scholarly journals Hemodynamic Response to Glucose-Insulin Infusion and Meals during Hemodialysis

2020 ◽  
Vol 45 (2) ◽  
pp. 249-262 ◽  
Author(s):  
Christoffer Svinth-Johansen ◽  
Mark Reinhard ◽  
Per Ivarsen
Keyword(s):  
Insulin Infusion ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Hemodynamic Instability ◽  
Maintenance Hemodialysis ◽  
Intradialytic Hypotension ◽  
Hemodynamic Parameters ◽  
Wave Analysis ◽  
Meal Intake ◽  
Meal Study

Introduction: Intradialytic nutrition may improve nutritional status and reduce mortality in patients on maintenance hemodialysis (HD) but has been associated with adverse events, mainly hemodynamic instability. Some dialysis centers therefore restrict intradialytic meals. In 2 clinical studies, we investigated the effects of intradialytic glucose-insulin infusion (GII) and meal intake on blood pressure (BP), pulse wave velocity (PWV), pulse wave analysis (PWA), and cardiac output (CO). PWA yielded augmentation index standardized with heart rate 75 (AIx@HR75). Methods: In the GII study, 12 nondiabetic HD patients had BP, PWV, PWA, and CO measured during 3 HD sessions: standard HD, HD with glucose infusion, and HD with GII. In the Meal study, 12 nondiabetic patients had BP and PWA measured on 3 study days: meal alone (non-HD), meal and HD, 2 meals and HD. Twelve matched healthy controls completed the non-HD day. Findings: In the GII study, glucose or GII had no additional effects on hemodynamic parameters compared with standard HD. HD resulted in a decrease in systolic BP of 13%, in diastolic BP of 9%, in AIx@HR75 of 17%, and CO of 18%. PWV was reduced by only 5%. In the Meal study, a meal alone did not change BP, whereas the combined influence of HD and meal intake reduced systolic BP with 22% and diastolic BP with 19%. Furthermore, AIx@HR75 decreased by 37% on HD days and by 36% in controls, but was unaffected on non-HD days. Discussion: In the GII study, HD significantly reduced BP, AIx@75, and CO, whereas PWV remained almost constant. No additional effects were observed by concomitant GII during HD. BP reductions seemed larger in the Meal study compared with the GII study. Taken together, HD per se appears as the main discriminant for intradialytic hypotension but in hemodynamically unstable patients the timing and route of nutrition provision should be considered carefully.

scholarly journals Associations of Del 301-303 alpha2B-adrenoceptor gene polymorphism with central hemodynamic parameters in the northern Russian population

2018 ◽  
Vol 50 (2) ◽  
pp. 100-101
Author(s):  
Vladimir N. Melnikov ◽  
Victor I. Baranov ◽  
Irina Yu. Suvorova ◽  
Sergey G. Krivoschekov
Keyword(s):  
Cardiac Cycle ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Russian Population ◽  
Coronary Perfusion ◽  
Hemodynamic Parameters ◽  
Wave Analysis ◽  
Central Hemodynamic ◽  
Stratified Analysis ◽  
Timing Structure

The ADRA2B gene 301–303 I/D polymorphism is associated with various cardiovascular phenotypes. However, an association of genotypes with the timing structure of cardiac cycle remains unclear. The central hemodynamic parameters were assessed by pulse wave analysis in 63 residents of the Kola Peninsula (68 N) aged 27–65 yr. The genotypes were determined by PCR. The paired comparisons revealed that II genotype carriers had higher values of augmentation index ( P = 0.014), ejection duration ( P = 0.045), and lower SEVR ( P = 0.035) than DD homozygotes. Multiple regression analysis adjusted for age, body mass index, heart rate, and blood pressure confirmed these results. Further sex stratified analysis showed that the associations existed only in men ( n = 33) whereas in women ( n = 30) the differences were suggestive ( P < 0.1). It is concluded that in a northern Russian population men carrying I allele have stiffer arteries, shorter diastole duration, and impaired coronary perfusion and seem to be at higher risk for cardiovascular diseases than DD carriers.

Acute Cardiovascular Responses to Self-selected Intensity Exercise in Parkinson's Disease

2021 ◽  
Author(s):  
Hélcio Kanegusuku ◽  
Gabriel Grizzo Cucato ◽  
Paulo Longano ◽  
Erika Okamoto ◽  
Maria Elisa Pimentel Piemonte ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Heart Rate ◽  
Parkinson's Disease ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Cardiovascular Responses ◽  
Cycle Ergometer ◽  
Control Session ◽  
Wave Analysis

AbstractParkinson’s disease patients frequently present cardiovascular dysfunction. Exercise with a self-selected intensity has emerged as a new strategy for exercise prescription aiming to increase exercise adherence. Thus, the current study evaluated the acute cardiovascular responses after a session of aerobic exercise at a traditional intensity and at a self-selected intensity in Parkinson’s disease patients. Twenty patients (≥ 50 years old, Hoehn & Yahr 1–3 stages) performed 3 experimental sessions in random order: Traditional session (cycle ergometer, 25 min, 50 rpm, 60–80% maximum heart rate); Self-selected intensity: (cycle ergometer, 25 min, 50 rpm with self-selected intensity); and Control session (resting for 25 min). Before and after 30 min of intervention, brachial and central blood pressure (auscultatory method and pulse wave analysis, respectively), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave analysis) were evaluated. Brachial and central systolic and diastolic blood pressure, heart rate, and the augmentation index increased after the control session, whereas no changes were observed after the exercise sessions (P<0.01). Pulse wave velocity and cardiac autonomic modulation parameters did not change after the three interventions. In conclusion, a single session of traditional intensity or self-selected intensity exercises similarly blunted the increase in brachial and central blood pressure and the augmentation index compared to a non-exercise control session in Parkinson’s disease patients.

scholarly journals Effect of Second hand Smoke on Arterial Stiffness among Healthy Women

2019 ◽  
Vol 18 (2) ◽  
pp. 340-346
Author(s):  
Suriyati Sariban ◽  
Siti Suhaila Mohd Yusoff ◽  
Juwita Shaaban ◽  
Norhayati Mohd Noor ◽  
Harmy Mohamed Yusoff
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Cigarette Smoke ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Pulse Wave Analysis ◽  
Second Hand Smoke ◽  
Wave Analysis ◽  
The Mean

Introduction: Arterial stiffness is recognised as a significant cardiovascular risk factor and an independent predictor of all causes of cardiovascular death. Women are the largest population exposed to cigarette smoke either at work or from their partner. The objectives of this study are to compare the arterial stiffness (augmentation index and pulse wave velocity) between second hand smoke (SHS) and non second hand smoke (non-SHS). Designs and method: Comparative cross-sectional study was conducted among 118 healthy female subjects (64 SHS and 54 non- SHS). The women were in the SHS group if their spouse is a smoker and they had an exposure to cigarette smoke for at least three years, minimum of15 minutes two days a week. Pulse wave analysis and pulse wave velocity was used to study the arterial stiffness. Pulse wave analysis reported as percentage of augmentation index. Pulse wave velocity equal to carotid femoral distance (meter) divided by time (second) Results: The mean augmentation index (AIx) for SHS groups was 17.9 (SD7.06) and for non SHS groups was 20.7(SD6.11). The mean of Pulse wave velocity was 8.94 (SD1.36) in SHS groups and 9.02 (SD8.68) in non SHS groups. ANOVA and ANCOVA shown significance difference in crude mean (p = 0.047) and estimated marginal mean (p = 0.028) of augmentation index between SHS and non - SHS after controlling for age and BMI. However, there was no significant difference in crude mean (p = 0.795) and estimated marginal mean (p = 0.716) pulse wave velocity between SHS and non - SHS after controlling for age and BMI. Conclusion: An increase in augmentation index amongst non SHS in this study most probably due to exposure to environmental tobacco at work compared to exposure to spouse’s smoke Bangladesh Journal of Medical Science Vol.18(2) 2019 p.340-346

Reproducibility of pulse wave velocity and augmentation index measured by pulse wave analysis

1998 ◽  
Vol 16 (Supplement) ◽  
pp. 2079-2084 ◽  
Author(s):  
Ian B. Wilkinson ◽  
Sabine A. Fuchs ◽  
Ilse M. Jansen ◽  
James C. Spratt ◽  
Gordon D. Murray ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Pulse Wave Analysis ◽  
Wave Analysis

The “backstage” of augmentation index evaluated by pulse wave analysis

2014 ◽  
Vol 8 (4) ◽  
pp. e40-e41
Author(s):  
Susana Tello-Blasco ◽  
Rosa Fabregate ◽  
Martín Fabregate ◽  
Cristina Martínez ◽  
Africa Duque ◽  
...  
Keyword(s):  
Pulse Wave ◽  
Augmentation Index ◽  
Pulse Wave Analysis ◽  
Wave Analysis

scholarly journals Evaluation of 24-Hour Arterial Stiffness Indices and Central Hemodynamics in Healthy Normotensive Subjects versus Treated or Untreated Hypertensive Patients: A Feasibility Study

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Stefano Omboni ◽  
Igor N. Posokhov ◽  
Anatoly N. Rogoza
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Central Hemodynamics ◽  
Wave Analysis ◽  
Hypertensive Patients ◽  
Reflected Wave ◽  
Function Impairment ◽  
Normotensive Subjects

Objective. Central blood pressure (BP) and vascular indices estimated noninvasively over the 24 hours were compared between normotensive volunteers and hypertensive patients by a pulse wave analysis of ambulatory blood pressure recordings.Methods. Digitalized waveforms obtained during each brachial oscillometric BP measurement were stored in the device memory and analyzed by the validated Vasotens technology. Averages for the 24 hours and for the awake and asleep subperiods were computed.Results. 142 normotensives and 661 hypertensives were evaluated. 24-hour central BP, pulse wave velocity (PWV), and augmentation index (AI) were significantly higher in the hypertensive group than in the normotensive group (119.3 versus 105.6 mmHg for systolic BP, 75.6 versus 72.3 mmHg for diastolic BP, 10.3 versus 10.0 m/sec for aortic PWV, −9.7 versus −40.7% for peripheral AI, and 24.7 versus 11.0% for aortic AI), whereas reflected wave transit time (RWTT) was significantly lower in hypertensive patients (126.6 versus 139.0 ms). After adjusting for confounding factors a statistically significant between-group difference was still observed for central BP, RWTT, and peripheral AI. All estimates displayed a typical circadian rhythm.Conclusions. Noninvasive assessment of 24-hour arterial stiffness and central hemodynamics in daily life dynamic conditions may help in assessing the arterial function impairment in hypertensive patients.

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