Decrease In Blood Flow Velocity Research Articles

Состояние барьеров микробной колонизации зубочелюстной системы в условиях имитированной невесомости

Введение. Условия космического полета приводят к изменению функциональных показателей многих органов и систем организма человека. Накопленный опыт показывает, что с увеличением длительности полета большое значение приобретают комплексные исследования состояния зубочелюстной системы. Цель исследования - изучение анаэробной составляющей микробиоты, иммунологических показателей ротовой жидкости и скорости кровотока в микроциркуляторном русле пародонта при моделировании невесомости. Методика. Наиболее адекватной моделью, воспроизводящей эффекты факторов полета в земных условиях, является «сухая» иммерсия. Было проведено комплексное обследование 20 мужчин добровольцев, в возрасте от 19 до 26 лет. В качестве модели микрогравитации использовали 5-суточную «сухую» иммерсию. Изучение состояния тканей пародонта включало микробиологические, иммунологические и микроциркуляторные исследования. Исследования выполняли в 1-е сут (фон), на 5-е сут иммерсии (выход) и на 7-е сут по окончании иммерсии. Качественный состав основных пародонтопатогенных видов микроорганизмов определяли методом полимеразной цепной реакцией. Концентрацию иммуноглобулинов (sIgA, IgA, IgМ) в ротовой жидкости - методом ИФА с помощью соответствующих наборов реагентов ЗАО «Вектор-Бест». Оценку кровотока в тканях пародонта проводили методом высокочастотной ультразвуковой допплеровской флуометрии ультразвуковым допплерографом «Минимакс-Допплер-К» (г. Санкт-Петербург) с датчиком непрерывного излучения, рабочая частота - 20 МГц. Результаты. Во время эксперимента в составе микробиоты пародонта обнаружено появление 5 основных пародонтопатогенных видов микроорганизмов (Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola). Отмечен рост концентрации в десневой жидкости sIgA, что связано с появлением пародонтопатогенной микробиоты. На 5-е сут и 7-е сут после «сухой» иммерсии у 12 человек отмечено статистически значимое снижение скорости кровотока в микроциркуляторном русле тканей пародонта как нижней, так и верхней челюсти. У 6 человек наблюдалась морфофункциональная перестройка микроциркуляторного русла в виде дилатации емкостных сосудов (венул) с частичным обеднением капиллярного звена, что свидетельствует о реакции венулярной компоненты на моделируемую микрогравитацию. Заключение. Комплексное исследование показало предрасположенность тканей пародонта в условиях «сухой» иммерсии к развитию воспалительных заболеваний и снижению барьерных функций пародонта.Comprehensive evaluation of 20 male volunteers aged 19-26 was conducted during exposure to 5-day “dry” immersion (DI). The aim was to examine periodontal tissues in the conditions of 5-day “dry” immersion, specifically, to study the anaerobic component of periodontal microbiota, immunological parameters of the oral fluid, and blood flow velocity in the periodontal microcirculation (PMC). Methods. Microgravity was modeled with the 5-day DI. Evaluation of the condition of periodontal tissues included microbiological, immunological, and microcirculatory studies. The studies were performed on day 1 (baseline), day 5 of immersion (completion), and day 7 upon the end of immersion. All studies were performed in the fasting state, before toothbrushing, in the supine position in the immersion bath, and in the sitting position 7 days after the immersion. PMC was studied at the same time points as in the immunoglobulin study. Blood flow in periodontal tissues was measured using the high-frequency ultrasonic Doppler fluorimetry (HFUDF) with a Minimax-Doppler-K ultrasonic dopplerograph (St. Petersburg) with a continuous radiation sensor at an operating frequency of 20 MHz. Results. Five major periodontopathogenic bacteria (Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Prevotella intermedia, Porphyromonas gingivalis, and Treponema denticola) emerged as a part of the periodontal microbiota during the experiment. An increased concentration of sIgA was observed in the gingival fluid, which was associated with the emergence of periodontopathogenic microbiota. On day 5 of SI and day 7 following SI, 12 subjects had a statistically significant decrease in blood flow velocity in PMC of both the lower and upper jaws. 6 subjects showed morphological and functional rearrangement of the PMC, including dilation of capacitance vessels (venules) with partial capillary depletion, which indicated a venular component response to the conditions of modeled microgravity. Conclusion. This comprehensive study showed predisposition of periodontal tissues to development of inflammatory diseases and impaired functioning of the periodontal barrier under the conditions of DI.

The effect of preset intraoperative intraocular pressure during phacoemulsification on the blood flow velocity in the central retinal artery

Aim. To evaluate the effect of preset elevated intraocular pressure (IOP) level during phacoemulsification on central retina artery and central retinal vein hemodynamics and to determine possible compensatory mechanisms of the ocular blood flow autoregulation in response to intraoperational IOP jump.
 Methods. This prospective study included 23 cataract patients without concomitant ocular vascular conditions (15 women and 8 men) aged from 62 to 83 years. The mean age was 72.5 5.7 years. In all patients, an intraoperational color duplex scanning in the regimens of color Doppler imaging and pulsed wave velocity imaging using ultrasound scanner Logiq S8 (GE). The blood flow was estimated in retrobulbar vessels: central retinal artery, central retinal vein with maximal systolic velocity, end-diastolic velocity of the blood flow, and resistance index (RI). The investigation was performed under IOP control, which was measured using Icare Pro tonometer, and under blood pressure control using patient monitoring system Draeger Vista 120. In the operating room, ocular blood flow was examined three times: immediately before surgery, straight after the surgical incision sealing at preset intraoperational IOP level, and after IOP normalization and repeated sealing of the corneal tunnel.
 Results. Under preset intraoperational IOP maintenance on 58.01 8.10 mm Hg level, there was a clinically significant (p 0.05) decrease of blood flow velocity in the central retinal artery. In 30.4% of cases, the blood flow velocity in the central retinal artery during diastolic phase was not registered. The flow velocity in central retinal vein did not change significantly, and did not depend on IOP level (p 0.05).
 Conclusions. At the 5560 mm Hg IOP level, in humans, compensatory blood flow autoregulation mechanisms in response to intraoperational IOP jumps are absent, up to complete blood flow stop in the central retinal artery at the diastolic phase, and this could be a risk factor for retinal ischemia.

Transcranial contrast-enhanced ultrasound in the rat brain reveals substantial hyperperfusion acutely post-stroke

Direct and real-time assessment of cerebral hemodynamics is key to improving our understanding of cerebral blood flow regulation in health and disease states such as stroke. While a number of sophisticated imaging platforms enable assessment of cerebral perfusion, most are limited either spatially or temporally. Here, we applied transcranial contrast-enhanced ultrasound (CEU) to measure cerebral perfusion in real-time through the intact rat skull before, during and after ischemic stroke, induced by intraluminal filament middle cerebral artery occlusion (MCAO). We demonstrate expected decreases in cortical and striatal blood volume, flow velocity and perfusion during MCAO. After filament retraction, blood volume and perfusion increased two-fold above baseline, indicative of acute hyperperfusion. Adjacent brain regions to the ischemic area and the contralateral hemisphere had increased blood volume during MCAO. We assessed our data using wavelet analysis to demonstrate striking vasomotion changes in the ischemic and contralateral cortices during MCAO and reperfusion. In conclusion, we demonstrate the application of CEU for real-time assessment of cerebral hemodynamics and show that the ischemic regions exhibit striking hyperemia post-MCAO. Whether this post-stoke hyperperfusion is sustained long-term and contributes to stroke severity is not known.

Ketidaksesuaian Dosis dan Interval Pemberian Antibiotik pada Lansia di Bangsal Penyakit Dalam RSUD dr Moewardi Solo serta Gambaran Timbulnya Efek Samping yang Merugikan

Aging causes a decrease in renal blood flow velocity and clearance values ​​related to renal filtration function. A decrease in kidney filtration function results in a decrease in the ability of drug elimination so that the drug and its metabolites tend to accumulate in the blood. The dose of certain antibiotics must be adjusted to the patient's kidney function. Clinical estimates of kidney filtration function are expressed in terms of creatinine clearance (CrCl). This study aims to determine the percentage of suitability of the dose and interval of antibiotic administration with the CrCl value of elderly patients and to see description of the side effects arising from the administration of antibiotics.
 This research was observational with data retrospective retrieval of medical records. The subjects of the study were elderly patients who were hospitalized in the ward ward in dr. Moewardi Solo Hospital in the period January - May 2019 , ≥ 60 years aged with a diagnosis of Pneumonia, Urinary Tract Infection (UTI), Cellulitis and sepsis with complete medical record data. The antibiotics evaluated are all antibiotics given to the patient while being treated.
 The results showed the suitability of the dose and interval of antibiotic administration with the CrCl value of elderly patients hospitalized in the disease ward in RSUD Dr. Moewardi Solo for the period January-May 2019 was 63.35%, the incidence of side effects arising from the administration of antibiotics was nausea and vomiting (10 patients ) and diarrhea (4 patients).

Evaluation of retrobulbar circulation in type 2 diabetic patients using color Doppler imaging.

Purpose:To investigate the retrobulbar circulatory parameters in type 2 diabetes mellitus patients with color Doppler imaging (CDI) and compare the results with nondiabetic controls.Methods:This prospective study included 50 type 2 diabetic patients and 50 age-matched controls. Seven field stereo fundus photography was used to diagnose and classify diabetic retinopathy (DR). Diabetic patients were further divided into two: Group 1, consisted of patients with no DR, mild and moderate non-proliferative DR (n = 36); Group 2, severe nonproliferative and proliferative DR (n = 14). CDI was performed using Philips iU22 xMATRIX ultrasound. The peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI) and pulsatile index (PI) of ophthalmic (OA), posterior ciliary artery (PCA), and central retinal artery (CRA) along with central retinal vein (CRV) were recorded.Results:RI in the ophthalmic artery was significantly higher in both DR groups than the control group (P = 0.000). Diabetic Group 1 had decreased blood flow velocity (PSV and EDV) in PCA compared to controls (P = 0.046 and P = 0.010, respectively). Group 2 DR had significantly reduced EDV and increased RI in CRA compared to Group 1 (P = 0.015). Binary logistic regression analysis revealed glycosylated hemoglobin and RI of OA to be independent risk factors of DR.Conclusion:Significant changes in resistivity index and flow velocities were observed in the retrobulbar vessels, especially in ophthalmic artery in diabetics compared to controls. CDI with results of increased resistance or decreased flow could be useful to predict individuals at higher risk for developing severe DR.

Atherosclerosis and the Structural and Functional State of the Vessels of the Carotid and Vertebro-basilar Basins

In connection with modern pathogenetic ideas about the mechanisms of development of ischemic stroke, the early diagnosis of this disease becomes even more important. A relevant issue at the present stage is the information content of non-invasive ultrasound research methods used to study the state of the cerebral arteries that participate in the blood supply to the brain.The objective: to study the structural and functional state of the vessels of the carotid and vertebro-basilar pools in elderly patients with cerebral atherosclerosis (CA) of stage 1–3, including depending on the hemispheric localization of the ischemic focus.Materials and methods. 229 patients with CA of the 2nd – 3rd degree took part in a comprehensive clinical and instrumental study. Patients were divided into 4 groups: I – the general group of patients who underwent ischemic atherothrombotic stroke in the basin of the middle cerebral artery (IS); II – in the right hemisphere (RH); ІІІ – transferred IS in the left hemisphere (LH); ІV – with CA of 1–2 degree (without IS – comparison group). Subsequently, elderly patients from 55 to 75 years old participated in the comparison of groups.Results. In chronic cerebrovascular diseases, a steadily progressing atherosclerotic process is accompanied by a decrease in blood flow velocity in the main arteries of the head. Moreover, changes in LSBV (Linear systolic blood velocity) are detected by transcranial dopplerography at earlier stages both at the extra– and intracranial level, and blood flow depression initially occurs both in the arteries of the vertebro-basilar basin and in the carotid channel. The identification of changes in a Doppler study, in general, precedes the increase in symptoms of organic damage to the nervous system. Compared to patients with initial manifestations of CA, patients who underwent IS are characterized by a high frequency of hemodynamically significant stenosis, a thickening of complex intima-media, a statistically significant decrease in LSBV and an increase in pulsatory and peripheral resistance index in individual vessels of the carotid and vertebro basilar basins on both sides.Conclusion. Structural and functional features of cerebral vessels in patients after ischemic atherothrombotic stroke in the late recovery period have hemispheric features. Moreover, a statistically significant difference in the rate of cerebral blood flow was observed only in the vessels of the carotid basin on the right, and the indices of peripheral vascular resistance and pulsativity were increased in different vessels of both pools from 2 sides.

Induction of developmental toxicity and cardiotoxicity in zebrafish embryos/larvae by acetyl-11-keto-β-boswellic acid (AKBA) through oxidative stress

Acetyl-11-keto-β-boswellic acid (AKBA), a triterpenoid from Boswellia serrate, is regarded as an angiogenesis inhibitor. However, its toxicity is unknown. The aim of this study was to examine its developmental toxicity and cardiotoxicity. A developmental toxicity assay in zebrafish embryos/larvae from 4 to 96 hours post-fertilization (hpf) was performed and a cardiotoxicity assay was designed from 48 to 72 hpf. Markers of oxidative stress and related genes were selected to access the possible mechanisms. According to the results, AKBA induced pericardium edema, yolk-sac edema, abnormal melanin, spinal curvature, hatching inhibition and shortened body length. Further, increased SV-BA distance, reduced heart rate, increased pericardium area and decreased blood flow velocity were detected in AKBA treated groups. The inhibition of cardiac progenitor gene expression, such as Nkx2.5 and Gata4, may be related to cardiotoxicity. The activities of antioxidant enzymes were decreased and the content of MDA was increased. In addition, AKBA treatment decreased the expression levels of Mn-Sod, Cat, and Gpx. These results suggested that AKBA induced developmental toxicity and cardiotoxicity through oxidative stress. As far as we know, this is the first report on the toxicity of AKBA. It reminds us to pay attention to developmental toxicity and cardiotoxicity of AKBA.

New features of the cerebral hemodynamics of brain arteries in patients with HIV-infection in Uzbekistan

We aim to study the cerebral hemodynamic indices of the brain arteries in HIV-infected patients. 56 HIV-infected patients were examined, with verified serological and clinical diagnosis, whose average age was 35.7 ± 1.3 years, among which there were 31 (55.4%) men and 25 (44.6%) women. The state of cerebral hemodynamics and vascular reactivity of the cerebral arteries was studied using standard techniques using sensors of 2, 4, 8 MHz on the Spectromed-300 device (Russia). Cerebral hemodynamic disorders in patients according to the Doppler study showed a decrease in blood flow velocity in the ICA by 24.5 and 33.9%, in the MCA by 25.4 and 34.5%, in the PA - by 24.3 and 44.7%, in OA - by 21.7 and 32.6% (groups 1 and 4, respectively) in relation to the indicators in the control group. There were also signs of an increase in vascular tone in all investigated vessels, according to an increase in the pulsation index (Pi) and circulatory resistance (Ri), on average, 1.5 and 2.3 times in group 1; 1.8 and 2.75 times in 4 groups. An increase in vascular tone suggests the inadequate functioning of dilatatory mechanisms at the capillary bed level, which indicates stress in the mechanisms of adaptation of cerebral vessels, which, if not corrected, can lead to their breakdown and development of dyscirculatory processes in the CNS in HIV-infected patients already at the preclinical stages of the disease.

Assessment of the optic nerve and its arterial supply by ultrasound imaging in multiple sclerosis patients

BackgroundTransorbital sonography (TOS) has emerged as a promising assessment tool of the optic nerve and orbital arterial supply in multiple sclerosis (MS) patients.ObjectiveTo evaluate optic nerve diameter (OND), optic nerve sheath diameter (ONSD), and orbital hemodynamics using TOS in MS patients.MethodsForty MS patients and 28 matched healthy controls were included. Thirty-three eyes with previous optic neuritis (ON) and 47 eyes without previous ON of MS patients were examined. All subjects were submitted to assessment of OND, ONSD, and parameters of orbital hemodynamics using orbital ultrasound.ResultsOND and ONSD were smaller in MS eyes with previous ON than in controls. MS eyes with and without previous ON had statistically significant higher peak systolic and mean velocity of posterior ciliary arteries than the control eyes. Orbital blood flow velocities were negatively correlated with the duration of disease and Expanded Disability Status Scale (EDSS). A statistically significant decrease in blood flow velocities of the central retinal artery was detected in secondary progressive MS (SPMS) patients than in relapsing-remitting MS patients (RRMS).ConclusionTOS can be used as a feasible tool to detect optic atrophy in MS patients. MS patients may have abnormal retrobulbar hemodynamics compared to healthy controls.

Decrease of blood flow velocity in the middle cerebral artery after stellate ganglion block following aneurysmal subarachnoid hemorrhage: a potential vasospasm treatment?

Cerebral vasospasm (CV) is a delayed, sustained contraction of the cerebral arteries that tends to occur 3-14 days after aneurysmal subarachnoid hemorrhage (aSAH) from a ruptured aneurysm. Vasospasm potentially leads to delayed cerebral ischemia, and despite medical treatment, 1 of 3 patients suffer a persistent neurological deficit. Bedside transcranial Doppler (TCD) ultrasonography is used to indirectly detect CV through recognition of an increase in cerebral blood flow velocity (CBFV). The present study aimed to use TCD ultrasonography to monitor how CBFV changes on both the ipsi- and contralateral sides of the brain in the first 24 hours after patients have received a stellate ganglion block (SGB) to treat CV that persists despite maximum standard therapy. The data were culled from records of patients treated between 2013 and 2017. Patients were included if an SGB was administered following aSAH, whose CBFV was ≥ 120 cm/sec and who had either a focal neurological deficit or reduced consciousness despite having received medical treatment and blood pressure management. The SGB was performed on the side where the highest CBFV had been recorded with 8-10 ml ropivacaine 0.2%. The patient's CBFV was reassessed after 2 and 24 hours. Thirty-seven patients (male/female ratio 18:19), age 17-70 years (mean age 49.9 ± 11.1), who harbored 13 clipped and 22 coiled aneurysms (1 patient received both a coil and a clip, and 3 patients had 3 untreated aneurysms) had at least one SGB. Patients received up to 4 SGBs, and thus the study comprised a total of 76 SGBs.After the first SGB, CBFV decreased in 80.5% of patients after 2 hours, from a mean of 160.3 ± 28.2 cm/sec to 127.5 ± 34.3 cm/sec (p < 0.001), and it further decreased in 63.4% after 24 hours to 137.2 ± 38.2 cm/sec (p = 0.007). A similar significant effect was found for the subsequent SGB. Adding clonidine showed no significant effect on either the onset or the duration of the SGB. Contralateral middle cerebral artery (MCA) blood flow was not reduced by the SGB. To the authors' knowledge, this is the largest study on the effects of administering an SGB to aSAH patients after aneurysm rupture. The data showed a significant reduction in ipsilateral CBFV (MCA 20.5%) after SGB, lasting in about two-thirds of cases for over 24 hours with no major complications resulting from the SGB.

Increased thickness and decreased blood flow velocity of the choroid in a patient with acute macular neuroretinopathy

BackgroundThe involvement of choroidal lesions in acute macular neuroretinopathy (AMN) is not yet fully understood. We quantitatively examined sequential changes in the morphology and circulation hemodynamics of the choroid using enhanced depth imaging optical coherence tomography (EDI-OCT) and laser speckle flowgraphy (LSFG) in a patient with AMN.Case presentationA 15-year-old boy was referred to our hospital due to AMN in his right eye alone. The next day AMN developed in his left eye. Three months later, AMN lesions in both eyes spontaneously resolved and the morphology of macular photoreceptors improved. Using EDI-OCT, central choroidal thickness (CCT) was examined for a period of three months, starting from the initial visit. Using LSFG, macular mean blur rate (MBR) was examined for three months, starting 1 week after the initial visit. At the first visit, CCT of the right eye with AMN was 82 μm higher than that of the left eye, which had not yet developed AMN, and decreased by 86 μm after three months. In the left eye, similarly, CCT increased by 16 μm after the AMN onset at 1 week compared with a pre-onset value at the first visit and thereafter decreased by 57 μm at 3 months. Macular MBR increased by 20–55% OD and 51–71% OS during the follow-up until 3 months.ConclusionsWe found that the choroid at the macula thickened at the onset of AMN and became thin with the regression of disease. Therefore, in concert with MBR data, these results further strengthened our hypothesis that choroidal circulation impairment plays a role in the pathogenesis of AMN.

Peculiarities of the reaction of the lower limbs venous blood flow to the orthostatic test in men with arterial hypertension

A comparative analysis of the dynamics of lower limb vein angioscopy parameters in case of orthostasis between male patients (age 30–50 years) with arterial hypertension (test group – 60 people) and normal arterial pressure (control group – 27 people) was made. Orthostatic sample in all examined patients was characterized by a reliable increase in the diameter and area of vein section at a decrease in blood flow rate. However, in patients with hypertension the increase in the area of vein section was significantly less than in the control group. In orthostasis, the drop in blood flow rate in the total femoral vein was lower in men with hypertension than in men in the control group. In the great saphenous vein, a larger decrease in blood flow velocity was recorded than in the control group. In hypertension, no increase in the number of refluxes was recorded in orthostasis. Thus, hypertension in men is characterized by altered reaction of venous blood flow to orthostasis in both deep and saphenous veins.

Dynamics of the speed of blood flow in the arteries of the bone regenerate of the limbs and in the brain arteries during functional tests and changes in the treatment mode

The results of a comparative study of the linear velocity of blood flow in the arteries of the bone regenerate in patients with fractures of the leg and shoulder bones and in the process of Ilizarov treatment are analyzed. Studies were conducted at rest and when performing a number of functional tests (orthostatic, muscular and with a dosed axial load on the limb). The effect of stress on the state of regional and cerebral blood flow in the conditions of inpatient treatment and after the transfer of patients to the outpatient treatment regimen was assessed.Material and methods. 41 adult patients with a closed diaphyseal fracture of the humerus and 57 patients with a fracture of the tibia bones during Ilizarov treatment were examined. The blood flow in the regenerate and along the middle cerebral arteries was determined by the method of ultrasonic doppler sonography.Results. With an increase in the functional load on the limb in patients with fractures of the humerus and tibial bones, respectively, up to 10 and 30 kgf, a temporary increase in the blood flow velocity in the arteries of the bone regenerate was observed. Large values of the load on the lower leg, accompanied by the acceleration of blood flow, indicate a better protection of the vascular bed of the tibial regenerate. The magnitude of the decrease in blood flow velocity in the regeneration of the lower leg arising from the behavior of an orthostatic test in the course of treating patients increased from 21 to 37 %, and indicated an increase in the reactivity of the vascular bed. In patients with injuries of the shoulder and lower leg, the transfer to the outpatient treatment regimen was accompanied by a statistically significant (p≤0.001) increase in the duration of the fixation period, respectively, to 82±3 and 94±7 days, a decrease in the increased blood flow velocity in the middle cerebral artery on the contralateral side by 43 % and 57 % and an increase in the magnitude of changes in cerebral blood flow rate during functional muscle test by 50 and 67 %.

ERECTILE DYSFUNCTION AND OBESITY IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA AND ARTERIAL HYPERTENSION

Objective: to study the relationship between erectile dysfunction and obesity parameters and the severity of obstructive sleep apnea in patients with arterial hypertension.Material and methods: 71 patients with different severity of erectile dysfunction, overweight and obesity of grade 1, mild and severe obstructive sleep apnea and arterial hypertension were included in the study. The data of cardiorespiratory monitoring, anthropometric parameters of obesity were analyzed and the severity of erectile dysfunction was assessed by intracavernous pharmacodopplerography, the results were compared with the subjective opinion of patients on the degree of severity of erectile dysfunction according to the IIEF-5 questionnaire. All patients underwent psychosomatic status analysis according to the questionnaire scales: assessment of daytime drowsiness on the Epworth scale, severity of personal and situational anxiety on the Spielberger scale and depression level on the Beck scale.Results: comparative analysis revealed statistically significant links between anthropometric data of obesity with OSA parameters (apnea/hypopnea index, desaturation index) (p&lt;0.05), as well as the severity of erectile dysfunction (in terms of erection and dopplerography with evaluation of the of penile blood flow) (p&lt;0.05). A statistically significant negative relationship between the quality of penile blood flow and the degree of arterial hypertension was revealed too (p=0.02). In a comparative analysis of the subjective state of erectile function and objective examination, no statistically significant association was revealed (p=0.07). As a result of the multifactorial linear regression, we have shown that with an increase of the waist circumference to the hip circumference ratio and a higher apnea/hypopnea index, the condition of penile arterial blood flow worsens, namely, a decrease in the peak systolic blood flow velocity (β=-0.39, p=0.05; β=-0.44, p=0.03, respectively). When assessing the psychosomatic state of patients, a significant correlation has been found between the severity of depression in the Beck scale and the level of personal and situational anxiety according to the Spielberger scale (p&lt;0.05). The relationship between depression level on the Beck scale and the degree of situational anxiety with the severity of erectile dysfunction on the Juname scale has been also shown (p&lt;0.05). Conclusion: the combination of overweight or obesity with obstructive sleep apnea and arterial hypertension gives ground to suspect the presence of different severity of erectile dysfunction. The severity of ED is directly proportional to the level of anxiety and depression according to the questionnaire scales.

PECULIARITIES OF THE FUNCTIONAL STATE OF THE MOTHER-PLACENTA–FETUS SYSTEM IN PREGNANT WOMEN WITH PLACENTAL DYSFUNCTION

Among the causes that lead to antenatal affliction of the fetus, namely its hypoxia, hypotrophy, ante- and intranatal distress, is placental dysfunction (PD). Perinatal mortality in PDs is 10.3‰ in newborn infants, 49 ‰ – in preterm infants. Perinatal morbidity with PD reaches 70‰, and mortality rate – 20%. Objective. To investigate the functional state of the fetoplacental complex (FPС) in pregnant women with PD. Material and methods. The functional status of the FPC in 104 patients with PD (main group) and in 136 women with uncomplicated pregnancy and delivery (control group) using ultrasound placentalography, Dopplerometry was examined. Research results. The ultrasound characteristics of the placental dysfunction were the following: discrepancy between the degree of maturity of the placenta of the gestation period, true thickening of the placenta, its hypoplasia, reduction of echogenicity of the placenta, oligohydramnios. Dopplerometric signs of disorder of the utero-placental blood flow were high peripheral vascular resistance, both in dominant and in subdominant UA, asymmetry of blood flow in UA. Hemodynamics of fetal-placental circulation against the ground of PD was characterized by a decrease in the final diastolic blood flow velocity, which was manifested by an increase resistance in the peripheral vascular of the fetal part of the placenta, decrease in placental coefficient. The peculiarity of fetal blood flow in pregnant women with PD was the decrease in the mean value of vascular resistance indices in the middle cerebral artery of the fetus and a significant decrease in the cerebral-umbilical index. Conclusions. In pregnant women with placental dysfunction hemodynamic changes in the utero-placental complex are associated with decrease in the intensity of placental-fetal blood flow and in 16.3% of cases by centralization of the fetal circulation. Timely Dopplerometry is important both in the diagnosis of the compensatory capabilities of the FPK, and during determination of reasonable suggested obstetrical tactics.

Maternal high-fat diet reversal improves placental hemodynamics in a nonhuman primate model of diet-induced obesity.

BackgroundIn a Japanese macaque model of diet-induced obesity, we have previously demonstrated that consumption of a high fat, ‘Western-style’ diet (WSD) is associated with placental dysfunction and adverse pregnancy outcomes, independent of an obese maternal phenotype. Specifically, we have reported decreased uterine placental blood flow and increased inflammation with maternal WSD consumption. We also previously investigated the use of a promising therapeutic intervention that mitigated the adverse placental effects of a WSD but had unexpected detrimental effects on fetal pancreatic development. Thus, the objective of the current study was to determine whether simple preconception diet reversal would improve placental function.MethodsFemale Japanese macaques were divided in to three groups: diet reversal animals (n=5) were switched from a chronic WSD (36% fat) to a low fat, control diet (14% fat) prior to conception and throughout pregnancy. The control (n=6) and WSD (n=6) cohorts were maintained on their respective diets throughout pregnancy. Maternal body weight and composition were regularly assessed and advanced non-invasive imaging was performed at mid-gestation (gestational day 90, G90 or 0.5 of gestation, where full term is G175), and G129, one day prior to C-section delivery at G130 (0.75 of gestation). Imaging studies comprised Doppler ultrasound (US), Contrast-Enhanced US (CEUS) and Dynamic-Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) to assess uteroplacental hemodynamics and maternal-side placental perfusion.ResultsDietary intervention resulted in significant maternal weight loss prior to pregnancy, and improved lean to fat mass ratio. By advanced imaging we demonstrated that a chronic WSD led to decreased blood flow velocity in the intervillous space, delayed blood flow transfer through the maternal spiral arteries and reduced total placental blood flow compared to control fed animals. Dietary reversal ameliorated these concerning derangements, restoring these hemodynamic parameters to control levels.ConclusionPreconception dietary modification has beneficial effects on the maternal metabolic phenotype, and results in improved placental hemodynamics.

Evoked brain potentials in patients with chronic vertebrobasilar ischaemia depending on the features of cerebral and regional perfusion

Objective. To evaluate the effectiveness of brain evoked potentials for the objectivization of early cognitive disorders (CD) induced by cerebral and regional hypoperfusion. Materials and methods. The influence of hypoperfusion in vertebrobasilar territory (VBT) on characteristics of cognitive functions in 52 patients with chronic brain ischemia was studied. The following methods were used: clinico-neurological, MRI, SPECT, duplex ultrasound scanning (DUS), EEG, and brain evoked potentials (EP). Results. The patients were split into two groups by DUS scan findings: 1 – those having structural lesions in vertebral arteries (VA), and haemodynamically significant disorders in VBT and 2 – those having none. The examination of patients of the 1 st group showed the following findings: high frequency of blood flow velocity decrease in VA; the tendency of decreasing in volumetric cerebral blood flow in brain segments and hemispheres according to SPECT data; prevalence of ataxia, coordination and long tract signs; high frequency of early CD in the domains of attention and memory; EP index changes. The patients with blood flow decompensation in VBT (according to DUS findings) showed changes in brainstem auditory EP parameters (BAEP): increase of III, IV, V latency peaks and III-V interpeak interval. According to the cognitive EP (CEP) study, the patients of the 1 st group consistently demonstrated higher frequency of N2 peak amplitude decrease, and P300 peak latency increase. Conclusions. Based on DUS scan findings, it is clinically appropriate to distinguish a group of patients with structural and haemodynamically significant disorders in VA. The deviations from the normal indices of CEP and BAEP correlate with CD occurring as a result of cerebral and regional hypoperfusion in VBT.

Abstract 373: An Animal Model of Left Atrial Thrombus

Left atrial thrombus (LAT) is a common funding of some cardiovascular diseases such as congestive heart failure (CHF), atrial fibrillation and myocardial injury. There is no proper animal model of LAT to date. The present study reports a model of congestive heart failure in rats that is characterized by LAT. Methods: LAT were induced by aortic banding 2 months plus 30 minutes ischemia and reperfusion 1 m followed with aortic de-banding 1 m in rats. Cardiac function and blood flow velocity were assessed by echocardiography. Masson’s stainings were conducted for histology. Results: congestive heart failure (CHF) in rats with LAT showed significant dilatation in left atrium (CHF = 56 ± 18 mm, N = 7, Control = 25 ± 6 mm, N = 10), significant decrease in left appendage blood flow velocity (CHF = 4.20 ± 0.09, Control = 0.21 ± 0.05 m/s) and mitral valve blood velocity (CHF = 0.76 ± 0.09 m/s, Control = 1.01 ± 0.04 m/s). Histology data showed that mature LAT had a complete membrane; the thrombus was characterized by significant fibrosis in middle and out layers. The outer layer of thrombus had microvessels and the cells were nucleated. The central part of the thrombus had very little fibrosis and showed necrosis. Small thrombus (0.05 - 0.1 mm) had a base from which the blood clot grew. Atrial neo-intimal fibrosis plays an important role in the formation of the base of microembolization. However, in some cases, micro-thrombi (&lt;0.01 mm) showed no fibrotic base. Conclusion: left atrial thrombus results from blood flow congestion. However, it is still not clear whether the thrombus is due to vascular proliferation from the atrial wall or through adhesion of coagulation fibers to the atrial wall. Figure. A. echocardiographic imaging. B. left atrial area . C. mitral valve blood velocity. D. echocardiography of left atrial blood velocity. E. left atrial blood flow velocity. F. regular imaging of LAT. G. cross sectional imaging. H. small LAT. I. endometrial fibrosis. J. micro thrombus. K. coagulation fiber.

Lactotripeptide ingestion increases cerebral blood flow velocity in middle-aged and older adults

The age-related decrease in cerebral blood flow velocity increases the risk of cerebrovascular disease. Milk protein-derived bioactive peptides, e.g., lactotripeptide (LTP), have been shown to inhibit angiotensin converting enzyme activities and increase vasodilator production. We hypothesized that LTP ingestion increases cerebral blood flow velocity in middle-aged and older adults. In a randomized, placebo-controlled, double-blind design, 15 healthy middle-aged and older adults were assigned to either a LTP group or a placebo group. The subjects ingested LTP or placebo orally for 8 weeks. Before and after intervention, middle cerebral blood flow velocity was measured using transcranial Doppler ultrasonography. The baseline middle cerebral blood flow velocity and most other key dependent variables did not differ between the groups. LTP ingestion significantly increased middle cerebral blood flow velocity, but there was no such improvement in the placebo groups. We concluded that 8 weeks of LTP ingestion increased middle cerebral blood flow velocity in middle-aged and older adults.

Study on the correlation between blood flow parameters and cerebral infarction in brain artery stenosis

Objective To evaluate the correlation of hemodynamic parameters and blood pressure with cerebral infarction in elderly patients with stenosis. Methods 216 elderly patients with transient ischemic attack(TIA)caused by cerebral stenosis were collected and divided into the cerebral infarction group and the control group.Differences in hemodynamic parameters and blood pressure between the two groups and the correlation between the parameters and cerebral infarction were analyzed.Receiver operating characteristic(ROC)curves were used to analyze the specificity, sensitivity and threshold of each parameter under different degrees of stenosis. Results After adjusting for the well-known associated factors, the occurrence of cerebral infarction was negatively correlated with systolic peak velocity(Vs), end diastolic velocity(Vd)and mean blood flow velocity(Vm), and positively correlated with diastolic blood pressure(r=-0.445、-0.420、-0.459、0.292, P 92.3 mmHg(1 mmHg=0.133 kPa); Vs≤185.8, Vd≤83.6, Vm≤123.7 cm/s, and diastolic blood pressure >104.5 mmHg; Vs≤198.6, Vd≤121.1, Vm≤137.5 cm/s, and diastolic blood pressure >109.6 mmHg, respectively. Conclusions There is a correlation between the blood flow parameters and elderly cerebral infarction.Based on the degree of cerebral arterial stenosis, the risk of cerebral infarction occurrence is greater with decreased blood flow velocity and increased diastolic blood pressure. Key words: Ischemic attack, transient; Brain infarction; Hemodynamics