scholarly journals Modifiable and unmodifiable factors associated with slow flow following rotational atherectomy

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250757
Author(s):  
Kenichi Sakakura ◽  
Yousuke Taniguchi ◽  
Kei Yamamoto ◽  
Takunori Tsukui ◽  
Hiroyuki Jinnouchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Beta Blockers ◽  
Multivariate Logistic Regression Analysis ◽  
Rotational Atherectomy ◽  
Lesion Length ◽  
Slow Flow ◽  
Factors Associated ◽  
Modifiable Factors ◽  
Flow Group

Background Although several groups reported the risk factors for slow flow during rotational atherectomy (RA), they did not clearly distinguish modifiable factors, such as burr-to-artery ratio from unmodifiable ones, such as lesion length. The aim of this retrospective study was to investigate the modifiable and unmodifiable factors that were associated with slow flow. Methods We included 513 lesions treated with RA, which were classified into a slow flow group (n = 97) and a non-slow flow group (n = 416) according to the presence or absence of slow flow just after RA. The multivariate logistic regression analysis was performed to find factors associated with slow flow. Results Slow flow was inversely associated with reference diameter [Odds ratio (OR) 0.351, 95% confidence interval (CI) 0.205–0.600, p<0.001], primary RA strategy (OR 0.224, 95% CI 0.097–0.513, p<0.001), short single run (≤15 seconds) (OR 0.458, 95% CI 0.271–0.776, p = 0.004), and systolic blood pressure (BP) ≥ 140 mmHg (OR 0.501, 95% CI 0.297–0.843, p = 0.009). Lesion length (every 5 mm increase: OR 1.193, 95% CI 1.093–1.301, p<0.001), angulation (OR 2.054, 95% CI 1.171–3.601, p = 0.012), halfway RA (OR 2.027, 95% CI 1.130–3.635, p = 0.018), initial burr-to-artery ratio (OR 1.451, 95% CI 1.212–1.737, p<0.001), and use of beta blockers (OR 1.894, 95% CI 1.004–3.573, p = 0.049) were significantly associated with slow flow. Conclusions Slow flow was positively associated with several unmodifiable factors including lesion length and angulation, and inversely associated with reference diameter. In addition, slow flow was positively associated with several modifiable factors including initial burr-to-artery ratio and use of beta blockers, and inversely associated with primary RA strategy, short single run, and systolic blood pressure just before RA. Application of this information could help to improve RA procedures.

scholarly journals Factors associated with left ventricular hypertrophy in adults with surgically repaired coarctation of the aorta

2015 ◽  
Vol 1 (2) ◽  
pp. 79
Author(s):  
Daniel Rinnström ◽  
Bengt Johansson
Keyword(s):  
Blood Pressure ◽  
Aortic Valve ◽  
Systolic Blood Pressure ◽  
Aortic Valve Disease ◽  
Univariate Analysis ◽  
Coarctation Of The Aorta ◽  
Left Ventricular ◽  
Valve Disease ◽  
Factors Associated ◽  
Modifiable Factors

Introduction: Most patients with repaired coarctation of the aorta (CoA) live normal lives and have good physical<br />performance. However, even after a successful surgical intervention, long-term cardiovascular risks including left ventricular<br />hypertrophy remain. The aim of the study was to identify factors associated with increased left ventricular mass (LVM) in<br />patients with surgically repaired CoA.<br />Methods: Consecutive cardiovascular magnetic resonance investigations in 51 patients with surgically repaired CoA (age<br />37+/-15 years, age at intervention 9.7 ± 6.8 years, 45% female) were reviewed. LVM was measured and indexed to body<br />surface area. The association between increased LVM index and clinical, anatomic and functional variables was investigated<br />with logistic regression analysis.<br />Results: In this population, 14/51 (27%) patients had a LVM index above normal limits. Factors associated with an increased<br />LVM index in univariate analysis were higher systolic blood pressure (odds ratio (OR) = 1.04, 95 % confidence interval<br />(CI) 1.00-1.08, p = 0.03), descending aortic diameter (OR = 1.48, CI 1.14-1.90, p = 0.003) and more than mild aortic valve<br />disease or previous aortic valve intervention (OR = 15.1, CI 2.50-48.4, p=0.002), but not diastolic blood pressure, diameter of<br />ascending aorta, diameter or ratio of CoA, velocity in descending aorta, smoking or bicuspid aortic valve (p &gt; 0.05 for all). In<br />multivariate analysis, only systolic blood pressure (p = 0.05) and aortic valve disease (p = 0.006) remained significant, yielding<br />R2 = 0.47, p = 0.002 for the model.<br />Conclusion: Increased LVM is a common late finding after surgically repaired CoA. This study showed that LVM was<br />associated with modifiable factors; systolic blood pressure and aortic valve disease. As most patients are young, and<br />increased LVM will eventually affect ventricular function, close attention to blood pressure optimization may be of particular<br />importance in the surgically repaired CoA population.

scholarly journals COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Coronary Syndrome ◽  
Group A ◽  
Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

Factors Associated With Intradialytic Systolic Blood Pressure Variability

2012 ◽  
Vol 59 (3) ◽  
pp. 409-418 ◽  
Author(s):  
Jennifer E. Flythe ◽  
Srikanth Kunaparaju ◽  
Kumar Dinesh ◽  
Kathryn Cape ◽  
Harold I. Feldman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Factors Associated ◽  
Systolic Blood Pressure Variability

A Model of Systolic Blood Pressure During the Course of Dialysis and Clinical Factors Associated With Various Blood Pressure Behaviors

2011 ◽  
Vol 58 (5) ◽  
pp. 794-803 ◽  
Author(s):  
Kumar Dinesh ◽  
Srikanth Kunaparaju ◽  
Kathryn Cape ◽  
Jennifer E. Flythe ◽  
Harold I. Feldman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Clinical Factors ◽  
Factors Associated

scholarly journals 379 Contemporary use of guideline directed medical therapy in dilated cardiomyopathy: therapeutic optimization and prognostic benefits

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Francesco Venturelli ◽  
Vincenzo Nuzzi ◽  
Paolo Manca ◽  
Giovanni Santi ◽  
Giulia Barbati ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Dilated Cardiomyopathy ◽  
Beta Blockers ◽  
Recommended Dose ◽  
Target Dose ◽  
Reduced Ejection Fraction ◽  
Number Of Patients

Abstract Aims Therapy with antineurohormonal drugs at target doses has a prognostic benefits in heart failure with reduced ejection fraction. Dilated cardiomyopathy (DCM) represents a particular setting where the possible benefit of target doses of antineurohormonal drugs is unexplored. Methods and results All patients enrolled from 1/1/1992 to 1/3/2020 in the Trieste Muscle Heart Disease register affected by DCM with data on the dosage of therapy available both enrollment and at follow-up visit (i.e., 6–12 month) were included. The population was divided according to the percentage of recommended dose prescribed (0–49%, 50–99%, 100%) of both renin-angiotensin system inhibitors (RASi) and beta blockers (BB). A composite of death/heart transplant/hospitalization for heart failure was considered as the primary endpoint; a composite of sudden cardiac death/major ventricular arrythmias/defibrillator intervention was evaluated as a secondary endpoint. Prognostic associations were explored with uni- and multivariate analyses, Cox regressions, Kaplan–Meier, cumulative incidence curves and propensity score matching. 826 patients were included. At baseline 789 (96%) were taking a RASi and 627 (76%) a BB. The target dose of RASi was prescribed in 29% and 36% of patients at enrolment and at follow-up visit, respectively. The percentage of patients taking the maximum recommended dose of BB was 10% at baseline and 17% after optimization. Predictors of reaching target dose for RASi were BMI &lt; 25 kg/m2, male sex [HR: 1.798 (95% CI: 1.073–3.012), P = 0.026] and higher systolic blood pressure [HR per mmHg 1.038 (95% CI: 1.025–1.051), P &lt; 0.001]. Target dose predictors of BB were age [HR per year 0.527 (95% CI: 0.347–0.802), P = 0.003] and highest systolic blood pressure [HR per mmHg 1.024 (95% CI: 1.013–1.035), P &lt; 0.001]. After adjustment target dose of RASi or BB did not show a significant association with the risk of primary outcome occurrence compared to those taking less than 50% (P = 0.550 for RASi and P = 0.921 for BB). The incidence of arrhythmic events was significantly lower in patients taking 100% of recommended dose of BB compared to those taking less than 50% (P = 0.009), after adjustment for confounders. The target dose of RASi was not associated with an arrhythmic events risk change (P = 0.688). Conclusions In DCM a significant number of patients do not tolerate maximal therapy doses, mainly due to hypotension. The achievement of the target dose of RASi and BB, after adjustment for confounders had a neutral effect on the incidence of heart failure-related events. Uptitration of BB to the recommended dose has a strong protective effect on arrhythmic events.

scholarly journals Indoor Cooking Practices and Associated Health Factors Among Participants in the Dominican Republic and Nicaragua: A Collaborative Study Between Respiratory Therapy Students and Comunidad Connect

2021 ◽  
Author(s):  
Rachel Culbreth ◽  
Rachel Trawick ◽  
Jon Thompson ◽  
Douglas Gardenhire
Keyword(s):  
Blood Pressure ◽  
Carbon Monoxide ◽  
Dominican Republic ◽  
Systolic Blood Pressure ◽  
Collaborative Study ◽  
Vital Signs ◽  
Flow Measurements ◽  
Middle Income ◽  
Factors Associated ◽  
Cooking Practices

The purpose of this study is to determine factors associated with indoor cooking practices and specific vital signs across two middle-income countries, Dominican Republic and Nicaragua. This study used data from Nicaragua (n=76) and Dominican Republic (n=62) (collected in 2018-2019). Multivariable linear regression was utilized to determine factors associated with carbon monoxide levels and systolic blood pressure. Among all participants (n=138), approximately half lived in Nicaragua (n=76, 55.1%) and half lived in Dominican Republic (n=62, 44.9%). The overall smoking prevalence in each country was low (9.2% in Nicaragua and 4.8% in Dominican Republic). Age was associated with higher carbon monoxide levels and higher systolic blood pressure measurements in each country. Future studies should examine a broader range of contextual and behavioral factors related to carbon monoxide and peak flow measurements in the two countries.

scholarly journals Use Of Invasive Blood Pressure Monitoring In Asymptomatic Mildly Hypotensive Cardiac Patients

2004 ◽  
Vol 3 (3) ◽  
pp. 53-54
Author(s):  
Bharat Rawat ◽  
DB Karki ◽  
Abhinav Vaidhya ◽  
Jessen Gurung ◽  
Ajay Shah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Beta Blockers ◽  
Cardiac Patients ◽  
Pressure Monitoring ◽  
Invasive Blood Pressure ◽  
Invasive Blood Pressure Monitoring

Beta-blockers and Angiotensin Converting Enzme Inhibitor (ACE-I) are still underused drugs by CAD or CHF patients. ' Patients with mild hypotension (noninvasive Systolic Blood Pressure (SBP): 80 — 90mm Hg) are often not prescribed these medications.

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