Background Elderly female hypertensives with arterial stiffening constitute a majority of patients with Heart Failure with preserved Ejection Fraction (HFpEF), a condition characterized by the inability to increase cardiac stroke volume (SV) with physical exercise. As SV is determined by the interaction between the left ventricle (LV) and its load, ...

BACKGROUND: -The clinical course in PAH is variable and there is limited information on the determinants and progression of RV dysfunction.. The objective is to develop PET metabolic imaging of the RV as a non-invasive tool in patients with pulmonary arterial hypertension (PAH). METHODS AND RESULTS: -We performed PET scanning ...

Increased right atrial (RA) and ventricular (RV) chamber volumes are a late maladaptive response to chronic pulmonary hypertension. The purpose of the current investigation was to characterize the early compensatory changes that occur in the right heart during chronic RV pressure overload before the development of chamber dilation. Magnetic resonance ...

Purpose:To prospectively correlate spleen elasticity and degree of portal hypertension estimated with the hepatic venous pressure gradient (HVPG) and to evaluate splenic elasticity as a predictor of gastroesophageal varices.Materials and Methods:The institutional review board approved this study, and patients provided written informed consent. In a pilot study of 60 patients ...

ABSTRACT: INTRODUCTION: Adequate volume expansion (VE) in patients with evidence of hypoperfusion should be aimed to achieve not only an increase in stroke volume (SV) and cardiac index (CI), but also an improved tissue perfusion and oxygenation. Our aim was to assess dynamic changes of muscle tissue oxygen saturation (StO2) ...

Resistant hypertension (RH), defined simply, is blood pressure (BP) requiring the use of four or more antihypertensive agents, whether controlled or uncontrolled. RH is an increasingly common problem in elderly patients and may affect as many as 20% of the hypertensive population. Unfortunately, at least 30% of patients evaluated for ...

OBJECTIVE: To assess the efficacy of arginine vasopressin (AVP) as a rescue therapy in children with catecholamine refractory vasodilatory shock and its effect on various hemodynamic, clinical, and laboratory variables. METHODS: This prospective hospital based study was conducted from January 2008 through July 2008 at a tertiary pediatric cardiac critical ...

Essential hypertension (EH) is associated with structural changes of small arteries (SMASCH) in terms of wall thickening and lumen narrowing throughout the entire resistance circulation. This remodelling process occurs early in EH development and is an important contributor to the elevation of vascular resistance. SMASCH also decreases the vasodilatory capability ...

OBJECTIVES:: Many mechanically ventilated patients with acute respiratory distress syndrome develop pulmonary fibrosis. Stresses induced by mechanical ventilation may explain the development of fibrosis by a number of mechanisms (e.g., damage the alveolar epithelium, biotrauma). The objective of this study was t test the hypothesis that mechanical ventilation plays an ...

Eur J Clin Invest 2011 ABSTRACT: Backgrounds  Metabolic syndrome (MetS) is a multiple risk factor paradigm widely considered in risk management. We aimed to investigate carotid artery alterations in MetS and the underlying risk factors. Materials and methods  A total of 400 Chinese subjects were recruited, divided into control (n = 200) ...

To determine the role of home blood pressure (BP) monitoring for a reproducible assessment of orthostatic hypertension (OHT) and the effectiveness of hypertension control by doxazosin. In this study, 605 medicated hypertensive outpatients were enrolled. Home BP in the sitting and standing positions was monitored in all patients in the ...

OBJECTIVE:: To measure the impact of a national propofol shortage on the duration of mechanical ventilation. DESIGN:: Before-after study. SETTING:: Three, noncardiac surgery, adult intensive care units at a 320-bed academic medical center. PATIENTS:: Consecutive patients requiring mechanical ventilation ≥48 hrs, administered a continuously infused sedative ≥24 hrs, extubated, and ...

Hypertension is an important cause of chronic kidney disease (CKD). Identifying risk factors for progression to CKD in patients with normal kidney function and hypertension may help target therapies to slow or prevent decline of kidney function. Our objective was to identify risk factors for development of incident CKD and ...

Abstract Given the high oxygen consumption of motor neurons, we sought to assess the frequency and prognostic value of arterial hypertension (affecting brain's oxygen supply) in amyotrophic lateral sclerosis (ALS). We consecutively and prospectively included all ALS patients with regular medical follow-up and documented blood pressure measurements and monitored them ...

Partial inferior turbinectomy is typically performed on patients suffering from chronic nasal obstruction due to hypertrophy of inferior turbinates and is refractory to other more conservative treatments. The effects of the various options of incision performed on the inferior turbinate in terms of the resulting nasal airflow pattern are examined ...

BACKGROUND: The benefits of compression legwear (CL) have been demonstrated in the improvement of vascular function and venous return of the lower extremities, but their effect on autonomic nervous system (ANS) activities and human stress response remain controversial. OBJECTIVE: To investigate the possible effects of CLs on ANS activities and ...

Chronic exertional compartment syndrome (CECS) of the lower limb is part of a group of overuse lower limb injuries with common presenting features. It is commonly diagnosed by the measurement of raised intramuscular pressures in the lower limb. The pathophysiology of the condition is poorly understood, and the criteria used ...

Background- It remains controversial whether restrictive mitral annuloplasty (RMA) for functional mitral regurgitation (MR) can induce functional mitral stenosis (MS) that may cause postoperative residual pulmonary hypertension (PH). Methods and Results- One hundred eight patients with left ventricular (LV) dysfunction and severe MR underwent RMA with stringent downsizing of the ...

BACKGROUND: Esophageal peristalsis and basal gastroesophageal junction (GEJ) pressure correlate poorly with dysphagia. AIM: To determine intraluminal pressures that reflect GEJ function and to determine manometric correlates for dysphagia before and after fundoplication. METHODS: The relationships between maximal intrabolus pressure, residual GEJ relaxation pressure and peak peristaltic pressure for water ...

OBJECTIVE: The objective of the current study was to confirm the degrees of dyssynchrony in patients with nonleft ventricular hypertrophy (LVH) and never-treated hypertension compared with normal controls or patients with LVH and never-treated hypertension. METHODS AND RESULTS: We enrolled 200 consecutive never-treated hypertensive patients and 104 age-matched and sex-matched ...

Aims:  To compare the effects of intensive multifactorial cardiovascular risk intervention with standard care in screen-detected Type 2 diabetes. Methods:  Twenty general practices randomly invited 30 950 adults without diagnosed diabetes for screening (World Health Organization, 1999). In a cluster randomized controlled trial, screen-detected cases were assigned by practice allocation to receive ...

Background: Endotoxin (Et) adsorption therapy with a column of polymyxin B-immobilized fibers (PMX) is effective in improving the partial pressure of arterial oxygen/fraction of inspired oxygen ratio (PaO(2)/FiO(2) ratio) and increasing mean arterial blood pressure (MAP) in sepsis. S100A12 and soluble receptor for advanced glycation end product (sRAGE) are useful ...

ABSTRACT: BACKGROUND: :The PEEP-ZEEP technique is previously described as a lung inflation through a positive pressure enhancement at the end of expiration (PEEP), followed by rapid lung deflation with an abrupt reduction in the PEEP to 0 cmH2O (ZEEP), associated to a manual bilateral thoracic compression. AIM: To analyze PEEP-ZEEP ...

The purpose of this study was to determine the relationship between the scores of Braden scale and pressure ulcer development among critically ill patients. All patients who admitted to intensive care unit (ICU) in 3 months (during July-October 2010) were surveyed with Braden scale. Patients who gained higher score of ...

The occurrence of additional cardiovascular events when the diastolic blood pressure is lowered below a critical level is referred to as "the diastolic J curve." Although the critical level of diastolic blood pressure where the J curve begins is not certain, increasingly strong evidence from prospective, controlled studies has confirmed ...

OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has been associated with hypertension in specific population groups and in cases with elevated levels of alanine aminotransferase (ALT). This study aimed to determine the strength of the association between NAFLD with prevalent hypertension and with high-normal blood pressure (BP) in nonhypertensive individuals from ...

BACKGROUND: We sought to determine plasma fibrin clot properties in hypertensive subjects and to evaluate potential effects of antihypertensive therapy on these parameters. PATIENTS AND METHODS: Sixty-one patients (30 men, 31 women) with essential arterial hypertension stage 1 or 2 (aged 46.6±14.4years), free of clinically evident vascular disease, were randomly ...

Fluid challenges are considered the cornerstone of resuscitation in critically ill patients. However, clinical studies have demonstrated that only about 50% of hemodynamically unstable patients are volume responsive. Furthermore, increasing evidence suggests that excess fluid resuscitation is associated with increased mortality. It therefore becomes vital to assess a patient's fluid ...

Diabetes is associated with atherogenic risk factors. Hypertension has a major influence on cardiovascular disease in diabetic patients. Ambulatory blood pressure monitoring (ABPM) is useful for identifying nocturnal hypertension. Carotid intima-media thickness (cIMT) is a good measure for identifying subclinical atherosclerosis. This study aimed to evaluate whether nocturnal hypertension affects ...

BACKGROUND: The cerebral pressure reactivity index (PRx) correlates with the outcome in intracerebral haemorrhage (ICH) patients and has been used to define an autoregulation-oriented "optimal cerebral perfusion pressure" (CPPopt). PRx has been calculated as a moving correlation coefficient between mean arterial pressure (MAP) and intracranial pressure (ICP) averaged over 5-10 s, ...

BACKGROUND: Hypocapnia before and during carbon dioxide (CO(2)) insufflation for laparoscopic cholecystectomy may reduce the adverse hemodynamic responses. METHODS: After ethical approval, 100 patients scheduled for laparoscopic cholecystectomy were ventilated using a tidal volume of 8 ml/kg, an inspiration:expiration ratio of 1:2.5, and a positive end-expiratory pressure (PEEP) of 5 cm H(2)O. ...

BACKGROUND: The utility of continuous positive airway pressure (CPAP) in the in-hospital treatment of congestive heart failure (CHF) is well established. Its exact role is less clear in the prehospital arena. OBJECTIVE: To describe the prehospital use of CPAP for patients presenting with acute severe heart failure in a large ...

The pathogenesis of symptoms in urolithiasis is poorly understood. Traditionally increased endoluminal pressure is considered the main mechanism causing pain in the upper urinary tract but clinical data are sparse. The aim of the present study was to develop a new model related to mechanosensation in order to describe the ...

Background: Encouragement of home blood pressure (BP) monitoring has a great potential to improve hypertension control rates. The purpose of this study was to test validation of the Omron M3 Intellisense (HEM-7051-E) upper arm BP measuring monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010 ...

BACKGROUND: The purpose of this study was to investigate endotracheal tube cuff pressure alteration in patients during laparoscopic cholecystectomy surgery. METHODS: Forty patients with ASA I-II physical status, who were scheduled for elective laparoscopic (group I) or open abdominal surgery (group II) were enrolled in the study. Tracheal intubation was ...

This study investigated whether low blood-lead levels (≤10μg/dL) were associated with blood pressure (BP) outcomes. The authors analyzed data from National Health and Nutrition Examination Survey 1999-2006 and participants aged 20 years or older. Outcome variables were systolic and diastolic BP measurements, pulse pressure, and hypertension status. Multivariable linear and ...

Hypertensive emergencies are acute elevations in blood pressure (BP) that occur in the presence of progressive end-organ damage. Hypertensive urgencies, defined as elevated BP without acute end-organ damage, can often be treated with oral agents, whereas hypertensive emergencies are best treated with intravenous titratable agents. However, a lack of head-to-head ...

Abstract Background: Augmentation index (AIx) and pulse wave velocity (PWV) are early markers of atherosclerotic vascular changes and also have been shown to be predictive of cardiovascular disease and total mortality. The aim of our study was to evaluate the relationship between PWV and AIx-HR75, which is the corrected form ...

Systolic blood pressure (SBP) at hospital admission predicts in-hospital and postdischarge mortality in patients with left ventricular systolic dysfunction. The relationship between admission SBP and mortality in heart failure with preserved (≥50%) ejection fraction (HFPEF) is still unclear. We aimed to investigate the relationship between admission SBP and 5-year outcome ...

BACKGROUND: Diastolic dysfunction is considered the first marker of diabetic cardiomyopathy. However, preclinical systolic alteration was also recently described by strain, but its association with diastolic dysfunction has never been investigated. METHODS: One hundred fourteen patients with type 2 diabetes mellitus (DM) with controlled blood pressure and without overt heart ...

Autosomal dominant polycystic kidney disease (ADPKD) is associated with a substantial cardiovascular disease burden including early onset hypertension, intracranial aneurysms, and left ventricular hypertrophy (LVH). A 41% prevalence of LVH has been reported in ADPKD, using echocardiographic assessment of LV mass (LVM). The HALT PKD study was designed to assess ...

PURPOSE:: To evaluate the effectiveness of 6 months treatment with ibopamine eye drops in raising the intraocular pressure in patients with therapy-resistant hypotony after vitreoretinal surgery for proliferative vitreoretinopathy secondary to rhegmatogenous retinal detachment or penetrating trauma. METHODS:: A 2% ibopamine eye drop was topically administered 3 times daily during ...

Dipping and nondipping blood pressure (BP) patterns are associated with different levels of target organ damage and cardiovascular risk. The aim of our investigation was to determine the relationship between different BP patterns (dipping, nondipping, extreme dipping and reverse dipping type) and cardiac structure, and function in hypertensive patients. This ...

Abstract BACKGROUND:Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have traditionally been treated surgically through emergent laparotomy. Intensivist-performed bedside drainage of free intra-peritoneal fluid or blood [percutaneous catheter decompression (PCD)] has been advocated as a less-invasive alternative to open abdominal decompression (OAD) METHODS:A single-center disease and severity of illness matched ...

PURPOSE: We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194-199, 1). In this study, we investigated whether these effects of DEX continue until the start of cardiopulmonary ...

BackgroundAugmentation pressure has emerged as a surrogate marker for cardiovascular disease, and endothelial dysfunction has been proposed as related factor. However, the relationship between augmentation pressure and digital endothelial function has not yet been well defined. We investigated the relationship between augmentation pressure and digital reactive hyperemia (RH) in patients ...

It has been suggested that blood loss during liver resection may be reduced if central venous pressure (CVP) is kept at a low level. This can be achieved by changing patient position but it is not known how position changes affect portal (PVP) and hepatic (HVP) venous pressures. The aim ...

Although most guidelines committees historically recommended initial diuretics and/or β blockers for uncomplicated hypertension, clinical trial outcomes analyzed in the last 5 to 7 years have been suboptimal with atenolol, the world's most popular β blocker. Several meta-analyses have suggested that despite lowering blood pressure, any and all β blockers inadequately ...

Objective. This study aims to compare the effects of Merocel nasal packs and silicone nasal septal splints with integral airway on the ventilation and pressure of the middle ear when applied intranasally after septoplasty for isolated septal deviation.Study Design. A prospective, randomized trial.Setting. A tertiary referral center.Subjects and Methods. Fifty-one ...

A bedside tool for monitoring changes in end-expiratory lung volume (ΔEELV) would be helpful to set optimal positive end-expiratory pressure (PEEP) in acute lung injury/acute respiratory distress syndrome patients. The hypothesis of this study was that the cumulative difference of the inspiratory and expiratory tidal volumes of the first 10 ...