Cardiovascular Parameters In Patients Research Articles

A comparative study of the effects of aerobic and resisted exercises on selected cardiopulmonary parameters in patients with asthma

Asthma is a multi-factorial disease associated with genetic, allergic, environmental, infectious, emotional, and nutritional issues. Globally, asthma affects about 300 million people and about 250,000 people die from it every year. These deaths are related to lack of proper treatment. Treatment involves controlling trigger factors, drug therapy, and other non-pharmacological methods. Although a few studies have evaluated the effects of exercises on asthma control, there is the need for well-designed outcome studies that will differentiate efficacious exercise management for asthma from those that hold little therapeutic value. This study compared the effects of aerobic and resisted exercises on selected cardiopulmonary parameters in patients with asthma.Forty-five patients with asthma were recruited from the Respiratory Unit, Department of Medicine, Lagos University Teaching Hospital (LUTH), Lagos and were randomly assigned to 3 different groups. Group A underwent aerobic exercise and counselling sessions; Group B, resisted exercise and counselling sessions; and Group C had counselling sessions only. Groups A and B had exercise intervention that lasted 10-15 minutes, twice weekly for 6 weeks. Cardiopulmonary parameters were assessed at baseline and at the end of 6 weeks.Only Group B showed significant improvements in all the cardiovascular variables (SBP: p=0.01, DBP: p=0.03, HR: p=0.02 and RPP: p=0.01). There were also significant improvements in most of the pulmonary 1 1 variables of Group A (RR: p=0.01, FEV : p=0.01, FVC: p=0.01 and FEV %: p=0.02), however, there was none in Groups B and C. Comparison of the mean changes in selected variables between the two therapeutic exercise 1 groups showed significant differences in SBP (p=0.01), DBP (p=0.04), RPP (p=0.02), RR (p=0.01), FEV 1 (p=0.01), FVC (p=0.05), FEV % (p=0.01) and IC (p=0.05).Aerobic exercise was more effective in improving pulmonary parameters while resisted exercise was more effective in improving cardiovascular parameters in patients with asthma.Keywords: aerobic exercise, asthma, cardiopulmonary, resisted exercise

Prospective Analysis of the Relationship Between the State of Periodontal Tissues and Changes in Selected Cardiovascular Parameters in Patients with Type 2 Diabetes.

Periodontitis is considered a risk factor in many systemic diseases, including cardiovascular pathologies and diabetes. Diabetes can also exacerbate early vascular changes, mainly due to the synthesis of advanced glycosylation end-products and oxidative stress. It has not yet been fully explained whether the additional presence of periodontal disease can affect the course of atherosclerosis and left ventricle hypertrophy in diabetic patients. The aim of the study was to assess the relationship between periodontal and cardiovascular diseases and their progression in patients with type 2 diabetes. The study included 119 patients diagnosed with type 2 diabetes. Periodontal pocket depth (PD), clinical attachment loss (CAL), plaque index (PI) and bleeding index (BOP) were determined. Basic laboratory tests were performed. The intima-media thickness (IMT) and the left ventricular mass index (LVMI) were determined by means of ultrasonography. After one year the examinations were repeated. The statistical analysis included the 84 patients who took part in both the first and second examinations. A positive correlation between the number of deep and active periodontal pockets and LVMI value was observed in men. The IMT value correlated with the mean CAL, PI and BOP, while a negative correlation was found between the IMT and the number of deep pockets, as well as between the IMT and the number of retained teeth. A multivariate analysis demonstrated a significant correlation between CAL and both IMT and LVMI change after one year. A relationship between periodontitis and cardiovascular diseases has been confirmed in diabetic patients. The most significant periodontal parameter in relation to the progression of atherosclerosis and left ventricle hypertrophy was shown to be clinical attachment loss - a measure of the history of periodontal disease during the patient's lifetime.

The Development of Selected Cardiovascular Parameters in Patients With Type 2 Diabetes Mellitus During a Spa Treatment

Diabetes mellitus is not just a simple metabolic disorder, however, it is considered to be a cardiovascular disease of a metabolic origin. This is apparent especially when speaking about type 2 diabetes (DM II). The objective of our study was to determine whether a comprehensive spa treatment (procedures and drinking cure) may affect the level of the sympathetic tone of patients suffering from DM II. As an indicator of the sympathetic tone, selected electrocardiographic parameters derived from the heart rate variability and microwave alternans were chosen. There were 96 patients enrolled in our study: 38 patients with poorly controlled DM II and two control groups: 9 patients with compensated DM II and 49 patients, average age without diabetes or other disorders of the glucose metabolism. All received an identical spa treatment and continued their medical therapy. The electrophysiological examination of patients was performed before and after a three-week spa treatment using the KARDiVAR system. Parameters derived from the analysis of heart rate variability (HRV), microvolt T-wave alternans, and microvolt R-wave alternans were analyzed in order to evaluate the tones of the autonomic nervous system (ANS). The control group showed a slight increase of parameter the index of activity of regulatory systems (IRSA) (4.4+/-1.3 vs. 3.8+/-1.4; p=0.006) after the spa treatment, while increased heart rate (80.9+/-11.0 vs. 74.6+/-9.6; p=0.028), reduced index of centralization (IC) (1.3+/-0.6 vs. 2.9+/-1.4; p=0.027) and reduced index of myocardium (IM) (9.9+/-7.4 vs. 18.0+/-6.3; p=0.041) were found in patients with a compensated DM II. Patients with a poorly compensated DM II showed a decreased IM (10.9+/-8.6 vs. 16.9+/-5.2; p=0.001) and also a reduced IRSA (4.1+/-3.5 vs. 6.3+/-1.9; p=0.001). The results proved favorable changes in ANS cardiovascular control of patients with DM II after a spa treatment, especially in terms of reducing the sympathoadrenal system activity (decreased IRSA), improving electrical stability of the myocardium and increasing centrally controlled heart rate variability without overloading the cardiovascular system (drop of IM).

A Low-Volume Sodium Picosulfate and Magnesium Citrate Bowel Preparation Has No Effect on Cardiovascular Parameters in Patients Preparing for Colonoscopy

Introduction: Although rare, hypermagnesemia may occur in patients receiving magnesium (Mg2+)-containing cathartics when serum Mg2+ concentrations increase to levels outside the normal range, 0.7-1.05 mmol/L. Mild clinical manifestations of hypermagnesemia begin at serum Mg2+ levels of 1.5-2.0 mmol/L, become more profound with increasing concentrations, and are primarily associated with cardiac muscle depolarization. We performed a post-hoc analysis of 2 pivotal clinical trials to assess the effects of a Mg2+-containing bowel preparation on electrocardiographic conduction in patients. Methods: Data were obtained from 2 phase 3 randomized, multicenter, assessor-blinded studies that investigated split-dose (Rex DK, et al. Gastrointest Endosc. 2013;78:132) or day-before (Katz P, et al. Am J Gastroenterol. 2013;108:401) dosing of a nonphosphate, dual-action, low-volume preparation containing sodium picosulfate, magnesium oxide, and citric acid (P/MC) compared with per labelled dosing of 2L PEG solution and 2 5-mg bisacodyl tablets in adults preparing for colonoscopy. In this post-hoc analysis, patients who received P/MC were stratified by serum Mg2+ levels (within vs outside the normal range) on the day of colonoscopy. Cardiac electrical conduction was assessed by: heart rate, PR, QRS, QT, QTc-B, QTc-F, and RR intervals, via serial ECGs and interval measurements with central read provided by eResearch Technology, Inc. Results: A total of 304 patients received split-dose, and 294 patients received day-before P/MC and were included in this analysis. No patients with elevated Mg2+ experienced QTc-B or QTc-F intervals >500 msec. Five (0.8%) patients had a QTc-B or QTc-F interval increase >60 msec from baseline; all of these patients had Mg2+ levels within the normal range. PR and QRS intervals were similar between patients with normal and abnormal Mg2+ levels, regardless of dosing regimen. On the day of colonoscopy, 11% (split-dose) and 9% (day-before dose) of patients had serum Mg2+ concentrations outside of the normal range (>1.05 mmol/L). Patients with increased serum Mg2+ levels did not have any clinically significant changes in cardiac function or electrophysiology. All serum Mg2+ levels returned to baseline 24-48 hours post colonoscopy. There were no reported cardiovascular treatment-emergent adverse events related to P/MC at the time of colonoscopy or at follow-up visits. Conclusion: Treatment with P/MC did not clinically alter electrocardiographic conduction in any patient preparing for colonoscopy, regardless of serum Mg2+ concentrations. Disclosure: Supported by funding from Ferring Pharmaceuticals Inc, Parsippany New Jersey. Editorial support was provided by The JB Ashtin Group, Inc. Disclosure - Dr Bertiger has served as a consultant for Ferring Pharmaceuticals Inc. Dr Epstein has received grant/research support, participated in speakers’ bureaus, and/or acted as a consultant for Abbott Laboratories, Otsuka Pharmaceuticals, Promethius, and Sucampo. Dr Marshall, Dr Dahdal, and Dr Joseph are employees of Ferring Pharmaceuticals Inc.

A single bout of resistance exercise does not modify cardiovascular responses during daily activities in patients with peripheral artery disease

To analyze the posteffects of a single bout of resistance exercise on cardiovascular parameters in patients with peripheral artery disease (PAD). Randomized cross-over. Seventeen PAD patients performed two experimental sessions: control (C) and resistance exercise (R). Both sessions were identical (eight exercises, 3×10 repetitions), except that the R session was performed with an intensity between 5 and 7 in the OMNI-RES scale and the C session was performed without any load. Systolic blood pressure (BP), diastolic BP, heart rate, and rate-pressure product (RPP) were measured for 1 h after the interventions in the laboratory and during 24-h using ambulatory BP monitoring. After the R session, systolic BP (greatest reduction: -6±2 mmHg, P<0.01) and RPP (greatest reduction: -888±286 mmHg×bpm; P<0.01) decreased until 50 min after exercise. From the second hour until 23 h after exercise, BP, heart rate, and RPP product were similar (P>0.05) between R and C sessions. BP load, nocturnal BP fall, and morning surge were also similar between R and C sessions (P>0.05). A single bout of resistance exercise decreased BP and cardiac work for 1 h after exercise under clinical conditions, and did not modify ambulatory cardiovascular variables during 24 h in patients with PAD.

Bioimpedance spectroscopy for assessment of fluid overload

Hur et al. report that fluid management guided by bioimpedance spectroscopy devices might improve cardiovascular parameters in patients on haemodialysis. However, caution is advisable when using these devices for extracellular volume assessment as overzealous reduction of target weights based on extracellular to intracellular volume ratios could cause premature loss of residual renal function.

Evaluation of a computerized cardiovascular simulation system using patient-specific data

Objectives: Different medical devices are used for the permanent monitoring of cardiovascular parameters in patients treated in the intensive care unit (ICU) following cardiac surgery. Syringe pumps achieve a continuous administration of cardiovascular-active drugs. Recently, we reported about the development of a computerized cardiovascular simulation including an automated controller to regulate the administration of cardiovascular-active drugs. Now, ICU data were collected from patient monitors, syringe pumps and medical records to evaluate the efficiency of the developed simulation.

Correlation between the state of periodontal tissues and selected cardiovascular parameters in patients with type 2 diabetes

Introduction: t ype 2 diabetes and periodontitis are chronic diseases with a two-way interrelation - ship. Periodontitis is a chronic inflammatory disease increasing the risk of cardiovascular complica- tions. Aim of the study: t o assess the impact of the state of periodontal tissues on selected cardiovascular parameters in patients with type 2 diabetes. Material and methods: the study included 84 patients with type 2 diabetes who were treated at the Clinical Department of internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of interior in warsaw. the patients had the following parameters determined: periodontal pocket depth, clinical attachment loss, plaque index, bleeding index, iMt, LVMi and systemic arterial pressure. Results: the periodontal status of patients treated for type 2 diabetes was unsatisfactory, high values of periodontal parameters were observed. in a follow-up observation after one year, the clinical condition of periodontium was significantly deteriorated. there were correlations between the number of teeth and clinical attachment loss on the one hand and iMt on the other hand (p < 0.05). Conclusions: Periodontitis in patients with type 2 diabetes may impact an increase of iMt (inti- ma-media thickness), which confirms the association between periodontitis and cardiovascular diseases.

Combination of coronary heart disease, chronic heart failure, and anaemic syndrome: clinical features and prognostic impact of anaemia treatment

Practitioners are often faced with a combination of coronary heart disease (CHD), chronic heart failure (CHF), and anaemic syndrome. These patients are typically characterised by a worse prognosis of acute and chronic CHD, as well as by a rapid progression of CHF and chronic renal failure (CKF). This review is focussed on the epidemiology of anaemia in CHD and CHF patients; the aetiology and pathogenesis of anaemia in CHD and CHF; and the changes of cardiovascular parameters in patients with anaemic syndrome. Despite the abundance of studies on CHD and CHF clinical course and prognosis in anaemic syndrome, very little is known about the effects of anaemia treatment on the clinical course and prognosis of CHD. The review presents the external evidence and original results on the prognosis of acute and chronic CHD in anaemic patients. A modern view on anaemia treatment in various CHD forms is also presented.

Article 11 The Impact of Locomotor Training on Cardiovascular Parameters in Patients with Incomplete Spinal Cord Injury

To examine cardiovascular health in a large cohort of individuals with incomplete spinal cord injury before and after Locomotor Training. Pre-Post Test. Out-Patient Locomotor Training Clinics within the Christopher and Dana Reeve Foundation NeuroRecovery Network. Three hundred and fifty individuals with incomplete American Spinal Injury Association Impairment Scores (AIS) C and D. Locomotor Training (LT). Heart rate, systolic and diastolic blood pressure during resting sitting, supine positions and after an orthostatic challenge before and after LT. Cardiovascular (CV) parameters significantly differed based on patient position. Neurological level (cervical, high and low thoracic) and age were most commonly associated with CV parameters where patients at the cervical level had the lowest resting CV parameters. After the othostatic challenge, blood pressure (BP) was highest for the low thoracic group and heart rate (HR) for the high thoracic group was higher. Time since SCI was negatively related to BP at rest but not after orthostatic challenge. Men exhibited higher SBP than women and lower HR. After LT for patients retested for CV parameters (n=151), diastolic BP and HR in supine (prior to orthostatic challenge) significantly decreased, and HR in the seated position (after orthostatic challenge) significantly decreased. Resting cardiovascular parameters of BP and HR are affected by position, age and neurological level. Changes in CV parameters as a result of LT were reduced on the average except for SBP. Results from this study provide reference for CV parameters for individuals with incomplete SCI.

Immediate effect of chandra nadi pranayama (left unilateral forced nostril breathing) on cardiovascular parameters in hypertensive patients

Introduction:Recent studies have reported differential physiological and psychological effects produced by exclusive right and left nostril breathing and clinical research is required to prove immediate and sustained efficacy of these techniques in various psychosomatic conditions such as hypertension (HT). The present study was designed to determine immediate effects of 27 rounds of exclusive left nostril breathing, a yogic pranayama technique known as chandra nadi pranayama (CNP) on cardiovascular parameters in patients of essential HT.Materials and Methods:Twenty two patients of essential HT under regular standard medical management were individually taught to perform CNP by a qualified yoga instructor with a regularity of 6 breaths/min throughout a performance of 27 rounds of CNP. Pre and post intervention heart rate (HR) and blood pressure (BP) measurements were recorded using non-invasive semi-automatic BP monitor and Students t test for paired data used to determine significant differences.Results:Twenty seven rounds of CNP produced an immediate decrease in all the measured cardiovascular parameters with the decrease in HR, systolic pressure (SP), pulse pressure, rate-pressure product and double product being statistically significant. Further, gender-based sub-analysis of our data revealed that our male participants evidenced significant reductions in HR and SP with an insignificant decrease in diastolic pressure, while in female participants only HR decreased significantly with an insignificant decrease in SP.Discussion and Conclusion:It is concluded that CNP is effective in reducing HR and SP in hypertensive patients on regular standard medical management. To the best of our knowledge, there are no previously published reports on immediate effects of left UFNB in patients of HT and ours is the first to report on this beneficial clinical effect. This may be due to a normalization of autonomic cardiovascular rhythms with increased vagal modulation and/or decreased sympathetic activity along with improvement in baroreflex sensitivity. Further studies are required to enable a deeper understanding of the mechanisms involved as well as determine how long such a BP lowering effect persists. We recommend that this simple and cost effective technique be added to the regular management protocol of HT and utilized when immediate reduction of BP is required in day-to-day as well as clinical situations.

Metabolische und Herz-Kreislauf-Auswirkungen von Muskelaktivität, Sport und Fitness bei Typ-2-Diabetes

Diabetes mellitus has reached epidemic proportions worldwide and is associated with an increased risk of cardiovascular disease and premature mortality. Chronic hyperglycemia is the clinical manifestation of diabetes and evolves through a multifactorial etiology of genetic, environmental, and behavioural factors. In the pathogenesis of type 2 diabetes, insulin resistance of the liver, skeletal muscle and fat as well as the inability of insulin secreting beta-cells to fully compensate for this insulin resistance are the central pathophysiological events. There are several lines of scientific evidence demonstrating a role of physical inactivity in the etiology and beneficial effects of exercise in both prevention and treatment of type 2 diabetes and its related morbidity. This review is focussing on recent studies that have examined the effects of increased physical activity and fitness on metabolic and cardiovascular parameters in patients with type 2 diabetes.

Low-Dose Physiological Growth Hormone in Patients With HIV and Abdominal Fat Accumulation

Antiretroviral therapy can be associated with visceral adiposity and metabolic complications, increasing cardiovascular risk, and reduced growth hormone (GH) secretion may be a contributing factor. To investigate the effects of low-dose physiological GH administration on body composition, glucose, and cardiovascular parameters in patients with human immunodeficiency virus (HIV) having abdominal fat accumulation and relative GH deficiency. A randomized, double-blind, placebo-controlled trial of 56 patients with HIV, abdominal fat accumulation, and reduced GH secretion (peak GH <7.5 ng/mL) conducted at a US academic medical center between November 2003 and October 2007. Patients were randomly assigned to receive either subcutaneous GH or matching placebo titrated to the upper quartile of normal insulinlike growth factor 1 (IGF-1) range for 18 months. Starting dose was 2 microg/kg/d and increased to maximum dose of 6 microg/kg/d (average dose, 0.33 mg/d). Change in body composition assessed by computed tomographic scan and dual-energy x-ray absorptiometry. Secondary outcomes included glucose, IGF-1, blood pressure (BP), and lipids. Treatment effect was the difference in the change between GH and placebo groups, using all available data. Fifty-five patients (26 with GH and 29 with placebo) were included in the safety analyses and 52 patients (25 with GH and 27 with placebo) were included in the efficacy analyses. Visceral adipose tissue area (treatment effect [last-value-carried-forward analysis {n = 56}, -19 cm(2); 95% confidence interval {CI}, -37 to -0.3 cm(2)], -19 cm(2); 95% CI, -38 to -0.5 cm(2); P = .049); trunk fat (-0.8 kg; 95% CI, -1.5 to -0.04 kg; P = .04); diastolic BP (-7 mm Hg; 95% CI, -11 to -2 mm Hg; P = .006); and triglycerides (-7 mg/dL, P = .002) improved but 2-hour glucose levels on glucose tolerance testing increased in the GH group vs the placebo group (treatment effect, 22 mg/dL; 95% CI, 6-37 mg/dL; P = .009). The IGF-1 levels increased (treatment effect, 129 ng/mL; 95% CI, 95-164 ng/mL; P < .001). Adverse events were not increased for GH vs placebo (23%; 95% CI, 9%-44% vs 28%; 95% CI, 13%-47%; P = .70). In HIV-associated abdominal fat accumulation and relative GH deficiency, low-dose GH received for 18 months resulted in significantly reduced visceral fat and truncal obesity, triglycerides, and diastolic BP, but 2-hour glucose levels on glucose tolerance testing were increased. clinicaltrials.gov Identifier: NCT00100698.

6.12 Long-Term Effects of Pharmacological and Surgical Treatment on Cardiovascular Parameters in Patients with Primary Aldosteronism

6.12 Long-Term Effects of Pharmacological and Surgical Treatment on Cardiovascular Parameters in Patients with Primary Aldosteronism

Benefit of Combined Cardiac Rehabilitation on Exercise Capacity and Cardiovascular Parameters in Patients with Type 2 Diabetes

Favorable effects of exercise training on cardiovascular prognosis have been reported repeatedly in patients with diabetes mellitus type 2 (DM2). However, little is known about the cardiovascular rehabilitation effects in diabetic patients with coronary artery disease (CAD). This study has evaluated the benefits of combined aerobic-resistance training in two groups of patients--diabetics and non-diabetics--after percutaneous coronary intervention (PCI). Changes in exercise capacity parameters, resting cardiovascular and anthropometrical parameters were evaluated in 77 patients who completed 12-weeks of combined aerobic-resistance training: 32 patients with DM2 (DM) and 45 patients without DM2 (NDM). Significant improvements in exercise capacity (total peak workload [W(peak)], peak workload per kg of body weight [W(peak)/kg], total peak oxygen uptake [VO(2peak)], peak oxygen uptake per kg of body weight [VO(2peak)/kg]) were found in both DM and NDM (p < 0.01 and p < 0.001, respectively). The decrease in resting heart rate (HR(rest)), resting systolic (SBP(rest)) resting diastolic (DBP(rest)) blood pressures, body weight (BW) and BMI in the DM group was not statistically significant. However, there was a statistically significant decrease in SBP(rest), BW and BMI in the NDM group. In conclusion, this study demonstrated similar beneficial effects of combined cardiovascular training on exercise capacity in patients with or without type 2 diabetes mellitus. Our results suggest that the combined cardiac training is well tolerated and useful in secondary prevention in patients with DM2 and CAD.

P.2.003 Effects of modern antidepressants with different mode of action on cardiovascular parameters in patients with major depressive disorder and response to treatment

P.2.003 Effects of modern antidepressants with different mode of action on cardiovascular parameters in patients with major depressive disorder and response to treatment

Cardiac Effects of Growth Hormone Treatment in Chronic Heart Failure: A Meta-Analysis

Experimental studies suggest that GH treatment may improve cardiovascular parameters in chronic heart failure (CHF). However, clinical trials involved small numbers of patients and did not allow a conclusion to be drawn on the effect of this treatment in humans. We systematically reviewed and analyzed all randomized controlled trials and open studies of sustained GH treatment in CHF. Twelve trials were identified in three databases. We conducted a combined analysis of GH effects on cardiovascular parameters using the overall effect size to evaluate significance and computing the weighted mean differences with and without treatment to assess effect size. GH treatment significantly modified morphological cardiovascular parameters [interventricular septum thickness, +0.55 (sd, 0.43) mm (P < 0.001); posterior wall thickness, +1.01 (0.44) mm (P < 0.01); left ventricle (LV) end-diastolic diameter, -2.02 (1.22) mm (P < 0.01); and LV end-systolic diameter, -5.30 (2.33) mm (P < 0.05)]; LV and systemic hemodynamics [LV end-systolic wall stress, -38.9 (13.3) dynes/cm(2) (P < 0.001); LV ejection fraction, +5.10 (1.74)% (P < 0.05); and systemic vascular resistance, +195.0 (204.5) dyn x sec(-1) x cm(-5) (P < 0.01)]; and functional parameters [New York Heart Association class, -0.97 (0.23) (P < 0.01); exercise duration, +103.7 (37.6) sec (P < 0.001); and maximal oxygen uptake, +2.48 (1.76) ml/kg x min (P < 0.01)]. Subgroup analysis and meta-regression showed significant relationships between the IGF-I response and GH treatment effects. Our meta-analysis suggests that GH treatment improves several relevant cardiovascular parameters in patients with CHF. However, these results must be confirmed by a large randomized placebo-controlled trial on hemodynamic, morphological, and functional parameters during long-term high-dose GH treatment of patients with CHF.

The concept of raynaud's phenomenon of the lung revisited

Having observed that a cold pressor test (CPT) induces a decrease in carbon monoxide single breath diffusing capacity (DLco) in normal subjects contrary to the findings of Fahey et al (Am J Med. 1984; 76:263-269), we compared the response to CPT for the two types of Raynaud's phenomenon. Two groups of 8 patients suffering from primary or secondary Raynaud's phenomenon were examined. Single breath diffusing capacity, mean pulmonary artery pressure (PAP), cardiac output (CO), pulmonary capillary wedge pressure (PwP), and pulmonary vascular resistance (PVR) were measured before and 30 minutes after CPT, which consisted of immersing both hands in a water bath at 12 degrees C for 2 minutes. Cold pressor testing induced no change in DLco or cardiovascular parameters in patients with secondary Raynaud's phenomenon. Conversely, in patients with the primary form, it induced a significant decrease in DLco (16%), PAP (20%), and PVR (27%), whereas CO and PwP remained unaltered. The concept of pulmonary Raynaud's phenomenon had to be reconsidered, as it is also observed in normal subjects, and is due to a vasodilatation and not to a vasoconstriction of the pulmonary artery (Frans et al, J Appl Physiol. 1994; 76:750-755). In patients with primary Raynaud's phenomenon, the decrease in DLco is not only a physiological response, but a pathological response to a CPT, as it is significantly more marked in patients than in control subjects (16% versus 10% for controls, same reference). The contribution by Fahey et al remains important, however, in that it allows assessing whether a patient with Raynaud's phenomenon suffers from the primary or secondary form of the disease.

Cholesterol Changes in Smoking Cessation Using the Transdermal Nicotine System

Background. Cigarette smoking is a well-known major risk factor in coronary heart disease. Smoking cessation results in a positive change in atherogenic factors. High-density lipoprotein cholesterol has been observed as increasing with smoking cessation. Since the use of nicotine transdermal replacement has become so widespread, this study examined the effect, if any, of the transdermal nicotine system on selected cardiovascular parameters in patients who were abstinent from cigarette smoking, and possible dose effect. Methods. Eight cardiovascular outcome measures were evaluated at baseline and Week 6 in both abstinent and nonabstinent patients randomized to four treatment groups; transdermal nicotine system 7 mg, 14 mg, and 21 mg per day, and placebos. Results. In abstinent patients, systolic blood pressure and heart rate decreased from baseline (while still smoking, before the start of the study) to the end of transdermal treatment, while weight increased. Similarly, HDL increased while LDL decreased and triglycerides increased. In nonabstinent patients, weight also increased from baseline to Week 6 while heart rate decreased. No other variables showed significant change. In abstinent patients, effect of nicotine dosage was observed with greater weight gain in placebo than 21 mg TTS patients and greater decrease in heart rate in placebo than 21 mg TTS patients. Conclusions. In summary, the abstinent patients showed a positive effect of smoking cessation on cardiovascular risk factors even while using the transdermal nicotine system. These findings are favorable since the transdermal nicotine system has become a useful method of nicotine replacement in smoking cessation programs.

Effect of Bronkosol and its components on cardiopulmonary parameters in asthmatic patients

Bronkosol and its components, isoetharine hydrochloride and phenylephrine hydrochloride, were compared in a double-blind randomized fashion for their effect on pulmonary and cardiovascular parameters in patients with reversible bronchospasm. Bronkosol and isoetharine produced significant bronchodilatation as measured by forced expiratory volume in one second (FEV 1 ), forced vital capacity (FVC), and mean forced expiratory flow during the middle half of the FVC (isovolume FEF 25% to 75%), and phenylephrine did not. There was no difference between Bronkosol and isoetharine in the degree or duration of bronchodilatation. Significantly more patients had to “discontinue” after 15 min on the day of testing with phenylephrine than with Bronkosol or isoetharine. Heart rate was not increased after Bronkosol or isoetharine, confirming its selective beta-2 action. The addition of phenylephrine to isoetharine had no beneficial effect on oxygen saturation. There was no significant difference between these drugs in systolic and diastolic blood pressure, pulse, or respiration. The results of this study cast doubt on the useful contribution of phenylephrine in Bronkosol.