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https://www.readbyqxmd.com/read/28719636/the-non-diuretic-hypotensive-effects-of-thiazides-are-enhanced-during-volume-depletion-states
#1
Saeed Alshahrani, Robert M Rapoport, Kamyar Zahedi, Min Jiang, Michelle Nieman, Sharon Barone, Andrea L Meredith, John N Lorenz, Jack Rubinstein, Manoocher Soleimani
Thiazide derivatives including Hydrochlorothiazide (HCTZ) represent the most common treatment of mild to moderate hypertension. Thiazides initially enhance diuresis via inhibition of the kidney Na+-Cl- Cotransporter (NCC). However, chronic volume depletion and diuresis are minimal while lowered blood pressure (BP) is maintained on thiazides. Thus, a vasodilator action of thiazides is proposed, likely via Ca2+-activated K+ (BK) channels in vascular smooth muscles. This study ascertains the role of volume depletion induced by salt restriction or salt wasting in NCC KO mice on the non-diuretic hypotensive action of HCTZ...
2017: PloS One
https://www.readbyqxmd.com/read/28719516/echocardiography-and-passive-leg-raising-in-the-postoperative-period-a-prospective-observational-study
#2
Yasser El Hadouti, Lucía Valencia, Angel Becerra, Aurelio Rodríguez-Pérez, Jean L Vincent
BACKGROUND: Signs of hypovolaemia are frequent in the postoperative period, but not all patients need or respond to fluid administration. An increase in cardiac output (CO) after passive leg raising (PLR) has been demonstrated to be useful as a volume response predictor in non-surgical, spontaneously breathing patients. OBJECTIVE: The objective of this study was to evaluate the accuracy of transthoracic echocardiography after PLR to predict fluid responsiveness in post-surgical patients...
July 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28719470/diurnal-variation-and-repeatability-of-arterial-stiffness-and-cardiac-output-measurements-in-the-third-trimester-of-uncomplicated-pregnancy
#3
Mohamed W Osman, Francesca Leone, Mintu Nath, Asma Khalil, David R Webb, Thompson G Robinson, Hatem A Mousa
AIM: To investigate same day repeated measures and diurnal variation of arterial stiffness, cardiac output (CO), stroke volume (SV) and total peripheral resistance (TPR) during the third trimester of normal pregnancy. METHODOLOGY: Pulse wave velocity (PWV) and augmentation index (AIx) were recorded using the Arteriograph, while CO, SV and TPR were recorded using noninvasive cardiac output monitoring. The measurements were obtained in the third trimester of pregnancy from 21 healthy pregnant women at four time points (morning, afternoon, evening and midnight) over a 24-h period...
July 14, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28719429/maternal-salvage-with-extracorporeal-life-support-lessons-learned-in-a-single-center
#4
Philippe Biderman, Uri Carmi, Eric Setton, Michael Fainblut, Oren Bachar, Sharon Einav
The American Heart Association scientific statement on cardiac arrest in pregnancy did not endorse extracorporeal life support for lack of cohort data. We studied all pregnancy and peripartum cases of extracorporeal life support in 1 medical center (n = 11), including collapse due to infection (n = 6, 55%), thromboembolism (n = 3, 27%), and cardiac disease (n = 2, 18%). Half of the cases (n = 5, 45%) involved extracorporeal cardiopulmonary resuscitation. Most mothers survived (n = 7, 64% [95% confidence interval, 32%-88%])...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719069/inaccuracy-of-a-continuous-arterial-pressure-waveform-monitor-when-used-for-congenital-cardiac-catheterization
#5
Michael D Seckeler, Katri Typpo, Jendar Deschenes, Ruth Higgins, Ricardo Samson, Peter Lichtenthal
OBJECTIVE: To determine the accuracy of a continuous cardiac output monitor (FloTrac sensor) for measuring cardiac index in children with congenital heart disease undergoing cardiac catheterization. Cardiac index is a critical hemodynamic parameter measured during catheterizations in children with congenital heart disease. This has been challenging to measure accurately and many clinicians rely on predictive equations for calculating cardiac index. DESIGN: Prospective, nonrandomized trial...
July 18, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28712261/application-of-living-high-training-low-enhances-cardiac-function-and-skeletal-muscle-oxygenation-during-submaximal-exercises-in-athletes
#6
Hun-Young Park, Sang-Seok Nam
PURPOSE: The aim of this study was to determine the efficiency of the application of living high-training low (LHTL) on cardiac function and skeletal muscle oxygenation during submaximal exercises compared with that of living low-training low (LLTL) in athletes. METHODS: Male middle- and long-distance runners (n = 20) were randomly assigned into the LLTL group (n = 10, living at 1000-m altitude and training at 700-1330-m altitude) and the LHTL group (n = 10, living at simulated 3000-m altitude and training at 700-1330-m altitude)...
March 31, 2017: Journal of Exercise Nutrition & Biochemistry
https://www.readbyqxmd.com/read/28710899/effects-of-dobutamine-dopamine-phenylephrine-and-noradrenaline-on-systemic-haemodynamics-and-intestinal-perfusion-in-isoflurane-anaesthetised-horses
#7
C Dancker, K Hopster, K Rohn, S B Kästner
BACKGROUND: In the horse, effects of cardiovascular-active drugs on local perfusion of the gastrointestinal tract are poorly understood. OBJECTIVES: To determine the effect of drugs commonly used to support blood pressure, on local intestinal blood flow and tissue oxygenation under isoflurane anaesthesia. STUDY DESIGN: In vivo randomised crossover experiment METHODS: Ten horses were anaesthetised with isoflurane. After 90 minutes of equilibration three doses (μg/kg bwt/min) of dobutamine (DOB 0...
July 15, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28709930/particle-image-velocimetry-study-of-the-celiac-trunk-hemodynamic-induced-by-continuous-flow-left-ventricular-assist-device
#8
Francesco Scardulla, Diego Bellavia, Leonardo D'Acquisto, Giuseppe M Raffa, Salvatore Pasta
Whereas left ventricular assist device (LVAD) is the gold-standard therapy for patients with heart failure, gastrointestinal bleeding is one of the most common complications. LVAD implantation may remarkably impact aortic hemodynamics so that experimental and computational flow analyses can be used to study the disease mechanisms. Here we present an experimentally-calibrated computational model of the celiac trunk hemodynamic of a LVAD-supported patient who experienced bleeding after device implantation. Specifically, both particle image velocimetry (PIV) and echocardiography were used to measure and compare flow distributions in each branch of a phantom model of the patient abdominal aorta...
July 12, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28709156/gastrointestinal-impedance-spectroscopy-to-detect-hypoperfusion-during-hemorrhage
#9
Andreas Bloch, Andreas Kohler, Horst Posthaus, David Berger, Laura Santos, Stephan Jakob, Jukka Takala, Matthias Haenggi
BACKGROUND: Changes in tissue impedance (Ω) have been proposed as early signs of impaired tissue perfusion. We hypothesized that hemorrhage may induce early changes in alimentary tract tissue impedance and that these can be detected by impedance spectroscopy. We evaluated impedance spectroscopy in an acute hemorrhage model in pigs. METHODS: Twenty anesthetized pigs were randomized to stepwise hemorrhage to mean arterial blood pressure (MAP) targets of 60 mm Hg, 50 mm Hg, 45 mm Hg, and 40 mm Hg, followed by retransfusion in two steps, or control (n = 10 each)...
August 2017: Shock
https://www.readbyqxmd.com/read/28707021/the-response-to-trendelenburg-position-is-minimally-affected-by-underlying-hemodynamic-conditions-in-patients-with-aortic-stenosis
#10
Abraham Sonny, Daniel I Sessler, Jing You, Babak Kateby Kashy, Sheryar Sarwar, Akhil K Singh, Shiva Sale, Andrej Alfirevic, Andra E Duncan
PURPOSE: Trendelenburg positioning is commonly used to temporarily treat intraoperative hypotension. The Trendelenburg position improves cardiac output in normovolemic or anesthetized patients, but not hypovolemic or non-anesthetized patients. Therefore, the response to Trendelenburg positioning may vary depending on patient population or hemodynamic conditions. We thus tested the hypothesis that the effectiveness of the Trendelenburg position, as indicated by an increase in cardiac output, improves after replacement of a stenotic aortic valve...
July 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28704819/electrical-cardiometry-to-monitor-cardiac-output-in-preterm-infants-with-patent-ductus-arteriosus-a-comparison-with-echocardiography
#11
Kai-Hsiang Hsu, Tai-Wei Wu, I-Hsyuan Wu, Mei-Yin Lai, Shih-Yun Hsu, Hsiao-Wen Huang, Tze-Yee Mok, Reyin Lien
BACKGROUND: Electrical cardiometry (EC) is an impedance-based monitoring that provides noninvasive cardiac output (CO) assessment. Through comparison to transthoracic echocardiography (Echo), the accuracy of EC has been verified. However, left-to-right patent ductus arteriosus (PDA) shunting is a concern because PDA shunts aortic flow to the pulmonary artery and may interfere with EC in measuring CO. OBJECTIVE: To determine the agreement between EC and Echo in preterm infants with a hemodynamically significant PDA (hsPDA)...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28703280/the-oregonheart-total-artificial-heart-design-and-performance-on-a-mock-circulatory-loop
#12
Jeremy Glynn, Howard Song, Bryan Hull, Stanley Withers, Jill Gelow, James Mudd, Albert Starr, Richard Wampler
Widespread use of heart transplantation is limited by the scarcity of donor organs. Total artificial heart (TAH) development has been pursued to address this shortage, especially to treat patients who require biventricular support. We have developed a novel TAH that utilizes a continuously spinning rotor that shuttles between two positions to provide pulsatile, alternating blood flow to the systemic and pulmonary circulations without artificial valves. Flow rates and pressures generated by the TAH are controlled by adjusting rotor speed, cycle frequency, and the proportion of each cycle spent pumping to either circulation...
July 13, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28702857/protein-kinase-c-and-cardiac-dysfunction-a-review
#13
REVIEW
Raphael M Singh, Emanuel Cummings, Constantinos Pantos, Jaipaul Singh
Heart failure (HF) is a physiological state in which cardiac output is insufficient to meet the needs of the body. It is a clinical syndrome characterized by impaired ability of the left ventricle to either fill or eject blood efficiently. HF is a disease of multiple aetiologies leading to progressive cardiac dysfunction and it is the leading cause of deaths in both developed and developing countries. HF is responsible for about 73,000 deaths in the UK each year. In the USA, HF affects 5.8 million people and 550,000 new cases are diagnosed annually...
July 12, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28701680/right-ventricular-end-diastolic-pressure-is-a-key-to-the-changes-in-cardiac-output-during-adaptive-servo-ventilation-support-in-patients-with-heart-failure
#14
Teruhiko Imamura, Koichiro Kinugawa
Adaptive servo-ventilation (ASV) is a recently-developed non-invasive therapy that improves the clinical course of heart failure (HF) patients. However, the precise hemodynamic response and predictors of ASV therapy remain uncertain. Overall, 69 patients with New York Heart Association HF class II-IV underwent 10-minute ASV testing along with hemodynamic studies. Among them, 21 (30%) achieved an acute response, which was defined as an increase in the cardiac index (CI) during ASV. ΔLeft ventricular end-diastolic pressure (LVEDP) did not correlate with ΔCI, whereas Δtransmural LVEDP, which was calculated by subtracting right ventricular end-diastolic pressure (RVEDP) from LVEDP, and ΔCI were positively correlated, similar to the ascending limb of Frank-Starling's law (P = 0...
July 13, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28701592/risk-factors-of-postcardiotomy-ventricular-dysfunction-in-moderate-to-high-risk-patients-undergoing-open-heart-surgery
#15
Christoph Ellenberger, Tornike Sologashvili, Mustafa Cikirikcioglu, Gabriel Verdon, John Diaper, Tiziano Cassina, Marc Licker
INTRODUCTION: Ventricular dysfunction requiring inotropic support frequently occurs after cardiac surgery, and the associated low cardiac output syndrome largely contributes to postoperative death. We aimed to study the incidence and potential risk factors of postcardiotomy ventricular dysfunction (PCVD) in moderate-to-high risk patients scheduled for open-heart surgery. METHODS: Over a 5-year period, we prospectively enrolled 295 consecutive patients undergoing valve replacement for severe aortic stenosis or coronary artery bypass surgery who presented with Bernstein-Parsonnet scores >7...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28699384/preclinical-safety-evaluation-of-allogeneic-ips-cell-based-therapy-in-a-swine-model-of-myocardial-infarction
#16
Carolina Gálvez-Montón, Carolina Soler-Botija, Oriol Iborra-Egea, Idoia Diaz-Guemes, Mercè Martí, Olalla Iglesias-Garcia, Cristina Prat-Vidal, Verónica Crisóstomo, Aida Llucià-Valldeperas, Isaac Perea-Gil, Santiago Roura, Francisco Miguel Sanchez Margallo, Ángel Raya, Antoni Bayés-Genís
The combination of biomatrices and induced pluripotent stem cell (iPSC) derivatives to aid repair and myocardial scar formation may soon become a reality for cardiac regenerative medicine. However, the tumor risk associated to residual undifferentiated cells remains an important safety concern of iPSC-based therapies. This concern is not satisfactorily addressed in xenotransplantation, which require immune suppression of the transplanted animal. Here, we assessed the safety of transplanting undifferentiated iPSC in an allogeneic setting...
July 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28698881/assessment-of-haemodynamic-response-to-nonselective-beta-blockers-in-portal-hypertension-by-phase-contrast-magnetic-resonance-angiography
#17
Natasha McDonald, David M L Lilburn, Neil J Lachlan, Gillian Macnaught, Dilip Patel, Arjun N A Jayaswal, Peter C Hayes, Scott I Semple, Jonathan A Fallowfield
A significant unmet need exists for accurate, reproducible, noninvasive diagnostic tools to assess and monitor portal hypertension (PHT). We report the first use of quantitative MRI markers for the haemodynamic assessment of nonselective beta-blockers (NSBB) in PHT. In a randomized parallel feasibility study in 22 adult patients with PHT and a clinical indication for NSBB, we acquired haemodynamic data at baseline and after 4 weeks of NSBB (propranolol or carvedilol) using phase-contrast MR angiography (PC-MRA) in selected intra-abdominal vessels...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28698692/cardiovascular-effects-of-constant-rate-infusions-of-lidocaine-lidocaine-and-dexmedetomidine-and-dexmedetomidine-in-dogs-anesthetized-at-equipotent-doses-of-sevoflurane
#18
Rafael Moran-Muñoz, Alexander Valverde, J A Ibancovichi, Carlos M Acevedo-Arcique, Sergio Recillas-Morales, Pedro Sanchez-Aparicio, Jorge Osorio-Avalos, Julio Raul Chavez-Monteagudo
This study evaluated the cardiovascular effects of a constant rate infusion (CRI) of lidocaine, lidocaine and dexmedetomidine, and dexmedetomidine in dogs anesthetized with sevoflurane at equipotent doses. Treatments consisted of T1-Lidocaine [loading dose 2 mg/kg body weight (BW), IV, and CRI of 100 μg/kg BW per min] at 1.4% end-tidal of sevoflurane (FESEV); T2-Dexmedetomidine (loading dose 2 μg/kg BW, IV, and CRI of 2 μg/kg BW per hour) and FESEV 1.1%; and T3-Lidocaine-Dexmedetomidine using the same doses of T1 and T2 and FESEV 0...
July 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28697026/smartphone-based-mobile-thermal-imaging-technology-to-assess-limb-perfusion-and-tourniquet-effectiveness-under-normal-and-blackout-conditions
#19
Morgan R Barron, John P Kuckelman, John M McClellan, Michael J Derickson, Cody J Phillips, Shannon T Marko, Joshua P Smith, Matthew J Eckert, Matthew J Martin
BACKGROUND: Over the past decade there has been a resurgence of tourniquet use in civilian and military settings. Several key challenges include assessment of limb perfusion and adequacy of tourniquet placement, particularly in the austere or pre-hospital environments. We investigated the utility of thermal imaging to assess adequacy of tourniquet placement. METHODS: The FLIR ONE™ smartphone-based thermal imager was utilized. Ten swine underwent tourniquet placement with no associated hemorrhage (n=5) or with 40% hemorrhage (n=5)...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28695721/aortic-isthmus-shunt-dynamics-in-normal-and-complicated-monochorionic-pregnancies
#20
Viola Seravalli, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat, Jena Miller
OBJECTIVE: To study fetal aortic isthmus (AoI) shunt dynamics in monochorionic (MC) twins. METHODS: Normal and complicated MC pregnancies were prospectively enrolled. The relationship of isthmus flow index (IFI) with Doppler parameters of umbilical artery (UA), descending aorta (DAo), middle cerebral artery (MCA), and ductus venosus (DV), and with left and right ventricular cardiac output and stroke volume was studied. RESULTS: The IFI was obtained in 180 examinations from 48 pregnancies (24 twin-twin-transfusion syndrome, TTTS; 4 selective intrauterine growth restriction, sIUGR; 12 TTTS+sIUGR; 8 uncomplicated)...
July 11, 2017: Prenatal Diagnosis
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