Risk profile and hemodynamic characteristics in young subjects with high normal arterial blood pressure

Introduction: The European Society of Cardiology classifies arterial pressure bellow 140/90 mmHg as optimal (below 120/80 mmHg), normal (120-129 mmHg for systolic and/or 80-84 mmHg for diastolic) and high normal (130-139 mmHg for systolic and/or 85-89 mmHg for diastolic). The argument is concerned with different cardiovascular risk. The possibility for arterial hypertension (AH) to appear is higher in individuals with high normal arterial pressure (HNAP). Such individuals could be treated with non-drug therapy as the idea is the appearance of AH to be delayed and the cardiovascular risk to be reduced.The goal of the study was to examine the risk and hemodynamic profile of medical students with HNAP.Material and methods:  The object of the investigation was focused on medical students with HNAP. The two followed-up groups - with HNAP and with optimal arterial blood pressure (OBP) assumed this pattern on the base of inquiry and screening among 116 students (60 men and 56 women). Inquiry and anthropometric methods, arterial pressure monitoring and impedance cardiography were carried out.Results: The dominance of some factors, predisposing hypertension appearance as overweight, increased salt consumption, family history was registered in HNAP group. Hemodynamic evaluation manifested hyperkinetic type of circulation.Conclusion: Medical students` risk and hemodynamic profile within HNAP group is close to that of the hypertensive individuals. That makes them a special risk group and there is a necessity of non-drug treatment in order to delay AH expression

Cardiovascular and autonomic consequences of sleep fragmentation

Introduction: Sleep disruption is commonly found in normal individuals and those with sleep disorders. Risk factors for sleep fragmentation involve a combination of lifestyle, environmental, psychosocial factors and/or medical conditions. The main objective of this study was to analyse the impact of acute, induced sleep fragmentation upon autonomic cardiovascular regulation, measured by a non-invasive haemodynamic measurement technique. Material and methods: The authors analysed beat-to-beat measurements of haemodynamic and autonomic parameters at 5-time points during sleep fragmentation: 9:00 a.m. (baseline), 9:00 p.m., 00:30 a.m., 4:00 a.m., and 7:30 a.m. Differences in the mean values for chronotropic parameters, cardiac contractility, parameters related to blood pressure regulation and workload of the left ventricle, and autonomic parameters were examined in seventeen healthy male volunteers. Direct results obtained from every time point were analysed using analysis of variance with repeated measures or the Friedman rank sum test. Results: Sleep fragmentation had a significant negative impact on haemodynamic parameters related to cardiac contractility (SV p < 0.001, IC p < 0.001, HI p < 0.001); parameters related to workload of the left ventricle (CO p < 0.001, LVWI p < 0.001, ACI p < 0.001); parameters related to blood pressure regulation (sBP p = 0.001, TPR p < 0.001); on chronotropic parameters (HR p < 0.001, PEP p < 0.001, LVET p < 0.001) and an indicator of cardiac autonomic regulation: LF-RRI (p = 0.001). Conclusions: Acute sleep fragmentation can modify haemodynamic control and autonomic cardiovascular regulation in healthy men; the most important changes were seen in the morning hours (4:00 a.m.). Therefore, conditions of chronic sleep fragmentation (e.g. shift work, uniformed services, clinicians), might lead to disturbance in the autonomic nervous system and therefore to problems with homeostasis in the cardiovascular system. Future research is needed in standardized conditions with large-scale studies to clarify the effects of chronic sleep fragmentation

Effects of whole-body cryotherapy and static stretching are maintained 4 weeks after treatment in most patients with chronic fatigue syndrome

Funding Information: This article/publication is based upon work from COST Action CA15111 ”European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, EUROMENE,” supported by COST (European Cooperation in Science and Technology, weblink: www.cost.eu , access date: 09.06.2022). Publisher Copyright: © 2023 The AuthorsIn the previous study, whole-body cryotherapy (WBC)+static stretching (SS) has been shown 25 to reduce the severity of some symptoms in Chronic Fatigue Syndrome (CFS) noted just after 26 the therapy. Here we consider the effects of treatment and explore the sustainability of 27 symptom improvements at four weeks (one-month) follow-up. Twenty-two CFS patients were 28 assessed one month after WBC+SS programme. Parameters related to fatigue (Chalder 29 Fatigue Questionnaire (CFQ), Fatigue Impact Scale (FIS), Fatigue Severity Scale (FSS)), 30 cognitive function (Trial Making test part A and B (TMT A and TMT B and its difference 31 (TMT B-A)), Coding) hemodynamic, aortic stiffness (aortic systolic blood pressure (sBP 32 aortic)) and autonomic nervous system functioning were measured. TMT A, TMT B, TMT B33 A and Coding improved at one month after the WBC+SS programme. WBC+SS had a 34 significant effect on the increase in sympathetic nervous system activity in rest. WBC+SS had 35 a significant, positive chronotropic effect on the cardiac muscle. Peripheral and aortic systolic 36 blood pressure decreased one month after WBC+SS in comparison to before. Effects of 37 WBC+SS on reduction of fatigue, indicators of aortic stiffness and symptoms severity related 38 to autonomic nervous system disturbance and improvement in cognitive function were 39 maintained at one month. However, improvement in all three fatigue scales (CFQ, FIS and 40 FSS) was noted in 17 of 22 patients. In addition, ten patients were treated initially but they 41 were not assessed at 4 weeks, and are thus not included in the 22 patients who were examined 42 on follow-up. The overall effects of WBC+SS noted at one month post-treatment should be 43 interpreted with caution.publishersversionPeer reviewe

Changes in the allostatic response to whole-body cryotherapy and static-stretching exercises in chronic fatigue syndrome patients vs. Healthy individuals

Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.This study represents a comparison of the functional interrelation of fatigue and cognitive, cardiovascular and autonomic nervous systems in a group of Chronic Fatigue Syndrome (CFS) patients compared with those in healthy individuals at different stages of analysis: at baseline and after changes induced by whole-body cryotherapy (WBC) combined with a static-stretching (SS) program. The study included 32 patients (Fukuda criteria) and 18 healthy controls. Fatigue, cogni-tive, cardiovascular and autonomic function and arterial stiffness were measured before and after 10 sessions of WBC with SS. In the patients, a disturbance in homeostasis was observed. The network relationship based on differences before and after intervention showed comparatively higher stress and eccentricity in the CFS group: 50.9 ± 56.1 vs. 6.35 ± 8.72, p = 0.002, r = 0.28; and 4.8 ± 0.7 vs. 2.4 ± 1, p < 0.001, r = 0.46, respectively. Before and after intervention, in the CFS group increased fatigue was related to baroreceptor function, and baroreceptor function was in turn related to aortic stiffness, but no such relationships were observed in the control group. Differences in the network structure underlying the interrelation among the four measured criteria were observed in both groups, before the intervention and after ten sessions of whole cryotherapy with a static stretching exercise.publishersversionPeer reviewe

Comprehensive in-hospital monitoring in acute heart failure : applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

This paper provides a practical clinical application of guideline recommendations relating to the inpatient monitoring of patients with acute heart failure, through the evaluation of various clinical, biomarker, imaging, invasive and non-invasive approaches. Comprehensive inpatient monitoring is crucial to the optimal management of acute heart failure patients. The European Society of Cardiology heart failure guidelines provide recommendations for the inpatient monitoring of acute heart failure, but the level of evidence underpinning most recommendations is limited. Many tools are available for the in-hospital monitoring of patients with acute heart failure, and each plays a role at various points throughout the patient's treatment course, including the emergency department, intensive care or coronary care unit, and the general ward. Clinical judgment is the preeminent factor guiding application of inpatient monitoring tools, as the various techniques have different patient population targets. When applied appropriately, these techniques enable decision making. However, there is limited evidence demonstrating that implementation of these tools improves patient outcome. Research priorities are identified to address these gaps in evidence. Future research initiatives should aim to identify the optimal in-hospital monitoring strategies that decrease morbidity and prolong survival in patients with acute heart failure.Peer reviewe

Evaluation der kontinuierlichen, nicht invasiven Messung des Blutdrucks unter Berücksichtigung verschiedener Kalibrierungsmethoden

Eine engmaschige, perioperative Überwachung des arteriellen Blutdrucks, vor allem bei Risikopatienten, gehört zu dem von Fachgesellschaften vorgeschriebenem Standardmonitoring. Die beiden aktuellen Standardverfahren, die oszillometrische Messung und die invasive arterielle Messung haben beide Limitationen. Der CNAP™-Monitor verspricht zumindest theoretisch, eine fast ideale Methode zu sein, um den arteriellen Druck zu messen. Diese sollte nicht-invasiv und kontinuierlich sein, ohne eine Kalibrierung auskommen, eine hohe Übereinstimmung mit dem „wahren Blutdruck“ zeigen und möglichst eine Austauschbarkeit mit dem Goldstandard der invasiven arteriellen Messung zu ermöglichen ohne dabei deren Risiken zu beinhalten. In dieser Studie wurde untersucht, mit welchem Kalibrierungsalgorithmus der CNAP™-Monitor diesen Zielen am nächsten kommt

Evaluation einer kontinuierlichen, nicht invasiven Blutdruckmessung im Vergleich zur invasiven arteriellen Blutdruckmessung

Ein kontinuierliches und intraoperatives Monitoring des arteriellen Blutdrucks zur Überwachung von Risikopatienten wird von den Fach-gesellschaften als Standardüberwachung empfohlen. Die zurzeit verwendeten Standardmethoden, die intraarterielle Blutdruckmessung und die oszillometrische Blutdruckmessung haben spezifisch jeweils ihre Einschränkungen. Jedoch versucht der CNAPTM Monitor in seiner Auslegung die jeweiligen Nachteile zu minimieren und einen nichtinvasiven kontinuierlichen arteriellen Blutdruck zu messen. Das bedeutet, die Blutdruckmessung sollte sowohl exakt als auch risikolos und einfach anzuwenden sein und eine kontinuierliche Blutdruckmessung ermöglichen. Zudem sollten die Risiken einer intraarteriellen Blut-druckmessung wie Gefäßverschlüsse und Infektionen aufgrund der notwendigen Kanülierung einer Arterie nicht mehr gegeben sein. Bestenfalls könnte auf eine Kalibrierung verzichtet werden und die neue Messmethode liefert eine Übereinstimmung und Austauschbarkeit der Blutdruckwerte zum Goldstandard der invasiven intraarteriellen Blutdruckmessung. In dieser Studie wurde untersucht, ob eine Austauschbarkeit der Blutdruckwerte in der Einleitung und in der Operation gegeben ist und ob die Fingermanschetten des CNAPTM Monitors eine metabolische Veränderung am Finger verursacht