83,189 results on '"circulatory and respiratory physiology"'
Search Results
2. Fetal defenses against intrapartum head compression—implications for intrapartum decelerations and hypoxic-ischemic injury
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Austin Ugwumadu, Peter Stone, Alexane Tournier, Christopher A. Lear, Alistair J. Gunn, Jenny A. Westgate, and Laura Bennet
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medicine.medical_specialty ,Fetus ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Baroreflex ,Hypoxemia ,Cerebral blood flow ,Internal medicine ,embryonic structures ,medicine ,Cardiology ,Cardiotocography ,Fetal head ,medicine.symptom ,Cerebral perfusion pressure ,business ,circulatory and respiratory physiology ,Intracranial pressure - Abstract
Uterine contractions during labor and engagement of the fetus in the birth canal can compress the fetal head. Its impact on the fetus is unclear and still controversial. In this integrative physiological review, we highlight evidence that decelerations are uncommonly associated with fetal head compression. Next, the fetus has an impressive ability to adapt to increased intracranial pressure through activation of the intracranial baroreflex, such that fetal cerebral perfusion is well-maintained during labor, except in the setting of prolonged systemic hypoxemia leading to secondary cardiovascular compromise. Thus, when it occurs, fetal head compression is not necessarily benign but does not seem to be a common contributor to intrapartum decelerations. Finally, the intracranial baroreflex and the peripheral chemoreflex (the response to acute hypoxemia) have overlapping efferent effects. We propose the hypothesis that these reflexes may work synergistically to promote fetal adaptation to labor.
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- 2023
3. Aplastic or twig-like middle cerebral artery and cardiogenic cerebral embolism mimicking moyamoya disease with RNF213 polymorphism: A case report
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Hiroyasu Inoue, Masahiro Oomura, Yusuke Nishikawa, Mitsuhito Mase, and Noriyuki Matsukawa
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Male ,Adenosine Triphosphatases ,Middle Cerebral Artery ,Polymorphism, Genetic ,Ubiquitin-Protein Ligases ,General Medicine ,nervous system diseases ,Cerebral Angiography ,Intracranial Embolism ,cardiovascular system ,Humans ,cardiovascular diseases ,Moyamoya Disease ,circulatory and respiratory physiology ,Aged - Abstract
Progressive stenosis and occlusion of the bilateral internal carotid artery terminals and circle of Willis are typical features of Moyamoya disease. However, aplastic or twig-like middle cerebral artery (Ap/T-MCA)—wherein the unilateral main trunk of the middle cerebral artery (MCA) is not depicted, and a plexiform arterial network is formed—is similar to the findings of Moyamoya disease. Here, we describe a 78-year-old man who presented with mild right paralysis and aphasia. Magnetic resonance angiography (MRA) at admission did not show the bilateral MCAs. The findings were similar to those of Moyamoya disease, and his symptoms worsened after hospitalization. Endovascular treatment was performed, and the left MCA was completely recanalized. Later, paroxysmal atrial fibrillation was detected, and we finally determined that left MCA occlusion had occurred due to embolism. The right MCA was completely occluded at its origin, indicating an Ap/T-MCA. Embolic occlusion of the unilateral MCA and contralateral Ap/T-MCA made this case resemble Moyamoya disease in the acute stage. Even when chronic occlusion is suspected on MRA in acute cerebral infarction, endovascular treatment should be considered. Additionally, a heterotypic R4810K polymorphism was later found in the RNF213 gene. To our knowledge, this is the second report of Ap/T-MCA with the RNF213 gene polymorphism; however, their association remains unclear and requires further analyses.
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- 2023
4. Corneal Injury Is Associated With Stromal and Vascular Alterations Within Cranial Dura Mater
- Abstract
The cornea and cranial dura mater share sensory innervation. This link raises the possibility that pathological impulses mediated by corneal injury may be transmitted to the cranial dura, trigger dural perivascular/connective tissue nociceptor responses, and induce vascular and stromal alterations affecting dura mater blood and lymphatic vessel functionality. In this study, using a mouse model, we demonstrate for the first time that two weeks after the initial insult, alkaline injury to the cornea leads to remote pathological changes within the coronal suture area of the dura mater. Specifically, we detected significant pro-fibrotic changes in the dural stroma, as well as vascular remodeling characterized by alterations in vascular smooth muscle cell (VSMC) morphology, reduced blood vessel VSMC coverage, endothelial cell expression of the fibroblast specific protein 1, and significant increase in the number of podoplanin-positive lymphatic sprouts. Intriguingly, the deficiency of a major extracellular matrix component, small leucine-rich proteoglycan decorin, modifies both the direction and the extent of these changes. As the dura mater is the most important route for the brain metabolic clearance, these results are of clinical relevance and provide a much-needed link explaining the association between ophthalmic conditions and the development of neurodegenerative diseases.
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- 2023
5. Closed-Loop Modeling of Central and Intrinsic Cardiac Nervous System Circuits Underlying Cardiovascular Control
- Abstract
The baroreflex is a multi-input, multi-output physiological control system that regulates blood pressure by modulating nerve activity between the brainstem and the heart. Existing computational models of the baroreflex do not explicitly incorporate the intrinsic cardiac nervous system (ICN), which mediates central control of heart function. We developed a computational model of closed-loop cardiovascular control by integrating a network representation of the ICN within central control reflex circuits. We examined central and local contributions to the control of heart rate, ventricular functions, and respiratory sinus arrhythmia (RSA). Our simulations match the experimentally observed relationship between RSA and lung tidal volume. Our simulations predicted the relative contributions of the sensory and the motor neuron pathways to the experimentally observed changes in the heart rate. Our closed-loop cardiovascular control model is primed for evaluating bioelectronic interventions to treat heart failure and renormalize cardiovascular physiology.
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- 2023
6. Factors and outcomes associated with improved left ventricular systolic function in patients with cardiomyopathy
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Dylan Eiger, Daniel P. Fishbein, Zainab Samad, Jeanne E. Poole, Kerry L. Lee, Daniel Friedman, Sana M. Al-Khatib, Gillian D Sanders, Daniel B. Mark, Qijun Li, Lurdes Y. T. Inoue, and Gust H. Bardy
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medicine.medical_specialty ,medicine.medical_treatment ,Cardiomyopathy ,Placebo ,Ventricular Function, Left ,Sudden cardiac death ,QRS complex ,Risk Factors ,Internal medicine ,Humans ,Medicine ,In patient ,cardiovascular diseases ,Heart Failure ,Ejection fraction ,business.industry ,Stroke Volume ,General Medicine ,medicine.disease ,Implantable cardioverter-defibrillator ,humanities ,Defibrillators, Implantable ,Death, Sudden, Cardiac ,Heart failure ,cardiovascular system ,Cardiology ,Female ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,business ,therapeutics ,circulatory and respiratory physiology - Abstract
Background: Many patients in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) had a significant improvement (> 10%) in the left ventricular ejection fraction (LVEF) during the course of the study, but the factors and outcomes associated with such improvement are uncertain. Methods: We examined factors and rates of mortality, cause-specific mortality, and implantable cardioverter defibrillator (ICD) shocks associated with improvement in LVEF by analyzing patients in the SCD-HeFT who were randomized to placebo or an ICD and who had an LVEF checked during follow-up. Results: During a median follow-up of 3.99 years, of 837 patients who had at least two follow-up LVEF measurements, 276 (33%) patients had > 10% improvement in LVEF and 561 (67%) patients had no significant change in LVEF. Factors significantly associated with LVEF improvement included female sex, white race, history of hypertension, a QRS duration < 120 ms, and beta-blocker use. Improvement in LVEF was associated with a significant improvement in survival. There was no significant association between improvement in LVEF and cause-specific death, but there was a significant association between improvement in LVEF and reduced risk of receiving appropriate ICD shocks. Conclusions: About a third of patients in this analysis, who were randomized to placebo or an ICD in SCD-HeFT, had a significant improvement in LVEF during follow-up; improvement in LVEF was associated with improved survival but not with cause-specific death, and with decreased likelihood of receiving appropriate ICD shocks.
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- 2022
7. Salvage Surgery Compared to Surgery After Induction Chemoradiation Therapy for Advanced Lung Cancer
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Shinsuke Uchida, Shun-ichi Watanabe, Yukihiro Yoshida, Kazuo Nakagawa, Keisuke Asakura, Yuko Nakayama, Aki K. Kobayashi, Yuichiro Ohe, and Masaya Yotsukura
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,genetic structures ,Locally advanced ,Carcinoma, Non-Small-Cell Lung ,medicine ,Humans ,cardiovascular diseases ,Lung cancer ,Neoplasm Staging ,Retrospective Studies ,Salvage Therapy ,business.industry ,Medical record ,Chemoradiotherapy ,Perioperative ,Surgical procedures ,medicine.disease ,Surgery ,Treatment Outcome ,cardiovascular system ,Salvage surgery ,Non small cell ,Neoplasm Recurrence, Local ,Pulmonary resection ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology - Abstract
Background Salvage surgery is performed for selected patients with relapses of locally advanced lung cancer after definitive chemoradiation therapy (CRT), and seems to be effective. To date, the feasibility of such salvage surgery, particularly anatomical pulmonary resection, has not been fully evaluated. To assess the feasibility of salvage surgery after definitive CRT, we compared clinical outcomes of surgery after definitive CRT to those of surgery after induction CRT. Methods Medical records of patients who underwent surgery from January 2000 to January 2018 were reviewed. We compared patients with salvage anatomical pulmonary resection after definitive CRT to patients with surgery after induction CRT in terms of perioperative and long-term outcomes. Results Twenty-three patients underwent salvage surgery after definitive CRT for locally advanced lung cancer (salvage group) and 36 underwent surgery after induction CRT for cN2-stage III non-small cell lung cancer (induction CRT group). The surgical procedures in the salvage group were 2 segmentectomies, 13 lobectomies, 1 bi-lobectomy and 7 pneumonectomies, and those in the induction CRT group were 34 lobectomies and 2 bi-lobectomies. There was no 30-day or 90-day mortality in either group. The 5-year overall survival was 44.7% for the salvage group and 58.6% for the induction CRT group. The 5-year progression-free interval was 42.2% for the salvage group and 47.7% for the induction CRT group. Conclusions Salvage anatomical pulmonary resection after definitive CRT for locally advanced lung cancer is feasible with acceptable morbidity and prognosis in highly selected patients.
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- 2022
8. Quantitative thrombus characteristics on thin-slice computed tomography improve prediction of thrombus histopathology
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Hund, H., Boodt, N., Terreros, N.A., Taha, A., Marquering, H.A., Es, A.C.G.M. van, Bokkers, R.P.H., Nijeholt, G.J.L.A., Majoie, C.B.L.M., Dippel, D.W.J., Lingsma, H.F., Beusekom, H.M.M. van, Lugt, A. van der, MR CLEAN Registry Investigators, Neurology, Cardiology, Radiology & Nuclear Medicine, Public Health, Radiology and nuclear medicine, ACS - Atherosclerosis & ischemic syndromes, Biomedical Engineering and Physics, Graduate School, Radiology and Nuclear Medicine, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neurovascular Disorders, ACS - Microcirculation, and Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE)
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Ischemic stroke ,Histopathology ,General Medicine ,CEREBRAL-ARTERY OCCLUSION ,cardiovascular system ,Radiology, Nuclear Medicine and imaging ,ACUTE ISCHEMIC-STROKE ,PERMEABILITY ,cardiovascular diseases ,Computed tomography ,Thrombus ,Thrombectomy ,CT ,circulatory and respiratory physiology - Abstract
Objectives Thrombus computed tomography (CT) characteristics might be used to assess histopathologic thrombus composition in patients treated with endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). We aimed to assess the variability in thrombus composition that could be predicted with combined thrombus CT characteristics. Methods Thrombi of patients enrolled in the MR CLEAN Registry between March 2014 and June 2016 were histologically analyzed with hematoxylin-eosin staining and quantified for percentages of red blood cells (RBCs) and fibrin/platelets. We estimated the association between general qualitative characteristics (hyperdense artery sign [HAS], occlusion location, clot burden score [CBS]) and thrombus composition with linear regression, and quantified RBC variability that could be explained with individual and combined characteristics with R2. For patients with available thin-slice (≤ 2.5 mm) imaging, we performed similar analyses for general and quantitative characteristics (HAS, occlusion location, CBS, [relative] thrombus density, thrombus length, perviousness, distance from ICA-terminus). Results In 332 included patients, the presence of HAS (aβ 7.8 [95% CI 3.9–11.7]) and shift towards a more proximal occlusion location (aβ 3.9 [95% CI 0.6–7.1]) were independently associated with increased RBC and decreased fibrin/platelet content. With general characteristics, 12% of RBC variability could be explained; HAS was the strongest predictor. In 94 patients with available thin-slice imaging, 30% of RBC variability could be explained; thrombus density and thrombus length were the strongest predictors. Conclusions Quantitative thrombus CT characteristics on thin-slice admission CT improve prediction of thrombus composition and might be used to further guide clinical decision-making in patients treated with EVT for AIS in the future. Key Points • With hyperdense artery sign and occlusion location, 12% of variability in thrombus RBC content can be explained. • With hyperdense artery sign, occlusion location, and quantitative thrombus characteristics on thin-slice (≤ 2.5 mm) non-contrast CT and CTA, 30% of variability in thrombus RBC content can be explained. • Absolute thrombus density and thrombus length were the strongest predictors for thrombus composition.
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- 2022
9. In-silico validation of Apocynin and NADPH Oxidase (NOX) enzyme for inhibiting ROS injuries
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Divya Jindal, Vinayak Agarwal, Shriya Agarwal, Ashok Kumar Tiwari, Manisha Singh, Vandana Tyagi, R Rachana, and Vaibhav Gandhi
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inorganic chemicals ,chemistry.chemical_classification ,NADPH oxidase ,biology ,In silico ,Protein subunit ,Molecular Docking Analysis ,Active site ,General Medicine ,respiratory system ,chemistry.chemical_compound ,Enzyme ,chemistry ,Biochemistry ,Apocynin ,cardiovascular system ,biology.protein ,NOx ,circulatory and respiratory physiology - Abstract
The present study was focused to analyse and evaluate potential targets of NADPH Oxidase (NOX) at varying sub-units and co-relating their interactions with apocynin to identify appropreiate mechanism of inhibition for NOX by applying specific facets of computational biology . Active site molecular docking analysis was carried for apocynin against various subunits of NOX and comparatively analysise the binding affinity profiles which were obtained when apocynin was docked with p47phox complete subunit of NOX and all the other subunits.
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- 2023
10. Examining the haemodynamic repercussions of ventilator hyperinflation in elderly patients: An explanatory study.
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Galhardo, Manuella Melo, da Cunha Chermont, Sergio Luiz Soares Marcos, de Lemos Venancio, Isabella Christina Diniz, Lopes, Agnaldo José, and Guimaraes, Fernando Silva
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OLDER patients , *HEMODYNAMICS , *CARDIAC output , *DIASTOLIC blood pressure , *OLDER people , *CARDIOGRAPHY - Abstract
This study assessed the cardiovascular repercussions of two VHI (ventilation hyperinflation) protocols using the volume-controlled mode, one with an inspiratory pause (VHI-P) and the other without an inspiratory pause (VHI-NP), in mechanically ventilated elderly patients. The patients underwent both VHI protocols in a randomized order, and impedance cardiography was used to record cardiovascular variables. During VHI-P, the diastolic blood pressure was lower than during VHI-NP (Δ = 10%; p = 0.009). VHI-NP and VHI-P demonstrated a decrease in cardiac output (CO) during the first and third sets compared to baseline (p < 0.05; ES=0.23 and 0.29, respectively). Arterial oxygen delivery decreased simultaneously with CO compared to baseline values (p < 0.05; ES=0.22 and 0.23, respectively). Five minutes after the intervention, the systolic time ratio values were lower for VHI-P than VHI-NP (Δ = 10%; p = 0.01). Left ventricular ejection time values were consistently lower in VHI-NP compared to VHI-P (Δ = 2%; p = 0.02). In conclusion, our study shows that VHI in volume-controlled mode induces hemodynamic changes in mechanically ventilated elderly patients, albeit with a small effect size and within the normal range. • Mechanically ventilated patients are at risk of pulmonary complications. • In such a scenario, ventilator hyperinflation (VHI) is applied to minimize pulmonary complications. • Elderly individuals often have ageing-related cardiovascular functional changes. • VHI in volume-controlled mode elicits hemodynamic changes in this population. • Cardiac output and oxygen delivery reduced during VHI, albeit with a small effect size. [ABSTRACT FROM AUTHOR]
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- 2023
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11. Relationship of the Circulating Endothelial Progenitor Cells to the Severity of a Coronary Artery Lesion in Unstable Angina
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Cheng Xiao, Lixiang Liu, Xi Li, Xiaoan Yang, and Hanxiong Liu
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Article Subject ,embryonic structures ,cardiovascular system ,Cardiology and Cardiovascular Medicine ,circulatory and respiratory physiology - Abstract
The number and function of circulating endothelial progenitor cells (EPCs) decreased in stable coronary artery disease. Nevertheless, there were few studies that explored the variation of EPC and the relationship with the severity of coronary artery lesions in unstable angina (UA). Therefore, this leaves an area for the investigation of the difference in the number and activity of circulating EPCs and the relationship with the Gensini score in unstable angina. Fluorescence-activated cell sorter analysis, as well as DiI-acLDL and lectin fluorescent staining measure the number of circulating EPCs. The transwell chamber assay and MTT were evaluated by the migration and proliferation of circulating EPCs. In addition, the flow-mediated dilation (FMD), Gensini score, and IL-6 levels in plasma were determined. We found that UA patients had the higher number and lower function of circulating EPCs. With the increase in severity of coronary artery lesions, the migration and proliferation of EPCs were decreased. Moreover, the function of the circulating EPCs was negatively associated with severity of coronary artery lesions in unstable angina. In addition, UA patients presented elevated IL-6, which was negatively correlated with the function of circulating EPCs and FMD and positively correlated with the severity of coronary artery lesions evaluated by the Gensini score. These findings revealed the decline in the function of circulating EPCs was associated with the severity of coronary artery disease, which may be related to systemic inflammation.
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- 2022
12. Compound Ipratropium Bromide plus Budesonide Inhalation in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Its Effect on Heparin-Binding Protein
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Yuan Dong and Qingling Li
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Article Subject ,Complementary and alternative medicine ,respiratory system ,circulatory and respiratory physiology ,respiratory tract diseases - Abstract
Objective. To analyze the clinical effect of compound ipratropium bromide combined with budesonide atomization inhalation on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on the heparin-binding protein. Methods. A total of 110 patients with AECOPD who were admitted to our hospital between January 2020 and January 2021 were enrolled and assigned into control group (conventional treatment + compound ipratropium bromide) and combined group (conventional treatment + compound ipratropium bromide + budesonide) in a 1 : 1 ratio according to different treatment methods. The clinical effects, pulmonary function indexes, and heparin-binding protein levels before and after treatment were compared between the two groups. Results. The treatment with oxygen-driven nebulization of ipratropium bromide combined with budesonide led to a significantly higher total effective rate versus the treatment with ipratropium bromide alone ( P < 0.001 ). After treatment, remarkably higher arterial oxygen partial pressure (PaO2), arterial oxygen saturation (SaO2), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC in the combined group vs. the control group were observed ( P < 0.001 ). The carbon dioxide partial pressure (PaCO2) levels in the two groups were significantly lower than those before treatment, and the decrease in the combined group was greater ( P < 0.001 ). A significantl reduction was observed in heparin-binding protein in both groups after treatment, and the decrease in the combined group was greater versus the control group ( P < 0.001 ). Conclusion. Compound ipratropium bromide plus budesonide via aerosol inhalation therapy might be a preferable approach for AECOPD patients. It exhibits a synergistic effect on inhibiting inflammatory mediators and cytokine networks, significantly reduces airway hyperresponsiveness, and improves blood gas indicators and lung function.
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- 2022
13. The Optimal Cell Salvage Settings to Maximize Hematocrit and Minimize Potassium Using the Cobe BRAT2 Autologous Blood Recovery Unit
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Jeron Zerillo, Qasim Simmons, Samuel DeMaria, Diana N Romano, Sang Kim, Natalie K. Smith, Elaine Boydston, and Hung-Mo Lin
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Blood transfusion ,Hyperkalemia ,Potassium ,medicine.medical_treatment ,Autologous blood ,chemistry.chemical_element ,Hematocrit ,Cell saver ,Blood Transfusion, Autologous ,Animal science ,Hematocrit increased ,medicine ,Humans ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Hemolysis ,Glucose ,Anesthesiology and Pain Medicine ,chemistry ,Lactates ,medicine.symptom ,Erythrocyte Transfusion ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology - Abstract
The objective was to determine the optimal cell saver device settings (infusion rate and wash rate) at which hematocrit is preserved and potassium and lactate are removed from banked red blood cells (RBC).Red cells were washed using the Cobe BRAT 2 Autologous Blood Recovery Unit and sampled for electrolyte composition and hematocrit pre- and postwash.This was a single-center study.Red cells were washed using six infusion rates (100-1,000 mL/min) and six wash rates (100-1,000 mL/min) for a total of 36 combinations. Hematocrit, potassium, glucose, and lactate were evaluated before and after washing.At wash rates ≤400 mL/min, hematocrit increased independent of infusion rate. At wash rates ≥400 mL/min, slower infusion rates were associated with higher hematocrit compared to faster infusion rates (p0.0001 for a wash rate 400-800 mL/min, p0.0005 for a wash rate 1,000 mL/min). Maximal wash speeds were associated with decreasing hematocrit. Infusion and wash rate were both independent predictors of potassium change; slower rates were associated with a larger decrease in potassium. Glucose decreased proportionally as infusion and wash rate decreased. Lactate did not show an association with either infusion or wash rate.Red-cell washing produces higher hematocrit and lower potassium as infusion rate and wash rate decrease. A 340-mL unit of RBC can be processed in 4.26 minutes without loss of hematocrit or an increase in potassium when both infusion and wash rates are set to 400 mL/min.
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- 2022
14. QTc prolongation in adolescents with acute alcohol intoxication
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Loes de Veld, Nico van der Lely, Ben J. M. Hermans, Joris J. van Hoof, Lichelle Wong, Arja Suzanne Vink, Fysiologie, RS: Carim - H08 Experimental atrial fibrillation, Health Services Management & Organisation (HSMO), Cardiology, Graduate School, Paediatric Cardiology, ACS - Heart failure & arrhythmias, and Amsterdam Cardiovascular Sciences
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Adult ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,Adolescent ,CARDIOVASCULAR-RESPONSES ,CHILDREN ,Adolescents ,LONG-QT ,Electrocardiography ,AGE ,Heart Rate ,AMERICAN-HEART-ASSOCIATION ,Humans ,INTERVAL ,cardiovascular diseases ,Arrhythmias, Cardiac ,RECOVERY ,Electrocardiogram ,Long QT Syndrome ,Alcohol intoxication ,Pediatrics, Perinatology and Child Health ,cardiovascular system ,SEX ,Human medicine ,GENDER ,MENSTRUAL-CYCLE ,QTc prolongation ,Alcoholic Intoxication ,circulatory and respiratory physiology - Abstract
In adults, alcohol intoxication is associated with prolongation of the QT interval corrected for heart rate (QTc). The QTc is influenced by age and sex. Although alcohol intoxication is increasingly common in adolescents, there are no data on the prevalence of QTc prolongation in adolescents with alcohol intoxication. This study aimed to determine the prevalence of QTc prolongation in adolescents with alcohol intoxication and identify at-risk adolescents. In this observational study including adolescents aged 10–18 years, heart rate and QT interval were automatically assessed from an electrocardiogram (ECG) at alcohol intoxication using a validated algorithm. The QTc was calculated using both the Bazett formula (QTcB) and Fridericia formula (QTcF). If present, an ECG recorded within 1 year of the date of admission to the emergency department was obtained as a reference ECG. A total of 317 adolescents were included; 13.3% had a QTcB and 7.9% a QTcF longer than the sex- and age-specific 95th-percentile. None of the adolescents had a QTcB or QTcF > 500 ms, but 11.8% of the adolescents with a reference ECG had a QTcB prolongation of > 60 ms, while no adolescents had a QTcF prolongation of > 60 ms. QTc prolongation was mainly attributable to an increase in heart rate rather than QT prolongation, which underlies the differences between QTcB and QTcF. Male sex and hypokalaemia increased the likelihood of QTc prolongation.Conclusion: QTc prolongation was seen in approximately 10% of the adolescents presenting with alcohol intoxication, and although no ventricular arrhythmias were observed in this cohort, QTc prolongation increases the potential for malignant QT-related arrhythmias. Clinicians must be aware of the possibility of QTc prolongation during alcohol intoxication and make an effort to obtain an ECG at presentation, measure the QT interval, and give an adequate assessment of the findings. We advocate admitting adolescents with alcohol intoxication and QTc prolongation. During hospital admission, we recommend limiting exposure to QTc-prolonging medication, increasing potassium levels to a high-normal range (4.5–5.0 mmol/L) and obtaining a reference ECG at discharge. What is Known:• One out of five deaths in adolescents is alcohol-related. Alcohol intoxication has been related to cardiac arrhythmias and sudden cardiac death.•In adults, alcohol intoxication is associated with QTc prolongation. What is New:•Approximately 10% of the adolescents with alcohol intoxication had a QTc longer than the age- and sexspecific cut-off. In contrast to adults, in adolescents with alcohol intoxication, QTc prolongation is attributable to an increase in heart rate, rather than a prolongation of the QT interval.•Especially males and adolescents with hypokalaemia are at risk of QTc prolongation.
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- 2022
15. Trends in Heart-Rate Variability Signal Analysis
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Naimul Mefraz Khan, Syem Ishaque, and Sridhar Krishnan
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Cardiac function curve ,medicine.medical_specialty ,Heartbeat ,lcsh:Medicine ,morbidity ,Review ,Pupil ,lcsh:QA75.5-76.95 ,03 medical and health sciences ,stress ,0302 clinical medicine ,Photoplethysmogram ,Internal medicine ,medicine ,Heart rate variability ,030304 developmental biology ,0303 health sciences ,Signal processing ,exercise ,business.industry ,lcsh:Public aspects of medicine ,lcsh:R ,heart rate variability ,drowsiness ,lcsh:RA1-1270 ,wireless sensors ,Autonomic nervous system ,machine learning ,Blood pressure ,Cardiology ,Digital Health ,lcsh:Electronic computers. Computer science ,business ,030217 neurology & neurosurgery ,circulatory and respiratory physiology - Abstract
Heart rate variability (HRV) is the rate of variability between each heartbeat with respect to time. It is used to analyse the Autonomic Nervous System (ANS), a control system used to modulate the body's unconscious action such as cardiac function, respiration, digestion, blood pressure, urination, and dilation/constriction of the pupil. This review article presents a summary and analysis of various research works that analyzed HRV associated with morbidity, pain, drowsiness, stress and exercise through signal processing and machine learning methods. The points of emphasis with regards to HRV research as well as the gaps associated with processes which can be improved to enhance the quality of the research have been discussed meticulously. Restricting the physiological signals to Electrocardiogram (ECG), Electrodermal activity (EDA), photoplethysmography (PPG), and respiration (RESP) analysis resulted in 25 articles which examined the cause and effect of increased/reduced HRV. Reduced HRV was generally associated with increased morbidity and stress. High HRV normally indicated good health, and in some instances, it could signify clinical events of interest such as drowsiness. Effective analysis of HRV during ambulatory and motion situations such as exercise, video gaming, and driving could have a significant impact toward improving social well-being. Detection of HRV in motion is far from perfect, situations involving exercise or driving reported accuracy as high as 85% and as low as 59%. HRV detection in motion can be improved further by harnessing the advancements in machine learning techniques.
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- 2023
16. Reclassification of Heart Failure with Preserved Ejection Fraction Following Cardiac Sympathetic Nervous System Activation: A New Cutoff Value of 58%
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Toshihiko Goto, Takafumi Nakayama, Junki Yamamoto, Kento Mori, Yasuhiro Shintani, Shohei Kikuchi, Hiroshi Fujita, Hidekatsu Fukuta, and Yoshihiro Seo
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Aged, 80 and over ,Heart Failure ,Male ,Sympathetic Nervous System ,Stroke Volume ,humanities ,Ventricular Function, Left ,cardiac sympathetic nervous system ,heart failure ,left ventricular ejection fraction ,metaiodobenzylguanidine ,mortality ,cardiovascular system ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,circulatory and respiratory physiology ,Aged ,Retrospective Studies - Abstract
Heart failure (HF) with preserved left ventricular ejection fraction (LVEF) is a heterogeneous syndrome. An LVEF of 50% is widely used to categorize patients with HF; however, this is controversial. Previously, we have reported that patients with an LVEF of ≥ 58% have good prognoses. Further, cardiac sympathetic nervous system (SNS) activation is a feature of HF. In this retrospective, observational study, the cardiac SNS activity of HF patients (n = 63, age: 78.4 ± 9.6 years; male 49.2%) with LVEF ≥ 58% (n = 15) and LVEF < 58% (n = 48) were compared using 123I-metaiodobenzylguanidine scintigraphy. During the follow-up period (median, 3.0 years), 18 all-cause deaths occurred. The delayed heart/mediastinum (H/M) ratio was significantly higher in the LVEF ≥ 58% group than in the LVEF < 58% group (2.1 ± 0.3 vs. 1.7 ± 0.4, p = 0.004), and all-cause mortality was significantly lower in patients in the former than those in the latter group (log-rank, p = 0.04). However, when these patients were divided into LVEF ≥ 50% (n = 22) and LVEF < 50% (n = 41) groups, no significant differences were found in the delayed H/M ratio, and the all-cause mortality did not differ between the groups (log-rank, p = 0.09). In conclusion, an LVEF of 58% is suitable for reclassifying patients with HF according to cardiac SNS activity.
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- 2022
17. Constrictive Pericarditis with Cardiac Ascites Caused Spontaneous Bacterial Peritonitis
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Yusuke Kashiwagi, Takashi Kunihara, Satoshi Hoshino, Michihiro Yoshimura, Tomohisa Nagoshi, Jun Yoshida, Michio Yoshitake, and Kenichi Hongo
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Liver Cirrhosis ,Constrictive pericarditis ,medicine.medical_specialty ,Cirrhosis ,medicine.medical_treatment ,Hemodynamics ,Peritonitis ,Gastroenterology ,Spontaneous bacterial peritonitis ,Internal medicine ,Ascites ,Internal Medicine ,Humans ,Medicine ,Pericardiectomy ,Chylous Ascites ,Heart Failure ,business.industry ,Pericarditis, Constrictive ,General Medicine ,medicine.disease ,Heart failure ,medicine.symptom ,Differential diagnosis ,business ,circulatory and respiratory physiology - Abstract
Patients with constrictive pericarditis (CP) typically present with symptoms related to right-sided heart failure, such as cardiac ascites. Spontaneous bacterial peritonitis (SBP) usually arises in association with ascites secondary to hepatic cirrhosis. We herein report a rare case of CP in which SBP developed due to cardiac ascites, even in the absence of cirrhosis. In this case, pericardiectomy improved both the hemodynamics and the ascites, while therapy with diuretics alone was insufficient. It is important to consider SBP in the differential diagnosis when any abdominal symptoms or an inflammatory response is found in patients with heart failure and cardiac ascites.
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- 2022
18. Peripheral Blood Erythrocyte Parameters in Β-Thalassemia Minor with Coexistent Iron Deficiency: Comparisons between Iron-Deficient and -Sufficient Carriers
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Deniz Aslan and Şeyda Değermenci
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hemic and lymphatic diseases ,β-thalassemia minor ,iron deficiency ,iron-deficient carriers ,iron-sufficient carriers ,erythrocyte parameters ,thalassemia screening ,nutritional and metabolic diseases ,circulatory and respiratory physiology - Abstract
Changes in erythrocyte parameters are well known in both β-thalassemia minor (BTM) and iron deficiency (ID) when either is present alone; however, to our knowledge, there has been no study showing the changes when the two conditions coexist. We herein assessed erythrocyte parameters in BTM with coexistent ID. The BTM cases were divided into two groups based on ferritin levels as ID+ and ID−; the ID+ group was then further divided based on hemoglobin (Hb) levels as iron-deficient carriers with (IDA+) and without (IDA−) anemia. When compared to the ID− group, all parameters were significantly different in the IDA+ group except mean corpuscular volume (MCV) and red blood cells (RBC). All parameters except RBC were significantly different between the IDA+ and IDA− groups. Hb, hematocrit (Hct), MCV, and mean corpuscular hemoglobin (MCH) levels in the IDA− group were found to be lower than in the ID− group. Changes in erythrocyte parameters in iron-deficient carriers are critical in screening for BT, particularly for correct formulation of mathematical algorithms utilized by artificial intelligence programs.
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- 2022
19. Jet-Induced Tissue Disruption for Blood Release
- Author
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Andrew J. Taberner, Jiali Xu, Poul M. F. Nielsen, James W. McKeage, and Bryan P. Ruddy
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Needle free ,Jet (fluid) ,Materials science ,Swine ,Capillary action ,Biomedical Engineering ,Equipment Design ,respiratory system ,equipment and supplies ,complex mixtures ,Vascular endothelium ,Drug Delivery Systems ,Pharmaceutical Preparations ,Drug delivery ,Jet injector ,Injections, Jet ,Animals ,Porcine skin ,Intradermal injection ,human activities ,Skin ,circulatory and respiratory physiology ,Biomedical engineering - Abstract
Objective Needle free jet injection is a drug delivery technique that uses the momentum of the fluid drug to break through the skin. This technique has recently also been applied to blood release, aiming to collect samples from capillaries in the skin without needing a lancet prick. This work provides new information about the wound geometry and tissue disruption caused by shallow jet injection with circular shaped and slot shaped jets. Methods We use histological analysis to compare the disruption of tissue, including blood vessels, caused by lancet-pricking and jet injection with a circular shaped jet and a lancet-inspired slot shaped jet. Results Intradermal injection into porcine skin using a slot shaped jet disrupted more vascular endothelium in the tissue than a circular shaped jet and did so at a smaller penetration depth with smaller wound volume. Our results suggest that shallow jet injections may have the potential to release more capillary blood than a lancet prick. Conclusion These findings demonstrate that a reversible jet injector might be used in diabetes management as a device to release and collect blood samples, in addition to being used to deliver insulin. Significance Tissue disruption is crucial to consider when using jet injection to deliver drug and release capillary blood.
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- 2022
20. Neuroanatomical and neurophysiological evidence of pulmonary nociceptor and carotid chemoreceptor convergence in the nucleus tractus solitarius and nucleus ambiguus
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Jekaterina Zyuzin and Nicholas Jendzjowsky
- Subjects
Neurons ,Medulla Oblongata ,nervous system ,Physiology ,General Neuroscience ,Solitary Nucleus ,Nociceptors ,Vagus Nerve ,Chemoreceptor Cells ,circulatory and respiratory physiology - Abstract
Pulmonary vagal nociceptors defend the airways. Cardiopulmonary vagal nociceptors synapse in the nucleus tractus solitarius (NTS). Evidence has demonstrated the convergence of cardiopulmonary nociceptors with afferents from carotid chemoreceptors. Whether sensory convergence occurs in motor nuclei and how sensory convergence affects reflexive efferent motor output directed toward the airways are critical knowledge gaps. Here, we show that distinct tracer injection into the pulmonary nociceptors and carotid chemoreceptors leads to co-labeled neurons in the nucleus tractus solitarius and nucleus ambiguus. Precise simultaneous stimulation delivered to pulmonary nociceptors and carotid chemoreceptors doubled efferent vagal output, enhanced phrenic pause, and subsequently augmented phrenic motor activity. These results suggest that multiple afferents are involved in protecting the airways and concurrent stimulation enhances airway defensive reflex output.
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- 2022
21. Association of Positive End-Expiratory Pressure and Lung Recruitment Selection Strategies with Mortality in Acute Respiratory Distress Syndrome
- Author
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Jose Dianti, Manuel Tisminetzky, Bruno L. Ferreyro, Marina Englesakis, Lorenzo Del Sorbo, Sachin Sud, Daniel Talmor, Lorenzo Ball, Maureen Meade, Carol Hodgson, Jeremy R. Beitler, Sarina Sahetya, Alistair Nichol, Eddy Fan, Bram Rochwerg, Laurent Brochard, Arthur S. Slutsky, Niall D. Ferguson, Ary Serpa Neto, Neill K. J. Adhikari, Federico Angriman, Ewan C. Goligher, and Intensive Care Medicine
- Subjects
Adult ,Pulmonary and Respiratory Medicine ,Respiratory Distress Syndrome ,Network Meta-Analysis ,Bayes Theorem ,hypoxemic respiratory failure ,respiratory system ,Critical Care and Intensive Care Medicine ,mortality ,respiratory tract diseases ,Positive-Pressure Respiration ,Humans ,ARDS ,lung recruitment maneuver ,Lung ,PEEP ,circulatory and respiratory physiology - Abstract
Rationale: The most beneficial positive end-expiratory pressure (PEEP) selection strategy in patients with acute respiratory distress syndrome (ARDS) is unknown, and current practice is variable. Objectives: To compare the relative effects of different PEEP selection strategies on mortality in adults with moderate to severe ARDS. Methods: We conducted a network meta-analysis using a Bayesian framework. Certainty of evidence was evaluated using grading of recommendations assessment, development and evaluation methodology. Measurements and Main Results: We included 18 randomized trials (4,646 participants). Compared with a lower PEEP strategy, the posterior probability of mortality benefit from a higher PEEP without lung recruitment maneuver (LRM) strategy was 99% (risk ratio [RR], 0.77; 95% credible interval [CrI], 0.60-0.96, high certainty), the posterior probability of benefit of the esophageal pressure-guided strategy was 87% (RR, 0.77; 95% CrI, 0.48-1.22, moderate certainty), the posterior probability of benefit of a higher PEEP with brief LRM strategy was 96% (RR, 0.83; 95% CrI, 0.67-1.02, moderate certainty), and the posterior probability of increased mortality from a higher PEEP with prolonged LRM strategy was 77% (RR, 1.06; 95% CrI, 0.89-1.22, low certainty). Compared with a higher PEEP without LRM strategy, the posterior probability of increased mortality from a higher PEEP with prolonged LRM strategy was 99% (RR, 1.37; 95% CrI, 1.04-1.81, moderate certainty). Conclusions: In patients with moderate to severe ARDS, higher PEEP without LRM is associated with a lower risk of death than lower PEEP. A higher PEEP with prolonged LRM strategy is associated with increased risk of death when compared with higher PEEP without LRM.
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- 2022
22. Bioactive Gelatin-based Date By-Product for Packaging Applications: Physico-Chemical and Biological Characterization
- Author
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Asim Faraz, Safa Ben Belgecem, Rachida Abbassi, Samira Jebahi, and Salma Bessaleh
- Subjects
genetic structures ,cardiovascular diseases ,circulatory and respiratory physiology - Abstract
Biodegradable films from gelatin (Gn) with various date by-product (DBP) concentrations (1, 2, 3 and 4 wt %) were prepared. Elaborated films were examined in terms of physical properties (thickness, density, water solubility, water content, degree of swelling, color), and antimicrobial properties (Escherichia coli and Staphylcoccus aureus). Adding the highest concentration of DBP (4%), resulted an increase in the WHC of film as compared with control film. Moreover, the incorporation of 1% DBP reduced the moisture level of Gn based composite films as compared with the control film. Furthermore, Film with 4% of DBP had the lowest solubility which reached 39.39%. Incorporation of DBP from 1 to 4% showed decrease of L- and a-values. The active Gn-DBP 1% showed less lightness as compared to Gn-DBP 3%. The incorporation of DBP into film-forming solutions led to increased opaqueness for all gelatin-based composite films. The calculated opacity value was inversely proportional to transparency. Moreover, the Active Gn-DBP 1% and 2% film presented effective antibacterial activity against bacteria such as Staphylococcus aureus and Escherichia coli. The results showed an enhancement in the biodegradability of Gn-DBP films in moist soil. The results reveal the benefits of date by-products incorporated into gelatin based films as a potential material for active food packaging.
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- 2022
23. Novel cysteine substitution p.(Cys1084Tyr) causes variable expressivity of qualitative and quantitative VWF defects
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Orla Rawley, Laura L. Swystun, Christine Brown, Kate Nesbitt, Margaret Rand, Taneya Hossain, Robert Klaassen, Paula D. James, Manuel D. Carcao, and David Lillicrap
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Mice ,von Willebrand Diseases ,congenital, hereditary, and neonatal diseases and abnormalities ,hemic and lymphatic diseases ,von Willebrand Factor ,Animals ,Cysteine ,Disulfides ,von Willebrand Disease, Type 2 ,Hematology ,circulatory and respiratory physiology - Abstract
von Willebrand factor (VWF) is an extremely cysteine-rich multimeric protein that is essential for maintaining normal hemostasis. The cysteine residues of VWF monomers form intra- and intermolecular disulfide bonds that regulate its structural conformation, multimer distribution, and ultimately its hemostatic activity. In this study, we investigated and characterized the molecular and pathogenic mechanisms through which a novel cysteine variant p.(Cys1084Tyr) causes an unusual, mixed phenotype form of von Willebrand disease (VWD). Phenotypic data including bleeding scores, laboratory values, VWF multimer distribution, and desmopressin response kinetics were investigated in 5 members (2 parents and 3 daughters) of a consanguineous family. VWF synthesis and secretion were also assessed in a heterologous expression system and in a transient transgenic mouse model. Heterozygosity for p.(Cys1084Tyr) was associated with variable expressivity of qualitative VWF defects. Heterozygous individuals had reduced VWF:GPIbM (
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- 2022
24. Low Diastolic Blood Pressure and Mortality in Older Women. Results From the Women’s Health Initiative Long Life Study
- Author
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Bernhard Haring, Aileen P McGinn, Victor Kamensky, Matthew Allison, Marcia L Stefanick, Peter F Schnatz, Lewis H Kuller, Jeffrey S Berger, Karen C Johnson, Nazmus Saquib, Lorena Garcia, Phyllis A Richey, JoAnn E Manson, Michael Alderman, and Sylvia Wassertheil-Smoller
- Subjects
Aging ,hypertension ,Original Contributions ,Clinical Sciences ,Blood Pressure ,Cardiovascular ,Risk Factors ,cardiovascular disease ,Clinical Research ,Internal Medicine ,Humans ,older women ,cardiovascular diseases ,Aged ,Prevention ,diastolic blood pressure ,blood pressure ,Blood Pressure Determination ,mortality ,Heart Disease ,Good Health and Well Being ,Cardiovascular System & Hematology ,Cardiovascular Diseases ,Hypertension ,Women's Health ,Female ,Hypotension ,circulatory and respiratory physiology - Abstract
Background Recommended systolic blood pressure targets often do not consider the relationship of low diastolic blood pressure (DBP) levels with cardiovascular disease (CVD) and all-cause mortality risk, which is especially relevant for older people with concurrent comorbidities. We examined the relationship of DBP levels to CVD and all-cause mortality in older women in the Women’s Health Initiative Long Life Study (WHI-LLS). Methods The study sample included 7,875 women (mean age: 79 years) who underwent a blood pressure measurement at an in-person home visit conducted in 2012–2013. CVD and all-cause mortality were centrally adjudicated. Hazard ratios (HRs) were obtained from adjusted Cox proportional hazards models. Results After 5 years follow-up, all-cause mortality occurred in 18.4% of women. Compared with a DBP of 80 mm Hg, the fully adjusted HR for mortality was 1.33 (95% confidence interval [CI]: 1.04–1.71) for a DBP of 50 mm Hg and 1.67 (95% CI: 1.29–2.16) for a DBP of 100 mm Hg. The HRs for CVD were 1.14 (95% CI: 0.78–1.67) for a DBP of 50 mm Hg and HR 1.50 (95% CI: 1.03–2.17) for a DBP of 100 mm Hg. The nadir DBP associated with lowest mortality risk was 72 mm Hg overall. Conclusions In older women, consideration should be given to the potential adverse effects of low and high DBP. Low DBP may serve as a risk marker. DBP target levels between 68 and 75 mm Hg may avoid higher mortality risk.
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- 2022
25. Angiotensin II infusion in COVID-19
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Ary Serpa Neto, Giovanni Landoni, Marlies Ostermann, Nuttha Lumlertgul, Lui Forni, Lucas Alvarez‐Belon, Tony Trapani, Patricia V. Alliegro, Kai Zacharowski, Carolin Wiedenbeck, Daniel de Backer, Rinaldo Bellomo, Serpa Neto, A., Landoni, G., Ostermann, M., Lumlertgul, N., Forni, L., Alvarez-Belon, L., Trapani, T., Alliegro, P. V., Zacharowski, K., Wiedenbeck, C., de Backer, D., Bellomo, R., and Intensive Care Medicine
- Subjects
Adult ,SARS coronavirus ,SARS-CoV-2 ,Angiotensin II ,coronavirus ,respiratory tract ,Communicable Diseases ,COVID-19 Drug Treatment ,Infectious Diseases ,biochemical analysis ,Virology ,cardiovascular system ,Humans ,Registries ,hormones, hormone substitutes, and hormone antagonists ,circulatory and respiratory physiology - Abstract
To expand our understanding of the role of angiotensin II (ANGII) in coronavirus infectious disease 2019 (COVID-19), we conducted an international, multicenter registry study to assess the use of ANGII in patients with COVID-19 compared to patients not receiving ANGII. Critically ill adult patients who were diagnosed with COVID-19 and received ANGII were matched with COVID-19 patients not receiving ANGII according to age, respiratory support, history of hypertension, use of angiotensin-converting enzyme inhibitors and/or ANGII receptor blocker, and date of admission. All outcomes were exploratory in nature and included improvement in oxygenation, duration of organ support, and mortality. In one year, 132 patients were included (65 in the ANGII group and 67 in the control group), and patients were comparable in baseline characteristics. During the first 12 h of infusion, patients in the ANGII had a faster decrease in FiO2and maintained similar mean arterial pressure levels. Hospital mortality was not statistically significantly different between the groups (53.8% vs. 40.3%; p = 0.226). Within the limitations of such a study design, our findings confirm previous observations of a potentially positive effect of ANGII on blood pressure and FiO2 but no effect on patient-centered outcomes.
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- 2022
26. Valsalva-derived Measures and Phenylephrine Test in Patients With Heart Failure With Reduced Ejection Fraction Receiving Comprehensive Neurohormonal Blockade Drug Therapy: A 5-year Event-free Survival Analysis
- Author
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Bartłomiej Paleczny, Krzysztof Nowak, Tymoteusz Okupnik, Małgorzata Wyciszkiewicz, Wojciech Łopusiewicz, Martyna Olesińska-Mader, Beata Ponikowska, Piotr Ponikowski, and Anna Podsiadły
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Phenylephrine ,Ventricular Dysfunction, Left ,Pharmacotherapy ,Internal medicine ,Valsalva maneuver ,Humans ,Medicine ,Retrospective Studies ,Heart Failure ,Ejection fraction ,business.industry ,Proportional hazards model ,Stroke Volume ,medicine.disease ,Progression-Free Survival ,Blockade ,Heart failure ,Shock (circulatory) ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology ,medicine.drug - Abstract
Aim: To assess relations between Valsalva- and phenylephrine test-derived measures and outcome in reduced ejection fraction heart failure (HFrEF) patients receiving comprehensive neurohormonal blockade pharmacotherapy. Methods: Data from 56 HFrEF patients (LVEF: 32±6%; mean±SD) subjected to Valsalva and phenylephrine tests were analyzed retrospectively. Baroreflex-related (Valsalva-ratio [cBRSVR] and BP-RRI slope from phase IV [cBRSIV_SLOPE]) and non-baroreflex-related measures (systolic BP rise in phase IV [ΔSBPPHASE_IV], and pulse-amplitude-ratio [PAR]) were calculated from Valsalva. Short-term outcome (HF-related hospitalization, ICD shock or all-cause death within 24-months from examination) and long-term outcome (ICD shock or all-cause death within 60-months) were analyzed. Results: The endpoint occurred in 16 and 18 patients, for short- and long-term outcome, respectively. Low ΔSBPPHASE_IV identified patients at risk in long-term perspective, as evidenced by low- vs. high ΔSBPPHASE_IV comparison (square-wave response patients assigned to low ΔSBPPHASE_IV group, P=0.002), and Cox model (HR: 0.91, CI: 0.86-0.96, P Conclusions: Non-baroreflex-related measures obtained from Valsalva: ΔSBPPHASE_IV and PAR, might carry prognostic value in HFrEF patients receiving neurohormonal blockade pharmacotherapy.
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- 2022
27. PREVALENCE OF EXFOLIATIVE TOXIN GENES AMONG CLINICAL ISOLATES OF STAPHYLOCOCCUS AUREUS IN IRAQ
- Author
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H. Y. Yassin, A. K. Melconian, and S. S. Mahmood
- Subjects
General Veterinary ,Food Animals ,cardiovascular system ,Animal Science and Zoology ,respiratory system ,Horticulture ,General Agricultural and Biological Sciences ,circulatory and respiratory physiology ,Food Science ,General Environmental Science - Abstract
The aim of this study is to determine the prevalence of eta, etb and etd genes among clinical isolates of S. aureus. 91 isolates of the bacterium were isolated from different clinical sites during the period from 2019 to 2020 from Baghdad hospitals, all the isolates were diagnosed by different biochemical tests and molecular method (PCR) using nuc gene. the PCR technique was used to detect eta, etb and etd genes among the isolates, the results showed that 91(100%) of the isolates were have nuc gene. while, 83 ( 91.2%) of the isolates at least carrying one of the ET genes; 20 (22%) , 0 (0%) and 63 (69.2%) of the 91 isolates expressed eta, etb and etd genes, respectively. While, 8 (8.8%) of isolates were lacking of these genes. In addition, 14 (15.4%) of isolates were carrying both eta and etd genes. Although the etd gene was found in all sample types, but eta gene was found only in wound, ear, throat and nose while, etb gene was not found in all types of clinical samples.
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- 2022
28. Analysis of D-Dimer Level and Prothombin Time (PT) Activated Prothombin Thromboplastin (APTT) on Heparin Administration to COVID-19 Patients
- Author
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Dela Yorike, Muhammad Rizki Kurniawan, and Mohamad Syafaat
- Subjects
circulatory and respiratory physiology - Abstract
Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Coronavirus is a dangerous pathogen that affects both humans and animals. Symptoms and indicators of COVID-19 infection include fever, cough, and shortness of breath, which are common in respiratory illnesses. COVID-19 has spread globally with high mortality and morbidity rates. Prothrombin Time (PT), Activated Prothrombin Thromboplastin (APTT), and D-Dimer parameters are blood tests to evaluate the coagulation status of COVID-19 patients, all these parameters increased in COVID-19 patients. This study aims at determininig the levels of D-Dimer, PT, and APTT in COVID-19 patients. Clinical and laboratory records were retrospectively reviewed from 100 cases of COVID-19 admitted to hospitals. This study used a a cross-sectional, descriptive, secondary data analysis design. The sample included patients from the Bhayangkara TK. I R.Said Sukanto Hospital between April-July 2021. The sample is a COVID-19 patient who was treated in the Intensive Care Unit (ICU), worsened, and given heparin. An independent variable is the administration of intravenous heparin at prophylactic doses. Dependent variables are D-Dimer, PT, and APTT values. The collected data is processed using Microsoft Office Excel and then being analyzed. D-Dimer, PT, and APTT levels in COVID-19 patients were initially high or increased after heparin administration decreased or became normal. In conclusion, there was a decrease in D-dimer levels, PT values, and APTT after administration of intravenous heparin at prophylactic doses.
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- 2022
29. Effect of Exercise Training on Arterial Stiffness in Overweight or Obese Populations
- Author
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Lijing Gong and Yujia Liu
- Subjects
Pediatric Obesity ,Adolescent ,Physical Therapy, Sports Therapy and Rehabilitation ,Overweight ,Pulse Wave Analysis ,Carotid Intima-Media Thickness ,Exercise Therapy ,Vasodilation ,Vascular Stiffness ,cardiovascular system ,Humans ,Orthopedics and Sports Medicine ,cardiovascular diseases ,Child ,Exercise ,circulatory and respiratory physiology - Abstract
The purpose was to analyze the effects of exercise training (ET) on arterial stiffness in all-age overweight or obese individuals. Sixty-one trials were included with ET improving flow-mediated dilation (FMD), pulse wave velocity (PWV), and intima-media thickness (IMT). In the subgroup analysis: (i) ET improved FMD in overweight or obese children and adolescents with a large effect size (SMD=0.83, 95% CI 0.42–1.25). PWV was decreased after ET regardless of age. IMT was decreased by ET in participants younger than 60, (ii) ET improved FMD, PWV, and IMT in participants whose BMI were smaller than 30 kg/m2, but ET only improved PWV of participants whose BMI were larger than 30 kg/m2. (iii) AE improved FMD, PWV, and IMT. High-intensity interval training (HIIT) decreased IMT. (iv) The increase of FMD only happened when training duration was longer than eight weeks. However, ET decreased PWV when the training duration was no longer than 12 weeks. IMT was decreased when the training duration was longer than eight weeks. ET instigated an improvement in endothelial function and arterial stiffness in overweight or obese populations, but depending on the different characteristics of exercise intervention and participants’ demographics.
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- 2022
30. Overview of Anti-platelet Drug Use in Ischemic Stroke Patients at UKI General Hospital in 2015
- Author
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Christina Roseville Lasma Aritonang and Mulyadi Djojosaputro
- Subjects
cardiovascular diseases ,circulatory and respiratory physiology - Abstract
Stroke is an acute neuro-deficit disease that occurs when there is a disturbance of cerebral blood flow. There are two kinds of stroke, hemorrhagic stroke and ischemic stroke. Ischemic stroke is a stroke that occurs due to the formation of thrombosis and emboli. Thrombosis and emboli block the bloodstream in small blood vessels or prominent blood vessels. Drugs that can cause disturbance to the hemostasis mechanism, such as antiplatelets, are usually used on stroke management. This study aims to know the types and amounts of antiplatelet drugs used on stroke ischemic patients in UKI General Hospital from January to December 2015. This research showed that stroke ischemic occurs more often at age 61 -70 (43%). There are no significant differences between both genders, the most common drugs are Aspilet 80 mg (22 times). For combination drugs, Clopidogrel with Aspilet is used more often than Clopidogrel with Ascardia. Keywords: stroke, thrombosis, antiplatelet
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- 2022
31. Cardiac ablation with pulsed electric fields: principles and biophysics
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Alan Sugrue, Elad Maor, Freddy Del-Carpio Munoz, Ammar M Killu, and Samuel J Asirvatham
- Subjects
immune system diseases ,Physiology (medical) ,Biophysics ,Catheter Ablation ,Humans ,Arrhythmias, Cardiac ,respiratory system ,Cardiology and Cardiovascular Medicine ,circulatory and respiratory physiology ,respiratory tract diseases - Abstract
Pulsed electric fields (PEFs) have emerged as an ideal cardiac ablation modality. At present numerous clinical trials in humans are exploring PEF as an ablation strategy for both atrial and ventricular arrhythmias, with early data showing significant promise. As this is a relatively new technology there is limited understanding of its principles and biophysics. Importantly, PEF biophysics and principles are starkly different to current energy modalities (radiofrequency and cryoballoon). Given the relatively novel nature of PEFs, this review aims to provide an understanding of the principles and biophysics of PEF ablation. The goal is to enhance academic research and ultimately enable optimization of ablation parameters to maximize procedure success and minimize risk.
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- 2022
32. Status of Red Blood Cell Indices in Iron Deficiency Anemia and β Thalassaemia Trait: A Comparative Study
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Biva Mondal, Mashud Parvez, Md Masud Rana, Lotifur Rahman, Rowshan Zahan, Kishor Chandra Pal, and Waqer Ahmed Khan
- Subjects
hemic and lymphatic diseases ,circulatory and respiratory physiology - Abstract
Background: Iron deficiency anemia (IDA) and b thalassemia trait (b -TT) are the two important differential diagnosis of microcytic hypochromic anaemia. It is important to distinguish between the above two conditions to avoid unnecessary iron therapy. Red blood cell (RBCs) indices are simple, easy, and cost effective method to get a primary and valuable information regarding the diagnosis of IDA and b -TT. Objectives: This study was aimed to compare the RBC count, hemoglobin (Hb), hematocrit (Hct%), RBC indices, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW) and redcell distribution width index (RDWI) in Iron deficiency anemia and b thalassemia trait. Methods: This cross-sectional comparative study was conducted in the department of clinical pathology, Dhaka Shishu Hospital, Dhaka from July 2019 to March 2020. Total 107 patients with microcytic hypochromic anaemia (64 subjects of IDA and 43 subjects of b -TT were tested for RBC count, Hb%, MCV, MCH, MCHC, RDW, and PCV from venous blood by haematology analyser. Serum ferritin was measured by Enzyme Linked Immunosorbent Assays (ELISA). Statistical analysis was performed by SPSS version 22. Statistical significance was set at p value less than 0.05. Results: RBC count, Hb, and Hct,MCV, MCH and MCHC were significantly lower and RDW and RDWI was significantly higher in IDA group than in b- TT group (p< 0.001). Similar result was observed in male and female participants when compared them in separate group. Conclusion: The study showed that RBC count, Hb, Hct, MCV, MCH, and MCHC were significantly lower in IDA group than in b-TT group, whereas RDW and RDWI were significantly higher in IDA group than in b-TT group. DS (Child) H J 2021; 37(1): 9-14
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- 2022
33. Single-cell transcriptional analysis of human endothelial colony-forming cells from patients with low VWF levels
- Author
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Christopher J. Ng, Alice Liu, Sujatha Venkataraman, Katrina J. Ashworth, Christopher D. Baker, Rebecca O’Rourke, Rajeev Vibhakar, Kenneth L. Jones, and Jorge Di Paola
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,Weibel-Palade Bodies ,Immunology ,Cell Biology ,Hematology ,Biochemistry ,von Willebrand Diseases ,hemic and lymphatic diseases ,von Willebrand Factor ,Human Umbilical Vein Endothelial Cells ,cardiovascular system ,Humans ,Blood Commentary ,RNA, Small Interfering ,Single-Cell Analysis ,circulatory and respiratory physiology - Abstract
von Willebrand factor (VWF) plays a key role in normal hemostasis, and deficiencies of VWF lead to clinically significant bleeding. We sought to identify novel modifiers of VWF levels in endothelial colony-forming cells (ECFCs) using single-cell RNA sequencing (scRNA-seq). ECFCs were isolated from patients with low VWF levels (plasma VWF antigen levels between 30 and 50 IU/dL) and from healthy controls. Human umbilical vein endothelial cells were used as an additional control cell line. Cells were characterized for their Weibel Palade body (WPB) content and VWF release. scRNA-seq of all cell lines was performed to evaluate for gene expression heterogeneity and for candidate modifiers of VWF regulation. Candidate modifiers identified by scRNA-seq were further characterized with small-interfering RNA (siRNA) experiments to evaluate for effects on VWF. We observed that ECFCs derived from patients with low VWF demonstrated alterations in baseline WPB metrics and exhibit impaired VWF release. scRNA-seq analyses of these endothelial cells revealed overall decreased VWF transcription, mosaicism of VWF expression, and genes that are differentially expressed in low VWF ECFCs and control endothelial cells (control ECs). An siRNA screen of potential VWF modifiers provided further evidence of regulatory candidates, and 1 such candidate, FLI1, alters the transcriptional activity of VWF. In conclusion, ECFCs from individuals with low VWF demonstrate alterations in their baseline VWF packaging and release compared with control ECs. scRNA-seq revealed alterations in VWF transcription, and siRNA screening identified multiple candidate regulators of VWF.
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- 2022
34. Contemporary antiplatelet therapy for secondary stroke prevention: a narrative review of current literature and guidelines
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Jay Shah, Shimeng Liu, and Wengui Yu
- Subjects
Ticagrelor ,Clinical Trials and Supportive Activities ,Asprin ,Brain Ischemia ,Clinical Research ,Humans ,cardiovascular diseases ,Ischemic Stroke ,Aspirin ,Ischemic Attack ,Transient ,Prevention ,Neurosciences ,Evaluation of treatments and therapeutic interventions ,Cerebral Infarction ,Dipyridamole ,Atherosclerosis ,Brain Disorders ,Cilostazol ,Clopidogrel ,Stroke ,Ischemic Attack, Transient ,6.1 Pharmaceuticals ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,Platelet Aggregation Inhibitors ,circulatory and respiratory physiology - Abstract
Antiplatelet therapy is one of the mainstays for secondary stroke prevention. This narrative review aimed to highlight the current evidence and recommendations of antiplatelet therapy for stroke prevention.We conducted advanced literature search for antiplatelet therapy. Landmark studies and randomised controlled trials evaluating antiplatelet therapy for secondary stroke prevention are reviewed. Results from Cochrane systematic review, pooled data analysis and meta-analysis are discussed.Single-antiplatelet therapy (SAPT) with aspirin, aspirin/extended-release dipyridamole or clopidogrel reduces the risk of recurrent ischaemic stroke in patients with non-cardioembolic ischaemic stroke or transient ischaemic attack (TIA). Dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel or ticagrelor for 21–30 days is more effective than SAPT in patients with minor acute noncardioembolic ischaemic stroke or high-risk TIA. Prolonged use of DAPT is associated with higher risk of haemorrhage without reduction in stroke recurrence than SAPT. Compared with placebo, aspirin reduces the relative risk of recurrent stroke by approximately 22%. Aspirin/dipyridamole and cilostazol are superior to aspirin but associated with significant side effects. Cilostazol or ticagrelor might be more effective than aspirin or clopidogrel in patients with intracranial stenosis.SAPT is indicated for secondary stroke prevention in patients with non-cardioembolic ischaemic stroke or TIA. DAPT with aspirin and clopidogrel or ticagrelor for 21–30 days followed by SAPT is recommended for patients with minor acute noncardioembolic stroke or high-risk TIA. Selection of appropriate antiplatelet therapy should also be based on compliance, drug tolerance or resistance.
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- 2022
35. Long-Term Vascular Function in CTO Recanalization: A Randomized Clinical Trial of Ticagrelor vs. Clopidogrel
- Author
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Gerardo Moreno-Terribas, Juan José Rodríguez-Arias, Luis Ortega-Paz, Victor Arévalos, Rafael Romaguera, Loreto Oyarzabal, Manel Sabaté, Josep Gómez-Lara, Teresa Gil-Jimenez, Joan-Antoni Gomez-Hospital, Juan Caballero-Borrego, Luis Teruel, and Salvatore Brugaletta
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Ticagrelor ,medicine.medical_specialty ,Loading dose ,law.invention ,Percutaneous Coronary Intervention ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Acute Coronary Syndrome ,business.industry ,Area under the curve ,General Medicine ,Blood flow ,Clopidogrel ,Clinical trial ,Treatment Outcome ,Conventional PCI ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,circulatory and respiratory physiology ,medicine.drug - Abstract
Background Coronary vascular function of a chronic coronary total occlusion (CTO) immediately after recanalization is known to be poor and to be partially improved by pre-treatment with loading dose of ticagrelor vs. clopidogrel . It is unknown if this vascular dysfunction is maintained at long-term follow-up and may be improved by 1-year dual antiplatelet therapy (DAPT). Methods The TIGER is a prospective, open-label, two parallel-group controlled clinical trial , which 1:1 randomized 50 CTO patients to pre-PCI loading dose and subsequent 1-year DAPT with ticagrelor vs. clopidogrel. Coronary blood flow (CBF) under stepwise adenosine infusion was assessed after drug loading dose and at follow-up and compared between the two drug groups, adjusting for time of follow-up. Results Out of 50 patients with index CBF evaluation, 38 (76%) patients underwent angiographic follow-up (23 and 15 at 1 and 3-year, respectively) and Doppler data was available in 35 (70%). A high CBF area under the curve (AUC), already observed after loading dose in ticagrelor vs. clopidogrel group (p = 0.027), was maintained at follow-up (AUC 34815.22 ± 24,206.06 vs. AUC 22712.47 ± 13,768.95; p = 0.071). Specifically, whereas high ticagrelor loading dose-related CBF was sustained at follow-up (p = 0.933), clopidogrel loading dose-related CBF increased at follow-up (p = 0.039). Conclusion The TIGER trial showed that DAPT with ticagrelor maintained a non-significantly higher CBF in a recanalized CTO as compared to clopidogrel, whose treated patients exhibit a lower CBF immediately after PCI with a significant increase at follow-up. The clinical value of such sustained high coronary flow should be evaluated in a larger group of patients. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT02211066 (ClinicalTrials.gov number NCT02211066 ).
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- 2022
36. Prognostication using SpO(2)/FiO(2) in invasively ventilated ICU patients with ARDS due to COVID-19-Insights from the PRoVENT-COVID study
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Jan-Paul Roozeman, Guido Mazzinari, Ary Serpa Neto, Markus W. Hollmann, Frederique Paulus, Marcus J. Schultz, Luigi Pisani, A.G. Algera, L.S. Boers, L.D.J. Bos, M. Botta, D.A. Dongelmans, M.W. Hollmann, J. Horn, F. Paulus, J. Pillay, M.J. Schultz, A. Serpa Neto, A.M. Tsonas, A.P.J. Vlaar, S. Ahuja, J.P. van Akkeren, C.K. Algoe, R.B. van Amstel, A. Artigas, O.L. Baur, P. van de Berg, A.E. van den Berg, D.C.J.J. Bergmans, D.I. van den Bersselaar, F.A. Bertens, A.J.G.H. Bindels, M.M. de Boer, S. den Boer, M. Bogerd, J.S. Breel, H. de Bruin, S. de Bruin, C.L. Bruna, L.A. Buiteman-Kruizinga, O.L. Cremer, R.M. Determann, W. Dieperink, H.S. Franke, M.S. Galek-Aldridge, M.J. de Graaff, L.A. Hagens, J.J. Haringman, S.T. van der Heide, P.L.J. van der Heiden, N.F.L. Heijnen, S.J.P. Hiel, L.L. Hoeijmakers, L. Hol, M.E. Hoogendoorn, R. van der Horst, E.L.K. Ie, D. Ivanov, N.P. Juffermans, E. Kho, E.S. de Klerk, A.W.M.M. Koopman-van Gemert, M. Koopmans, S. Kucukcelebi, M.A. Kuiper, D.W. de Lange, N. van Mourik, S.G. Nijbroek, M. Onrust, E.A.N. Oostdijk, C.J. Pennartz, L. Pisani, I.M. Purmer, T.C.D. Rettig, J.P. Roozeman, M.T.U. Schuijt, M.E. Sleeswijk, M.R. Smit, P.E. Spronk, W. Stilma, A.C. Strang, P.R. Tuinman, C.M.A. Valk, F.L. Veen-Schra, L.I. Veldhuis, P. van Velzen, W.H. van der Ven, P. van Vliet, P.H.J. van der Voort, L. van Welie, H.J.F.T. Wesselink, H.H. van der Wier-Lubbers, B. van Wijk, T. Winters, W.Y. Wong, A.R.H. van Zanten, Intensive Care, MUMC+: MA Medische Staf IC (9), MUMC+: MA Arts Assistenten IC (9), RS: NUTRIM - R2 - Liver and digestive health, Lectoraat Critical Care, Faculteit Gezondheid, Anesthesiology, Graduate School, APH - Quality of Care, Intensive Care Medicine, ACS - Heart failure & arrhythmias, APH - Global Health, ACS - Microcirculation, Nursing, AII - Infectious diseases, AII - Inflammatory diseases, ACS - Pulmonary hypertension & thrombosis, ACS - Diabetes & metabolism, ANS - Neuroinfection & -inflammation, AII - Amsterdam institute for Infection and Immunity, Center of Experimental and Molecular Medicine, Emergency Department, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Pulmonary medicine, Intensive care medicine, and Group, PRoVENT-COVID Collaborative
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Resource limited settings ,PAO2/FIO2 ,SpO/FiO ,Acute respiratory distress syndrome ,fungi ,COVID-19 ,RESPIRATORY-DISTRESS-SYNDROME ,respiratory system ,Critical Care and Intensive Care Medicine ,respiratory tract diseases ,Pulse oximetry ,Mechanical ventilation ,RATIO ,RACIAL BIAS ,SpO(2)/FiO(2) ,circulatory and respiratory physiology - Abstract
Background: The SpO2/FiO2 is a useful oxygenation parameter with prognostic capacity in patients with ARDS. We investigated the prognostic capacity of SpO2/FiO2 for mortality in patients with ARDS due to COVID–19. Methods: This was a post-hoc analysis of a national multicenter cohort study in invasively ventilated patients with ARDS due to COVID–19. The primary endpoint was 28–day mortality. Results: In 869 invasively ventilated patients, 28–day mortality was 30.1%. The SpO2/FiO2 on day 1 had no prognostic value. The SpO2/FiO2 on day 2 and day 3 had prognostic capacity for death, with the best cut-offs being 179 and 199, respectively. Both SpO2/FiO2 on day 2 (OR, 0.66 [95%–CI 0.46–0.96]) and on day 3 (OR, 0.70 [95%–CI 0.51–0.96]) were associated with 28–day mortality in a model corrected for age, pH, lactate levels and kidney dysfunction (AUROC 0.78 [0.76–0.79]). The measured PaO2/FiO2 and the PaO2/FiO2 calculated from SpO2/FiO2 were strongly correlated (Spearman's r = 0.79). Conclusions: In this cohort of patients with ARDS due to COVID–19, the SpO2/FiO2 on day 2 and day 3 are independently associated with and have prognostic capacity for 28–day mortality. The SpO2/FiO2 is a useful metric for risk stratification in invasively ventilated COVID–19 patients.
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- 2022
37. Quantification of cerebral blood volume changes caused by visual stimulation at 3 T using DANTE-prepared dual-echo EPI
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Peter A. Bandettini, Christine S. Law, Sean Marrett, Laurentius Huber, Yuhui Chai, Linqing Li, Peter Jezzard, RS: FPN CN 5, and MRI
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FLOW ,Stimulation ,ACTIVATION ,DANTE-prepared dual-echo EPI ,Nuclear magnetic resonance ,Imaging Tool ,blood signal suppression ,PERFUSION ,medicine ,Cerebral Blood Volume ,Humans ,Bold fmri ,Radiology, Nuclear Medicine and imaging ,Vein ,Blood-oxygen-level dependent ,Chemistry ,OXYGEN-METABOLISM ,fMRI ,Brain ,VASO ,VELOCITY ,FUNCTIONAL MRI ,HUMAN BRAIN ,Magnetic Resonance Imaging ,SIGNAL ,quantification of CBV changes ,medicine.anatomical_structure ,Cerebral blood volume ,Cerebrovascular Circulation ,Dual echo ,SPIN-ECHO ,Photic Stimulation ,circulatory and respiratory physiology ,BOLD - Abstract
Purpose We investigate the influence of moving blood-attenuation effects when using "delay alternating with nutation for tailored excitation" (DANTE) pulses in conjunction with blood oxygen level dependent (BOLD) of functional MRI (fMRI) at 3 T. Based on the effects of including DANTE pulses, we propose quantification of cerebral blood volume (CBV) changes following functional stimulation. Methods Eighteen volunteers in total underwent fMRI scans at 3 T. Seven volunteers were scanned to investigate the effects of DANTE pulses on the fMRI signal. CBV changes in response to visual stimulation were quantified in 11 volunteers using a DANTE-prepared dual-echo EPI sequence. Results The inflow effects from flowing blood in arteries and draining vein effects from flowing blood in large veins can be suppressed by use of a DANTE preparation module. Using DANTE-prepared dual-echo EPI, we quantitatively measured intravascular-weighted microvascular CBV changes of 25.4%, 29.8%, and 32.6% evoked by 1, 5, and 10 Hz visual stimulation, respectively. The extravascular fraction ( increment S/S)(extra) at TE = 30 ms in total BOLD signal was determined to be 64.8 +/- 3.4%, which is in line with previous extravascular component estimation at 3 T. Results show that the microvascular CBV changes are linearly dependent on total BOLD changes at TE = 30 ms with a slope of 0.113, and this relation is independent of stimulation frequency and subject. Conclusion The DANTE preparation pulses can be incorporated into a standard EPI fMRI sequence for the purpose of minimizing inflow effects and reducing draining veins effects in large vessels. Additionally, the DANTE-prepared dual-echo EPI sequence is a promising fast imaging tool for quantification of intravascular-weighted CBV change in the microvascular space at 3 T.
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- 2022
38. The difference between the patients' initial and previously measured systolic blood pressure as predictor of mortality in older emergency department patients
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Wouter Raven, Iris P. H. van Doormalen, Bas de Groot, Bart G. J. Candel, Iris B. van Ingen, Lisette A. A. Mignot-Evers, Evert de Jonge, RS: CAPHRI - R1 - Ageing and Long-Term Care, and Health Services Research
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Emergency medical services ,medicine.medical_specialty ,Aging ,INCOME ,HYPERTENSION ,business.industry ,Mortality rate ,Baseline systolic blood pressure ,Emergency department ,ADULTS ,Geriatric emergency medicine ,PREVALENCE ,Blood pressure ,Increased risk ,Older patients ,Internal medicine ,Medicine ,Electronic health records ,cardiovascular diseases ,Hypotension ,business ,VITAL SIGNS ,circulatory and respiratory physiology ,Cohort study - Abstract
Purpose To assess how often baseline systolic blood pressure (SBP) could be retrieved from the Electronic Health Record (EHR) in older Emergency Department (ED) patients. Second, to assess whether the difference between baseline SBP and initial SBP in the ED (Delta SBP) was associated with 30-day mortality. Methods A multicenter hypothesis-generating cohort study including patients >= 70 years. EHRs were searched for baseline SBPs. The association between Delta SBP and 30-day mortality was investigated. Results Baseline SBP was found in 220 out of 300 patients (73.3%; 95%CI 68.1-78.0%). In 72 patients with normal initial SBPs (133-166 mmHg) in the ED, fifteen (20.8%) had a negative Delta SBP with 20.0% mortality. A negative Delta SBP was associated with 30-day mortality (AHR 4.7; 1.7-12.7). Conclusion Baseline SBPs are often available in older ED patients. The Delta SBP has prognostic value and could be used as an extra variable to recognize hypotension in older ED patients. Future studies should clarify whether the Delta SBP improves risk stratification in the ED.Key summary pointsAim To investigate whether a baseline systolic blood pressure (SBP) in older Emergency Department (ED) patients of >= 70 years has prognostic value, when compared with the initial SBP at presentation in the ED (= Delta SBP). Findings A baseline SBP could be retrieved from the Electronic Health Record for most older ED patients (73.3%). A negative Delta SBP was associated with 30-day mortality. In 20% of the patients with a normal initial SBP in the ED, the Delta SBP was negative, with a high mortality rate. Message A baseline SBP value could be retrieved from the Electronic Health Record in most hospitalized ED patients >= 70 years. In addition, the 21% with a normal SBP at ED presentation had a negative Delta SBP and these patients had an increased risk for 30-day mortality. As a result, Delta SBP may contribute to improved risk stratification and may help to recognize hypotension in older patients.
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- 2022
39. Underlying mechanisms of saphenous vein graft stenosis after coronary artery bypass caused by clipping of the side branches: an experimental study
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Yanlong, Ren, Bangrong, Song, Jiang, Li, Tieduo, Kang, Jin, Sheng, Shangqiu, Ning, Liying, Chen, Ran, Dong, and Wenxian, Liu
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Pulmonary and Respiratory Medicine ,surgical procedures, operative ,education ,cardiovascular system ,Original Article ,cardiovascular diseases ,circulatory and respiratory physiology - Abstract
BACKGROUND: Saphenous veins are regular bypass conduits selected in non-left anterior descending artery (LAD) coronary artery bypass graft (CABG) surgery. Despite the technical errors, acute thrombosis, intimal hyperplasia and arteriosclerosis which could lead to saphenous vein graft (SVG) failure, the metal-clipping-related SVG failure is unique and rare. This study was conducted to investigate the clinical and underlying mechanisms of the metal-clipping-related SVG failure. METHODS: We collected 6 typical cases of the metal-clipping-related SVG failure in 41 patients who were diagnosed graft stenosis by coronary angiograph after CABG in the Department of Cardiology, Beijing Anzhen Hospital, from January 2020 to September 2021. Furthermore, we built an in vitro model to verify the identical intravascular ultrasound (IVUS) pattern of metal clip. RESULTS: There were 6 in 41 cases of SVG stenosis caused by clipping of the side branches. We found that the stenosis of SVG caused by metal clipping mostly occurred at the corner and multipole clipping points. In this situation, great resistance could be felt when pushing the instruments through the stenosis and crystallized cholesterol was rarely caught by the distal protection device. We verified the similar IVUS pattern of metal clip at the side-branches of SVG in vitro. CONCLUSIONS: The metal-clipping-related stenosis may lead to SVG failure. The stenosis of SVG caused by metal clipping mostly occurred at the corner and multipole clipping points. IVUS showed great modality for clarification.
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- 2022
40. Epigenetic Modification of the von Willebrand Factor Promoter Drives Platelet Aggregation on the Pulmonary Endothelium in Chronic Thromboembolic Pulmonary Hypertension
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Xue D. Manz, Robert Szulcek, Xiaoke Pan, Petr Symersky, Chris Dickhoff, Jisca Majolée, Veerle Kremer, Elisabetta Michielon, Ekaterina S. Jordanova, Teodora Radonic, Irene V. Bijnsdorp, Sander R. Piersma, Thang V. Pham, Connie R. Jimenez, Anton Vonk Noordegraaf, Frances S. de Man, Reinier A. Boon, Jan Voorberg, Peter L. Hordijk, Jurjan Aman, Harm Jan Bogaard, Graduate School, ACS - Atherosclerosis & ischemic syndromes, ACS - Diabetes & metabolism, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Experimental Vascular Medicine, Landsteiner Laboratory, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, Pulmonary medicine, Cardio-thoracic surgery, Surgery, CCA - Cancer Treatment and quality of life, CCA - Cancer biology and immunology, Physiology, Molecular cell biology and Immunology, Obstetrics and gynaecology, Pathology, CCA - Imaging and biomarkers, Urology, Medical oncology laboratory, Amsterdam Neuroscience - Neurodegeneration, and Amsterdam Reproduction & Development (AR&D)
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Proteomics ,Pulmonary and Respiratory Medicine ,congenital, hereditary, and neonatal diseases and abnormalities ,Platelet Aggregation ,epigenetics ,vonWillebrand factor ,Hypertension, Pulmonary ,Critical Care and Intensive Care Medicine ,endothelial cells ,Epigenesis, Genetic ,chronic thromboembolic pulmonary hypertension ,hemic and lymphatic diseases ,von Willebrand Factor ,cardiovascular system ,Humans ,Endothelium, Vascular ,nuclear factor κB ,circulatory and respiratory physiology - Abstract
Rationale: von Willebrand factor (vWF) mediates platelet adhesion during thrombosis. While chronic thromboembolic pulmonary hypertension (CTEPH) is associated with increased plasma levels of vWF, the role of this protein in CTEPH has remained enigmatic. Objectives: To identify the role of vWF in CTEPH. Methods: CTEPH-specific patient plasma and pulmonary endarterectomy material from patients with CTEPH were used to study the relationship between inflammation, vWF expression, and pulmonary thrombosis. Cell culture findings were validated in human tissue, and proteomics and chromatin immunoprecipitation were used to investigate the underlying mechanism of CTEPH. Measurements and Main Results: vWF is increased in plasma and the pulmonary endothelium of CTEPH patients. In vitro, the increase in vWF gene expression and the higher release of vWF protein upon endothelial activation resulted in elevated platelet adhesion to CTEPH endothelium. Proteomic analysis revealed that nuclear factor (NF)-kB2 was significantly increased in CTEPH. We demonstrate reduced histone tri-methylation and increased histone acetylation of the vWF promoter in CTEPH endothelium, facilitating binding of NF-kB2 to the vWF promoter and driving vWF transcription. Genetic interference of NFkB2 normalized the high vWF RNA expression levels and reversed the prothrombotic phenotype observed in CTEPH-pulmonary artery endothelial cells. Conclusions: Epigenetic regulation of the vWF promoter contributes to the creation of a local environment that favors in situ thrombosis in the pulmonary arteries. It reveals a direct molecular link between inflammatory pathways and platelet adhesion in the pulmonary vascular wall, emphasizing a possible role of in situ thrombosis in the development or progression of CTEPH.
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- 2022
41. Lung Injury Induces Alveolar Type 2 Cell Hypertrophy and Polyploidy with Implications for Repair and Regeneration
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Laura A. Dada, A. Weng, Satoshi Watanabe, Annette S. Flozak, Monique Hinchcliff, Rogan A. Grant, M. Maciel-Herrerias, G.S. Budinger, Lynn C. Welch, Raul Piseaux Aillon, SeungHye Han, Cara J. Gottardi, and Alexander V. Misharin
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Pulmonary and Respiratory Medicine ,Cell ,Clinical Biochemistry ,Biology ,Lung injury ,Muscle hypertrophy ,Polyploidy ,medicine ,Integrated stress response ,Humans ,Progenitor cell ,Molecular Biology ,Regeneration (biology) ,food and beverages ,Cell Differentiation ,Cell Biology ,Hypertrophy ,Lung Injury ,respiratory system ,Cell biology ,medicine.anatomical_structure ,Alveolar Epithelial Cells ,cardiovascular system ,Wound healing ,hormones, hormone substitutes, and hormone antagonists ,Cytokinesis ,circulatory and respiratory physiology - Abstract
Epithelial polyploidization post-injury is a conserved phenomenon, recently shown to improve barrier restoration during wound healing. Whether lung injury can induce alveolar epithelial polyploidy is not known. We show that bleomycin injury induces AT2 cell hypertrophy and polyploidy. AT2 polyploidization is also seen in short term ex vivo cultures, where AT2-to-AT1 trans-differentiation is associated with substantial binucleation due to failed cytokinesis. Both hypertrophic and polyploid features of AT2 cells can be attenuated by inhibiting the integrated stress response (ISR) using the small molecule ISRIB. These data suggest that AT2 hypertrophic growth and polyploidization may be a feature of alveolar epithelial injury. As AT2 cells serve as facultative progenitors for the distal lung epithelium, a propensity for injury-induced binucleation has implications for AT2 self-renewal and regenerative potential upon reinjury, which may benefit from targeting the ISR.
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- 2023
42. Computational simulations of the 4D micro-circulatory network in zebrafish tail amputation and regeneration
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Mehrdad Roustaei, Kyung In Baek, Zhaoqiang Wang, Susana Cavallero, Sandro Satta, Angela Lai, Ryan O'Donnell, Vijay Vedula, Yichen Ding, Alison Lesley Marsden, and Tzung K. Hsiai
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haemodynamic shear stress ,Mechanotransduction ,General Science & Technology ,1.1 Normal biological development and functioning ,Biomedical Engineering ,Biophysics ,Bioengineering ,Stress ,Cardiovascular ,Biochemistry ,Mechanotransduction, Cellular ,non-Newtonian blood flow ,Amputation, Surgical ,Biomaterials ,Underpinning research ,Surgical ,Animals ,Amputation ,Zebrafish ,Life Sciences–Engineering interface ,Hemodynamics ,vascular remodelling ,Mechanical ,microvascular injury and regeneration ,cardiovascular system ,Cellular ,Stress, Mechanical ,Shear Strength ,Blood Flow Velocity ,circulatory and respiratory physiology ,Biotechnology - Abstract
Wall shear stress (WSS) contributes to the mechanotransduction underlying microvascular development and regeneration. Using computational fluid dynamics, we elucidated the interplay between WSS and vascular remodelling in a zebrafish model of tail amputation and regeneration. The transgenic Tg ( fli1:eGFP ; Gata1:ds-red ) zebrafish line was used to track the three-dimensional fluorescently labelled vascular endothelium for post-image segmentation and reconstruction of the fluid domain. Particle image velocimetry was used to validate the blood flow. Following amputation to the dorsal aorta and posterior cardinal vein (PCV), vasoconstriction developed in the dorsal longitudinal anastomotic vessel (DLAV) along with increased WSS in the proximal segmental vessels (SVs) from amputation. Angiogenesis ensued at the tips of the amputated DLAV and PCV where WSS was minimal. At 2 days post amputation (dpa), vasodilation occurred in a pair of SVs proximal to amputation, followed by increased blood flow and WSS; however, in the SVs distal to amputation, WSS normalized to the baseline. At 3 dpa, the blood flow increased in the arterial SV proximal to amputation and through anastomosis with DLAV formed a loop with PCV. Thus, our in silico modelling revealed the interplay between WSS and microvascular adaptation to changes in WSS and blood flow to restore microcirculation following tail amputation.
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- 2023
43. Treatment with apocynin selectively restores hippocampal arteriole function and seizure-induced hyperemia in a model of preeclampsia
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Marilyn J Cipolla, Sarah Tremble, Nicole DeLance, Dana Allison, and Abbie C Johnson
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Acetophenones ,Hyperemia ,Original Articles ,Hippocampus ,Elastin ,Rats ,Rats, Sprague-Dawley ,Vasodilation ,Arterioles ,Neurology ,Pre-Eclampsia ,Pregnancy ,Seizures ,cardiovascular system ,Animals ,Humans ,Female ,cardiovascular diseases ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,circulatory and respiratory physiology - Abstract
Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with neurovascular dysfunction, cognitive impairment and increased seizure susceptibility. Here, we sought to determine if treatment of experimental PE (ePE) rats with apocynin could prevent hippocampal arteriolar (HA) dysfunction and impaired seizure-induced hyperemia within the hippocampus, a brain region central to cognition and seizure generation. Isolated and pressurized HAs from Sprague Dawley rats that were normal pregnant (Preg; n = 8), ePE (n = 8) or ePE treated with apocynin for 2 weeks of gestation (ePE + apo; n = 8) were compared. Hippocampal blood flow (n = 6/group) was measured using hydrogen clearance before and during seizure. Aorta elastin was quantified using histochemistry. ePE was associated with HA dysfunction including reduced contraction to endothelin-1 and diminished dilation to the endothelium-dependent vasodilator NS309 that was prevented by apocynin. However, apocynin had no effect on ePE-induced impairment of dilation to the nitric oxide donor sodium nitroprusside, but increased myogenic tone and substantially increased HA distensibility. Seizure-induced hyperemia was impaired in ePE rats that was restored by apocynin. Aorta from ePE rats had reduced elastin content, suggesting large artery stiffness, that was unaffected by apocynin. Thus, while apocynin partially prevented HA dysfunction, its restoration of functional hyperemia may be protective of seizure-induced injury during eclampsia.
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- 2023
44. The Association Between Baseline and Change in Circulating Biomarkers with Geriatric Syndromes after Physical Therapy Following a Heart failure Hospitalization: The Rehab-HF Trial'
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deFilippi, Christopher, Damluji, Abdulla, and Bruce, Scott
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Medical Sciences ,Musculoskeletal, Neural, and Ocular Physiology ,Geriatrics ,Cardiovascular Diseases ,troponin ,Cardiology ,Medicine and Health Sciences ,Medical Specialties ,heart failure ,Diseases ,Biomarker ,Circulatory and Respiratory Physiology ,Chemicals and Drugs - Abstract
This is a secondary analysis of the REHAB-HF study to evaluate circulating biomarkers of cardiac physiology, inflammation and renal function at baseline and upon completion of a physical rehabilitation program (12 weeks) in these older adults recently hospitalized with specific aims directed and mechanistic insights and prognosis
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- 2023
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45. Functional capacity and echocardiography in a post COVID-19 population: protocol for a systematic review
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Wexler, Noah, Smith, Joel, Marwick, Thomas, and Hutcheon, Evelyn
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Medical Sciences ,#Post Acute Sequelae of Covid-19 ,Cardiology ,Medicine and Health Sciences ,Medical Specialties ,Circulatory and Respiratory Physiology ,#Long Covid - Abstract
While the Post-Acute Sequelae of COVID-19 (long-covid) is emerging as a prevalent and debilitating condition, its aetiology remains poorly understood. This systematic review seeks to characterise the nature of exercise intolerance in a post COVID-19 population and assess the extent to which cardiac dysfunction may be playing a role. To achieve this, we will review studies which assess both functional capacity (with either cardiopulmonary exercise testing or 6-minute walk times) and echocardiography. What role does cardiac dysfunction play in the reduction of functional capacity associated with the post-acute sequelae of COVID-19?
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- 2023
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46. The effect of rigid cells on blood viscosity: linking rheology and sickle cell anemia
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Antonio Perazzo, Zhangli Peng, Y.-N. Young, Zhe Feng, David K. Wood, John M. Higgins, and Howard A. Stone
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Erythrocytes ,Viscosity ,hemic and lymphatic diseases ,Humans ,hemic and immune systems ,General Chemistry ,Anemia, Sickle Cell ,Condensed Matter Physics ,Blood Viscosity ,Rheology ,Article ,circulatory and respiratory physiology - Abstract
Sickle cell anemia (SCA) is a disease that affects red blood cells (RBCs). Healthy RBCs are highly deformable objects that under flow can penetrate blood capillaries smaller than their typical size. In SCA there is an impaired deformability of some cells, which are much stiffer and with a different shape than healthy cells, and thereby affect regular blood flow. It is known that blood from patients with SCA has a higher viscosity than normal blood. However, it is unclear how the rigidity of cells is related to the viscosity of blood, in part because SCA patients are often treated with transfusions of variable amounts of normal RBCs and only a fraction of cells will be stiff. Here, we report systematic experimental measurements of the viscosity of a suspension varying the fraction of rigid particles within a suspension of healthy cells. We also perform systematic numerical simulations of a similar mixed suspension of soft RBCs, rigid particles, and their hydrodynamic interactions. Our results show that there is a rheological signature within blood viscosity to clearly identify the fraction of rigidified cells among healthy deformable cells down to a 5% volume fraction of rigidified cells. Although aggregation of RBCs is known to affect blood rheology at low shear rates, and our simulations mimic this effect via an adhesion potential, we show that such adhesion, or aggregation, is unlikely to provide a physical rationalization for the viscosity increase observed in the experiments at moderate shear rates due to rigidified cells. Through numerical simulations, we also highlight that most of the viscosity increase of the suspension is due to the rigidity of the particles rather than their sickled or spherical shape. Our results are relevant to better characterize SCA, provide useful insights relevant to rheological consequences of blood transfusions, and, more generally, extend to the rheology of mixed suspensions having particles with different rigidities, as well as offering possibilities for developments in the field of soft material composites.
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- 2023
47. Wrapped left anterior descending artery STEMI: time to revisit
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Mochamad Yusuf Alsagaff and Novia Kusumawardhani
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medicine.medical_specialty ,Coronary Vessel Anomalies ,Case Report ,030204 cardiovascular system & hematology ,Coronary Angiography ,Posterior descending artery ,03 medical and health sciences ,Coronary circulation ,Electrocardiography ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Internal medicine ,Occlusion ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Artery occlusion ,Interventional cardiology ,business.industry ,ST elevation ,General Medicine ,Middle Aged ,medicine.disease ,Coronary Vessels ,surgical procedures, operative ,medicine.anatomical_structure ,Treatment Outcome ,Coronary Occlusion ,cardiovascular system ,Cardiology ,ST Elevation Myocardial Infarction ,Drug Therapy, Combination ,Female ,business ,circulatory and respiratory physiology ,Artery - Abstract
We report three cases of acute myocardial infarction caused by left anterior descending (LAD) artery occlusion presenting as ST elevation in the inferior. Therefore, coronary angiography showed an occlusion of the LAD coronary artery. Our cases show the rare occurrence of left coronary circulation dominance affecting inferior leads. These cases show an unusual and very rare form of left dominance coronary circulation where LAD is wrapped around the apex and continuing as a posterior descending artery. This would make inferior myocardial infarction because of occluded LAD or determine as wrapped LAD.
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- 2023
48. Spectral Doppler: Basic Principles and Instrumentation
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Dev Maulik
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Pulse repetition frequency ,Spectrum analyzer ,Computer science ,business.industry ,Acoustics ,Ultrasound ,Spectral doppler ,Duplex (telecommunications) ,Velocimetry ,Sound power ,symbols.namesake ,cardiovascular system ,symbols ,business ,Doppler effect ,circulatory and respiratory physiology - Abstract
Spectral Doppler ultrasound velocimetry involves systematic analysis of the spectrum of frequencies that constitute the Doppler signal. This chapter presents a general perspective on Doppler signal anlyses and describes the spectral Doppler ultrasound devices commercially available for clinical use. They include continuous-wave (CW) Doppler, pulsed-wave (PW) Doppler and duplex Doppler devices. Within the realm of obstetric usage, the application needs are diverse and require various choices of equipment. For example, fetal Doppler echocardiography requires advanced duplex ultrasound instrumentation, which combines the capabilities of high-resolution two-dimensional imaging with the PW Doppler mode and an acoustic power output appropriate for fetal application. For umbilical arterial hemodynamic assessment, simpler, substantially less expensive CW Doppler equipment with a spectral analyzer may be sufficient. It is essential therefore that one develop a basic understanding of the implementation of Doppler ultrasound technology.
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- 2023
49. The splanchnic circulation
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John W. Osborn and Gregory D. Fink
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medicine.medical_specialty ,Sympathetic nervous system ,Splanchnic Circulation ,business.industry ,Orthostatic vital signs ,Blood pressure ,medicine.anatomical_structure ,Anesthesia ,Internal medicine ,Circulatory system ,cardiovascular system ,medicine ,Cardiology ,medicine.symptom ,business ,Splanchnic ,Vasoconstriction ,circulatory and respiratory physiology ,Artery - Abstract
Publisher Summary This chapter focuses on the effect of splanchnic circulation on overall circulatory function. The splanchnic circulation powerfully influences systemic arterial pressure via two distinct mechanisms. Widespread contraction of arteries in the splanchnic bed reduces blood flow to the region. Active constriction of veins in the splanchnic organs reduces regional blood volume. This has relatively little effect on total peripheral resistance but raises cardiac output and arterial pressure by increasing central blood volume and thus cardiac preload. Splanchnic sympathetic nerve activity (splSNA) is controlled by arterial and cardiopulmonary baroreceptors, and by inputs from other somatic and visceral afferents. Some stimuli are able to alter splSNA in a selective fashion. Impaired sympathetic splanchnic vasoconstriction is an important cause of orthostatic hypotension and other orthostatic disorders such as postural tachycardia syndrome. In portal hypertension there is a very marked increase in sympathetic nervous system activity, including to the splanchnic organs. During the development of arterial hypertension in humans, increased vascular resistance is observed first in the splanchnic circulation.
- Published
- 2023
50. Rbf Regulates Drosophila Spermatogenesis via Control of Somatic Stem and Progenitor Cell Fate in the Larval Testis
- Author
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Fengwei Yu, Nicole A Siddall, Mai Tran, Yu Cai, Hongyan Wang, Leonie M. Quinn, Nicole Dominado, John E. La Marca, W. Gregory Somers, James Heaney, and Gary R. Hime
- Subjects
Male ,0301 basic medicine ,Somatic cell ,proliferation ,Cellular differentiation ,testis ,retinoblastoma protein ,self-renewal ,germline ,medicine.disease_cause ,Biochemistry ,Article ,Germline ,03 medical and health sciences ,0302 clinical medicine ,Genetics ,medicine ,Animals ,Drosophila Proteins ,Cell Lineage ,stem cell niche ,Progenitor cell ,Spermatogenesis ,reproductive and urinary physiology ,Cell Proliferation ,Uncategorized ,Mutation ,biology ,urogenital system ,Stem Cells ,Retinoblastoma protein ,Cell Differentiation ,Cell Biology ,Null allele ,stem cell ,Drosophila melanogaster ,Germ Cells ,030104 developmental biology ,Larva ,biology.protein ,Drosophila ,Stem cell ,030217 neurology & neurosurgery ,Transcription Factors ,circulatory and respiratory physiology ,Developmental Biology - Abstract
Summary The Drosophila testis has been fundamental to understanding how stem cells interact with their endogenous microenvironment, or niche, to control organ growth in vivo. Here, we report the identification of two independent alleles for the highly conserved tumor suppressor gene, Retinoblastoma-family protein (Rbf), in a screen for testis phenotypes in X chromosome third-instar lethal alleles. Rbf mutant alleles exhibit overproliferation of spermatogonial cells, which is phenocopied by the molecularly characterized Rbf11 null allele. We demonstrate that Rbf promotes cell-cycle exit and differentiation of the somatic and germline stem cells of the testes. Intriguingly, depletion of Rbf specifically in the germline does not disrupt stem cell differentiation, rather Rbf loss of function in the somatic lineage drives overproliferation and differentiation defects in both lineages. Together our observations suggest that Rbf in the somatic lineage controls germline stem cell renewal and differentiation non-autonomously via essential roles in the microenvironment of the germline lineage., Graphical Abstract, Highlights • Rbf null testes exhibit failure of germline stem cells to differentiate • Rbf expression in somatic cells of L3 testes rescues the GSC differentiation defect • Somatic Rbf RNAi disrupts cyst stem cell and germline stem cell differentiation • Somatic depletion of E2f1 rescues Rbf germline proliferation and differentiation, The Drosophila testis contains germline and somatic cyst stem cell populations. Progeny from these populations cross regulate the differentiation of each lineage. In this article, Hime, Quinn, and colleagues show that the Drosophila Retinoblastoma ortholog, Rbf, is cell autonomously required by somatic cells of the testis to facilitate cyst stem cell differentiation and subsequent germline stem cell differentiation.
- Published
- 2023
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