Systemic Arterial Blood Pressure Research Articles

The Current Status of Blood Glucose Level in Patients with Hypertension Complicated with Diabetes Mellitus

Background: Hypertension, characterized by elevated systemic arterial blood pressure, can cause various complications. Type 2 diabetes mellitus (hereinafter referred to as diabetes) is the most common complication in patients with hypertension, and hypertension complicated with diabetes can increase the risk of cardiovascular disease. It is pointed out that the prevalence of hypertension complicated with diabetes in China is 24.3%~ 38.4%. Objective: To analyze the blood glucose level and its related influencing factors in patients with hypertension complicated with diabetes mellitus. Methods: A retrospective survey using self-designed questionnaires was carried out in patients diagnosed with hypertension plus diabetes mellitus hospitalized in the Department of Cardiology of a Grade III Level A hospital in Guangzhou from October 2015 to March 2016. The binary Logistic regression was used to analyze the influencing factors for blood glucose level. Results: A total of 437 patients with hypertension plus diabetes mellitus were included in the study. The standard-reaching rate of blood glucose was 24.3% which was of significant difference between different diabetic durations (P=0.007). The binary Logistic regression analysis showed that the duration of diabetes (OR: 1.094; 95% CI: 1.036, 1.155) was the independent risk factor for the standard-reaching rate of blood glucose. Conclusions: The standard-reaching rate of blood glucose in patients with hypertension complicated with diabetes mellitus was relatively low and the duration of diabetes was an important risk factor for standard-reaching rate of blood glucose.

Abstract 252: Older Brains vs. Younger Brains: Effect of Cardiac Arrest on Hemodynamic Fluctuations and Neurologic Impairment in a Rodent Model

Introduction: The patient suffering from cardiac arrest (CA) is elderly. Numerous laboratory experimental studies of CA are based on the young rodent model. Post-CA patients are often hemodynamically unstable, hypotension is correlated with poor neurologic outcomes. To improve the clinical relevance of CA research in laboratory, we compared the effect of CA in retired breeder (RB) and young group (YG) rats. Hypothesis: The objective of this study was to investigate the effect of CA on systemic arterial blood pressure and neurologic impairment outcomes in RB and YG rats. We hypothesize that RB rats will demonstrate lower mean arterial pressure (MAP) and delayed restoration of electroencephalogram (EEG) associated with neurologic recovery. Methods: Male RB Wistar rats (10-12 months, n=7) and male YG Wistar rats (2-2.5 months, n=6) were subjected to 7 min of asphyxia CA. Multiple parameters including MAP, EEG were recorded. The neurological outcomes were evaluated via neurological deficit score (NDS). Results: There was no significant difference between the two groups’ pre-arrest baseline characteristics except for the body weights (RB vs YG as 581 ± 54 vs 395 ± 9 g). This includes baseline heart rate, MAP, EEG and time to CA. After CA, RB rats showed significantly longer time to achieve return of spontaneous circulation (ROSC) compared to the YG (123 ± 42 vs 81 ± 9 sec, p < 0.05). RB rats showed lower MAP post ROSC compared to YG (98.8 ± 19.0 vs 115.0 ± 16.2 mmHg, p < 0.05 during 0-30 min post ROSC). The recovery sequences of EEG post ROSC are as follows: non-detectable cortical activity (non-DCA); intermittent cortical activity (ICA); continuous cortical activity (CCA). Analysis of recovering EEG indicates a higher gamma fraction for the RB rats during CCA period (p<0.03). High gamma is a surrogate for better EEG recovery for complex cognitive function. NDS scores were no significant difference for both groups from 4 hours to 7 days post ROSC. Conclusion: It appears that older rats have slower hemodynamic recovery post ROSC compared to younger rats. The neurologic deficits are similar in both groups, but cognitive recovery by Gamma fraction seems better in RB. More study is needed to fully understand the effect of aging on the post ROSC brain.

Maxillomandibulocardiac reflex in a dog

BackgroundThe trigeminocardiac reflex (TCR) is a brainstem reflex that may be observed in anaesthesia during surgical procedures stimulating the intracranial or peripheral portion of the trigeminal nerve. The peripheral TCR is divided into the oculocardiac reflex and the maxillomandibulocardiac reflex based on the affected sensory branches of the trigeminal nerve. In veterinary medicine the oculocardiac reflex has been described, however the maxillomandibulocardiac reflex has never been reported.Case presentationA 5-year-old male Epagneul Breton was presented for surgical management of an upper lip mass. During surgery, a sudden severe bradycardia and a decrease in systemic arterial blood pressure developed. The occurrence of a maxillomandibulocardiac reflex was suspected on the basis of the temporary link between surgical stimulation and haemodynamic changes. Three doses of atropine were given before starting a dopamine infusion due to lack of response. The dopamine infusion normalized heart rhythm and blood pressure. The dog recovered uneventfully and he was discharged 24 h later with a sinus rhythm and no sign of recurrence of arrhythmias.ConclusionThe TCR is a rare but potentially life-threatening complication of procedures involving the sensory areas innervated by the three branches of the trigeminal nerve and it may cause bradycardia with hypotension. The use of a β1-adrenergic receptor agonist such as dopamine may be indicated in cases of a refractory response to the conventional treatment with atropine.

Defective Choroidal Blood Flow Baroregulation and Retinal Dysfunction and Pathology Following Sympathetic Denervation of Choroid.

PurposeWe sought to determine if sympathetic denervation of choroid impairs choroidal blood flow (ChBF) regulation and harms retina.MethodsRats received bilateral superior cervical ganglionectomy (SCGx), which depleted choroid of sympathetic but not parasympathetic innervation. The flash-evoked scotopic ERG and visual acuity were measured 2 to 3 months after SCGx, and vasoconstrictive ChBF baroregulation during high systemic arterial blood pressure (ABP) induced by LNAME was assessed by laser Doppler flowmetry (LDF). Eyes were harvested for histologic evaluation.ResultsChBF increased in parallel with ABP in SCGx rats over an ABP range of 90% to 140% of baseline ABP, while in sham rats ChBF remained stable and uncorrelated with ABP. ERG a- and b-wave latencies and amplitudes, and visual acuity were significantly reduced after SCGx. In SCGx retina, Müller cell GFAP immunolabeling was upregulated 2.5-fold, and Iba1+ microglia were increased 3-fold. Dopaminergic amacrine cell fibers in inner plexiform layer were reduced in SCGx rats, and photoreceptors were slightly depleted. Functional deficits and pathology were correlated with impairments in sympathetic regulation of ChBF.ConclusionsThese studies indicate that sympathetic denervation of choroid impairs ChBF baroregulation during elevated ABP, leading to choroidal overperfusion. This defect in ChBF regulation is associated with impaired retinal function and retinal pathology. As sympathetic ChBF baroregulatory defects have been observed in young individuals with complement factor H (CFH) polymorphisms associated with risk for AMD, our results suggest these defects may harm retina, perhaps contributing to AMD pathogenesis.

The Relationship Between Lifestyle, Health Promotion Lifestyle Profile II And High Blood Pressure In University Students.

BACKGROUND:Identifying and controlling systemic arterial blood pressure is important in young people, and it is possible to reduce the frequency of systemic arterial hypertension by improving the lifestyle.AIM:The aim of the study is to assess the relationship between healthy lifestyle behaviors and systemic blood pressure in university students.MATERIALS:The study sample consisted of 200 university students from a state university in Edirne. Lifestyles and habits were evaluated with Health Promotion Lifestyle Profile II. Students’ blood pressure was measured from both arms twice.RESULTS:The mean HPLP-II score of those who frequently feel good was significantly higher than those who rarely feel good. The mean score of those who frequently wake up between 06:00-09:00 in the morning was statistically significantly higher than those who wake up outside these hours. Those who perform social or artistic activities during their leisure times had a mean scale score higher than those who don’t perform. Although there wasn’t a statistically significant difference according to smoking status, the mean score of non-smokers was higher than smokers. The mean scale scores were higher in frequent salt users than non-frequent users; participants with low saturated fatty acid intake had higher scores than those with high intake, and rare fast food consumers had higher scores than frequent consumers. The statistically significant difference between blood pressure values of females and males was due to higher blood pressure in male students. Those working in a part-time job had higher blood pressure values than those who weren’t working. Among the students whose body mass indexes could be evaluated, there were differences in blood pressure values.CONCLUSION:It has been observed in our study that health-related responsibilities and lifestyle behaviours increase with better leisure time activities, improved eating habits and a positive outlook on life. Turning youngs’ tendencies towards healthy lifestyle behaviours to habits can make them healthier, more collective and more productive regarding physical, social and psychological well-being.

Ultrasound Evaluation of Lung Fields in Healthy Dogs: Scanning Technic and Aspects of Normality.

Background: The ultrasound exam has always played a secondary role in pulmonary imaging, with its applicability restricted in emergency care to screen for pleural and/or pericardial effusion, pneumothorax and pulmonary contusion. The recognition of different reverberating artifacts arising from the normal aerated lungs (A lines) and in the presence of lungs with interstitial and/or alveolar infiltrates (B lines) led to wider application of the technique in patients with respiratory syndrome. The objective of this study was to describe the ultrasound imaging methodology and the aspects of the pleura, pleural space and lung fields in healthy dogs.Materials, Methods & Results: Twenty healthy dogs of different breeds and ages, males and females were evaluated in this study; good health status was confirmed by physical examination, electro and echocardiographic assessment, thoracic radiography and systemic arterial blood pressure measurements. Dogs were scanned by a single examiner experienced in diagnostic imaging and previously trained for 6 months in thoracic ultrasound image interpretation. A MyLab 40 with a microconvex multifrequency probe (5-8 MHz) was used in this study. Evaluation was performed in an orthopneic position (standing or sternal recumbecy) under manual containment. Ultrasound examinations were based on the VetBLUE (Veterinary Bedside Lung Ultrasound Exam) protocol. Lung fields were regionally scanned at the 2nd-3rd, 4-5th, 6-7th and 8-9th intercostal spaces in the right and left hemithorax. A subxiphoid window was added to screen for free fluid in the pleural space and/or pericardial sac. Pleural sliding and A lines, that are hyperechoic parallel equidistant lines arising from the visceral pleura-lung interface could be easily seen at all intercostal spaces in all dogs in this sample, with more difficult visualization at the 2nd-3rd intercostal space. B lines were observed in seven out of twenty dogs (35%). However, this artifact was limited to one intercostal space and a maximum of two lines were detected per field. B line artifacts were more commonly seen in the right hemithorax, at the level of the 8-9th intercostal space however without significant differences. In the subxiphoid window evaluation A lines were not detected.Discussion: The observation of B lines in healthy dogs was previously described and as in our study there were no significant differences relative to B line observation relatively to the intercostal space neither between the right and the left hemithorax. B lines are generally associated with decreased pulmonary aeration in response to interstitial/alveolar infiltration, which generates reflections and comet tail artifacts. The low number of B lines observed in this study may be associated with larger veins or lymphatics vessels, focal interstitial thickening or microatelectasia. The high respiratory frequency does not interfere in the sonographic evaluation. The dyspnea presented for animals with acute respiratory syndromes can be aggravated in stress situations, such as the displacement to the radiology service and manipulation necessary to the radiographic projections. Regional scanning by some acoustic windows allows rapid assessment of the thorax, with significant contributions to decision making in emergency situations. However, ultrasonography does not eliminate the need for other imaging modalities such as radiography and computed tomography and should be seen as a screening tool for patients presenting with acute respiratory syndromes.

AMPK-α1 or AMPK-α2 Deletion in Smooth Muscles Does Not Affect the Hypoxic Ventilatory Response or Systemic Arterial Blood Pressure Regulation During Hypoxia.

The hypoxic ventilatory response (HVR) is markedly attenuated by AMPK-α1 deletion conditional on the expression of Cre-recombinase in tyrosine hydroxylase (TH) expressing cells, precipitating marked increases in apnea frequency and duration. It was concluded that ventilatory dysfunction caused by AMPK deficiency was driven by neurogenic mechanisms. However, TH is transiently expressed in other cell types during development, and it is evident that central respiratory depression can also be triggered by myogenic mechanisms that impact blood supply to the brain. We therefore assessed the effect on the HVR and systemic arterial blood pressure of AMPK deletion in vascular smooth muscles. There was no difference in minute ventilation during normoxia. However, increases in minute ventilation during severe hypoxia (8% O2) were, if affected at all, augmented by AMPK-α1 and AMPK-α2 deletion in smooth muscles; despite the fact that hypoxia (8% O2) evoked falls in arterial SpO2 comparable with controls. Surprisingly, these mice exhibited no difference in systolic, diastolic or mean arterial blood pressure during normoxia or hypoxia. We conclude that neither AMPK-α1 nor AMPK-α2 are required in smooth muscle for the regulation of systemic arterial blood pressure during hypoxia, and that AMPK-α1 deficiency does not impact the HVR by myogenic mechanisms.

Activation of the β-common receptor by erythropoietin impairs acetylcholine-mediated vasodilation in mouse mesenteric arterioles.

Clinically, erythropoietin (EPO) is known to increase systemic vascular resistance and arterial blood pressure. However, EPO stimulates the production of the potent vasodilator, nitric oxide (NO), in culture endothelial cells. The mechanism by which EPO causes vasoconstriction despite stimulating NO production may be dependent on its ability to activate two receptor complexes, the homodimeric EPO (EPOR 2) and the heterodimeric EPOR/β‐common receptor (β CR). The purpose of this study was to investigate the contribution of each receptor to the vasoactive properties of EPO. First‐order, mesenteric arteries were isolated from 16‐week‐old male C57BL/6 mice, and arterial function was studied in pressure arteriographs. To determine the contribution of each receptor complex, EPO‐stimulating peptide (ESP), which binds and activates the heterodimeric EPOR/β CR complex, and EPO, which activates both receptors, were added to the arteriograph chamber 20 min prior to evaluation of endothelium‐dependent (acetylcholine, bradykinin, A23187) and endothelium‐independent (sodium nitroprusside) vasodilator responses. Only ACh‐induced vasodilation was impaired in arteries pretreated with EPO or ESP. EPO and ESP pretreatment abolished ACh‐induced vasodilation by 100% and 60%, respectively. EPO and ESP did not affect endothelium‐independent vasodilation by SNP. Additionally, a novel β CR inhibitory peptide (β IP), which was computationally developed, prevented the impairment of acetylcholine‐induced vasodilation by EPO and ESP, further implicating the EPOR/β CR complex. Last, pretreatment with either EPO or ESP did not affect vasoconstriction by phenylephrine and KCl. Taken together, these findings suggest that acute activation of the heterodimeric EPOR/β CR in endothelial cells leads to a selective impairment of ACh‐mediated vasodilator response in mouse mesenteric resistance arteries.

Cardiorespiratory evaluation of brachycephalic syndrome in dogs

ABSTRACT: Brachycephalic syndrome (BS) in dogs is characterized by the combination of primary and secondary upper respiratory tract abnormalities and may result in significant upper airway obstruction. It can trigger inspiratory dyspnea, culminating in secondary respiratory distress, soft tissue edema, upper airway obstruction, turbulent airflow, inspiratory noise, and even death. These changes lead to increased resistance of the air passages, which can cause elevation of pulmonary pressure and clinical manifestations attributable to pulmonary hypertension. The consequence is right-sided cardiac remodeling (Cor pulmonale) with possible progression to right congestive heart failure. To investigate the effects of BS on the cardiovascular system, 28 animals were recruited for a prospective study and assigned to either the Brachycephalic Group (BG), composed of 22 French bulldogs with BS or the Control Group (CG), which was composed of 6 healthy Beagle dogs. All animals underwent a detailed physical examination, as well as laboratory analyses, electrocardiography, echocardiography, chest radiography and indirect measurement of systemic arterial blood pressure. The most relevant finding was a lower PaO2 (90.6±12.9mmHg) in BG as compared to CG (104.9±5.2), (p≤0.05), possibly attributable to hypoventilation due to anatomical alterations.

Afferent neural feedback overrides the modulating effects of arousal, hypercapnia and hypoxaemia on neonatal cardiorespiratory control.

Evidence obtained at whole animal, organ-system, and cellular and molecular levels suggests that afferent volume feedback is critical for the establishment of adequate ventilation at birth. As a result of the irreversible nature of the vagal ablation studies performed to date, it was difficult to quantify the roles of afferent volume input, arousal and changes in blood gas tensions on neonatal respiratory control. During reversible perineural vagal block, profound apnoeas and hypoxaemia and hypercarbia were observed, necessitating the termination of perineural blockade. Respiratory depression and apnoeas were independent of sleep state. We demonstrate that profound apnoeas and life-threatening respiratory failure in vagally denervated animals do not result from a lack of arousal or hypoxaemia. A change in sleep state and concomitant respiratory depression result from a lack of afferent volume feedback, which appears to be critical for the maintenance of normal breathing patterns and adequate gas exchange during the early postnatal period. Afferent volume feedback plays a vital role in neonatal respiratory control. Mechanisms for the profound respiratory depression and life-threatening apnoeas observed in vagally denervated neonatal animals remain unclear. We investigated the roles of sleep states, hypoxic-hypercapnia and afferent volume feedback on respiratory depression using reversible perineural vagal block during the early postnatal period. Seven lambs were instrumented during the first 48h of life to record/analyse sleep states, diaphragmatic electromyograph, arterial blood gas tensions, systemic arterial blood pressure and rectal temperature. Perineural cuffs were placed around the vagi to attain reversible blockade. Postoperatively, during the awake state, both vagi were blocked using 2% xylocaine for up to 30min. Compared to baseline values, pHa , and decreased and increased during perineural blockade (P<0.05). Four of seven animals exhibited apnoeas of ≥20s requiring the immediate termination of perineural blockade. Breathing rates decreased from the baseline value of 53±12 to 24±20breathsmin-1 during blockade despite an increased (P<0.001). Following blockade, breathing patterns returned to baseline values despite marked hypocapnia ( 33±3torr; P=0.03). Respiratory depression and apnoeas were independent of sleep states. The present study provides the much needed physiological evidence indicating that profound apnoeas and life-threatening respiratory failure in vagally denervated animals do not result from a lack of arousal or hypoxaemia. Rather, a change in sleep state and concomitant respiratory depression result from a lack of afferent volume feedback, which appears to be critical for the maintenance of normal breathing patterns and adequate gas exchange during the early postnatal period.

Cerebral Autoregulation in Stroke.

Cerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication. Existing data suggest that CA is generally impaired in various cerebrovascular disorders. In patients with small vessel ischemic stroke, CA has been shown to be impaired in both hemispheres, whereas in large territorial strokes, CA impairment has been limited to the affected hemisphere. In these latter patients, impaired CA is also predictive of secondary complications such as hemorrhagic transformation and cerebral edema, hence worse functional outcome. In patients with carotid stenosis, impaired CA may also be associated with a higher ipsilateral hemispheric stroke risk. CA is also strongly linked to outcome in patients with intracranial hemorrhage. In patients with intraparenchymal hemorrhage, CA impairment correlated with clinical and imaging severity, whereas in those with subarachnoid hemorrhage, CA measures have a predictive value for development of delayed cerebral ischemia and radiographic vasospasm. Assessment of CA is increasingly more accessible in acute cerebrovascular disorders and promises to be a valuable measure in guiding hemodynamic management and predicting secondary complication, thus enhancing the care of these patients in the acute setting.

Hypertension Induced Morphological and Physiological Changes in Cells of the Arterial Wall.

Morphological and physiological changes in the vasculature have been described in the evolution and maintenance of hypertension. Hypertension-induced vascular dysfunction may present itself as a contributing, or consequential factor, to vascular remodeling caused by chronically elevated systemic arterial blood pressure. Changes in all vessel layers, from the endothelium to the perivascular adipose tissue (PVAT), have been described. This mini-review focuses on the current knowledge of the structure and function of the vessel layers, specifically muscular arteries: intima, media, adventitia, PVAT, and the cell types harbored within each vessel layer. The contributions of each cell type to vessel homeostasis and pathophysiological development of hypertension will be highlighted.

Aortic dissecting aneurysm associated with systemic arterial hypertension in a cat.

Aortic dissection is characterized by a tear in the aortic wall resulting in blood from the aortic lumen penetrating into the media, which causes dissection. When aortic dissection does not cause rupture, it provokes localized dilation of the aorta or aneurism, also called dissecting aortic aneurism (DAA). This case report describes a DAA in a cat associated with systemic arterial hypertension (SAHT). A 10-year-old male Domestic shorthair cat was presented for cardiac evaluation. Anamnestic clinical complaints were a syncope associated with paraparesis and weak femoral pules. Cardiomegaly had been found radiographically, and cardiogenic arterial thromboembolism had been suspected. Upon presentation physical abnormalities were tachycardia and a heart murmur. Measurement of systolic systemic arterial blood pressure (SABP) revealed severe SAHT. Echocardiographic images showed severe DAA, and marked aortic valve insufficiency. Palliative antihypertensive treatment resulted in fast clinical improvement and significant decrease in blood pressure. Four months later, acute severe respiratory distress due to cardiogenic pulmonary edema led to the cat's euthanasia. In human medicine, DAA is a well-reported complication of SAHT. This is the second case of DAA with congestive heart failure reported in a hypertensive cat.

Colonic Indole And Hydrogen Sulfide, Gut Bacterial Metabolites, Affect Portal Blood Pressure in Healthy And Cirrhotic Rats

Liver cirrhosis is a leading cause of portal hypertension, and is often accompanied by systemic hypotension. Accumulating evidence suggests that gut bacteria may affect hemodynamics, however, the mechanisms are not clear. We investigated the effect of colon‐administered gut bacteria metabolites on portal blood pressure (PBP), portal blood flow (PBF) and systemic arterial blood pressure (ABP) in healthy (controls) and cirrhotic rats (CRH).10‐week‐old, male, Sprague Dawley rats were maintained either on tap water (controls) or water solution of thioacetamide for 18 weeks to induce liver cirrhosis (CRH). PBP, PBF and ABP were measured in anaesthetized rats at baseline and after the intracolonic administration of either a vehicle, indole, or Na2S, a hydrogen sulfide (H2S) donor into the colon.CRH showed significantly higher PBP but lower ABP than controls. The intracolonic administration of indole increased portal blood level of indole, and peripheral blood level of indoxyl sulfate, a liver metabolite of indole. Rats treated with Na2S showed increased portal blood levels of thiosulfate and sulfane sulfur, products of H2S oxidation. The intracolonic administration of vehicle did not affect hemodynamic parameters. In controls intracolonic H2S increased PBP but decreased PBF and ABP. In contrast, intracolonic indole increased both BPB and PBF, whereas did not affect significantly ABP. In comparison to controls, CRH showed significantly greater hemodynamic responses to H2S but not to indole. Cirrhotic livers had a significantly higher concentration of H2S but lower expression of rhodanese, an enzyme converting H2S to sulfate.Colon‐administered indole and H2S increase portal blood pressure via distinct hemodynamic mechanisms. Indole increases, whereas H2S decreases portal blood flow. Indole and H2S signaling in the gut‐liver axis may be involved in the control of portal blood pressure and in the etiology of portal hypertension. Further studies on the effects of gut bacterial metabolites on portal circulation are needed.Support or Funding InformationThis work was supported by the National Science Centre, Poland grant no. UMO‐2016/22/E/NZ5/00647This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Plasma homocysteine in a non-rodent model of cardiovascular diseases: Establishment of a reference interval and assessment of biological variations in cats

Cats are a relevant small animal model for several spontaneous cardiovascular diseases, such as hypertrophic cardiomyopathy and systemic hypertension. In people, homocysteine is an independent risk factor for cardiovascular diseases. Cats are obligate carnivores and have numerous metabolic peculiarities that may predispose them to alterations of homocysteine. The purpose of this study was to determine a reference interval and to assess biological variations for plasma homocysteine in healthy privately-owned cats. All participating cats underwent a complete physical examination, urinalysis and blood testing to rule out any signs of disease. Systemic arterial blood pressure was measured by use of high-definition oscillometry. Plasma homocysteine was measured in healthy cats with a high-performance liquid chromatography – tandem mass spectrometry method. Of 111 cats evaluated, 4 cats showed at least one significant abnormality on physical examination and 16 cats were not included due to a fractious behavior. Ninety-one cats completed the study and 14 of them were excluded due to at least one significant abnormality on blood work or urinalysis. The nonparametric reference interval for plasma homocysteine in 77 healthy cats was 6.1–52.8 μmol/L. There was no influence of the breed, age, sex and body condition score. The reference interval for plasma homocysteine is much wider in the feline population than in humans. Contrary to what is described in people, plasma homocysteine in cats is not higher in males than in females and does not increase with age. The role of environmental factors, such as dietary considerations, on plasma homocysteine will be studied. The impact of plasma homocysteine on systemic arterial blood pressure will also be discussed.

Middle cerebral artery pressure changes following Pipeline flow diversion.

Objective Pipeline embolization devices (PED) are commonly used for endovascular treatment of cerebral aneurysms but changes in intracranial hemodynamics after PED deployment are poorly understood. Here, we assess middle cerebral artery (MCA) and systemic blood pressure before and after PED treatment. Methods Records of patients with cerebral aneurysms proximal to the internal carotid artery terminus treated with PED at our institution between 2015 and 2017 were retrospectively reviewed. Patients were included if ipsilateral MCA pressure measurements were available. Ipsilateral MCA pressure was transduced via the microcatheter before and after PED deployment. Systemic arterial blood pressure was also simultaneously recorded. MCA, systemic blood pressure, and ratios of MCA to systemic blood pressure values were compared before and after treatment among the study cohort using the two-sample paired Student t test. Results Fourteen patients were included. Mean age was 54 years. Among the entire cohort, the ratio of MCA to systemic systolic and mean blood pressure were significantly higher after treatment (respectively 0.76 vs. 0.69, p = 0.01, and 0.94 vs. 0.89, p = 0.03), and the ratio of MCA to systemic diastolic pressures showed an increasing trend (1.08 vs. 1.03, p = 0.09). The percentage of ratio increase was independent of aneurysm size ( r = -0.24, p = 0.42 for systolic ratio; r = -0.09, p = 0.74 for diastolic ratio; r = -0.09; p = 0.76 for mean ratio, respectively). Conclusions Following PED deployment, the ratio of ipsilateral MCA to systemic systolic and mean blood pressure increased. These pressure changes should be further evaluated in a larger sample size.

Apelin/APJ expression in the heart and kidneys of hypertensive rats

Hypertension is an important health problem that is manifested by systemic arterial blood pressure being permanently elevated and leading to serious complications. Hypertension is the basis for coronary heart diseases, heart failure, kidney damage, cerebrovascular diseases. Due to ethical concerns, there is no detailed study of the mechanism, side effects and treatment of hypertension in humans. For this reason, specific studies related to the organ of hypertension are performed in experimental animals. The heart and kidney tissue, which are the most important organs that hypertension has damaged, have formed specific organs of our work.In our experimental study, a total of 35 (hypertensive group: 20, control group: 15) Rattus Norvegicus Wistar albino rats were used. In order to obtain our hypertension model, our experimental animals were given L-NAME together with drinking water for six weeks. After six weeks, the experimental procedures were terminated. Heart and kidney tissues of the hypertensive and control group were obtained. Expression of apelin and apelin receptor (APJ) was demonstrated by immunohistochemical and Western Blot protocols.Hypertrophic cardiac atrium of the hearts of the large cavities, interventricular septum and myocardium to the disintegration, as well as an increase in the diameter of the coronary artery has been observed. In general, kidney tissues of the hypertensive group showed narrowing in cortical renal structures and enlargement in structures in the renal medulla.As a result, in hypertensive cases, there was an increase in expression of Apelin and APJ receptor in heart tissue, and a decrease in expression of Apelin and APJ receptor in kidney tissue. We think that our findings may contribute to experimental or clinical studies related to hypertension and apelin.

The mechanism effects of CD4+ CD25+ Foxp3+ regulatory T cells in essential hypertension

Primary hypertension is a kind of cardiovascular syndrome which main clinical manifestation is elevated systemic arterial blood pressure, and it's exact pathogenesis remains unclear. Regulatory T cells are a group of T cell subgroups with immunosuppressive and immunocompromised functions, they play an irreplaceable role in the process of immune suppression and immune tolerance. Recently many studies have showed that hypertension is often accompanied by abnormal immune functions. To search the mechanism of action of regulatory T cells in the development of hypertension is significance to prevent and treat hypertension. Key words: Hypertension/IM; T-lymphocytes, regulatory; CD4-positive T-lymphocytes; Review

A Novel Macroscale Acoustic Device for Blood Filtration.

Retransfusion of a patient's own shed blood during cardiac surgery is attractive since it reduces the need for allogeneic transfusion, minimizes cost, and decreases transfusion related morbidity. Evidence suggests that lipid micro-emboli associated with the retransfusion of the shed blood are the predominant causes of the neurocognitive disorders. We have developed a novel acoustophoretic filtration system that can remove lipids from blood at clinically relevant flow rates. Unlike other acoustophoretic separation systems, this ultrasound technology works at the macroscale, and is therefore able to process larger flow rates than typical micro-electromechanical system (MEMS) scale acoustophoretic separation devices. In this work, we have first demonstrated the systematic design of the acoustic device and its optimization, followed by examining the feasibility of the device to filter lipids from the system. Then, we demonstrate the effects of the acoustic waves on the shed blood; examining hemolysis using both haptoglobin formation and lactate dehydrogenase release, as well as the potential of platelet aggregation or inflammatory cascade activation. Finally, in a porcine surgical model, we determined the potential viability of acoustic trapping as a blood filtration technology, as the animal responded to redelivered blood by increasing both systemic and mean arterial blood pressure.

The Cardiac Function in the Beach Chair Position under General Anesthesia

Background: Shoulder surgery is performed in the beach chair position (BCP). The systemic arterial blood pressure (BP) must be increased to prevent cerebral hypoperfusion. However, it is not clear how the cardiac function is affected when BP increase to maintain cerebral perfusion pressure in anesthetized patients. Methods: An analysis was performed using the data from 13 patients. We prepared a parallel circuit using a FloTrac Sensor transducer and an arterial BP transducer. Following the transfer of the patient to the BCP under general anesthesia, the FloTrac Sensor transducer was placed at the level of the fourth intercostal space, the arterial BP transducer was placed at the external auditory meatus level. We selected two points before surgery (120 s apart), during which the mean arterial BP (mABP) at the level of the brain was stable and at which the values in the supine position and the BCP were within 5 mmHg. Results: While the patients were in the supine position, the mean mABP at the mid-axillary level was 65.7 mmHg. In the BCP, the mean mABP was 66.5 mmHg at the external auditory meatus and 80.7 mmHg at the fourth intercostal space. The cardiac index changed from 2.2 (supine position) to 2.5 l/min/m2 (BCP). The stroke volume index was significantly increased from 35.8 to 42.3 ml/m2 (P = 0.003). The heart rate changed from 63.0 to 58.6 beats/min. The stroke volume variation was significantly decreased from 12.4% to 8.8% (P = 0.024). Conclusion: In order to ensure patient safety, close attention should be paid to the systemic cardiovascular changes that occur when the BP is increased.