Blood Pressure Rate Research Articles

Chronic L-Name-Treatment Produces Hypertension by Different Mechanisms in Peripheral Tissues and Brain: Role of Central eNOS.

The goal of our study was to analyze the time course of the effect of NG-nitro-L-arginine methyl ester (L-NAME) on nitric oxide synthase (NOS) isoforms and nuclear factor–κB (NF-κB) protein expression, total NOS activity, and blood pressure (BP) in rats. Adult 12-week-old male Wistar rats were subjected to treatment with L-NAME (40 mg/kg/day) for four and seven weeks. BP was increased after 4- and 7-week L-NAME treatments. NOS activity decreased after 4-week-L-NAME treatment; however, the 7-week treatment increased NOS activity in the aorta, heart, and kidney, while it markedly decreased NOS activity in the brainstem, cerebellum, and brain cortex. The 4-week-L-NAME treatment increased eNOS expression in the aorta, heart, and kidney and this increase was amplified after 7 weeks of treatment. In the brain regions, eNOS expression remained unchanged after 4-week L-NAME treatment and prolonged treatment led to a significant decrease of eNOS expression in these tissues. NF-κB expression increased in both peripheral and brain tissues after 4 weeks of treatment and prolongation of treatment decreased the expression in the aorta, heart, and kidney. In conclusion, decreased expression of eNOS in the brain regions after 7-week L-NAME treatment may be responsible for a remarkable decrease of NOS activity in these regions. Since the BP increase persisted after 7 weeks of L-NAME treatment, we hypothesize that central regulation of BP may contribute significantly to L-NAME-induced hypertension.

Infusion therapy for sepsis in patients with burns

Background. Sepsis develops in 8-42.5 % of patients with burns and is the leading cause of death among them. The criteria for sepsis are suspected or documented infection and the presence of two or more criteria on the SOFA scale. The involvement of remote from the primary pathological focus organs or systems in the generalized pathological process is the key sign of sepsis.
 Objective. To describe infusion therapy (IT) for sepsis in patients with burns.
 Materials and methods. Analysis of literature data on this topic; own research. The study involved 52 patients with sepsis due to severe burns, who were prescribed individually selected comprehensive treatment. Patients in group 1 received IT according to the following scheme: Ringera lactate (“Yuria-Pharm”) + glucose + isoosmolar crystalloids, group 2 – Ringera lactate + glucose + Reosorbilact (“Yuria-Pharm”) at a dose of 10 ml/kg, group 3 – Ringera lactate + glucose + Reosorbilact at a dose of 15 ml/kg.
 Results and discussion. Sepsis in patients with burns differs from sepsis in general surgery patients, as the former lose the main protective barrier – their skin. Due to the hypermetabolic response patients with burns for several months may have tachycardia, tachypnea, leukocytosis, shift of the leukocyte formula to the left, fever, signs of multiorgan dysfunction. The development of sepsis in patients with burn disease depends on the area and depth of the injury, as well as on the condition of the patient’s immune system. Treatment of sepsis may include antibiotic therapy, surgery (removal of non-viable tissues, closure of skin defects), IT, vasopressor therapy, heparin, inotropic support, glucocorticoid therapy, administration of blood products, mechanical lung ventilation. Despite the leading role of IT in the treatment of sepsis in patients with burns, the question of the optimal solution and its dose is still unclear. The goals of IT in this case are to ensure the delivery of oxygen to tissues in conditions of increased consumption and detoxification. According to the results of our own study, patients in groups 2 and 3 had a significantly lower heart rate (HR) and higher systolic blood pressure (SBP) than in group 1 (HR: 1st group – 119.5±5.4 bpm, 2nd group – 108.2±4.3 bpm, 3rd group – 104.5±5.3 bpm; SBP: 1st group – 82.6±5.3 mm Hg, 2nd group – 82.5±4.6 mm Hg, 3rd group – 92.4±3.2 mm Hg). The increase in SBP was accompanied by an increase in glomerular filtration rate and rate of diuresis. The use of Reosorbilact at a dose of 10 ml/kg/day reduced the total volume of infusions by 7.8 %, and at a dose of 15 ml/kg/day – by 19.5 % compared with group 1. Patients in both groups of Reosorbilact had a lower frequency of septic shock (11.8 and 12.5 % vs. 15.7 % in group 1) and shorter duration of treatment with vasopressors. The use of Reosorbilact in both doses helped to reduce the level of leukocytes, urea, creatinine, C-reactive protein. Hemodynamic, osmodiuretic and detoxifying effects of Reosorbilact justify its use in patients with severe burns and sepsis.
 Conclusions. 1. Sepsis develops in 8-42.5 % of patients with burns and is the leading cause of death among them. 2. Sepsis in patients with burns is different from sepsis in general surgery patients. 3. Despite the leading role of IT in the treatment of burn sepsis, the question of the optimal solution and its dose still remains unclear. 4. The use of Reosorbilact helps to reduce heart rate, increase SBP, reduce the total volume of infusions, reduce the frequency of septic shock and reduce treatment with vasopressors.

Main approaches to prevention of health disorders in workers in contact with physical factors

Introduction. One of the leading causes of occupational health loss, especially in mining and machine-building enterprises, is the combined impact of industrial noise and vibration. The wide prevalence of cardiovascular diseases is one of the most important medical and social problems, due to persistent disability and high mortality, bringing prevention of health disorders to the first place as the basis for preserving labor longevity. The aim of study is to identify the main approaches aimed at preventing health problems in workers who come into contact with vibration and noise at mining and machine-building enterprises. Materials and methods. A survey and survey of 296 industrial workers was conducted. Group 1 (160 people) included men who were exposed to noise and vibration factors above the maximum permissible levels, group 2 consisted of 136 men who did not have direct contact with noise and vibration generating equipment. When conducting an in-depth laboratory and instrumental examination in a hospital setting, all workers additionally calculated the level of cardiovascular risk on the SCORE scale. Statistical analysis was performed using the software package "Statistica 6.0". Results. It is determined that the priority adverse factors of the working environment in production are noise and vibration. It has been shown that individuals who come into contact with these factors are more likely to detect violations of lipid metabolism and endothelial function, have a higher average heart rate and systolic blood pressure, and have an increased risk of developing cardiovascular diseases. Conclusions. Taking into account the obtained results of the proposed diagnostic approaches aimed at the prevention of health disorders among workers of industrial enterprises. If employees are found to have an increased cardiovascular risk, it is necessary to conduct a more in-depth examination and timely medical and preventive measures.

Intraoperative clonidine vs lidocaine on hemodynamic response to laryngoscopic intubation and immune function in gynecological surgeries

BackgroundThis prospective randomised double-blind study was carried out on forty patients American Society of Anesthesiologists (ASA) physical status I–II , aged 40–60 years, scheduled for elective abdominal gynecological surgeries under general anesthesia after obtaining the approval of the local institutional ethical committee and oral consent of the patients. This study was conducted to evaluate the effects of perioperative intravenous clonidine versus lidocaine on hemodynamic stress response to laryngoscopic intubation, immune function, pain intensity, time to the first request for analgesia, and total dose of analgesic requirement in the first 24 h postoperatively in gynecological surgeries.ResultsThroughout the study, heart rate and mean arterial blood pressure were significantly lower in clonidine group (group C) compared to lidocaine group (group L). Postoperatively, the levels of IL-6 were significantly higher in (group L) compared to (group C). VAS pain scores were lower in the clonidine group in comparison to the lidocaine group. There was a higher total dose of analgesia in the lidocaine group when compared to the clonidine group.ConclusionsBoth clonidine and lidocaine can be used to attenuate the hemodynamic response; however, clonidine was better in the reduction of postoperative pain scores and the decrease in the production of pro-inflammatory cytokines.

Program «Smart ECG – ranolazin» - own experience and world approach

Purpose - comprehensive analysis of the world approach of the use of ranolazine in various clinical trials and the introduction of the program "Smart ECG" to assess the effectiveness of ranolazine.Matherial and methods. Evaluation of European guidelines, analysis of global randomized clinical trials of the ranolazine use, presentation of our own trial: we examined 40 patients with Q wave myocardial infarction (STEMI), were instituted basic therapy according to the modern recommendations which contained interventional treatment with restoration of patency of a heart attack-conditioned coronary artery, double antiplatelet therapy, statins, β-adrenergic blocker, angiotensin-converting enzyme inhibitors, aldosterone antagonists with addition of ranolazine (group I, 30 patients diagnosed STEMI), control - group II, 10 patients with STEMI, who received basic therapy without addition of ranolazine. Results. Analysis of clinical trials (CARISA, MARISA, ERICA, TERISA, MERLIN-TIMI, RIVER-PCI, RIMINI-TRIAL) proved the effectiveness of ranolazine as an antianginal and anti-ischemic drugs. The use of own program «Smart ECG» demonstrates the positive effect of ranolazine on STEMI and requires further implementation.Conclusion. In the European Society of Cardiology guidelines of the management of stable angina pectoris, ranolazine is given a class IIa (level of evidence B) recommendation as a second-line treatment to reduce angina frequency and improve exercise tolerance in subjects who cannot tolerate, have contraindications to, or whose symptoms are not adequately controlled by β- adrenergic blockers, calcium channel blockers and long-acting nitrates. In subjects with baseline low heart rate and low blood pressure, ranolazine may be considered as a first-line drug to reduce angina frequency and improve exercise tolerance - class IIa (level of evidence C) recommendation. Own study, which partially reflects the global approach according to the analyzed clinical studies, demonstrates the positive effect of ranolazine for patients with STEMI - analogue scale EQ–VAS indicates a positive effect, positive influence on the markers of electrical myocardial instability: decreasing of the probability of cases of SDNN decrease, depression of QT and maybe increase of ratio of maximum velocity for differentiated T wave.

Arecoline induces dual modulation of blood pressure in rat, including an initial downregulation and a subsequent upregulation

Purpose: To determine the role of arecoline in cardiovascular modulation in rats.Methods: After rats were anaesthetized with intraperitoneal urethane (1.4 g/kg body weight), saline or arecoline (at doses of 1.0, 3.0 and 10.0 mg/kg) was intraperitoneally administered, and blood pressure (BP) was continuously recorded using a physiological apparatus. Mean arterial pressure (MAP), maximum changes in MAP and reaction time due to arecoline stimulations were calculated and analyzed.Results: Arecoline induced biphasic modulation in BP, including an initial downregulation followed by a subsequent upregulation. The MAP and maximum change in MAP exhibited a concentration-dependent effect in the downregulation phase (p < 0.001 within each group), but not in the upregulation phase (p > 0.05 within each group), while BP reaction time showed a dose-dependent prolongation in both downregulation and upregulation phases (ps < 0.01 within each group). Remarkably, arecoline-induced BP downregulation more rapidly and drastically than upregulation in each arecoline group.Conclusion: These results indicate that arecoline exerts a complex effect in cardiovascular modulation that should be considered as side effects in the clinical use of arecoline and/or with the habitual chewing of areca nuts.
 Keywords: Arecoline, Blood pressure, Downregulation, Upregulation

Abstract 16443: Effects of Dietary Salt Intakes on Blood Pressure, Renal Function and Oxidative Stress in Rats Treated With Candesartan

Candesartan is one of angiotensin II type1 receptor blockers(ARB) and commonly used as first-line antihypertensive treatment. Low salt diet is often recommended by clinicians to the patients with hypertension and kidney diseases. However,it is not clear whether salt restriction is beneficial to the patients taking ARB. In order to explore this problem, the impacts of different salt diets on blood pressure (BP),renal function and oxidative stress were determined in 2-3 months old male Sprague Dawley rats treated with candesartan. The rats were randomly divided into 4 groups fed agar-gelled food rationally with NaCl content at 0.01%, 0.8%, 2% and 4% respectively(4-7 rats/group) while all rats were intraperitoneally injected with candesartan at 1mg / kg / day for 7 days. SBP started to decline on day 2 in all except 4% NaCl groups relative to day 0 (recorded 5-6 hrs before the first injection). On day 6, systolic BP (mmHg, tail-cuff, Softron,BP-98A) was lower in 0.8% (103.7+2.3) & 0.01% (101.6+3) groups than 2% (113.5+4.1) & 4% (129.9+4.6) groups (one way ANOVA,LSD test, P<0.05) and correlated positively with food NaCl intakes (R 2 =0.9832). DBP was changed in a similar pattern as SBP. Serum creatinine (μmol/L) was higher in 0.01% group (225+39) than groups of 0.8% (1328+350), 2% (2095+242) and 4% (1576+703) while creatinine clearance (ml/day) was lower in 0.01% group (69.3+9) than groups of 0.8% (43.7+9), 2%(27.7+2) and 4%(29+0.6). In order to determine whether oxidative stress plays any role in the BP regulation and renal function maintenance, we also checked renal protein expression of ROS components. Relative to 0.8% group, renal NOXs were not altered in 0.01% group while NOX1 (145+18,% of 0.8% group), NOX2 (240+54) and NOX4 (197+41) was higher in 2% group than other groups. Mn-SOD (77+7.8), not Cu-Zn SOD, was decreased while HO1 (170+16), not HO2, was increased in 0.01% group. Renal abundance of nitrotyrosine was lower in 0.01% than other groups indicating a decreased oxidative stress, possibly caused by increase in HO1. We concluded that salt restriction with candesartan is beneficial to antihypertensive effect of AT1R blockade but disadvantage to maintenance of renal function. Thus, cautions to choice of low salt intakes are necessary when taking ARB agents.

Abstract 13868: Effects of Chronic Electronic Cigarette Vapor Exposures on the Cardiovascular Function in Rats

Background: We investigated the effects of chronic electronic cigarettes with nicotine (E-Cig) exposure on cardiovascular function in rats. Methods: Adult Sprague Dawley rats were exposed to either pure air (n=10) or E-Cig (n=14) for 12 weeks. After 12 weeks of exposure, flow-mediated vasodilation was measured in anesthetized rats with ultrasound to measure femoral artery diameter. Femoral artery flow velocity was measured before and 5 minutes after reperfusion of a 5-minute femoral artery occlusion. Cardiac function was assessed by echocardiogram. A Millar catheter was used to record systemic arterial and LV pressures. Cardiac output was measured using a themodilution catheter. Results: The femoral artery internal diameter and blood flow velocity were comparable between the 2 groups before and after artery occlusion. However, in the E-cig group, blood flow velocity significantly decreased from 55.5 ± 5.2 cm/s prior to occlusion to 41.3 ± 4.1 cm/s after reperfusion (p = 0.005); it remained similar prior to (47.8 ± 3.4 cm/s) and after (47.8 ± 5.5 cm/s) occlusion in the air group. There were no statistically significant differences in left ventricular diastolic and systolic dimensions, LV fractional shortening, heart rate or mean blood pressure (80 ± 3 mmHg in air and 79 ± 5 mmHg in E-cig group) , LV end-diastolic pressure (Ped), end-systolic pressure (Pes), peak -dP/dt, Tau, or cardiac output (48.3 ± 3.3 ml/min in air and 47.6 ± 3.9 ml/min in E-cig group) between the E-Cig and the pure air group. There was a trend toward a reduction in peak LV +dP /dt in the E-Cig group (5574 ± 341 mmHg/s) compared to the air group (6166 ± 238 mmHg/s). LV weight and wall thickness were similar between groups. Conclusions: Twelve weeks of E-Cig exposure did not affect heart rate or blood pressure; but did tend to reduce contractility. E-cigarette exposure slowed the flow-mediated blood flow velocity probably at a microvascular level, possibly by altering endothelial function.

Abstract 143: The Modified Shock Index Separates Survivors from Non-Survivors in a Swine Model of Hemorrhagic Shock and Traumatic Brain Injury

The ratio between heart rate and arterial blood pressure during hemorrhagic shock has been shown useful to identify individuals at risk of death. We herein compared the index using the systolic arterial pressure (SI) and using the mean arterial pressure (MSI) along with other measurements including cardiac index and lactate in a swine model of hemorrhagic shock and traumatic brain injury developed to model injury in the battlefield. The parent study was designed to compare three different types of vasopressin agonists with control solution while practicing fluid-restricted resuscitation. The present analysis included 60 experiments focused on the initial 240 minutes with induction of hemorrhagic shock by liver laceration removing approximately 1,000 ml of blood in 30 minutes. Eight animals died during the acute phase and compare to 52 survivors, they had higher (median, IQR) MSI (4.6; 3.3 - 5.4 vs 2.5; 2.0 - 3.1; p < 0.001), SI (2.7; 2.1 - 3.1 vs 1.8; 1.6 - 2.2; p < 0.001), lower cardiac index (2.8; 2.3 - 3.4 vs 3.7; 3.2 - 4.2; p < 0.001), but no differences in lactate levels. Three of the eight non-survivors (37.5%) and 42 of the 52 survivors (80.1%) received a vasopressin analog (p = 0.019). Compared to other measurements of hemodynamic stability, monitoring the ratio between the heart rate and mean arterial pressure is a feasible and practical approach to deploy in various out of hospital settings including the battlefield as well as in civilian trauma. This approach could also guide interventions including the use of vasopressor agents, which our studies demonstrate having a survival effect during acute bleeding caused by hemorrhagic shock.

Abstract 15153: Functional Cardiac Adaptation to 60 Days Strict Head-Down-Tilt Bedrest

Background: Reduced physical activity increases the risk for heart failure. Myocardial strain measurements capture subtle abnormalities in myocardial function. We tested the hypothesis that bedrest deconditioning produces cardiac dysfunction in healthy persons. Methods: In the AGBRESA study, which assessed artificial gravity through centrifugation as potential countermeasure for space travel, 24 healthy persons (8 women) were submitted to 60 days strict -6°-head-down-tilt bedrest. 8 subjects each were included in a control group or groups subjected to continuous artificial gravity training on a short-arm centrifuge [30 minutes/day] or intermittent centrifugation [6x5 min/day]. We assessed cardiac morphology, function, strain and hemodynamics by cardiac-MRI (baseline, end of bedrest, recovery) and echocardiography (baseline, end of bedrest). Before and after bedrest, we assessed orthostatic heart rate responses as measure of cardiovascular deconditioning. Results: We conducted a pooled analysis because cardiovascular responses to bedrest did not differ between groups. Supine heart rate (baseline: 64±9.6bpm; bedrest: 72.3±10.5bpm; recovery: 69.6±10.5bpm, p <0.0001) and diastolic blood-pressure (69.6±7.3mmHg; bedrest: 78.5±6.9mmHg; recovery: 70.3±6.3mmHg, p <0.0001) increased with bedrest. With head-up tilt, heart rate increased 22.8±10.5bpm before and 45.9±213bpm at the end of bedrest ( p <0.0001) consistent with cardiovascular deconditioning. Cardiac-output decreased from 6.6±0.9l/min to 6±1l/min at end of bedrest (recovery: 6.8±1.2l/min, p =0.0096). Left ventricular ejection fraction and mass-index did not change. Echocardiographic global longitudinal strain (baseline: -19.90±2.1%; bedrest: -18.1±2.1%, p <0.0001) decreased, whereas global circumferential strain in MRI tended to increase (baseline: -18.6±1.7%; bedrest: -19.1±1.6%, p =0.0843). After four days of recovery MRI measurements had returned to baseline. Conclusion: In healthy persons, cardiovascular deconditioning through 60 days head-down-tilt bedrest does not lead to cardiac atrophy or sustained reductions in cardiac performance. The transient nature of cardiac strain changes suggests functional rather than structural changes in the heart.

Chromosome 2 Fragment Substitutions in Dahl Salt-Sensitive Rats and RNA Sequencing Identified Enpep and Hs2st1 as Vascular Inflammatory Modulators.

Chromosome 2 introgression from normotensive Brown Norway (BN) rats into hypertensive Dahl salt-sensitive (SS) background (SS-chromosome 2BN/Mcwi; consomic S2B) reduced blood pressure and vascular inflammation under a normal-salt diet (NSD). We hypothesized that BN chromosome 2 contains anti-inflammatory genes that could reduce blood pressure and vascular inflammation in rats fed NSD or high-salt diet (HSD). Four- to 6-week old male SS and congenic rats containing the BN chromosome 2 distal portion (SS.BN-[rs13453786-rs66377062]/Aek; S2Ba) and middle segment (SS.BN-[rs106982173-rs65057186]/Aek; S2Bb) were fed NSD or HSD (4% NaCl) up to age 12 to 13 weeks. Systolic blood pressure determined by telemetry was higher in SS rats fed HSD versus NSD. Systolic blood pressure was lower in both congenic rats than in SS under NSD, but similar under HSD versus SS. Reactive oxygen species generation using dihydroethidium staining, expression of vascular cell adhesion molecule-1 and monocyte chemoattractant protein-1, and immune cell infiltration by immunofluorescence demonstrated that S2Ba rats present less inflammation under NSD and more under HSD versus SS rats. RNA sequencing and reverse transcription-quantitative PCR identified 2 differentially expressed genes encoded within BN chromosome 2 distal portion that could act as regulators of vascular inflammation. These were downregulated glutamyl aminopeptidase (Enpep) that was anti-inflammatory under NSD and upregulated heparan sulfate 2-O-sulfotransferase 1 (Hs2st1) that was proinflammatory under HSD. In conclusion, 2 differentially expressed genes encoded within introgressed BN chromosome 2 distal fragment were identified: Enpep associated with reduced vascular inflammation under NSD, and Hs2st1, associated with increased vascular inflammation under HSD.

Repeatability of the 6-min walk test in non-cystic fibrosis bronchiectasis

Non-cystic fibrosis bronchiectasis (NCFB) is a chronic lung disease characterized by progressive and irreversible changes of the bronchial tree. The evaluation of exercise capacity is essential to manage this disease. This study aims to determine the within-subject repeatability of two Six Minute Walk Test (6MWT) in adults with NCFB. NCFB. This cross-sectional observational study included 66 NCFB subjects above 18 years-old (mean of 55 ± 17 years old, 68% women). 73% of the participants presented moderate to severe clinical condition classified by Bronchiectasis Severity Index. It showed that these participants walked 16.6 m less (95%CI 3.8 to 29.4; p < 0.01) in the second 6MWT when compared to the first test, with a within-subject coefficient variation of 9.4% (95%CI 7.2–11.2%) and an intra-test reliability with a high intraclass correlation coefficient of 0.88 (95%CI 0.80–0.93). Bland–Altman plot showed an agreement regarding test repeatability, besides presented a large limit of agreement (− 85 to 116 m). Respiratory rate and systolic blood pressure were significantly higher before starting the second test. In conclusion, 6MWT seems to be reproducible in NCFB subjects and vital sign verification should be attentively checked to assess if the patient is fully recovered to perform a second test, as well as the disease severity score. Other studies on this matter should be conducted with a larger number of participants to confirm the findings of the present study.

Evaluation of heart rate variability, blood pressure and lipid profile alterations from dual transceiver mobile phone radiation exposure

Electromagnetic fields have been reported to alter electrical activities in the brain and heart. However, there is paucity of information on the potential functional alterations that magnetic fields from mobile phone could cause to the heart. This study investigated heart rate variability (HRV), blood pressure (BP) and lipid profile in Wistar rats exposed to electromagnetic field radiation from a dual transceiver mobile phone (DTrMP). Twenty-one male albino Wistar rats (140-180g) were randomly assigned to two major groups positioned 5m apart as follows: control: no phone (n=7) and treatment group (n=14) continuously exposed to electromagnetic field from Tecno T312 DTrMP 900/1800MHz set in silence mode. Experimental treatment consisted in 10min calls/day, directed to this device for a period of six weeks. Seven animals from the treatment group were allowed to recover for a period of two weeks after exposure. HRV, systolic, diastolic and mean arterial BP were noninvasively investigated, while serum lipid profile and heart tissue nitric oxide (NO) activities were determined using standard procedures. There was significant (p<0.05) increase in systolic, diastolic, mean arterial BP and a decrease in HRV. Serum high density lipoproteins decreased, while total cholesterol, atherogenic indices, and heart NO levels increased significantly in the radiation exposed animals. The alterations observed in exposed animals remained unchanged even after the recovery period. These results suggest that exposure to electromagnetic radiation from dual transceiver mobile phones could be a risk factor to increase in blood pressure.

Artemisia restores systolic blood pressure, attenuates serum sodium/potassium levels and prevents cardiac oxidative stress in hypertension

PurposeThis paper aims to evaluate systolic blood pressure (SBP), serum sodium/potassium levels and cardiac antioxidants after Artemisia herba-alba oral administration in spontaneous hypertensive rats (SHR).Design/methodology/approachHypertension is a silent killer disease. The SHR model was used in this study due to the similarity of high blood pressure in human and rat. The SBP, serum sodium and potassium, urinary sodium and potassium, cardiac antioxidants and heart histology were examined in SHR after oral administration with 10 and 20% of the LD50 of Artemisia herba-alba during four weeks.FindingsThe LD50 of Artemisia herba-alba was found to be 1000 mg/kg. Doses of 100 mg/kg (10% LD50) and 200 mg/kg (20% LD50) were considered in the present study. The oral administration of SHR rats with Artemisia extract at 100 and 200 mg/kg decreased (p < 0.01) the body weights, SBP and serum sodium and potassium. Meanwhile, cardiac superoxide dismutase and gluthatione peroxidase were increased in SHR-treated rats. Histology of SHR cardiac tissues showed tissue degenerative but oral intake of 100 and 200 mg/kg artemisia exhibited normal muscle fibers, acidophilic cytoplasm and central nuclei.Originality/valueThe cardiovascular diseases are the first reason for high death rate in Western countries and collapsing economies due to hypertensive patients suffering high health-care costs. The advantage of hypertension Herba l treatment occurred due to its cheap and available source. Artemisia herba-alba leaves restored SBP, attenuated serum sodium/potassium levels and prevented cardiac oxidative stress in SHR.

Therapeutic Effects of Hydro-alcoholic Extract of Papaver Rhoeas on Cardiovascular side effect of MIA Induced Osteoarthritis in male Rat

In this study 'Therapeutic Effects of Hydro-alcoholic Extract of Papaver Rhoeas on Cardiovascular side effect of MIA Induced Osteoarthritis in male Rat is investigated. OA model in 35 male rats was created by injection of monosodium iodoacetate(MIA) into the right knee joint and then gavage with extract of Papaver Rhoeas for14 days, on day 30 The veins and arteries of the animal were then for injection and then Blood pressure parameters (systolic, diastolic, mean arterial pressure) were recorded and analysis effect of cholinergic and niterergic system .The results were analyzed by SPSS software. The effect of oral extracts of Papaver Rhoeas (200 mg/kg Dosage) on Systolic, diastolic, mean arterial pressure (mmHg) and heart rate (Beat/min) reduced compared with negative group (P <0/05). According to findings, extract of Papaver Rhoeas has a decreasing effect on blood pressure in rats with OA and have been observed at 200mg/kg doses, the least joint damage and the best physiological function of the heart. This effect may be due to inhibition of the niterergic and cholinergic system.

Compared presentation, management and long-term outcomes after acute myocardial infraction in men and women &amp;lt;50 years of age. The FAST-MI programme

Abstract The number of young women suffering acute myocardial infarction (AMI) is increasing. There are conflicting results on the prognostic impact of gender in young patients with AMI. The aim of the present study was to assess in-hospital and 5-year outcomes in men and women ≤50 years old admitted for AMI and participating in the FAST-MI programme. Methods FAST-MI consists in one-month nationwide French surveys of patients admitted for a recent AMI, repeated every 5 years since 2005. We used the 2005, 2010 and 2015 data with up to 5-year follow-up, to describe baseline characteristics and outcomes according to gender in young patients. Of 13,130 patients included, 1,912 were ≤50 years old (335 women, 17.5%). Results Men and women had a similar age (44±5 years), BMI, current smoking (72% vs 75%), diabetes, family history, prior history of CVD, GRACE score (104±22 vs 106±23), and LVEF (54±10%). LDL at admission was lower in women (127±46 vs 138±46 mg/dl). Women had a higher admission heart rate (81±19 vs 78±17 BPM) and lower systolic blood pressure (133±26 vs 136±25 mm Hg). Presenting AMI was STEMI in 63% in women vs 68% in men (P=0.08). All in-hospital complications except reinfarction (1.8 vs 0.6%, p&amp;lt;0.03) were similar in women and men; in-hospital death was 1.5% vs 0.8%, P=0.20. Coronary angiography was performed slightly less often (97.6% vs 99.0%, P=0.047) and more women had non-significant coronary artery disease (CAD) (13% vs 6%, P&amp;lt;0.001); PCI was less often used (74% vs 85.5%, P&amp;lt;0.001). At discharge, ESC guidelines-recommended medical treatment was less often prescribed in women (41% vs 53%, P&amp;lt;0.001), even in patients with significant CAD (46% vs 55%, P=0.004). Kaplan-Meier 5-year survival did not differ in women (94.7%) and men (95.2%), P=0.56 (Figure). The respective figures for hospital survivors were 96.1% and 96.0% (HR 1.00, 95% CI 0.52–1.91; HR adjusted on age, type of MI, previous history of CAD, presence of significant CAD, LVEF, Killip class and appropriate medications at discharge: 0.99, 95% CI 0.51–0.92). Similar results were found for the combined end-point of death, AMI or stroke. Conclusion There were more similarities than differences between women and men who sustained an AMI at age ≤50 years. Women had lower LDL-c, lower haemoglobin, higher heart rate and lower blood pressure on admission. Non-significant CAD was more frequently found in women, who were less often treated with PCI and recommended medications at discharge. Five-year outcomes, however, did not differ according to gender. Five-year mortality Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Pfizer, MSD, AstraZeneca

The Impact of hs-CRP on Cardiovascular Risk Stratification in Pilots and Air Traffic Controllers.

INTRODUCTION: We assessed determinants of serum hs-CRP level in pilots and air traffic controllers (ATCs) and its impact on their atherosclerotic cardiovascular disease (ASCVD) risk.METHODS: We obtained serum hs-CRP measurements, evaluated traditional cardiovascular risk factors and assessed global ASCVD risk based on 2018 ESH/ESC guidelines. Elevated hs-CRP was hs-CRP values > 3 mg L1. Determinants of elevated hs-CRP were assessed using stepwise logistic regression analysis. We used the net reclassification method to evaluate the impact of hs-CRP levels on global ASCVD risk.RESULTS: Of the 335 subjects (mean age 45.4 11.6 yr, 70% pilots, 99% men, 37% Caucasians), 127 individuals (39.5%) presented with elevated hs-CRP levels. Compared to those with normal hs-CRP, individuals with elevated hs-CRP were older with faster heart rate and higher blood pressure, BMI, and P wave amplitude. The proportion of individuals with elevated hs-CRP was greater among those with smoking habits, physical inactivity, MetS, tachycardia, altered P wave axis, LVH, and HT-TOD. Aging (aOR 2.15 [1.676.98]), hypertension (aOR 3.88 [2.296.58]), type 2 diabetes (aOR 6.71 [1.7710.49]), tachycardia (aOR 2.03 [1.914.53]), and LVH (aOR 2.13 [1.647.11]) were the main factors associated with elevated hs-CRP levels. Low, moderate, high, and very high risk were observed in 24 (15%), 68 (41%), 62 (37%), and 12 (7%) subjects, respectively. Including hs-CRP resulted in the net reclassification of 25% of subjects, mostly from moderate to high risk.CONCLUSION: The integration of hs-CRP improved the estimation of global ASCVD risk stratification. However, a survey with a comprehensive population assessing the cost/benefit impact of such a referral is needed.Buila NB, Ntambwe ML, Mupepe DM, Lubenga YN, Bantu J-MB, Mvunzi TS, Kabanda GK, Lepira FB, Kayembe PK, Ditu SM, MBuyamba-Kabangu J-R. The impact of hs-CRP on cardiovascular risk stratification in pilots and air traffic controllers. Aerosp Med Hum Perform. 2020; 91(11):886891.

The unexpected role of PI3-kinase gamma in pulmonary hypertension

Abstract Introduction Pulmonary hypertension (PH) is a pulmonary vascular disease that is associated with unacceptably high morbidity and mortality. PH is characterized by chronically increased pulmonary arterial pressure, increased pulmonary vascular resistance and right ventricular (RV) dysfunction and hypertrophy. Underlying mechanisms include increased proliferation and reduced apoptosis of both vascular smooth muscle cells (SMC) and endothelial cells (EC), as well as dysregulated immune responses. We have previously shown that class IA phosphatidylinositol-3-kinase (PI3K) isoforms, activated via receptor tyrosine kinases, are critically involved in the pathogenesis of PH. However, recent findings suggest that the class IB isoform PI3Kγ, which is activated downstream of G protein coupled receptors, is also important. It has been shown that PI3Kγ is involved in numerous processes that promote both vascular remodelling and maladaptive cardiac hypertrophy, including leukocyte recruitment, expression of proinflammatory chemokines and cytokines, as well as SMC and EC proliferation and survival. Therefore, the aim of our study was to investigate the role of PI3Kγ in the pathogenesis of PH. Methods The impact of PI3Kγ on the pathogenesis of PH was analysed in vivo using mice expressing a catalytically inactive form of PI3Kγ (PI3KγKD/KD) in the hypoxia-induced mouse model of PH. Mice were kept at 10%O2 (HOX) for 21 days or left under normoxic conditions (NOX). Subsequently, systolic right ventricular pressure (RVSP) was measured with a pressure catheter. RV hypertrophy was expressed as the ratio of RV weight to left ventricular + septum weight. Migration and proliferation of human pulmonary arterial SMC (hPASMC) as well as EC (hMVEC) were analysed using a PI3Kγ isoform-specific inhibitor (AS605240 [0.1; 0.3; 1μM]). Chemotaxis was determined by means of a modified Boyden chamber, and proliferation was quantified by a Bromodeoxyuridine (BrdU) incorporation assay. Results Whereas PI3Kγ inactivation had no effect on NOX animals, hypoxia led to increased RVSP and RV hypertrophy in WT animals (34.67±2.02 mmHg; 0.38±0.087) which were unexpectedly further increased in PI3KγKD/KD mice (37.67±1.3 mmHg, p=0.0104 vs. HOX WT; 0.47±0.06, p=0.0155 vs. HOX WT). Heart rate and systemic blood pressure remained unchanged. Inhibition of PI3Kγ by means of AS605240 did not affect proliferation of hPASMC and hMVEC, induced by multiple stimuli (FCS [10%], PDGF-BB [30ng/ml], or CXCL12 [100ng/ml], VEGF [50ng/ml]), respectively. However, FCS-induced migration of these cells was significantly reduced by AS605240 [0.3μM] (p&amp;lt;0.05). Conclusion Contrary to our expectations, the results show that kinase inactivation of PI3Kγ was not able to attenuate the pathogenesis of PH, but surprisingly led to a significant increase without critically changing cellular responses of SMC and EC. Therefore, our results indicate an unexpected protective effect of PI3Kγ on PH. Funding Acknowledgement Type of funding source: None

The mechanisms of age-realted difference of annual changes in ankle-brachial pressure index

Abstract In addition to both pulse wave velocity (PWV; a marker of arterial stiffness) and augmentation index (AI; a marker of central hemodynamics), not only the decrease of ankle-brachial pressure index (ABI) but also its increase predict the future cardiovascular events. While arterial stiffness and central hemodynamics have been proposed to affect the increase in ABI logically, their effects on increase in ABI have not been fully clarified. The present cross-sectional and longitudinal studies were conducted to examine the associations of arterial stiffness and central hemodynamics with increase in ABI and also examine the age-related difference of those associations. In 4016 men (42±9 years old), ABI, brachial-ankle PWV (baPWV) and radial AI (rAI) were measured annually for 9 years' observation period. In the cross-sectional analyses adjusted with age, heart rate and mean blood pressure, both baPWV and rAI were associated with ABI in men aged &amp;lt;50, but not in men aged &amp;gt;50. As shown in Figure, ABI was annually increased in subjects aged &amp;lt;50 (n=2870), but not in those aged &amp;gt;50 (n=1146) during the follow-up period. The mixed model linear regression analysis (MMA) conducted in 9 years' annual repeated measurement data demonstrated that increased baPWV (estimate = 0.017, p&amp;lt;0.05) and increased rAI (estimate 0.254, p&amp;lt;0.05) were significant determinant of annual increase of ABI (p&amp;lt;0.01) in men aged &amp;lt;50, but not in men aged &amp;gt;50. In conclusion, the arterial stiffness and central hemodynamics may individually affect the increase in ABI in men aged &amp;lt;50, but not in men &amp;gt;50. Thus, further studies are needed to clarify whether ABI, arterial stiffness, and central hemodynamics individually predicts future cardiovascular events, and their age-related difference of their predictabilities. figure1 Funding Acknowledgement Type of funding source: Private hospital(s). Main funding source(s): Tokyo Medical University

Intraventricular hemodynamic forces do not differentiate between healthy controls and heart failure patients with preserved ejection fraction

Abstract Background Hemodynamic force analysis has been proposed as a noninvasive marker of cardiac function. In a recent study, longitudinal (apical-to-basal) hemodynamic forces were derived from anatomical MRI images and found decreased in heart failure with preserved ejection fraction (HFpEF) patients compared to controls, indicating a potential use for prognostication and testing of therapeutic response. This issue has not been investigated using the reference method of measurement. Purpose To investigate whether intraventricular hemodynamic forces computed using gold-standard cardiac magnetic resonance flow maps can reproducibly differentiate between healthy controls and HFpEF patients. Methods 4D flow data were acquired in 59 subjects through cardiac magnetic resonance imaging using a 1.5T scanner (Siemens Healthcare, Erlangen, Germany). Hemodynamic forces within the LV were computed across the cardiac cycle using the Navier-Stokes equation to find the global pressure gradient, which was then integrated over the LV volume to produce the instantaneous hemodynamic force (unit: Newton) and subsequently normalized to ventricular volume, resulting in a force-volume index (N/l). Average longitudinal forces (root mean square, FRMS) were quantified over the entire cardiac cycle, with and without volume normalization. Results We studied 33 healthy subjects, 14 patients with HFpEF, 6 patients with HFmEF and 6 patients with HFrEF. Groups were similar with regards to sex, cardiac output, heart rate, systolic and diastolic blood pressure, and body surface area. Volume-normalized FRMS did not differ between controls and HFpEF (0.86±0.19 vs. 0.75±0.19 N/l, p=0.08) while lower values were found in HFmEF (0.60±0.19 N/l, p=0.004) and HFrEF (0.38±0.15 N/l, p&amp;lt;0.0001) compared to controls (Figure 1A). There was a significant positive correlation between EF and FRMS, both for the entire population (R2 = 0.54, Figure 1B) and for patients (R2 = 0.67, p&amp;lt;0.0001 for both). Importantly, non-normalized FRMS did not differ between controls (Figure 1C, 0.10±0.03 N) and HFpEF (0.09±0.03 N, p=0.25), HFmEF (0.11±0.02 N, p=0.18) or HFrEF (0.09±0.02 N, p=0.67). Moreover, no correlation was seen between non-normalized FRMS and EF (Figure 1D). Conclusions Hemodynamic forces computed from reference standard 4D flow CMR data do not differentiate between healthy controls and HFpEF patients regardless of whether volume normalization is used or not. Our findings do not support a role for hemodynamic forces in HFpEF assessment. Figure 1. (A) Volume-normalized hemodynamic forces over the entire cardiac cycle (lines: average values, shaded area: ±1SD for HFpEF), and (B) variation of volume-normalized average force, FRMS, with left ventricular ejection fraction (LVEF). (C), (D): When indexing to LV volume was not performed, the differences between groups was attenuated, and no correlation was seen between EF and FRMS. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swedish Heart and Lung Foundation, Region of Scania