Abstract WP46: Blood Pressure, Clinical Improvement And Recanalization Following Acute MCA Occlusion

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Nandakumar Nagaraja ◽  
Steven Warach ◽  
Amie W Hsia ◽  
Sungyoung Auh ◽  
Lawrence L Latour ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Improvement ◽  
Clinical Information ◽  
Collateral Flow ◽  
Stroke Patients ◽  
Mca Occlusion ◽  
The Mean ◽  
The Difference ◽  
Pre Treatment ◽  
B Test

Background: Blood pressure (BP) drop in the first 24 hours after stroke onset may occur in response to vessel recanalization. Clinical improvement could be due to recanalization or better collateral flow with persistent occlusion. We hypothesize that patients with combination of significant improvement on the NIHSS and a drop in BP at 24hr post tPA is associated with recanalization. Methods: We included intravenous t-PA patients from the Lesion Evolution of Stroke Ischemia On Neuroimaging (LESION) registry who had pre-treatment and 24 hour MRA scan, NIHSS scores at those times and an M1 MCA occlusion at baseline, but excluded those on pressors, pre tPA SBP<120 and tandem ICA occlusion. We classified recanalization status on the 24 hour MRA as none, partial or complete. We abstracted all BP measurements for the first 24 hours from the chart and calculated BP drop as the difference of the triage pre-tPA BP and the average of the last 3 hour readings preceding the 24 hour MRI. NIHSS improvement was defined as ≥4points improvement on NIHSS or NIHSS of 0 at 24hour. Patients with combination of drop in BP and NIHSS improvement were compared with others for recanalization status on 24hr MRA by Kendall Tau-b test. Results: Seventeen patients met the study criteria. There were 13 women, the mean age was 76 years and the median baseline NIHSS was 15. On the 24 hour MRA, 3, 8 and 6 patients had none, partial and complete recanalization, respectively. Patients with NIHSS improvement and a SBP drop ≥20 mmHg were more like to have recanalization at 24 hrs (57% Vs 0%, p=0.03). Similar patterns were seen for patients with NIHSS improvement and DBP drop ≥5mmHg (50% Vs 0%, p=0.04) or MAP drop ≥20mmHg (50% Vs 0%, p=0.04). Complete recanalization was only associated with the combination of NIHSS improvement with SBP drop ≥ 20mmHg (66% Vs 0%, p=0.04). A significant association was not found for recanalization with NIHSS improvement alone or drop in BP alone. Conclusion: There is an association of clinical improvement and BP drop in patients who recanalize. Bedside clinical information may be useful in the management of stroke patients.

scholarly journals Switch Strategy from Direct Aspiration First Pass Technique to Solumbra Improves Technical Outcome in Endovascularly Treated Stroke

2021 ◽  
Vol 18 (5) ◽  
pp. 2670
Author(s):  
Enrico Pampana ◽  
Sebastiano Fabiano ◽  
Gianluca De Rubeis ◽  
Luca Bertaccini ◽  
Alessandro Stasolla ◽  
...  
Keyword(s):  
Added Value ◽  
Stroke Patients ◽  
First Line ◽  
Anterior Circulation ◽  
First Pass ◽  
Procedural Time ◽  
The Mean ◽  
The Difference ◽  
Number Of Passes ◽  
Switch Strategy

Background: The major endovascular mechanic thrombectomy (MT) techniques are: Stent-Retriever (SR), aspiration first pass technique (ADAPT) and Solumbra (Aspiration + SR), which are interchangeable (defined as switching strategy (SS)). The purpose of this study is to report the added value of switching from ADAPT to Solumbra in unsuccessful revascularization stroke patients. Methods: This is a retrospective, single center, pragmatic, cohort study. From December 2017 to November 2019, 935 consecutive patients were admitted to the Stroke Unit and 176/935 (18.8%) were eligible for MT. In 135/176 (76.7%) patients, ADAPT was used as the first-line strategy. SS was defined as the difference between first technique adopted and the final technique. Revascularization was evaluated with modified Thrombolysis In Cerebral Infarction (TICI) with success defined as mTICI ≥ 2b. Procedural time (PT) and time to reperfusion (TTR) were recorded. Results: Stroke involved: Anterior circulation in 121/135 (89.6%) patients and posterior circulation in 14/135 (10.4%) patients. ADAPT was the most common first-line technique vs. both SR and Solumbra (135/176 (76.7%) vs. 10/176 (5.7%) vs. 31/176 (17.6%), respectively). In 28/135 (20.7%) patients, the mTICI was ≤ 2a requiring switch to Solumbra. The vessel’s diameter positively predicted SS result (odd ratio (OR) 1.12, confidence of interval (CI) 95% 1.03–1.22; p = 0.006). The mean number of passes before SS was 2.0 ± 1.2. ADAPT to Solumbra improved successful revascularization by 13.3% (107/135 (79.3%) vs. 125/135 (92.6%)). PT was superior for SS comparing with ADAPT (71.1 min (CI 95% 53.2–109.0) vs. 40.0 min (CI 95% 35.0–45.2); p = 0.0004), although, TTR was similar (324.1 min (CI 95% 311.4–387.0) vs. 311.4 min (CI 95% 285.5–338.7); p = 0.23). Conclusion: Successful revascularization was improved by 13.3% after switching form ADAPT to Solumbra (final mTICI ≥ 2b was 92.6%). Vessel’s diameter positively predicted recourse to SS.

scholarly journals COGNITIVE IMPAIRMENT, THEIR DYNAMICS AND STRUCTURE IN THE ACUTE AND RECOVERY PERIODS OF STROKE, DEPENDING ON ARTERIAL HYPERTENSION SEVERITY AND DURATION

2018 ◽  
Vol 13 (3-4) ◽  
pp. 22-27
Author(s):  
T.M. Cherenko ◽  
Yu.L. Heletyuk
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Cognitive Status ◽  
Neurological Deficits ◽  
Stroke Patients ◽  
Mean Values ◽  
Post Stroke ◽  
The Mean

Relevance. Cognitive impairment is common in the post-stroke period. Different characteristics of arterial hypertension (AH), namely its severity, duration and variability of blood pressure, can affect the development of cognitive impairment in stroke patients. Objective: to investigate cognitive impairment, their dynamics and structure in acute and recovering stroke periods, depending on the arterial hypertension severity and duration. Materials and methods. 150 patients with a primary ischemic stroke and history of hypertension: 74 (49,3 %) women and 76 (50,7 %) men, the mean age (67,4±0,7) years have been examined. Neurological deficits was evaluated by the NIHSS scale. The cognitive status was evaluated by the MMSE scale at the end of an acute period of 21 days and 1 year. Diagnosis of hypertension was based on the clinical and instrumental examination results and medical documents. Daily blood pressure monitoring was using on admission and every 4 hours during 6 days of acute stroke stage. Mean SBP, mean DBP, maximum SBP and DBP, standard deviation (SD) of SBP and DBP were studied. Results. By the mean score on the MMSE scale, there are differences in patients during acute post-stroke period, depending on the severity of hypertension: 27,2±0,6 points in the case of hypertension stage 1, 24,3±0,6 in the case of hypertension stage 2 and 20,7±0,8 in case of AH stage 3, (p=0.001). By this indicator, patients with different AH duration were different: 26,4±0,9 points; 25,1±0,5 points; 20,5±0,7 points, respectively. The significance of these differences by the mean values of MMSE score was obtained in patients with a duration of AH less than 5 years and more than 10 years, as well as when comparing the group of "6-10 years" and "over 10 years" (p=0,001). Significant differences in the structure of cognitive deficits severity, depending on the hypertension stage and its duration, were observed only in patients with moderate and severe stroke (p=0,006). Cognitive deterioration a year after a stroke was observed in 40 (31,5 %) patients. They have significantly higher mean values SD 1-3, SD 1-6, SBP on the first day after a stroke, and duration of hypertension. Conclusions. The relationship between the degree of intellectual decline and the duration of hypertension (r=0,592, p=0,001), severity of hypertension (r=0,459, p=0,001) was found. The severity of the neurological deficiency affects the structure of cognitive impairment at discharge in patients with different severity and duration of hypertension, and higher mean values of the variability of blood pressure from 1 to 6 days, SBP on the first day after stroke and higher duration of hypertension in the history is associated with a negative dynamics of cognitive impairment in stroke patients in a year after stroke.

scholarly journals INVESTIGATION ON PRE-TREATMENT PROCESS IN MICROCRYSTALLINE CELLULOSE (MCC) FROM OIL PALM EMPTY FRUIT BUNCH (EFB)

2018 ◽  
Vol 3 (1) ◽  
pp. 87-96
Author(s):  
Muhammad Arif Fahmi Supian ◽  
Khairatun Najwa Mohd Amin ◽  
Saidatul Shima Jamari ◽  
Shahril Mohamad
Keyword(s):  
Microcrystalline Cellulose ◽  
Morphological Characteristics ◽  
Alkaline Treatment ◽  
Empty Fruit Bunch ◽  
Characteristic Peak ◽  
Reinforcing Agent ◽  
Good Potential ◽  
The Mean ◽  
The Difference ◽  
Pre Treatment

In this study, microcrystalline cellulose (MCC) was extracted from empty fruit bunch (EFB) with alkaline treatment, bleaching and acid hydrolysis treatment and its properties were compared with commercial MCC. Two conditions were optimized in this study which are fiber consistency and sodium hydroxide (NaOH) concentration in alkaline pretreatment. The obtained optimum consistency and alkaline concentration are 5% and 20%respectively. The physicochemical and morphological characteristics, elemental composition and size distribution of the obtained alpha cellulose and MCC were analyzed in this work. Fourier transform infrared spectroscopy (FTIR) analysis provided clear evidence that the characteristic peak of lignin and hemicellulose were absent in the spectrum of the alpha cellulose and MCC. The difference in surface morphology and aggregation between alpha cellulose, MCC and commercialized MCC were observed by scanning electron microscopy (SEM). The mean length of approximately 251.3 μm, 41.4 μm and 138.6 μm were measured for alpha cellulose, MCC and commercialized MCC respectively. Thus, the isolated MCC from EFB has a good potential to be utilized as reinforcing agent in green composites and may be a precursor for future roselle derived nanocellulose, and thus a promising subject in nanocomposite research.

scholarly journals The Difference of Blood Pressure between the Paretic and the Intact Arm of Stroke Patients

1987 ◽  
Vol 15 (1) ◽  
pp. 205-208
Author(s):  
Shunichi YAGI ◽  
Shuichi ICHIKAWA ◽  
Tetsuo SAKAMAKI ◽  
Yoshiaki TAKAYAMA ◽  
Kazuhiko MURATA ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Stroke Patients ◽  
The Difference

Abstract P199: Keep Moving, Your Health Depends On It: Impact Of Improved Physical Activity And Weight Loss In A Wellness Program

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ebenezer T Oni ◽  
Ehimen Aneni ◽  
Maribeth Rouseff ◽  
Thinh Tran ◽  
Henry Guzman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Weight Loss ◽  
Intervention Program ◽  
South Florida ◽  
Metabolic Equivalents ◽  
Baseline Weight ◽  
The Mean ◽  
The Difference

Negative impact of CVD as the leading cause of death in the US is worsened by the significant burden of obesity and associated morbidity and concerns about the growing population inactivity. The American Heart Association has emphasized worksite-based interventions to improve CV health. We evaluated the benefits of improved physical activity(PA) and weight loss(WL) among employees of the Baptist Health South Florida enrolled in a wellness intervention program. Methods: Employees with two or more Cardio-metabolic risk factors , such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were enrolled in an intervention program themed “My unlimited potential”. Interventions were focused on diet and PA modifications. We defined improved physical activity as the difference in the metabolic equivalents (METs) at 12 weeks follow-up and at baseline. WL (lbs) was the difference in weight at follow-up. The relationship between WL and changes in METs was explored in an ordered logistic regression. Results: Overall 203 (48±10 years, 78% females) employees were enrolled with a retention rate of 89% (n=181) at 12 weeks follow-up. At baseline the median weights was 211 lbs., and mean METs- 8.6, while at follow-up the median weight was 200 lbs, and the mean METs 11. At 12 weeks follow up 38% had significant WL (lost >5% of baseline weight). The median WL was 8.4 (IQR 4.8-13.0) lbs and the mean change in METs was 2.4±1.8. Median WL increased with increasing tertiles of METs change; tertile1- 6.5(4-11) lbs., tertile2- 9(6-13)lbs. tertile3- 11(7-15)lbs. Increased PA was related to increased WL across BMI categories adjusting for age, gender and baseline weight. Conclusion: This study points strongly toward the benefit of increasing PA among other lifestyle modification interventions in controlling weight. Although further follow-up of this population to evaluate sustainability of change is needed, our results clearly relate improved PA and health.

Blood Pressure Estimation with Considering of Stroke Volume Effect

2008 ◽  
pp. 173-180
Author(s):  
Moha’med O. Al-Jaafreh ◽  
Adel A. Al-Jumaily
Keyword(s):  
Blood Pressure ◽  
Stroke Volume ◽  
Applied Pressure ◽  
Peripheral Resistance ◽  
Volume Effect ◽  
Signal Features ◽  
Measure Blood Pressure ◽  
The Mean ◽  
The Difference ◽  
Blood Pressure Estimation

The mean arterial pressure (MAP) is a very important cardiovascular parameter for physicians to diagnose various cardiovascular diseases. Many algorithms were used to estimate MAP with different accuracy. These algorithms used different factors, such as blood level, pulses, and external applied pressure, photo-plethysmography (PPG) signal features, heart rate (HR), and other factors. In addition, some natural-based techniques were employed to minimize the difference between estimated and measured blood pressure, as well as to measure blood pressure continuously. This article presents an algorithm to estimate MAP, utilizing the HR, Stroke Volume (SV), and Total Peripheral Resistance (TPR), with considering SV changing influence; this consideration is investigated mathematically, and by the Particle Swarm Optimization (PSO) technique.

Catecholamine Infusion versus Intraaortic Counterpulsation at the Initial Phase of Left Intraventricular Balloon Pumping in the Fibrillating Animal Heart

1993 ◽  
Vol 16 (2) ◽  
pp. 86-90 ◽  
Author(s):  
S. Stamatelopoulos ◽  
N. Zakopoulos ◽  
N. Saridakis ◽  
S. Stefanou ◽  
A. Adractas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Experimental Study ◽  
Left Atrial ◽  
Initial Phase ◽  
Aortic Pressure ◽  
Aortic Flow ◽  
Aortic Blood ◽  
Aortic Blood Pressure ◽  
The Mean ◽  
The Difference

This experimental study compares the effect of catecholamine infusion to the effect of intraaortic counterpulsation (IABP) while initiating intraventricular balloon pumping (IVBP) in the fibrillating heart. In 12 dogs IVBP started immediately after the induction of ventricular fibrillation. Intravenous adrenaline or noradrenaline (at a progressively increasing infusion rate until the systolic aortic blood pressure was 120 mm Hg) was interchanged with IABP. The systolic aortic pressure, the aotic flow and the mean left atrial pressure were, respectively, 120.4 ± 0.5 mm Hg, 42 ± 4 mlkg-1min-1 and 18.7 ± 1.2 mm Hg (x ± SEM) ten min after initiating catecholamine infusion and 97 ± 5 mm Hg (with a 131 ± 4 mm Hg diastolic wave), 69.6 ± 4 mlkg-1min-1 and 16 ± 1.5 mm Hg ten min after initiating IABP. The difference in aortic flow was significant (p<0.001). The results indicate that a better aortic flow may be obtained by combining IVBP and IABP than IVBP and vasoconstrictive agents in the fibrillating heart. If IVBP, IABP and catecholamines are combined, both AF and AP may increase.

scholarly journals Comparison of Autonomic Function using Valsalva Ratio, Heart Rate, and Blood Pressure in Meditators and Nonmeditators

2017 ◽  
Vol 1 (1) ◽  
pp. 6-9
Author(s):  
Roopam Bassi ◽  
Kiran   ◽  
Kawalinder Girgla
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Autonomic Function ◽  
Valsalva Maneuver ◽  
Well Being ◽  
Control Group ◽  
Relaxation Techniques ◽  
Mean Values ◽  
The Mean ◽  
The Difference

ABSTRACT Introduction In recent years, the various health benefits of meditation have been acknowledged by the scientific community as well as by the public. Apart from its physiological benefits, it can also improve the psychological and spiritual well-being. A case–control study was planned to investigate the effect of Rajyoga Meditation on cardiovascular autonomic activity in meditators and nonmeditators. Materials and methods The study was conducted on 100 subjects, randomized into two groups: meditators (n = 50; age 35.80 ± 7.69 years) and nonmeditators (n = 50; age 36.76 ± 6.38 years). The meditator group practiced meditation for 30 minutes in the morning as well as in the evening. The control group did not practice any type of meditation or relaxation techniques. The cardiovascular parameters – heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), and Valsalva maneuver tests – were performed in both the groups in the same environmental conditions. The data were compiled and analyzed using unpaired t test. Results The mean values of HR in meditators and the control group were 77.08 ± 5.39 and 80.68 ± 5.71 respectively, and the difference was statistically significant (p < 0.001). The mean values of SBP in meditators and nonmeditators were 124.60 ± 5.39 and 129.56 ± 4.30 mm Hg respectively, while those for DBP were 77.84 ± 4.65 and 80.80 ± 4.78 mm Hg respectively. The difference in both was statistically significant. In meditators, Valsalva ratio was 1.60 ± 0.20, while in nonmeditators, it was 1.33 ± 0.13, and the difference was highly significant. Conclusion Significant improvement is seen in physiological, cardiac, and parasympathetic parameters in Rajyoga meditators. A shift of the autonomic balance toward the parasympathetic side is seen. By purposefully energizing the parasympathetic system by meditation, we can combat the ill effects of stress and help heal many health conditions. How to cite this article Kiran, Thaman RG, Bassi R, Girgla K. Comparison of Autonomic Function using Valsalva Ratio, Heart Rate, and Blood Pressure in Meditators and Nonmeditators. Curr Trends Diagn Treat 2017;1(1):6-9.

scholarly journals Twenty-four-hour Blood Pressure Monitoring in Central Serous Chorioretinopathy – A Case-control Study

2013 ◽  
Vol 07 (01) ◽  
pp. 42
Author(s):  
Pradeep Venkatesh ◽  
Vikas Jain ◽  
Satpal Garg ◽  
◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
Central Serous Chorioretinopathy ◽  
Case Control Study ◽  
Blood Pressure Monitoring ◽  
Case Control ◽  
Mean Difference ◽  
National Committee ◽  
The Mean ◽  
The Difference ◽  
Control Study

Purpose:A case-control study to explore the diurnal variation of blood pressure (BP) in patients with central serous chorioretinopathy (CSCR).Methods:One-hundred patients (50 cases with central serous chorioretinopathy and 50 age- and sex-matched controls) participated in this study. Twenty-four-hour BP was recorded by auscultatory method using manual standard mercury sphygmomanometer by a single, trained observer. Hypertension was categorised according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VII) classification.Results:Mean systolic BP (SBP) and diastolic BP (DBP) in cases and controls were 123.4 mmHg (range 112.3–134.6), 81.72 mmHg (range 73.0–90.5); 118.33 mmHg (range 108.4–128.2); and 77.50 mmHg (range 71.4–83.6), respectively. The difference in SBP and DBP was statistically significant at p=0.02 for the former and p=0.006 for the latter. The mean difference in maximum and minimum SBP in cases was 18 (±15.81) mmHg versus 9.04 (±3.08) mmHg in controls (p=0.001). Mean difference for DBP in cases was 15.16 (±7.86) mmHg versus 9.16 (±3.68) mmHg in controls (0.001). On the JNC-VII classification scale for hypertension, 66 % of cases were found to be pre-hypertensive (60 %) or hypertensive (6 %). Comparative figures for controls were pre-hypertension (30 %) and hypertension (2 %). The mean SBP and DBP was consistently higher in patients with CSCR compared with controls over the entire 24-hour period. The difference in variation between maximum and minimum SBP and DBP was also found to be statistically significant between the groups.Conclusion:A significant correlation exists between higher values BP and central serous chorioretinopathy. Screening of CSCR patients for pre-hypertension may be useful in decreasing the risk of progression to established hypertension, with its associated risks.

scholarly journals COMPARISON OF HAEMODYNAMIC STABILITY WITH 0.5% AND 0.75% HYPERBARIC BUPIVACAINE DURING SPINAL ANAESTHESIA IN WOMEN UNDERGOING CAESAREAN SECTION

2021 ◽  
Vol 71 (6) ◽  
pp. 2078-81
Author(s):  
Hina Iftikhar ◽  
Aneel Aslam ◽  
Habib Ur Rehman ◽  
Zulfiqar Ali ◽  
Mohammad Ali Abbass ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
P Value ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
The Mean ◽  
The Difference

Objective: To compare the effect of 0.5% and 0.75% hyperbaric Bupivacaine on haemodynamic stability in terms of mean systolic blood pressure and heart rate recorded at 4 min in patients undergoing caesarian section in spinal anesthesia. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Malir, from Jul to Dec 2018. Methodology: The patients were assigned in two groups (A and B) using lottery method. Group A received 0.5% hyperbaric Bupivacaine solution. Group B received 0.5% hyperbaric Bupivacaine solution. Spinal anaesthesia was given, blood pressure and heart rate were recorded. Data were analyzed in SPSS version 23. Both groups were compared for mean systolic blood pressure and heart rate by using independent sample t-test. Results: The mean age of patients was 29.62 ± 6.21 years in 0.75% Bupivacaine group while 29.31 ± 6.20 years in 0.5% Bupivacaine group. The mean systolic blood pressure of patients was 111.63 ± 5.96 mmHg in 0.75% Bupivacaine group while 117.16 ± 7.12 mmHg in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). The mean heart rate of patients was 92.27 ± 4.71 beats per min (bpm) in 0.75% Bupivacaine group while 97.68 ± 4.58 bpm in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). Conclusion: 0.5% hyperbaric Bupivacaine was better than 0.75% hyperbaric Bupivacaine solution in spinal anaesthesia during caesarean section.

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