scholarly journals Dynamics of characteristics of cerebral circulation during combined treatment with amlodipine and bisoprolol

2017 ◽  
Vol 94 (12) ◽  
pp. 908-914
Author(s):  
Irina L. Zapesochnaya ◽  
A. G. Avtandilov
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Velocity ◽  
Combined Therapy ◽  
Peripheral Resistance ◽  
Resistance Index ◽  
Downward Trend ◽  
Hypertensive Patients ◽  
Group 2 ◽  
Group 1

Objective: to assess dynamics of cerebral blood flow when starting combined therapy with amlodipine and bisoprolol in hypertensive patients working in the Far North under various labor schedules. Material and methods. We studied 140 patients with grade 1-2 hypertension divided into two groups depending on their work schedule. Group 1 (n=72) included subjects working only at daytime; group 2 (n=68) consisted of subjects working in shifts. All patients received combined therapy with amlodipine and bisoprolol. The final mean daily dose of amlodipine/bisoprolol amounted to 8,3±1,3/9,8±1,6 mg/day and 9,5±1,5/14,5±1,2 mg/day in groups 1 and 2 respectively. Doppler ultrasound of the common carotid, internal carotid and vertebral arteries (OCA, BCA and PA, respectively) was performed before, 12 weeks, and 6 months after onset of therapy. Results. At the end-point of intervention (6 months) patients of group 1 showed an increase in peak systolic velocity (Vps) in OCA, BCA and PA (by 4,1, 5,9 and 5,5% respectively) and maximum end-diastolic flow velocity (Ved) in ОCA and ВCA (by 5,8 and 5,2% respectively). Patients of group 2 showed an increase of Vps in OCA, BCA and PA by 6,3, 8,4 and 7,1% respectively; Ved in OCA and BCA by 6,4 and 14,5% respectively. All patients exhibited a pronounced downward trend of the peripheral resistance index of in all studied arteries. The tendency to a decrease in the thickness of the intima-media complex was documented: by 4,1%, in group 1, 6,8% in group 2, without reaching the normal level. Conclusion. 6-month starting combined therapy with amlodipine and bisoprolol in hypertensive patients has positive effect on cerebral hemodynamics manifest as the increase in parameters of cerebral blood flow velocity and reduced peripheral resistance index. Pronounced downward trend in the thickness of the intima-media monitoring in both groups was apparent but without reaching the standard level.

Effects of Sufentanil on Cerebral Hemodynamics and Intracranial Pressure in Patients with Brain Injury

1995 ◽  
Vol 83 (4) ◽  
pp. 721-726. ◽  
Author(s):  
Christian Werner ◽  
Eberhard Kochs ◽  
Hanswerner Bause ◽  
William E. Hoffman ◽  
Jochen Schulte am Esch
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Flow Velocity ◽  
Cerebral Artery ◽  
Blood Flow Velocity ◽  
Artery Blood Flow ◽  
Arterial Blood ◽  
Norepinephrine Infusion ◽  
Group 2 ◽  
Group 1

Background The current study investigates the effects of sufentanil on cerebral blood flow velocity and intracranial pressure (ICP) in 30 patients with intracranial hypertension after severe brain trauma (Glasgow coma scale < 6). Methods Mechanical ventilation (FIO2 0.25-0.4) was adjusted to maintain arterial carbon dioxide tensions of 28-30 mmHg. Continuous infusion of midazolam (200 micrograms/kg/h intravenous) and fentanyl (2 micrograms/kg/h intravenous) was used for sedation. Mean arterial blood pressure (MAP, mmHg) was adjusted using norepinephrine infusion (1-5 micrograms/min). Mean blood flow velocity (Vmean, cm/s) was measured in the middle cerebral artery using a 2-MHz transcranial Doppler sonography system. ICP (mmHg) was measured using an epidural probe. After baseline measurements, a bolus of 3 micrograms/kg sufentanil was injected, and all parameters were continuously recorded for 30 min. The patients were assigned retrospectively to the following groups according to their blood pressure responses to sufentanil: group 1, MAP decrease of less than 10 mmHg, and group 2, MAP decrease of more than 10 mmHg. Results Heart rate, arterial blood gases, and esophageal temperature did not change over time in all patients. In 18 patients, MAP did not decrease after sufentanil (group 1). In 12 patients, sufentanil decreased MAP > 10 mmHg from baseline despite norepinephrine infusion (group 2). ICP was constant in patients with maintained MAP (group 1) but was significantly increased in patients with decreased MAP. Vmean did not change with sufentanil injection regardless of changes in MAP. Conclusions The current data show that sufentanil (3 micrograms/kg intravenous) has no significant effect on middle cerebral artery blood flow velocity and ICP in patients with brain injury, intracranial hypertension, and controlled MAP. However, transient increases in ICP without changes in middle cerebral artery blood flow velocity may occur concomitant with decreases in MAP. This suggests that increases in ICP seen with sufentanil may be due to autoregulatory decreases in cerebral vascular resistance secondary to systemic hypotension.

Influence of adenosine on cerebral blood flow during hypoxic hypoxia in the newborn piglet

1990 ◽  
Vol 68 (4) ◽  
pp. 1534-1541 ◽  
Author(s):  
N. Laudignon ◽  
E. Farri ◽  
K. Beharry ◽  
J. Rex ◽  
J. V. Aranda
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
High Performance ◽  
Severe Hypoxia ◽  
Group 4 ◽  
Csf Levels ◽  
Group 3 ◽  
Group 2 ◽  
Arterial Po2 ◽  
Group 1

This study investigated the role of adenosine in the regulation of neonatal cerebral blood flow (CBF) during moderate (arterial PO2 = 47 +/- 9 Torr) and severe (arterial PO2 = 25 +/- 4 Torr) hypoxia. Twenty-eight anesthetized and ventilated newborn piglets were assigned to four groups: 8 were injected intravenously with the vehicle (controls, group 1); 13 received an intravenous injection of 8-phenyltheophylline (8-PT), a potent adenosine receptor blocker, either 4 mg/kg (group 2, n = 6, mean cerebrospinal fluid (CSF) levels less than 1 mg/l) or 8 mg/kg (group 3, n = 7, mean CSF levels less than 3.5 mg/l); and 7 received an intracerebroventricular injection of 10 micrograms 8-PT (group 4). During normoxia, CBF was not altered by vehicle or 8-PT injections. In group 1, 10 min of moderate and severe hypoxia increased total CBF by 112 +/- 36 and 176 +/- 28% (SE), respectively. Compared with controls, the cerebral hyperemia during moderate hypoxia was not altered in group 2, attenuated in group 3 (to 53 +/- 13%, P = NS), and completely blocked in group 4 (P less than 0.01). CBF increase secondary to severe hypoxia was attenuated only in group 4 (74 +/- 29%, P less than 0.05). CSF concentrations of adenosine and adenosine metabolites measured by high-performance liquid chromatography increased during hypoxia. Arterial O2 content was inversely correlated (P less than 0.005) to maximal CSF levels of adenosine (r = 0.73), inosine (r = 0.87), and hypoxanthine (r = 0.80).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of exercise on the cerebral circulation and metabolism

1965 ◽  
Vol 20 (6) ◽  
pp. 1289-1293 ◽  
Author(s):  
Eldred G. Zobl ◽  
Frederick N. Talmers ◽  
Raymond C. Christensen ◽  
Lesem J. Baer
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Physical Exercise ◽  
Cerebral Metabolism ◽  
Peripheral Resistance ◽  
Hypertensive Patients ◽  
Total Body ◽  
Cerebral Resistance ◽  
The Brain ◽  
Cerebral Vascular Resistance

Cerebral hemodynamics and metabolism were studied in 13 normal patients and 14 hypertensive patients at rest and during vigorous physical exercise. Cerebral blood flow was determined by the nitrous oxide method. The cerebral vascular resistance in normal and hypertensive patients remained remarkably constant during exercise despite a marked reduction in total peripheral resistance. Cerebral blood flow was relatively unaffected by the marked increase in cardiac output and the cerebral metabolism did not share in the increased total body metabolism. During vigorous physical exercise the brain behaved as a steady-state organ. cerebral resistance; cerebral blood flow; cerebral oxygen consumption; exercise Submitted on February 4, 1965

scholarly journals Cerebral blood flow velocity after hyperventilation-induced vasoconstriction in hypertensive patients.

Stroke ◽  
1992 ◽  
Vol 23 (12) ◽  
pp. 1728-1732 ◽  
Author(s):  
L S Malatino ◽  
S Bellofiore ◽  
M P Costa ◽  
G Lo Manto ◽  
F Finocchiaro ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Cerebral Blood Flow Velocity ◽  
Hypertensive Patients

Increased stroke risk predicted by compromised cerebral blood flow reactivity

1993 ◽  
Vol 79 (4) ◽  
pp. 483-489 ◽  
Author(s):  
Howard Yonas ◽  
Holly A. Smith ◽  
Susan R. Durham ◽  
Susan L. Pentheny ◽  
David W. Johnson
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Stroke Incidence ◽  
Initial Flow ◽  
Content Type ◽  
Symptomatic Carotid Stenosis ◽  
History Of ◽  
Group 2 ◽  
Fine Print ◽  
Group 1

✓ The authors sought to determine risk for stroke in individuals with symptomatic carotid stenosis or occlusion based upon an assessment of cerebral blood flow (CBF) reserves. Vascular reserve was assessed by two consecutive xenon/computerized tomography (Xe/CT) CBF studies with intravenous acetazolamide introduced 20 minutes prior to the second study. Patients were assigned to one of two vasoreactivity groups. Group 2 included individuals who experienced a CBF reduction of more than 5% in at least one vascular territory and had a baseline flow of 45 cc/100 gm/min or less. Group 1 included all other individuals. Any territory with volume loss on CT of more than 50% was eliminated from analysis. Sixty-eight individuals were followed at 6-month intervals for a mean of 24 months. In Group 1 two strokes were observed contralateral to the side with lowest reserve, for a stroke incidence of 4.4%; in Group 2 eight strokes were observed ipsilateral to the side with lowest reserve, for a stroke incidence of 36%. The latter group had a 12.6 times greater chance of stroke (p = 0.0007). History of stroke, history of transient ischemic attacks, baseline CBF, and degree of stenosis were not associated with an increased stroke rate. In this study, significantly compromised vascular reserves accompanied by relatively low initial flow identified individuals who subsequently demonstrated a significantly increased rate of ipsilateral stroke.

Continuous Versus Multiple Rapid Infusions of Indomethacin: Effects on Cerebral Blood Flow Velocity

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 244-248 ◽  
Author(s):  
Cathy Hammerman ◽  
Joram Glaser ◽  
Michael S. Schimmel ◽  
Benjamin Ferber ◽  
Michael Kaplan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Cerebral Blood Flow Velocity ◽  
Ductus Arteriosus ◽  
Area Under The Curve ◽  
Resistance Index ◽  
Color Flow ◽  
Rapid Injection

Objective. Therapeutic administration of indomethacin for patent ductus arteriosus (PDA) closure has been documented to decrease cerebral blood flow velocity which may be harmful to the vulnerable premature neonate. We have therefore compared the effects of administering indomethacin by rapid injection versus slow, continuous indomethacin infusion at the same total therapeutic dose on middle cerebral artery (MCA) systolic and diastolic flow velocity, resistance index, and cerebral blood flow (as reflected by the integrated area under the curve). Methods. Premature neonates (<1750 g) documented echocardiographically to have a PDA were randomized to receive indomethacin either by three rapid injection doses or by continuous intravenous infusion over the ensuing 36 hours, providing an equivalent total dose. Echocardiograms and transcranial color flow mapping of the MCA flow velocity were measured at baseline and serially following initiation of therapy in both groups. Effects on cerebral blood flow velocity are presented. Results. Eighteen infants [rapid injection-1.2 ± 0.3 kg (n = 9) and continuous-1.1 ± 0.2 kg (n = 9)] were studied. In the rapid injection treated infants decreased flow velocity in the MCA as manifested by abrupt, significant decreases in systolic (to 70 ± 8% baseline) and diastolic (to 65 ± 13% baseline) flow velocity and area under the curve (to 60 ± 10% of baseline) were evident by 4 minutes and progressed to 30 minutes after treatment initiation. These changes were not observed in the group treated with continuous indomethacin. Both therapeutic modalities were equally successful in closing the ductus, although the numbers are too small to definitively determine therapeutic efficacy. Conclusions. Slow, continuous infusion eliminated the decrease in cerebral flow velocity and appears to be effective in closing the PDA.

HEMODYNAMIC DISORDERS IN VARICOSE VEIN DISEASE

2021 ◽  
Vol 9 (1) ◽  
pp. 68-76
Author(s):  
R.E. Kalinin ◽  
◽  
I.A. Suchkov ◽  
I.N. Shanaev ◽  
V.A. Yudin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Velocity ◽  
Varicose Vein ◽  
Blood Flow Velocity ◽  
Peripheral Resistance ◽  
Resistance Index ◽  
Significant Difference ◽  
Retrograde Blood Flow ◽  
Varicose Disease ◽  
Vein Disease

Aim. Duplex ultrasound scanning (DUS) is a routine diagnostic procedure in patients with varicose vein disease. DUS mostly evaluates the qualitative (anatomical) parameters of the disease. Still, it is difficult to assess the microcirculatory parameters in trophic disorders based only on the anatomy, therefore assessment of quantitative blood flow parameters is needed. Our aim was to determine the potentials of conventional DUS in assessment of the hemodynamic disorders in patients with varicose disease. Materials and Methods. The study included 583 patients with varicose disease, 348 of which had trophic alterations. The patients were divided into 4 groups according to the CEAP clinical classes. Standard Valsalva and Siegel tests were performed during DUS. The following parameters were assessed in the superficial and deep veins: diameter of veins, antegrade blood flow velocity, retrograde blood flow velocity, reflux time; in the perforator veins (PV) – diameter, maximum velocity and average velocity of reflux. Peripheral resistance index (RI) in the arteries accompanying the PV was also analyzed. Results. A statistically significant difference in the diameter of the GSV was obtained between classes C2 and C3, C3 and C4, but not between class C5, 6 and class C4. Similar findings were observed in the assessment of diameter of the PVs and the velocity of retrograde blood flow through them. A gradual increase in these parameters could be seen with the progression of the disease, but a statistically significant difference was obtained only between classes C2 and C3 for the diameter of the PV and the peak velocity of retrograde blood flow. As for the average blood flow velocity, a statistically significant difference was obtained between classes C2 and C3, C3 and C4. Arteries in the perforator bundles demonstrated low RI which may be attributed to the presence of an arteriolo-venular bypass. Statistically significant differences were obtained for CEAP classes C2 and C3. Conclusions. Ultrasound duplex scanning of the study with use of Superb Micro-Vascular Imaging mode is an effective method in assessing the quantitative and microcirculatory parameters of hemodynamic disorders in patients with varicose vein disease of the lower extremities. Trophic ulcers in varicose vein disease are not an obligatory component of the disease, but only its complication.

Cerebral blood flow and systemic hemodynamics during exposure to 2 kPa CO2-300 kPa O2 in rats

1995 ◽  
Vol 78 (6) ◽  
pp. 2100-2108 ◽  
Author(s):  
G. W. Bergo ◽  
I. Tyssebotn
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Stem ◽  
Systolic Arterial Pressure ◽  
Respiratory Frequency ◽  
Systemic Hemodynamics ◽  
Arterial Blood ◽  
Group 2 ◽  
O2 Supply ◽  
Group 1

Cerebral blood flow (CBF), systemic hemodynamics, and arterial blood gases were measured during control conditions and during and after exposure to either 300 kPa O2 (group 1) or 300 kPa O2 with 2 kPa CO2 (group 2) in awake rats. The respiratory frequency fell with no change of arterial PCO2 (PaCO2) in group 1, but in group 2, respiratory frequency and PaCO2 increased linearly. The cardiac output (CO) and heart rate (HR) fell and systolic arterial pressure (SAP) rose independent of PACO2. O2 breathing caused CBF to fall by 30% in group 1, whereas CBF rose linearly with the PaCO2 increase and pH decline in group 2. Regional CBF (rCBF) fell in group 1, whereas rCBF rose gradually in all regions in group 2, but the responses varied similarly in both groups. Regional brain O2 supply was unaltered in most areas. However, the O2 supply was possibly reduced in the brain stem in group 1 but markedly increased in group 2. After decompression, HR and SAP were high, whereas CO returned to its control value. CBF and all rCBF levels remained markedly elevated in group 2. In group 1, CBF returned to control levels. By contrast, rCBF and O2 delivery to brain stem regions remained subnormal. In conclusion, the O2-induced changes in HR, CO, and SAP were not influenced by hypercapnia. CBF and rCBF fell despite unaltered PaCO2, whereas hypercapnia prevented these declines. An uneven effect of O2 was observed on rCBF, most pronounced in brain stem regions, independent of the PaCO2. There was a prolonged suppression of O2 supply to brain stem regions both during and after the exposure to O2 in the absence of CO2.

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