scholarly journals Quantitative and qualitative blood pressure clusters in patients of Truskavets’ SPA and their hemodynamic accompaniment

2020 ◽  
Vol 10 (6) ◽  
pp. 445-454
Author(s):  
Nataliya Kozyavkina ◽  
Nataliya Voronych-Semchenko ◽  
Yuliya Vovchyna ◽  
Walery Zukow ◽  
Igor Popovych
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Optimal Level ◽  
Systolic Volume ◽  
Hemodynamic Support ◽  
Discriminant Model ◽  
Heart Work ◽  
Wide Range ◽  
End Systolic Volume ◽  
Forward Stepwise

Background. The influence of balneotherapy at the Truskavets’ spa on the blood pressure (BP) of his patients is still not in the focus of researchers. Therefore, we initiated the project “Neuroendocrine-immune and metabolic mechanisms of the effect of balneotherapy on BP”. The first swallow of the project is the analysis of a condition of BP and its hemodynamic support of profile patients of a resort. Materials and methods. Under an observations were 44 patients with chronic pyelonephritis and cholecystitis in the phase of remission. Testing was performed twice - on admission and after 7-10 days of standard balneotherapy. The main object of the study was BP (tonometer “Omron M4-I”, Netherlands). Simultaneously the parameters of hemodynamics were determined (echocamera “Toshiba-140”, Japan). Results. The optimal level of systolic BP (range 120÷129 mmHg) stated in 18,2% of cases only, high norm (130÷139 mmHg) in 14,8%, arterial hypertension (AH) I (140÷160 mmHg) – in 39,8%, AH II (over 160 mmHg) in 12,5%, however, in 14,8% of cases the BP was lower than 120 mmHg. In order to identify among the registered parameters of hemodynamics, those for which the BP clusters differ from each other, a discriminant analysis was performed. The program forward stepwise included in the discriminant model 13 parameters out of 17. The most informative among them: contractility index of left ventricle, heart work per minute, ejection fraction and time as well as end-systolic volume. Conclusion. Profile patients of Truskavets’ spa are characterized by a wide range of blood pressure - from low norm to arterial hypertension II that correspond to the hemodynamics parameters.

scholarly journals Autonomic and endocrine accompaniments of quantitative-qualitative blood pressure clusters in patients of Truskavets’ spa

2020 ◽  
Vol 10 (7) ◽  
pp. 465-477
Author(s):  
Nataliya Kozyavkina ◽  
Nataliya Voronych-Semchenko ◽  
Yuliya Vovchyna ◽  
Walery Zukow ◽  
Igor Popovych
Keyword(s):  
Blood Pressure ◽  
Parathyroid Hormone ◽  
Vagal Tone ◽  
The Other ◽  
Patient Classification ◽  
Discriminant Model ◽  
Wide Range ◽  
Forward Stepwise ◽  
The One ◽  
Regulation Of Blood Pressure

Background. Earlier we showed that profile patients of Truskavets’ spa are characterized by a wide range of blood pressure (BP) - from low norm to arterial hypertension III that correspond to the hemodynamics parameters. The purpose of this study is to clarify the autonomic and endocrine accompaniments of quantitative-qualitative BP clusters in the same contingent. Materials and methods. Under an observations were 44 patients with chronic pyelonephritis and cholecystitis in the phase of remission. Testing was performed twice - on admission and after 7-10 days of standard balneotherapy. The main object of the study was BP (tonometer “Omron M4-I”, Netherlands). The parameters of HRV ("CardioLab+HRV", Ukraine), plasma levels of Cortisol, Aldosterone, Testosterone, Triiodothyronine and Calcitonin (ELISA) as well as Ca-P marker of parathyroid hormone were determined. Results. In order to identify among the registered parameters, those for which the BP clusters differ from each other, a discriminant analysis was performed. The program forward stepwise included in the discriminant model 29 parameters. The most informative among them are HRV-markers of sympathetic tone and sympathetic-vagal balance as well as testosterone and cortisol, whose levels are maximal in patients with hypertension II, while minimal in patients with low norm BP, on the one hand, and markers of vagal tone and Kerdoe vegetative index, the levels of which are polar, on the other hand. The accuracy of patient classification is 98,9%. Conclusion. Autonomic and endocrine accompaniments of quantitative-qualitative blood pressure clusters corresponding to the existing ideas about the regulation of blood pressure.

scholarly journals A Comparative Study of Bisoprolol with Carvedilol on LV Systolic Function in Patients with Chronic Heart Failure

2018 ◽  
Vol 14 (1) ◽  
pp. 3-8
Author(s):  
Mohammad Ashraf Hossain ◽  
Khurshed Ahmed ◽  
Md Faisal Ibn Kabir ◽  
Md Fakhrul Islam Khaled ◽  
Rakibul H Rashed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Group I ◽  
End Systolic Volume ◽  
Group Ii

Background: Chronic heart failure (CHF) is the most common and prognostically unfavorable outcome of many diseases of the cardiovascular system. Recent data suggest that beta-blockers are beneficial in patients with CHF. Among β-blocker class of drugs, bisoprolol is a highly selective β1-adrenergic receptor blocker whereas Carvedilol is non-selective. Many large-scale trials have confirmed that both these β-blockers are superior to placebo and other β-blockers. This study was designed to compare the effects of carvedilol and bisoprolol in patients with chronic HF in a single center.Methods: It was a quasi experimental study. A total of 288 cases of heart failure were selected by purposive sampling, from January 2017 to June 2017. Each patient was allocated into either of the two groups, and was continued receiving treatment with either bisoprolol (Group-I) or carvedilol (Group-II). Each patient was evaluated clinically and echocardiographically at the beginning of treatment (baseline) and at the end of 3rd month. Echocardiography was performed to find out change in left ventricular systolic function.Result: After 3 months of treatment, ejection fraction was found higher in the bisoprolol group (42.6 ± 6.5 versus 38.3 ± 4.6%; P < 0.05). Ejection fraction (EF) changes were 8.4% in bisoprolol group and 4.1% in carvedilol group. A significant reduction in left ventricular end-systolic volume (21.9±2.5 in group I versus 14.9±5.7 in group II; P < 0.05) and left ventricular systolic diameter (3.2±0.1 in group I versus 2.3±0.5 in group II; P<0.05) occurred after 3 months of treatment. But no significant differences were observed in left ventricular end-diastolic volume (10.1±3.2 versus 6.1±6.4; P=0.101) and left ventricular diastolic diameter (1.7±0.8 versus 1.3±0.8; P=0.081) between groups. Three months after treatment, heart rate was reduced in the bisoprolol group from 87.7±9 to 74.5±8.1 and carvedilol group from 88.8±9.1 to 80.1±8.7. Differences in heart rate responses between 2 groups were not statistically significant (P=0.113). Assessment of blood pressure three months later of treatment shows, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were improved in both group but difference between two groups were statistically non significant (p>0.05).Conclusion: In this study, bisoprolol was superior to carvedilol in increasing left-ventricular ejection fraction, improving left ventricular end systolic volume and left ventricular end systolic diameter but no significant difference was observed in LV end diastolic volume, LV end diastolic diameter, heart rate and blood pressure.University Heart Journal Vol. 14, No. 1, Jan 2018; 3-8

scholarly journals P1270 Systolic blood pressure at age 40 is associated with left atrial volumes at age 64

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
P Selmer Roenningen ◽  
T Berge ◽  
M G Solberg ◽  
S Enger ◽  
S Nygaard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Left Atrial ◽  
Early Adulthood ◽  
P Value ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Cardiovascular Morbidity And Mortality ◽  
End Systolic Volume ◽  
Screening Survey

Abstract Funding Acknowledgements Vestre Viken Hospital Trust Background Left atrial (LA) enlargement is associated with elevated blood pressure (BP) and with cardiovascular morbidity and mortality. In the assessment of LA size, echocardiographic guidelines recommend the use of LA end-systolic volume (LAVmax). LA end-diastolic volume (LAVmin) and LA emptying fraction (LAEF) may add valuable information in risk assessment. The knowledge of early adulthood BP and its association to LA volumes and LAEF later in life is limited. Purpose To explore the association between systolic BP at age 40 and LA volumes and LAEF at age 64. Methods We linked data from subjects who had participated in both a nationwide cardiovascular screening survey (1990-1991) at the age of 40, and the Akershus Cardiac Examination (ACE) 1950 Study (2012-2015) at the age of 64 (n = 2,597). In the ACE 1950 Study, LAVmax and LAVmin were measured with echocardiography according to the summation of discs method. LAEF was calculated as (LAVmax-LAVmin/LAVmax)x100%. The association between systolic BP at age 40 and LA volumes and LAEF at age 64 was assessed in univariate and multivariate linear regression analyses. Results Systolic BP at age 40 was associated with LAVmax and LAVmin but not with LAEF at age 64. In our multivariate model, a 10 mm Hg higher systolic BP at age 40 was associated with a 0.9 ml greater LA end-systolic volume and a 0.5 ml greater LA end-diastolic volume at age 64. Conclusion Early adulthood systolic BP is associated with LA volumes 24 years later in life. Table. Association of systolic blood pressure at age 40 to left atrial (LA) volumes and LAEF at age 64 Univariate Multivariate* Dependent variable B (95% CI) p-value B (95% CI) p-value LAVmax (ml) 2.4 (2.0, 2.9) &lt;0.001 0.9 (0.4, 1.4) 0.001 LAVmin (ml) 1.5 (1.1, 1.8) &lt;0.001 0.5 (0.1, 0.9) 0.015 LAEF (%) -0.01 (-0.3, 0.3) 0.938 0.2 (-0.2, 0.5) 0.294 *Adjusted for gender, body mass index, smoking, resting heart rate and antihypertensive treatment, all assessed at age 40. B (95% CI), regression coefficient for systolic blood pressure (per 10 mm Hg) with 95% confidence interval; LAVmax, LA end-systolic volume; LAVmin LA end-diastolic volume; LAEF, LA emptying fraction

Methods of Physiotherapy in the Medical Rehabilitation of Children with Primary Arterial Hypertension

2020 ◽  
Vol 98 (4) ◽  
pp. 55-61
Author(s):  
L.V. Kuyantseva ◽  
E.A. Turova ◽  
I.I. Trunina ◽  
M.S. Petrova ◽  
I.A. Lomaga
Keyword(s):  
Blood Pressure ◽  
Central Nervous System ◽  
Nervous System ◽  
Arterial Hypertension ◽  
Self Regulation ◽  
Medical Rehabilitation ◽  
Medication Therapy ◽  
Wide Range ◽  
Treatment Of Hypertension ◽  
The Central Nervous System

Introduction. Arterial hypertension (AH) is a widely occurring disease of the cardiovascular system in the children’s population, which often debuts in childhood, persists into adulthood, which dictates the need for early treatment and prevention of arterial hypertension. The formation of AH is associated with maladaptation of physiological mechanisms of self-regulation, with a complex interaction of psychosocial and genetic factors. The use of non-medicinal agents to reduce blood pressure is a starting approach in the treatment of children and adolescents with hypertension and complements medication therapy. Purpose. analysis of literature sources on the effectiveness of hardware physiotherapy methods in the treatment of hypertension in children. Discussion. In the treatment of children with hypertension, the leading role belongs to hardware physiotherapy technologies. Widely used sedative, hypotensive and vegetative-corrective methods are pathogenetically justified and can be used at all stages of arterial hypertension development. Transcranial pulsed electrotherapy (transcranial electrostimulation, electroson, infitotherapy), darsonvalization, aromafitotherapy and medicinal electrophoresis of sedatives belong sedative methods aimed at enhancing inhibitory processes in the Central nervous system. Amplipulster therapy, intermittent normobaric hypoxytherapy, low-intensity magnetic therapy, medicinal electrophoresis of spasmolytic drugs, EHF therapy, laser therapy, which lead to a decrease in arterial hypertension and improve microcirculation, are hypotensive methods. Bio-controlled aerionotherapy, aimed at correcting vegetative dysfunction, is a vegetative corrective method. Conclusion. Currently, there is a wide range of scientifically-based methods of hardware physiotherapy used in the medical rehabilitation of children with arterial hypertension, allowing to improve cerebral hemodynamics, normalize neurophysiological and hemodynamic processes in the Central nervous system, provide sedative and hypotensive effects, stimulate peripheral vasodepressor mechanisms, normalize neuroendocrine processes. The use of hardware physiotherapy methods in the complex treatment of hypertension can improve the quality of life of patients, achieve stable normalization of blood pressure, and reduce the risk of early cardiovascular diseases.

3151The prognostic meaning of a reduced reserve of left ventricular force during exercise in hypertrophic cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M G D'Alfonso ◽  
J Peteiro ◽  
C C De Azevedo Bellagamba ◽  
M A R Torres ◽  
F Re ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Hypertrophic Cardiomyopathy ◽  
Systolic Blood Pressure ◽  
Nyha Class ◽  
Left Ventricular ◽  
Exercise Stress ◽  
Force Frequency ◽  
Systolic Volume ◽  
End Systolic Volume

Abstract Background Hypertrophic cardiomyopathy (HCM) patients with blunted force-frequency relationship assessed with pacing during cardiac catheterization are at greater risk of adverse events. Left ventricular contractile reserve (LVCR) based on force can be obtained noninvasively during exercise stress echocardiography (ESE). Purpose To evaluate the prognostic correlates of force-based LVCR during ESE in HCM. Methods We enrolled 332 HCM patients (age 51±15 years, 193 males, New York Heart Association, NYHA, Class I-III, EF 68±9%, maximal wall thickness 20±5 mm, left ventricular outflow tract gradient, LVOTG, present at rest in 34 pts, 10%) referred for ESE in 7 quality-controlled labs. SE assessment included LVOTG (mm Hg), LV Force (systolic blood pressure by cuff sphygmomanometer + LVOTG/LV end-systolic volume assessed with 2-D, mmHg/ml) and LVCR (peak/rest ratio of LV Force). LV volumes were measured from apical biplane (4- and 2-chamber) views with Simpson method when feasible (n=290) or with linear Teichholz (T) method from parasternal (long- or short-axis) view (n=42). All patients were followed-up. Results Force values were 8.5±6.7 at rest and 15.0±13.7 mmHg/mL at peak stress (P<0.001). During a median follow-up time of 58 months, 50 patients experienced at least one event: 19 deaths (10 cardiac), 9 hospitalizations for acute heart failure, 16 myotomy/myectomy and 22 atrial fibrillations. The event-free survival was lower in the 195 patients with LVCR <1.77 (identified with Receiver-Operator Characteristic analysis) compared to the 137 with LVCR ≥1.77: see figure. Multivariate analysis identified LVCR (Hazard ratio, HR, 2.032, 95% confidence intervals, CI, 1.042–3.964, P=0.037), age (HR, 1.033, 95% CI 1.009–1.058, P=0.007) and NYHA class (HR 2.204, 95% CI 1.161–4.185, P<0.016) as independent predictors of events. Figure 1. HCM-LVCR Conclusion A non-invasive evaluation of LVOTG, systolic blood pressure and LV end-systolic volume during ESE allows to assess force-based LVCR in HCM. Lower LVCR is associated with greater risk of events at follow-up.

P4985Blunted heart rate reserve as an imaging-independent predictor of abnormal left ventricular contractile reserve

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Zagatina ◽  
T Bombardini ◽  
A Djordjevic-Dikic ◽  
H Rodriguez-Zanella ◽  
Q Ciampi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Confidence Intervals ◽  
Odds Ratio ◽  
Wall Motion ◽  
Left Ventricular ◽  
Contractile Reserve ◽  
Heart Rate Reserve ◽  
Systolic Volume ◽  
Specific Analysis ◽  
End Systolic Volume

Abstract Background Stress echocardiography (SE) relies on regional wall motion and left ventricular contractile reserve (LVCR) based on force (systolic blood pressure/end-systolic volume). An additional non-imaging parameter based on EKG is the blunted heart rate reserve (HRR) which is a simple marker of altered autonomic balance and is associated with worse prognosis independently of ischemia. Aim To assess the relationship between HRR and LVCR in patients undergoing SE. Methods We enrolled 4707 patients (age 63.6±11.3 yrs, 2800 males) referred to SE for known or suspected coronary artery disease (CAD) and/or heart failure (HF) in 21 SE laboratories in 8 countries. The employed stress was exercise (n=2062), dipyridamole (n=2007) or dobutamine (n=638). We assessed LVCR (stress/rest ratio of force=systolic blood pressure/end-systolic volume, ESV). Stress-specific abnormal cutoff value of LVCR were <2.0 for exercise and dobutamine and <1.1 for dipyridamole. All readers had passed the upstream quality control reading for wall motion abnormalities and ESV. HR (with 12-lead ECG) was obtained each minute and recorded at rest and peak stress. HR reserve (HRR) was calculated as the peak/rest HR ratio. Results HRR was related to LVCR at cumulative (n=4707; r=0.351; p<0.001: see figure) and stress-specific analysis for exercise (r=0.351; p<0.001), dipyridamole (r=0.241; p<0.001) and dobutamine (r=0.214; p<0.001). At multivariate logistic regression analysis, blunted HRR (optimal cutoff: 1.73 for exercise, 1.306 for dipyridamole, 1.932 for dobutamine) was a significant predictor of abnormal LVCR at stress-specific analysis for exercise (Odds ratio = 0.285, 95% Confidence Intervals: 0.149–0.546, p=0.0001), dobutamine (Odds ratio = 0.187, 95% Confidence Intervals: 0.057–0.617, p=0.0001) and dipyridamole (Odds ratio = 0.263, 95% Confidence Intervals: 0.115–0.602, p=0.002). Conclusion A blunted HRR is a useful non-imaging predictor of abnormal LVCR response during exercise or pharmacological SE. HRR is a simple biomarker of autonomic unbalance of physiologic and potentially prognostic meaning. A “slow heart” during stress (with blunted HRR) is more often a “weak heart”, with blunted increase in force.

scholarly journals Age matters: differences in exercise-induced cardiovascular remodelling in young and middle aged healthy sedentary individuals

2020 ◽  
pp. 204748732092630
Author(s):  
Camilla Torlasco ◽  
Andrew D’Silva ◽  
Anish N Bhuva ◽  
Andrea Faini ◽  
Joao B Augusto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Right Ventricular ◽  
Left Ventricular ◽  
Systolic Volume ◽  
Non Invasive ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Unsupervised Training ◽  
Exercise Induced ◽  
First Time

Aims Remodelling of the cardiovascular system (including heart and vasculature) is a dynamic process influenced by multiple physiological and pathological factors. We sought to understand whether remodelling in response to a stimulus, exercise training, altered with healthy ageing. Methods A total of 237 untrained healthy male and female subjects volunteering for their first time marathon were recruited. At baseline and after 6 months of unsupervised training, race completers underwent tests including 1.5T cardiac magnetic resonance, brachial and non-invasive central blood pressure assessment. For analysis, runners were divided by age into under or over 35 years (U35, O35). Results Injury and completion rates were similar among the groups; 138 runners (U35: n = 71, women 49%; O35: n = 67, women 51%) completed the race. On average, U35 were faster by 37 minutes (12%). Training induced a small increase in left ventricular mass in both groups (3 g/m2, P < 0.001), but U35 also increased ventricular cavity sizes (left ventricular end-diastolic volume (EDV)i +3%; left ventricular end-systolic volume (ESV)i +8%; right ventricular end-diastolic volume (EDV)i +4%; right ventricular end-systolic volume (ESV)i +5%; P < 0.01 for all). Systemic aortic compliance fell in the whole sample by 7% ( P = 0.020) and, especially in O35, also systemic vascular resistance (–4% in the whole sample, P = 0.04) and blood pressure (systolic/diastolic, whole sample: brachial –4/–3 mmHg, central –4/–2 mmHg, all P < 0.001; O35: brachial –6/–3 mmHg, central –6/–4 mmHg, all P < 0.001). Conclusion Medium-term, unsupervised physical training in healthy sedentary individuals induces measurable remodelling of both heart and vasculature. This amount is age dependent, with predominant cardiac remodelling when younger and predominantly vascular remodelling when older.

scholarly journals Cardiac structure and function in schizophrenia: cardiac magnetic resonance imaging study

2020 ◽  
Vol 217 (2) ◽  
pp. 450-457 ◽  
Author(s):  
Emanuele F. Osimo ◽  
Stefan P. Brugger ◽  
Antonio de Marvao ◽  
Toby Pillinger ◽  
Thomas Whitehurst ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Blood Pressure ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Resonance Imaging ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Cardiac Structure And Function ◽  
And Function

BackgroundHeart disease is the leading cause of death in schizophrenia. However, there has been little research directly examining cardiac function in schizophrenia.AimsTo investigate cardiac structure and function in individuals with schizophrenia using cardiac magnetic resonance imaging (CMR) after excluding medical and metabolic comorbidity.MethodIn total, 80 participants underwent CMR to determine biventricular volumes and function and measures of blood pressure, physical activity and glycated haemoglobin levels. Individuals with schizophrenia (‘patients’) and controls were matched for age, gender, ethnicity and body surface area.ResultsPatients had significantly smaller indexed left ventricular (LV) end-diastolic volume (effect size d = −0.82, P = 0.001), LV end-systolic volume (d = −0.58, P = 0.02), LV stroke volume (d = −0.85, P = 0.001), right ventricular (RV) end-diastolic volume (d = −0.79, P = 0.002), RV end-systolic volume (d = −0.58, P = 0.02), and RV stroke volume (d = −0.87, P = 0.001) but unaltered ejection fractions relative to controls. LV concentricity (d = 0.73, P = 0.003) and septal thickness (d = 1.13, P < 0.001) were significantly larger in the patients. Mean concentricity in patients was above the reference range. The findings were largely unchanged after adjusting for smoking and/or exercise levels and were independent of medication dose and duration.ConclusionsIndividuals with schizophrenia show evidence of concentric cardiac remodelling compared with healthy controls of a similar age, gender, ethnicity, body surface area and blood pressure, and independent of smoking and activity levels. This could be contributing to the excess cardiovascular mortality observed in schizophrenia. Future studies should investigate the contribution of antipsychotic medication to these changes.

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