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Cardiopulmonary interactions

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https://www.readbyqxmd.com/read/29025008/cardiopulmonary-interactions-with-beta-blockers-and-inhaled-therapy-in-copd
#1
S Jabbal, W Anderson, P Short, A Morrison, A Manoharan, B J Lipworth
Background: Beta-blockers remain underused in patients with chronic obstructive pulmonary disease (COPD) and cardiovascular disease. Aim: We compared how different inhaled therapies affect tolerability of bisoprolol and carvedilol in moderate to severe COPD. Design: A randomized, open label, cross-over study. Methods: We compared the cardiopulmonary interactions of bisoprolol 5 mg qd or carvedilol 12.5 mg bid for 6 weeks in conjunction with: (i) triple: inhaled corticosteroid/long acting beta-agonist/long acting muscarinic antagonist (ICS + LABA + LAMA), (ii) dual: ICS + LABA and (iii) ICS alone...
July 24, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28993402/exercise-intolerance-in-hfpef-diagnosing-and-ranking-its-causes-using-personalized-o2-pathway-analysis
#2
Nicholas E Houstis, Aaron S Eisman, Paul P Pappagianopoulos, Luke Wooster, Cole S Bailey, Peter D Wagner, Gregory D Lewis
Background -Heart failure with preserved ejection fraction (HFpEF) is a common syndrome with a pressing shortage of therapies. Exercise intolerance is a cardinal symptom of HFpEF, yet its pathophysiology remains uncertain. Methods -We investigated the mechanism of exercise intolerance in each of 134 patients referred for cardiopulmonary exercise testing (CPET): 79 with HFpEF and 55 controls. We performed CPET with invasive monitoring to measure hemodynamics, blood gases, and gas exchange during exercise. We used these measurements to quantify 6 steps of oxygen transport and utilization (the "O2 pathway") in each HFpEF patient, identifying the defective steps that impair each one's exercise capacity (peak VO2)...
October 9, 2017: Circulation
https://www.readbyqxmd.com/read/28991109/patient-blood-management-in-pediatric-cardiac-surgery-a-review
#3
Jill M Cholette, David Faraoni, Susan M Goobie, Victor Ferraris, Nabil Hassan
Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperative bleeding further contribute to blood product utilization in this vulnerable population...
October 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28974059/predictor-of-fluid-responsiveness-in-the-grey-zone-augmented-pulse-pressure-variation-through-a-temporary-increase-in-tidal-volume
#4
J J Min, N-S Gil, J-H Lee, D K Ryu, C S Kim, S M Lee
Background: Pulse pressure variation (PPV) is widely used as a predictor of fluid responsiveness. However, a previous study has suggested a 'grey zone' between 9 and 13% in which PPV would be inconclusive to predict fluid responsiveness. Considering PPV is based on cardiopulmonary interactions, we evaluated whether an augmented PPV using a temporary increase in tidal volume (V T ) from 8 to 12 ml kg -1 has the predictability for fluid responsiveness in patients within the grey zone...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28910330/quality-of-life-measures-predict-cardiovascular-health-and-physical-performance-in-chronic-renal-failure-patients
#5
A Rogan, K McCarthy, G McGregor, T Hamborg, G Evans, S Hewins, N Aldridge, S Fletcher, N Krishnan, R Higgins, D Zehnder, S M Ting
BACKGROUND: Patients with advanced chronic kidney disease (CKD) experience complex functional and structural changes of the cardiopulmonary and musculoskeletal system. This results in reduced exercise tolerance, quality of life and ultimately premature death. We investigated the relationship between subjective measures of health related quality of life and objective, standardised functional measures for cardiovascular and pulmonary health. METHODS: Between April 2010 and January 2013, 143 CKD stage-5 or CKD5d patients (age 46...
2017: PloS One
https://www.readbyqxmd.com/read/28890081/factors-associated-with-postoperative-atrial-fibrillation-and-other-adverse-events-after-cardiac-surgery
#6
Emmanuel Akintoye, Frank Sellke, Roberto Marchioli, Luigi Tavazzi, Dariush Mozaffarian
OBJECTIVE: The study objective was to evaluate the impact of various surgical characteristics and practices on the risk of postoperative atrial fibrillation and other adverse outcomes after cardiac surgery. METHODS: By using the prospectively collected data of patients who underwent cardiac surgery in 28 centers across the United States, Italy, and Argentina, the details of surgery characteristics were collected for each patient and the outcomes, including postoperative atrial fibrillation, major adverse cardiovascular events, and mortality...
August 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28877974/exertional-dyspnoea-in-pulmonary-arterial-hypertension
#7
Daniel Dumitrescu, Olivier Sitbon, Jason Weatherald, Luke S Howard
Dyspnoea is a principal presenting symptom in pulmonary arterial hypertension (PAH), and often the most distressing. The pathophysiology of PAH is relatively well understood, with the primary abnormality of pulmonary vascular disease resulting in a combination of impaired cardiac output on exercise and abnormal gas exchange, both contributing to increased ventilatory drive. However, increased ventilatory drive is not the sole explanation for the complex neurophysiological and neuropsychological symptom of dyspnoea, with other significant contributions from skeletal muscle reflexes, respiratory muscle function, and psychological and emotional status...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28814495/right-ventricular-pulmonary-vascular-interactions
#8
REVIEW
Diana M Tabima, Jennifer L Philip, Naomi C Chesler
Accurate and comprehensive evaluation of right ventricular (RV)-pulmonary vascular (PV) interactions is critical to the assessment of cardiopulmonary function, dysfunction, and failure. Here, we review methods of quantifying RV-PV interactions and experimental results from clinical trials as well as large- and small-animal models based on pressure-volume analysis. We conclude by outlining critical gaps in knowledge that should drive future studies.
September 2017: Physiology
https://www.readbyqxmd.com/read/28802909/variable-prognostic-value-of-blood-pressure-response-to-exercise
#9
Yuko Kato, Shinya Suzuki, Tokuhisa Uejima, Hiroaki Semba, Takeshi Yamashita
AIM: The aim of this study was to evaluate the impact of patient background including exercise capacity on the relationship between the blood pressure (BP) response to exercise and prognosis in patients visiting a cardiovascular hospital. METHODS: A total of 2134 patients who were referred to our hospital underwent symptom-limited maximal cardiopulmonary exercise testing, and were followed through medical records and mail. The BP response to exercise was defined as the difference between peak and rest systolic BP...
August 9, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28763290/powered-air-purifying-respirator-use-in-healthcare-effects-on-thermal-sensations-and-comfort
#10
Jeffrey B Powell, Jung-Hyun Kim, Raymond J Roberge
Twelve subjects wore an N95 filtering facepiece respirator (N95 FFR), one tight-fitting full facepiece powered air-purifying respirator (PAPR), two loose-fitting PAPRs, and one elastomeric/PAPR hybrid for 1 hr each during treadmill walking at 5.6 km/h while undergoing physiological and subjective response monitoring. No significant interaction (p≥.05) was noted between the five respirators in heart rate, respiratory rate, oxygen saturation, transcutaneous carbon dioxide, and perceptions of breathing effort or discomfort, exertion, facial heat, and overall body heat...
August 1, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/28729396/acute-volume-loading-exacerbates-direct-ventricular-interaction-in-a-model-of-copd
#11
William Spencer Cheyne, Alexandra Mackenzie Williams, Megan I Harper, Neil Derek Eves
Volume loading increases left ventricular (LV) stroke volume (LVSV) through series interaction but may paradoxically reduce LVSV in the presence of large increases in right ventricular (RV) afterload due to direct ventricular interaction (DVI). RV afterload is often increased in COPD as a result of pathological changes to respiratory mechanics, namely increased negative intrathoracic pressure (nITP), dynamic lung hyperinflation (DH) and increased pulmonary vascular resistance (PVR). These hallmarks of COPD negatively impact LV hemodynamics in normovolemia...
July 20, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28727673/exercise-training-improves-ventilatory-efficiency-in-patients-with-a-small-abdominal-aortic-aneurysm-a-randomized-controlled-study
#12
Ricardo M Lima, Baruch Vainshelboim, Rucha Ganatra, Ronald Dalman, Khin Chan, Jonathan Myers
PURPOSE: To investigate the effects of exercise training on ventilatory efficiency and physiological responses to submaximal exercise in subjects with small abdominal aortic aneurysm (AAA). METHODS: Sixty-five male patients (72.3 ± 7.0 years) were randomized to exercise training (n = 33) or usual care group (n = 32). Exercise subjects participated in a training groups for 3 mo. Cardiopulmonary exercise testing was performed before and after the study period and peak VO2, the ventilatory threshold (VT), the oxygen uptake efficiency slope (OUES), and the VE2/VCO2 slope were identified...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28706270/comprehensive-multi-dimensional-mri-for-the-simultaneous-assessment-of-cardiopulmonary-anatomy-and-physiology
#13
Joseph Y Cheng, Tao Zhang, Marcus T Alley, Martin Uecker, Michael Lustig, John M Pauly, Shreyas S Vasanawala
Diagnostic testing often assesses the cardiovascular or respiratory systems in isolation, ignoring the major pathophysiologic interactions between the systems in many diseases. When both systems are assessed currently, multiple modalities are utilized in costly fashion with burdensome logistics and decreased accessibility. Thus, we have developed a new acquisition and reconstruction paradigm using the flexibility of MRI to enable a comprehensive exam from a single 5-15 min scan. We constructed a compressive-sensing approach to pseudo-randomly acquire highly subsampled, multi-dimensionally-encoded and time-stamped data from which we reconstruct volumetric cardiac and respiratory motion phases, contrast-agent dynamics, and blood flow velocity fields...
July 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28679570/cardiopulmonary-physiology-why-the-heart-and-lungs-are-inextricably-linked
#14
Kevin Verhoeff, Jamie R Mitchell
Because the heart and lungs are confined within the thoracic cavity, understanding their interactions is integral for studying each system. Such interactions include changes in external constraint to the heart, blood volume redistribution (venous return), direct ventricular interaction (DVI), and left ventricular (LV) afterload. During mechanical ventilation, these interactions can be amplified and result in reduced cardiac output. For example, increased intrathoracic pressure associated with mechanical ventilation can increase external constraint and limit ventricular diastolic filling and, therefore, output...
September 1, 2017: Advances in Physiology Education
https://www.readbyqxmd.com/read/28622235/central-venous-pressure-and-mean-airway-pressure-back-for-outcome-in-mechanically-ventilated-patients-still-more-consideration-for-cardiopulmonary-interactions-at-the-bedside
#15
https://www.readbyqxmd.com/read/28620680/landscape-climate-and-hantavirus-cardiopulmonary-syndrome-outbreaks
#16
REVIEW
Paula Ribeiro Prist, Paulo Sérgio D Andrea, Jean Paul Metzger
We performed a literature review in order to improve our understanding of how landscape and climate drivers affect HCPS outbreaks. Anthropogenic landscape changes such as forest loss, fragmentation and agricultural land uses are related with a boost in hantavirus reservoir species abundance and hantavirus prevalence in tropical areas, increasing HCPS risk. Additionally, higher precipitation, especially in arid regions, favors an increase in vegetational biomass, which augments the resources for reservoir rodents, also increasing HCPS risk...
June 15, 2017: EcoHealth
https://www.readbyqxmd.com/read/28608149/exercise-capacity-and-self-efficacy-are-associated-with-moderate-to-vigorous-intensity-physical-activity-in-children-with-congenital-heart-disease
#17
Laura Banks, Shelly Rosenthal, Cedric Manlhiot, Chun-Po Steve Fan, Adam McKillop, Patricia E Longmuir, Brian W McCrindle
This study sought to determine whether exercise capacity, self-efficacy, and gross motor skills are associated with moderate-to-vigorous physical activity (MVPA) levels in children, and if these associations differ by congenital heart disease (CHD) type. Medical history was abstracted from chart review. We assessed MVPA levels (via accelerometry), percent-predicted peak oxygen consumption ([Formula: see text] cardiopulmonary exercise test), gross motor skill percentiles (test of gross motor development version-2), and self-efficacy [children's self-perceptions of adequacy and predilection for physical activity scale (CSAPPA scale)]...
August 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28592188/polymer-coated-cardiopulmonary-bypass-circuit-attenuates-upregulation-of-both-proteases-protease-inhibitors-and-platelet-degranulation-in-pigs
#18
Shoichi Suehiro, Kouji Shimizu, Kensuke Imai, Atsushi Niii, Kazuhiro Akeho, Hayato Nakata, Akane Yamaguchi, Ken-Ichi Matsumoto, Teiji Oda
INTRODUCTION: Interaction of blood with a cardiopulmonary bypass (CPB) circuit activates the coagulation-fibrinolysis, complement and kinin-kallikrein systems that are mainly supported by proteases and their inhibitors. METHODS: Biocompatibility of a new polymer-coated (SEC-coated) CPB circuit was globally evaluated and compared with that of a non-coated CPB circuit by quantitative proteomics, using isobaric tags for relative and absolute quantification labeling tandem mass spectrometry...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28574698/ozone-exposure-cardiopulmonary-health-and-obesity-a-substantive-review
#19
REVIEW
Patricia D Koman, Peter Mancuso
From 1999-2014, obesity prevalence increased among adults and youth. Obese individuals may be uniquely susceptible to the proinflammatory effects of ozone because obese humans and animals have been shown to experience a greater decline in lung function than normal-weight subjects. Obesity is independently associated with limitations in lung mechanics with increased ozone dose. However, few epidemiologic studies have examined the interaction between excess weight and ozone exposure among adults. Using PubMed keyword searches and reference lists, we reviewed epidemiologic evidence to identify potential response-modifying factors and determine if obese or overweight adults are at increased risk of ozone-related health effects...
July 17, 2017: Chemical Research in Toxicology
https://www.readbyqxmd.com/read/28572979/complex-effects-of-high-flow-nasal-cannula-therapy-on-hemodynamics-in-the-pediatric-patient-after-cardiac-surgery
#20
EDITORIAL
Yu Inata, Muneyuki Takeuchi
BACKGROUND: The high-flow nasal cannula (HFNC) system has been widely used for children in various clinical settings. However, the physiological and clinical impact of HFNC therapy on the pediatric patient with respiratory distress after cardiac surgery has not been thoroughly investigated. MAIN BODY OF THE ABSTRACT: It seems logical to use HFNC as a primary therapy for post-extubation respiratory failure after congenital heart surgery, in which low cardiac output syndrome and upper airway obstruction are commonly encountered; the HFNC therapy alleviates the work of breathing and large negative swings of intrathoracic pressure, which in turn helps to decrease the systemic ventricular afterload...
2017: Journal of Intensive Care
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