Changes in micro- and central hemodynamic parameters in rats under the action of acetylsalicylic acid and its coordination compounds with metals

Introduction. The cutaneous blood circulation is a representative model both for studying the mechanisms of vascular diseases and for assessing the current state of the central hemodynamics in preclinical researches of various chemical compounds. Aim. The changes in the parameters of cutaneous microcirculation and central hemodynamics (heart rate and blood pressure) were studied in the animals under the action of acetylsalicylic acid and its coordination compounds with cations of cobalt, zinc, nickel and manganese at a dose of 20 mg/kg. Materials and methods. The research was conducted using the laser Doppler flowmetry method on the Lazma-MC device (manufactured by RPE Lazma, Russia) and the NIBP200A system (Biopac Systems, Inc., USA). Results. The study shows that animals develop bradycardia, and microcirculation and central hemodynamics change in two ways after the introduction of acetylsalicylic acid and the tested metal salicylates. These ways are hypotension-related hyperemia (acetylsalicylic acid and cobalt salicylate) and ischemia (zinc, nickel and manganese salicylates) associated with hypertension. Conclusion. The obtained data confirm the cardiotropic activity of new coordination compounds. The data also prove that the generation of the acetylsalicylic acid derivatives allows enhancing it physiological effects, as well as obtaining completely new molecules. The molecules are different from the precursor one and are necessary for the production of effective drugs.

Central Hemodynamic Adjustments during Post-Exercise Hypotension in Hypertensive Patients with Ischemic Heart Disease: Concurrent Circuit Exercise versus High-Intensity Interval Exercise. A Preliminary Study

Concurrent aerobic plus resistance exercise (RAE) and high-intensity interval exercise (HIIE) are both effective at inducing post-exercise hypotension (PEH) in patients with hypertension. However, central hemodynamic changes associated with PEH in hypertensive subjects with underlying ischemic heart disease (IHD) have been poorly investigated. The study aim was to compare the acute effects produced by these two exercise modalities on left ventricular diastolic function and left atrial function. Twenty untrained male patients with a history of hypertension and IHD under stable pharmacological therapy were enrolled. Each patient underwent three exercise sessions: RAE, HIIE and a control session without exercise, each lasting 45 min. An echocardiography examination was performed before and between 30 min and 40 min from the end of the exercise sessions. Following the exercise sessions, BP values decreased in a similar way in RAE and HIIE and were unchanged after the control session. Compared to pre-session, the ratio between early filling velocity (E) and mitral annulus early diastolic velocity (E’). E/E’ increased after HIIE and remained unchanged after both RAE and control sessions (between-sessions p 0.002). Peak atrial longitudinal strain (PALS) increased slightly after RAE (+1.4 ± 1.1%), decreased after HIIE (−4.6 ± 2.4%) and was unchanged after the control session (between-sessions p 0.03). Peak atrial contraction strain (PACS) was mildly increased after RAE, was reduced after HIIE and was unchanged after the control session. Atrial volume was unchanged after both exercise sessions. Left ventricular and left atrial stiffness increased significantly after HIIE, but remained unchanged after the RAE and control sessions. Stroke volume and cardiac output increased after RAE, decreased after HIIE, and were unchanged after the control session. In conclusion, single session of RAE and HIIE brought about similar PEH in hypertensive subjects with IHD, while they evoked different central hemodynamic adjustments. Given its neutral effects on diastolic and atrial functions, RAE seems more suitable for reducing blood pressure in hypertensive patients with IHD.

DEVELOPMENT OF A DEVICE FOR NON-INVASIVE ASSESSMENT OF CENTRAL HEMODYNAMIC PARAMETERS

В статье представлена разработка технического проекта по созданию прибора для неинвазивной оценки параметров центральной гемодинамики. Сердечно-сосудистые заболевания являются основной причиной смерти во всем мире: ни по какой другой причине ежегодно не умирает столько людей, сколько от патологий сердца. По оценкам, за последние годы от сердечных заболеваний умерло 17,9 миллиона человек, что составило 31% всех случаев смерти в мире. Другой известной причиной смертей являются различные аритмии. Таким образом, из-за растущего количества людей, страдающих патологий сердца, необходимо во время лечения как можно подробнее изучать состояние сердечно-сосудистой системы во избежание негативных последствий. Чтобы обеспечить более высокую результативность лечения, используется метод электроимпедансной реокардиографии, который позволяет оценить суммарное кровенаполнение органов и тканей. Целью данной статьи являлась разработка технического проекта по созданию прибора для неинвазивной оценки параметров центральной гемодинамики. Представлен теоретический этап разработки технического устройства. Описаны существующие методы измерений - трансторакальные или прекордиальные для нахождения необходимых параметров сердечно-сосудистой системы с помощью реокардиографии. Предложены технические характеристики разрабатываемой биотехнической системы, а также схема и описание прибора The article presents the development of a technical project for the creation of a device for non-invasive assessment of the parameters of central hemodynamics. Cardiovascular disease is the leading cause of death worldwide: for no other reason as many people die every year as from heart disease. An estimated 17.9 million people have died from heart disease in recent years, accounting for 31% of all deaths worldwide. Various arrhythmias are another known cause of death. Thus, due to the growing number of people suffering from heart pathologies, it is necessary during treatment to study the state of the cardiovascular system in as much detail as possible in order to avoid negative consequences. To ensure a higher efficiency of treatment, the method of electrical impedance rheocardiography is used, which allows to assess the total blood volume of organs and tissues. The purpose of this article was to develop a technical project to create a device for non-invasive assessment of the parameters of central hemodynamics. The theoretical stage of the development of a technical device is presented. The existing measurement methods are described - transthoracic or precordial to find the necessary parameters of the cardiovascular system using rheocardiography. The technical characteristics of the developed biotechnical system, as well as the scheme and description of the device are proposed

Cardiac Function Index as a Possible Target Parameter Hemodynamic Correction in Abdominal Sepsis (Pilot Study)

Aim of the study: to determine the predictive value of central hemodynamic parameters in relation to mortality and evaluate their potential acceptability for goal-directed therapy during days 1-4 of treatment in patients with sepsis.Material and methods. The results of investigation and treatment of 62 patients aged 50.9±2.13 years with abdominal sepsis were analyzed. The patient severity on admission to the intensive care unit was 13 [10-15] on the APACHE II scale, 8 [6.75-9.25] on the SOFA scale. Lethal outcome 15.6±1.4 days after admission occurred in 19 (31%) patients. Central hemodynamic parameters were studied by transpulmonary thermodilution according to the standard technique. Infusions and administration of sympathomimetic drugs were performed according to Sepsis-3 guidelines. Statistical analysis was performed using logistic regression and ROC analysis.Results. The median values of the main circulatory parameters during days 1-4 of sepsis treatment were within normal ranges. Cardiac index, afterload-related cardiac performance, global cardiac ejection fraction and cardiac function index were predictors of mortality at all stages of treatment. However, the first three parameters did not provide either sufficient model quality at the study stages or a stable cutoff value with acceptable sensitivity and specificity. The cardiac function index maintained good model quality (area under the ROC curve 0.708-0.753) and a stable cutoff value (≤5.75 to ≤5.81 min-1) with acceptable and balanced sensitivity and specificity of about 70% at all study stages.Conclusion. The cardiac index, afterload cardiac performance, global cardiac ejection fraction and cardiac function index during days 1-4 of intensive care of sepsis are predictors of lethal outcome. At the same time, only the cardiac function index maintains good model quality and consistent cut-off point value with acceptable sensitivity and specificity at all stages of the study. The feasibility of using the cardiac function index as one of the parameters of goal-directed therapy aimed at cardiovascular function improvement in sepsis needs further investigation.

Analysis of Central Hemodynamic Parameters in Medical Students during the Pre-Examination Study Period

Background: One of the main negative factors of the educational environment is the increased stress impact on the cardiovascular system of students preparing for examinations. The cumulative effect of a long-term, systematic exposure to stressors may be accompanied by impaired mental and somatic health of students. The extent of response to stress is individual; it is usually determined by cardiovascular health and a complex of psychophysiological characteristics of the body. Objective: To study the main parameters of central hemodynamics in medical students depending on the body mass index and adaptive potential in the pre-examination study period Materials and methods: In spring–summer 2019, 170 medical students (young men and women aged 20.4 ± 0.3 years) with different adaptive potential of the circulatory system were surveyed during a pre-exam study period to establish their anthropometric indicators, blood pressure and heart rate and to further estimate the body mass index and the main central hemodynamics parameters. Results: The average heart rate of students during the pre-exam study period was 85.4 ± 12.21 beats per minute. The level of metabolic and energy processes in the myocardium was characterized as moderate with a tendency to insufficient functional capacity of the cardiovascular system (CI = 90.4 ± 1.22). Significant differences were revealed in a number of parameters un-der study depending on gender, body mass index (F = 3.99; p = 0.00890) and the adaptive potential of the circulatory system (F = 23.08; p = 0.00000). Conclusions: In the pre-examination study period, both the heart rate and the Kerdo index among the students were elevated, which indicates the predominance of sympathetic autonomic stress. The students with tense adaptation mechanisms demonstrated higher values of certain hemodynamic parameters. The pulse pressure and the Robinson index were higher in overweight students compared to their peers with a normal body mass index. None of the students with class 1 obesity had a satisfactory level of adaptation of the circulatory system. The analysis of central hemodynamic parameters enables the assessment of tolerance of the cardiovascular system of students to the burden of learning.

Separating ventricular activity in thoracic EIT using 4D image-based FEM simulations

One challenge in central hemodynamic monitoring based on electrical impedance tomography (EIT) is to robustly detect ventricular signal components and the corresponding EIT image region without external monitoring information. Current stimulation and voltage measurement of EIT were simulated with finite element porcine torso models in presence of a multitude of thoracic blood volume shifts. The simulated measurement data was examined for linear dependence on changes in stroke volume. Based on the results the EIT measurement information regarding stroke volume changes is sparse

INDICATORS OF CENTRAL CARDIOHEMODYNAMICS IN PATIENTS WITH ARTERIAL HYPERTENSION WITH POSTINFARCTION CARDIOSCLEROSIS AND DIABETES MELLITUS TYPE 2

Central hemodynamic parameters in 40 patients with arterial hypertension, postinfarction cardiosclerosis and type 2 diabetes were evaluated. Based on the study, it is proved that type 2 diabetes mellitus is a predictor of concentric LV myocardial hypertrophy, which can be considered as a reaction of the heart to prolonged increased load and disruption of myocardial microcirculation, contributes to complex structural and functional reorganization of the heart with a tendency to reduce myocardial contractility. Comorbidity of hypertension, postinfarction cardiosclerosis and type 2 diabetes increases the incidence of signs of left ventricular diastolic dysfunction type 1 (type of relaxation disorder), which leads to a worsening of the prognosis of cardiovascular complications.

The International Database of Central Arterial Properties for Risk Stratification: Research Objectives and Baseline Characteristics of Participants

Objective To address to what extent central hemodynamic measurements, improve risk stratification, and determine outcome-based diagnostic thresholds, we constructed the International Database of Central Arterial Properties for Risk Stratification (IDCARS), allowing a participant-level meta-analysis. The purpose of this article was to describe the characteristics of IDCARS participants and to highlight research perspectives. Methods Longitudinal or cross-sectional cohort studies with central blood pressure measured with the SphygmoCor devices and software were included. Results The database included 10930 subjects (54.8% women; median age 46.0 years) from thirteen studies in Europe, Africa, Asia and South America. The prevalence of office hypertension was 4446 (40.1%), of which 2713 (61.0%) were treated, and of diabetes mellitus was 629 (5.8%). The peripheral and central systolic/diastolic blood pressure averaged 129.5/78.7 mm Hg and 118.2/79.7 mm Hg, respectively. Mean aortic pulse wave velocity was 7.3 meter per seconds. Among 6871 participants enrolled in 9 longitudinal studies, the median follow-up was 4.2 years (5th–95th percentile interval, 1.3–12.2 years). During 38957 person-years of follow-up, 339 participants experienced a composite cardiovascular event and 212 died, 67 of cardiovascular disease. Conclusions IDCARS will provide a unique opportunity to investigate hypotheses on central hemodynamic measurements that could not reliably be studied in individual studies. The results of these analyses might inform guidelines and be of help to clinicians involved in the management of patients with suspected or established hypertension.

Association of free fatty acid binding protein with central aortic stiffness, myocardial dysfunction and preserved ejection fraction heart failure

There is an established link between cardiometabolic abnormality, central arterial stiffness, and preserved ejection fraction heart failure (HFpEF). Adipocyte free fatty acid binding protein (a-FABP) has been shown to signal endothelial dysfunction through fatty acid toxicity, though its role in mediating ventricular-arterial dysfunction remains unclear. We prospectively examined the associations of a-FABP with central arterial pressure using non-invasive applanation tonometry (SphygmoCor) and cardiac structure/function (i.e., tissue Doppler imaging [TDI] and global longitudinal myocardial strain [GLS]) in patients with cardiometabolic (CM) risk (n = 150) and HFpEF (n = 50), with healthy volunteers (n = 49) serving as a control. We observed a graded increase of a-FABP across the healthy controls, CM individuals, and HFpEF groups (all paired p < 0.05). Higher a-FABP was independently associated with higher central systolic and diastolic blood pressures (CSP/CPP), increased arterial augmentation index (Aix), lower early myocardial relaxation velocity (TDI-e′), higher left ventricle (LV) filling (E/TDI-e′) and worsened GLS (all p < 0.05). During a median of 3.85 years (interquartile range: 3.68–4.62 years) follow-up, higher a-FABP (cutoff: 24 ng/mL, adjusted hazard ratio: 1.01, 95% confidence interval: 1.001–1.02, p = 0.04) but not brain natriuretic peptide, and higher central hemodynamic indices were related to the incidence of heart failure (HF) in fully adjusted Cox models. Furthermore, a-FABP improved the HF risk classification over central hemodynamic information. We found a mechanistic pathophysiological link between a-FABP, central arterial stiffness, and myocardial dysfunction. In a population with a high metabolic risk, higher a-FABP accompanied by worsened ventricular-arterial coupling may confer more unfavorable outcomes in HFpEF.