22 research outputs found
Brain metabolites in autonomic regulatory insular sites in heart failure
Autonomic, pain, and neuropsychologic comorbidities appear in heart failure (HF), likely resulting from brain changes, indicated as loss of structural integrity and functional deficits. Among affected brain sites, the anterior insulae are prominent in serving major regulatory roles in many of the disrupted functions commonly seen in HF. Metabolite levels, including N-acetylaspartate (NAA), creatine (Cr), choline (Cho), and myo-inositol (MI), could indicate the nature of anterior insula tissue injury in HF. The study aim was to assess anterior insular metabolites to determine processes mediating autonomic, pain, and neuropsychologic disruptions in HF. We performed magnetic resonance spectroscopy in bilateral anterior insulae in 11 HF and 53 controls, using a 3.0-Tesla magnetic resonance imaging scanner. Peaks for NAA at 2.02ppm, Cr at 3.02ppm, Cho at 3.2ppm, and MI at 3.56ppm were assigned, peak areas calculated, and metabolites expressed as ratios, including NAA/Cr, Cho/Cr, and MI/Cr. HF patients showed significantly increased Cho/Cr ratios, indicative of glial proliferation or injury, on the left anterior insula, and reduced NAA/Cr levels, suggesting neuronal loss/dysfunction, on the right anterior insula over controls. No differences in MI/Cr ratios appeared between groups. Right anterior insular neuronal loss and left glial alterations may contribute to distorted autonomic, pain, and neuropsychologic functions found in HF
Blutdruckmessung mittels Puls-Transit-Zeit
Es besteht eine lineare, negative Beziehung zwischen der Puls-Transit-Zeit (PTZ) und dem Blutdruck. Die vorliegende Studie untersucht die Validität der PTZ-Blutdruckmessung in Ruhe und unter positiver Überdruckbeatmung.
Bei 78 Patienten eines kardiologischen Schlaflabors wurde fĂĽr jeweils 10 Minuten ein kontinuierlicher, positiver Atemwegsdruck von 0, 4, 8 und 12 appliziert und simultan der Blutdruck mittels oszillometrischer Oberarmmessung sowie mittels PTZ-Methode bestimmt.
Die aufgezeichnete PTZ konnte bei 64 Patienten (82%) in verwertbare Blutdruckwerte umgerechnet werden. Der Vergleich beider Methoden ergab keine signifikanten Unterschiede, aber eine sehr starke lineare Korrelation der absoluten systolischen und diastolischen Messergebnisse. Mit steigendem Beatmungsdruck zeigte sich eine zunehmende Abweichung der Messwerte beider Methoden
Development And Validation Of A Goal Oriented Course Evaluation System.
PhDEducational psychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/187270/2/7229191.pd
Hypotensive effects of positive airway pressure ventilation in heart failure patients with sleep-disordered breathing
Oldenburg O, Bartsch S, Bitter T, et al. Hypotensive effects of positive airway pressure ventilation in heart failure patients with sleep-disordered breathing. Sleep And Breathing. 2012;16(3):753-757.Obstructive sleep apnoea (OSA) as well as central sleep apnoea (CSA) are highly prevalent in heart failure (HF) patients. Positive airway pressure (PAP) therapy is usually intended to treat OSA and CSA. The aim of the present study was to investigate immediate hemodynamic effects of PAP therapy in these patients. In 61 consecutive HF patients (NYHA a parts per thousand yenaEuro parts per thousand II, EF a parts per thousand currency signaEuro parts per thousand 45%) with moderate to severe OSA or CSA (AHI a parts per thousand yenaEuro parts per thousand 15/h) blood pressure (BP) and heart rate (HR) response to PAP therapy initiation was investigated during mask fitting with patients being awake and in supine position. While applying an endexspiratory pressure of 5.8 +/- 0.9 cm H2O, there was a significant decrease in systolic (-8.9 +/- 12.1 mmHg, p < 0.001) and diastolic BP (-5.1 +/- 9.2 mmHg, p < 0.001) without a change in HR (p = n.s.). At least a transient drop in mean arterial pressure a parts per thousand currency sign70 mmHg was seen in 10% of these patients. Logistic regression analysis revealed a significant impact of baseline BP on potential BP drops: lower baseline BP was associated with BP drops. PAP therapy may cause unexpected hypotension especially in patients with low baseline BP as seen in HF patients treated according to current guidelines. Whether these hypotensive effects sustain, cause any harm to the patients and/or is responsible for non-acceptance or non-adherence of PAP therapy needs to be determined
Hypotensive effects of positive airway pressure ventilation in heart failure patients with sleep-disordered breathing
Oldenburg O, Bartsch S, Bitter T, et al. Hypotensive effects of positive airway pressure ventilation in heart failure patients with sleep-disordered breathing. Sleep And Breathing. 2012;16(3):753-757.Obstructive sleep apnoea (OSA) as well as central sleep apnoea (CSA) are highly prevalent in heart failure (HF) patients. Positive airway pressure (PAP) therapy is usually intended to treat OSA and CSA. The aim of the present study was to investigate immediate hemodynamic effects of PAP therapy in these patients. In 61 consecutive HF patients (NYHA a parts per thousand yenaEuro parts per thousand II, EF a parts per thousand currency signaEuro parts per thousand 45%) with moderate to severe OSA or CSA (AHI a parts per thousand yenaEuro parts per thousand 15/h) blood pressure (BP) and heart rate (HR) response to PAP therapy initiation was investigated during mask fitting with patients being awake and in supine position. While applying an endexspiratory pressure of 5.8 +/- 0.9 cm H2O, there was a significant decrease in systolic (-8.9 +/- 12.1 mmHg, p < 0.001) and diastolic BP (-5.1 +/- 9.2 mmHg, p < 0.001) without a change in HR (p = n.s.). At least a transient drop in mean arterial pressure a parts per thousand currency sign70 mmHg was seen in 10% of these patients. Logistic regression analysis revealed a significant impact of baseline BP on potential BP drops: lower baseline BP was associated with BP drops. PAP therapy may cause unexpected hypotension especially in patients with low baseline BP as seen in HF patients treated according to current guidelines. Whether these hypotensive effects sustain, cause any harm to the patients and/or is responsible for non-acceptance or non-adherence of PAP therapy needs to be determined