Abstract 4121: Clomipramine Infusion During Tilt Test To Imply The Neurocardiogenic Origin Of Syncopes And Presyncopes Of Unknown Aetiology

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Gael Cinquetti ◽  
Eric Perrier ◽  
Jacques Deroche ◽  
Olivier Manen ◽  
Michel Lerecouvreux ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Challenge Test ◽  
Tilt Test ◽  
Unknown Aetiology ◽  
Significant Difference ◽  
Group A ◽  
Head Up Tilt ◽  
Drug Challenge ◽  
Group B ◽  
Type 3

The aim of this study was to prospectively evaluate the diagnostic accuracy for neurocardiogenic syncopes (NCS) of two Head-Up Tilt table test (HUT) strategies in 991 patients with syncopes/presyncopes of unknown aetiology after negative clinical and non invasive investigations. HUT is a widely accepted tool in the evaluation of patients with evidence of VVS but questions remain about the sensitivity and the use of provocative agents.Clomipramine (CP), a serotonin re-uptake inhibitor, was recently proposed as a new drug challenge test for the diagnosis of neurocardiogenic syncope (NCS). Group A : the first 341 pts (207 male ; mean age = 49,9 ± 23 years) were passively tilted at 60° for 30 minutes (min), then for 15 min with 2 μg/min isoproterenol infusion rate. Group B : the following 650 pts (383 male ; mean age = 48,3 ± 21 years) were tilted at 60° for 20 min with 5 mg CP infused during the first 5 min of tilt. A positive HUT was defined as reproducting the patient’s syncope or presyncope, associated with an abrupt fall in blood pressure (systolic blood pressure <80 mmHg) and/or concomitant bradycardia (<50 beats/min). Positives responses were classified in 3 types according to the Brignole’s modification of the VASIS classification. There was no significant difference between group A/B in sex or age. Group A : Positive HUT* : 103 (Sensitivity : 30,2%) Group B : Positive HUT* : 382 (Sensitivity : 58,8 %) (*) type 1 : 36 vs 157 ; type 2A : 8 vs 13 ; Type 2B: 9 vs 57 (14,9%) ; Type 3 : 50 vs 155. No adverse effect was noticed. CP during HUT increase significantly the accuracy of the test for NCS diagnosis, especially for type 2B answers, and patients <30 yo. The duration of the test is notably shortened, and the tolerance is remarkable. If previously reported specificity (87 to 94%) was confirmed, CP-HUT might be the most valuable tool in the evaluation of pts with syncopes/presyncopes of unknown aetiology.

scholarly journals Analisis Efektivitas Kontrol Penurunan Tekanan Darah pada Pasien Hipertensi yang Mendapat Terapi Obat Antihipertensi Golongan Angiotensin Receptor Blocker’s (Candersartan, Valsartan, Kalium Losartan)

2017 ◽  
Vol 2 (2) ◽  
pp. 9-14
Author(s):  
Ninik Mas Ulfa
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Therapy Group ◽  
Age Factors ◽  
Blood Pressure Reduction ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B

ABSTRAKHipertensi adalah peningkatan tekanan darah sistolik lebih dari 140 mmHg dan tekanan darah diastolik lebih dari 90 mmHg pada dua kali pengukuran dengan selang waktu lima menit dalam keadaan cukup istirahat. Faktor penyebab hipertensi adalah faktor gaya hidup, faktor genetika dan faktor usia. Hipertensi termasuk dalam penyakit degeneratif dimana terjadi penurunan organ tubuh. Tujuan dari penelitian ini adalah untuk mengetahui efektifitas kontrol penurunan teakanan darah dari terapi obat Candersartan, Valsartan dan Kalium Losartan. Pada penelitian ini dilakukan di RS X wilayah Surabaya Selatan dan RS Y wilayah Surabaya Timur. Penelitian ini bersifat retrospektif dengan pengamatan observasioanl. Penelitian ini terbagi dalam 3 kelompok terapi dengan jumlah total populasi adalah 57 pasien. Data tekanan darah sistolik-diastolik diamati selama 5 bulan terapi darimasing-masing kelompok terapi A (Candersartan n = 19), kelompok terapi B (Valsartan n= 19), dan kelompok terapi C (Kalium Losartan n= 19).Hasil penelitian menunjukkan bahwa terjadi penurunan tekanan darah sistolik pada kelompok A sebesar 21,18%, kelompok B = 24,20%, dan kelompok C = 22,51%. Penurunan tekanan darah diastolic pada kelompok A sebesar 12,14%, kelompok B = 14,04% dan kelompok C = 10,98%. Berdasarkan hasil analisa statistik diperoleh hasil p = 0,967 > α = 0,05 yang berarti tidak ada perbedaan yang bermakna dari ketiga kelompok terapi tersebut dalam penurunan tekanan darah sistolik maupun diastolik pada pasien hipertensi. Hal ini berarti bahwa efektifitas ketiga obat tersebut dalam kontrol penurunan tekanan darah pada pasien Hipertensi mempunyai efektifitas yangKata Kunci: Candersartan, Valsartan, Kalium Losartan, HipertensiABSTRACTHypertension is an increase in systolic blood pressure of more than 140 mmHg and diastolic blood pressure of more than 90 mmHg in two measurements with an interval of five minutes in a resting state. Factors causing hypertension are lifestyle factors, genetic factors and age factors. Hypertension is included in degenerative diseases where there is a decrease in body organs. The purpose of this study was to determine the effectiveness of blood pressure control of Candersartan, Valsartan and Potassium Losartan. This research was conducted in RS X of South Surabaya and RS Y of East Surabaya. This study is retrospective with observational. The study was divided into 3 therapeutic groups with a total population of 57 patients. Data on systolic-diastolic blood pressurewere observed for 5 months of therapy from each of the therapy groups A (Candersartan n = 19), therapy group B (Valsartan n = 19), and therapy group C (Potassium Losartan n = 19). That there was a decrease in systolic blood pressure in group A of 21,18%, group B = 24,20%, and group C = 22,51%. Diastolic blood pressure decrease in group A was 12,14%, group B = 14,04% and group C = 10,98%. Based on the results of statistical analysis obtained results p = 0.967> α = 0.05 which means there is no significant difference of the three groups of therapy in the reduction of systolic blood pressure and diastolic in hypertensive patients. This means that the effectiveness of the three drugs in the control of blood pressure reduction in hypertensive patients has the same effectiveness.Key Words: Candersartan, Valsartan, Potasium Losartan, Hypertesion

scholarly journals Cardiovascular Changes in Smoker and Nonsmoker Male Stroke Patients

2010 ◽  
Vol 14 (Number 1) ◽  
pp. 32-35
Author(s):  
N Habib ◽  
Md. R Amin ◽  
US N Begum ◽  
N Akhter ◽  
D Akther ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Descriptive Study ◽  
Stroke Patients ◽  
Medical College ◽  
Significant Difference ◽  
Group A ◽  
Altered Physiology ◽  
Group B

This descriptive study was done in the Deponment of Physiology. Dhaka Medical College, Dhaka. during the period of January 2008 to December 2008. The objective of the study was to measure pulse and blood pressure in smokers and nonsmoker adult male stroke patients and to find out changes in pulse and blood pressure among the smoker and non-smoker stroke patients. To accomplish this purpose 105 patient of over 20 years of age were selected. They were divided into two groups: Group A consisting of thirty n on-smoker and group B consisting of seven,' five smoker stroke patients. The finding showed that smoking caused no statistical significant difference 1p>0.05) in pulse and systolic blood pressure among she groups. Diastolic blood pressure was significantly higher (p<0.05) fill smokers than non-smokers. The study therefore provides the scope to understand the altered physiology of smoker stroke pollen's.

scholarly journals Comparative Study of Propofol and Etomidate on the Haemodynamic Effects During Induction and Endotracheal Intubation

2019 ◽  
Vol 18 (2) ◽  
pp. 7-15
Author(s):  
Mallika Rayamajhi ◽  
Puja Thapa ◽  
Anjan Khadka ◽  
Biswa Ram Amatya ◽  
Udaya Bajracharya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Endotracheal Intubation ◽  
Arterial Blood ◽  
Significant Difference ◽  
Group A ◽  
Blood Pressures ◽  
Group B ◽  
Induction Agents

Introduction: While most intravenous induction agents decrease arterial blood pressure, laryngoscopy and endotracheal intubation increase the heart rate and blood pressure. Propofol causes a decrease in systemic blood pressure whereas etomidate has minimal effects on the cardiovascular system. This study aims to evaluate and compare the hemodynamic effects of propofol and etomidate during induction and endotracheal intubation. Methods: 62 ASA I and II patients, 20-60 years of age, scheduled for elective surgery were enrolled in this prospective, randomised and double blind comparative study. Group A received inj. Propofol (2 mg/kg) and group B received inj. Etomidate (0.3 mg/kg), as induction agents. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded after induction and after intubation at one, three, five and ten minutes and intergroup comparisons were made. Results: After induction the decrease in systolic, diastolic and the mean arterial pressures were more in group A compared to group B (p = 0.003, 0.004 and 0.002). After 1 minute of intubation all haemodynamic parameters increased from the baseline with no significant differences between the two groups (p >0.05). At three minutes the decrease in heart rate, diastolic blood pressure and mean arterial pressure was more in group A than group B with p values of 0.001, 0.002 and 0.05, however systolic blood pressures showed no significant difference (p = 0.144). The decrease in blood pressures showed significant difference between the two groups (p <0.05) at five and ten minutes but the decrease in heart rate remained significant only at five minutes of intubation (p = 0.001). Conclusions: Propofol and etomidate are both effective in preventing the haemodynamic changes due to induction and endotracheal intubation, with etomidate providing more haemodynamic stability.

Anti-hypertensive Effect of Chunghyul-dan (Qingxue-dan) on Stroke Patients with Essential Hypertension

2005 ◽  
Vol 33 (03) ◽  
pp. 357-364 ◽  
Author(s):  
Sang Pil Yun ◽  
Woo Sang Jung ◽  
Seong Uk Park ◽  
Sang Kwan Moon ◽  
Chang Nam Ko ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Rate ◽  
Blood Pressure Monitoring ◽  
Blood Pressure Reduction ◽  
Drug Intake ◽  
Stroke Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Stage 1

Hypertension is one of the modifiable risk factors for stroke. Lowering blood pressure is helpful for primary and secondary prevention of stroke. This study is aimed to assess the efficacy of Chunghyul-dan on stroke patients with stage 1 hypertension using 24 hours ambulatory blood pressure monitoring (24ABPM). Forty hospitalized stroke patients with stage 1 hypertension were included in the study and they were randomly assigned into two groups: group A was treated with Chunghyul-dan 1200 mg once a day for 2 weeks, while group B was not. Twelve subjects were dropped out because of unexpected early discharge or data errors, thus the remaining 28 subjects were included in the final analysis (15 in group A and 13 in group B). Blood pressure was monitored every 30 minutes for 24 hours at baseline and 2 weeks after medication. Blood pressure, pulse rate, trough/peak ratio (TPR) [the value calculated by dividing the blood pressure change at trough (22 to 24 hours after drug intake) by the change at peak (2 adjacent hours with a maximal blood pressure reduction between the second and eighth hour after drug intake)] and smoothness index (SI) (the value calculated as the ratio between the average of the 24 hours, treatment-induced blood pressure changes and its standard deviation) were compared to assess the efficacy of Chunghyul-dan. To assess the safety of Chunghyul-dan, any adverse effects during medication period were monitored. There was no significant difference in the baseline assessment between the two groups. Systolic blood pressure was lower in group A than in group B (141.37 ± 8.96 mmHg versus 132.28 ± 9.46 mmHg , P = 0.03), while diastolic blood pressure and pulse rate had no significant difference between the two groups. Systolic TPR and SI was 0.87 and 1.04 in group A, respectively. This suggests that Chunghyul-dan have anti-hypertensive effect on stroke patients with stage 1 hypertension.

scholarly journals Bronchial Hyperresponsiveness in Adults with Seasonal and Perennial Rhinitis: Is There a Link for Asthma and Rhinitis?

2002 ◽  
Vol 15 (1) ◽  
pp. 69-73 ◽  
Author(s):  
G. Riccioni ◽  
R. Della Vecchia ◽  
M. Castronuovo ◽  
V. Di Pietro ◽  
R. Spoltore ◽  
...  
Keyword(s):  
Challenge Test ◽  
Bronchial Hyperresponsiveness ◽  
Exposure Period ◽  
Epidemiological Studies ◽  
Response Curves ◽  
Mean Values ◽  
Significant Difference ◽  
Group A ◽  
Perennial Rhinitis ◽  
Group B

Epidemiological studies have shown that asthma and rhinitis often coexist in the same patients and the prevalence of asthma is greater in patients with rhinitis. The aim of this study was to evaluate the differences in bronchial reactivity in subjects with seasonal and perennial rhinitis. We enrolled 128 subjects with seasonal or perennial allergic rhinitis divided into three groups: A with perennial rhinitis and allergy to “Dermatophagoides Pteronissynus”; B with seasonal rhinitis and allergy to “Graminae” and “Parietaria”, who underwent methacholine challenge test (MCHt) during the exposure period (fron March until May); C with seasonal rhinitis and allergy to “Graminae” and “Parietaria”, who underwent MCHt during the non exposure period (from June until February). The PC20 mean values of group A (1774.8 ± 20.7) and group B (1740.7 ± 38.8) were not significantly different, but significantly lower than those of group C (3010.0 ± 56.9) (p=0.001). The subjects with group A were positive to the MCHt in 54.54%, against 29.28% of group B and 11.62% of group C (p=0.007). The results show differences in the degree of bronchial responsiveness. The dose-response curves documented a lower value of PC20 in the group with perennial rhinitis and a statistically significant difference of bronchial hyperresponsiveness prevalence between the three groups (p=0.007).

scholarly journals Assessment of the Cardioankle Vascular Index in Pregnant Women Complicated with Hypertensive Disorders

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Atsushi Yoshida ◽  
Takashi Sugiyama ◽  
Norimasa Sagawa
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Pulse Wave ◽  
Chronic Hypertension ◽  
Significant Difference ◽  
Group A ◽  
The Subject ◽  
The Difference ◽  
Group B ◽  
Group D

It was previously reported that the brachial-ankle pulse wave velocity (baPWV) is elevated in preeclamptic women. However, baPWV is strongly affected by blood pressure. Recently, a new index of vascular stiffness, the cardioankle vascular index (CAVI), was developed. CAVI is thought to be an index independent of blood pressure. We assessed CAVI in normotensive and hypertensive pregnant women. We studied a total of 109 Japanese women consisting of 23 nonpregnant healthy women (group A), 45 normotensive pregnant women (group B), 28 pregnant women complicated with established preeclampsia (group C), and 13 pregnant women with chronic hypertension (group D). The subject remained supine while the blood pressure, baPWV, and CAVI were recorded. No significant difference in baPWV was present between groups C and D, but the difference in CAVI was significantly high in group D. We believe that we can distinguish the vessel structural change between chronic hypertension and preeclampsia through simultaneous baPWV and CAVI measurements.

scholarly journals Role of antihypertensives drugs on proteinuria in patients with chronic kidney disease and hypertension

2017 ◽  
Vol 6 (10) ◽  
pp. 2522
Author(s):  
Ritu Bala ◽  
Harminder Singh ◽  
. Rupali ◽  
Kuhu Verma
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
P Value ◽  
Biochemical Tests ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Hypertension is the most prevalent cardiovascular disease and the relevant data suggest that the burden, risk factors and co-morbidities associated with the essential hypertension is increasing with every passing day. It is one of the major chronic diseases resulting in high mortality and morbidity in today’s world. Aim: The aim of the study was to compare effects of cilnidipine and amlodipine on the blood pressure (BP), heart rate and proteinuria among patients of hypertension with chronic kidney disease.Methods: 100 patients were included in this study. Patients were randomly assigned into two groups Group A and Group B (50 each). Group A: Patients received Cilnidipine (5-10mg/day). Group B: Patients received amlodipine (5-10mg/day).Results: No significant difference in SBP, DBP, MBP and proteinuria while comparing both the groups of patients taking cilnidipine and amlodipine at baseline i.e. 0 to 12 week, 12 to 24 weeks and 0 to 24 weeks. Cilnidipine caused decrease in HR 0 to 12 week (p value 0.001), 12 to 24 weeks (p value 0.001) and 0 to 24 weeks (p value 0.0001). Amlodipine had increased heart rate from baseline to 12 weeks (p value 0.0001), 12 to 24 weeks (p value 0.051) and 0 to 24 weeks (p value 0.001). No significant difference was seen in any biochemical readings.Conclusions: There was a significant change in all the parameters including BP, heart rate, proteinuria and other biochemical tests when they compared within the group but no significant difference while comparing both the groups.

scholarly journals Clinical Study on the Effects of Different Positions on Supine Hypotensive Syndrome in Cesarean Section after Lumbar Anesthesia

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Chunyan Zhao ◽  
Yi Tang ◽  
Cibo Chen ◽  
Bingchun Xia
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
Supine Position ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Significant Difference ◽  
Group A ◽  
Hypotensive Syndrome ◽  
Group B

Aim: To explore the effects of different positions on supine hypotensive syndrome in cesarean section after lumbar anesthesia. Methods: 600 full-term parturient were randomly divided into 4 groups. The patented positioning pads (patent number: ZL 2017 2 0618886.5) in our department was used in the left-leaning position. The parturient lied in a supine position for anesthesia in, and then the group of positioning pads was placed after turning into the lateral position. The parturient were divided into group A (supine position), group B (left-leaning to 10 °), group C (left-leaning to 20 °), and group D (30 °). Observation index: Main index: Comparison of maternal blood pressure changes and neonatal blood gas analysis in the supine position without using a position pad and with the use of patent positioning pads in different tilt angles (10°, 20°, 30°). Minor index: 1) the use and frequency of vasoactive drugs, whether a left-leaning operating bed or uterine displacement is required; 2) the consciousness of the parturient; 3) newborn’s Apgar scores of 1 minute, 5 minutes, and 10 minutes after birth; 4) whether the obstetrician can perform the operation smoothly in the corresponding left leaning position. Results: The blood pressure at the supine position after anesthesia, the beginning of surgery and the time when the newborn was delivered in group A and group B were significantly different from those in group C (P<0.05). There were significant differences at different timings in group A and group B, and the decline was more significant at the supine position after anesthesia, the beginning of surgery and the time when the newborn was delivered (P<0.05). The pH value of blood gas analysis of newborns in group A, group B and group C was between 7.25 and 7.37, and there was no significant difference between the three groups (P?0.05). Conclusion: The use of positioning pads can prevent the adverse effects of supine hypotensive syndrome on parturient and newborns to a certain extent.

GESTATIONAL HYPERTENSION

2018 ◽  
Vol 21 (05) ◽  
pp. 969-974
Author(s):  
Kinza Alam ◽  
Ayesha Snover ◽  
Sarwat Navid ◽  
Shahida Tasneem
Keyword(s):  
Blood Pressure ◽  
Uric Acid ◽  
Birth Weight ◽  
Serum Uric Acid ◽  
Gestational Hypertension ◽  
Maternal Outcome ◽  
Fetal Mortality ◽  
Significant Difference ◽  
Group A ◽  
Group B

… Objective: Aim of the study was to ascertain prospectively the prognostic value of serum uric acid for fetal and maternal outcomes in women with gestational hypertension. Patients and Methods: This prospective study was conducted at department of Gynae & Obs, Maternal and Child Health Center, PIMS Islamabad, from January to December 2003. A total of 200 women with a gestational age >20 weeks, and blood pressure >130/90 mmHg were inducted in the study. At presentation serum uric acid, creatinine, hemoglobin, and platelets were measured along with blood pressure. All patients were divided into group A (uric acid <4.5 mg/dl) and group B (>4.5 mg/dl) and were followed for one month after the delivery to record pregnancy and neonatal outcome. Results: A significant difference (p<0.05) in the levels of uric acid, hemoglobin, platelet count, creatinine and blood pressure was noted between patients of group A and B. A significant decrease (p<0.05) in preterm delivery, baby birth weight and increase in fetal mortality was noted in patients of group B as compared to those of group A. Regarding maternal outcome preeclampsia (p=0.005, CI: 0.143-0.689), deranged liver functions (p=0.000, CI: 0.062-0.397), and disseminated intravascular coagulation (p=0.005; CI: 0.049-0.626) was noted in patients of group B as compared to group A. The patients of Group B showed a significant low birth weight, increased fetal mortality rate (p=0.005, CI: 0.030-0.622) and more chances of shifting neonates to NICU (p=0.002, CI: 0.164-0.667) as compared to those of group A. Conclusions: Hyperuricaemia in setting of gestational hypertension was associated with adverse fetal and maternal outcome.

scholarly journals Comparison of ropivacaine alone or with dexamethasone as an adjuvant for reducing pain during positioning for neuraxial blockade with ultrasound-guided fascia iliaca compartment block

2020 ◽  
Vol 8 (6) ◽  
pp. 2270
Author(s):  
Suvir Dubey ◽  
Uday Ambi ◽  
Priya Taank ◽  
Shalendra Singh ◽  
Vikas Marwah
Keyword(s):  
Blood Pressure ◽  
Hip Fracture ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Gradual Improvement ◽  
Neuraxial Blockade ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Comparison of ropivacaine alone or with dexamethasone as an adjuvant for reducing pain during positioning for neuraxial blockade with ultrasound-guided fascia iliaca compartment block.Methods: In this double-blinded study, a total of 60 patients between 18 to 80 years of age, undergoing surgery for hip fracture were enrolled. Patients in Group A received 40 ml of 0.25% ropivacaine +2 ml saline and patients in Group B received 40 ml of 0.25% ropivacaine +8 mg dexamethasone. USG guided FICB and postoperative monitoring was done by the chief investigator who was unaware of group allotted and drug administered.Results: There is no significant difference in the heart rate between the two groups after 30 min of the block. The variation of systolic blood pressure of both the group for the first 30 min after giving FICB block was not significant (p>0.05). The absolute value of diastolic blood pressure (DBP) was significantly lower in Group B compared to group A just before the block, a variation of DBP with time was not significant. There was a gradual improvement of pain score from mean 6.7 in Group A and 6.6 in Group B at 0 min to score of 2 at the end of 30 min in both the group. This improvement was achieved earlier in Group B compared to Group A, although the difference was not significant (p>0.05). Vital parameters like HR, SBP, DBP, SpO2 values were similar in both the groups. No patients in either group required any interventions both pre-operatively and pos-operatively. Time of rescue analgesia was noted with the VAS score was significantly more in Group B (p≤0.004). The incidence of hematoma, accidental intravascular injection, convulsion, and paresthesia were nil in both groups.Conclusions: Although both the groups had comfortable and pain-free positioning for administering spinal anaesthesia before surgery. USG guided FICB is easy to perform block and give excellent analgesia for positioning and mobilization of hip fracture patients pre and post-operatively both, and dexamethasone as an adjuvant to 0.25%ropivavaine prolong its local anesthetic effect significantly.

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