scholarly journals ROLE OF HEART RATE REDUCTION WITH IVABRADINE IN LEFT VENTRICULAR FAILURE

2020 ◽  
Vol 70 (6) ◽  
pp. 1839-42
Author(s):  
Safia Batool ◽  
Jamal Waris ◽  
Muhammad Usman Sajid ◽  
Shazia Nisar ◽  
Imran Khan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Left Ventricular ◽  
Left Ventricular Failure ◽  
Heart Rate Reduction ◽  
Rate Reduction ◽  
Ventricular Failure

Objective: To compare mean heart rate reduction in Ivabradine and placebo group in left ventricular failurepatients. Study Design: Quasi experimental study. Place and Duration of Study: Study was conducted at CMH, Kharian, from Jul 2018 to Dec 2018. Methodology: 64 patients participated in the study. They were randomly divided into two groups of 32each. One group was given Tab Ivabradine (10 mg twice a day) while second group received a placebo for aperiod of 4 weeks. After 4 weeks each patient was evaluated and heart rate, systolic and diastolic blood pressure were recorded. Mann-whitney U test selected to compare heart rate and ages of both groups t- test used to compare systolic and diastolic blood pressure among both groups. Chi-square test used to determine the association of heart rate between two groups. A p-value ≤0.05 was considered significant. Results: Median (IQR) heart rate was significantly lower in Ivabradine group 58.3 (4) as compared to placebo64.1(1) (p<0.01). Systolic blood pressure (132.8 ± 3.6) was significantly lower in ivabradine group as comparedto placebo group (137.1 ± 4.5) (p<0.01). Difference in diastolic blood pressure was insignificant in both groups (p=0.55). There was a significant association between heart rate of 55-60 beats per minute and ivabradine use(p<0.01). Conclusion: Ivabradine is safe and efficative drug in reducing heart rate and systolic blood pressure for patients suffering from left ventricular failure. Early detection and management of left ventricular failure with ivabradine use leads to better prognosis of the disease.

scholarly journals Effect of short-acting b--blockers on heart rate and blood pressure in patients with acute coronary syndrome during percutaneous and coronary intervention

2021 ◽  
Vol 4 (2) ◽  
pp. 36-44
Author(s):  
L Rasputina ◽  
D Didenko ◽  
A Solomonchyk
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Heart Rate Reduction ◽  
Rate Reduction ◽  
Coronary Syndrome ◽  
History Of

Background. The use of b- blockers in acute coronary syndrome (ACS) is recommended for all patients, who has not contraindications. The study of the effects of esmolol during percutaneous coronary intervention (PCI) remains relevant. Objective. To evaluate the features of the effect of esmolol (Biblock, “YURiA-PHARM”) on heart rate and blood pressure in patients with ACS during PCI.Materials and methods. The study included 30 patients, 15 men and 15 women, who were hospitalized in a specialized cardiology department with ACS with elevation of the ST segment. All patients underwent a general clinical examination, ECG recording in 12 leads, PCI according to the standard protocol with ECG and blood pressure monitoring. All patients were given infusion of esmolol before the standard therapy. The level of heart rate reduction, systolic blood pressure (SBP), diastolic blood pressure (DBP), the correlation of heart rate reduction during esmolol infusion with the clinical and functional parameters of patients and the degree of coronary artery (CA) damage were analyzed.Results. Decreased heart rate and blood pressure during infusion of esmolol in all patients. Before the infusion, the heart rate av-eraged (109.8 ± 4.0) beats per minute. After the infusion – (92.8 ± 3.2) beats per minute, (p < 0.001) with an average duration of infusion (18.2 ± 2.3) minutes. The decrease in SBP levels during infusion occurred on average by (22.8 ± 2.5) mm Hg, DBP – by (16.0 ± 2.1) mm Hg, no patient had hypotension. According to the results of correlation analysis, it was found that the decrease in heart rate with the use of esmolol has a correlation with the average age of patients (r = -0.47, p = 0.0012), with the presence of multivascular coronary artery disease (r = -0.38, p = 0.002). Weaker negative correlation was found with the initial level of SBP (r = -0.28, p = 0.015), the presence of a history of myocardial infarction (r = -0.27, p = 0.005), the presence of signs of left ventricular hypertrophy (LVH) on the ECG (r = -0.22, p = 0.008), and a history of arterial hypertension that was not treated according to current recommendations (r = -0.21, p = 0.032).Conclusions. The use of esmolol solution in patients with ACS who have supraventricular tachycardia and elevated blood pressure during PCI can improve control of heart rate, SBP and DBP, a significant decrease is observed after 10 minutes of dose titration. Careful titration of esmolol solution and monitoring of ECG and blood pressure revealed no side effects, including bradycardia and hypotension, which indicates a high safety profile of the drug.

Cardiovascular Responding during Anger and Fear Imagery

1982 ◽  
Vol 50 (1) ◽  
pp. 219-230 ◽  
Author(s):  
Richard J. Roberts ◽  
Theodore C. Weerts
Keyword(s):  
College Students ◽  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Scene Change ◽  
Emotional Responding ◽  
Analysis Of Change ◽  
Screening Interview

This study was designed to determine if visualization of anger- and fear-provoking scenes produced differential physiological patterns similar to those produced by in vivo manipulations. Normotensive college students were selected on the basis of their responses to newly developed Anger and Fear/Anxiety questionnaires and for their ability to construct arousing scenes during a screening interview. In a 2 × 2 design (intensity × emotion), four scenes (high and low anger, high and low fear) were constructed individually for each of 16 subjects to imagine. Diastolic blood pressure, systolic blood pressure, and heart rate were monitored during visualization of each scene. Change in diastolic blood pressure was significantly greater for high anger than for high fear as predicted. Analysis of change in heart rate and systolic blood pressure showed significant effects for intensity only. These results provide further support for the concept of physiological differentiation in human emotion and suggest the utility of imagery for systematic study of human emotional responding.

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.

scholarly journals A randomized comparative study of preloading with Ringers lactate and intravenous Ephedrine for the prevention of hypotension due to propofol during induction of general anesthesia

2016 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Manisha Pradhan ◽  
Brahma Dev Jha
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Physical Status ◽  
Volume Loading

Background: The ideal method to prevent hypotension due to intravenous propofol for induction of anesthesia is still debatable. The aim of the study was to compare the hemodynamic response of ephedrine and volume loading with ringer lactate in preventing the hypotension caused by propofol as inducing agent in patients scheduled for elective surgeries requiring general anesthesia with endotracheal intubation.Methods: This was prospective randomized study conducted in 40 patients of ASA physical status I, aged 20-50 years, scheduled for elective surgeries requiring general anesthesia with endotracheal intubation. Group I received intravenous ephedrine sulphate (70 mcg/kg) just before induction of anaesthesia, and patients assigned to Group II received preloading with Ringer's lactate (12 ml/kg) over the 10-15 minutes before the administration of propofol. The variables compared were heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure following induction of anesthesia till 10 minutes after intubation of trachea.Results: We found that there were increase in systolic blood pressure, diastolic blood pressure and mean arterial pressure after induction in both the groups but the difference between the groups was not significant. The increase in heart rate was found to be significantly higher in ephedrine group in comparison to volume loading group.Conclusion: Our study showed that both the methods used were equally effective in preventing hypotension induced by propofol in the adult ASA physical status I patients requiring general anesthesia with endotracheal intubation. However, the heart rate was significantly higher in patients receiving ephedrine in comparison to volume loading group.

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