The functional state of microcirculatory vessels in patients with arterial hypertension I-II degree with different degrees of cardiovascular risk

Aim: to evaluate the main parameters of the microcirculatory blood flow and to determine its reserve capacity in patients with arterial hypertension (AH) and different degrees of cardiovascular risk (CVR).Subjects and methods. We examined 64 subjects aged 47-58 years, of which 27 were healthy volunteers and 37 patients with 1st and 2nd degree arterial hypertension, with medium, high and very high CVR (the antihypertensive therapy was cancelled for 2 weeks before the study). In all subjects laser Doppler flowmetry (LDF) with studing initial perfusion parameters, 2 constrictor and 3 dilatator tests waky perfomed. To assess the status of the tone-shaping «active» and «passive» parts of microcirculatory modulation, analysis of the amplitude and frequency spectrum of LDF- grams was carried out.Results. A significant increase in the rate of «base perfusion» in all hypertensive groups compared with the control group was found. The amplitude of respiratory oscillations was one-third higher in high and very high CVR groups in comparison with the control, the amplitude of the myogenic and neurogenic oscillations were maximal and reached significant values in very high CVR group. A reduction in constrictor response in hypertensive patients with middle and high CVR and its increase in the very high CVR group was shown during constrictor functional tests. The power of perfusion increase was reduced in response to all kinds of dilatator stimulus in hypertensive patients group.Conclusion. The findings indicate a progressive increase in the level of «base perfusion», worsening of venous congestion symptoms in hypertensive patients with the progression in CVR severity. High and very high CVR patients showed a reduction in myogenic tone of microvessels when compared with those with normotension. Dilatator functional tests showed a tendency to lower capillary blood flow reserve in hypertensive patients compared with the control group.

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Hypertensive patients features of the microcirculation type after new coronavirus infection of COVID-19

Regional blood circulation and microcirculation ◽

10.24884/1682-6655-2021-20-4-45-51 ◽

2022 ◽

Vol 20 (4) ◽

pp. 45-51

Author(s):

I. A. Zolotovskaya ◽

G. R. Gimatdinova ◽

I. L. Davydkin

Keyword(s):

Blood Flow ◽

Heart Disease ◽

Family History ◽

Adverse Events ◽

Skin Blood Flow ◽

Control Group ◽

Doppler Flowmetry ◽

Hypertensive Patients ◽

History Of ◽

And Control

Introduction. The COVID-19 pandemic multiplies the incidence of long-term adverse events. Family history of heart disease predicates the necessity of study hemostasis in hypertensive patients. The purpose was to study the microcirculation in hypertensive COVID-19 survivors. Materials and methods. We selected patients treated at the hospitals of Samara from January to March 2021. COVID-19 survivors (diagnosis was confirmed by polymerase chain reaction analysis) were divided into 2 groups and analysed: the group with family history of hypertension (167 patients) and control group with no relevant past medical history (68 patients). The main microcirculation characteristics were evaluated by laser Doppler flowmetry of skin blood flow. Results. The average age of COVID-19 survivors was 52.3±14.2 years, n=86 (51.4 %) – male. The majority of patients (n=61/36.5 %) were 45 to 54 years. A fifth of the patients (n=35/20.9 %) showed no complaints about the underlying disease, the clinical manifestations of the rest were general weakness, fever, shortness of breath, cough, headaches, unstable blood pressure, inflammation of the ENT organs. By comparison the microcirculation parameters of the case patients and control group, a decreased perfusion was detected. It requires a preventive medicine to prevent from early and distant micro and macrothrombosis. Conclusion. The study of microcirculation essential features by the LDF of skin blood flow revealed a pathological type with a predominance of vasoconstrictions in patients with a history of hypertension. Taking into account the proven increase in the incidence of thrombotic events in COVID-19 survivors, the noticed changes in microcirculation require a new approach to prevent from adverse events concerning the hypercoagulation process, especially in patients with famil y history of heart disease.

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Assessment of Coronary Microcirculation During Cardiac Catheterization

Current Pharmaceutical Design ◽

10.2174/1381612824666180702112018 ◽

2018 ◽

Vol 24 (25) ◽

pp. 2950-2953

Author(s):

Sasko Kedev ◽

Ivan Vasilev

Keyword(s):

Blood Flow ◽

Coronary Angiography ◽

Myocardial Blood Flow ◽

Functional Tests ◽

Fractional Flow ◽

Catheterization Laboratory ◽

Flow Reserve ◽

Objective Evidence ◽

Value Based Care ◽

User Friendly

Functional tests used in the catheterization laboratory have emerged as a very important adjunctive tool to coronary angiography that can identify patients with myocardial blood flow impairment. Fractional Flow Reserve (FFR) measurement is highly recommended for detection of ischemia-related coronary lesion(s) when objective evidence of vessel-related ischemia is not available. Recently, the much simpler instantaneous wave free ratio (iFR) was proposed as an alternative to FFR without the requirement for administration of vasodilators. More user-friendly techniques like iFR might further contribute to value-based care in coronary interventions.

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Antihypertensive Efficacy of Fixed Combination of Amlodipine and Ramipril in Patients with Arterial Hypertension and Very High Cardiovascular Risk

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2018-14-6-840-845 ◽

2019 ◽

Vol 14 (6) ◽

pp. 840-845

Author(s):

O. Yu. Korennova ◽

S. P. Podolnaya ◽

E. P. Prihodko ◽

E. A. Turusheva ◽

S. N. Starinskaya ◽

...

Keyword(s):

Cardiovascular Risk ◽

Coronary Artery ◽

Fixed Combination ◽

Antihypertensive Drugs ◽

Antihypertensive Efficacy ◽

High Cardiovascular Risk ◽

Hypertensive Patients ◽

Coronary Artery Stenting ◽

History Of ◽

Very High

Aim. To evaluate the antihypertensive efficacy and tolerability of a fixed combination of amlodipine and ramipril in hypertensive patients with very high cardiovascular risk. Material and methods. A retrospective cohort study of real clinical practice of prescribing antihypertensive drugs according to 255 medical records of outpatient hypertensive patients with a history of acute coronary syndrome (ACS) and coronary artery stenting was performed in the first part. An open observational study was performed in the second part. 69 people older than 18 years with a history of ACS and coronary artery stenting, without reaching the target blood pressure (BP) level while using free combinations of antihypertensive drugs and with indications for a fixed combination of ramipril and amlodipine were included into the study. Analysis of self-monitoring of BP, office BP, daily BP monitoring (ABPM) and patients’ adherence to treatment (Morisky-Green test) initially, after 4 and after 12 weeks of taking the fixed combination of ramipril and amlodipine was performed to assess the clinical efficacy of the studied drug. Results. It was found that 42.0% of patients did not follow the recommendations for regular intake of antihypertensive drugs. So, hypertension of all patients regarded as false-refractory, which was the basis for the prescription of the fixed combination of ramipril and amlodipine in accordance with clinical guidelines for the diagnosis and treatment of hypertension. After 4 weeks of therapy, there was significant decrease in office BP with the achievement and preservation of the target level by the 12th week, normalization to the 12th week of day and night BP variability in 54.9% of patients. 78.0% of patients followed medical recommendations for regular administration of antihypertensive drugs, none of the patients had adverse events. Conclusion. The use of fixed combinations of drugs, in particular, amlodipine and ramipril as a part of multicomponent therapy in hypertensive patients with very high cardiovascular risk, led to the achievement of target BP by the 4th week of therapy and stable preservation of antihypertensive effect in 12 weeks of treatment as well as gradual normalization of day and night BP variability in more than half of patients. Fixed combination of ramipril and amlodipine allowed to improve adherence of patients to cardiovascular diseases.

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USE OF FIXED COMBINATIONS OF RAMIPRIL AND HYDROCHLOROTHIAZIDE IN PATIENTS WITH ARTERIAL HYPERTENSION AND HIGH OR VERY HIGH CARDIOVASCULAR RISK (OPTIMIST 2 STUDY): RESULTS OF THE NONCOMPARATIVE STUDY

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2011-7-4-426-430 ◽

2011 ◽

Vol 7 (4) ◽

pp. 426-430 ◽

Cited By ~ 1

Author(s):

I. A. Velizhanina ◽

L. I. Gapon ◽

E. S. Velizhanina ◽

A. V. Rudakov ◽

T. S. Zhupanova

Keyword(s):

Cardiovascular Risk ◽

Arterial Hypertension ◽

Noncomparative Study ◽

High Cardiovascular Risk ◽

Study Results ◽

Very High

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Prognosis criteria of the severe postembolization syndrome in patients with uterine myoma

Bulletin of Russian State Medical University ◽

10.24075/brsmu.2020.006 ◽

2020 ◽

pp. 67-74

Author(s):

E.T. Nurmukhametova ◽

M.E. Shlyapnikov

Keyword(s):

Blood Flow ◽

Uterine Myoma ◽

Microvascular Blood Flow ◽

Timely Initiation ◽

Adequate Treatment ◽

Doppler Flowmetry ◽

Occlusion Test ◽

Prognostic Criteria ◽

Flow Reserve ◽

Postembolization Syndrome

Recently specialists take an interest in organ-preserving methods of uterine fibroids treatment, one of which is uterine artery embolization (UAE). One of the method’s negative aspects is the severe postembolization syndrome (PES) development, requiring timely initiation of adequate treatment in order to avoid severe complications that could lead to the organ removal. The study was aimed to search for the prognostic criteria of the severe PES development during the preoperative period. The study included 81 UAE-treated women aged 19–50 with 7–17 week uterine myoma. The patients’ anthropometric measurements were used, as well as the skin microcirculation data obtained by laser Doppler flowmetry together with the occlusion test. Based on prognostic criteria, models with AUC (area under ROC curve) > 0.8 were presented. According to the models, the anthropometric predictors of the severe PES were the following: age under 38.5 (p < 0.05); BMI lower than 25 kg/m2 (р < 0.05), and microcirculation value (M) prior to UAE below 9.55 PU (р = 0.001). Microvascular blood flow during the occlusion test indicate that the higher the oxygen consumption index (I), intravascular resistance (Rc), capillary blood flow reserve capacity in the models, the higher the risk of the severe PES development (p < 0.05). Low alpha angle value obtained by the occlusion test (p = 0.003) as well as the UVLF value (p = 0.004) in the models also indicate the increased risk of severe PES. Multidimensional prognostic modelling admits to expect the severe PES development prior to UAE, which allows the doctor to prepare the woman for specific management and treatment.

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The structural and functional features of the microcirculatory bed in patients with arterial hypertension and type 2 diabetes mellitus

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2005-11-3-177-180 ◽

2005 ◽

Vol 11 (3) ◽

pp. 177-180 ◽

Cited By ~ 1

Author(s):

L. A. Lohankova ◽

Yu. V. Kotovskaya ◽

A. S. Milto ◽

Zh. D. Kobalava

Keyword(s):

Diabetes Mellitus ◽

Blood Flow ◽

Arterial Hypertension ◽

Control Group ◽

Microcirculatory Bed ◽

Type 2 Dm ◽

Group A ◽

Functional Features

The structural and functional features of the microcirculatory heel (MCB) were studied in patients with arterial hypertension (AH) in relation to the presence or absence of type 1 diabetes mellitus (DM). Two hundred and twelve patients were examined. These included 110 patients with grades 1 and 2 arterial hypertension (AH) and type 2 DM, 82 patients with AH without type 2 DM, and 20 apparently healthy individuals. Laser Doppler flowmetry (LDF) was used to estimate basal blood flow, the loading test parameters characterizing the structural and functional status of MCB, and the incidence of hemodynamic types of microcirculation. Patients with AH concurrent with type 1 DM were found to have the following microcirculatory features: an increase in perfusion blood flow (microcirculation index, 8,8±1,8 perf. units versus 4,9±0,8 perf, units in patients with AH without DM and 6,7±0,9 perf. units in the control group), a drastic reduction in myogenic activity to 13,2±5,7 % versus 16,7±6,8 and 25,2±6,4 %, respectively, a decrease in vascular resistance, impairment of autoregulation, and low reserve capacities (reserve capillary blood flow was 197,8±31,6 % versus 429,9±82,01 % in the group of AH without DM and 302,8±50,1 % in the control group), a predominance of the hyperemic hemodynamic type (58,8 % in patients with AH and DM, 20,9 % in those with AH without DM, and 20,0 % in the controls). The specific features of the altered microcirculatory bed in patients with AH concurrent with type 2 DM were ascertained. These included the predominance of hyperemic microcirculation, impaired autoregulation. diminished microvascular resistance, and the low reserve capacities of the microcirculatory bed.

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Regional Cerebral Blood Flow in Patients with Aneurysms: Estimation by Xenon 133 Inhalation

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100024380 ◽

1978 ◽

Vol 5 (3) ◽

pp. 301-305 ◽

Cited By ~ 29

Author(s):

Bryce Weir ◽

Devidas Menon ◽

Thomas Overton

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Regional Cerebral Blood Flow ◽

Normal Values ◽

Regional Distribution ◽

Progressive Increase ◽

Control Group ◽

Regional Cerebral Blood ◽

Progressive Reduction ◽

Distribution Of Flow

SUMMARY:Seventy six regional cerebral blood flow (rCBF) studies were conducted on 32 patients who had a total of 39 aneurysms. Twenty three of these patients were studied pre- and post-operatively. Normal values were obtained from a control group of 33 subjects, each of whom underwent one rCBF study. Flow was reduced following subarachnoid hemorrhage (SAH); it increased significantly postoperatively. Lower flows were associated with poorer clinical grades. There was a greater variation in regional distribution of flow immediately following SAH than in normals or in patients who had recovered from the acute phase. rCBF studies correlated with CT scans demonstrated that a progressive increase in ventricular size was accompanied by a progressive reduction in flow. In addition, intraventricular hemorrhage (IVH) was associated with a significant reduction in cerebral blood flow (CBF). No significant correlation between CBF and spasm was demonstrable.

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