectively. Given the high frequency of the deleterious allele, it is likely that the relative contribution of MYH15 polymorphisms to pulmonary hypertension is small, supporting previous predictions that the disease is polygenic. We evaluated allelic frequency of MYH15 in the Himalayan yak (Bos grunniens), a closely related species adapted to high altitude, and found 100% prevalence of T allele homozygosity. In summary, we identified a polymorphism in MYH15 significantly associated with mPAP. This finding may aid selection of cattle suitable for high altitude and contribute to understanding human hypoxia-induced pulmonary hypertension.

  5. In vivo evaluation of a novel, wrist-mounted arterial pressure sensing device versus the traditional hand-held tonometer.

    Science.gov (United States)

    Vardoulis, Orestis; Saponas, T Scott; Morris, Dan; Villar, Nicolas; Smith, Greg; Patel, Shwetak; Tan, Desney

    2016-10-01

    Although hemodynamic parameters can be assessed non-invasively, state-of-the-art non-invasive systems generally require an expert operator and are not applicable for ambulatory measurements. These limitations have restricted our understanding of the continuous behavior of hemodynamic parameters. In this manuscript, we introduce a novel wrist-mounted device that incorporates an array of pressure sensors which can be used to extract arterial waveforms and relevant pulse wave analysis biomarkers. In vivo evaluation is performed with Bland-Altman analysis to compare the novel sensor to a gold-standard hand-held tonometer by assessing their reproducibility and agreement in peripheral augmentation index (AIx) estimation at the radial artery. Arterial waves from 28 randomly selected participants were recorded in a controlled environment. Initially we assess the reproducibility of AIx results for both devices. The intra-class correlation coefficient (ICC) and mean difference ± SD were [0.913, 0.033±0.048] and [0.859, 0.039±0.076] for the hand-held and the wrist-mounted tonometer respectively. We then show that the AIx values derived from the novel tonometer have good agreement, accuracy, and precision when compared against the AIx values derived from the reference hand-held tonometer (ICC 0.927, mean difference 0.026±0.049). In conclusion, we have presented evidence that the new wrist-mounted arterial pressure sensor records arterial waveforms that can be processed to yield AIx values that are in good agreement with its traditional hand-held counterpart.

  6. Left and right ventricular diastolic dysfunction and diastolic heart failure: does one lead to the other?

    Institute of Scientific and Technical Information of China (English)

    Faramarz Tehrani; Anita Phan; Ernst R. Schwarz

    2009-01-01

    Background and Objective Diastolic dysfunction of the left ventricle is a mechanical abnormality diagnosed primarily by echocardiogram, and can be distinguished into three separate degrees based on the severity of reduction in passive compliance and active myocardial relaxation. Methods A literature search was performed for basic science studies, clinical studies and major practice guidelines on the subject of diastolic dysfunction and diastolic heart failure. Important findings were analyzed and correlated with regard to clinical relevance. Results Left ventricular diastolic dysfunction appears to compromise exercise tolerance and is believed to contribute to the pathophysiology in patients with diastolic heart failure. In the clinical setting, however, oftentimes no clear distinction is made between echocardiographically diagnosed diastolic dysfunction and diastolic heart failure, and adequate treatment recommendations are sparse and aimed to prevent worsening and progression of clinical symptoms. To date, there is a lack of high powered trials assessing the possible progression rate from echocardiographically diagnosed diastolic dysfunction to the clinical diagnosis of diastolic heart failure. Furthermore, there are no solid indices to assess the degree of severity of diastolic dysfunction or its progression. Pure right ventricular diastolic dysfunction appears to be even less understood and under-recognized, although it may play a role in the development of both right and left heart failure. Currently there are few but interesting data on the possible interaction between ventricles with diastolic dysfunction and the overall affect on the development of heart failure. Conclusions The timeline and progression of diastolic dysfunction to diastolic heart failure have not been well established and warrant further investigation.

  7. Association between blood pressure measures and recurrent headache in adolescents: cross-sectional data from the HUNT-Youth study

    OpenAIRE

    Tronvik, Erling; Zwart, John-Anker; Hagen, Knut; Dyb, Grete; Holmen, Turid Lingaas; Stovner, Lars Jacob

    2011-01-01

    The relationship between blood pressure and headache in youth has not been explored and the objective of the present study was to provide data on this association in an adolescent population. Cross-sectional data from a large population-based survey, the Young-HUNT study, on 5,847 adolescents were used to evaluate the association between blood pressure (systolic, diastolic, mean arterial and pulse pressure) and recurrent headache, including migraine and tension-type headache. Increasing pulse...

  8. Non-invasive Technology for Arterial Blood Pressure Signal Based on Photo-diode%基于光电二极管的动脉血压信号无损监测技术

    Institute of Scientific and Technical Information of China (English)

    熊元姣

    2015-01-01

    用红外发光二极管和光电二极管组成的光耦合指套,放置在人身体的指尖部位,通过检测人体末梢组织在动脉舒张和收缩时对红外光的吸收度变化率,来检测人体动脉血压信号的异常。红外发射二极管的驱动采用PWM信号调制的恒流驱动,光电二极管接收穿透人体后的红外光并转换成微弱的电信号,再经过前置放大、倒相、压控二阶低通滤波、陷波电路、A/D 转换等处理后,MCU 从采集的数据中提取有关动脉血压信号的特征值,实现血压信号异常的无损连续监测。%An optical coupling finger stall, composed of IR LED and photo-diode, is placed at fingertip, when the IR transmission light intensity across a finger changes with the diastole and systole of arterial blood pressure, the inverter current of photo-diode varies. Therefore, the arterial blood pressure anomalies can be detected according to the changes. The drive current of IR LED, controlled by PWM is constant in the process of detection. The voltage signal converted by photo-diode is very week, so that it can easily be disturbed. The signal must be processed by the pre-amplification circuit, second order filter circuit, and wave trap. Finally, the data from A/D converter is collected and processed by MCU.

  9. A fluid-structure interaction model of the internal carotid and ophthalmic arteries for the noninvasive intracranial pressure measurement method.

    Science.gov (United States)

    Misiulis, Edgaras; Džiugys, Algis; Navakas, Robertas; Striūgas, Nerijus

    2017-03-22

    Accurate and clinically safe measurements of intracranial pressure (ICP) are crucial for secondary brain damage prevention. There are two methods of ICP measurement: invasive and noninvasive. Invasive methods are clinically unsafe; therefore, safer noninvasive methods are being developed. One of the noninvasive ICP measurement methods implements the balance principle, which assumes that if the velocity of blood flow in both ophthalmic artery segments - the intracranial (IOA) and extracranial (EOA) - is equal, then the acting ICP on the IOA and the external pressure (Pe) on the EOA are also equal. To investigate the assumption of the balance principle, a generalized computational model incorporating a fluid-structure interaction (FSI) module was created and used to simulate noninvasive ICP measurement by accounting for the time-dependent behavior of the elastic internal carotid (ICA) and ophthalmic (OA) arteries and their interaction with pulsatile blood flow. It was found that the extra balance pressure term, which incorporates the hydrodynamic pressure drop between measurement points, must be added into the balance equation, and the corrections on a difference between the velocity of blood flow in the IOA and EOA must be made, due to a difference in the blood flow rate.

  10. The mixing rate of the arterial blood pressure waveform Markov chain is correlated with shock index during hemorrhage in anesthetized swine.

    Science.gov (United States)

    Adibuzzaman, Mohammad; Kramer, George C; Galeotti, Loriano; Merrill, Stephen J; Strauss, David G; Scully, Christopher G

    2014-01-01

    Identifying the need for interventions during hemorrhage is complicated due to physiological compensation mechanisms that can stabilize vital signs until a significant amount of blood loss. Physiological systems providing compensation during hemorrhage affect the arterial blood pressure waveform through changes in dynamics and waveform morphology. We investigated the use of Markov chain analysis of the arterial blood pressure waveform to monitor physiological systems changes during hemorrhage. Continuous arterial blood pressure recordings were made on anesthetized swine (N=7) during a 5 min baseline period and during a slow hemorrhage (10 ml/kg over 30 min). Markov chain analysis was applied to 20 sec arterial blood pressure waveform segments with a sliding window. 20 ranges of arterial blood pressure were defined as states and empirical transition probability matrices were determined for each 20 sec segment. The mixing rate (2(nd) largest eigenvalue of the transition probability matrix) was determined for all segments. A change in the mixing rate from baseline estimates was identified during hemorrhage for each animal (median time of 13 min, ~10% estimated blood volume, with minimum and maximum times of 2 and 33 min, respectively). The mixing rate was found to have an inverse correlation with shock index for all 7 animals (median correlation coefficient of -0.95 with minimum and maximum of -0.98 and -0.58, respectively). The Markov chain mixing rate of arterial blood pressure recordings is a novel potential biomarker for monitoring and understanding physiological systems during hemorrhage.

  11. Detection of postischemic regional left ventricular delayed outward wall motion or diastolic stunning after exercise-induced ischemia in patients with stable effort angina by using color kinesis.

    Science.gov (United States)

    Ishii, Katsuhisa; Miwa, Kunihisa; Sakurai, Takahiro; Kataoka, Kazuaki; Imai, Makoto; Kintaka, Aya; Aoyama, Takeshi; Kawanami, Masaki

    2008-04-01

    To determine whether postischemic diastolic stunning could be detected using color kinesis, we evaluated regional left ventricular (LV) diastolic wall motion in 36 patients with stable effort angina and a coronary stenosis (> or = 70% of luminal diameter), and in 30 control subjects. Regional LV filling fraction in the short-axis view during the first 30% of the LV filling time (color kinesis diastolic index) was determined before, 20 minutes, 1 hour, and 24 hours after the treadmill exercise test. In 33 of the 36 patients (92%), new regional LV delayed outward motion during early diastole (color kinesis diastolic index < or = 40%) was detected at 20 minutes after exercise. The regional LV delayed diastolic wall motion showed significant improvement but persisted 1 hour afterward in 20 of 36 patients (56%), and disappeared 24 hours after exercise. Detection of regional stunned myocardium with impaired diastolic function may be a useful tool for the diagnosis of coronary artery disease.

  12. Maternal and Neonatal Outcomes of Preeclampsia Accompanied by Absent or Reversed End-Diastolic Velocity in Umbilical Artery%子痫前期并发胎儿脐动脉舒张末期血流缺失及返流的母婴结局

    Institute of Scientific and Technical Information of China (English)

    张庆英; 程海东

    2015-01-01

    目的:探讨子痫前期并发胎儿脐动脉舒张末期血流缺失或返流(absent or reversed end‐diastolic velocity ,AEDV )的母婴结局。方法:回顾分析2010年1月—2013年11月复旦大学附属妇产科医院产科收治的13例出现 AEDV 的子痫前期(AEDV组)及50例未发生AEDV的重度子痫前期孕妇(对照组)的临床资料并比较。结果:AEDV组胎儿宫内发育迟缓、早产及死胎、新生儿死亡的发生率均明显高于无AEDV组(P<0.05)。两组孕妇的年龄、产次以及羊水过少、妊娠糖尿病发生率和剖宫产率比较,差异均无统计学意义(P>0.05)。两组新生儿的性别比例、血红蛋白、血PH值、红细胞压积、血清丙氨酸氨基转移酶和血清天门冬氨酸氨基转移酶比较,差异均无统计学意义(P>0.05)。两组孕妇的孕龄以及胎儿的出生体质量和血小板数的差异有统计学意义(P<0.05)。结论:对于孕28周后子痫前期的孕妇,如胎儿出现脐动脉AEDV ,则表明母体‐胎盘、胎儿‐胎盘循环障碍,提示胎儿预后不良,应加强监护,尽早终止妊娠。%Objective:To explore the maternal and neonatal outcomes of preeclampsia accompanied by absent or reversed end‐diastolic velocity(ARDEV) in umbilical artery .Methods:The maternal and neonatal clinical data of 13 cases of preeclampsia accompanied by AREDV(AREDV group) ,which were admitted by department of obstetrics and Gynecology Hospital of Fudan University from January 2010 to November 2013 ,were retrospectively analyzed and compared with the data of 50 cases of severe preeclampsia without AREDV (control group) .Results:The incidence rates of intrauterine fetal growth restriction , premature delivery and fetal death ,and neonatal death in AREDV group were significantly higher than those in control group (P0 .05) .There was no significant difference between the two groups in neonatal gender ,hemoglobin

  13. Effect of continuous positive airway pressure treatment on serum adiponectin level and mean arterial pressure in male patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xi-long; YIN Kai-sheng; LI Chong; JIA En-zhi; LI Yan-qun; GAO Zhao-fang

    2007-01-01

    Background Recent research suggested that obstructive sleep apnea syndrome (OSAS) might be independently associated with hypoadiponectinemia, which was linked to some complications of OSAS, such as hypertension, diabetes,etc. This study was conducted to investigate the effect of continuous positive airway pressure (CPAP) treatment on changes of both serum adiponectin levels and mean arterial pressure and their possible links in male OSAS patients.Methods Twenty-three adult male patients with moderate-to-severe OSAS but without obesity, coronary heart disease and diabetes were recruited. Their blood sampleswere collected and moming mean arterial pressure (MAP) was measured before CPAP treatment and on day 3, 7, 14 of CPAP treatment respectively. The serum adiponectin concentration was tested with radioimmunoassay.Results Compared with the serum adiponectin level before CPAP treatment, no significant change was found in OSAS patients on day 3 and day 7 of CPAP treatment (P>0.05). It was not until day 14 of CPAP treatment did a significant elevation in serum adiponectin level occur (P<0.01). Meanwhile, the MAP showed no statistically significant difference among its levels before CPAP, on day 3 and day 7 of CPAP treatment (P>0.05). However, on day 14 of CPAP treatment,a significantly lower MAP than that obtained before treatment was observed (P<0.05).Conclusions CPAP treatment can gradually reverse hypoadiponectinemia and reduce MAP in OSAS patients.Hypoadiponectinemia might be involved in the pathogenesis of OSAS-mediated hypertension.

  14. Therapeutic effect of low-dose imatinib on pulmonary arterial hypertension in dogs.

    Science.gov (United States)

    Arita, Shinji; Arita, Noboru; Hikasa, Yoshiaki

    2013-03-01

    This was a pilot study to determine the effectiveness of low-dose imatinib therapy for hemodynamic disturbances, including pulmonary arterial hypertension (PAH), and clinical manifestations caused by chronic heart failure in dogs. Six client-owned dogs with PAH were administered imatinib mesylate orally, 3 mg/kg body weight q24h, for 30 d. Physical examination, blood biochemical tests, radiography, and Doppler echocardiography were performed prior to imatinib administration and again 30 days after administration. Clinical scores were significantly reduced after imatinib treatment. Systolic pulmonary arterial pressure, heart rate, maximum tricuspid regurgitation velocity, left atrium/aorta ratio, right and left ventricular Tei indexes, early diastolic transmitral flow wave/mitral annulus velocity ratio, and plasma atrial natriuretic peptide concentration decreased significantly after therapy. Diastolic blood pressure, stroke volume, cardiac output, and left ventricular fractional shortening increased significantly after therapy. These results indicate that low-dose imatinib therapy was effective for heart failure in dogs with PAH.

  15. Patient-Specific Simulation of Coronary Artery Pressure Measurements: An In Vivo Three-Dimensional Validation Study in Humans

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Siogkas

    2015-01-01

    Full Text Available Pressure measurements using finite element computations without the need of a wire could be valuable in clinical practice. Our aim was to compare the computed distal coronary pressure values with the measured values using a pressure wire, while testing the effect of different boundary conditions for the simulation. Eight coronary arteries (lumen and outer vessel wall from six patients were reconstructed in three-dimensional (3D space using intravascular ultrasound and biplane angiographic images. Pressure values at the distal and proximal end of the vessel and flow velocity values at the distal end were acquired with the use of a combo pressure-flow wire. The 3D lumen and wall models were discretized into finite elements; fluid structure interaction (FSI and rigid wall simulations were performed for one cardiac cycle both with pulsatile and steady flow in separate simulations. The results showed a high correlation between the measured and the computed coronary pressure values (coefficient of determination [r2] ranging between 0.8902 and 0.9961, while the less demanding simulations using steady flow and rigid walls resulted in very small relative error. Our study demonstrates that computational assessment of coronary pressure is feasible and seems to be accurate compared to the wire-based measurements.

  16. Estimation of cardiac output and total peripheral resistance in preterm infants by arterial waveform analysis.

    Science.gov (United States)

    Zhang, Ying; Chan, Gregory S H; Tracy, Mark B; Hinder, Murray; Redmond, Stephen J; Savkin, Andrey V; Lovell, Nigel H

    2013-01-01

    This study investigated whether arterial blood pressure waveform analysis could be useful for estimating left ventricular outflow (LVO) and total peripheral resistance (TPR) in preterm infants. A cohort of 27 infants were studied, with 89 measurements of left ventricular outflow (LVO) using Doppler echocardiography and arterial pressure using catheters, performed in 0, 12, 24 and 36 hours after birth. TPR was computed as mean arterial pressure divided by LVO. The diastolic decay rate (1/τ) was obtained via fitting an exponential function to the last one third of each arterial pulse, with the mean rate computed from 50 pulses selected from each infant. This decay rate was considered to be inversely related to TPR while positively related to LVO. The results of regression analysis have confirmed that the diastolic decay rate had significant positive and negative relationships with LVO and TPR respectively(r = 0.383, P = 0.0002 and r = -0.379, P = 0.0002 respectively). These preliminary results demonstrated the potential utility of arterial pressure waveform analysis for estimating LVO and TPR in preterm infants, but more advanced multi-parameter models may be needed to improve accuracy of the estimation.

  17. 西洋参改善低舒张压的老年高血压患者预后的临床研究%American ginseng improving the prognosis of elderly hypertensive patients with low diastolic blood pressure of clinical research

    Institute of Scientific and Technical Information of China (English)

    阳永扬

    2014-01-01

    目的:观察西洋参联合降压药物治疗低舒张压的老年高血压的临床疗效。方法选取100名65岁以上的经正规降压治疗后的低舒张压的老年高血压患者,其收缩压>150 mmHg、舒张压<70 mmHg,随机分为治疗组及对照组各50例,其中治疗组采用西洋参联合降压药物治疗,对照组单纯使用降压药物治疗,评价两组的治疗效果、副作用及再入院情况。结果治疗组和对照组治疗后的临床症状、血压均有所改善,但治疗组的疗效明显优于对照组(P<0.01),其舒张压稳定甚至有所回升,且因心脑血管疾病再住院率较对照组明显下降(P<0.01),两组均无明显不良反应。结论西洋参联合降压药物治疗低舒张压的老年高血压疗效确切,安全性较好,为临床用药提供了一个新选择。%Objective To observe the clinical efficacy of combination therapy of American Ginseng and antihypertensive drugs to treat elderly hypertensive patients with low diastolic blood pressure. Methods In the study, 100 elderly hypertensive patients after regular antihypertensive therapy with low diastolic blood pressure (systolic blood pressure>150mmHg and diastolic blood pressure<70mmHg), who were older than 65 years old, were enrolled and randomized into the treatment group and the control group. The patients in the treatment group received combination therapy of American Ginseng and antihypertensive drugs, and the patients in the control group were treated only with antihypertensive drugs. The clinical efifcacy, side effects and re-admissions in the two groups were evaluated. Results The two groups both had clinical improvements in symptoms and blood pressures. However, the treatment group showed a greater improvement than control group (P<0.01). The treatment group had a lower re-admission rate than the control group (P<0.01). There were no adverse drug reactions in either group. Conclusions The combination

  18. Effects of Recombinant Human Thyrotropin Administration on 24-Hour Arterial Pressure in Female Undergoing Evaluation for Differentiated Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Gianna Rentziou

    2014-01-01

    Full Text Available Objective. Thyroid-stimulating-hormone (TSH receptors are expressed in endothelial cells. We investigated whether elevated TSH levels after acute recombinant TSH (rhTSH administration may result in alterations in blood pressure (BP in premenopausal women with well-differentiated thyroid carcinoma (DTC. Designs. Thirty euthyroid DTC female patients were evaluated by rhTSH stimulation test (mean age 40.4±8.6 years. A 24 h ambulatory systolic and diastolic blood pressure (SBP, DBP monitoring (24 hr ABPM was performed on days 2-3(D2-3. TSH was measured on day 1(D1, day 3(D3, and day 5(D5. Central blood pressure was evaluated on D3. Twenty-three patients were studied 1–4 weeks earlier (basal measurements. Results. TSH levels were D1: median 0.2 mU/L, D3: median 115.0 mU/L, and D5: median 14.6 mU/L. There were no significant associations between TSH on D1 and D3 and any BP measurements. Median D5 office-SBP and 24 h SBP, DBP, and central SBP were correlated with D5-TSH (P<0.04. In those where a basal 24 h ABPM had been performed median pulse pressure was higher after rhTSH-test (P=0.02. Conclusions. TSH, when acutely elevated, may slightly increase SBP, DBP, and central SBP. This agrees with previous reports showing positive associations of BP with TSH.

  19. Estimation of benchmark dose as the threshold amount of alcohol consumption for blood pressure in Japanese workers.

    Science.gov (United States)

    Suwazono, Yasushi; Sakata, Kouichi; Oishi, Mitsuhiro; Okubo, Yasushi; Dochi, Mirei; Kobayashi, Etsuko; Kido, Teruhiko; Nogawa, Koji

    2007-12-01

    In order to determine the threshold amount of alcohol consumption for blood pressure, we calculated the benchmark dose (BMD) of alcohol consumption and its 95% lower confidence interval (BMDL) in Japanese workers. The subjects consisted of 4,383 males and 387 females in a Japanese steel company. The target variables were systolic, diastolic, and mean arterial pressures. The effects of other potential covariates such as age and body mass index were adjusted by including these covariates in the multiple linear regression models. In male workers, BMD/BMDL for alcohol consumption (g/week) at which the probability of an adverse response was estimated to increase by 5% relative to no alcohol consumption, were 396/315 (systolic blood pressure), 321/265 (diastolic blood pressure), and 326/269 (mean arterial pressures). These values were based on significant regression coefficients of alcohol consumption. In female workers, BMD/BMDL for alcohol consumption based on insignificant regression coefficients were 693/134 (systolic blood pressure), 199/90 (diastolic blood pressure), and 267/77 (mean arterial pressure). Therefore, BMDs/BMDLs in males were more informative than those in females as there was no significant relationship between alcohol and blood pressure in females. The threshold amount of alcohol consumption determined in this study provides valuable information for preventing alcohol-induced hypertension.

  20. Tissue Doppler Findings in Patients with Pulmonary Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Firoozeh Abtahi

    2016-09-01

    Full Text Available In conclusion, our results suggested that increasing degrees of pulmonary artery systolic pressure affected timing of some tissue Doppler-derived intervals within the cardiac cycle, including IVC time, time to peak systolic myocardial velocity (Sm, and time to peak strain. Therefore, tissue Doppler imaging could be used in assessment of patients with suspected pulmonary arterial hypertension. Background: Pulmonary hypertension is an untreatable condition with poor prognosis and factors such as more elevated pulmonary arterial systolic pressure and right ventricular dysfunction are associated with a worse outcome. Objectives: Considering the limitations of the current modalities, this study aimed to find the relationship between tissue Doppler-derived systolic and diastolic parameters and elevated pulmonary arterial pressure in order to assess the routine application of tissue Doppler imaging in evaluation of pulmonary arterial hypertension. Patients and Methods: This study was conducted on 100 inpatient and outpatient individuals referred to the Department of Echocardiography in Shahid Faghihi hospital, Shiraz, Iran from July 2012 to March 2013. The individuals who had preserved right ventricular function in the presence of pulmonary arterial hypertension were included in the case group. On the other hand, the patients who did not have echocardiographic signs of pulmonary arterial hypertension were enrolled into the control group. All the patients underwent a complete transthoracic echocardiogram including 2-dimensional, color flow, and spectral Doppler as well as tissue Doppler imaging using a vivid E9 system, and the desired systolic and diastolic parameters were recorded. The relationship among these parameters was evaluated by independent sample t-test using the SPSS statistical software, version 16. Besides, P < 0.05 was considered to be statistically significant. Results: The mean time to peak strain was significantly longer in the case

  1. Pressão arterial em crianças portadoras de doença falciforme Presión arterial en niños portadores de enfermedad falciforme Blood pressure in children with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Ho Chi Hsien

    2012-01-01

    Full Text Available OBJETIVO: Avaliar os valores da pressão arterial (PA em crianças portadoras de doença falciforme (DF. MÉTODOS: Estudo observacional unicêntrico descritivo de 70 crianças portadoras de DF. Os valores da PA obtidos foram classificados conforme as V Diretrizes Brasileiras de Hipertensão Arterial. Os pacientes foram distribuídos segundo o genótipo em grupo HbSS e HbSC e segundo a faixa etária: grupo I (três anos a quatro anos e 11 meses, grupo II (cinco anos a oito anos e 11 meses e grupo III (nove anos a 13 anos e 11 meses. Na análise estatística, aplicou-se o teste t de Student e a ANOVA, sendo significante pOBJETIVO: Evaluar los valores de la presión arterial (PA en niños portadores de enfermedad falciforme (EF. MÉTODOS: Estudio observacional unicéntrico descriptivo de PA de 70 niños portadores de EF acompañadas en el ambulatorio de Hematología Pediátrica. Los valores de la PA obtenidos fueron clasificados conforme a las V Directrices Brasileñas de Hipertensión Arterial. Los pacientes fueron distribuidos según el genotipo en grupo HbSS y HbSC, y según la franja de edad: grupo I (tres años a cuatro años y 11 meses, grupo II (cinco años a ocho años y 11 meses y grupo III (nueve años a 13 años y 11 meses. RESULTADOS: El promedio y la desviación estándar (DE de las medidas de la PA sistólica (PAS (mmHg fueron 95,9±11,45 y de la PA diastólica (PAD 62,6±7,78. Los promedios de la PA por franja de edad fueron: grupo I, PAS 91,2±5,78 y PAD 61,5±7,15; grupo II, PAS 97,3±10,86 y PAD 64,4±7,89; y grupo III, PAS 100,0±9,88 y PAD 61,5±4,94. Se observó que el 5,7% de los pacientes presentaban hipertensión arterial (HA y el 8,6% eran pre-hipertensos. El promedio de los valores de la PAS y PAD entre los pacientes HbSS y HbSC no difirió significativamente. En el análisis estadístico, se aplicó la prueba t de Student y ANOVA, siendo significante pOBJECTIVE: To evaluate blood pressure (BP in children with sickle cell

  2. Estimation of cerebral vascular tone during exercise; evaluation by critical closing pressure in humans

    DEFF Research Database (Denmark)

    Ogoh, Shigehiko; Brothers, R Matthew; Jeschke, Monica;

    2010-01-01

    The aim of the present study was to calculate critical closing pressure (CCP) of the cerebral vasculature at rest and during exercise to estimate cerebral vascular tone. Five men and two women were seated upright for 15 min and then performed 15 min of right-legged knee extension exercise at 40, 60...... and 75% of their maximal workload (WL(max)). Middle cerebral artery blood velocity (MCA V) and blood pressure in the radial artery were recorded. The CCP was calculated by linear extrapolation from 1 min recordings of pairs of systolic and diastolic pressure and MCA V waveforms from both the right...

  3. 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....

  4. Accuracy of a new wrist cuff oscillometric blood pressure device: comparisons with intraarterial and mercury manometer measurements.

    Science.gov (United States)

    Watson, S; Wenzel, R R; di Matteo, C; Meier, B; Lüscher, T F

    1998-12-01

    Accurate measurement of arterial blood pressure is of great importance for the diagnosis and treatment of hypertension. Because of the chronic nature of antihypertensive drug therapy, the involvement of the patient in blood pressure control is desirable. Such an involvement, however, is only feasible if simple, user-friendly, and precise blood pressure measurement devices are available. In this study we tested a new wrist cuff oscillometric blood pressure measurement device in 100 consecutive patients undergoing cardiac catheterization. Blood pressures were simultaneously taken intraarterially (axillary artery) and with a mercury manometer and stethoscope or noninvasive measurement device (OMRON R3). Intraarterial measurements were directly compared with two measurements taken in random order with either an arm cuff mercury manometer or the wrist cuff device. Systolic and diastolic blood pressure as assessed with the mercury manometer was higher, especially when compared with the intraarterial and the wrist cuff values, which were comparable. Correlations of blood pressure values with intraarterial measurement were 0.86 systolic and 0.75 diastolic (P mercury manometer measurements. Reproducibility of both measurements was good for the wrist cuff device ([systolic/diastolic]: r = 0.94/0.92; P mercury manometer (r = 0.97/0.88; P mercury manometer were higher than intraarterial values and those of the wrist cuff. Both noninvasive devices overestimated high diastolic values.

  5. Robust pulse wave velocity estimation by application of system identification to proximal and distal arterial waveforms.

    Science.gov (United States)

    Xu, Da; Ryan, Kathy L; Rickards, Caroline A; Zhang, Guanqun; Convertino, Victor A; Mukkamala, Ramakrishna

    2010-01-01

    Pulse wave velocity (PWV) is a marker of arterial stiffness and may permit continuous, non-invasive, and cuff-less monitoring of blood pressure. Here, robust PWV estimation was sought by application of system identification to proximal and distal arterial waveforms. In this approach, the system that optimally couples the proximal waveform to the distal waveform is identified, and the time delay of this system is then used to calculate PWV. To demonstrate proof-of-concept, a standard identification technique was applied to non-invasive impedance cardiography and peripheral arterial blood pressure waveforms from six humans subjected to progressive reductions in central blood volume induced by lower body negative pressure. This technique estimated diastolic pressure with an overall root-mean-squared-error of 5.2 mmHg. For comparison, the conventional detection method for estimating PWV yielded a corresponding error of 8.3 mmHg.

  6. Effect of continuous positive airway pressure treatment on pulmonary artery pressure in patients with isolated obstructive sleep apnea: a meta-analysis.

    Science.gov (United States)

    Imran, Tasnim F; Ghazipura, Marya; Liu, Spencer; Hossain, Tanzib; Ashtyani, Hormoz; Kim, Bernard; Michael Gaziano, J; Djoussé, Luc

    2016-09-01

    Pulmonary hypertension (PH) can occur in patients with obstructive sleep apnea (OSA) in the absence of cardiac or lung disease. Data on the development and severity of PH, and the effect of continuous positive airway pressure (CPAP) therapy on pulmonary artery (PA) pressures in these patients have been inconsistent in the literature. We sought to determine whether CPAP therapy affects PA pressures in patients with isolated OSA in this meta-analysis. We searched PubMed, Medline, EMBASE and other databases from January 1980 to August 2015. Studies of patients with OSA, defined as an apnea-hypopnea index >10 events/h, and PH, defined as PA pressure >25 mmHg were included. Two reviewers independently extracted data and assessed risk of bias. A total of 222 patients from seven studies (341.53 person-years) had reported PA pressures before and after treatment with CPAP therapy. 77 % of participants were men, with a mean age of 52.5 years, a mean apnea-hypopnea index of 58 events/h, and mean PA pressure of 39.3 ± 6.3 mmHg. CPAP treatment duration ranged from 3 to 70 months. Using fixed effects meta-analysis, CPAP therapy was associated with a decrease in PA pressure of 13.3 mmHg (95 % CI 12.7-14.0) in our study population. This meta-analysis found that CPAP therapy is associated with a significantly lower PA pressure in patients with isolated OSA and PH.

  7. [RIGHT VENTRICULAR DIASTOLIC FUNCTION AND PERIPHERAL HEMODYNAMICS IN PATIENTS WITH CHRONIC COR PULMONALE RECEIVING VARIOUS THERAPY REGIMENS].

    Science.gov (United States)

    2010-01-01

    Right ventricular diastolic function, pulmonary hemodynamics, and peripheral endothelial vasoregulatory function were studied in patients with chronic cor pulmonale during complex treatment over time. The study confirmed the vasodilatory effect of ozone therapy and amlodipine during standard therapy, which appeared as lower blood pressure and better right ventricular diastolic function.

  8. Total average diastolic longitudinal displacement by colour tissue doppler imaging as an assessment of diastolic function

    DEFF Research Database (Denmark)

    de Knegt, Martina Chantal; Biering-Sørensen, Tor; Søgaard, Peter;

    2016-01-01

    BACKGROUND: The current method for a non-invasive assessment of diastolic dysfunction is complex with the use of algorithms of many different echocardiographic parameters. Total average diastolic longitudinal displacement (LD), determined by colour tissue Doppler imaging (TDI) via the measurement...... by TDI, and the degree of diastolic dysfunction, based on current guidelines. Of these 206 patients, 157 had cardiac anomalies that could potentially affect diastolic LD such as severe systolic heart failure (n = 45), LV hypertrophy (n = 49), left ventricular (LV) dilation (n = 30), and mitral...

  9. 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

    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.

  10. Modelling of the dynamic relationship between arterial pressure, renal sympathetic nerve activity and renal blood flow in conscious rabbits.

    Science.gov (United States)

    Berger, C S; Malpas, S C

    1998-12-01

    A linear autoregressive/moving-average model was developed to describe the dynamic relationship between mean arterial pressure (MAP), renal sympathetic nerve activity (SNA) and renal blood flow (RBF) in conscious rabbits. The RBF and SNA to the same kidney were measured under resting conditions in a group of eight rabbits. Spectral analysis of the data sampled at 0.4 Hz showed that the low-pass bandwidth of the signal power for RBF was approximately 0. 05 Hz. An autoregressive/moving-average model with an exogenous input (ARMAX) was then derived (using the iterative Gauss-Newton algorithm provided by the MATLAB identification Toolbox), with MAP and SNA as inputs and RBF as output, to model the low-frequency fluctuations. The model step responses of RBF to changes in SNA and arterial pressure indicated an overdamped response with a settling time that was usually less than 2 s. Calculated residuals from the model indicated that 79 5 % (mean s.d., averaged over eight independent experiments) of the variation in RBF could be accounted for by the variations in arterial pressure and SNA. Two additional single-input models for each of the inputs were similarly obtained and showed conclusively that changes in RBF, in the conscious resting rabbit, are a function of both SNA and MAP and that the SNA signal has the predominant effect. These results indicate a strong reliance on SNA for the dynamic regulation of RBF. Such information is likely to be important in understanding the diminished renal function that occurs in a variety of disease conditions in which overactivity of the sympathetic nervous system occurs.

  11. 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;

    2014-01-01

    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......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...

  12. Quadratic function between arterial partial oxygen pressure and mortality risk in sepsis patients: an interaction with simplified acute physiology score

    OpenAIRE

    Zhongheng Zhang; Xuqing Ji

    2016-01-01

    Oxygen therapy is widely used in emergency and critical care settings, while there is little evidence on its real therapeutic effect. The study aimed to explore the impact of arterial oxygen partial pressure (PaO2) on clinical outcomes in patients with sepsis. A large clinical database was employed for the study. Subjects meeting the diagnostic criteria of sepsis were eligible for the study. All measurements of PaO2 were extracted. The primary endpoint was death from any causes during hospita...

  13. Kidney transplant artery stenosis. Interrelationship between blood pressure, kidney function, renin-aldosterone system and body sodium content.

    Science.gov (United States)

    Kornerup, H J; Pedersen, E B; Fjeldborg, O

    1977-01-01

    Among 9 hypertensive recipients with kidney transplant artery stenosis (KTAS) evidence of increased activity of the renin system was present in 3. Surgical repair of KTAS in 4 recipients resulted in an increase in renal plasma flow and glomerular filtration rate associated with a decrease in exchangeable sodium and blood pressure. Peripheral plasma renin and aldosterone values were normal before and after operation in all. It is suggested that sodium retention may counterbalance increased activity of the renin system in KTAS. Preoperative determinations of plasma renin do not predict the effect of surgical repair of KTAS on hypertension.

  14. Estimated aortic blood pressure based on radial artery tonometry underestimates directly measured aortic blood pressure in patients with advancing chronic kidney disease staging and increasing arterial stiffness.

    Science.gov (United States)

    Carlsen, Rasmus K; Peters, Christian D; Khatir, Dinah S; Laugesen, Esben; Bøtker, Hans Erik; Winther, Simon; Buus, Niels H

    2016-10-01

    Central blood pressure (BP) can be assessed noninvasively based on radial tonometry and may potentially be a better predictor of clinical outcome than brachial BP. However, the validity of noninvasively obtained estimates has never been examined in patients with chronic kidney disease (CKD). Here we compared invasive aortic systolic BP (SBP) with estimated central SBP obtained by radial artery tonometry and examined the influence of renal function and arterial stiffness on this relationship. We evaluated 83 patients with stage 3 to 5 CKD (mean estimated glomerular filtration rate [eGFR] 30 ml/min/1.73 m(2)) and 41 controls without renal disease undergoing scheduled coronary angiography. BP in the ascending aorta was measured through the angiography catheter and simultaneously estimated using radial tonometry. The mean difference between estimated central and aortic SBP was -13.2 (95% confidence interval -14.9 to -11.4) mm Hg. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cf-PWV) and was significantly increased in CKD patients compared with (versus) control patients (mean 10.7 vs. 9.3 m/s). The difference in BP significantly increased 1.0 mm Hg for every 10 ml/min decrease in eGFR and by 1.6 mm Hg per 1 m/s increase in cfPWV. Using multivariate regression analysis including both eGFR and cfPWV, the difference between estimated central and invasive aortic SBP was significantly increased by 0.7 mm Hg. For the entire cohort brachial SBP significantly better reflected invasive SBP than estimated SBP. Thus, tonometry-based estimates of central BP progressively underestimate invasive central SBP with decreasing renal function and increasing arterial stiffness in CKD patients.

  15. Effect of stellate block on vasomotor factor, vascular endothelial nitricoxide synthase and pulmonary arterial pressure in rabbits with hypoxic pulmonary artery hypertension

    Institute of Scientific and Technical Information of China (English)

    Shunhou He; Qing Li; Sen Chen; Qingxiu Wang

    2007-01-01

    BACKGROUND: At present, inhalation of nitrogen monoxidum (NO) or other angiotenic is widely used to cure hypoxic pulmonary artery hypertension. In addition, recent researches demonstrate that postganglionic fiber of stellate ganglion can regulate contents of blood vessel endothelium-calcitonin gene-related peptide (BE-CGRP) and nitricoxide synthase (NOS) in lung tissue. Therefore, stellate ganglion which is blocked with the local anesthetic may cause therapeutic effects on hypoxic pulmonary artery hypertension.OBJECTIVE: To observe the effects of stellate block on calcitonin gene-related peptide (CGRP) of vasodilation factors, prostacyclin, endothelin-1 of vasoconstriction factors, thromboxan, blood vessel endothelium-nitricoxide synthase (BE-NOS) and mean arterial pressure of lung tissue in rabbits with hypoxic pulmonary artery hypertension.DESIGN: Randomly controlled animal study.SETTING: Neurological Institute of Taihe Hospital Affiliated to Yunyang Medical College.MATERIALS: A total of 24 adult Japanese rabbits of both genders and weighing 2.3 - 2.6 kg were provided by Animal Experimental Center of Hubei Academy of Medical Science. SP kit was provided by Beijing Zhongshan Biotechnology Co., Ltd.; moreover, kits of endothelin-1, CGRP, prostacyclin and thromboxan were provided by Radioimmunity Institute, Scientific and Technological Developing Center, General Hospital of Chinese PLA, and color image analytical system (Leica-Q500IW) was made in Germany.METHODS: The experiment was carried out in the Neurological Institute of Taihe Hospital affiliated to Yunyang Medical College from February to December 2002, ① Rabbits were performed with aseptic manipulation to exposure left stellate ganglion and then it was put in epidural catheter for 1 week. In addition,one end of epidural catheter was fixed near by stellate ganglion and the other end was fixed through dorsal neck. All rabbits were randomly divided into 4 groups, including normal control group, stellate block

  16. Personalized Computer Simulation of Diastolic Function in Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Ali Amr; Derliz Mereles; h Edgar Zitron; Andreas E Posch; Maximilian Wu rstle; Tommaso Mansi; Hugo A Katus; Benjamin Meder; Elham Kayvanpour; Farbod Sedaghat-Hamedani; Tiziano Passerini; Viorel Mihalef; e Alan Lai; f Dominik Neumann; g Bogdan Georgescu; Sebastian Buss

    2016-01-01

    The search for a parameter representing left ventricular relaxation from non-invasive and invasive diagnostic tools has been extensive, since heart failure (HF) with preserved ejection fraction (HF-pEF) is a global health problem. We explore here the feasibility using patient-specific cardiac computer modeling to capture diastolic parameters in patients suffering from different degrees of systolic HF. Fifty eight patients with idiopathic dilated cardiomyopathy have undergone thorough clinical evaluation, including cardiac magnetic resonance imaging (MRI), heart catheterization, echocardiography, and cardiac biomarker assessment. A previously-introduced framework for creating multi-scale patient-specific cardiac models has been applied on all these patients. Novel parameters, such as global stiffness factor and maximum left ventricular active stress, representing cardiac active and passive tissue properties have been computed for all patients. Invasive pressure measurements from heart catheterization were then used to evaluate ventricular relaxation using the time constant of isovolumic relaxation Tau (s). Parameters from heart catheterization and the multi-scale model have been evaluated and compared to patient clinical presentation. The model parameter global stiffness factor, representing diastolic passive tissue properties, is correlated signif-icantly across the patient population with s. This study shows that multi-modal cardiac models can successfully capture diastolic (dys) function, a prerequisite for future clinical trials on HF-pEF.

  17. Correlation between Diastolic Function and Endothelial Function in Patients with Type 2 Diabetes and Hypertension

    Science.gov (United States)

    Bedirian, Ricardo; Neves, Mario Fritsch; Oigman, Wille; Gismondi, Ronaldo Altenburg Odebrecht Curi; Pozzobon, Cesar Romaro; Ladeira, Marcia Cristina Boaventura; Castier, Marcia Bueno

    2016-01-01

    Background: Endothelial dysfunction may be involved in the pathophysiology of cardiac abnormalities in patients with diabetes mellitus (DM). A correlation between endothelial dysfunction and diastolic dysfunction in patients with type 1 DM has been demonstrated, but this relationship has not been well investigated in type 2 DM. Objective: Compare groups of patients with type 2 DM and hypertension with and without diastolic dysfunction using endothelial function indexes, and to assess whether correlations exist between the diastolic function and the endothelial function indexes. Method: This was a cross-sectional study of 34 men and women with type 2 DM and hypertension who were aged between 40 and 70 years and were categorized based on assessments of their Doppler echocardiographic parameters as having normal (14 patients) and abnormal (20 patients) diastolic function. Flow-mediated dilatation (FMD) assessments of the brachial artery evaluated the patients’ endothelial function. Results: The mean maximum FMD was 7.15 ± 2.80% for the patients with diastolic dysfunction and it was 11.85 ± 4.77% for the patients with normal diastolic function (p = 0.004). Correlations existed between the maximum FMD and the E/e' ratio (p = 0.040, r = -0.354) and the early wave velocity (e') at the lateral mitral annulus (p = 0.002, r = 0.509). Conclusion: The endothelial function assessed by FMD was worse in hypertensive diabetic patients with diastolic dysfunction. There were correlations between the diastolic function indexes and the endothelial function indexes in our sample. PMID:27867429

  18. 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.

  19. 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

  20. 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

  1. Nicorandil prevents right ventricular remodeling by inhibiting apoptosis and lowering pressure overload in rats with pulmonary arterial hypertension.

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    Xiang-Rong Zuo

    Full Text Available BACKGROUND: Most of the deaths among patients with severe pulmonary arterial hypertension (PAH are caused by progressive right ventricular (RV pathological remodeling, dysfunction, and failure. Nicorandil can inhibit the development of PAH by reducing pulmonary artery pressure and RV hypertrophy. However, whether nicorandil can inhibit apoptosis in RV cardiomyocytes and prevent RV remodeling has been unclear. METHODOLOGY/PRINCIPAL FINDINGS: RV remodeling was induced in rats by intraperitoneal injection of monocrotaline (MCT. RV systolic pressure (RVSP was measured at the end of each week after MCT injection. Blood samples were drawn for brain natriuretic peptide (BNP ELISA analysis. The hearts were excised for histopathological, ultrastructural, immunohistochemical, and Western blotting analyses. The MCT-injected rats exhibited greater mortality and less weight gain and showed significantly increased RVSP and RV hypertrophy during the second week. These worsened during the third week. MCT injection for three weeks caused pathological RV remodeling, characterized by hypertrophy, fibrosis, dysfunction, and RV mitochondrial impairment, as indicated by increased levels of apoptosis. Nicorandil improved survival, weight gain, and RV function, ameliorated RV pressure overload, and prevented maladaptive RV remodeling in PAH rats. Nicorandil also reduced the number of apoptotic cardiomyocytes, with a concomitant increase in Bcl-2/Bax ratio. 5-hydroxydecanoate (5-HD reversed these beneficial effects of nicorandil in MCT-injected rats. CONCLUSIONS/SIGNIFICANCE: Nicorandil inhibits PAH-induced RV remodeling in rats not only by reducing RV pressure overload but also by inhibiting apoptosis in cardiomyocytes through the activation of mitochondrial ATP-sensitive K(+ (mitoK(ATP channels. The use of a mitoK(ATP channel opener such as nicorandil for PAH-associated RV remodeling and dysfunction may represent a new therapeutic strategy for the amelioration of RV

  2. 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.

  3. 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.

  4. 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.

  5. 高血压前期患者颈动脉内膜中层厚度与血压变异的相关性研究%Association of carotid artery intima-media thickness and blood pressure variation in patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    闫文珍; 王瑞英; 黄淑田

    2015-01-01

    目的:探讨高血压前期患者颈动脉内膜中层厚度(IMT)与血压变异的关系。方法392例高血压前期患者依据颈动脉 IMT 分为颈动脉增厚组204例、无颈动脉增厚组188例,超声测定颈动脉IMT,并且均行动态血压监测。结果(1)24 h 动态血压分析显示:颈动脉增厚组与无颈动脉增厚组平均收缩压[(136.85±9.67)mmHg 与(121.92±6.54)mmHg]、收缩压变异性[(4.13±0.67)%与(2.64±0.86)%]、舒张压变异性[(2.97±0.45)%与(2.06±0.36)%]比较差异均有统计学意义( t 值分别为21.08、5.97、3.32,P 均<0.05)。(2)24 h 动态血压与颈动脉 IMT 增厚率:随着收缩压变异性增大,颈动脉 IMT 增厚率增加(P =0.001),而舒张压变异性、平均舒张压与 IMT 增厚率无关(P 值分别为0.435、0.126);平均收缩压越大,IMT 增厚率越高(P =0.013)。(3)回归分析提示收缩压变异性、超敏 C 反应蛋白、平均收缩压、餐后2 h 血糖与 IMT 呈正相关。结论高血压前期患者收缩压变异性对 IMT 影响最大。%Objective To investigate the relationship of carotid artery intima-media thickness(IMT) and blood pressure variation in patients with prehypertension. Methods Three hundred and ninety-two patients were selected as our subjects. Artery IMT was measured by Doppler ultrasonography. All patients were divided into carotid artery IMT group( n = 204 ),not carotid artery IMT group( n = 188 ) based on carotid IMT. Meanwhile,all patients were monitored by ambulatory blood pressure. Results (1)The indices of 24 h mean systolic blood pressure,systolic blood pressure variability and diastolic blood pressure variability in patients of carotid artery IMT group were(136. 85 ± 9. 67)mmHg,(4. 13 ± 0. 67)% ,(2. 97 ± 0. 45)% respectively, higher than those of Not carotid artery IMT group((121. 92 ± 6. 54)mmHg,(2. 64 ± 0. 86)% ,(2. 06 ± 0. 36)% ;t = 21. 08,5. 97,3. 32;P < 0. 05

  6. 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

    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

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

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    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.

  8. Physiological outflow boundary conditions methodology for small arteries with multiple outlets: a patient-specific hepatic artery haemodynamics case study.

    Science.gov (United States)

    Aramburu, Jorge; Antón, Raúl; Bernal, Nebai; Rivas, Alejandro; Ramos, Juan Carlos; Sangro, Bruno; Bilbao, José Ignacio

    2015-04-01

    Physiological outflow boundary conditions are necessary to carry out computational fluid dynamics simulations that reliably represent the blood flow through arteries. When dealing with complex three-dimensional trees of small arteries, and therefore with multiple outlets, the robustness and speed of convergence are also important. This study derives physiological outflow boundary conditions for cases in which the physiological values at those outlets are not known (neither in vivo measurements nor literature-based values are available) and in which the tree exhibits symmetry to some extent. The inputs of the methodology are the three-dimensional domain and the flow rate waveform and the systolic and diastolic pressures at the inlet. The derived physiological outflow boundary conditions, which are a physiological pressure waveform for each outlet, are based on the results of a zero-dimensional model simulation. The methodology assumes symmetrical branching and is able to tackle the flow distribution problem when the domain outlets are at branches with a different number of upstream bifurcations. The methodology is applied to a group of patient-specific arteries in the liver. The methodology is considered to be valid because the pulsatile computational fluid dynamics simulation with the inflow flow rate waveform (input of the methodology) and the derived outflow boundary conditions lead to physiological results, that is, the resulting systolic and diastolic pressures at the inlet match the inputs of the methodology, and the flow split is also physiological.

  9. Left ventricular diastolic filling improvement obtained by intravenous verapamil in mild to moderate essential hypertension: a complex effect.

    Science.gov (United States)

    Franchi, F; Fabbri, G; Monopoli, A; Rossi, D; Matassi, L; Strazzulla, G; Bisi, G

    1989-01-01

    In order to try and evaluate through what prevailing mechanism verapamil (V) can induce an improvement in left ventricular (LV) diastolic early filling in mild to moderate essential hypertension, 43 properly classified essential hypertensives, aged 41-74 years (mean age 58.1 +/- 10.3), and 20 age-matched normotensives were studied. All subjects underwent both echocardiographic evaluation and 99mTc radionuclide angiocardiography in basal conditions between 8.00 a.m. and noon, after an overnight rest. In essential hypertensives gated equilibrium angiocardiography was repeated 3 and 30 min after i.v. V (0.1-mg/kg bolus, followed by 0.005 mg/kg/min for the period of radionuclide data acquisition). Simultaneously, supine arterial pressure was measured with a cuff manometer. In 36 essential hypertensives a phono-echo evaluation was obtained, both at 3 and 30 min after V, deriving a LV isovolumetric relaxation index (IRTI). Among diastolic early filling indices, we particularly considered the ratio of peak filling rate (PFR) to peak ejection rate (PER) in order to take into account the interaction of systolic performance with LV relaxation and diastolic early filling. Three minutes after V the increase in PFR (from 2.47 +/- 0.5 to 3.04 +/- 0.8 EDV/s, p less than 0.001) and the upwards tendency of PFR/PER were coupled with the enhancement in ejection fraction (from 61.1 +/- 13.3 to 63.9 +/- 13.8%, p less than 0.001) and heart rate (from 70.3 +/- 12.6 to 77.7 +/- 12.2 b/min, p less than 0.001) and with the reduction in mean arterial pressure (from 122 +/- 16 to 107 +/- 14 mm Hg, p less than 0.001), systemic arterial resistance index (from 3,234 +/- 968 to 2,432 +/- 678 dyn s cm-5 m2, p less than 0.001) and end-systolic volume index (from 32.9 +/- 17.1 to 31.5 +/- 18.3 ml/m2, p less than 0.02). On the contrary, 30 min after V, when systolic indices, heart rate, mean arterial pressure and systemic arterial resistance index had returned towards baseline values, PFR/PER showed

  10. Dependence of P-wave dispersion on mean arterial pressure as an independent hemodynamic variable in school children

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    Elibet Chávez González

    2013-09-01

    Full Text Available Introduction:The relationship between diastolic dysfunction and P-wave dispersion (PWD in the electrocardiogram has been studied for some time. In this regard, echocardiography is emerging as a diagnostic tool to improve risk stratification for mild hypertension.Objective:To determine the dependence of PWD on the electrocardiogram and on echocardiographic variables in a pediatric population.Methods: Five hundred and fifteen children from three elementary schools were studiedfrom a total of 565 children. Those whose parents did not want them to take part in the study, as well as those with known congenital diseases, were excluded. Tests including 12-lead surface ECGs and 4 blood pressure (BP measurements were performed. Maximum and minimum P-values were measured, and the PWD on the electrocardiogram was calculated. Echocardiography for structural measurements and the pulsed Doppler of mitral flow were also performed.Results: A significant correlation in statistical variables was found between PWD and mean BP for pre-hypertensive and hypertensive children, i.e., r= 0.32, p <0.01 and r= 0.33, p <0.01, respectively. There was a significant correlation found between PWD and the left atrial area (r= 0.45 and p <0.01.Conclusions: We highlight the dependency between PWD, the electrocardiogram and  mean  blood pressure. We also draw attention to the dependence of PWD on the left atrial area.  This result provides an explanation for earlier changes in atrial electrophysiological and hemodynamic characteristics in pediatric patients.

  11. Physiologic Basis and Pathophysiologic Implications of the Diastolic Properties of the Cardiac Muscle

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    João Ferreira-Martins

    2010-01-01

    Full Text Available Although systole was for long considered the core of cardiac function, hemodynamic performance is evenly dependent on appropriate systolic and diastolic functions. The recognition that isolated diastolic dysfunction is the major culprit for approximately fifty percent of all heart failure cases imposes a deeper understanding of its underlying mechanisms so that better diagnostic and therapeutic strategies can be designed. Risk factors leading to diastolic dysfunction affect myocardial relaxation and/or its material properties by disrupting the homeostasis of cardiomyocytes as well as their relation with surrounding matrix and vascular structures. As a consequence, slower ventricular relaxation and higher myocardial stiffness may result in higher ventricular filling pressures and in the risk of hemodynamic decompensation. Thus, determining the mechanisms of diastolic function and their implications in the pathophysiology of heart failure with normal ejection fraction has become a prominent field in basic and clinical research.

  12. The different patterns of blood pressure elevation by rofecoxib and nabumetone.

    Science.gov (United States)

    Reitblat, T; Zamir, D; Estis, L; Priluk, R; Drogenikov, T; Viskoper, J R

    2002-06-01

    Hypertension and knee osteoarthritis (OA) are frequent comorbidities. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to relieve pain in such patients. In the last decade selective NSAIDs are used more commonly since they lead to less gastrointestinal complications. As has been shown, the treatment with NSAIDs may cause a mild rise of arterial blood pressure (BP). The influence of selective NSAIDs on BP, particularly in hypertensive patients has still to be investigated. The aim of this study was to determine arterial BP changes in patients suffering from stable arterial hypertension and knee OA and treated with rofecoxib or nabumetone. Two groups of patients with knee OA and stable arterial hypertension received either 25 mg rofecoxib once daily or namebutone 2000 mg once daily during the first week of treatment and 1000 mg for the following 3 weeks. Twenty-four hour arterial BP monitoring was performed prior to initiation of treatment and at the end of a 4-week period. The results were that no changes were found in the mean systolic and diastolic characteristics of BP in the rofecoxib treatment group during day time (delta systolic BP -0.4 mm Hg and delta diastolic BP -0.4 mm Hg), while nocturnal BP increased significantly: delta systolic BP +15.7 mm Hg and delta diastolic BP +8.5 mm Hg. The mean systolic arterial pressure in the nabumeton group raised delta systolic BP 2.9 mm Hg in the daytime and 5 mm Hg during the night-time after the treatment. The mean diastolic arterial pressure also rose delta diastolic 3.2 mm Hg and 4.9 mm Hg at day and night hours respectively. In conclusion rofecoxib treatment did not change arterial BP during day time hours, however, there was a distinct increase in night-time systolic and diastolic BP leading to a disappearance of the physiological diurnal variation. Nabumetone caused a moderate increase of day and night BP, without changes in biological diurnal variation.

  13. Excess pressure integral predicts cardiovascular events independent of other risk factors in the conduit artery functional evaluation substudy of Anglo-Scandinavian Cardiac Outcomes Trial.

    Science.gov (United States)

    Davies, Justin E; Lacy, Peter; Tillin, Therese; Collier, David; Cruickshank, J Kennedy; Francis, Darrel P; Malaweera, Anura; Mayet, Jamil; Stanton, Alice; Williams, Bryan; Parker, Kim H; McG Thom, Simon A; Hughes, Alun D

    2014-07-01

    Excess pressure integral (XSPI), a new index of surplus work performed by the left ventricle, can be calculated from blood pressure waveforms and may indicate circulatory dysfunction. We investigated whether XSPI predicted future cardiovascular events and target organ damage in treated hypertensive individuals. Radial blood pressure waveforms were acquired by tonometry in 2069 individuals (aged, 63±8 years) in the Conduit Artery Functional Evaluation (CAFE) substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Measurements of left ventricular mass index (n=862) and common carotid artery intima media thickness (n=923) were also performed. XSPI and the integral of reservoir pressure were lower in people treated with amlodipine±perindopril than in those treated with atenolol±bendroflumethiazide, although brachial systolic blood pressure was similar. A total of 134 cardiovascular events accrued during a median 3.4 years of follow-up; XSPI was a significant predictor of cardiovascular events after adjustment for age and sex, and this relationship was unaffected by adjustment for conventional cardiovascular risk factors or Framingham risk score. XSPI, central systolic blood pressure, central augmentation pressure, central pulse pressure, and integral of reservoir pressure were correlated with left ventricular mass index, but only XSPI, augmentation pressure, and central pulse pressure were associated positively with carotid artery intima media thickness. Associations between left ventricular mass index, XSPI, and integral of reservoir pressure and carotid artery intima media thickness and XSPI were unaffected by multivariable adjustment for other covariates. XSPI is a novel indicator of cardiovascular dysfunction and independently predicts cardiovascular events and targets organ damage in a prospective clinical trial.

  14. 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.

  15. Oxygen tension and normalisation pressure modulate nifedipine-sensitive relaxation of human placental chorionic plate arteries.

    Science.gov (United States)

    Cooper, E J; Wareing, M; Greenwood, S L; Baker, P N

    2006-01-01

    Fetoplacental blood vessel constriction in response to reduced oxygenation has been demonstrated in placenta perfused in vitro. In pulmonary vessels, hypoxic vasoconstriction involves Ca2+ influx into smooth muscle through membrane ion channels including voltage-gated Ca2+ channels (VGCCs). We hypothesised that VGCCs are involved in agonist-induced constriction of fetoplacental resistance vessels and that their contribution is modulated by oxygen. Chorionic plate small arteries were studied using wire myography. Arteries were normalised at high (0.9 of L(13.3 kPa)) or low (0.9 of L(5.1 kPa)) stretch and experiments performed at 156, 38 or 15 mmHg oxygen. At low stretch, U46619 (thromboxane-mimetic) or KCl (smooth muscle depolarisation) constriction was greater at 38 than 156 or 15 mmHg oxygen. An L-type VGCC blocker nifedipine, inhibited KCl constriction by >85% but was less effective in U46619 constrictions (43-67%). At high stretch, nifedipine inhibition of KCl- and U46619-induced constriction was less at 15 than 38 or 156 mmHg oxygen. Oxygen did not affect constriction to U46619 or nifedipine-induced relaxation when vessels were normalised at high stretch. In conclusion, oxygen modulates chorionic plate arterial constriction at low stretch but regulation is lost at high stretch. U46619 constriction is underlain by VGCCs and nifedipine-insensitive processes; their relative contribution is influenced by oxygen.

  16. 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

    Directory of Open Access Journals (Sweden)

    Victoria García-Espinosa

    2016-01-01

    Full Text Available 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.

  17. 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;

    1983-01-01

    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......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......Hg (range 18-98) (P less than 0.02). The average washout constant for the three different tracers were approximately equal and correlated statistically significant with the SPP; (2) In 59 legs with AOD, segmental SPP was compared to segmental systolic blood pressures on the thigh, calf, ankle and first...

  18. Asymptomatic cardiovascular manifestations in diabetes mellitus: Left ventricular diastolic dysfunction and silent myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Seferović-Mitrović Jelena P.

    2011-01-01

    Full Text Available Introduction. Several cardiovascular manifestations in patients with diabetes may be asymptomatic. Left ventricular diastolic dysfunction (LVDD is considered to be the earliest metabolic myocardial lesion in these patients, and can be diagnosed with tissue Doppler echocardiography. Silent myocardial ischemia (SMI is a characteristic and frequently described form of ischemic heart disease in patients with diabetes. Objective. The aim of the study was to assess the prevalence of LVDD and SMI in patients with type 2 diabetes, as well as to compare demographic, clinical, and metabolic data among defined groups (patients with LVDD, patients with SMI and patients with type 2 diabetes, without LVDD and SMI. Methods. We investigated 104 type 2 diabetic patients (mean age 55.4±9.1 years, 64.4% males with normal blood pressure, prehypertension and arterial hypertension stage I. Study design included basic laboratory assessment and cardiological workup (transthoracic echocardiography and tissue Doppler, as well as the exercise stress echocardiography. Results. LVDD was diagnosed in twelve patients (11.5%, while SMI was revealed in six patients (5.8%. Less patients with LVDD were using metformin, in comparison to other two groups (χ2 =12.152; p=0.002. Values of HDL cholesterol (F=4.515; p=0.013 and apolipoprotein A1 (F=5.128; p= 0.008 were significantly higher in patients with LVDD. Conclusion. The study confirmed asymptomatic cardiovascular complications in 17.3% patients with type 2 diabetes.

  19. 依托咪酯和咪唑安定对不停跳冠状动脉旁路搭桥手术气管插管期间心率和血压影响的比较%Comparison of etomidate and midazolam on heart rate and blood pressure during tracheal intubation in off-pump coronary artery bypass graft

    Institute of Scientific and Technical Information of China (English)

    余奇劲; 杨洁; 陈娟; 尹述洲

    2011-01-01

    Objective To compare the effect of etomidate and midazolam on heart rate and blood pressure during tracheal intubation in off-pump coronary artery bypass graft. Methods Sixty patients scheduled for coronary artery bypass graft surgery without cardiopulmonary bypass shunt were randomly and double-blindly divided into etomidate group ( Group E, n = 30) and midazolam group ( Croup M, n = 30 ) based on the anesthetic used for induction. Electrocardiogram, systolic blood pressure (SBP) , diastolic blood pressure ( DBP) , heart rate ( HR) and pulse oximetry saturation ( SpO-2 ) were measured and recorded continuously, as well as the value of rate-pressure product ( RPP). The time used for tracheal intubation was also recorded. Results In Group M,compared with pre-tracheal intubation,the SBP and DBP of all patients decreased remarkably at the beginning of tracheal intubation ( P < 0.05 ). At 1 minute post-trachealintubation,the SBP,DBP and HR increased remarkably (P <0.01) ; meanwhile, the values of RPP were increased significantly than those at the beginning of tracheal intubation and pre-tracheal intubation (P<0.01). Compared with the values in Croup E,at the beginning of tracheal intubation,the values of SBP and DBP in Group M were significantly decreased ( P < 0.05 and P < 0.01,respectively) , while the values of SBP,DBP and RPP at 1 minute after tracheal intubation were significantly increased ( P < 0. 05 and P <0. 01,respectively). Conclusions Compared with midazolam, etomidate used in anesthetic induction for coronary artery bypass graft surgery without cardiopulmonary bypass shunt may more effectively alleviate the cardiovascular responses to tracheal intubation.

  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

  1. 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

  2. Assessment of renal artery stenosis using both resting pressures ratio and fractional flow reserve: relationship to angiography and ultrasonography.

    Science.gov (United States)

    Kadziela, Jacek; Witkowski, Adam; Januszewicz, Andrzej; Cedro, Krzysztof; Michałowska, Ilona; Januszewicz, Magdalena; Kabat, Marek; Prejbisz, Aleksander; Kalińczuk, Lukasz; Zieleń, Piotr; Michel-Rowicka, Katarzyna; Warchoł, Ewa; Rużyłło, Witold

    2011-08-01

    BACKGROUND. Clinical benefit from renal artery revascularization remains controversial, probably because of inaccurate stenosis severity assessment. Objective. The aim of the study was to evaluate resting translesional pressures ratio and renal fractional flow reserve (rFFR) in relation to angiography and Doppler duplex ultrasonography in patients with at least moderate renal artery stenosis (RAS). METHODS. 44 hypertensive patients (48% of males, mean age 65 years) with at least moderate RAS were investigated. Translesional systolic pressure gradient (TSPG), resting Pd/Pa ratio (the ratio of mean distal to lesion and mean proximal pressures) and hyperemic rFFR - after intrarenal administration of papaverine - were evaluated. Quantitative angiographic analysis of stenosis severity was performed including minimal lumen diameter (MLD) and percent diameter stenosis (DS) assessment. Renal/aortic ratio (RAR), resistive index (RI) and deltaRI (side-to side difference) were obtained in Doppler-duplex ultrasonography. The predictive value of selected variables was calculated using receiver-operating characteristics curves. RESULTS. Mean Pd/Pa ratio was 0.86 ± 0.12 and decreased to 0.79 ± 0.13 after papaverine administration. Both Pd/Pa ratio and rFFR strongly correlated with TSPG (r = -0.92, p ratio and 0.80 for rFFR. CONCLUSIONS. Mean Pd/Pa ratio and rFFR strongly correlated with angiographic data and in less pronounced manner with ultrasound parameters reflecting intrarenal blood flow. The best accuracy cut-off points for severe RAS predicting were 0.93 and 0.80, respectively.

  3. Diastolic filling dynamics in patients with aortic stenosis.

    Science.gov (United States)

    Murakami, T; Hess, O M; Gage, J E; Grimm, J; Krayenbuehl, H P

    1986-06-01

    Left ventricular filling dynamics were investigated in 24 patients with aortic stenosis (AS). Biplane cineangiography was performed with simultaneous micromanometry in these 24 patients and in six control subjects. Twelve of the patients with AS had moderate hypertrophy with a left ventricular muscle mass index of less than 180 g/m2 (ASI group) and 12 had severe hypertrophy with an index of 180 g/m2 or more (AS2 group). Filling dynamics were also evaluated postoperatively in eight patients in the AS1 and six patients in the AS2 group. Preoperatively, end-diastolic and end-systolic volume indexes were larger and ejection fraction was lower in the AS2 compared with the control or AS1 group. Percent volume increase during the first half of diastole (%V1) was smaller in the AS1 than in the AS2 group. Peak filling rate in the first half of diastole (PFR 1) was higher in the AS2 than in the control or in AS1 group, while peak filling rate in the second half of diastole (PFR2) was considerably greater in the AS1 group than in the other two groups. The time constant of left ventricular pressure decline, an index of the rate of relaxation, was prolonged in the AS2 group. In contrast, mitral valve opening pressure (MVOP) was significantly higher in this group than in the other two groups. The constant of left ventricular chamber stiffness was slightly but not significantly greater in both AS groups than in the control subjects. After surgery in patients in the AS1 group, preoperatively reduced %V1 had increased and preoperatively enhanced PFR2 had decreased. In patients in the AS2 group, excluding one with a persistent low ejection fraction after surgery, preoperatively enhanced PFR1 decreased in association with a decrease in MVOP. Thus, left ventricular filling dynamics vary in patients with AS depending on the degree of left ventricular hypertrophy and systolic function. In patients with AS and moderate hypertrophy %V1 is slightly reduced but is compensated for by a

  4. Diastolic Left Ventricular Dysfunction : A Clinical Appraisal

    NARCIS (Netherlands)

    Bronzwaer, J.G.F.

    2003-01-01

    Diastolic left ventricular (LV) distensibility is determined by the material properties of the LV wall and by LV geometry (i.e., LV shape, LV volume and LV wall thickness). These material properties are influenced both by the physical structure of the LV myocardium and by the dynamic process of myoc

  5. 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.

  6. [Arterial CO2- and O2 partial pressure at rest and during exertion in pulmonary emphysema].

    Science.gov (United States)

    Scherrer, M; Zeller, C; Bachofen, H

    1977-07-30

    In 83 patients with severe, largely irreversible bronchial obstruction (FEV1/VC less than 40% and FEV1 after orciprenaline inhalation less than 120% of the control value) and radiologie evidence of AD-emphysema, arterial PCO2 and PO2 were measured at rest in supine position and on the bicycle ergometer during a steady-state exercice of 5 min. Alveolar hypoventilation (PCO2 greater than 45 mm Hg) was most often observed in the cases with FEV1 less than 1.01 (in 22 patients [27%] at rest and in 26 patients [31%] during exercise). However, there was no significant correlation of the PCO2 increase with the degree of bronchial obstruction. In all patients there was a marked inhomogeneity of the alveolar ventilation or the alveolar-capillary O2 transfer in relation to alveolar blood perfusion. Indeed, the alveolar-arterial PO2 difference was increased (40 mm Hg at rest and 45 mm Hg during exercise). The additional increase of this gradient during exercise was due to an unequal distribution of alveolar O2 diffusing capacities in connection with the alveolar blood flow (preceding measurements of the N2 gradient between alveolar air and arterial blood revealed a mean fall from 18 at rest to 8 mm Hg during exercise). The observed deterioration of hypoxemia during exercise (without additional hypercapnia) is to a great extent related to the degree of bronchial obstruction measured by simple spirometry. Thus, measurements of PCO2 and PO2 at rest and during exercise appear to be a helpful adjuvant to routine spirometry in the diagnosis of subclinical emphysema.

  7. 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.

  8. 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

  9. Arterial pressure variations as parameters of brain perfusion in response to central blood volume depletion and repletion

    Directory of Open Access Journals (Sweden)

    Anne-Sophie G.T. Bronzwaer

    2014-04-01

    Full Text Available Rationale:A 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.

  10. Role of the medulla oblongata in normal and high arterial blood pressure regulation: the contribution of Escola Paulista de Medicina - UNIFESP.

    Science.gov (United States)

    Cravo, Sergio L; Campos, Ruy R; Colombari, Eduardo; Sato, Mônica A; Bergamaschi, Cássia M; Pedrino, Gustavo R; Ferreira-Neto, Marcos L; Lopes, Oswaldo U

    2009-09-01

    Several forms of experimental evidence gathered in the last 37 years have unequivocally established that the medulla oblongata harbors the main neural circuits responsible for generating the vasomotor tone and regulating arterial blood pressure. Our current understanding of this circuitry derives mainly from the studies of Pedro Guertzenstein, a former student who became Professor of Physiology at UNIFESP later, and his colleagues. In this review, we have summarized the main findings as well as our collaboration to a further understanding of the ventrolateral medulla and the control of arterial blood pressure under normal and pathological conditions.

  11. Impact of local endothelial challenge with cytomegalovirus or glycoprotein B on vasodilation in intact pressurized arteries from nonpregnant and pregnant mice.

    Science.gov (United States)

    Gombos, Randi B; Teefy, Jana; Lee, Albert; Hemmings, Denise G

    2012-10-01

    Cytomegalovirus (CMV) infections are associated with vascular diseases in the human population. We have previously shown vascular dysfunction in systemic and uterine arteries dissected from nonpregnant (NP) mouse CMV (mCMV)-infected mice that was further impaired during late pregnancy (LP). CMV attachment alone through glycoprotein B (GB) can generate signals that impact vascular tone regulation. However, the contribution of direct virus interactions with endothelium to the vascular dysfunction we previously observed after in vivo mCMV infection is not known. We used a pressure myograph system to infuse GB or whole intact mCMV inside arteries dissected from uninfected mice and assessed vasodilation to methacholine infused inside pressurized arteries rather than applied abluminally. These results were compared to those observed after methacholine infusion into untreated arteries dissected from mCMV-infected mice. In mesenteric arteries, vasodilation to infused methacholine did not differ among treatments in NP or LP groups in contrast to previously published studies. However, increased vasoconstrictor activity was unmasked after blocking thromboxane receptors or prostaglandin production. Vasodilation in uterine arteries from uninfected NP mice to infused methacholine was increased by both GB and whole intact mCMV pretreatment. Untreated uterine arteries from mCMV-infected NP mice showed even greater vasodilation. There was no effect of GB or whole intact mCMV pretreatment in uterine arteries from uninfected LP mice, whereas vasodilation to infused methacholine was reduced in untreated uterine arteries from mCMV-infected LP mice. CMV exerts direct effects on vascular function which should be considered during viral reactivation leading to viremia and during GB-based vaccine administration.

  12. Preoperative cardiac variables of diastolic dysfunction and clinical outcomes in lung transplant recipients.

    Science.gov (United States)

    Yadlapati, Ajay; Lynch, Joseph P; Saggar, Rajan; Ross, David; Belperio, John A; Weigt, Stephen; Ardehali, Abbas; Grogan, Tristan; Yang, Eric H; Aboulhosn, Jamil

    2013-01-01

    Background. Orthotopic lung transplantation is now widely performed in patients with advanced lung disease. Patients with moderate or severe ventricular systolic dysfunction are typically excluded from lung transplantation; however, there is a paucity of data regarding the prognostic significance of abnormal left ventricular diastolic function and elevated pretransplant pulmonary pressures. Methods. We reviewed the characteristics of 111 patients who underwent bilateral and unilateral lung transplants from 200 to 2009 in order to evaluate the prognostic significance of preoperative markers of diastolic function, including invasively measured pulmonary capillary wedge pressure (PCWP) and echocardiographic variables of diastolic dysfunction including mitral A > E and A' > E'. Results. Out of 111 patients, 62 were male (56%) and average age was 54.0 ± 10.5 years. Traditional echocardiographic Doppler variables of abnormal diastolic function, including A' > E' and A > E, did not predict adverse events (P = 0.49). Mildly elevated pretransplant PCWP (16-20 mmHg) and moderately/severely elevated PCWP (>20 mmHg) were not associated with adverse clinical events after transplant (P = 0.30). Additionally, all clinical endpoints did not show any statistical significance between the two groups. Conclusions. Pre-lung transplant invasive and echocardiographic findings of elevated pulmonary pressures and abnormal left ventricular diastolic function are not predictive of adverse posttransplant clinical events.

  13. Preoperative Cardiac Variables of Diastolic Dysfunction and Clinical Outcomes in Lung Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Ajay Yadlapati

    2013-01-01

    Full Text Available Background. Orthotopic lung transplantation is now widely performed in patients with advanced lung disease. Patients with moderate or severe ventricular systolic dysfunction are typically excluded from lung transplantation; however, there is a paucity of data regarding the prognostic significance of abnormal left ventricular diastolic function and elevated pretransplant pulmonary pressures. Methods. We reviewed the characteristics of 111 patients who underwent bilateral and unilateral lung transplants from 200 to 2009 in order to evaluate the prognostic significance of preoperative markers of diastolic function, including invasively measured pulmonary capillary wedge pressure (PCWP and echocardiographic variables of diastolic dysfunction including mitral A>E and A′>E′. Results. Out of 111 patients, 62 were male (56% and average age was 54.0 ± 10.5 years. Traditional echocardiographic Doppler variables of abnormal diastolic function, including A′>E′ and A>E, did not predict adverse events (P=0.49. Mildly elevated pretransplant PCWP (16–20 mmHg and moderately/severely elevated PCWP (>20 mmHg were not associated with adverse clinical events after transplant (P=0.30. Additionally, all clinical endpoints did not show any statistical significance between the two groups. Conclusions. Pre-lung transplant invasive and echocardiographic findings of elevated pulmonary pressures and abnormal left ventricular diastolic function are not predictive of adverse posttransplant clinical events.

  14. Concentration-dependent effects of cocaine on monoamine-induced constriction of cannulated, pressurized cerebral arteries from fetal sheep.

    Science.gov (United States)

    Schreiber, M D; Madden, J A; Covert, R F; Hershenson, M B; Torgerson, L J

    1995-01-01

    Drugs, such as cocaine, which may alter monoamine neurotransmitter responsiveness, could adversely affect the regulation of cerebral vasculature. Cocaine exhibits at least two mechanisms that may alter vascular responsiveness: synaptic uptake inhibition, which may augment response to stimulation, and Na+ channel inhibition, which may attenuate response. To help elicit the concentration-dependent effects of cocaine, the effects of cocaine on monoamine neurotransmitter responsiveness were studied in vitro on fetal sheep cerebral arteries (120 days gestation). The changes in diameter of segments of cannulated, pressurized fetal sheep cerebral artery were measured with a videomicroscaler system. Cumulative concentration-response curves (10(-10) to 10(-4)M) were generated for two monoamines, norepinephrine and serotonin, alone and in the presence of cocaine (10(-5) or 10(-4)M). Cocaine caused concentration-dependent alteration of response. At 10(-4)M, cocaine attenuated mean maximal norepinephrine-induced vasoconstriction 46.2% (P < 0.05). At 10(-5)M, cocaine increased sensitivity to norepinephrine (log EC50 decreased -6.63 +/- 0.09 to -7.11 +/- 0.03) and to serotonin (log EC50 decreased -7.24 +/- 0.04 to -7.81 +/- 0.09) (P < 0.05). The higher concentration of cocaine (10(-4)M) did not significantly decrease log EC50 norepinephrine. Cocaine (10(-4)M) also attenuated the response to single doses of norepinephrine (10(-6)M) and serotonin (10(-6)M) by 26.5% and 40.0%, respectively (P < or = 0.05). It is concluded that cocaine has concentration-dependent effects on vasoconstriction of the fetal sheep cerebral artery in vitro. This cocaine-induced alteration of cerebral vascular responsiveness to monoamines may be important in the regulation of fetal cerebral blood flow.

  15. Cardiac mechanical energy and effects on the arterial tree.

    Science.gov (United States)

    Muñoz, H R; Sacco, C M

    1997-05-01

    Blood flow pulsatility is the result of the heart's activity as a pump unable to develop steady flow, and its interaction with the arterial tree. Thus, the heart is a cyclic energy generator whose adequate function requires the two phases of this cycle to be normal. Diastolic properties determine the degree of filling of the ventricles and the strength of the following systole. Systole, in turn, must generate enough energy to overcome forces opposing ejection. These can be divided into internal (the mechanical characteristics of the ventricle itself) and external loads (the characteristics of the arterial tree). As a result, hydraulic energy is imparted to blood (external ventricular work) that manifests itself as blood pressure and flow. Given the cyclic nature of cardiac activity, the external ventricular work has steady and pulsatile components. The steady component is energy lost during steady flow because of vascular resistance, and the pulsatile work is that lost in arterial pulsations and mainly depends on the aortic impedance. Thus, the characteristics of the arterial tree will determine the relative contribution of these two components to blood flow and the efficency of the heart. In addition, the arterial tree modifies the different waves (pressure and flow) traveling in the circulation. These modifications have important consequences for cardiac function. The ventricle and the arterial tree constitute a coupled biological system, and its overall performance is a function of the behavior of each unit at any given moment.

  16. 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.

  17. Preliminary study of abnormal increase of postexercise systolic blood pressure in the diagnosis of coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    于宗良; 杨向军; 王国强; 高美雯; 李勋; 惠杰; 蒋廷波; 宋建平; 刘志华; 蒋文平

    2003-01-01

    Objectives This study sought to evaluate the diagnostic value of abnormal increase of postexercise systolic blood pressure (SBP) for detecting coronary artery disease (CAD) in patients with or without hypertension. Methods Treadmill exercise testing (TET) was conducted in 88 patients (40 CAD patients, 48 control subjects)with or without hypertension, each of whom underwent selective coronary angiography (CAG). The abnormal increase of postexercise SBP was defined as 10mmHg higher than earlier periods during the recovery phase (6 minutes)of exercise testing. Results The abnormal increase of postexercise SBP had higher sensitivity, specificity,and accuracy for detecting CAD than those of ST - segment depression in patients with or without hypertension. Its accuracy increased with the severity of CAD while decreased in patients with hypertension, and the increase value of SBP had a positive correlation with the extent of coronary artery lesion. The combination of ST - segment depression and abnormal increase of postexercise SBP diagnosed CAD most accurately in patients with hypertension. Conclusions Abnormal increase of postexercise SBP may be a useful index for diagnosing CAD.

  18. Increasing mean arterial pressure in cardiogenic shock secondary to myocardial infarction: effects on hemodynamics and tissue oxygenation.

    Science.gov (United States)

    Perez, Pierre; Kimmoun, Antoine; Blime, Vincent; Levy, Bruno

    2014-04-01

    There are very few data regarding the effects of norepinephrine uptitration on global and regional hemodynamics in cardiogenic shock. We studied 25 patients with shock secondary to myocardial infarction successfully treated with percutaneous coronary intervention. Before the inclusion, 16 of 25 patients presented a cardiac arrest in the presence of medical staff. Norepinephrine was titrated to increase mean arterial pressure (MAP) from 65 to 85 mmHg during 1 h. Swan-Ganz variables, arterial and mixed venous blood gases, lactate, and thenar near-infrared spectroscopy variables (muscle tissue oxygen saturation [StO2] and its changes during a vascular occlusion test) were measured before, 1 h after norepinephrine uptitration, and 1 h after norepinephrine downtitration. To obtain a MAP at 85 mmHg, norepinephrine was increased from 0.6 (0.28-1.2) to 1.53 µg · kg · min (0.76-2.6 µg · kg · min) (P cardiogenic shock complicated by pos