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blood pressure in stroke

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https://www.readbyqxmd.com/read/29339351/high-target-vs-low-target-blood-pressure-management-during-cardiopulmonary-bypass-to-prevent-cerebral-injury-in-cardiac-surgery-patients-a-randomized-controlled-trial
#1
Anne G Vedel, Frederik Holmgaard, Lars S Rasmussen, Annika Langkilde, Olaf B Paulson, Theis Lange, Carsten Thomsen, Peter Skov Olsen, Hanne Berg Ravn, Jens C Nilsson
Background -Cerebral injury is an important complication following cardiac surgery with the use of cardiopulmonary bypass (CPB). The rate of overt stroke after cardiac surgery is 1-2%, whereas silent strokes, detected by diffusion-weighed magnetic resonance imaging (DWI), are found in up to 50% of patients. It is unclear if a higher versus a lower blood pressure during cardiopulmonary bypass reduces cerebral infarction in these patients. Methods -In a patient- and assessor-blinded randomized trial, we allocated patients to a higher (70-80 mmHg) or lower (40-50 mmHg) target for mean arterial pressure by the titration of norepinephrine during cardiopulmonary bypass...
January 16, 2018: Circulation
https://www.readbyqxmd.com/read/29338111/the-exaggerated-blood-pressure-response-to-exercise-in-the-sub-acute-phase-after-stroke-is-not-affected-by-aerobic-exercise
#2
Magnus O Wijkman, Klas Sandberg, Marie Kleist, Lars Falk, Paul Enthoven
The prevalence of an exaggerated exercise blood pressure (BP) response is unknown in patients with subacute stroke, and it is not known whether an aerobic exercise program modulates this response. The authors randomized 53 patients (27 women) with subacute stroke to 12 weeks of twice-weekly aerobic exercise (n = 29) or to usual care without scheduled physical exercise (n = 24). At baseline, 66% of the patients exhibited an exaggerated exercise BP response (peak systolic BP ≥210 mm Hg in men and ≥190 mm Hg in women) during a symptom-limited ergometer exercise test...
January 16, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29336875/systems-pharmacology-dissection-of-the-anti-stroke-mechanism-for-the-chinese-traditional-medicine-xing-nao-jing
#3
Yuhua Chen, Yue Sun, Wende Li, Hong Wei, Tianlin Long, Hua Li, Quanhua Xu, Wei Liu
Xing-Nao-Jing (XNJ) is a well-known injection that has been extensively applied in clinical treatment of stroke in China. However, the underlying mechanism of clinical administration of XNJ in stroke remains unclear. In this study, a systems pharmacology strategy based on pharmacokinetic and pharmacodynamics data was applied to analyze the pharmacological effect of XNJ on stroke. Sixteen active compounds were filtered from XNJ through Drug-likeness (DL) and Brain-blood-barrier (BBB) evaluations. Ninety-four potential targets of these active components were identified by SysDT and SEA...
December 20, 2017: Journal of Pharmacological Sciences
https://www.readbyqxmd.com/read/29336360/early-neurological-deterioration-after-recanalization-treatment-in-patients-with-acute-ischemic-stroke-a-retrospective-study
#4
Ying-Bo Zhang, Ying-Ying Su, Yan-Bo He, Yi-Fei Liu, Gang Liu, Lin-Lin Fan
BACKGROUND: Early neurological deterioration (END) is a prominent issue after recanalization treatment. However, few studies have reported the characteristics of END after endovascular treatment (EVT) as so far. This study investigated the incidence, composition, and outcomes of END after intravenous recombinant tissue plasminogen activator (IV rt-PA) and EVT of acute ischemic stroke, and identified risk factors for END. METHODS: Medical records of patients who received recanalization treatment between January 1, 2014, and December 31, 2015 were reviewed...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29335617/cardiovascular-function-of-modern-pigs-does-not-comply-with-allometric-scaling-laws
#5
Gerard J van Essen, Maaike Te Lintel Hekkert, Oana Sorop, Ilkka Heinonen, Jolanda van der Velden, Daphne Merkus, Dirk J Duncker
Growing concerns have been expressed regarding cardiovascular performance in modern farm pigs, which has been proposed as a critical factor contributing to the reduced adaptability of modern pigs to stress. Here we tested the hypothesis that cardiac dimensions and pump function in modern heavy farm pigs are disproportionally low for their body weight, and investigated potential underlying mechanisms. The results from the present study indeed demonstrate disproportionally low values for stroke volume and cardiac output in pigs with bodyweights over 150 kg...
January 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29334713/-prevalence-and-influential-factors-of-stroke-in-jiangxi-province-in-2014
#6
W Zhou, B Zhang, X Huang, C J You, B M Zhan, R Q Yang, Y F Dong, J X Li, P Li, K Hong, Y Q Wu, Q H Wu, H Su, H H Bao, X S Cheng
Objective: To discuss the prevalence and influential factors of stroke among population in Jiangxi Province. Methods: Four cities in urban areas and four counties in rural areas were selected firstly, in which two districts or townships were selected; and then three communities or villages were chosen from each district and township, respectively, using the simple random sampling (SRS) method. Finally 15 269 subjects aging 15 years old or above, living in Jiangxi Province ≥6 months were randomly selected to participate in this survey from November 2013 to August 2014...
January 6, 2018: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/29334680/blood-pressure-variability-in-acute-ischemic-stroke-influence-of-infarct-location-in-the-insular-cortex
#7
Juri Kitamura, Hiroki Ueno, Michiaki Nagai, Naohisa Hosomi, Kie Honjo, Masahiro Nakamori, Tomoya Mukai, Eiji Imamura, Tomohisa Nezu, Shiro Aoki, Tomohiko Ohshita, Eiichi Nomura, Shinichi Wakabayashi, Hirofumi Maruyama, Masayasu Matsumoto
BACKGROUND: The aim of this study was to elucidate the influence of insular infarction on blood pressure (BP) variability and outcomes according to the region of the insular cortex affected. METHODS: A total of 90 patients diagnosed with acute unilateral ischemic stroke were registered. The BP variability was calculated over 24 h after admission (hyperacute) and for 2-3 days after admission (acute). Patients were classified into groups of right and left, and then right anterior, right posterior, left anterior, and left posterior insular infarction...
January 15, 2018: European Neurology
https://www.readbyqxmd.com/read/29334265/prevalence-and-covariates-of-uncontrolled-hypertension-in-ischemic-stroke-survivors-the-norwegian-stroke-in-the-young-study
#8
Åshild Oftedal, Eva Gerdts, Ulrike Waje-Andreassen, Annette Fromm, Halvor Naess, Anja Linde, Sahrai Saeed
PURPOSE: Hypertension is the most important modifiable risk factor for stroke. Few data are available on control of hypertension in younger ischemic stroke survivors. MATERIAL AND METHODS: We assessed clinic and ambulatory blood pressure (BP) measurements in 320 patients aged 15-60 years (mean 48 ± 10) included in the Norwegian Stroke in the Young Study during 3-months follow-up after the index stroke. Controlled hypertension was defined as ambulatory BP <130/80 mmHg...
January 15, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29333567/predictors-for-intracranial-hemorrhage-following-intravenous-thrombolysis-in-posterior-circulation-stroke
#9
Dorňák Tomáš, Král Michal, Sedláčková Zuzana, Šaňák Daniel, Čecháková Eva, Divišová Petra, Zapletalová Jana, Kaňovský Petr
Intravenous thrombolysis (IVT) is a standard treatment for anterior (ACS) and posterior circulation stroke (PCS). However, due to the low occurrence of PCS and of intracranial hemorrhage (ICH) in PCS, the knowledge about ICH predictors following IVT in PCS is sparse. Our aim was to identify predictors for ICH following IVT in PCS. The set consisted of 1281 consecutive ischemic stroke (IS) patients treated with IVT, out of which 158 (103 males; mean age 65.6 ± 12.3 years) had PCS. Collected data include baseline characteristics, common stroke risk factors, pre-medication, stroke severity, admission blood glucose level, blood pressure and treatment with intravenous antihypertensive therapy before and during IVT, occlusion of arteries, recanalization rate, time to treatment, and clinical outcome at day 90...
January 15, 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/29327562/development-of-a-porcine-beating-heart-model-of-self-myocardial-retroperfusion-evaluation-of-hemodynamic-and-cardiac-responses-to-ischemia-and-clinical-applications
#10
Daniel Grandmougin, Jean-Mathieu Casse, Antoine Chalon, Yun Luo, Aude Falanga, Vanessa Marie, Fréderique Groubatch-Joineau, Brice Mourer, Marie Grandmougin, David Grandmougin, Guillaume Gauchotte, Juan-Pablo Maureira, Nguyen Tran
BACKGROUND: Retrograde perfusion into the coronary sinus is used to deliver cardioplegia. We developed an in-vivo porcine beating-heart model of self-myocardial retroperfusion (SMR) using the venous route to supply myocardial oxygenation and sought to assess hemodynamic and cardiac responses triggered by SMR before and after a prolonged occlusion of the LAD. METHODS: A bypass-line between the ascending aorta and the coronary sinus was made to perform a selective retrograde perfusion of the great cardiac vein with oxygenated blood (SMR)...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29326289/prevalence-of-hippocampal-enlarged-perivascular-spaces-in-a-sample-of-patients-with-hypertension-and-their-relation-with-vascular-risk-factors-and-cognitive-function
#11
Joan Jiménez-Balado, Iolanda Riba-Llena, Edurne Garde, Marta Valor, Belen Gutiérrez, Francesc Pujadas, Pilar Delgado
OBJECTIVES: The clinical importance of hippocampal enlarged perivascular spaces (H-EPVS) remains uncertain. We aimed to study their association with vascular risk factors, cognitive function and mild cognitive impairment (MCI). METHODS: Data were obtained from the ISSYS (Investigating Silent Strokes in hYpertensives, a magnetic resonance imaging Study) cohort, which is a prospective study of patients with hypertension aged 50-70 with no prior stroke or dementia...
January 11, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29325370/-association-between-carotid-artery-plaques-and-all-cause-mortality-and-cardiovascular-events
#12
W Li, F Ma, Y M Jiang, J J Li, L Song, S H Chen, X M Liu, X Q Li, S L Wu
Objective: To observe the association of carotid artery plaque with all-cause mortality and cardiovascular events. Methods: A total of 7 017 participants who completed the carotid sonography examination between 2010 and 2011 were selected from the stroke and the elderly prospective cohort Kailuan study. The participants of stroke cohort received health examination between 2006 and 2007, and participants of elderly cohort received health examination between 2010 and 2011. All participants were divided into plaque group (3 285 cases) and without plaque group (3 732 cases) according to with or without carotid artery plaque...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29324835/subject-specific-pulse-wave-propagation-modeling-towards-enhancement-of-cardiovascular-assessment-methods
#13
Jan Poleszczuk, Malgorzata Debowska, Wojciech Dabrowski, Alicja Wojcik-Zaluska, Wojciech Zaluska, Jacek Waniewski
Cardiovascular diseases are the leading cause of death worldwide. Pulse wave analysis (PWA) technique, which reconstructs and analyses aortic pressure waveform based on non-invasive peripheral pressure recording, became an important bioassay for cardiovascular assessment in a general population. The aim of our study was to establish a pulse wave propagation modeling framework capable of matching clinical PWA data from healthy individuals on a per-subject basis. Radial pressure profiles from 20 healthy individuals (10 males, 10 females), with mean age of 42 ± 10 years, were recorded using applanation tonometry (SphygmoCor, AtCor Medical, Australia) and used to estimate subject-specific parameters of mathematical model of blood flow in the system of fifty-five arteries...
2018: PloS One
https://www.readbyqxmd.com/read/29322480/intra-operative-video-characterization-of-carotid-artery-pulsation-patterns-in-case-series-with-post-endarterectomy-hypertension-and-hyperperfusion-syndrome
#14
Yiming Xiao, Hassan Rivaz, Hidetoshi Kasuya, Suguru Yokosako, Cristina Mindru, Jeanne Teitelbaum, Denis Sirhan, David Sinclair, Mark Angle, Benjamin W Y Lo
Cerebral hyperperfusion syndrome (CHS) is a complication that can occur after carotid endarterectomy (CEA), the treatment of choice to decrease the subsequent risk of fatal or disabling stroke for patients with symptomatic severe stenosis of the carotid artery. Because of its rarity and complexity, the mechanism of the condition is still unclear, making its prevention via prediction and monitoring challenging. This is especially true during surgery, when multiple factors can induce physiological changes, including blood pressure and baroreceptor functions, which are crucial factors for post-CEA hypertension and CHS...
January 10, 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/29321134/efficacy-of-a-chronic-care-based-intervention-on-secondary-stroke-prevention-among-vulnerable-stroke-survivors-a-randomized-controlled-trial
#15
Eric M Cheng, William E Cunningham, Amytis Towfighi, Nerses Sanossian, Robert J Bryg, Thomas L Anderson, Frances Barry, Susan M Douglas, Lillie Hudson, Monica Ayala-Rivera, Jeffrey J Guterman, Sandra Gross-Schulman, Sylvia Beanes, Andrea S Jones, Honghu Liu, Barbara G Vickrey
BACKGROUND: Disparities of care among stroke survivors are well documented. Effective interventions to improve recurrent stroke preventative care in vulnerable populations are lacking. METHODS AND RESULTS: In a randomized controlled trial, we tested the efficacy of components of a chronic care model-based intervention versus usual care among 404 subjects having an ischemic stroke or transient ischemic attack within 90 days of enrollment and receiving care within the Los Angeles public healthcare system...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29318860/-effect-of-transcutaneous-acupoint-electrical-stimulation-on-hemodynamic-fluctuation-caused-by-loosing-tourniquet-in-elderly-patients-undergoing-knee-joint-replacement
#16
Han-Sheng Liang, Yi Feng
OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45-60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50-70) for remifentanil dosage adjustment...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29317969/pulse-pressure-analysis-to-guide-intraoperative-phlebotomy-prior-to-cardiac-surgery
#17
Brian Schloss, Dmitry Tumin, Aymen Naguib, Julie Rice, Mark Galantowicz, Joseph D Tobias
Background: The aim of this study was to evaluate the response of the LiDCO-rapid™ during intraoperative phlebotomy in anesthetized children prior to surgery for congenital heart disease. Methods: After the induction of general anesthesia and endotracheal intubation, baseline vital signs were recorded, along with pulse pressure variability (PPV) and stroke volume variability (SVV) from the LiDCO-rapid™ and cerebral oxygenation (rSO2) using near-infrared spectroscopy (NIRS)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29317741/effects-of-anti-hypertensive-treatment-on-major-cardiovascular-events-in-populations-within-prehypertensive-levels-a-systematic-review-and-meta-analysis
#18
Zhongqiu Hong, Tao Wu, Shuxian Zhou, Boshui Huang, Jingfeng Wang, Dongmei Jin, Dengfeng Geng
Uncertainties still remain in terms of the efficacy of anti-hypertensive treatment on the risk of major cardiovascular (CV) events within prehypertensive levels. This review aims to assess the efficacy and safety of anti-hypertensives on the CV risks in populations within prehypertensive levels. Randomized controlled trials (RCTs) concerning active treatment vs placebo in populations within prehypertensive levels were identified through electronic database and manual search. Outcomes included the first co-primary outcomes, stroke, heart failure (HF), myocardial infarction (MI), all-cause mortality, and cardiovascular mortality...
January 9, 2018: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29317418/home-polygraphic-recording-with-telemedicine-monitoring-for-diagnosis-and-treatment-of-sleep-apnoea-in-stroke-hopes-study-study-protocol-for-a-single-blind-randomised-controlled-trial
#19
Stefan Thomas Kotzian, Angela Schwarzinger, Sandra Haider, Bernd Saletu, Josef Spatt, Michael Timothy Saletu
INTRODUCTION: Meta-analyses report that more than 50% of patients who had a stroke suffer from moderate to severe sleep apnoea (SA), with adherence rates to positive airway pressure (PAP) therapy of only 30%. The primary objective of this study is to determine whether PAP adherence in patients who had a stroke with obstructive sleep apnoea (OSA) can be improved by a PAP training strategy during inhospital rehabilitation combined with a telemedicine monitoring system after discharge. Further objectives are (1) to compare the validity of a non-attended level-III polygraphy with that of a level-II polysomnography (PSG) in the diagnosis of SA, (2) to compare the validity of an apnoea-hypopnoea index (AHI) yielded by the PAP device with that obtained during PSG, (3) to determine changes in nocturnal systolic blood pressure (BP) due to PAP therapy with the pulse transit time (PTT) method and (4) to assess the impact of telemonitored PAP therapy on neurorehabilitation outcome parameters...
January 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29316564/primary-prevention-of-stroke-in-chronic-kidney-disease-patients-a-scientific-update
#20
Stefana Catalina Bilha, Alexandru Burlacu, Dimitrie Siriopol, Luminita Voroneanu, Adrian Covic
BACKGROUND: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking. SUMMARY: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population...
January 9, 2018: Cerebrovascular Diseases
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