Articoli di riviste: "Central aortic"

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O’Rourke, Michael F. "Central aortic pressure". Journal of Hypertension 33, n. 1 (gennaio 2015): 187–88. http://dx.doi.org/10.1097/hjh.0000000000000450.

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Narayan, Om, Anthony Dart, Ian T. Meredith e James D. Cameron. "Central aortic pressure". Journal of Hypertension 33, n. 1 (gennaio 2015): 188–89. http://dx.doi.org/10.1097/hjh.0000000000000451.

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Carlsen, Rasmus Kirkeskov, Simon Winther, Christian D. Peters, Esben Laugesen, Dinah S. Khatir, Hans E. Bøtker, Morten Bøttcher, Per Ivarsen, My Svensson e Niels Henrik Buus. "Aortic Calcification Affects Noninvasive Estimates of Central Blood Pressure in Patients with Severe Chronic Kidney Disease". Kidney and Blood Pressure Research 44, n. 4 (2019): 704–14. http://dx.doi.org/10.1159/000501226.

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Background: Central blood pressure (BP) assessed noninvasively considerably underestimates true invasively measured aortic BP in chronic kidney disease (CKD) patients. The difference between the estimated and the true aortic BP increases with decreasing estimated glomerular filtration rates (eGFR). The present study investigated whether aortic calcification affects noninvasive estimates of central BP. Methods: Twenty-four patients with CKD stage 4–5 undergoing coronary angiography and an aortic computed tomography scan were included (63% males, age [mean ± SD ] 53 ± 11 years, and eGFR 9 ± 5 mL/min/1.73 m2). Invasive aortic BP was measured through the angiography catheter, while non-invasive central BP was obtained using radial artery tonometry with a SphygmoCor® device. The Agatston calcium score (CS) in the aorta was quantified on CT scans using the CS on CT scans. Results: The invasive aortic systolic BP (SBP) was 152 ± 23 mm Hg, while the estimated central SBP was 133 ± 20 mm Hg. Ten patients had a CS of 0 in the aorta, while 14 patients had a CS >0 in the aorta. The estimated central SBP was lower than the invasive aortic SBP in patients with aortic calcification compared to patients without (mean difference 8 mm Hg, 95% CI 0.3–16; p = 0.04). The brachial SBP was lower than the aortic SBP in patients with aortic calcification compared to patients without (mean difference 10 mm Hg, 95% CI 2–19; p = 0.02). Conclusion: In patients with advanced CKD the presence of aortic calcification is associated with a higher difference between invasively measured central aortic BP and non-invasive estimates of central BP as compared to patients without calcifications.

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Buchnieva, Olha Volodymyrivna. "PROTECTION OF CENTRAL AND PERIPHERAL ORGANS IN AORTIC SURGERY". International Medical Journal, n. 3 (2020): 19–23. http://dx.doi.org/10.37436/2308-5274-2019-3-3.

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The introduction into clinical practice of hypothermic circulatory arrest, both in the non−perfusion version and with an artificial circulation, was the beginning of active use of systemic hypothermia as an effective element of cerebral and visceral protection during combined cardiac surgeries, including in aorta pathology. To evaluate ways of protecting visceral organs and spinal cord, namely the "no perfusion" technique with drainage of cerebrospinal fluid, lateral aortic compression, left−atrial−femoral bypass, deep hypothermia with cardiac arrest, i.e. hypothermic circulatory arest, bypass grafting, artificial blood circulation and moderate hypothermia in surgery for acute aortic syndrome the results of treatment of the patients with acute bundle aortic aortic abdominal localization were analyzed. There was characterized the proposed and implemented in practice original method of protection, consisting in an access to aorta, which is pressed above the aneurysm at the level of bifurcation, and selective perfusion into the mouth of vessels supplying the internal organs with a custodiol solution with a temperature of 3−4°. All the patients with combined occlusion−stenotic lesions of different arterial pools have aortic prostheses with the inclusion of visceral arteries into bloodstream in different variants. The tendency of the more favorable post−surgery period in the patients to whom the implemented methods of protection were applied. Key words: aortic aneurysm, surgical treatment, organ protection.

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Adji, Audrey, e Michael F. O’Rourke. "Central aortic pressure calibration". Journal of Hypertension 35, n. 4 (aprile 2017): 893–94. http://dx.doi.org/10.1097/hjh.0000000000001246.

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Middeke, Martin. "Zentraler aortaler Blutdruck: Bedeutender Parameter für Diagnostik und Therapie". DMW - Deutsche Medizinische Wochenschrift 142, n. 19 (settembre 2017): 1430–36. http://dx.doi.org/10.1055/s-0043-113212.

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AbstractIn recent years great emphasis has been placed on the role of central aortic blood pressure as measured non invasively using pulse wave analysis in pathophysiology of cardiovascular diseases and clinical aspects of hypertension. The difference of blood pressure between the central aorta and the brachial artery (amplification) is not constant but varies according to physiological, pathological and pharmacological mechanisms. Central aortic blood pressure is more strongly related to cardiovascular organ damages than does brachial pressure. Several antihypertensive drugs have different effects on aortic blood pressure as compared with brachial pressure. Central aortic blood pressure emerges superior to brachial pressure as target blood pressure in antihypertensive treatment.

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O’Rourke, Michael F., e Kenji Takazawa. "Measurement of central aortic pressure". Journal of Hypertension 29, n. 10 (ottobre 2011): 2038–39. http://dx.doi.org/10.1097/hjh.0b013e32834b17b4.

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Boutouyrie, Pierre. "Measurement of central aortic pressure". Journal of Hypertension 29, n. 10 (ottobre 2011): 2040–41. http://dx.doi.org/10.1097/hjh.0b013e32834b17c7.

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Segers, Patrick, Jan G. Kips, Sebastian J. Vermeersch e Luc M. Van Bortel. "Measurement of central aortic pressure". Journal of Hypertension 29, n. 10 (ottobre 2011): 2039–40. http://dx.doi.org/10.1097/hjh.0b013e32834b22ff.

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Bulpitt, Christopher J., C. Rajkumar e James D. Cameron. "Central aortic blood pressure measurements". Journal of Human Hypertension 14, n. 8 (agosto 2000): 531. http://dx.doi.org/10.1038/sj.jhh.1001066.

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V., Shantaram. "Importance of Central Aortic Pressure". Indian Journal of Cardiovascular Disease in Women WINCARS 02, n. 04 (dicembre 2017): 065–66. http://dx.doi.org/10.1055/s-0038-1622967.

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Rajab, TK, JD Schmitto e RP Gallegos. "Technique for central aortic cannulation in extensive aortic dissection". Annals of The Royal College of Surgeons of England 94, n. 6 (1 settembre 2012): 439. http://dx.doi.org/10.1308/003588412x13373405386015c.

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J. Moon, S.-H. Lee, Y.-g. Ko, Y. Jang, W.-H. Shim e D.-H. Choi. "Central aortic pressure in aortic aneurysm and aortic dissection: a novel prognostic marker". Acta Cardiologica 65, n. 3 (30 giugno 2010): 303–8. http://dx.doi.org/10.2143/ac.65.3.2050346.

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Zhu, Yuanjia, Samir Kapadia, Amar Krishnaswamy, Lars G. Svensson e Stephanie Mick. "Reoperative transapical transcatheter aortic valve replacement for central aortic regurgitation". Journal of Cardiac Surgery 31, n. 9 (12 luglio 2016): 572–74. http://dx.doi.org/10.1111/jocs.12798.

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Forneris, Arianna, Miriam Nightingale, Alina Ismaguilova, Taisiya Sigaeva, Louise Neave, Amy Bromley, Randy D. Moore e Elena S. Di Martino. "Heterogeneity of Ex Vivo and In Vivo Properties along the Length of the Abdominal Aortic Aneurysm". Applied Sciences 11, n. 8 (13 aprile 2021): 3485. http://dx.doi.org/10.3390/app11083485.

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The current clinical guidelines for the management of aortic abdominal aneurysms (AAAs) overlook the structural and mechanical heterogeneity of the aortic tissue and its role in the regional weakening that drives disease progression. This study is a comprehensive investigation of the structural and biomechanical heterogeneity of AAA tissue along the length and circumference of the aorta, by means of regional ex vivo and in vivo properties. Biaxial testing and histological analysis were performed on ex vivo human aortic specimens systematically collected during open repair surgery. Wall-shear stress and three-dimensional principal strain analysis were performed to allow for in vivo regional characterization of individual aortas. A marked effect of position along the aortic length was observed in both ex vivo and in vivo properties, with the central regions corresponding to the aneurysmal sac being significantly different from the adjacent regions. The heterogeneity along the circumference of the aorta was reflected in the ex vivo biaxial response at low strains and histological properties. Present findings uniquely show the importance of regional characterization for aortic assessment and the need to correlate heterogeneity at the tissue level with non-invasive measurements aimed at improving clinical outcomes.

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Williams, Bryan, e Peter S. Lacy. "Central aortic pressure and clinical outcomes". Journal of Hypertension 27, n. 6 (giugno 2009): 1123–25. http://dx.doi.org/10.1097/hjh.0b013e32832b6566.

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Meijin, Zhang, Qing Liu, Zhuo You e Jinxiu Lin. "A3170 Affecting central aortic systolic pressure". Journal of Hypertension 36 (ottobre 2018): e143. http://dx.doi.org/10.1097/01.hjh.0000548579.06724.dd.

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O’Rourke, Michael F., Michel E. Safar e Audrey Adji. "Resistant hypertension and central aortic pressure". Journal of Hypertension 32, n. 3 (marzo 2014): 699. http://dx.doi.org/10.1097/hjh.0000000000000088.

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Narayan, Om, Joshua Casan, Martin Szarski, Anthony M. Dart, Ian T. Meredith e James D. Cameron. "Estimation of central aortic blood pressure". Journal of Hypertension 32, n. 9 (settembre 2014): 1727–40. http://dx.doi.org/10.1097/hjh.0000000000000249.

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O’Rourke, Michael F., e Audrey Adji. "Noninvasive Studies of Central Aortic Pressure". Current Hypertension Reports 14, n. 1 (15 novembre 2011): 8–20. http://dx.doi.org/10.1007/s11906-011-0236-5.

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Clarenbach, Christian F., Giovanni Camen, Noriane A. Sievi, Christophe Wyss, John R. Stradling e Malcolm Kohler. "Effect of simulated obstructive hypopnea and apnea on thoracic aortic wall transmural pressures". Journal of Applied Physiology 115, n. 5 (1 settembre 2013): 613–17. http://dx.doi.org/10.1152/japplphysiol.00439.2013.

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Preliminary evidence supports an association between obstructive sleep apnea (OSA) and thoracic aortic dilatation, although potential causative mechanisms are incompletely understood; these may include an increase in aortic wall transmural pressures, induced by obstructive apneas and hypopneas. In patients undergoing cardiac catheterization, mean blood pressure (MBP) in the thoracic aorta and esophageal pressure was simultaneously recorded by an indwelling aortic pigtail catheter and a balloon-tipped esophageal catheter in randomized order during: normal breathing, simulated obstructive hypopnea (inspiration through a threshold load), simulated obstructive apnea (Mueller maneuver), and end-expiratory central apnea. Aortic transmural pressure (aortic MBP minus esophageal pressure) was calculated. Ten patients with a median age (range) of 64 (46–75) yr were studied. Inspiration through a threshold load, Mueller maneuver, and end-expiratory central apnea was successfully performed and recorded in 10, 7, and 9 patients, respectively. The difference between aortic MBP and esophageal pressure (and thus the extra aortic dilatory force) was median (quartiles) +9.3 (5.4, 18.6) mmHg, P = 0.02 during inspiration through a threshold load, +16.3 (12.8, 19.4) mmHg, P = 0.02 during the Mueller maneuver, and +0.4 (−4.5, 4.8) mmHg, P = 0.80 during end-expiratory central apnea. Simulated obstructive apnea and hypopnea increase aortic wall dilatory transmural pressures because intra-aortic pressures fall less than esophageal pressures. Thus OSA may mechanically promote thoracic aortic dilatation and should be further investigated as a risk factor for the development or accelerated progression of thoracic aortic aneurysms.

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Williams, Bryan, Ewan McFarlane, Dawid Jedrzejewski e Peter S. Lacy. "Identifying and treating high blood pressure in men under 55 years with grade 1 hypertension: the TREAT CASP study and RCT". Efficacy and Mechanism Evaluation 6, n. 13 (dicembre 2019): 1–90. http://dx.doi.org/10.3310/eme06130.

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Background There is uncertainty regarding whether or not younger (i.e. aged < 55 years), low-risk patients with grade 1 hypertension (i.e. a clinic blood pressure of 140–159/90–99 mmHg) should be treated with blood pressure-lowering medication. This is a heterogeneous group of patients because of variation in systolic/pulse pressure amplification from the central aorta to the brachial artery. It is hypothesised that within grade 1 hypertension, patients can be divided into those with high central aortic systolic pressure and those with low central aortic systolic pressure. Objectives The aims of this study were to (1) evaluate whether or not non-invasive central aortic systolic pressure measurement can better identify younger patients with grade 1 hypertension, who are more likely to have an increased left ventricular mass index; and (2) determine whether or not blood pressure lowering regresses early cardiac structural change in patients with high central aortic systolic pressure. Setting A university hospital with satellite primary care recruitment sites. Participants A total of 726 men (aged 18 to < 55 years) were screened to identify 162 men with grade 1 hypertension and low or high central aortic systolic pressure. Blood pressure status was classified according to seated clinic blood pressure, central aortic systolic pressure and 24-hour ambulatory blood pressure. Design (1) Evaluating the strength of the correlation between central aortic systolic pressure, clinic blood pressure and 24-hour ambulatory blood pressure with left ventricular mass index in 162 patients; (2) a 12-month randomised controlled trial in patients with grade 1 hypertension and high central aortic systolic pressure (i.e. a central aortic systolic pressure of ≥ 125 mmHg) (n = 105), using a prospective, open, blinded, end-point design; and (3) a 12-month observational study in 57 patients with grade 1 hypertension and low central aortic systolic pressure (i.e. a central aortic systolic pressure of < 125 mmHg). Interventions Randomised controlled trial – patients with high central aortic systolic pressure randomised to blood pressure lowering medication (50–100 mg of losartan ± 5–10 mg of amlodipine once daily) versus usual care (no treatment) for 12 months. Main outcomes Randomised controlled trial primary end point – change in left ventricular mass index as measured by cardiac magnetic resonance imaging, comparing treatment with no treatment. Results (1) At baseline, left ventricular mass index was higher in men with high central aortic systolic pressure than in those with low central aortic systolic pressure (mean ± standard deviation 67.9 ± 8.8 g/m2 vs. 64.0 ± 8.5 g/m2; difference 4.0 g/m2, 95% confidence interval 1.1 to 6.9 g/m2; p < 0.01). Central aortic systolic pressure was not superior to clinic blood pressure as a determinant of left ventricular mass index. Univariate analysis, regression coefficients and slopes for left ventricular mass index were similar for clinic systolic blood pressure, ambulatory systolic blood pressure and central aortic systolic pressure. (2) In the randomised controlled trial, blood pressure-lowering treatment reduced central aortic systolic pressure (–21.1 mmHg, 95% confidence interval – 24.4 to –17.9 mmHg; p < 0.001) and clinic systolic blood pressure (–20.0 mmHg, 95% confidence interval – 23.3 to –16.6 mmHg; p < 0.001) versus no treatment. Treatment was well tolerated and associated with a greater change (i.e. from baseline to study closeout) in left ventricular mass index versus no treatment [–3.3 g/m2 (95% confidence interval –4.5 to –2.2 g/m2) vs. –0.9 g/m2 (95% confidence interval –1.7 to –0.2 g/m2); p < 0.01], with a medium-to-large effect size (Cohen’s d statistic –0.74). (3) Patients with low central aortic systolic pressure had no significant change in left ventricular mass index after 12 months (mean change –0.5 g/m2, 95% confidence interval –1.2 to 0.2 g/m2; p = 0.18). Conclusions Men with grade 1 hypertension and high central aortic systolic pressure tended to have higher clinic blood pressure and more hypertension-mediated cardiac structural change than those with low central aortic systolic pressure. Central aortic systolic pressure was not superior to clinic blood pressure or ambulatory blood pressure at stratifying risk of increased left ventricular mass index. Blood pressure-lowering treatment led to a regression of left ventricular mass index in men with grade 1 hypertension and high central aortic systolic pressure compared with no treatment. Limitations The study was limited to a moderate sample of men and there was a low prevalence of very high amplification. Future work Evaluating effects of blood pressure lowering on cardiac function. Trial registration Current Controlled Trials ISRCTN09502665. Funding This project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership and will be published in full in Efficacy and Mechanism Evaluation; Vol. 6, No. 13. See the NIHR Journals Library website for further project information.

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Lantelme, Pierre, Anastase Dzudie, Hugues Milon, Giampiero Bricca, Liliana Legedz, Jean-Michel Chevalier e Patrick Feugier. "Effect of abdominal aortic grafts on aortic stiffness and central hemodynamics". Journal of Hypertension 27, n. 6 (giugno 2009): 1268–76. http://dx.doi.org/10.1097/hjh.0b013e3283299b22.

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Hays, Brandon S., Michael Baker, Annie Laib, Wei Tan, Sebastian Udholm, Bryan H. Goldstein, Stephen P. Sanders, Alexander R. Opotowsky e Gruschen R. Veldtman. "Histopathological abnormalities in the central arteries and veins of Fontan subjects". Heart 104, n. 4 (29 settembre 2017): 324–31. http://dx.doi.org/10.1136/heartjnl-2017-311838.

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ObjectiveFontan circulations have obligatory venous hypertension, depressed cardiac output and abnormal arterial elastance. Ventriculovascular coupling is known to be abnormal, but the underlying mechanisms are poorly defined. We aim to describe the histopathological features of vascular remodelling encountered in the central arteries and veins in the Fontan circulation as a possible underlying pathological representation of abnormal ventriculovascular coupling.MethodsPostmortemvasculature (inferior vena cava (IVC), superior vena cava (SVC), pulmonary artery (PA), pulmonary vein (PV) and aorta) of 13 patients with a Fontan circulation (mean age 29.9 years, range 9.0–59.8 years) and 2 biventricular controls (ages 17.9 and 30.2 years) was examined.ResultsIVC and SVC: Eccentric and variable intimal fibromuscular proliferation occurred in 11 Fontan subjects. There was variable loss of medial smooth muscle bundles with reciprocal replacement with dense collagenous tissue.PA: Similar intimal fibromuscular proliferation was seen; however, these intimal changes were accompanied by medial thinning rather than expansion, medial myxoid degeneration and elastic alteration.PV: The PVs demonstrated intimal fibroproliferation and disorganisation of the muscular media.Aorta: The aortic lamina intima was thickened, with associated fibromuscular proliferation and elasticisation. There was also moderate lymphocytic inflammation in the aortic wall.ConclusionsVascular architectural remodelling is common in Fontan patients. The central veins demonstrate profound changes of eccentric intimal expansion and smooth muscle replacement with collagen. The pulmonary demonstrated abnormal intimal proliferation, and aortic remodelling was characterised by intima lamina thickening and a moderate degree of aortic wall inflammation.

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Kuznetsov, A. A., E. E. Tsvetkova, D. V. Denisova, Yu I. Ragino e M. I. Voevoda. "Central Aortic Pressure: Reference and Diagnostic Values". Kardiologiia 59, n. 3 (13 aprile 2019): 11–17. http://dx.doi.org/10.18087/cardio.2019.3.10235.

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Objective. Practical application of central aortic pressure (CAP) parameters is limited by the absence of generally recognized reference and threshold diagnostic indices. The purpose of this work is to establish their values in the general population of Novosibirsk. Materials and Methods. A total of 327 people were examined: 155 men and 172 women aged 25–44 years from a representative sample from the general population of Novosibirsk. Applanation tonometry of the radial artery was performed by the SphygmoCor system. The reference values of CAP parameters were obtained by a nonparametric method according to the Clinical and Laboratory Standards Institute (CLSI) recommendations (95 % percentile interval with 2.5 % and 97.5 % cut-off points and their 90 % confidence intervals). Diagnostic thresholds and categories of CAP were determined as mean values depending on the categories of brachial arterial pressure (BP) and on the basis of risk estimates, as well as sensitivity and specificity values for left ventricular hypertrophy similar to risk and sensitivity and specificity values of threshold levels (categories) of brachial BP. Results. The reference values of the parameters of the CAP were: 18–43 mm Hg for pulse pressure; 5–24 mm Hg for the amplification of pulse pressure; – 8.8–40 % for the augmentation index. Diagnostic categories of CAP were determined to be: optimal – less than 110 / 80, normal – 110 / 80–114 / 84, high normal – 115 / 85–124 / 89, hypertension – more than 125 / 90 mm Hg. Conclusion. The reference values, diagnostic thresholds and categories of parameters of CAP in the general population of Novosibirsk aged 25–44 years have been determined. It is expedient to further study them.

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Inoue, Yoshito, e Toshihiko Ueda. "Central cannulation in acute aortic dissection repair". Journal of Thoracic and Cardiovascular Surgery 134, n. 2 (agosto 2007): 545. http://dx.doi.org/10.1016/j.jtcvs.2007.02.047.

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O’Rourke, Michael F., Kenji Takazawa e Nobuhiro Tanaka. "Validity of noninvasive central aortic pressure measurement". Journal of Hypertension 37, n. 11 (novembre 2019): 2300–2301. http://dx.doi.org/10.1097/hjh.0000000000002211.

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Avolio, Alberto. "Central Aortic Blood Pressure and Cardiovascular Risk". Hypertension 51, n. 6 (giugno 2008): 1470–71. http://dx.doi.org/10.1161/hypertensionaha.107.108910.

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Tsarenok, Svetlana Yu, Vladimir V. Gorbunov e Tatiana A. Aksenova. "The central aortic blood pressure and arterial stiffness during the daily monitoring procedure in postmenopausal women with osteoporosis". Osteoporosis and Bone Diseases 20, n. 2 (15 dicembre 2017): 46–51. http://dx.doi.org/10.14341/osteo2017246-51.

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Aim: to evaluate the data of the central aortic pressure and arterial stiffness during the daily monitoring procedure in postmenopausal women with osteoporosis. Methods: 79 postmenopausal women (age from 57 to 78) were examined. All patients were divided into two groups: the first group consisted of 36 women with osteoporosis, the second group consisted of 43 women – control group. A daily monitoring of central aortic pressure and arterial stiffness were performed all women by the apparatus BPLab v.3.2. Results: increase of the mean daily of systolic, diastolic and mean aortic pressure was found out in women with osteoporosis. The main data of arterial stiffness (PWV, ASI, AASI, PPA) were higher in this group of women. The direct correlation between the data of central aortic blood pressure, arterial stiffness and presence of osteoporotic fractures and their number, as well as indicators of absolute ten-year risk of osteoporotic fractures and hip fracture was revealed. Pathological profiles of systolic pressure in aortae were more frequent in patients with osteoporosis. The type of hyperdispers was predominant. Conclusions: the results obtained may indicate a possible relationship between cardiovascular diseases and osteoporosis.

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Skibitskiy, V. V., A. A. Kiselev e A. V. Fendrikova. "Effectiveness of Chrono-Pharmacotherapy Depending on the Salt Sensitivity of Patients with Arterial Hypertension and Diabetes Mellitus Type 2". Rational Pharmacotherapy in Cardiology 14, n. 6 (5 gennaio 2019): 846–51. http://dx.doi.org/10.20996/1819-6446-2018-14-6-846-851.

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Aim. To study the effect of two regimens of combined antihypertensive therapy during the day on daily monitoring of arterial pressure, central aortic pressure, and arterial stiffness, depending on the salt sensitivity of hypertensive patients with diabetes mellitus type 2. Material and methods. 130 hypertensive patients with type 2 diabetes mellitus were included into the study. They were divided into 2 subgroups: salt-sensitive (group 1) and salt-resistant (group 2), and then randomized to subgroups A and B of ongoing therapy: in the morning ramipril and indapamide retard, bedtime – amlodipine (subgroup 1A and 2A); or in the morning amlodipine and indapamide retard, bedtime – ramipril (subgroup 1B and 2B). Initially and after 24 weeks of antihypertensive therapy, 24-hour blood pressure monitoring was performed, the indices of central aortic pressure and arterial stiffness were determined. Results. After 24 weeks, in all subgroups, there was a significant positive dynamics of the parameters of 24-hour blood pressure monitoring, central aortic pressure and arterial stiffness indices. In the subgroup 1В, it was registered a significant improvement in the majority of parameters of 24-hour blood pressure monitoring (decrease in 24-hours systolic BP by 24.4%, 24-hours diastolic BP by 22.1%; p<0.05), central aortic pressure (decrease in aortal systolic BP by 15.9%, aortal diastolic BP by 20.8%; p<0.05) and vascular wall stiffness parameters (decrease in pulse wave velocity by 13.8%; p<0.05) in comparison with group 1A (decrease in 24-hours systolic BP by 17.5%, 24-hours diastolic BP by 14.6%, aortal systolic BP by 12.7%, aortal diastolic BP by 9.7%, pulse wave velocity by 9.2%; p<0.05 in comparison with the group 1B). In the case of salt-resistant patients, there were comparable positive changes in the parameters of 24-hour blood pressure monitoring, central aortic pressure and arterial stiffness indices against the background of both dosing regimens during the day. Conclusion. In the study, it was demonstrated the more pronounced antihypertensive and vasoprotective efficacy of the combination of thiazide-like diuretic with calcium channel blocker in the morning and ACE inhibitor in bedtime compared to the alternative regimen of prescribed pharmacotherapy in salt-sensitive patients, and comparable efficacy of both regimens in salt-resistant hypertensive patients with diabetes mellitus type 2.

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Kawahito, Koji, Naoyuki Kimura, Atsushi Yamaguchi e Kei Aizawa. "Malperfusion in type A aortic dissection: results of emergency central aortic repair". General Thoracic and Cardiovascular Surgery 67, n. 7 (7 febbraio 2019): 594–601. http://dx.doi.org/10.1007/s11748-019-01072-z.

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Matsukawa, Kanji, Kei Ishii, Akito Kadowaki, Nan Liang e Tomoko Ishida. "Differential effect of central command on aortic and carotid sinus baroreceptor-heart rate reflexes at the onset of spontaneous, fictive motor activity". American Journal of Physiology-Heart and Circulatory Physiology 303, n. 4 (15 agosto 2012): H464—H474. http://dx.doi.org/10.1152/ajpheart.01133.2011.

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Our laboratory has reported that central command blunts the sensitivity of the aortic baroreceptor-heart rate (HR) reflex at the onset of voluntary static exercise in conscious cats and spontaneous contraction in decerebrate cats. The purpose of this study was to examine whether central command attenuates the sensitivity of the carotid sinus baroreceptor-HR reflex at the onset of spontaneous, fictive motor activity in paralyzed, decerebrate cats. We confirmed that aortic nerve (AN)-stimulation-induced bradycardia was markedly blunted to 26 ± 4.4% of the control (21 ± 1.3 beats/min) at the onset of spontaneous motor activity. Although the baroreflex bradycardia by electrical stimulation of the carotid sinus nerve (CSN) was suppressed ( P < 0.05) to 86 ± 5.6% of the control (38 ± 1.2 beats/min), the inhibitory effect of spontaneous motor activity was much weaker ( P < 0.05) with CSN stimulation than with AN stimulation. The baroreflex bradycardia elicited by brief occlusion of the abdominal aorta was blunted to 36% of the control (36 ± 1.6 beats/min) during spontaneous motor activity, suggesting that central command is able to inhibit the cardiomotor sensitivity of arterial baroreflexes as the net effect. Mechanical stretch of the triceps surae muscle never affected the baroreflex bradycardia elicited by AN or CSN stimulation and by aortic occlusion, suggesting that muscle mechanoreflex did not modify the cardiomotor sensitivity of aortic and carotid sinus baroreflex. Since the inhibitory effect of central command on the carotid baroreflex pathway, associated with spontaneous motor activity, was much weaker compared with the aortic baroreflex pathway, it is concluded that central command does not force a generalized modulation on the whole pathways of arterial baroreflexes but provides selective inhibition for the cardiomotor component of the aortic baroreflex.

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Westerhof, Berend E., Ilja Guelen, Wim J. Stok, Han A. J. Lasance, Carl A. P. L. Ascoop, Karel H. Wesseling, Nico Westerhof, Willem Jan W. Bos, Nikos Stergiopulos e Jos A. E. Spaan. "Individualization of transfer function in estimation of central aortic pressure from the peripheral pulse is not required in patients at rest". Journal of Applied Physiology 105, n. 6 (dicembre 2008): 1858–63. http://dx.doi.org/10.1152/japplphysiol.91052.2008.

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Central aortic pressure gives better insight into ventriculo-arterial coupling and better prognosis of cardiovascular complications than peripheral pressures. Therefore transfer functions (TF), reconstructing aortic pressure from peripheral pressures, are of great interest. Generalized TFs (GTF) give useful results, especially in larger study populations, but detailed information on aortic pressure might be improved by individualization of the TF. We found earlier that the time delay, representing the travel time of the pressure wave between measurement site and aorta is the main determinant of the TF. Therefore, we hypothesized that the TF might be individualized (ITF) using this time delay. In a group of 50 patients at rest, aged 28–66 yr (43 men), undergoing diagnostic angiography, ascending aortic pressure was 119 ± 20/70 ± 9 mmHg (systolic/diastolic). Brachial pressure, almost simultaneously measured using catheter pullback, was 131 ± 18/67 ± 9 mmHg. We obtained brachial-to-aorta ITFs using time delays optimized for the individual and a GTF using averaged delay. With the use of ITFs, reconstructed aortic pressure was 121 ± 19/69 ± 9 mmHg and the root mean square error (RMSE), as measure of difference in wave shape, was 4.1 ± 2.0 mmHg. With the use of the GTF, reconstructed pressure was 122 ± 19/69 ± 9 mmHg and RMSE 4.4 ± 2.0 mmHg. The augmentation index (AI) of the measured aortic pressure was 26 ± 13%, and with ITF and GTF the AIs were 28 ± 12% and 30 ± 11%, respectively. Details of the wave shape were reproduced slightly better with ITF but not significantly, thus individualization of pressure transfer is not effective in resting patients.

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Kaleda, Vasily I., Alexander P. Nissen, Anatoly V. Molochkov, Ivan A. Alekseev, Sergey Yu Boldyrev e Tom C. Nguyen. "Simple Technique for Central Venous Cannulation with Cannula-Free Wound in Minimally Invasive Aortic Valve Surgery". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 15, n. 4 (22 maggio 2020): 369–71. http://dx.doi.org/10.1177/1556984520925549.

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There are several approaches to venous cannulation in minimally invasive aortic valve surgery. Frequently used options include central dual-stage right atrial cannulation, or peripheral femoral venous cannulation. During minimally invasive aortic surgery via an upper hemisternotomy, central venous cannulas may obstruct the surgeon’s visualization of the aortic valve and root, or require extension of the skin incision, while femoral venous cannulation requires an additional incision, time and resources. Here we describe a technique for central venous cannulation during minimally invasive aortic surgery, utilizing a novel device, to facilitate simple, convenient, and expedient central cannulation with a cannula-free surgical working space.

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Geltser, B. I., T. A. Brodskaya, V. A. Nevzorova e E. V. Motkina. "Evaluation of the central arterial pressure in patients with bronchial asthma". PULMONOLOGIYA, n. 3 (28 giugno 2008): 15–19. http://dx.doi.org/10.18093/0869-0189-2008-0-3-15-19.

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The purpose of this work was to study the central arterial pressure (CAP) and its correlation with peripheral arterial pressure (PAP) and aortic stiffness in patients with bronchial asthma (BА). We examined 45 asthmatic patients and 25 healthy volunteers using noninvasive arteriography (TensioClinic TL1 arteriograph, TensioMed, Hungary). Aortic stiffness parameters and aortic systolic arterial pressure (SAP) were measured. We estimated a difference between the central SAP and the peripheral SAP (ΔSAP) and calculated index of CAP to PAP conformity (IC). According to the indirect arteriography, the central (aortic) SAP was 20 to 40 % higher in majority of patients with exacerbation of severe and moderate BА compared to the normal level. During BА exacerbation, ΔSAP was significantly decreased and IC was increased in comparison with the healthy persons in whom ΔSAP was 10.2 ± 2.1 mm Hg. This indicates abnormal CAP/PAP ratio in BA exacerbation. In stable BA, CAP, PAP, ΔSAP, and IC did not differ from control values; this assumes transitory character of hemodynamic disorders in BA exacerbation. The degree of increase in aortic SAP during BA exacerbation is thought to be closely connected with abnormal mechanical properties of the arterial walls. This was confirmed by significant correlations between aortic SAP and hypoxemia, systemic inflammation, oxidative stress, and hyponitrooxidemia. These factors could play an important role in the pathogenesis of growth in aortic SAP in BA patients.

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Armstrong, Matthew K., Martin G. Schultz, Dean S. Picone, J. Andrew Black, Nathan Dwyer, Philip Roberts-Thomson e James E. Sharman. "Associations of Reservoir-Excess Pressure Parameters Derived From Central and Peripheral Arteries With Kidney Function". American Journal of Hypertension 33, n. 4 (1 febbraio 2020): 325–30. http://dx.doi.org/10.1093/ajh/hpaa013.

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Abstract BACKGROUND Central artery reservoir-excess pressure parameters are clinically important but impractical to record directly. However, diastolic waveform morphology is consistent across central and peripheral arteries. Therefore, peripheral artery reservoir-excess pressure parameters related to diastolic waveform morphology may be representative of central parameters and share clinically important associations with end-organ damage. This has never been determined and was the aim of this study. METHODS Intra-arterial blood pressure (BP) waveforms were measured sequentially at the aorta, brachial, and radial arteries among 220 individuals (aged 61 ± 10 years, 68% male). Customized software was used to derive reservoir-excess pressure parameters at each arterial site (reservoir and excess pressure, systolic and diastolic rate constants) and clinical relevance was determined by association with estimated glomerular filtration rate (eGFR). RESULTS Between the aorta and brachial artery, the mean difference in the diastolic rate constant and reservoir pressure integral was −0.162 S−1 (P = 0.08) and −0.772 mm Hg s (P = 0.23), respectively. The diastolic rate constant had the strongest and most consistent associations with eGFR across aortic and brachial sites (β = −0.20, P = 0.02; β = −0.20, P = 0.03, respectively; adjusted for traditional cardiovascular risk factors). Aortic, but not brachial peak reservoir pressure was associated with eGFR in adjusted models (aortic β = −0.48, P = 0.02). CONCLUSIONS The diastolic rate constant is the most consistent reservoir-excess pressure parameter, in both its absolute values and associations with kidney dysfunction, when derived from the aorta and brachial artery. Thus, the diastolic rate constant could be utilized in the clinical setting to improve BP risk stratification.

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Gravlee, G. P., S. D. Brauer, M. F. O'Rourke e A. P. Avolio. "A Comparison of Brachial, Femoral, and Aortic Intra-Arterial Pressures before and after Cardiopulmonary Bypass". Anaesthesia and Intensive Care 17, n. 3 (agosto 1989): 305–11. http://dx.doi.org/10.1177/0310057x8901700311.

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Following recent evidence that brachial and femoral artery pressures are more reliable than radial artery pressures after cardiopulmonary bypass, thirty-one adults had simultaneous pre and post-bypass measurements of brachial, femoral, and ascending aortic pressures. Two minutes after cardiopulmonary bypass, brachial artery systolic pressure and mean arterial pressure fell significantly below corresponding pressures in the femoral artery and aorta. Five minutes after cardiopulmonary bypass, only brachial artery systolic pressure was still less than femoral and aortic systolic pressures. By ten minutes after bypass, all significant pressure differences had resolved except between brachial and femoral artery systolic pressures. Clinically significant (≥ 5 mmHg) aortic-to-brachial reductions in mean arterial pressures occurred in six (19%) patients at two minutes and in three (10%) patients at five and ten minutes after bypass. Equivalent aortic-to-femoral mean pressure diminution occurred in two (6%) patients at two minutes and one (3%) patient at five and ten minutes after bypass. Neither systemic vascular resistance nor body temperatures contributed significantly to post-bypass central-to-peripheral pressure reductions. Immediately following bypass, femoral artery pressures reproduce central aortic pressures more reliably than do radial or brachial artery pressures.

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Matsukawa, Kanji, Kei Ishii, Akito Kadowaki, Tomoko Ishida, Mitsuhiro Idesako e Nan Liang. "Signal transduction of aortic and carotid sinus baroreceptors is not modified by central command during spontaneous motor activity in decerebrate cats". American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 306, n. 10 (15 maggio 2014): R735—R746. http://dx.doi.org/10.1152/ajpregu.00538.2013.

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Our laboratory has suggested that central command provides selective inhibition of the cardiomotor component of aortic baroreflex at the start of exercise, preserving carotid sinus baroreflex. It is postulated that central command may modify the signal transduction of aortic baroreceptors, so as to decrease aortic baroreceptor input to the cardiovascular centers, and, thereby, can cause the selective inhibition of aortic baroreflex. To test the hypothesis, we directly analyzed the responses in multifiber aortic nerve activity (AoNA) and carotid sinus nerve activity (CsNA) during spontaneous motor activity in decerebrate, paralyzed cats. The increases of 62–104% in mean AoNA and CsNA were found during spontaneous motor activity, in proportion to a rise of 35 ± 3 mmHg (means ± SE) in mean arterial blood pressure (MAP), and had an attenuating tendency by restraining heart rate (HR) at the lower intrinsic frequency of 154 ± 6 beats/min. Brief occlusion of the abdominal aorta was conducted before and during spontaneous motor activity to produce a mechanically evoked increase in MAP and, thereby, to examine the stimulus-response relationship of arterial baroreceptors. Although the sensitivity of the MAP-HR baroreflex curve was markedly blunted during spontaneous motor activity, the stimulus-response relationships of AoNA and CsNA were not influenced by spontaneous motor activity, irrespective of the absence or presence of the HR restraint. Thus, it is concluded that aortic and carotid sinus baroreceptors can code beat-by-beat blood pressure during spontaneous motor activity in decerebrate cats and that central command is unlikely to modulate the signal transduction of arterial baroreceptors.

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Bas, Ahmet, Deniz Goksedef, Sedat G. Kandemirli, Fatih Gulsen e Furuzan Numan. "Central venous catheter insertion into the false lumen of a complicated aortic dissection". Scottish Medical Journal 62, n. 3 (20 giugno 2017): 115–18. http://dx.doi.org/10.1177/0036933017715962.

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Thoracic endovascular repair is considered the first-line treatment in complicated acute type B dissection. Central venous catheters provide valuable vascular access during endovascular treatments. However, central venous catheters are not without complications. Herein, we report a case of central venous catheter insertion into the false lumen of a complicated acute type B aortic dissection by direct aortic puncture. The tip of the central venous catheter was in the false lumen. The central venous catheter was left in place initially and was removed after graft stent deployment. This case illustrates the importance of image guidance during central venous catheter insertion, which may further complicate an already complicated aortic dissection case.

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Edwards, David G., Amie L. Gauthier, Melissa A. Hayman, Jesse T. Lang e Robert W. Kenefick. "Acute effects of cold exposure on central aortic wave reflection". Journal of Applied Physiology 100, n. 4 (aprile 2006): 1210–14. http://dx.doi.org/10.1152/japplphysiol.01154.2005.

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The purpose of this study was to determine the effects of acute cold exposure on the timing and amplitude of central aortic wave reflection and central pressure. We hypothesized that cold exposure would result in an early return of reflected pressure waves from the periphery and an increase in central aortic systolic pressure as a result of cold-induced vasoconstriction. Twelve apparently healthy men (age 27.8 ± 2.0 yr) were studied at random, in either temperate (24°C) or cold (4°C) conditions. Measurements of brachial artery blood pressure and the synthesis of a central aortic pressure waveform (by noninvasive radial artery applanation tonometry and use of a generalized transfer) were conducted at baseline and after 30 min in each condition. Central aortic augmentation index (AI), an index of wave reflection, was calculated from the aortic pressure waveform. Cold induced an increase ( P < 0.05) in AI from 3.4 ± 1.9 to 19.4 ± 1.8%. Cold increased ( P < 0.05) both brachial and central systolic pressure; however, the magnitude of change in central systolic pressure was greater ( P < 0.05) than brachial (13 vs. 2.5%). These results demonstrate that cold exposure and the resulting peripheral vasoconstriction increase wave reflection and central systolic pressure. Additionally, alterations in central pressure during cold exposure were not evident from measures of brachial blood pressure.

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Michail, Michael, Alun D. Hughes, Andrea Comella, James N. Cameron, Robert P. Gooley, Liam M. McCormick, Anthony Mathur, Kim H. Parker, Adam J. Brown e James D. Cameron. "Acute Effects of Transcatheter Aortic Valve Replacement on Central Aortic Hemodynamics in Patients With Severe Aortic Stenosis". Hypertension 75, n. 6 (giugno 2020): 1557–64. http://dx.doi.org/10.1161/hypertensionaha.119.14385.

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Boczar, Kevin E., Munir Boodhwani, Luc Beauchesne, Carole Dennie, Kwan Leung Chan, George A. Wells e Thais Coutinho. "Aortic Stiffness, Central Blood Pressure, and Pulsatile Arterial Load Predict Future Thoracic Aortic Aneurysm Expansion". Hypertension 77, n. 1 (gennaio 2021): 126–34. http://dx.doi.org/10.1161/hypertensionaha.120.16249.

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Thoracic aortic aneurysm is a disease associated with high morbidity and mortality. Clinically useful strategies for medical management of thoracic aortic aneurysm are critically needed. To address this need, we sought to determine the role of aortic stiffness and pulsatile arterial load on future aneurysm expansion. One hundred five consecutive, unoperated subjects with thoracic aortic aneurysm were recruited and prospectively followed. By combining arterial tonometry with echocardiography, we estimated measures of aortic stiffness, central blood pressure, steady, and pulsatile arterial load at baseline. Aneurysm size was measured at baseline and follow-up with imaging; growth was calculated in mm/y. Stepwise multivariable linear regression assessed associations of arterial stiffness and load measures with aneurysm growth after adjusting for potential confounders. Mean±SD age, baseline aneurysm size, and follow-up time were 62.6±11.4 years, 46.24±3.84 mm, and 2.92±1.01 years, respectively. Aneurysm growth rate was 0.43±0.37 mm/y. After correcting for multiple comparisons, higher central systolic (β±SE: 0.026±0.009, P =0.007), and pulse pressures (β±SE: 0.032±0.009, P =0.0002), carotid-femoral pulse wave velocity (β±SE: 0.032±0.011, P =0.005), amplitudes of the forward (β±SE: 0.044±0.012, P =0.0003) and reflected (β±SE: 0.060±0.020, P =0.003) pressure waves, and lower total arterial compliance (β±SE: −0.086±0.032, P =0.009) were independently associated with future aneurysm growth. Measures of aortic stiffness and pulsatile hemodynamics are independently associated with future thoracic aortic aneurysm growth and provide novel insights into disease activity. Our findings highlight the role of central hemodynamic assessment to tailor novel risk assessment and therapeutic strategies to patients with thoracic aortic aneurysm.

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Bethencourt, Daniel M., Jennifer Le, Gabriela Rodriguez, Robert W. Kalayjian e Gregory S. Thomas. "Minimally Invasive Aortic Valve Replacement via Right Anterior Minithoracotomy and Central Aortic Cannulation". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 12, n. 2 (marzo 2017): 87–94. http://dx.doi.org/10.1177/155698451701200203.

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Bethencourt, Daniel M., Jennifer Le, Gabriela Rodriguez, Robert W. Kalayjian e Gregory S. Thomas. "Minimally Invasive Aortic Valve Replacement via Right Anterior Minithoracotomy and Central Aortic Cannulation". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 12, n. 2 (marzo 2017): 87–94. http://dx.doi.org/10.1097/imi.0000000000000358.

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Objective This study reports the evolution of a minimally invasive aortic valve replacement (mini-AVR) technique that uses a right anterior minithoracotomy approach with central cannulation, for a 13-year period. This technique has become our standard approach for isolated primary AVR in nearly all patients. Methods This observational study evaluated perioperative clinical outcomes of patients 18 years or older who underwent mini-AVR from November 2003 to June 2015. Results The mini-AVR technique was used in 202 patients during two periods of 2003 to 2009 (n = 65, “early”) and 2010 to 2015 (n = 137, “late”). The mean ± SD age was 72.5 ± 12.9 years and 60% were male. Demographic parameters were statistically similar between the study periods, except for increased body weight in the later period (75.3 ± 14.7 vs 80.9 ± 20.8 kg, P = 0.03). The mean cardiopulmonary bypass and aortic cross-clamp times were significantly different by each year and Bonferroni adjustment, with significant decreases in cardiopulmonary bypass and aortic cross-clamp times beginning 2006. Compared with the early study period, late study period patients were more often extubated intraoperatively (52% vs 12%, P < 0.001), had less frequent prolonged ventilator use postoperatively (6% vs 16%, P = 0.018), required fewer blood transfusions (mean, 2.0 ± 2.3 U vs 3.6 ± 3.0 U; P = 0.011), and had shorter postoperative stay (6.3 ± 4.5 days vs 8.0 ± 5.9 days, P = 0.026). Numerically, fewer postoperative strokes (1% vs 6%, P = 0.09) and fewer reoperations for bleeding (3% vs 6%, P = 0.3) occurred in the late period. In-hospital mortality did not differ (1/65 early vs 3/137 late). Conclusions Overall mini-AVR intraoperative and postoperative clinical outcomes improved for this 13-year experience.

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Ruegg, Gion, Rebecca H. Mason, Maxine Hardinge, Jeremy Perkins, Marc Husmann, Erich W. Russi, Konrad E. Bloch, John R. Stradling e Malcolm Kohler. "Augmentation index and central aortic blood pressure in patients with abdominal aortic aneurysms". Journal of Hypertension 28, n. 11 (novembre 2010): 2252–57. http://dx.doi.org/10.1097/hjh.0b013e32833e1187.

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Almousa, Ayman, e Ravi K. Ghanta. "Commentary: Straight into the heart of danger: Central aortic cannulation for aortic dissection". Journal of Thoracic and Cardiovascular Surgery 158, n. 1 (luglio 2019): 37–38. http://dx.doi.org/10.1016/j.jtcvs.2018.12.052.

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Rajani, Ronak, Phil Chowienczyk, Simon Redwood, Antoine Guilcher e John B. Chambers. "The noninvasive estimation of central aortic blood pressure in patients with aortic stenosis". Journal of Hypertension 26, n. 12 (dicembre 2008): 2381–88. http://dx.doi.org/10.1097/hjh.0b013e328313919f.

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48

Bulas, J., M. Potocarova, V. Kupcova, L. Gaspar, G. Wimmer e J. Murin. "Central systolic blood pressure increases with aortic stiffness". Bratislava Medical Journal 120, n. 12 (2019): 894–98. http://dx.doi.org/10.4149/bll_2019_150.

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Ramasamy, S., J. M. Ravichandran e Pradeep G. Nayar. "Central Aortic Blood Pressure: An Evidence-based Approach". Hypertension Journal 4, n. 4 (2018): 219–24. http://dx.doi.org/10.15713/ins.johtn.0138.

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Chen, Gailing, Kevin P. Bliden, Rahul Chaudhary, Fang Liu, Himabindu Kaza, Eliano P. Navarese, Udaya S. Tantry e Paul A. Gurbel. "Central aortic pulse pressure, thrombogenicity and cardiovascular risk". Journal of Thrombosis and Thrombolysis 44, n. 2 (10 luglio 2017): 223–33. http://dx.doi.org/10.1007/s11239-017-1524-y.

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