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https://www.readbyqxmd.com/read/28722077/invasive-haemodynamic-evaluation-of-the-pulmonary-circulation-in-pulmonary-hypertension
#1
Alberto Pagnamenta, Andrea Azzola, Maurice Beghetti, Frédéric Lador, On Behalf Of The Swiss Society Of Pulmonary Hypertension
The term pulmonary hypertension refers to a serious condition characterised by high pulmonary vascular pressure, mainly as a consequence of various cardiac and respiratory diseases. Current clinical classification of pulmonary hypertension considers five distinct groups. Transthoracic echocardiography represents the first and most important noninvasive screening tool for estimating the probability of pulmonary hypertension. The diagnostic approach to pulmonary hypertension is supported by a proposed algorithm, which identifies the underlying cause...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28614093/central-diastolic-pressure-decay-mediates-the-relationship-between-aortic-stiffness-and-myocardial-viability-potential-implications-for-aortosclerosis-induced-myocardial-ischemia
#2
Junichiro Hashimoto, Sadayoshi Ito
OBJECTIVE: Stiffening of the aorta often precedes coronary events, but little is known about the aetiological mechanism. We hypothesized that the predisposition to myocardial ischemia could be attributable to aortosclerosis-induced alterations in the central haemodynamics during diastole. METHODS: Using noninvasive tonometry and ultrasonography, we investigated the arterial pressure pulse waveforms, pulse wave velocities (PWVs) and compliance in 222 patients with hypertension...
June 16, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28603219/central-hemodynamics-for-management-of-arteriosclerotic-diseases
#3
Junichiro Hashimoto
Arteriosclerosis, particularly aortosclerosis, is the most critical risk factor associated with cardiovascular, cerebrovascular, and renal diseases. The pulsatile hemodynamics in the central aorta consists of blood pressure, flow, and stiffness and substantially differs from the peripheral hemodynamics in muscular arteries. Arteriosclerotic changes with age appear earlier in the elastic aorta, and age-dependent increases in central pulse pressure are more marked than those apparent from brachial pressure measurement...
June 10, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28590772/arterial-stiffness-in-fertile-women-with-metabolic-syndrome
#4
Tiina Vilmi-Kerälä, Teemu Koivistoinen, Outi Palomäki, Jukka Uotila, Ari Palomäki
INTRODUCTION: Although metabolic syndrome (MetS) is evidently associated with the risk of cardiovascular disease (CVD), recently its use has been questioned. We studied the utility of MetS diagnosis when estimating individual CVD risk. METHODS: We compared 27 fertile women with MetS and 27 counterparts without the syndrome, matched pairwise according to well-known risk factors of CVD. Pulse wave velocity (PWV) and central blood pressure (cBP) were determined noninvasively via a SphygmoCor device...
June 7, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28570147/estimating-arterial-partial-pressure-of-carbon-dioxide-in-ventilated-patients-how-valid-are-surrogate-measures
#5
Boulos S Nassar, Gregory A Schmidt
The arterial partial pressure of carbon dioxide (PaCO2) is an important parameter in critically ill, mechanically ventilated patients. To limit invasive procedures or for more continuous monitoring of PaCO2, clinicians often rely on venous blood gases, capnography, or transcutaneous monitoring. Each of these has advantages and limitations. Central venous Pco2 allows accurate estimation of PaCO2, differing from it by an amount described by the Fick principle. As long as cardiac output is relatively normal, central venous Pco2 exceeds the arterial value by approximately 4 mm Hg...
June 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28522275/impact-of-continuous-positive-airway-pressure-on-left-ventricular-systolic-loading-and-coronary-flow-reserve-in-healthy-young-men
#6
Volker Schulze, Christian Meyer, Christian Eickholt, Roberto Sansone, Stefanie Keymel, Christian Heiss, Tienush Rassaf, Malte Kelm, Stephan Steiner
BACKGROUND: Increased augmentation index (AIx) is accompanied by an elevated cardiovascular risk. A reduction of AIx is known for long-term continuous positive airway pressure (CPAP) therapy. We hypothesised that acute preload and left ventricular workload effects AIx and subendocardial viability ratio (SEVR) as a marker of coronary flow reserve. METHODS: Increased augmentation index and central blood pressure parameters were measured by radial artery tonometry in 17 healthy men (32/±6years) at rest and during CPAP ventilation at pressures of 5, 10mbar and after recovery...
March 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28448179/comparison-of-arterial-stiffness-in-preeclamptic-and-normotensive-pregnant-women-from-a-semi-rural-region-of-south-africa
#7
A Namugowa, J Iputo, J Wandabwa, A Meeme, G A B Buga
BACKGROUND: Preeclampsia is associated with arterial stiffness and endothelial dysfunction. The pathophysiology of arterial tone in preeclampsia has not been well described in rural African population, where the incidence is higher. OBJECTIVE: The aim of the study was to compare arterial tone of preeclamptic with pregnant normotensive women assessed with noninvasive techniques, using applanation tonometry with SphygmoCor. METHOD: This was a cross-sectional study...
2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28406485/cardiac-hemodynamics-before-during-and-after-elective-cesarean-section-under-spinal-anesthesia-in-low-risk-women
#8
M Ram, A Lavie, S Lev, Y Blecher, U Amikam, Y Shulman, T Avnon, E Weiner, A Many
OBJECTIVE: The aim of this study was to describe maternal central hemodynamic parameters before and during delivery as well at the early puerperium in healthy women undergoing elective cesarean section (CS) at term. STUDY DESIGN: The noninvasive Cardiac System (NICaS, NI Medical, Petah-Tikva, Israel) is a regional impedance device that measures cardiac output (CO) and its derivatives with a good correlation with the gold standard Swan-Ganz catheter. We performed a prospective longitudinal study of healthy women with a singleton pregnancy at term...
April 13, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28363617/exploring-the-best-predictors-of-fluid-responsiveness-in-patients-with-septic-shock
#9
Nianfang Lu, Xiuming Xi, Li Jiang, Degang Yang, Kai Yin
OBJECTIVE: To evaluate respiratory variations in carotid and brachial peak velocity and other hemodynamic parameters to predict responsiveness to fluid challenge. METHODS: A prospective observational study was performed on mechanically ventilated patients with septic shock. Outcomes included the measurements of central venous pressure, intrathoracic blood volume index, stroke volume variation (SVV), pleth variability index(PVI), and ultrasound assessments of respiratory variations in inferior vena cava diameter (ΔIVC), carotid Doppler peak velocity (ΔCDPV), and brachial artery peak velocity (ΔVpeak brach)...
March 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28346013/the-physiology-of-blood-loss-and-shock-new-insights-from-a-human-laboratory-model-of-hemorrhage
#10
REVIEW
Alicia M Schiller, Jeffrey T Howard, Victor A Convertino
The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss...
April 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28324975/quantification-of-peripheral-and-central-blood-pressure-variability-using-a-time-frequency-method
#11
Z Kouchaki, M Butlin, A Qasem, A P Avolio
Systolic blood pressure variability (BPV) is associated with cardiovascular events. As the beat-to-beat variation of blood pressure is due to interaction of several cardiovascular control systems operating with different response times, assessment of BPV by spectral analysis using the continuous measurement of arterial pressure in the finger is used to differentiate the contribution of these systems in regulating blood pressure. However, as baroreceptors are centrally located, this study considered applying a continuous aortic pressure signal estimated noninvasively from finger pressure for assessment of systolic BPV by a time-frequency method using Short Time Fourier Transform (STFT)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227135/quantification-of-peripheral-and-central-blood-pressure-variability-using-a-time-frequency-method
#12
Z Kouchaki, M Butlin, A Qasem, A P Avolio, Z Kouchaki, M Butlin, A Qasem, A P Avolio, Z Kouchaki, A P Avolio, M Butlin, A Qasem
Systolic blood pressure variability (BPV) is associated with cardiovascular events. As the beat-to-beat variation of blood pressure is due to interaction of several cardiovascular control systems operating with different response times, assessment of BPV by spectral analysis using the continuous measurement of arterial pressure in the finger is used to differentiate the contribution of these systems in regulating blood pressure. However, as baroreceptors are centrally located, this study considered applying a continuous aortic pressure signal estimated noninvasively from finger pressure for assessment of systolic BPV by a time-frequency method using Short Time Fourier Transform (STFT)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28149028/comparative-evaluation-of-central-venous-pressure-and-sonographic-inferior-vena-cava-variability-in-assessing-fluid-responsiveness-in-septic-shock
#13
Manjri Garg, Jyotsna Sen, Sandeep Goyal, Dhruva Chaudhry
OBJECTIVE: Fluid infusion, the most critical step in the resuscitation of patients with septic shock, needs preferably continuous invasive hemodynamic monitoring. The study was planned to evaluate the efficacy of ultrasonographically measured inferior vena cava collapsibility index (IVC CI) in comparison to central venous pressure (CVP) in predicting fluid responsiveness in septic shock. MATERIALS AND METHODS: Thirty-six patients of septic shock requiring ventilatory support (invasive/noninvasive) were included...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28115510/abnormal-wave-reflections-and-left-ventricular-hypertrophy-late-after-coarctation-of-the-aorta-repair
#14
Michael A Quail, Rebekah Short, Bejal Pandya, Jennifer A Steeden, Abbas Khushnood, Andrew M Taylor, Patrick Segers, Vivek Muthurangu
Patients with repaired coarctation of the aorta are thought to have increased afterload due to abnormalities in vessel structure and function. We have developed a novel cardiovascular magnetic resonance protocol that allows assessment of central hemodynamics, including central aortic systolic blood pressure, resistance, total arterial compliance, pulse wave velocity, and wave reflections. The main study aims were to (1) characterize group differences in central aortic systolic blood pressure and peripheral systolic blood pressure, (2) comprehensively evaluate afterload (including wave reflections) in the 2 groups, and (3) identify possible biomarkers among covariates associated with elevated left ventricular mass (LVM)...
March 2017: Hypertension
https://www.readbyqxmd.com/read/28108065/assessment-of-central-venous-physiology-of-fontan-circulation-using-peripheral-venous-pressure
#15
Satoshi Masutani, Clara Kurishima, Akiko Yana, Seiko Kuwata, Yoichi Iwamoto, Hirofumi Saiki, Hirotaka Ishido, Hideaki Senzaki
OBJECTIVE: Elevated central venous pressure is a major cause of morbidity and mortality after the Fontan operation. The difference between mean circulatory filling pressure and central venous pressure, a driving force of venous return, is important in determining dynamic changes in central venous pressure in response to changes in ventricular properties or loading conditions. Thus, noninvasive central venous pressure and mean circulatory filling pressure estimation may contribute to optimal management in patients undergoing the Fontan operation...
December 19, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28063813/assessment-of-vascular-function-in-low-socioeconomic-status-preschool-children-a-pilot-study
#16
Lama Ghazi, Tanja Dudenbostel, Daisy Xing, Deborah Ejem, Anne Turner-Henson, Cynthia Irwin Joiner, Olivia Affuso, Andres Azuero, Suzanne Oparil, David A Calhoun, Marti Rice, Fadi G Hage
Elevated brachial blood pressure (BP) in childhood tracks into adulthood. Central BP and measures of arterial stiffness, such as aortic augmentation index (AIx) and pulse wave velocity (PWV), have been associated with future cardiovascular disease. This pilot study assessed the feasibility of noninvasively measuring these parameters in preschool children and explored factors that may be associated with elevated BP in this age group. Brachial BP was measured using an electronic oscillometric unit (Dinamap PRO 100) and defined as elevated when systolic BP (SBP) and/or diastolic BP (DBP) was ≥ the 90th percentile for age, gender, and height...
December 24, 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28043670/vascular-aging-and-hypertension-implications-for-the-clinical-application-of-central-blood-pressure
#17
REVIEW
Hao-Min Cheng, Sungha Park, Qifang Huang, Satoshi Hoshide, Ji-Guang Wang, Kazuomi Kario, Chang-Gyu Park, Chen-Huan Chen
Vascular aging may be responsible for the high residual lifetime risk for hypertension in the middle-aged and elderly individuals. Increased arterial stiffness and wave reflection has been recognized as the dominant hemodynamic manifestations of vascular aging, and both are major determinants of central blood pressure (BP) and independent predictors for incident hypertension. Because central BP is strongly linearly associated with age, it can be regarded as an integrated marker for vascular aging. Central BP can be measured noninvasively using various techniques, including the convenient cuff-based oscillometric central BP monitors...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27939486/changes-in-cerebral-autoregulation-in-the-second-half-of-pregnancy-and-compared-to-non-pregnant-controls
#18
Teelkien R van Veen, Ronney B Panerai, Sina Haeri, Paul P van den Berg, Gerda G Zeeman, Michael A Belfort
OBJECTIVE: The mechanism by which pregnancy affects the cerebral circulation is unknown, but it has a central role in the development of neurological complications in preeclampsia, which is believed to be related to impaired autoregulation. We evaluated the cerebral autoregulation in the second half of pregnancy, and compared this with a control group of healthy, fertile non-pregnant women. METHODS: In a prospective cohort analysis, cerebral blood flow velocity of the middle cerebral artery (determined by transcranial Doppler), blood pressure (noninvasive arterial volume clamping), and end-tidal carbon dioxide (EtCO2) were simultaneously collected for 7min...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27930515/usefulness-of-the-maximum-rate-of-pressure-rise-in-the-central-and-peripheral-arteries-after-weaning-from-cardiopulmonary-bypass-in-pediatric-congenital-heart-surgery-a-retrospective-analysis
#19
Jung-Won Kim, Ji-Yeon Bang, Chun Soo Park, Mijeung Gwak, Won-Jung Shin, Gyu-Sam Hwang
The maximum rate of pressure rise (dP/dtmax) in radial artery has been proposed as a noninvasive surrogate of aortic dp/dtmax, reflecting left ventricular (LV) contractility in children. The aim of this study was to investigate relationship between aortic and radial dp/dtmax at weaning from cardiopulmonary bypass (CPB) and usefulness of these indices for estimating postoperative outcomes in pediatric congenital heart surgery.Aortic and radial arterial pressure waveforms were analyzed simultaneously during weaning from CPB in 29 congenital heart surgery...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27915164/can-the-cerebral-regional-oxygen-saturation-be-a-perfusion-parameter-in-shock
#20
Ashraf Al Tayar, Amr Abouelela, Khaja Mohiuddeen
INTRODUCTION: Shock, defined as a state of tissue hypoperfusion and the tissues reperfusion, is the main goal of management of shock. Increase in central venous saturation (CvSo2) and decrease in blood lactate level are useful in assessment of adequacy of tissue perfusion. Near-infrared spectroscopy is a noninvasive way to observe real-time changes in regional cerebral saturation and has been used in patients with different brain diseases. There is a small body of literature suggesting that cerebral regional oxygen saturation (CrSo2) monitoring added a value in assessment and management of intensive care unit (ICU) patients...
April 2017: Journal of Critical Care
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