PERIPHERAL HEMODYNAMICS PECULIARITIES IN YOUNG AND MIDDLE-AGED MEN WITH A RECIDIVATING MYOCARDIAL INFARCTION

2021 ◽  
pp. 51-57
Author(s):  
Golikov A.V. ◽  
Epifanov S.Yu. ◽  
Reiza V.A.
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Heart Rate ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Study Group ◽  
Poor Outcome ◽  
Peripheral Hemodynamics ◽  
Recurrent Myocardial Infarction ◽  
Recurrent Ischemia

Relevance. Hemodynamics changes in recidivating myocardial infarction and early postinfarction angina are not well understood. In recent years, the frequency of these complications has been increasing. Aim. To evaluate peripheral hemodynamics changes in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 102 patients; II - control, without it - 541 patients. A comparative assessment of hemodynamics changes in first 48 hours (1) and the end of third week disease (2), also risk analysis of recurrent ischemia and poor outcome in selected groups were performed. Results. The study group was distinguished by a high level of total peripheral resistance1 (2055.5±965.2 (dyn×sec×cm-5)) from the control (2055.5± 965.2 (dyn×sec×cm-5); p=0.02). In both groups, a decrease in the values of all indicators was noted (p<0.05). A more pronounced decrease in total peripheral resistance was found in the study group, and in the parameters of blood pressure and heart rate - in the control group. The values of total peripheral resistance1 ≥1600 dyne×sec×cm-5 were the markers of the risk of ischemia recurrence. Predictors of poor outcome are blood pressure levels1 (systolic <97; diastolic <70; mean <93.3 (mm Hg)); total peripheral resistance1 <1746.2 dyne×sec×cm-5 and heart rate (˃92 per min). Conclusions. Patients with recurrent ischemia are characterized by higher levels of total peripheral resistance in the first hours of myocardial infarction. For both groups, a decrease in all studied indicators is determined. The above values of hemodynamic parameters should be used in the formation of groups with a high risk of early recurrence of ischemia and an unfavorable outcome, as well as for prognostic modeling of these complications.

KIDNEY FUNCTION DURING THE MYOCARDIAL INFARCTION WITH RECURRENT EPISODES OF ISCHEMIA IN YOUNG AND MIDDLE-AGED MEN

2021 ◽  
pp. 49-56
Author(s):  
Gordienko A.V. ◽  
Epifanov S.Yu. ◽  
Tassybayev B.B.
Keyword(s):  
Myocardial Infarction ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Study Group ◽  
Type I ◽  
Poor Outcome ◽  
Recurrent Myocardial Infarction ◽  
Recurrent Ischemia

Relevance. Changes in renal function and their significance in reinfarction and early postinfarction angina have not been insufficiently established. Aim. To evaluate renal function changes in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction and/or early postinfarction angina - 110 patients; II - control, without it - 555 patients. A comparative assessment of renal function changes in first 48 hours (1) and the end of third week disease (2), also risk analysis of recurrent ischemia and poor outcome in selected groups were performed. Results. The study group was distinguished by high levels of creatinine1 (0.11±0.03 (mmol/l)), lower - glomerular filtration rate (74.2±20.6 (ml/min/1.73 m2)) from the control (0.10±0.02 (mmol/l) and 78.3±17.9 (ml/min/1.73 m2), respectively; p=0.04). In both groups, there was a deterioration in indicators (creatinine, I: 2.3%; II: 5.9%; glomerular filtration rate - I: -5.8 and -6.3%, respectively; p<0.0001) during the observation period. The risk of recurrent ischemia increases with creatinine1 levels≥0.11 mmol/l and a glomerular filtration rate1˂70 ml/min/1.73 m2. In the study group, the risk of poor outcome is high with normal renal function. In the control group, it increased at creatinine1 levels≥0.10 mmol/l, glomerular filtration rate1˂65 ml/min/1.73 m2. Conclusions. Patients with recurrent ischemia have higher creatinine levels than controls. In both groups, during the study, there was a slight increase in creatinine and a decrease in glomerular filtration rate. The above values of renal function indices should be used in the formation of groups at high risk of early recurrence of ischemia and poor outcomes, as well as for predictive modeling of these complications.

THE SYSTEMIC CIRCULATION IN MEN UNDER 60 YEARS OF OLD WITH MYOCARDIAL INFARCTION AND ACUTE KIDNEY INJURY

2021 ◽  
pp. 7-13
Author(s):  
Gordienko A.V. ◽  
Nosovich D.V. ◽  
Tassybayev B.B.
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Kidney Injury ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Kidney Injury ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Acute Kidney Injury Development

Relevance. Hemodynamics changes in myocardial infarction complicated by acute kidney injury are interpreted in different ways. Aim. To evaluate peripheral hemodynamics changes in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative assessment of circulation indices changes in first 48 hours (1) and the end of third week disease (2), their dynamics, also acute kidney injury development risk analysis (ANOVA) were performed. Results. The study group differed from the control group in lower values of heart rate1 (66.3±12.2 and 75.8±18.8 (bpm), respectively; p=0.003) and higher - arterial pressure, systolic1 (155.6±24.0 and 139.5±28.9 (mm Hg); p=0.006), diastolic1 (98.0 ± 16.0 and 86.6 ± 18.9 (mm Hg); p = 0.002), mean1 (117.2±17.6 and 104.3±21.3 (mm Hg); p=0.001). In the study group compared in the control group, there was a greater decrease in blood pressure (mean: -18.3 and -8.3%, respectively) and total peripheral resistance (-33.5 and -26.3%) (p<0.0001). The risk markers of the acute kidney injury development were the mean arterial pressure1≥106.7, systolic1≥140.0, diastolic1≥90.0 (mm Hg) and heart rate1˂66 bpm. Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by arterial hypertension and bradycardia in the first hours of the disease, as well as more pronounced decline dynamics of blood pressure and total peripheral resistance at the end of its subacute period. The listed above values of the circulation parameters should be used in the high-risk groups for the acute kidney injury development formation, as well as prognostic modeling.

Effect of sympathetic blockade on diurnal variation of hemodynamic patterns

1989 ◽  
Vol 256 (3) ◽  
pp. R778-R785 ◽  
Author(s):  
M. I. Talan ◽  
B. T. Engel
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Stroke Volume ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Base Line ◽  
Sympathetic Blockade ◽  
Selective Blockade ◽  
Arterial Blood

Heart rate, stroke volume, and intra-arterial blood pressure were monitored continuously in each of four monkeys, 18 consecutive h/day for several weeks. The mean heart rate, stroke volume, cardiac output, systolic and diastolic blood pressure, and total peripheral resistance were calculated for each minute and reduced to hourly means. After base-line data were collected for approximately 20 days, observation was continued for equal periods of time under conditions of alpha-sympathetic blockade, beta-sympathetic blockade, and double sympathetic blockade. This was achieved by intra-arterial infusion of prazosin, atenolol, or a combination of both in concentration sufficient for at least 75% reduction of response to injection of agonists. The results confirmed previous findings of a diurnal pattern characterized by a fall in cardiac output and a rise in total peripheral resistance throughout the night. This pattern was not eliminated by selective blockade, of alpha- or beta-sympathetic receptors or by double sympathetic blockade; in fact, it was exacerbated by sympathetic blockade, indicating that the sympathetic nervous system attenuates these events. Because these findings indicate that blood volume redistribution is probably not the mechanism mediating the observed effects, we have hypothesized that a diurnal loss in plasma volume may mediate the fall in cardiac output and that the rise in total peripheral resistance reflects a homeostatic regulation of arterial pressure.

Carotid baroreceptor control of liver and spleen volume in cats

1991 ◽  
Vol 260 (1) ◽  
pp. H254-H259
Author(s):  
R. Maass-Moreno ◽  
C. F. Rothe
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Arterial Blood Pressure ◽  
Total Peripheral Resistance ◽  
Venous Pressure ◽  
Peripheral Resistance ◽  
Normal Brain ◽  
Spleen Volume ◽  
Arterial Blood

We tested the hypothesis that the blood volumes of the spleen and liver of cats are reflexly controlled by the carotid sinus (CS) baroreceptors. In pentobarbital-anesthetized cats the CS area was isolated and perfused so that intracarotid pressure (Pcs) could be controlled while maintaining a normal brain blood perfusion. The volume changes of the liver and spleen were estimated by measuring their thickness using ultrasonic techniques. Cardiac output, systemic arterial blood pressure (Psa), central venous pressure, central blood volume, total peripheral resistance, and heart rate were also measured. In vagotomized cats, increasing Pcs by 100 mmHg caused a significant reduction in Psa (-67.8%), cardiac output (-26.6%), total peripheral resistance (-49.5%), and heart rate (-15%) and significantly increased spleen volume (9.7%, corresponding to a 2.1 +/- 0.5 mm increase in thickness). The liver volume decreased, but only by 1.6% (0.6 +/- 0.2 mm decrease in thickness), a change opposite that observed in the spleen. The changes in cardiovascular variables and in spleen volume suggest that the animals had functioning reflexes. These results indicate that in pentobarbital-anesthetized cats the carotid baroreceptors affect the volume of the spleen but not the liver and suggest that, although the spleen has an active role in the control of arterial blood pressure in the cat, the liver does not.

Autonomic Cardiovascular Dysregulation at Rest and During Stress in Chronically Low Blood Pressure

2019 ◽  
Vol 33 (1) ◽  
pp. 39-53 ◽  
Author(s):  
Stefan Duschek ◽  
Alexandra Hoffmann ◽  
Casandra I. Montoro ◽  
Gustavo A. Reyes del Paso
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiac Output ◽  
Stroke Volume ◽  
Total Peripheral Resistance ◽  
Baroreflex Sensitivity ◽  
Peripheral Resistance ◽  
Control Group ◽  
Low Blood Pressure

Abstract. Chronic low blood pressure (hypotension) is accompanied by symptoms such as fatigue, reduced drive, faintness, dizziness, cold limbs, and concentration difficulties. The study explored the involvement of aberrances in autonomic cardiovascular control in the origin of this condition. In 40 hypotensive and 40 normotensive subjects, impedance cardiography, electrocardiography, and continuous blood pressure recordings were performed at rest and during stress induced by mental calculation. Parameters of cardiac sympathetic control (i.e., stroke volume, cardiac output, pre-ejection period, total peripheral resistance), parasympathetic control (i.e., heart rate variability), and baroreflex function (i.e., baroreflex sensitivity) were obtained. The hypotensive group exhibited markedly lower stroke volume, heart rate, and cardiac output, as well as higher pre-ejection period and baroreflex sensitivity than the control group. Hypotension was furthermore associated with a smaller blood pressure response during stress. No group differences arose in total peripheral resistance and heart rate variability. While reduced beta-adrenergic myocardial drive seems to constitute the principal feature of the autonomic impairment that characterizes chronic hypotension, baroreflex-related mechanisms may also contribute to this state. Insufficient organ perfusion due to reduced cardiac output and deficient cardiovascular adjustment to situational requirements may be involved in the manifestation of bodily and mental symptoms.

MO096ROLE OF THE ENDOTHELIN SYSTEM IN THE INTERACTIONS OF THE VASOPRESSOR SYSTEMS IN VIVO IN MEN - IMPORTANCE OF GENETIC HOST FACTORS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Bastian Brune ◽  
Johannes Korth ◽  
Sebastian Dolff ◽  
Benjamin Wilde ◽  
Winfried Siffert ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Hypertension ◽  
Dose Response ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Oral Application ◽  
Endothelin System ◽  
C825t Polymorphism ◽  
Gnb3 C825t

Abstract Background and Aims Arterial hypertension is one of the most common diseases of the cardiovascular system worldwide and is still the cause of most deaths in Germany. Data on interactions of the endothelin-system with the renin-angiotensin- and the sympathoadrenergic system in the regulation of systemic hemodynamics in humans are lacking. In our present investigation we study the effects of Endothelin A-, Alpha1- and Angiotensin II-type-1-receptor antagonization on the systemic pressor effects of intravenous Endothelin-1-application in young, healthy men. In addition, we analyzed the effects of the genetic variations of the GNB3 C825T-polymorphism on hemodynamic changes. GNB3 825CT/TT-allele-carriers are considered to have a higher risk for multiple diseases with structural, vascular degeneration, such as arterial hypertension, diabetes mellitus and obesity. Method 21 healthy male volunteers were included in this double- blind, randomized, placebo-controlled cross-over study and were studied on four days. Endothelin-1 (ET-1) (0.5, 1, 2.5, 5 ng/kg/min for 20 min each) was given intravenous 2.0 hours after oral application of either placebo or Doxazosin, 3.5 hours after oral application of Candesartan (Candesartan 8 mg) or in the presence of a continuous infusion of the ET-A-selective antagonist BQ123 (60 μg/min). Blood pressure (BP) and heart rate (HR) were recorded and total peripheral resistance (TPR) was measured using impedance cardiography. ET-1-dose-response curves were analyzed with ANOVA. Data are presented as mean ± SD. Since we suspected an effect of the GNB3 C825T-polymorphism we divided the overall collective into 2 sub-collectives according to the GNB3 C825T-genotypes (n = 21, GNB3 825CC: n = 10, GNB3 825CT/TT: n = 11). Our analyses considered the overall collective and compared the sub-collectives intraday and interday. Results ET-1 increased systolic blood pressure (SBD) (p ≤ 0,01), diastolic blood pressure (DBD) and mean arterial pressure (MBP) as well as total peripheral resistance (TPR) (each p ≤ 0,001) with decreasing heart rate (HR5) (p ≤ 0,05). Elevation of blood pressure existed in both sub-collectives (GNB3 825CC: SBD & MBD: p ≤ 0,01, DBP & TPR: p ≤ 0,05, GNB3 825CT/TT: DBD, MBD & TPR: p ≤ 0,01, SBP p ≤ 0,05). Antagonization of ETA-receptors reversed the effect in the overall collective as well as in the sub-collectives. Both, Doxazosin, as well as Candesartan led to a decrease in blood pressure, however, dose-response relationship was influenced more by doxazosin (DBD: p ≤ 0,001, MBD: p ≤ 0,01) than by candesartan (all values: p &gt; 0,05). For both drugs, blood pressure and TPR remained elevated under maximum ET-1-application compared to baseline measurement. Blood pressure dependent heart rate changes were observed in the overall collective and in GNB3 825CC-allele-carriers under sole ET-1-therapy (p ≤ 0.05) (Fig. 1). Candesartan reversed the effect of ET-1 on the sub-collectives (p &gt; 0.05). GNB3 825CT/TT-allele-carriers showed no reduction in heart rate under ET-1-application, but with accompanying candesartan therapy (p ≤ 0.01) (Fig. 2). The genotype collectives thus behaved oppositely to the drugs in this respect. Conclusion In summary, ET-1 increased systolic, diastolic and mean arterial blood pressure as well as systemic vascular resistance. Doxazosin, Candesartan and BQ123 led to a decrease in blood pressure. Blood pressure and TPR remained elevated under maximum ET-1 application plus Candesartan or Doxazosin. The heart rate changes of the genotype-separated sub-collectives were opposite when ET-1 was administered compared to ET-1 and Candesartan.

scholarly journals Dissection of carotid sinus hypersensitivity: the timing of vagal and vasodepressor effects and the effect of body position

2011 ◽  
Vol 121 (9) ◽  
pp. 389-396 ◽  
Author(s):  
C. T. Paul Krediet ◽  
David L. Jardine ◽  
Wouter Wieling
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Total Peripheral Resistance ◽  
Sympathetic Nerve Activity ◽  
Carotid Sinus ◽  
Body Position ◽  
Muscle Sympathetic Nerve Activity ◽  
Peripheral Resistance ◽  
Head Up Tilt

We assessed the timing of vagal and sympathetic factors that mediate hypotension during CSM (carotid sinus massage) in patients with carotid sinus hypersensitivity. We hypothesized that a fall in cardiac output would precede vasodepression, and that vasodepression would be exaggerated by head-up tilt. We performed pulse contour analyses on blood pressure recordings during CSM in syncope patients during supine rest and head-up tilt. In a subset we simultaneously recorded muscle sympathetic nerve activity supine. During supine rest, systolic blood pressure decreased from 150±7 to 107±7 mmHg (P<0.001) and heart rate from 64±2 to 39±3 beats/min (P<0.01). Cardiac output decreased with heart rate to nadir (66±6% of baseline), 3.1±0.4 s after onset of bradycardia. In contrast, total peripheral resistance reached nadir (77±3% of baseline) after 11±1 s. During head-up-tilt, systolic blood pressure fell from 149±10 to 90±11 mmHg and heart rate decreased from 73±4 to 60±7 beats/min. Compared with supine rest, cardiac output nadir was lower (60±8 compared with 83±4%, P<0.05), whereas total peripheral resistance nadir was similar (81±6 compared with 80±3%). The time to nadir from the onset of bradycardia did not differ from supine rest. At the onset of bradycardia there was an immediate withdrawal of muscle-sympathetic nerve activity while total peripheral resistance decay occurred much later (6–8 s). The haemodynamic changes following CSM have a distinct temporal pattern that is characterized by an initial fall in cardiac output (driven by heart rate), followed by a later fall in total peripheral resistance, even though sympathetic withdrawal is immediate. This pattern is independent of body position.

Cardiovascular effects produced by L-glutamate stimulation of the lateral hypothalamic area

1989 ◽  
Vol 257 (2) ◽  
pp. H540-H552 ◽  
Author(s):  
S. E. Spencer ◽  
W. B. Sawyer ◽  
A. D. Loewy
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Cardiac Output ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Lateral Hypothalamic Area ◽  
Hypothalamic Area ◽  
Pharmacological Blockade ◽  
Stimulation Of

L-Glutamate microinjections into the tuberal region of the lateral hypothalamic area (LHAt) caused a fall in blood pressure and heart rate in pentobarbital-anesthetized rats. The bradycardia was mediated by both beta-adrenergic and muscarinic mechanisms as demonstrated with pharmacological blockade. The hypotension was due to a decrease in cardiac output, not a decrease in total peripheral resistance. In addition, there was a reduction in coronary blood flow. If heart rate was held constant by pharmacological blockade or by electrical cardiac pacing, L-glutamate stimulation of the LHAt still caused a fall in blood pressure. When the electrically paced model was used, this hypotension was due to a fall in cardiac output. In contrast, with the pharmacological blockade of the heart, the hypotension was due to a decrease in the total peripheral resistance. The cardiac output reduction in the paced condition was not mediated solely by either beta-sympathetic or parasympathetic mechanisms as determined by pharmacological blockade. With heart rate held constant by either drugs or pacing, LHAt stimulation did not alter regional blood flow or resistance in any vascular bed, including the coronary circulation. We conclude that L-glutamate stimulation of the LHAt lowers the cardiac output and heart rate by both parasympathetic and beta-adrenergic mechanisms and elicits hypotension by lowering cardiac output in the naive and electrically paced model.

Hemodynamic Effects of "San-Huang-Hsieh-Hsin-Tang" in Patients with Essential Hypertension

1986 ◽  
Vol 14 (03n04) ◽  
pp. 153-156 ◽  
Author(s):  
Ho-Chan Chen ◽  
Ming-Tsuen Hsieh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Essential Hypertension ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Contractile Force ◽  
Hemodynamic Effects ◽  
Cardiac Contractile ◽  
The Ancient Chinese

The ancient Chinese formula of "San-Huang-Hsieh-Hsin-Tang" (S-T) was originally used for patients with "epigastric fullness, flushing, restlessness, constipation and a hard pulse" (Chang 115 B.C.). All these symptoms are frequently observed in patients with essential hypertension. We assessed the antihypertensive and hemodynamic effects of this formula, and found that S-T decreased blood pressure, total peripheral resistance, heart rate and cardiac contractile force. S-T had no apparent effects on cardiac output and blood volume.

Disparities in circulatory adjustment to standing between young and elderly subjects explained by pulse contour analysis

1992 ◽  
Vol 83 (2) ◽  
pp. 149-155 ◽  
Author(s):  
W. Wieling ◽  
D. P. Veerman ◽  
J. H. A. Dambrink ◽  
B. P. M. Imholz
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Total Peripheral Resistance ◽  
Age Groups ◽  
Peripheral Resistance ◽  
The Elderly ◽  
Pulse Contour ◽  
Elderly Subjects ◽  
Orthostatic Stress ◽  
Young Subjects

1. The circulatory adjustment to standing was investigated in two age groups. Young subjects consisted of 20 healthy 10–14-year-old girls and boys. Elderly subjects consisted of 40 70–86-year-old healthy and active females and males. Continuous responses of blood pressure and heart rate were recorded by Finapres. A pulse contour algorithm applied to the finger arterial pressure waveform was used to assess stroke volume responses. 2. During the first 30 s (initial phase), an almost identical drop in mean blood pressure was found in both age groups (young, 16 ± 10 mmHg; old, 17 ± 10 mmHg), but the initial heart rate increase was attenuated in the elderly subjects (young, 29 ± 7 beats/min; old, 17 ± 7 beats/min). 3. During the period from 30 s to 10 min of standing, mean blood pressure increased from 96 ± 12 to 106 ± 12 mmHg in the elderly subjects compared with almost no change in the young subjects (from 82 ± 8 to 84 ± 7 mmHg). In the elderly subjects a progressive increase in total peripheral resistance (from 114 ± 14% to 146 ± 29%) was found, compared with an initial rapid increase in total peripheral resistance (126 ± 18% after 30 s) with no further change during prolonged standing (124 ± 17% after 10 min) in the young subjects. In this age group the decrease in stroke volume and the increase in heart rate after 10 min of standing were large (young, −37 ± 11% and 27 ± 11 beats/min; old, −31 ± 9% and 7 ± 6 beats/min, respectively). 4. In conclusion, young subjects adjust to orthostatic stress mainly by a marked increase in heart rate. In healthy elderly subjects an attenuation of the heart rate response during orthostatic stress is compensated by a pronounced increase in total peripheral resistance resulting in an increase in blood pressure.

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