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https://www.readbyqxmd.com/read/28711449/intrarenal-flow-alterations-during-transition-from-euvolemia-to-intravascular-volume-expansion-in-heart-failure-patients
#1
Petra Nijst, Pieter Martens, Matthias Dupont, W H Wilson Tang, Wilfried Mullens
OBJECTIVES: The goal of this study was to assess: 1) the intrarenal flow in heart failure (HF) patients during the transition from euvolemia to intravascular volume overload; and 2) the relationship between intrarenal flow and diuretic efficiency. BACKGROUND: Intrarenal blood flow alterations may help to better understand impaired volume handling in HF. METHODS: Resistance index (RI) and venous impedance index (VII) were assessed in 6 healthy subjects, 40 euvolemic HF patients with reduced ejection fraction (HFrEF) and 10 HF patients with preserved ejection fraction (HFpEF)...
July 6, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28708599/assessing-right-ventricular-function-in-pulmonary-hypertension-patients-and-the-correlation-with-the-new-york-heart-association-nyha-classification
#2
Xiaoke Shang, Shuna Xiao, Nianguo Dong, Rong Lu, Lijun Wang, Bin Wang, Yousan Chen, Liang Zhong, Mei Liu
This investigation aimed to compare the pressure-volume loop (PV loop) measurements in three less symptomatic categories (New York Heart Association classes , NYHA I, II, and III) of pulmonary hypertension (PH) patients since NYHA classification system performance is limited by the shortcomings discussed above.Thirty-six patients were enrolled in this study with PV loop measurement acquisition via micro-conductance catheters. Functional classification according to NYHA was determined with comprehensive assessing function and activity...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28699322/a-respiratory-marker-derived-from-left-vagus-nerve-signals-recorded-with-implantable-cuff-electrodes
#3
Cristian Sevcencu, Thomas N Nielsen, Benedict Kjaergaard, Johannes J Struijk
OBJECTIVE: Left vagus nerve (LVN) stimulation (LVNS) has been tested for lowering the blood pressure (BP) in patients with resistant hypertension (RH). Whereas, closed-loop LVNS (CL-LVNS) driven by a BP marker may be superior to open-loop LVNS, there are situations (e.g., exercising) when hypertension is normal. Therefore, an ideal anti-RH CL-LVNS system requires a variable to avoid stimulation in such conditions, for example, a respiratory marker ideally extracted from the LVN. As the LVN conducts respiratory signals, this study aimed to investigate if such signals can be recorded using implantable means and if a marker to monitor respiration could be derived from such recordings...
July 11, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28682837/closed-loop-and-decision-assist-guided-fluid-therapy-of-human-hemorrhage
#4
Gabriel Hundeshagen, George C Kramer, Nicole Ribeiro Marques, Michael G Salter, Aristides K Koutrouvelis, Husong Li, Daneshvari R Solanki, Alexander Indrikovs, Roger Seeton, Sheryl N Henkel, Michael P Kinsky
OBJECTIVES: We sought to evaluate the efficacy, efficiency, and physiologic consequences of automated, endpoint-directed resuscitation systems and compare them to formula-based bolus resuscitation. DESIGN: Experimental human hemorrhage and resuscitation. SETTING: Clinical Research Laboratory. SUBJECTS: Healthy volunteers. INTERVENTIONS: Subjects (n = 7) were subjected to hemorrhage and underwent a randomized fluid resuscitation scheme on separate visits 1) formula-based bolus resuscitation; 2) semiautonomous (decision assist) fluid administration; and 3) fully autonomous (closed loop) resuscitation...
July 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28682025/-hypertension-in-chronic-kidney-disease
#5
Antonio De Pascalis, Alessandro Balducci
The progression of chronic kidney disease CKD is largely independent of the underlying kidney disorder once renal function has fallen below a critical level. Hypertension is an independent risk factor for disease progression in both adult and pediatric patients with kidney disorders. Optimal blood pressure control (130 /80mm Hg) represents a main goal of conservative therapy in patients with chronic kidney disease CKD but it is rarely achieved in clinical practice. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are more effective than other drugs in slowing progression of proteinuric CKD...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28679580/use-of-an-ipad-app-to-simulate-pressure-volume-loops-and-cardiovascular-physiology
#6
Staci Leisman, Daniel Burkhoff
The purpose of this laboratory exercise is to model the changes in preload, afterload, and contractility on a simulated pressure-volume loop and to correlate those findings with common measurements of clinical cardiovascular physiology. Once students have modeled these changes on a healthy heart, the students are asked to look at a simulated case of cardiogenic shock. Effects on preload, contractility, and afterload are explored, as well as the hemodynamic effects of a number of student-suggested treatment strategies...
September 1, 2017: Advances in Physiology Education
https://www.readbyqxmd.com/read/28679200/closed-loop-ventilation-mode-in-intensive-care-unit-a-randomized-controlled-clinical-trial-comparing-the-numbers-of-manual-ventilator-setting-changes
#7
Jean-Michel Arnal, Aude Garnero, Dominik Novotni, Gaëlle Corno, Stéphane Y Donati, Didier Demory, Gabrielle Quintana, Laurent Ducros, Thomas Laubscher, Jacques Durand-Gasselin
BACKGROUND: There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user. METHODS: This randomized controlled trial compared the number of manual ventilator setting changes between a full closed loop ventilation and oxygenation mode (INTELLiVENT-ASV®) and conventional ventilation modes (volume assist control and pressure support) in intensive care unit (ICU) patients...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28655466/three-dimensional-echocardiography-derived-non-invasive-right-ventricular-pressure-volume-analysis
#8
Kuan-Chih Huang, Lian-Yu Lin, Juey-Jen Hwang, Lung-Chun Lin
In patients with pulmonary hypertension, repeated evaluations of right ventricular (RV) function are still required for clinical decision making, but the invasive nature of current pressure-volume analysis makes conducting regular follow-ups in a clinical setting infeasible. We enrolled 12 patients with pulmonary arterial hypertension (PAH) and 10 with pulmonary venous hypertension (PVH) May 2016-October 2016. All patients underwent a clinically indicated right heart catheterization (RHC), from which the yielded right ventricular pressure recordings were conjugated with RV volume by 3-D echocardiography to generate a pressure-volume loop...
June 24, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28653135/closed-loop-mechanical-ventilation-for-lung-injury-a-novel-physiological-feedback-mode-following-the-principles-of-the-open-lung-concept
#9
David Schwaiberger, Philipp A Pickerodt, Anake Pomprapa, Onno Tjarks, Felix Kork, Willehad Boemke, Roland C E Francis, Steffen Leonhardt, Burkhard Lachmann
Adherence to low tidal volume (VT) ventilation and selected positive end-expiratory pressures are low during mechanical ventilation for treatment of the acute respiratory distress syndrome. Using a pig model of severe lung injury, we tested the feasibility and physiological responses to a novel fully closed-loop mechanical ventilation algorithm based on the "open lung" concept. Lung injury was induced by surfactant washout in pigs (n = 8). Animals were ventilated following the principles of the "open lung approach" (OLA) using a fully closed-loop physiological feedback algorithm for mechanical ventilation...
June 26, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28633398/a-novel-system-for-the-treatment-of-aortic-annular-dilation-an-ex-vivo-investigation
#10
Pallav Shah, Claudia Romagnoni, Michal Jaworek, Federico Lucherini, Monica Contino, Alan Menkis, Guido Gelpi, Gianfranco B Fiore, Carlo Antona, Riccardo Vismara
OBJECTIVES: The main reason for aortic repair failures is recurrent annular dilatation. The fibrous portion of left ventricular outflow tract dilates. A novel device was designed to tackle this problem. METHODS: The device consists of an internal ring applied at the aortic annulus plus an external flexible band at the level of the aortic root. The internal ring has a semi-rigid portion (40%, placed at ventriculo-arterial junction) and a flexible portion to allow it to conform along the curves of the non-coronary/right coronary leaflet and right coronary/left coronary leaflet commissures...
June 15, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28614115/trafficking-and-regulation-of-the-nkcc2-cotransporter-in-the-thick-ascending-limb
#11
Kerim Mutig
PURPOSE OF REVIEW: The kidney Na-K-2Cl cotransporter (NKCC2) is essential for urinary concentration and renal electrolyte handling. Loss of function mutations in the NKCC2 gene cause urinary salt and potassium wasting, whereas excessive NKCC2 function has been linked to high blood pressure. Loop diuretics, targeting the transporter, are instrumental for relieving edema or hypertension. This review focuses on intrinsic mechanisms regulating NKCC2 activity at the posttranslational level, namely its trafficking and phosphorylation...
June 12, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28606851/cardiorespiratory-action-of-opioid-tachykinin-agonist-peptide-hybrid-in-anaesthetized-rats-transduction-pathways
#12
Piotr Wojciechowski, Małgorzata Szereda-Przestaszewska, Andrzej Wojciech Lipkowski
AWL3106 composed of opioid (dermorphin) and tachykinin (substance P7-11) pharmacophores is a new compound with high analgesic potency and markedly reduced ability to induce tolerance and dependence. The present study aimed to determine the respiratory and cardiovascular responses evoked by this peptide in urethane-chloralose anaesthetized, spontaneously breathing rats in the presence or absence of vagal connection. Intravenous injection of AWL3106 at a dose of 0.3μmol/kg in intact rats resulted in apnoea lasting 5...
June 9, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28600088/invasive-hemodynamics-of-pulmonary-disease-and-the-right-ventricle
#13
REVIEW
David Silber, Justine Lachmann
Pulmonary hypertension (PH) falls into 5 groups, as defined by the World Health Organization. Swan-Ganz catheters determine precapillary versus postcapillary PH. The hemodynamic values of PH at rest and with vasodilatory challenge categorize the etiology of PH and guide treatment. RV maladaptations to increased pulmonary vascular resistance (PVR) and the chronicity of the right ventricle's (RV) response to increased PH and/or increased PVR can be understood with pressure-volume (PV) loops constructed with use of conductance catheters...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28597590/in-vitro-evaluation-of-pediatric-hollow-fiber-membrane-oxygenators-on-hemodynamic-performance-and-gaseous-microemboli-handling-an-international-multicenter-multidisciplinary-approach
#14
Shigang Wang, Luiz F Caneo, Marcelo B Jatene, Fábio B Jatene, Idagene A Cestari, Allen R Kunselman, Akif Ündar
The objective of this study was to compare the hemodynamic performances and gaseous microemboli (GME) handling ability of two pediatric oxygenators in a simulated pediatric cardiopulmonary bypass (CPB) model and the importance of adding an arterial filter in the circuit. The circuit consisted of a Braile Infant oxygenator or a Maquet Quadrox-I Pediatric oxygenator without integrated arterial filter (parallel arrangement), 1/4 in. ID tubing A-V loop, and a 12-Fr arterial cannula, primed with lactated Ringer's solution and packed red blood cells...
June 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28593869/a-mock-heart-engineered-with-helical-aramid-fibers-for-in-vitro-cardiovascular-device-testing
#15
So-Hyun Jansen-Park, Po-Lin Hsu, Indra Müller, Ulrich Steinseifer, Dirk Abel, Rüdiger Autschbach, Rolf Rossaint, Thomas Schmitz-Rode
Mock heart circulation loops (MHCLs) serve as in-vitro platforms to investigate the physiological interaction between circulatory systems and cardiovascular devices. A mock heart (MH) engineered with silicone walls and helical aramid fibers, to mimic the complex contraction of a natural heart, has been developed to advance the MHCL previously developed in our group. A mock aorta with an anatomical shape enables the evaluation of a cannulation method for ventricular assist devices (VADs) and investigation of the usage of clinical measurement systems like pressure-volume catheters...
April 4, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28589706/technical-performance-and-clinical-effectiveness-of-drop-type-with-adjustable-concentrator-cell-free-and-concentrated-ascites-reinfusion-therapy
#16
Yosuke Yamada, Makoto Harada, Akinori Yamaguchi, Yasuko Kobayashi, Takashi Chino, Takashi Minowa, Takashi Kosuge, Wataru Tsukada, Koji Hashimoto, Yuji Kamijo
Cell-free and concentrated ascites reinfusion therapy (CART) is a very useful treatment method for refractory ascites but is difficult for many hospitals to employ due to its need for specialized equipment. We have therefore developed drop-type with adjustable concentrator CART (DC-CART) that uses a drop-type filtration mechanism and requires only a simple pump and pressure monitor for its concentration process. Easy adjustment of ascites concentration is possible through a recirculation loop, and filter membrane washing is aided by DC-CART's external pressure-type filtration to enable the processing of any quality or quantity of ascites...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28588092/stunning-and-right-ventricular-dysfunction-is-induced-by-coronary-balloon-occlusion-and-rapid-pacing-in-humans-insights-from-right-ventricular-conductance-catheter-studies
#17
Richard G Axell, Joel P Giblett, Paul A White, Andrew Klein, James Hampton-Til, Michael O'Sullivan, Denise Braganza, William R Davies, Nick E J West, Cameron G Densem, Stephen P Hoole
BACKGROUND: We sought to determine whether right ventricular stunning could be detected after supply (during coronary balloon occlusion [BO]) and supply/demand ischemia (induced by rapid pacing [RP] during transcatheter aortic valve replacement) in humans. METHODS AND RESULTS: Ten subjects with single-vessel right coronary artery disease undergoing percutaneous coronary intervention with normal ventricular function were studied in the BO group. Ten subjects undergoing transfemoral transcatheter aortic valve replacement were studied in the RP group...
June 6, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28550178/severity-of-structural-and-functional-right-ventricular-remodeling-depends-on-training-load-in-an-experimental-model-of-endurance-exercise
#18
Maria Sanz-de la Garza, Cira Rubies, Montserrat Batlle, Bart Bijnens, Lluís Mont, Marta Sitges, Eduard Guasch
An arrhythmogenic right ventricle (RV) remodeling has been reported in response to regular training, but it remains unclear how exercise intensity affects the presence and extent of such remodeling. We aimed at assessing the relationship between RV remodeling and exercise load in a long-term endurance training model. Wistar rats were conditioned to run at moderate (MOD, 45 min, 30cm/s) or intense (INT, 60 min, 60cm/s) workloads for 16 weeks; sedentary rats (SED) served as controls. Cardiac remodeling was assessed with standard echocardiographic and tissue Doppler techniques, sensor-tip pressure catheters and pressure-volume loop analyses...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28533073/the-impact-of-sevoflurane-on-coupling-of-the-left-ventricular-to-systemic-vasculature-in-rats-with-chronic-pulmonary-hypertension
#19
Lu Wang, Hui Luo, Gang Qin, Yanan Cao, Xiaowei Gao, Zhong Zhang, Zhi Ye, Junjie Zhang, Qulian Guo, E Wang
OBJECTIVES: The relationship between left ventricular function and afterload has not been investigated as much as the right ventricular function under chronic pulmonary hypertension (PH) during anesthesia. This study was designed to investigate effects of sevoflurane on the intrinsic coupling relationship between the left ventricle and systemic vasculature in the presence of PH. DESIGN: A randomized, controlled study. SETTING: University hospital...
February 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28476921/non-invasive-evaluation-of-left-ventricular-elastance-according-to-pressure-volume-curves-modeling-in-arterial-hypertension
#20
Benjamin Bonnet, Franck Jourdan, Guilhem du Cailar, Pierre Fesler
Background- End systolic left ventricular (LV) elastance (Ees) has been previously calculated and validated invasively using LV pressure-volume (PV) loops. Non invasive methods have been proposed, but clinical application remains complex. The aim of the present study was to 1) estimate Ees according to modeling of LV PV curve during ejection ("Ejection PV Curve" method) and validate our method with existing published LV PV loops data. 2) test clinical applicability to detect non invasively a difference in Ees between normotensive and hypertensive subjects...
May 5, 2017: American Journal of Physiology. Heart and Circulatory Physiology
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