Changes In Cardiovascular Parameters Research Articles

Phase 3 efficacy and safety trial of proposed liraglutide biosimilar for reduction of glycosylated hemoglobin (HbA1c) in patients with Type 2 diabetes mellitus

Liraglutide is indicated for glycaemic control in adults with Type 2 diabetes mellitus (T2DM) as an adjunct to diet and exercise. A proposed biosimilar of liraglutide (Levim Liraglutide) was investigated for efficacy & safety in a phase 3 study against the originator reference liraglutide (Victoza®) manufactured by Novo Nordisk A/S, Denmark. Patients aged 18–65 years of age with glycosylated hemoglobin (HbA1c) between 7 and 10 %, among other criteria, were included in the study. Patients were randomized 1:1 to receive daily doses of either Levim liraglutide or reference liraglutide for 24 weeks. The least square mean (standard error, SE) for the primary efficacy endpoint of reduction in HbA1c% at Week 24 was −1.09 (0.15)% for Levim liraglutide group and −1.04 (0.14)% for reference liraglutide. The upper bound of the confidence interval for treatment difference was less than the non-inferiority margin of 0.4 % at one-sided alpha of 0.025 (P-value = 0.0003). The secondary endpoints for proportion of patients achieving reduction in HbA1c, glycaemic level and weight, changes in cardiovascular parameters and the overall safety profiles of the study drugs were comparable. Levim liraglutide demonstrated non-inferior efficacy and similar safety to reference liraglutide and may be an option in treatment of T2DM (CTRI.nic.in, no. CTRI/2022/02/040261).

Comparison of Baseline and Test Day Cardiovascular Parameters, Anxiety Scores and Coffee Consumption Among Medical Students Undergoing Objective Structured Clinical Examinations in Jordan.

Objective Structured Clinical Examinations (OSCEs) are considered an integral part of the assessment process of many schools of medicine worldwide. Close monitoring by examiners, scrutinized interactions with patients, and fear of the unknown, among other factors have been reported to cause psychological stress among students during the examinations period. In this study, we aimed to assess changes in cardiovascular parameters, anxiety scores, and lifestyle patterns of medical students during their OSCEs as compared to their baseline. We recruited healthy medical students from our institution's medical school. General demographics, academic, and baseline lifestyle characteristics were collected 1-2 months before the OSCE day. The Generalized Anxiety Disorder 7-item (GAD-7) scale was used to measure anxiety symptoms. Data related to coffee consumption in addition to systolic, diastolic blood pressure and heart rate measurements were collected both at baseline and on OSCE day. This study included 325 students (144 (44.3%) males and 181 (55.7%) females). The mean systolic blood pressure, diastolic blood pressure, and heart rate measurements were significantly higher on OSCE day as compared to the baseline. In addition, the daily consumption of coffee increased significantly during OSCE day as compared to the baseline. Although the anxiety score increased during OSCE day compared to the baseline, the difference was not statistically significant. However, the change in anxiety score (OSCE day - baseline) was significantly higher in females compared to males. In our study, we observed significant increases in blood pressure, heart rate, and coffee intake on the day of the test compared to baseline measurements. These findings underscore the significance of implementing measures to reduce the harmful effects of stress on students during exam preparations and medical school assessments.

Does Adding the Pulmonary Infarction and Right Ventricle to Left Ventricle Diameter Ratio to the Qanadli Index (A Combined Qanadli Index) More Accurately, Predict Short-Term Mortality in Patients with Pulmonary Embolism?

Background The Qanadli index can be used to assess the severity of pulmonary arterial involvement in patients with acute pulmonary embolism. However, it seems that considering pulmonary infarction and right ventricle/left ventricle (RV/LV) ratio along with this index (called the combined Qanadli index) can provide a more accurate view of changes in cardiovascular parameters in these patients and help predict mortality in a better manner. In this regard, we evaluated the ability of the combined Qanadli index versus the Qanadli index in predicting short-term mortality in patients with pulmonary embolism. Methods This retrospective study enrolled 234 patients with acute pulmonary embolism. Patients were divided into two groups: those who expired in 30 days and who survived. Then they were evaluated by computed tomography angiography of pulmonary arteries. The RV/LV diameter ratio and also pulmonary artery obstruction index (PAOI) were calculated. The patient's computed tomography scans were reviewed for pulmonary infarction. By adding the RV/LV ratio and pulmonary infarction to PAOI, a new index called the modified Qanadli score was made. Univariable and multivariable logistic regression was done for finding predictors of mortality. Results Nine cases (40%) of patients in the mortality group and 42 (20%) of survivors had ischemic heart disease and the difference was significantly meaningful. The mean Qanadli index in the mortality group was 16.8 ± 8.45 and in survivors was 8.3 ± 4.2. By adding the pulmonary infarction score and PAOI score to RV/LV ratio score, the odds ratio (OR) for predicting mortality increased significantly to 13 and 16, respectively, which were significantly meaningful. Based on our findings, the highest OR for predicting short-term mortality was obtained through a combined Qanadli index (PAOI score + pulmonary infarction score + RV/LV score) that was 17 in univariable and 18 in multivariable logistic regression analysis ( p -value = 0.015). Conclusion The new combined Qanadli index has more ability than the Qanadli index and RV/LV ratio for predicting changes in cardiovascular parameters and short-term mortality in patients with pulmonary embolism.

Stimulant Medication Treatment in Children with Congenital Heart Disease and Attention-Deficit/Hyperactivity Disorder: Cardiovascular Outcomes.

Children with congenital heart disease (CHD) are at increased risk for attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to determine whether children with CHD and ADHD clinically treated with stimulant medication were at increased risk for changes in cardiovascular parameters or death compared with CHD-matched controls. In this retrospective cohort study, patients with CHD + ADHD treated with stimulant medication (exposed group [EG]) were matched by CHD diagnosis and visit age to patients not on stimulants (nonexposed group [NEG]). Cardiovascular parameters (heart rate [HR] and systolic and diastolic blood pressure [SBP and DBP]) and electrocardiograms (ECGs) from medical records over 12 months were compared using mixed effects models. Cardiovascular parameters for 151 children with CHD (mean age 8 ± 4 years) were evaluated (N = 46 EG and N = 105 NEG). Stimulant medication use was not associated with sudden cardiac death. HR and SBP did not significantly change over time in the EG and remained similar between groups. EG children had higher DBP compared with NEG children over time ( p = 0.001). Group × time interactions for HR, SBP, and DBP were not different between the EG and NEG. QTc was not significantly different between the EG and NEG (447 ms vs 439 ms, p = 0.23). EG children demonstrated improvement in ADHD symptoms. Stimulant medication use in children with CHD was not associated with clinically significant changes in cardiovascular parameters compared with controls. Stimulants should be considered for ADHD treatment in children with CHD when prescribed with appropriate monitoring and coordination with the cardiologist.

Association of respiratory failure with inhibition of NaV1.6 in the phrenic nerve

ABSTRACT As part of a drug discovery effort to identify potent inhibitors of NaV1.7 for the treatment of pain, we observed that inhibitors produced unexpected cardiovascular and respiratory effects in vivo. Specifically, inhibitors administered to rodents produced changes in cardiovascular parameters and respiratory cessation. We sought to determine the mechanism of the in vivo adverse effects by studying the selectivity of the compounds on NaV1.5, NaV1.4, and NaV1.6 in in vitro and ex vivo assays. Inhibitors lacking sufficient NaV1.7 selectivity over NaV1.6 were associated with respiratory cessation after in vivo administration to rodents. Effects on respiratory rate in rats were consistent with effects in an ex vivo hemisected rat diaphragm model and in vitro NaV1.6 potency. Furthermore, direct blockade of the phrenic nerve signaling was observed at exposures known to cause respiratory cessation in rats. Collectively, these results support a significant role for NaV1.6 in phrenic nerve signaling and respiratory function.

Intravenous Magnesium Sulphate in Standing Horses: Effects on Physiological Parameters, Plasma Concentration of Magnesium and Nociceptive Threshold Tests☆

A bolus of 50 mg kg −1 MgSO4 (treatment Mg) or the same volume of saline (treatment S) was infused over 15 minutes in 5 adult healthy horses. T0 was the end of the infusion. Physiological parameters were recorded throughout the study period. Measurements of electrical, thermal, and mechanical nociceptive thresholds were performed at the pelvic limbs at baseline (before T0), and at specific timepoints. Blood samples were taken at fixed timepoints before, during and until 12 hours after the infusion. For statistical analysis, the 95% confidence intervals (CI's) for the differences in nociceptive thresholds between treatments were calculated. Physiological parameters were compared using a linear mixed model (global α = 0.05, with Bonferroni correction α = 0.0125). The concentrations of ions were also compared with the baseline values at specific timepoints, using a linear mixed model. The Pearson's correlation coefficient was derived between the ion concentrations. The 95% CI's of thermal, mechanical and electrical thresholds were [-1; +2]°C, [0; +3] N and [-1; +1] mA (positive differences indicate higher thresholds for treatment Mg), respectively. Heart rate was significantly higher (P < .0001) and non-invasive systolic arterial pressure (P < .0001) and respiratory rate (P = .0002) significantly lower after treatment Mg compared to treatment S. Additionally, non-invasive systolic arterial pressure was significantly different at T45 (P < .001). Although mild changes in cardiovascular parameters and plasma concentrations were seen with intravenous administration of MgSO4, no changes in nociceptive thresholds were detected in standing non-sedated horses.

Low Klotho/Fibroblast Growth Factor 23 Ratio Is an Independent Risk Factor for Renal Progression in Chronic Kidney Disease: Finding From KNOW-CKD.

BackgroundWe aimed to evaluate soluble Klotho and circulating fibroblast growth factor 23 (FGF23) ratio as a risk factor for renal progression, cardiovascular (CV) events, and mortality in chronic kidney disease (CKD).MethodsWe analyzed 2,099 subjects from a CKD cohort whose soluble Klotho and C-terminal FGF23 levels were measured at enrollment. The Klotho to FGF23 ratio was calculated as Klotho values divided by FGF23 values + 1 (hereinafter called the Klotho/FGF23 ratio). Participants were categorized into quartiles according to Klotho/FGF23 ratio. The primary outcome was renal events, defined as the doubling of serum creatinine, 50% reduction of estimated glomerular filtration rate from the baseline values, or development of end-stage kidney disease. The secondary outcomes consisted of CV events and death. Changes in CV parameters at the time of enrollment and during follow-up according to the Klotho/FGF23 ratio were also examined.ResultsDuring the follow-up period of 64.0 ± 28.2 months, 735 (35.1%) and 273 (13.0%) subjects developed renal events and composite outcomes of CV events and death, respectively. After adjustment, the first (HR: 1.36; 95% CI: 1.08–1.72, P = 0.010) and second (HR: 1.45; 95% CI: 1.15–1.83, P = 0.002) quartiles with regard to the Klotho/FGF23 ratio showed elevated risk of renal events as compared to the fourth quartile group. There was no significant association between Klotho/FGF23 ratio and the composite outcome of CV events and death. The prevalence of left ventricular hypertrophy and vascular calcification was higher in the low Klotho/FGF23 ratio quartiles at baseline and at the fourth-year follow-up.ConclusionsLow Klotho/FGF23 ratio was significantly associated with increased renal events in the cohort of Korean predialysis CKD patients.

Effect of Gravidity on Cardiovascular Markers in Normotensive Pregnant Women

Gravidity, or the number of pregnancies a woman has had, is linked to a number of biochemical alterations, including changes in cardiovascular parameters. These modifications may increase the likelihood of cardiovascular disease in this population. The aim of this research was to evaluate the effect gravidity has on some cardiovascular markers among normotensive pregnant women. A cross-sectional study of 100 women of reproductive age was carried out at Rivers State University and Rivers State University Teaching Hospital, the subjects were chosen at random for the study. Blood samples were taken and tested for total cholesterol, triglycerides, high density lipoprotein, uric acid, and Apolipoprotein A1 and B. Apolipoprotein A1 and B were all measured in blood samples for biochemical analysis. The levels of low density lipoprotein and very low density lipoprotein were determined. Graph Pad Prism Version 8.0.2.263 was used to analyze the data from the study. Result gotten from the study showed that Gravidity had no significant effect on biochemical parameters (TC, TG, UA, LDL, Apo A1, Apo B, CRP, and VLDL) in pregnant women (P&gt;0.05), but there was a significant increase (P&lt;0.05) in HDL levels among the group; 0.87 ± 0.21 (1-2), 0.93 ± 0.21 (3-4), 0.86 ± 0.12(5-6) and 1.30 ± 0.00 for (7-8). The effect of gravidity (1-2, 3-4, 5-6, 7-8) on HDL was shown to be significant for ANOVA and Turkey post hoc multiple comparison test; (1-2 vs 7-8) (P= 0.0204) and (5-6 vs 7-8) (P= 0.0250).. This study demonstrated that gravidity had little or no effect on the biochemical parameters but increases the HDL cholesterol level in normotensive pregnant women. &#x0D; &#x0D;

Graded Microstructured Flexible Pressure Sensors with High Sensitivity and an Ultrabroad Pressure Range for Epidermal Pulse Monitoring.

Precisely detecting epidermal pulse waves with pressure sensors is crucial for pulse-based personalized health-monitoring technologies. However, developing a pressure sensor that simultaneously demonstrates high sensitivity and an ultrabroad pressure range and a convenient fabrication process for large-scale production is a considerable challenge. Herein, by utilizing a commercial conductive fabric (CF) and a silica gel film, we develop a high-performance pressure sensor (HPPS) for the monitoring of human physiological signals. Based on convenient turnover formwork technology, the silica gel film was fabricated by replicating the microstructure of the sandpaper surface. This microstructure and the plain weave structure on the CF surface together provide a sharp increase in the contact-separation area and structural compressibility, which are beneficial for the enhancement of output performance. Made of these two materials, the graded microstructured HPPS holds high sensitivity (4.5 mV/Pa), an ultrabroad pressure range (0-30 kPa), a wide working frequency bandwidth (up to 35 Hz), decent stability (>50,000 cycles), and a simple fabrication process that is suitable for large-scale production. Given these noticeable features, the developed HPPS not only succeeds in precisely detecting subtle pulse waves on various positions of different people but can also objectively capture changes in cardiovascular parameters caused by exercise training at different intensities in real time. These findings exhibit the enormous potential application of HPPS in tracking an individual's health status and comprehensively evaluating exercise intensity.

Social observation increases the cardiovascular response of hearing-impaired listeners during a speech reception task

Certain cardiovascular measures allow for distinction between sympathetic and parasympathetic nervous system activity. Applied during listening, these measures may provide a novel and complementary insight into listening effort. To date, few studies have implemented cardiovascular measures of listening effort and seldom have these included hearing-impaired participants. These studies have generally measured changes in cardiovascular parameters while manipulating environmental factors, such as listening difficulty. Yet, listening effort is also known to be moderated by individual factors, including the importance of performing successfully. In this study, we aimed to manipulate success importance by adding observers to the traditional laboratory set-up. Twenty-nine hearing-impaired participants performed a speech reception task both alone and in the presence of two observers. Auditory stimuli consisted of Danish Hearing in Noise Test (HINT) sentences masked by four-talker babble. Sentences were delivered at two individually adapted signal-to-noise ratios, corresponding to 50 and 80% of sentences correct. We measured change scores, relative to baseline, of pre-ejection period, two indices of heart rate variability, heart rate and blood pressure (systolic, diastolic, and mean arterial pressure). After each condition, participants rated their effort investment, stress, tendency to give up and preference to change the situation to improve audibility. A multivariate analysis revealed that cardiovascular reactivity increased in the presence of the observers, compared to when the task was performed alone. More specifically, systolic, diastolic, and mean arterial blood pressure increased while observed. Interestingly, participants’ subjective ratings were sensitive only to intelligibility level, not the observation state. This study was the first to report results from a range of different cardiovascular variables measured from hearing-impaired participants during a speech reception task. Due to the timing of the observers’ presence, we were not able to conclusively attribute these physiological changes to being task related. Therefore, instead of representing listening effort, we suggest that the increased cardiovascular response detected during observation reveals increased physiological stress associated with potential evaluation.

Effect of a long-term high-energy diet on cardiovascular parameters in Shetland pony mares.

BackgroundChanges in cardiovascular parameters, including blood pressure (BP) and cardiac anatomical dimensions, are an inconsistent feature of the equine metabolic syndrome. The order in which these changes arise is unknown.ObjectivesDetermine the order in which EMS‐associated changes in cardiovascular parameters arise.AnimalsTwenty Shetland pony mares.MethodsHigh‐energy (HE) diet mares were fed 200% of net energy requirements for 1 (n = 3) or 2 (n = 7) consecutive diet‐years, with 17 weeks of hay‐only between years. Noninvasive BP measurements and echocardiograms were performed during both years. Resting 24‐hour ECGs and measurements of autonomic tone (splenic volume and packed cell volume [PCV]) were performed at the end of diet‐year 1. Results were compared to control mares receiving a maintenance diet for 1 (n = 7) or 2 (n = 3) consecutive years.ResultsIn year 1, HE mares had significantly higher values than control mares for mean relative left ventricular wall thickness (P = .001). After 2 diet‐years, mean systolic (P = .003), diastolic (P < .001) and mean arterial BP (P = .001), heart rate (HR; P < .001), and mean left ventricular wall thickness (P = .001) also were significantly increased in HE compared to control mares. No pathological arrhythmias or differences in splenic volume or PCV were detected.Conclusions and Clinical ImportanceIngesting a HE diet first induced minor changes in BP, and progressed to left‐sided cardiac hypertrophy in Shetland pony mares. These findings are of interest given the increasing incidence of obesity in horses.

Cardiovascular Risk Comparison between Expanded Hemodialysis Using Theranova and Online Hemodiafiltration (CARTOON): A Multicenter Randomized Controlled Trial

Expanded hemodialysis (HDx) with medium cutoff (MCO) membranes, which remove middle-to-large molecules well, may be a good option to replace online hemodiafiltration (online-HDF). To provide more evidence, this randomized controlled trial compared several cardiovascular parameters between patients undergoing HDx and online-HDF. Eighty patients undergoing thrice-weekly hemodialysis were randomly assigned to receive either HDx with a Theranova membrane (n = 43) or online-HDF (n = 37). The primary endpoints were changes in brachial-ankle pulse wave velocity (baPWV), echocardiographic parameters, and coronary artery calcium (CAC) scores over 1 year, and the secondary endpoints included blood cardiovascular biomarkers, mortality, and patient-reported outcomes. A linear mixed model and log-rank test were used to estimate the group differences. 65 patients had completed the trial. The changes in baPWV and echocardiographic parameters did not differ between the two groups. The CAC scores remained stable in the online-HDF group, whereas an increasing trend was shown in the HDx group (P = 0.012). Other endpoints, including cardiovascular and all-cause mortalities, were similar between the two groups. The changes in cardiovascular parameters did not differ between HDx with an MCO membrane and online-HDF. However, attention may be needed in patients with high CAC scores or scores with an increasing tendency when online-HDF is replaced with HDx with an MCO membrane.

Gravity Threshold and Dose Response Relationships: Health Benefits Using a Short Arm Human Centrifuge.

PurposeIncreasing the level of gravity passively on a centrifuge, should be equal to or even more beneficial not only to astronauts living in a microgravity environment but also to patients confined to bed. Gravity therapy (GT) may have beneficial effects on numerous conditions, such as immobility due to neuromuscular disorders, balance disorders, stroke, sports injuries. However, the appropriate configuration for administering the Gz load remains to be determined.MethodsTo address these issues, we studied graded G-loads from 0.5 to 2.0g in 24 young healthy, male and female participants, trained on a short arm human centrifuge (SAHC) combined with mild activity exercise within 40–59% MHR, provided by an onboard bicycle ergometer. Hemodynamic parameters, as cardiac output (CO), stroke volume (SV), mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were analyzed, as well as blood gas analysis. A one-way repeated measures ANOVA and pairwise comparisons were conducted with a level of significance p < 0.05.ResultsSignificant changes in heart rate variability (HRV) and its spectral components (Class, Fmax, and VHF) were found in all g loads when compared to standing (p < 0.001), except in 1.7 and 2.0g. There were significant changes in CO, cardiac index (CI), and cardiac power (CP) (p < 0.001), and in MAP (p = 0.003) at different artificial gravity (AG) levels. Dose-response curves were determined based on statistically significant changes in cardiovascular parameters, as well as in identifying the optimal G level for training, as well as the optimal G level for training. There were statistically significant gender differences in Cardiac Output/CO (p = 0.002) and Cardiac Power/CP (p = 0.016) during the AG training as compared to standing. More specifically, these cardiovascular parameters were significantly higher for male than female participants. Also, there was a statistically significant (p = 0.022) gender by experimental condition interaction, since the high-frequency parameter of the heart rate variability was attenuated during AG training as compared to standing but only for the female participants (p = 0.004).ConclusionThe comprehensive cardiovascular evaluation of the response to a range of graded AG loads, as compared to standing, in male and female subjects provides the dose-response framework that enables us to explore and validate the usefulness of the centrifuge as a medical device. It further allows its use in precisely selecting personalized gravity therapy (GT) as needed for treatment or rehabilitation of individuals confined to bed.

Splenic Nerve Neuromodulation Reduces Inflammation and Promotes Resolution in Chronically Implanted Pigs.

Neuromodulation of the immune system has been proposed as a novel therapeutic strategy for the treatment of inflammatory conditions. We recently demonstrated that stimulation of near-organ autonomic nerves to the spleen can be harnessed to modulate the inflammatory response in an anesthetized pig model. The development of neuromodulation therapy for the clinic requires chronic efficacy and safety testing in a large animal model. This manuscript describes the effects of longitudinal conscious splenic nerve neuromodulation in chronically-implanted pigs. Firstly, clinically-relevant stimulation parameters were refined to efficiently activate the splenic nerve while reducing changes in cardiovascular parameters. Subsequently, pigs were implanted with a circumferential cuff electrode around the splenic neurovascular bundle connected to an implantable pulse generator, using a minimally-invasive laparoscopic procedure. Tolerability of stimulation was demonstrated in freely-behaving pigs using the refined stimulation parameters. Longitudinal stimulation significantly reduced circulating tumor necrosis factor alpha levels induced by systemic endotoxemia. This effect was accompanied by reduced peripheral monocytopenia as well as a lower systemic accumulation of CD16+CD14high pro-inflammatory monocytes. Further, lipid mediator profiling analysis demonstrated an increased concentration of specialized pro-resolving mediators in peripheral plasma of stimulated animals, with a concomitant reduction of pro-inflammatory eicosanoids including prostaglandins. Terminal electrophysiological and physiological measurements and histopathological assessment demonstrated integrity of the splenic nerves up to 70 days post implantation. These chronic translational experiments demonstrate that daily splenic nerve neuromodulation, via implanted electronics and clinically-relevant stimulation parameters, is well tolerated and is able to prime the immune system toward a less inflammatory, pro-resolving phenotype.

Changes in cardiovascular parameters in rats exposed to chronic widespread mechanical allodynia induced by hind limb cast immobilization.

To elucidate the relationship between chronic pain conditions with cast immobilization and autonomic function, we investigated the functional changes of the autonomic nervous system in conscious rats with chronic post-cast pain (CPCP) induced by a two-week cast immobilization of one hind limb. We telemetrically examined the time courses of systolic arterial blood pressure (SBP), heart rate (HR), and the middle-frequency (MF) component obtained from the power spectral analysis of SBP variability as a vasomotor sympathetic index. We also investigated the baroreflex sensitivity to phentolamine, an α-adrenoceptor antagonist, and the SBP and HR responses to a low ambient temperature (LT; 9.0 ± 0.2°C) exposure, a sympathetic stimulant. Rats exposed to cast immobilization exhibited mechanical allodynia lasting for at least 10 weeks after cast removal in the calf area (skin and muscle) of the bilateral hind limbs. Under resting conditions, the SBP, HR, and MF components were significantly increased during cast immobilization (all p < 0.001). Following cast removal, these parameters gradually decreased and within 1 week reached lower than baseline levels, lasting for over 10 weeks. Phentolamine administration (10 mg/kg, intraperitoneally) significantly decreased the SBP before and during cast immobilization (before, p < 0.001; during, p = 0.001) but did not lower the SBP after cast removal. The baroreflex gain after phentolamine administration, calculated as the HR increase divided by the SBP reduction, was significantly increased after cast removal (p = 0.002). The SBP increase on LT exposure was significantly greater after cast removal than that before cast immobilization, suggesting hypersensitivity to sympathetic neurotransmitters. These results revealed that, in the CPCP model, sympathetic activation was augmented during cast immobilization, which then decreased after cast removal and remained below normal levels with persisting pain behaviors. Additionally, the responsiveness of the autonomic nervous system was impaired in the CPCP model.

Effect of Sudarshan Kriya Yoga on cold pressor response in healthy young adults

Background: Stress is the much underestimated and invisible pandemic affecting humans and is the underlying cause of many disorders such as essential hypertension, angina, and insomnia to name a few. Stress affects the various systems of our body adversely including autonomic nervous system. Cold pressor test (CPT) is a simple and well-documented laboratory test to evaluate the sympathetic autonomic functions. Yoga is one of the best and cost-effective non-pharmacological therapies to combat stress. Aims and Objectives: This study aims to compare the cold pressor response in non-yoga practitioners and Sudarshan Kriya Yoga practitioners. Materials and Methods: The study consisted of 140 subjects, randomly divided into two groups: Control group of 70 volunteers and intervention group of 70 volunteers. CPT was conducted for all the participants at the beginning of the study. Intervention group practiced Sudarshan Kriya Yoga (SKY) for a duration of 6 months. CPT was conducted for intervention and control groups at the end of the 2nd month and again at the end of 6 months of duration study. Results: No significant change was observed in cold pressor response in the controls at the end of 2 months and 6 months of study duration, whereas the cold pressor response was significantly less in the study group after 2 months and 6 months of practice of SKY. Conclusion: This implies that the SKY practice can significantly decrease stress-induced changes in cardiovascular parameters by shifting the cardiovascular autonomic balance toward the parasympathetic side.

Влияние гипоксических тренировок на ортостатическую устойчивость человека до и после моделированной микрогравитации

Reduced orthostatic tolerance (OT) is a serious concern facing space medicine. This work sought to evaluate the effects of intermittent hypoxic training (IHT) on OT in humans before and after 3 days of head-down bed rest (HDBR) used to model microgravity. The study was carried out in 16 male volunteers aged 18 to 40 years and included 2 series of experiments with 11-day and 21-day IHT administered on a daily basis. During the first IHT session, the concentration of oxygen in the inspired gas mixture was 10%; for other sessions it was adjusted to 9%. OT was assessed by a 20-minute-long orthostatic tilt test (OTT) conducted before and after HDBR. Before HDBR, orthostatic intolerance was observed in 3 participants, while after HDBR, it was observed in 9 of 16 volunteers (p &lt; 0.05). During OTT conducted after HDBR, the heart rate (HR) exceeded control values by 26.8% (p &lt; 0.01). Preexposure to any of the applied IHT regimens led to a reduction in the number of volunteers with orthostatic intolerance. After the 11-day IHT program, there was a less pronounced increase in HR during OTT before HDBR; with the extended IHT regimen, less pronounced changes were observed for HR, systolic, diastolic and mean blood pressure (BP). The increase in HR during OTT after HDBR was significantly lower in the group that had completed the 11-day IHT program, while BP remained stable. The changes in HR and systolic BP were less pronounced in the group that had completed the 21-day IHT program than in the control group (p &lt; 0.05). Thus, IHT reduced the risk of orthostatic disorders and mitigated changes in cardiovascular parameters during the orthostatic test.

Physical and Mathematical Model of Heart and Cardiovascular System

The cardiovascular system is modelled as a fluid flow system consisting of networks of pumps and piping systems. A mathematical model relating different cardiovascular parameters was developed. The change in cardiovascular parameters with individuals’ physical activity level, habits and environmental factors was established. The models used to predict how an individual can control the cardiovascular parameters to be healthy and diagnosing problems in the system.Keywords: Blood Pressure; Circulatory system modelling; Heart Rate.

Effects of Lisinopril on Arterial Stiffness, Cerebral Blood Flow and Cortical Thickness in Hypertensive Dahl‐S Rats

Study objectivesCentral arterial stiffness (CAS), associated with hypertension, is likely underlies the stiffening of cerebral arterial wall resulting in cerebral hypoperfusion, neuronal density loss and cognitive decline. We previously found associations between pulse wave velocity (PWV), a marker of CAS, and hippocampal cerebral blood flow (CBF) and neuronal density in 6‐mo old hypertensive Dahl salt‐sensitive (Dahl‐S) rats. This study examined the effect of ACE inhibitor, Lisinopril, on cardiovascular and brain parameters in hypertensive Dahl‐S rats.MethodsMale Dahl‐S rats (n=32) were fed with a normal salt diet (0.5% NaCl) for a duration of study. Systolic blood pressure (SBP), PWV (by echocardiography); hippocampal N‐acetyl aspartate (NAA) concentration, hippocampal CBF were measured at 6‐mo of age (baseline) and after 3‐mo and 6‐mo of Lisinopril (15mg/kg body weight/day in drinking water; n=14) or control (n=18) treatment. NAA was measured using proton spectroscopy in a 7T Bruker Biospec MRI scanner; CBF was measured using continuous arterial spin labeling (CASL) in the coronal slice with the largest hippocampal area; cortical thickness (CT) analysis was done using a T2 weighted RARE 3D image (n=12). Advanced Normalization Tools (ANTs) were used for the CT estimation. T‐test and 2‐way ANOVA linear mix effect model analyses were performed in R, EXCEL and MATLAB. Data presented as mean±SE.ResultsAt 6‐mo of age, the Dahl‐S rats developed advanced hypertension vs. 3‐mo (SBP: 164±4 vs. 141±3 mmHg; P&lt;0.01, t‐test). SBP of non‐treated (NT) animals was steadily high at all time points while treated animals exhibited a decrease in SBP at 9‐mo vs. 6‐mo of age. SBP remained low from 9‐mo to 12‐mo of age (Fig. 1a). In treated animals, PWV decreased at all timepoints after 6‐mo of age. For NT animals, PWV remained steady from 6‐mo to 9‐mo but increases from 9‐mo to12‐mo of age (Fig. 1b). Hippocampal CBF of NT animals decreased in a downwards trend but remain stabilized in the treated group across timepoints (Fig. 1c). Likewise, the hippocampal NAA, among treated animals remained stabilized, while in NT animals this parameter fluctuated with an eventual downwards trend (Fig. 1d). The mean difference maps of the CT for the NT and treated rats are similar except for the regions denoted by the red arrows when comparing treated to NT (Fig. 2a–b). The occipital region showed cortical thickening (blue) and parietal region showed cortical thinning (yellow). The P value maps show that those regions of significant thickening and thinning are greater in the treated vs. NT rats (Fig. 2c–d).ConclusionThe posterior cerebral artery is a dominant source of perfusion to the hippocampus and the occipital lobe; thus, our findings suggest a coherent pattern through which CAS can affect the cerebral arteries in hypertensive Dahl‐S rats. Lisinopril treatment decrease CAS and improve regional CBF and neuronal density. Therefore, CAS may be a therapeutic target for vascular dementia.Support or Funding InformationThe work was supported by the Intramural Research Program of the National Institute on Aging of the National Institutes of Health.Longitudinal changes in cardiovascular parameters in Lisinopril treated Dahl‐S rats. Systolic blood pressure SBP (a), pulse wave velocity PWV (b), hippocampal CBF (c), and NAA (d) in Lisinopril treated (T) and nontreated (NT) rats. By 2‐way ANOVA Linear Mixed Effects: *p &lt; 0.001 vs. age‐matched treated rats; #p &lt; 0.03 vs. 6‐mo, ## p &lt;0.001 vs. 6‐mo; by paired T‐test (c, d): * p = 0.07 vs. 6‐mo; # p = 0.06 vs. 9‐mo NT.Figure 1Mean Differences in Cortical Thickness and their p value maps (6‐mo subtracted by 12‐mo). Mean difference between age 6‐mo and 12‐mo of (a) nontreated animals and (b) lisinopril treated animals. Blue indicates regions of thickening. Yellow indicated regions of thinning. Occipital and parietal regions indicated by the red arrows. P value map of nontreated animals (c) and lisinopril treated animals (d). All insignificant p values &gt; 0.05 were revalued as 0.05 for visualization purposes.Figure 2

Effect of Live‐Firefighting on Ventricular‐Vascular Coupling in Middle‐Aged Firefighters

IntroductionCardiovascular events are a leading cause of line of duty‐related death among firefighters. Increased risk potentially manifests from detrimental changes in ventricular function, vascular load, or their interaction defined as ventricular‐vascular coupling (VVC). Young firefighters exhibit ventricular‐vascular uncoupling after live firefighting, however it is unknown whether higher‐risk, middle‐aged firefighters respond similarly.PurposeDetermine the effect of live fire‐firefighting on ventricular function, vascular load, and VVC in middle‐aged firefighters (40–60 yr).MethodsEighteen middle‐aged male firefighters (48±5 years, 28±4.9 kg·m−2) underwent hemodynamic and cardiac measures before and 10 minutes after an 18‐minute bout of intermittent, high intensity live‐firefighting activities in personal protective equipment. Blood pressure (BP), left ventricular function (ejection fraction [EF]), ventricular elastance (Elv: end systolic pressure [ESP]/end systolic volume [ESV]), and vascular load, defined as arterial elastance (Ea: [ESP]/stroke volume [SV]) were measured. VVC quantified as the ratio of Ea to Elv.ResultsFollowing a single bout of high intensity, intermittent live‐firefighting activities, mean arterial pressure and ESP decreased while heart rate increased (see table ). EF, Elv and Ea were maintained, and VVC was preserved.ConclusionApparently healthy middle‐aged firefighters maintained the balance between ventricular function and vascular load following a single bout of live‐firefighting. Therefore, impaired VVC may not be related to the increased cardiovascular risk during a single bout of live‐firefighting in apparently healthy middle‐aged firefighters. Further investigations should examine the effect of an extended firefighting bout on ventricular function, vascular load, and VVC in individuals with cardiovascular disease risk factors. Changes in cardiovascular parameters pre/post firefighting activity. Pre Post p SBP (mmHg) 132 ± 11 123 ± 10 &lt;0.01 DBP (mmHg) 81 ± 6 79 ± 6 0.06 MAP (mmHg) 98 ± 7 94 ± 6 &lt;0.01 HR (bpm) 65 ± 10 85 ± 11 &lt;0.01 SV (ml) 85 ± 18 76 ± 15 0.11 EDV (ml) 126 ± 29 122 ± 27 0.40 ESV (ml) 43 ± 16 46 ± 17 0.40 ESP (mmHg) 102.6 ± 8.9 97.7 ± 6.7 &lt;0.01 EF (%) 66.1 ± 6.9 63.0 ± 7.1 0.12 Ea (mmHg/ml) 1.3 ± 0.3 1.4 ± 0.2 0.24 Ely (mmHg/ml) 2.8 ± 1.0 2.5 ± 0.8 0.33 VVC 0.5 ± 0.1 0.6 ± 0.2 0.08 SBP: systolic blood pressure, DBP: diastolic blood pressure, MAP: mean arterial pressure, HR: heart rate, SV: stroke volume, EDV: end diastolic volume, ESV: end systolic volume, ESP: end systolic pressure, EF: ejection fraction, Ea: arterial elastance, Elv: ventricular elastance, VVC: ventricular‐vascular coupling