scholarly journals Combined application of kinesis and laser therapy for the correction of disorders in regional hemodynamics at the dilatation cardiomyopathy

2020 ◽  
Vol 24 (1) ◽  
pp. 18-25
Author(s):  
I. A. Mamedyarova

Purpose: To study a combined application of kinesis and laser therapy for correcting regional hemodynamic disorders in patients having dilatation cardiomyopathy (DCMP) with simultaneous supportive pharmaceutical therapy. Material and methods. 100 patients with a verified diagnosis of DCMP were taken into the study. All patients had a differentiated supportive pharmtherapy. In three months after selection of the supportive differentiated drug therapy, patients were divided into two groups comparable by gender, age, disease course, severity of state and ways of medicine administration. Patients from Group 1, in addition to the supporting differentiated drug therapy, were given intravenous laser blood irradiation (ILBI) and unloading physical exercises. Patients from Group 2 continued their course of differentiated drug therapy.Research techniques included: clinical and functional observations; venous-occlusive plethysmography for assessing regional hemodynamics with a generally accepted method: measurement of blood flow (Qr) and regional vascular resistance (Rr) at rest; venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) under the functional loading test. Results. The data obtained during dynamic observations (in 1, 3, 6, 9 and 12 months) in Group 1 demonstrated a significant increase in volumetric blood flow velocity at rest (Qr) and reserve blood flow (QH); decrease of the regional vascular resistance at rest (Rr) and under functional loading (RH) as well as the decrease of venous tone (Vt), respectively. In Group 2 (controls), there were no significant positive dynamics; moreover, regional hemodynamics significantly worsened in 9 and 12 months. Conclusion. By the findings of venous-occlusive plethysmography, regional hemodynamics significantly improved in patients with DCMP under unloading therapeutic gymnastics in combination with ILBI and correctly selected differentiated drug therapy. The developed curative technique can be used in medical practice by GPs, therapists, cardiologists for optimizing treatment of patients with DCMP.

2020 ◽  
Vol 97 (3) ◽  
pp. 69-75
Author(s):  
O.D. Lebedeva ◽  
A.A. Achilov ◽  
A.V. Baranov ◽  
R.D. Mustafaev

The aim of the study: Combined use of kineso- and laser therapy to correct regional hemodynamic disorders in patients with dilated cardiomyopathy (DCMP). Material and methods: The study included 100 patients diagnosed with DCMP. The diagnosis "DCMP" was established for patients with dilatation of the heart cavity of non-coronatural origin, increased heart size (final diastolic size of the left ventricle - LV CDR > 6.0 cm). The determination of the CHF FC was made according to the Russian National Recommendations of the RSCS (2018) and OSSN on the diagnosis and treatment of CHF. All patients took differentiated medication-assisted therapy according to indications during 3 months. Patients were divided into 2 comparable groups by sex, age, disease course, severity of the condition, and specifics of medication therapy. Patients of the 1st group were treated with intravenous laser irradiation of blood (ILIB) and selection of unloading therapeutic gymnastics against the background of supporting differentiated medication therapy. Patients of the 2nd group (control) received only differentiated medication therapy. The main method of investigation was venous occlusal plethysmography to evaluate regional hemodynamics with the determination of blood flow (Qr) and regional vascular resistance (Rr) at rest, venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) on the background of a functional load test. РResults: The data obtained during the dynamic observation (in 1, 3, 6 and 12 months) in the main group showed a reliable increase in the volume velocity of the blood flow at rest (Qr) and the reserve blood flow (QH), a decrease in the regional vascular resistance at rest (Rr) and under functional load (RH), venous tone (Vt), respectively. In the control group there was no reliable positive dynamics, after 12 months of observation indicators of regional hemodynamics significantly deteriorated. Conclusion: In patients with DCMP, according to venous occlusal plethysmography, the use of relieving therapeutic gymnastics in combination with ILIB on the background of medication therapy has significantly improved the indices of regional hemodynamics. The developed method of non-drug therapy can be used by cardiologists, general practitioners, therapists, doctors of physical and rehabilitation medicine to optimize treatment of patients with DCMP.


2003 ◽  
Vol 284 (2) ◽  
pp. H668-H675 ◽  
Author(s):  
Jorge A. Guzman ◽  
Ariosto E. Rosado ◽  
James A. Kruse

Effects of a dopamine-1 (DA-1) receptor agonist on systemic and intestinal oxygen delivery (D˙o 2)-uptake relationships were studied in anesthetized dogs during sequential hemorrhage. Control ( group 1) and experimental animals ( group 2) were treated similarly except for the addition of fenoldopam (1.0 μg · kg−1 · min−1) in group 2. Both groups had comparable systemic criticalD˙o 2(D˙o 2crit), but animals in group 2 had a higher gut D˙o 2crit(1.12 ± 1.13 vs. 0.80 ± 0.09 ml · kg−1 · min−1, P < 0.05). At the mucosal level, a clear biphasic delivery-uptake relationship was not observed in group 1; thus oxygen consumption by the mucosa may be supply dependent under physiological conditions. Group 2 demonstrated higher peak mucosal blood flow and lack of supply dependency at higher mucosalD˙o 2 levels. Fenoldopam resulted in a more conspicuous biphasic relationship at the mucosa and a rightward shift of overall splanchnic D˙o 2crit despite increased splanchnic blood flow. These findings suggest that DA-1 receptor stimulation results in increased gut perfusion heterogeneity and maldistribution of perfusion, resulting in increased susceptibility to ischemia.


2019 ◽  
Vol 34 (1) ◽  
pp. 54-60
Author(s):  
M. S. Kamenskikh ◽  
A. V. Zagatina ◽  
N. T. Zhuravskaya ◽  
Yu. N. Fedotov ◽  
D. V. Shmatov

Aim of the study was to identify the effects of myocardial revascularization on the prognosis in patients with altered coronary blood flow detected by transthoracic ultrasound.Material and Methods. Four hundred and twelve (412) patients were included in the study. The inclusion criterion was coronary velocity more than 70 cm/s during echocardiography. The study population was divided into three groups: Group 1 comprised patients with high velocities in the coronary arteries detected by ultrasound, in whom myocardial revascularization was performed; Group 2 comprised patients with high velocities in the coronary arteries, in whom myocardial revascularization was not performed and; the Control Group comprised patients with normal coronary blood flow according to ultrasound. The follow-up period was 10–11 months.Results. Seventeen (17) deaths (4.7%) occurred during follow-up. Death rates were 1.6 vs. 8.1 vs. 0% in Group 1, Group 2 and the Control Group, respectively, with a p-value for the difference between Group 1 and Group 2 (p1) of <0.009; and a p-value for the differences compared with the Control group (р2) of <0.03. Death, myocardial infarction, pulmonary edema, and acute coronary syndrome were observed in 27 patients (7.7% of the study group with accelerated blood flow). The rates of these outcomes were 4.9 vs. 11.0 vs. 0% in Group 1, Group 2, and the Control Group, respectively (p1<0.05; p2<0.006). Discussion. The study showed high rates of mortality or acute coronary events in the group of patients with pathologically high coronary flow velocities. The positive effects of revascularization on survival in this group were verified.Conclusions: 1. Left artery coronary flow velocities over 70 cm/s indicate a high probability of death or acute coronary events within 10.5 months.2. Myocardial revascularization has a significant positive effect on the survival rate and incidence of acute coronary events in patients with coronary artery flow velocities greater than 70 cm/s.3. Patients with high coronary blood flow velocities should be referred to coronary angiography or other diagnostic tests without waiting for clinical manifestations and specific symptoms for coronary artery disease.


1998 ◽  
Vol 275 (2) ◽  
pp. H680-H688 ◽  
Author(s):  
Linda Keyes ◽  
David M. Rodman ◽  
Douglas Curran-Everett ◽  
Kenneth Morris ◽  
Lorna G. Moore

Decreased vascular resistance and vasoconstrictor response during pregnancy enables an increase in cardiac output and regional blood flow to the uterine circulation. We sought to determine whether inhibition of vascular smooth muscle ATP-sensitive potassium ([Formula: see text]) channel activity during pregnancy increased systemic and/or regional vascular resistance and resistance response to ANG II. A total of 32 catheterized, awake, pregnant or nonpregnant guinea pigs were treated with either the [Formula: see text]channel inhibitor glibenclamide (3.5 mg/kg) or vehicle (DMSO) ( n = 8/group). In nonpregnant and pregnant animals, glibenclamide raised blood pressure and systemic, uterine, and coronary vascular resistance, diminishing cardiac output and organ blood flow. Glibenclamide produced a greater rise in coronary vascular resistance in the pregnant than nonpregnant groups and increased renal and cerebral vascular resistance in the pregnant animals only. ANG II infusion raised blood pressure and systemic and renal vascular resistance and lowered cardiac output and renal blood flow in vehicle-treated animals. Glibenclamide augmented ANG II-induced systemic vasoconstriction in the nonpregnant and pregnant groups and the rise in uteroplacental vascular resistance in the pregnant animals. We concluded that [Formula: see text] channel activity likely modulates systemic, uterine, and coronary vascular resistance and opposes ANG II-induced systemic vasoconstriction in nonpregnant and pregnant guinea pigs. Pregnancy augments[Formula: see text] channel activity in the uterine, coronary, renal, and cerebral vascular beds and the uteroplacental circulation during ANG II infusion. Thus increased[Formula: see text] channel activity appears to influence regional control of vascular resistance during guinea pig pregnancy but cannot account for the characteristic decrease in systemic vascular resistance and ANG II-induced systemic vasoconstrictor response.


1995 ◽  
Vol 83 (4) ◽  
pp. 721-726. ◽  
Author(s):  
Christian Werner ◽  
Eberhard Kochs ◽  
Hanswerner Bause ◽  
William E. Hoffman ◽  
Jochen Schulte am Esch

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 &lt; 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 &gt; 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.


2009 ◽  
Vol 21 (1) ◽  
pp. 254 ◽  
Author(s):  
A. Hanstedt ◽  
K. Höffmann ◽  
Ä Honnens ◽  
H. Bollwein ◽  
C. Wrenzycki

On average, only 20% of the cumulus–oocyte complexes (COC) develop to the blastocyst stage (Merton et al. 2003 Theriogenology 59, 651–674). An increase in the blood supply to individual follicles appears to be associated with follicular growth rates, whereas a reduction seems to be closely related to follicular atresia (Acosta et al. 2003 Reproduction 125, 759–767). The purpose of this study was to determine whether qualitative perifollicular blood flow changes can be used to predict the developmental competence of COC collected during repeated ovum pickup (OPU) sessions once or twice weekly. Lactating Holstein cows (n = 20) were used as oocyte donors. After dominant follicle removal, OPU was performed twice (group 1, for 3 weeks) or once (group 2, for six weeks) weekly employing a 7.5-MHz transducer (GE 8C-RS) of an ultrasound scanner (GE Logiq Book). Follicle size and Doppler characteristics were recorded by transvaginal ultrasonography just before COC collection using color flow imaging. Owing for technical limitations for measurement of blood flow in small individual follicles, only the presence or absence of blood flow was assessed for each follicle. When a clearly visible blue or red spot (blood flow) was detected in the follicle wall, it was considered as a follicle with detectable blood flow. Follicles with or without detectable blood flow from each individual cow were aspirated separately. After morphological classification of COC, standard protocols for IVP were used for embryo production (Wrenzycki et al. 2001 Biol. Reprod. 65, 323–331). Cleavage and blastocyst rates were recorded at Day 3 and Day 8, respectively. In total, 464 (246 with and 218 without detectable blood flow) and 243 (125 with and 118 without detectable blood flow) follicles ≥3 mm were aspirated in group 1 and group 2, respectively. Morphology of the COC was similar in all groups. Developmental rates for COC stemming from follicles with or without detectable blood flow in group 1 did not show differences for cleavage rates, 54.0% (34/63) and 56.7% (45/81), and for blastocyst rates, 25.4% (16/63) and 22.2% (18/83), respectively. In group 2, the cleavage rates were also similar for COC originating from follicles with and without detectable blood flow, 54.3% (25/46) and 51.5% (34/66). However, developmental rates up to the blastocyst stage did show a significant difference, 23.9% (11/46) and 15.2% (10/66) for COC aspirated from follicles with or without detectable blood flow (P ≤ 0.05). These results show that using COC originating from follicles with detectable perifollicular blood flow collected once weekly may have a higher developmental competence compared to those from follicle without detectable blood flow. Within the detection limits of this study, differences in perifollicular blood flow during repeated OPU sessions once weekly were predictive of oocyte competence. Ruthe Research Farm, Germany, for providing the animals; Masterrind GmbH, Germany, for donation of the semen; and the HW Schaumann Stiftung for financial support.


1990 ◽  
Vol 68 (4) ◽  
pp. 1534-1541 ◽  
Author(s):  
N. Laudignon ◽  
E. Farri ◽  
K. Beharry ◽  
J. Rex ◽  
J. V. Aranda

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)


1991 ◽  
Vol 71 (6) ◽  
pp. 2338-2345 ◽  
Author(s):  
I. Mayers ◽  
D. Johnson ◽  
T. Hurst ◽  
T. To

We studied the effects of endotoxin and tumor necrosis factor (TNF-alpha) on hypoxic pulmonary vasoconstriction (HPV) in 12 isolated perfused canine lung lobes. Group 1 lobes were perfused with whole blood, and group 2 lobes were perfused with granulocyte-depleted blood. All lobes were sequentially ventilated with control (35% O2) and hypoxic (3% O2) gas mixtures before and after receiving TNF-alpha. After TNF-alpha, group 2 lost HPV but group 1 retained HPV. After TNF-alpha, total pulmonary vascular resistance decreased in group 2 from 0.085 +/- 0.013 to 0.049 +/- 0.016 cmH2O.ml-1.min (P less than 0.05). We conclude that TNF-alpha acts as a pulmonary vascular vasodilator. In lobes perfused with whole blood, HPV is paradoxically preserved. We speculate that in the presence of cells rich in TNF-alpha receptors, i.e., granulocytes, the circulating levels of TNF-alpha are depressed and full expression of its vascular effects is blunted.


1987 ◽  
Vol 63 (6) ◽  
pp. 2240-2246 ◽  
Author(s):  
E. M. Baile ◽  
S. Guillemi ◽  
P. D. Pare

Tracheobronchial blood flow increases two- to fivefold in response to isocapnic hyperventilation with warm dry or cold dry air in anesthetized, tracheostomized dogs. To determine whether this response is governed by central nervous system thermoregulatory control or is a local response to the drying and/or cooling of the airway mucosa, we studied eight anesthetized spontaneously breathing dogs in a thermally controlled chamber designed so that inspired air temperature, humidity, and body temperature could be separately regulated. Four dogs breathed through the nose and mouth (group 1), and four breathed through a short tracheostomy tube (group 2). Dogs were studied under the following conditions: 1) a normothermic control period and 2) two periods of hyperthermia in which the dogs panted with either warm 100% humidified air or warm dry (approximately 10% humidified) air. Radiolabeled microspheres (15 +/- 3 micron diam) were injected into the left ventricle as a marker of nasal, lingual, and tracheobronchial blood flow. After the final measurements, the dogs were killed and tissues of interest excised. Results showed that lingual and nasal blood flow (ml.min-1.g-1) increased during panting (P less than 0.01) in both groups and were not affected by the inspired air conditions. In group 1, tracheal mucosal blood flow barely doubled (P less than 0.01) and bronchial blood flow did not change during humid and dry air panting. In group 2, there was a sevenfold increase in tracheal mucosal and about a threefold increase in bronchial blood flow (P less than 0.01), which was only observed during dry air panting.(ABSTRACT TRUNCATED AT 250 WORDS)


2016 ◽  
Vol 7 (3) ◽  
pp. 92-97 ◽  
Author(s):  
Arutyun F Arutyunyan ◽  
Sergey N Gaydukov ◽  
Vitaly N Kustarov

The purpose of our study was to assess the effectiveness of the use of drugs containing indole-3-carbinol and epigallocatechin-3 gallate in combination with effective natural methods (TES-therapy and hirudotherapy) depending on the degree of morphological adenomyosis. The study involved 205 women with diffuse adenomyosis. Based on survey data from 205 women surveyed in 67 verified adenomyosis first degree (Group 1), 79 - second degree adenomyosis (group 2), and 59 - third degree adenomyosis (group 3). Doppler results showed that in patients with adenomyosis first degree nizkorezistentny uterine blood flow was observed. Improvement of clinical symptoms of the disease, increasing the numerical values of R & D in the uterine arteries at the first degree adenomyosis indicates pathogenic effects of the proposed treatment. At the same time in patients with adenomyosis II-III degree was observed with highly bloodstream, indicating the deterioration of blood flow in the uterine vascular basin, as evidenced by some of hemostasis. Thus, studies have provided credible evidence pathogenesis mediated relations between the characteristics of the circulation of the uterus, the processes of neoangiogenesis, proliferation in the myometrium and the extent of spread of the disease, which will choose the appropriate methods of conservative treatment. Using drugs and Indinol epigallat affecting the basic pathogenetic mechanisms of adenomyosis, opens a new direction in the treatment of this disease, and effective natural methods - new opportunities in the treatment of adenomyosis.


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