MO736ELECTROCHEMICAL SKIN CONDUCTANCE BY SUDOSCAN: A NEW TOOL TO PREDICT INTRA-DIALYTIC HYPOTENSION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Pauline Reach ◽  
Maxime Touzot ◽  
Yannis Lombardi ◽  
Catherine Maheas ◽  
Emmanuelle Sacco ◽  
...  
Keyword(s):  
Skin Conductance ◽  
Cumulative Risk ◽  
Intradialytic Hypotension ◽  
Multiple Risk Factors ◽  
Non Invasive ◽  
Invasive Test ◽  
Arterial Blood ◽  
A Value ◽  
Increased Risk ◽  
Before And After

Abstract Background and Aims Intradialytic hypotension (IDH) is a common complication in hemodialysis (HD) patients. It is associated with multiple risk factors including cardiac dysfunction and alterations of the peripheral autonomic nervous system. To which extent, dysautonomia may contributed to the occurrence of IHD remains elusive. We sought to investigate the clinical utility of Sudocan®, a device that quantify dysautonomia, in the prediction of IDH. Method We conducted a prospective monocentric study in adult HD patients from July 2019 to February 2020. Dysautonomia was assessed by the measurements of hand and foot Electrochemical Skin Conductance (ESC) by Sudocan®, before and after the end of HD. A pathological hand ESC was defined by an ESC value < 40 μs in Caucasian or < 30 μs in afro-American and Caribbean patients, and a pathological foot ESC by a value < 50 μs in Caucasian or < 30 μs in afro-American and Caribbean patients. Arterial blood pressure (BP) was monitored before, every thirty minutes and after the end of the HD session. The primary end point was the incidence of IDH, according to the NKD/K-DOQI definition, during the 3 month-period study. Results A total of 176 HD patients (64 ±14 years old) were enrolled. Mean pre-dialysis hand and foot ESC were 45±20 μS and 54±22 μS, respectively. Thirty-five and 40% of patients had a pathological ESC at the hand and foot, respectively. Forty-Six IDH occurred during the study period. Logistic regression showed that a pathological hand ESC was associated with an increased risk of IDH [OR=0.39, IC95% (0.15-0.97), p= 0.04]. The cumulative risk incidence of IHD during the study was 2.17 [IC95% (1.21-3.89), p= 0.01] and 1.89 [IC95% (1.06-2.38), p= 0.03], with a pathological hand and foot ESC, respectively. Conclusion A pathological hand ESC, as assessed by a simple, non-invasive test, such as Sudoscan®, is associated with an increased risk of IDH.

Fractional Flow Reserve: Does a Cut-off Value add Value?

2016 ◽  
Vol 11 (1) ◽  
pp. 17
Author(s):  
Shah R Mohdnazri ◽  
◽  
◽  
◽  
Thomas R Keeble ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Intervention ◽  
Grey Zone ◽  
Fractional Flow ◽  
Non Invasive ◽  
Invasive Test ◽  
Flow Reserve ◽  
A Value ◽  
Percutaneous Coronary ◽  
Value Add

Fractional flow reserve (FFR) has been shown to improve outcomes when used to guide percutaneous coronary intervention (PCI). There have been two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with a value of ≤0.75 shown to predict a positive ischaemia test. It was then shown in the DEFER study that a vessel FFR value of ≥0.75 was associated with safe deferral of PCI. During the validation phase, a ‘grey zone’ for FFR values of between 0.76 and 0.80 was demonstrated, where a positive non-invasive test may still occur, but sensitivity and specificity were sub-optimal. Clinical judgement was therefore advised for values in this range. The FAME studies then moved the FFR cut-off point to ≤0.80, with a view to predicting outcomes. The ≤0.80 cut-off point has been adopted into clinical practice guidelines, whereas the lower value of ≤0.75 is no longer widely used. Here, the authors discuss the data underpinning these cut-off values and the practical implications for their use when using FFR guidance in PCI.

scholarly journals OCT angiography metrics predict intradialytic hypotension episodes in chronic hemodialysis patients: a pilot, prospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppe Coppolino ◽  
Adriano Carnevali ◽  
Valentina Gatti ◽  
Caterina Battaglia ◽  
Giorgio Randazzo ◽  
...  
Keyword(s):  
Chronic Hemodialysis ◽  
Dialysis Session ◽  
Intradialytic Hypotension ◽  
Inverse Association ◽  
Non Invasive ◽  
Kaplan Meier ◽  
Optimal Thresholds ◽  
Scanning Area ◽  
Before And After ◽  
Capillary Plexus

AbstractIn chronic hemodialysis (HD) patients, intradialytic hypotension (IDH) is a complication that increases mortality risk. We run a pilot study to analyzing possible relationships between optical coherence tomography angiography (OCT-A) metrics and IDH with the aim of evaluating if OCT-A could represent a useful tool to stratify the hypotensive risk in dialysis patients. A total of 35 eyes (35 patients) were analyzed. OCT-A was performed before and after a single dialysis session. We performed OCT-A 3 × 3 mm and 6 × 6 mm scanning area focused on the fovea centralis. Patients were then followed up to 30 days (10 HD sessions) and a total of 73 IDHs were recorded, with 12 patients (60%) experiencing at least one IDH. Different OCT-A parameters were reduced after dialysis: central choroid thickness (CCT), 6 × 6 mm foveal whole vessel density (VD) of superficial capillary plexus (SPC) and 6 × 6 mm foveal VD of deep capillary plexus (DCP). At logistic regression analysis, IDH was positively associated with baseline foveal VD of SCP and DCP, while an inverse association was found with the choroid. In Kaplan–Meier analyses of patients categorized according to the ROC-derived optimal thresholds, CCT, the 3 × 3 foveal VD of SCP, the 3 × 3 mm and 6 × 6 mm foveal VD of DCP and the 6 × 6 mm foveal VD of SCP were strongly associated with a higher risk of IDH over the 30-days follow-up. In HD patients, a single OCT-A measurement may represent a non-invasive, rapid tool to evaluate the compliance of vascular bed to HD stress and to stratify the risk of IDH in the short term.

scholarly journals Interrelationships between pulse arrival time and arterial blood pressure during postural transitions before and after spaceflight

2019 ◽  
Vol 127 (4) ◽  
pp. 1050-1057
Author(s):  
Katelyn N. Wood ◽  
Danielle K. Greaves ◽  
Richard L. Hughson
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Arrival Time ◽  
Standing Posture ◽  
Pulse Arrival Time ◽  
Arterial Blood ◽  
Increased Risk ◽  
Before And After ◽  
Acute Changes ◽  
Pulse Arrival

We tested the hypothesis that acute changes in arterial blood pressure (BP) when astronauts moved between supine and standing posture before and after spaceflight can be tracked by beat-to-beat changes in pulse arrival time (PAT). Nine male crewmembers (45 ± 7 yr of age; mean mission length: 165 ± 13 days) participated in a standardized supine-to-sit-to-stand test (5 min-30 s-3 min) before flight and 1 day following return to Earth with continuous monitoring of ECG and finger arterial BP. PAT was determined from the R-wave of the ECG to the foot of the BP waveform. On average, modest cardiovascular deconditioning was detected by ~10 beats/min increase in heart rate in supine and standing posture after spaceflight ( P < 0.05). When looking across the full data collection period, the r2 values between inverse of PAT (1/PAT) and systolic (SBP) and diastolic BP (DBP) varied considerably between individuals (SBP preflight 0.142 ± 0.186, postflight 0.262 ± 0.243). Individual variability was consistent during periods of transition (SBP preflight 0.284 ± 0.324, postflight 0.297 ± 0.269); however, when SBP dropped >20 mmHg, r2 was significant in 5 of 5 preflight tests and 5 of 7 postflight tests. The standard error of the estimate based on a simple linear model during both pre- and postflight testing was 9–11 mmHg for SBP and 6–7 mmHg for DBP. Overall, the results support the hypothesis that PAT tracked dynamic changes in BP. PAT as a noninvasive, nonintrusive surrogate for changes in BP could be developed as an indicator of risk for syncope on return from spaceflight or other Earth-based applications. NEW & NOTEWORTHY Astronauts returning to Earth’s gravity are at increased risk of low blood pressure on standing. Arterial pulse arrival time tracked the decrease in arterial blood pressure on moving from supine to upright posture. Nonintrusive technology providing indicators sensitive to acute changes in blood pressure could act as an early warning system to identify risk for hypotension that place astronauts, or people on Earth, at risk of impaired cognitive performance, fainting, and falls.

The effect of nimodipine on intracranial pressure

1987 ◽  
Vol 67 (3) ◽  
pp. 387-393 ◽  
Author(s):  
Mark N. Hadley ◽  
Robert F. Spetzler ◽  
Mary S. Fifield ◽  
William D. Bichard ◽  
John A. Hodak
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Systemic Blood Pressure ◽  
Artery Occlusion ◽  
Content Type ◽  
Arterial Blood ◽  
Increased Risk ◽  
Before And After ◽  
The Right ◽  
Cerebral Artery Occlusion

✓ Nimodipine was administered by intravenous infusion to six male baboons before, during, and after 6 hours of middle cerebral artery occlusion. Intracranial pressure (ICP) and systemic blood pressure were monitored continuously. An epidural balloon was inflated at regular intervals at three levels of arterial CO2 tension (25, 35, and 50 mm Hg) before and after the administration of nimodipine, and volume-pressure curves were generated. In every case, curves generated after intravenous nimodipine infusion were lower and shifted more to the right than the same set of curves generated before nimodipine administration, regardless of the baseline ICP. The reduction in ICP following nimodipine infusion was not due to a reduction in mean arterial blood pressure and was statistically significant at all three levels of pCO2 (p < 0.01). These results suggest that, in the presence of elevated ICP due to cerebral infarction, there is no increased risk of exacerbating intracranial hypertension with the addition of nimodipine.

scholarly journals Fractional Flow Reserve: Does a Cut-off Value add Value?

2016 ◽  
Vol 11 (1) ◽  
pp. 17 ◽  
Author(s):  
Shah R Mohdnazri ◽  
◽  
◽  
◽  
Thomas R Keeble ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Intervention ◽  
Grey Zone ◽  
Fractional Flow ◽  
Non Invasive ◽  
Invasive Test ◽  
Flow Reserve ◽  
A Value ◽  
Percutaneous Coronary ◽  
Value Add

Fractional flow reserve (FFR) has been shown to improve outcomes when used to guide percutaneous coronary intervention (PCI). There have been two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with a value of ≤0.75 shown to predict a positive ischaemia test. It was then shown in the DEFER study that a vessel FFR value of ≥0.75 was associated with safe deferral of PCI. During the validation phase, a ‘grey zone’ for FFR values of between 0.76 and 0.80 was demonstrated, where a positive non-invasive test may still occur, but sensitivity and specificity were sub-optimal. Clinical judgement was therefore advised for values in this range. The FAME studies then moved the FFR cut-off point to ≤0.80, with a view to predicting outcomes. The ≤0.80 cut-off point has been adopted into clinical practice guidelines, whereas the lower value of ≤0.75 is no longer widely used. Here, the authors discuss the data underpinning these cut-off values and the practical implications for their use when using FFR guidance in PCI.

scholarly journals Assessment of Heart Rate Variability in Fibromyalgia after Micro-physiotherapy.

2014 ◽  
Vol 12 ◽  
pp. 189
Author(s):  
Adriano Pinto Pereira ◽  
Eluciene Maria dos Santos Carvalho ◽  
Ivo Ilvan Kerppers ◽  
Meiriélly Furmann ◽  
Juliana Aparecida Wosch Pires ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Low Frequency ◽  
Treatment Method ◽  
The Body ◽  
Autonomous Nervous System ◽  
Self Healing ◽  
Non Invasive ◽  
A Value ◽  
Before And After

Introduction: Fibromyalgia syndrome is characterized by musculo-skeletal pain. Heart rate variability (HRV) is a versatile and promising non-invasive marker of the autonomous nervous system. Micro-physiotherapy involves manual physiotherapy that seeks to identify the primary cause of a disease or symptom and to stimulate self-healing, in which the body recognizes the aggressor (antigen) and begins the elimination process, through cellular and tissue reprogramming. Method: The sample was composed of 15 individuals, aged between 35 and 40 years, with fibromyalgia. The Nerve Express method was used to assess the variability of the heart rate. Two sessions of micro-physiotherapy were conducted using global methods, with an interval of 45 days between sessions. Results: Based on the HRV results, the high frequency band was confirmed at p=0.203, with the low frequency recording a statistically significant value of p=0.001, thereby demonstrating sympathetic activity. Upon comparison of the mean heartbeat before and after treatment, a value of p=0.0006 was obtained. A value of p=0.049 was recorded in the analysis of the median R-R interval values. Conclusion: The use of micro-physiotherapy as a treatment method for fibromyalgia effectively improved the lives of patients by promoting sympathicotonia.

scholarly journals Thoracic electrical bioimpedance in the follow-up of patients with cardiovascular disorders

2005 ◽  
Vol 133 (5-6) ◽  
pp. 297-302
Author(s):  
Vesna Stojanov ◽  
Mirko Saranovic ◽  
Branko Jakovljevic ◽  
Katarina Paunovic
Keyword(s):  
High Frequency ◽  
Invasive Technique ◽  
Non Invasive ◽  
Arterial Blood ◽  
Thoracic Electrical Bioimpedance ◽  
Patients With Heart Failure ◽  
Before And After ◽  
Electrical Bioimpedance ◽  
Low Amplitude

Thoracic electrical bioimpedance is a new non-invasive technique for obtaining haemodynamic parameters. The method involves the passing of low amperage, high frequency current through the thorax. The current induces a change of resistance within the thorax, which is registered by electrodes. The overall impedance of the thorax is a measure of the electrical resistance of the thorax to this high frequency, low amplitude current. In clinical practice, thoracic electrical bioimpedance has been applied in diagnostic, therapeutic, and prognostic use in patients with heart failure and hypertension, patients with pacemakers, within the scope of early diagnosis of implant rejection following heart transplantation, as well as in patients with kidney disorders, before and after dialysis. However, one of its most important applications is in the determination of antihypertensive therapy, because it provides the parameters that reflect the genesis of arterial blood pressure, in assessing these parameters, optimal therapy adjusted to the haemodynamic status of each patient can be prescribed.

The influence of danazol on angiogenesis in endometriosis woman

2016 ◽  
Vol 4 ◽  
pp. 45-53
Author(s):  
Maria Szubert ◽  
Jacek Suzin ◽  
Markus Duechler ◽  
Agata Szuławska ◽  
Małgorzata Czyż ◽  
...  
Keyword(s):  
Analogue Scale ◽  
Case Control Study ◽  
Case Control ◽  
Ca 125 ◽  
Non Invasive ◽  
Invasive Test ◽  
Before And After ◽  
The Given ◽  
Control Study ◽  
Stimulation Of

<b>Background</b>: Angiogenesis and inflammation are pivotal processes in developing endometriosis in the peritoneal cavity. The aim of the study was to evaluate these two processes in women with endometriosis and treated with danazol. The second object of the study was to determine the sensitivity of a non-invasive test combined of studied biomarkers in diagnosing endometriosis.<b> Methods>/b>: The case control study was conducted in a group of 103 women diagnosed laparoscopically for endometriosis. 35 patients were qualified to the treatment with danazol. Pain assessment was in Visual Analogue Scale. Endometriosis was assessed with rASRM scale. In serum Ca-125, CRP, VEGF and IL-1β were determined before and after danazol treatment. IL-8 expression in the endometrium was determined before treatment. <b>Results</b>: Endometriosis group (68.9% of patients) demonstrated a higher concentration of Ca-125 in serum and higher levels of both Ca125 and VEGF in the peritoneal fluid. The expression of mRNA for IL-8 in the endometrium was significantly higher in the study group. After treatment with danazol a lower VAS score and a lower level of Ca-125 (p<0.001) was observed. The concentration of VEGF in plasma increased (p=0.009). For the diagnosis of endometriosis, no combination of the given markers reached a sensitivity higher than 60%. <b>Conclusions</b>: Treatment with danazol is highly effective in relieving pain and decreasing the concentration of Ca-125. A higher level of VEGF in plasma after treatment might imply stimulation of angiogenesis.

scholarly journals Non-invasive detection of upper tract urothelial carcinomas through the analysis of driver gene mutations and aneuploidy in urine

2017 ◽  
Author(s):  
Simeon Springer ◽  
Chung-Hsin Chen ◽  
Lu Li ◽  
Chris Douville ◽  
Yuxuan Wang ◽  
...  
Keyword(s):  
Gene Mutations ◽  
Standard Of Care ◽  
Herbal Remedies ◽  
Driver Gene ◽  
Current Standard ◽  
Upper Tract ◽  
Non Invasive ◽  
Invasive Test ◽  
Urothelial Carcinomas ◽  
Increased Risk

AbstractUpper tract urothelial carcinomas (UTUC) of the renal pelvis or ureter can be difficult to detect and challenging to diagnose. Here, we report the development and application of a non-invasive test for UTUC based on molecular analyses of DNA recovered from cells shed into the urine. The test, called UroSEEK, incorporates assays for mutations in eleven genes frequently mutated in urologic malignancies and for allelic imbalances on 39 chromosome arms. At least one genetic abnormality was detected in 75% of urinary cell samples from 56 UTUC patients but in only 0.5% of 188 samples from healthy individuals. The assay was considerably more sensitive than urine cytology, the current standard-of-care. UroSEEK therefore has the potential to be used for screening or to aid in diagnosis in patients at increased risk for UTUC, such as those exposed to herbal remedies containing the carcinogen aristolochic acid.

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