Increase In Peripheral Resistance Research Articles

Antioxidant-induced modulation of sympathetic transduction to arterial blood pressure in humans

Purpose: Excess plasma free fatty acids (FAA) promote oxidative stress and an increase in peripheral resistance. Therefore, we tested the hypothesis that excess FAA limits sympathetic control of arterial blood pressure (BP) and that sympathetic control would be restored during co-administration of ascorbic acid, which is an antioxidant with vasodilatory properties. Methods: A 20% IV fat emulsion (Intralipid) was administered for 2 hours to 5 lean, healthy adults with and without co-infusion of ascorbic acid (separate visits) in a double-blinded, crossover study design. Sympathetic control of BP was examined by determining the BP response to individual bursts of muscle sympathetic nerve activity (MSNA) (microneurography). Briefly, beat-to-beat mean arterial pressure (MAP) was measured continuously (finger cuff) and signal-averaged over 15 cardiac cycles following each detected burst of MSNA over a 10-min resting period. Results: In contrast to our hypothesis, no change was observed in sympathetic transduction during lipid infusion (1.5 ± 0.4 vs. 1.4 ± 3 mmHg, P=0.75). However, co-infusion of ascorbic acid significantly increased sympathetic transduction compared with baseline (1.5 ± 0.4 vs. 2.0 ± 3 mmHg, P=0.04), in addition to reducing peripheral resistance (0.73 ± 0.11 vs. 0.53 ± 12 mmHg·min·mL−1, P=0.07). MSNA and MAP were not significantly changed during the 2-hr infusions. Conclusions: These preliminary findings suggest that excess FAA do not modulate sympathetic transduction in lean, healthy adults. However, ascorbic acid infusion reduces peripheral resistance and increases sympathetic transduction, demonstrating an inverse relation between peripheral resistance and sympathetic transduction in healthy adults. Funding and support: R01HL159370-01 (S.W.H.). This work was also supported by a CTSA grant from NCATS awarded to the University of Kansas for Frontiers: University of Kansas Clinical and Translational Science Institute (# UL1TR002366) The contents are solely the responsibility of the authors and do not necessarily represent the offcial views of the NIH or NCATS. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

First Real-Life Data on the Diving Response in Healthy Children.

Swimming and diving are popular recreational activities, representing an effective option in maintaining and improving cardiovascular fitness in healthy people. To date, only little is known about the cardiovascular adaption to submersion in children. This study was conducted to improve an understanding thereof. We used a stepwise apnea protocol with apnea at rest, apnea with facial immersion, and at last apnea during whole body submersion. Continuous measurement of heart rate, oxygen saturation, and peripheral resistance index was done. Physiologic data and analysis of influencing factors on heart rate, oxygen saturation, and peripheral vascular tone response are reported. The current study presents the first data of physiologic diving response in children. Data showed that facial or whole body submersion leads to a major drop in heart rate, and increase of peripheral resistance, while the oxygen saturation seems to be unaffected by static apnea in most children, with apnea times of up to 75s without change in oxygen saturation.

Physiological Mechanisms of Dietary Salt Sensing in the Brain, Kidney, and Gastrointestinal Tract.

Excess dietary salt (NaCl) intake is strongly correlated with cardiovascular disease and is a major contributing factor to the pathogenesis of hypertension. NaCl-sensitive hypertension is a multisystem disorder that involves renal dysfunction, vascular abnormalities, and neurogenically-mediated increases in peripheral resistance. Despite a major research focus on organ systems and these effector mechanisms causing NaCl-induced increases in arterial blood pressure, relatively less research has been directed at elucidating how NaCl is sensed by various tissues to elicit these downstream effects. The purpose of this review is to discuss how the brain, kidney, and gastrointestinal tract sense NaCl including key cell types, the role of NaCl versus osmolality, and the underlying molecular and electrochemical mechanisms.

Integrated Thermofluid Lumped Parameter Model for Analyzing Hemodynamics in Human Fatigue State

It is well known that driving while fatigued is dangerous and can lead to serious traffic accidents. However, there is a lack of studies on the mechanism of fatigue. This paper sought to infer changes in the cardiovascular system through hand and head skin temperature peripheral factors via an integrated lumped parameter model. A multi-layer inner structure with variable blood perfusion was used to construct a full-body thermal model. The cardiovascular system model provided blood perfusion using lumped parameters. The peripheral resistance and heart rate in the cardiovascular system model were adjusted to match the experimental temperatures of the head and hands obtained from induced fatigue experiments. The simulation results showed that the heart rate and blood pressure decreased, and the peripheral skin resistance of the hands and head increased after fatigue. A decrease in heart rate and an increase in peripheral resistance affect the magnitude of blood flow to the periphery of the body, leading to a decrease in skin temperature during fatigue. The present integrated model elucidates a key effect of human fatigue on the cardiovascular system, which is expected to help improve the accuracy of fatigue monitoring systems.

Assessment of morphological criteria for the efficiency of radiofrequency circumferential denervation of the pulmonary artery in the experiment (animals, pigs)

The aim of the study. To assess the influence of radiofrequency circumferential exposure modes on the morphological parameters of the pulmonary artery tissues in animal experiment (pigs).Material and methods. In the experiments, we used outbred pigs divided into 3 groups (4 animals in each). The first experimental group included 188 histological samples of the pulmonary arteries (PA) after radiofrequency circumferential exposure on the PA using an ablator clamp. Two lines of exposure on the PA and two lines of exposure on each PA mouth were performed. Ablation was performed until the target level of tissue impedance between the ablator branches corresponding to the values at transmural damage was reached. The second experimental group included 162 histological samples of the PA after circumferential denervation of pulmonary trunk and both PA mouths. Ablation was completed upon reaching 50 % impedance level relative to the impedance values at transmural damage. The third group (control) included 55 histological samples of PA without radiofrequency exposure. The material obtained was studied using light microscopy, hematoxylin and eosin and van Gieson’s staining, and also by impregnation with silver salts according to S. Ramón y Cajal.Conclusions. Morphological criteria for irreversible destruction of nerve fibers and ganglia of the pulmonary trunk adventitial layer and for PA bifurcation were obtained when using two studied ablation modes. Circumferential PA denervation using subthreshold power of radiofrequency exposure made it possible to avoid irreversible damage to the nerve endings and ganglia of the PA intimal layer and thus to preserve physiological neuroreflectory regulation of the PA and the entire pulmonary circulation. Turning off the cascade of pathological reflexes eliminates the factor of the progression of pulmonary hypertension associated with an increase in peripheral resistance of the pulmonary arterioles precapillary link.

Influence of tobacco smoking on the functional state of the male cardiovascular system

The paper presents the data on functional state of the male cardiovascular system, depending on the period of tobacco smoking. The analysis of the research results shows that tobacco smoking leads to a significant increase in heart rate, blood pressure, pulsatility, average dynamic arterial pressure, minute blood volume, and circulatory efficiency ratio. Gradually increasing, the heart rate reached a maximum value of 86.6 (P <0.001) beats per minute in the group with over 20 years of smoking, while in the control group it was 73.2.The highest level of systolic and diastolic blood pressure was 138.7 (P<0.001) and 88.8 (P<0.001) mm Hg. in the group of smokers with the smoking experience of more than 20 years, while in non-smokers the indicators were 114.1 and 73.9, respectively. The maximum level of pulsatility was 49.9 (P<0.001) and that of average dynamic arterial pressure — 109.8 (P<0.001) mm Hg., identified in the group of smokers with over 20 years of smoking, while the initial levels were 40.2 and 90.8, respectively. The range of systolic blood volume between the groups was 4.3 ml. Minute blood volume in groups of men under 20 years and over increased to 4.11 (P <0.01) and 4.06 (P <0.02) l/min, while in the group of non-smokers it accounted for 3.69. The increase in the duration of tobacco smoking led to a slight increase in peripheral resistance. As the smoking period lengthens, the circulatory efficiency value undergoes a gradual increase, reaching a maximum value of 4,323 (P <0.001) in the group with over 20 years of smoking, while in the control group it was 1,898. The difference between the maximum and minimum circulatory efficiency values between the experimental male groups was 1.3.

Effects of lung volume and trigeminal nerve stimulation on diving response in breath-hold divers and non-divers

PurposeThis study investigated the effects of lung volume and trigeminal nerve stimulation (TS) on diving responses in breath-hold divers (BHDs) and non-divers (NDs). MethodsEight BHDs and nine NDs performed four breath-hold trials at different lung volumes, with or without TS, and one trial of TS. Haemodynamic parameters and electrocardiograms were measured for each trial. ResultsDuring the TS trial, the total peripheral resistance increased more in BHDs. Breath-hold performed at total lung capacity showed a more pronounced decrease in stroke volume and cardiac output in BHDs. The decrease in heart rate and increase in total peripheral resistance were more pronounced in BHDs when breath-holding was performed with TS. ConclusionThe more pronounced diving response in BHDs was attributed to the greater increase in total peripheral resistance caused by TS. Furthermore, the lower stroke volume and cardiac output in BH performed at total lung capacity could also cause a more pronounced diving response in BHDs.

Lifetime cannabis exposure and small airway function in a population-based cohort study.

Background and objectiveThe long-term effects of cannabis on small airway function remain unclear. We investigated associations between cannabis use and small airway function in a general population sample.MethodsCannabis use was ascertained at multiple ages from age 18 to 45 years and quantified as joint-years among 895 participants in the Dunedin Multidisciplinary Health and Development Study. Small airway function at ages 38 and 45 years was measured using impulse oscillometry (IOS) before and after inhalation of salbutamol. Analyses used multiple linear regression adjusting for tobacco use, body mass index and height. Longitudinal analyses of cannabis use between 38 and 45 years also adjusted for IOS at age 38 years.ResultsAssociations between lifetime cannabis joint-years and IOS differed between men and women: in women, cannabis use was associated with pre-bronchodilator resistance at 5 Hz (R5) and 20 Hz (R20), reactance at 5 Hz, area of reactance and resonant frequency, and marginally associated with the difference between R5 and R20. Cannabis use was only statistically significantly associated with pre-bronchodilator resonant frequency in men. Cannabis use between the ages of 38 and 45 years was associated with a similar pattern of changes in IOS measures. After salbutamol, cannabis use was only statistically significantly associated with R5 and R20 among women and none of the IOS measures among men.ConclusionsCannabis use is associated with small airway dysfunction at age 45 years, indicating an increase in peripheral airway resistance and reactance. These associations were greater and mostly only statistically significant among women. Associations were weaker and mostly nonsignificant after bronchodilator use, suggesting that cannabis-induced changes in small airways may be at least partially reversible.

ПРИМЕНЕНИЕ ЭЛЕКТРОМАГНИТНОЙ СТИМУЛЯЦИИ У РОДИЛЬНИЦ С ПОСЛЕРОДОВОЙ СУБИНВОЛЮЦИЕЙ МАТКИ

A comprehensive examination and treatment of 77 patients with uterine subinvolution after childbirth was carried out, 29 of which received electromagnetic stimulation from the CETA device (a course of 5 daily procedures), 28 patients of the comparison group received standard uterotonic therapy (intramuscular injection of 5 IU of oxytocin 2 times a day in within 5 days). The results of the clinical efficacy of the compared methods of treatment were evaluated for the first time according to the data of uterine tonusometry during hysterography using the SMART F 9 device. As a result of the studies, it was found that under the influence of CETA in a stimulating mode, aimed at increasing the contractile ability of the myometrium, in puerperas there is a significant decrease in the size of the uterine cavity, an increase in the tone of the myometrium according to tonusometry and an increase in the tone of the uterine arteries. It has been established that under the influence of electromagnetic stimulation, the frequency of complicated course of the postpartum period with the development of hypotonic postpartum endometritis decreases in comparison with the group of patients who received uterotonics. The favorable effect of magnetic stimulation on the tone of the uterine arteries was evidenced by a significantly more significant increase in the Doppler parameters of the uterine arteries, reflecting an increase in peripheral resistance and a decrease in the risk of bleeding, compared with patients who received only drug therapy.

Surgical and cell therapy in critical limb ischemia: Current evidence and rationale for combined treatment with special focus on diabetic patients

Critical limb ischemia (CLI) is considered the end-stage of peripheral arterial disease, with a prevalence between 2% and 4% in the general population and more than 15% in older adults. One-year major amputation rate can reach 30%, and diabetic patients are five times more likely to develop CLI than nondiabetics. The vascular damage and the complexity in the anatomical extension of the lesions are also worse in people with diabetes with poorer outcomes after vascularization attempts. Following the classifications suggested by international guidelines, we can define the presence of CLI and have a precise evaluation of the amputation risk and the best revascularization procedure for the patient. Nowadays, new endovascular techniques and devices make it possible to treat tibial vessels and even arteries below the ankle with promising initial results. Nevertheless, the re-occlusions rate and the need to re-do treatments at 1 year remain between 30% and 50%. The disease progression and hyperplasia can because it. However, the damage at the microcirculatory level can also lead to a decrease in tissue runoff and an increase in peripheral resistance, which determine the revascularization failure. In the last 20 years, several trials have been designed to avoid amputation in patients with no surgical options. The aim is to find a valid cellular base therapy to create a new vessel web in the ischemic tissue based on the angiogenetic power that stem cells have already demonstrated in vitro and animal studies. Different types of cells have been tested with different concentrations and administration routes with promising results. CD34+ Mononuclear cells, Mesenchymal stem cells, growth factors have demonstrated their contribution to the neo-angiogenesis in ischemic areas. At Abu Dhabi Stem Cells Center, we created a cellular cocktail as an adjunct treatment to surgical revascularization. We think that acting at the microcirculatory and immunological level. We may reduce postsurgery hyperplasia and increase tissue perfusion, ultimately prolonging the patency of revascularization procedures.

Left ventricular mechanical, cardiac autonomic and metabolic responses to a single session of high intensity interval training.

High-intensity interval training (HIIT) produces significant health benefits. However, the acute physiological responses to HIIT are poorly understood. Therefore, we aimed to measure the acute cardiac autonomic, haemodynamic, metabolic and left ventricular mechanical responses to a single HIIT session. Fifty young, healthy participants completed a single HIIT session, comprising of three 30-s maximal exercise intervals on a cycle ergometer, interspersed with 2-min active recovery. Cardiac autonomics, haemodynamics and metabolic variables were measured pre-, during and post-HIIT. Conventional and speckle tracking echocardiography was used to record standard and tissue Doppler measures of left ventricular (LV) structure, function and mechanics pre- and post-HIIT. Following a single HIIT session, there was significant post-exercise systolic hypotension (126 ± 13 to 111 ± 10mmHg, p < 0.05), parallel to a significant reduction in total peripheral resistance (1640 ± 365 to 639 ± 177dyne⋅s⋅cm5, p < 0.001) and significant increases in baroreceptor reflex sensitivity and baroreceptor effectiveness index (9.2 ± 11 to 24.8 ± 16.7ms⋅mmHg-1 and 41.8 ± 28 to 68.8 ± 16.2, respectively) during recovery compared to baseline. There was also a significant increase in the low- to high-frequency heart rate variability ratio in recovery (0.7 ± 0.48 to 1.7 ± 1, p < 0.001) and significant improvements in left ventricular global longitudinal strain (- 18.3 ± 1.2% to - 29.2 ± 2.3%, p < 0.001), and myocardial twist mechanics (1.27 ± 0.72 to 1.98 ± 0.72°·cm-1, p = 0.028) post-HIIT compared to baseline. A single HIIT session is associated with acute improvements in autonomic modulation, haemodynamic cardiovascular control and left ventricular function, structure and mechanics. The acute responses to HIIT provide crucial mechanistic information, which may have significant acute and chronic clinical implications.

Modern ultrasound methods for the diagnosing vibration disease

Introduction. According to the latest statistical data analysis, vibration disease (VD) remains the leading pathology in the structure of occupational morbidity in the Russian Federation. The main symptom of VD is peripheral angiodystonic syndrome, which develops as a result of peripheral vessels angiospasm of extremities, which is clinically manifested in the form of pain in hands, temperature decrease and pallor of the skin. Materials and methods. The article presents the results of an ultrasound assessment of the velocity and anatomical parameters of the main arteries of upper extremities in patients with stage 2 VD from exposure to general and local vibration. Results. According to the data of sanitary and hygienic characteristics, in all examined patients with stage 2 VD from exposure to general and local vibration, the class of working conditions was assessed as class 3 (harmful). In contrast, the excess in local vibration along the X, Y, Z axes ranged from 1 to 7 dBA. Ultrasound of the main arteries of upper extremities shows a decrease in the velocity parameters along the radial and ulnar arteries symmetrically, a significant increase in the tone of the wall of the forearm arteries. Discussion. One of the most critical problems in solving expert questions is assessing pathological process severity due to the lack of transparent and objective methods. Ultrasound research is the most affordable and safest method for evaluating the vascular system of upper extremities in stage 2 VD. It also significantly increases the objectification of expert decisions on the connection of this disease with occupation. Conclusion. VD II from the impact of general and local vibration is characterized by decreased pulse velocity on the ulnar and radial arteries symmetrically on both sides with a pronounced increase of peripheral resistance, indicating a severe angiospastic syndrome to generalized.

BIOMICROSCOPY OF THE CAPILLARY FLOW - INTERDISCIPLINARY APPROACH AND EFFECTIVENESS OF PATHOLOGICAL CONDITIONS DIAGNOSTICS

The goal – to evaluate the features and diagnostic value of the capillary bedbiomicroscopy results in various pathological conditions.Material and methods. The paper presents data on microcirculation study in patientsof various ages (adults and children) with different somatic pathologies (with diabetesmellitus, arterial hypertension, chronic gastroduodenitis, acute bronchitis) comparedwith healthy persons. The state of microcirculation was recorded using a digital USBmicroscope and evaluated by qualitative and semi quantitative assessment.Results. In patients with diabetes, the most changes in the form of capillariesand venules microaneurism, reduction of the functioning vessels number, slowingblood flow, decrease of arteriolo-venular coefficient were registered. In arterialhypertension, the signs of an increase in peripheral resistance were dominated, andin inflammatory diseases of the gastroduodenal zone and during bronchitis there wasa slowing of blood flow in arterioles and capillaries, an increase in the vascularity ofarterioles and the erythrocytes adhesion inside vessels.Conclusions. Biomicroscopy is simple and informative method for studyingmicrocirculation both chronic and acute diseases, the volume and nature of violationspredominantly depends on the type of pathology, its severity and duration.

Aging under Pressure: The Roles of Reactive Oxygen and Nitrogen Species (RONS) Production and Aging Skeletal Muscle in Endothelial Function and Hypertension-From Biological Processes to Potential Interventions.

The proportion of adults living with hypertension increases significantly with advancing age. It is therefore important to consider how health and vitality can be maintained by the aging population until end of life. A primary risk factor for the progression of cardiovascular diseases (CVD) is hypertension, so exploring the factors and processes central to this burden of disease is essential for healthy aging. A loss of skeletal muscle quantity and quality is characteristic in normal aging, with a reduction of vasodilatory capacity caused by endothelial dysfunction, and subsequent increase in peripheral resistance and risk for hypertension. Reactive Oxygen and Nitrogen Species (RONS) encompass the reactive derivatives of NO and superoxide, which are continuously generated in contracting skeletal muscle and are essential mediators for cellular metabolism. They act together as intra and intercellular messengers, gene expression regulators, and induce programmed cell death. In excessive amounts RONS can inflict damage to endothelial and skeletal muscle cells, alter signaling pathways or prematurely promote stress responses and potentially speed up the aging process. The age-related increase in RONS by skeletal muscle and endothelial mitochondria leads to impaired production of NO, resulting in vascular changes and endothelial dysfunction. Changes in vascular morphology is an early occurrence in the etiology of CVDs and, while this is also a normal characteristic of aging, whether it is a cause or a consequence of aging in hypertension remains unclear. This review serves to focus on the roles and mechanisms of biological processes central to hypertension and CVD, with a specific focus on the effects of aging muscle and RONS production, as well as the influence of established and more novel interventions to mediate the increasing risk for hypertension and CVD and improve health outcomes as we age.

Geometric Features of the Pial Arteriolar Networks in Spontaneous Hypertensive Rats: A Crucial Aspect Underlying the Blood Flow Regulation.

BackgroundSeveral studies indicate that hypertension causes major changes in the structure of the vessel wall by affecting the regulation of blood supply to the tissues. Recently, it has been observed that capillary blood flow is also considerably influenced by the structural arrangement of the microvascular networks that undergo rarefaction (reduction of the perfused vessel number). Therefore, this study aimed to assess the geometric arrangements of the pial arteriolar networks and the arteriolar rhythmic diameter changes in spontaneously hypertensive rats (SHRs).MethodsFluorescence microscopy was utilized to observe in vivo the pial microcirculation through a closed cranial window. Pial arterioles were classified according to Strahler’s method. The arteriolar rhythmic diameter changes were evaluated by a generalization short-time Fourier transform.ResultYoung SHRs showed four orders of vessels while the adult ones only three orders. The diameter, length, and branching number obeyed Horton’s law; therefore, the vessels were distributed in a fractal manner. Larger arterioles showed more asymmetrical branches than did the smaller ones in young SHRs, while in adult SHRs smaller vessels presented asymmetrical branchings. In adult SHRs, there was a significant reduction in the cross-sectional area compared with the young SHRs: this implies an increase in peripheral resistance. Young and adult age-matched normotensive rats did not show significant alterations in the geometric arteriolar arrangement with advancing age, both had four orders of arteriolar vessels, and the peripheral resistance did not change significantly. Conversely, the frequency components evaluated in arteriolar rhythmic diameter changes of young and adult SHRs showed significant differences because of a reduction in the frequency components related to endothelial activity detected in adult SHRs.ConclusionIn conclusion, hypertension progressively causes changes in the microarchitecture of the arteriolar networks with a smaller number of vessels and consequent reduced conductivity, characteristic of rarefaction. This was accompanied by a reduction in the formation and release of independent and dependent – endothelial nitric oxide components regulating arterial vasomotion.

Ultrasound features of peripheral angiodistonic syndrome of the upper extremities in vibration disease

Introduction. Vibration disease (VD) is an example of the most common pathology due to the systematic exposure of the worker to intense vibration with sufficient work experience, the main manifestation of which is peripheral angiodystonic syndrome. The aim of study was to learn the features of peripheral blood flow in the arteries of the forearm in vibration disease using the ultrasound method. Materials and methods. The radial and ulnar arteries in patients with vibration disease were examined by ultrasound in B- and PW-mode. These materials present the results of an ultrasound assessment of the speed indicators of the main arteries of the forearm in vibration disease stages 1 and 2. The selection criteria for patients in the study ware the presence of pronounced clinical manifestations of angiodystonic syndrome in vibration disease, confirmed by instrumental research methods and data on the sanitary and hygienic characteristics of working conditions, the absence of cardiovascular chronic diseases (ischemic heart disease, heart defects, rhythm and conduction disturbances), rheumatic, oncological, infectious diseases, osteo-traumatic changes in the upper extremities. Results. The groups of patients with the established diagnosis of vibration disease of 1 and 2 degrees were studied. With vibration disease stage 1 a decrease in the pulse velocity of blood flow was observed in isolation on the ulnar artery and an increase in peripheral resistance (pulsation index and resistance index) in the radial and ulnar arteries symmetrically on both upper extremities. The second stage of vibration disease differed from the first by a more significant decrease in speed indicators both on the ulnar and radial arteries on both sides, symmetrically in combination with a more pronounced increase in peripheral resistance indicators on both main arteries of the forearm (pulsation index and resistance index). The revealed changes were determined with the same frequency in men and women. Conclusions. A significant decrease in speed indicators on the ulnar artery and an increase in peripheral resistance indicators are detected already at the initial stages of vibration disease. Thus, the method of ultrasound examination of the main arteries of the middle caliber of the upper extremities is currently the only available and objective method for examining the vascular system in vibration disease.

FEATURES OF MICROCIRCULATORY DYSFUNCTION ACCORDING TO WAVLET ANALYSIS LASER DOPPLER FLOWMETRY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE AND CONCOMITANT DIFFUSE LIVER DISEASES

Aim. To determine the features of microcirculatory dysfunction and in patients with chronic ischemic heart disease, depending on the presence of concomitant diffuse liver disease. Materials and methods. We performed a prospective study on the basis of MC «Doctor Vera», as well as in the diagnostic department of Medbud Clinic between 2009 and 2019. A total of 187 patients were examined. Patients' blood flow was assessed by transthoracic echocardiography, wavelet analysis laser Doppler flowmetry (LDF). Results. In the analysis of indicators of microcirculatory dysfunction in patients with ischemic heart disease, statistically significant deterioration of wavelet analysis laser Doppler flowmetry was determined. In patients with ischemic heart disease and left ventricular ejection fraction &lt; 40 %, indicators of wavelet analysis LDF were significantly lower. We also found that the severity of diffuse liver disease significantly disrupts peripheral blood flow (Р &lt; 0.05). Conclusions. The results of intracardiac hemodynamics, microcirculatory dysfunction were first presented. In patients with isolated ischemic heart disease as the left ventricular EF decreased, a significant decrease in capillary blood flow was observed as a result of deterioration of central hemodynamics, development of atherosclerotic vascular changes, as well as an increase in their vascular tone. We have proved that in the presence of DLD in patients with ischemic heart disease and EF &lt; 40 %, the degree of increase in peripheral resistance and impaired venous outflow were more pronounced due to the depletion of vasoactive substances production, impaired their excretion by hepatocytes due to irreversible morpho-functional changes in liver at the stage of decompensation of HF, severe fibrosis, the formation of regeneration nodes. In patients with LC, the most severe disorders of peripheral blood flow were determined according to the data of the digital capillaroscopy, which testifies to the influence of the degree of liver damage on the state of microcirculation.

Low steady-state oxidative stress inhibits adipogenesis by altering mitochondrial dynamics and decreasing cellular respiration

Adipogenesis is a fundamental process of white adipose tissue function, supporting lipid storage and release, while avoiding its spillover and ectopic accumulation in tissues and organs. During aging adipogenesis is impaired and among other factors, oxidative stress contributes to this process. Adipogenesis requires functional and dynamic mitochondria; however, this organelle itself becomes dysfunctional during aging and accounts for most of reactive oxygen species (ROS) production. Here, we evaluated whether oxidative stress impairs adipogenesis through functional impairment of mitodynamics by utilizing hyperoxia as a continuous source of oxidative stress while maintaining cellular viability. This negatively impacted mitochondrial function, including respiration and dynamics and ultimately blocked adipogenesis. Interestingly, this state was reversible by using the antidiabetic drug, Rosiglitazone, which reduced oxidative stress, restored mitochondrial dynamics and respiration and augmented adipogenesis. Moreover, in vitro results were in agreement with in vivo models of oxidative stress and aging, in which mice depleted of the superoxide dismutase enzyme 1 (SOD1) and old wild-type C57BL/6JRj mice demonstrated the same trend of adipogenic potential. Importantly, in humans the results follow the same pattern, showing a downregulation of adipogenic markers during aging. Since the levels of oxidative stress and peripheral insulin resistance increase with age, while adipogenesis decreases during aging, our model helps to understand a possible way to overcome physiologically low, steady stress conditions and restore adipogenesis, avoiding accumulation of deleterious hypertrophic adipocytes in favor of beneficial hyperplasia.

Features of thermography in schoolchildren with arterial hypertension

Arterial hypertension occurs as a result of violations of the mechanisms of neurohumoral regulation of the cardiovascular system. Children of pubertal age are most prone to the development of arterial hypertension; it is determined by the vegetative dysfunctions and microcirculatory disorders inherent in these childhood periods. It is proved that microcirculatory disorders are also the basis of disorders of the cardiovascular system, in particular in the regulation of blood pressure. The state of microcirculation can be assessed using infrared thermography.The purpose of the work: to study the features and diagnostic value of thermography of the distal upper limbs in schoolchildren with arterial hypertension.Material and methods. A total of 61 school‑age children were examined. Children were divided into three groups: the first main group (21 people) included children with hypertension, the second main group (20 people) included children with hypertension, the control group (20 people) consisted of children with normal blood pressure. Anamnestic survey and general clinical examination were performed in children. Blood pressure measurement was performed by certified automatic blood pressure monitors (OMRON 705IT, OMRON, Japan) in the morning, in both arms, three times with an interval of 2 minutes. Average pressure values were estimated from percentile tables for age, gender, and height. Infrared thermography in children was performed remotely using a certified Flir One Pro thermal imager with thermal matrix resolution 160x120 pixels. Children were thermographed on their hands, on the back surface, with special attention paid to the distal part of the fingers (projections of the nail plates). The permissible error when measuring the temperature was ± 0.15º C.Results. The following data were obtained by tonometry: in 20 children (32.8%), the level of blood pressure was within the range of 90‑95%, which is estimated as arterial hypertension (2nd main group) in 21 children (34.4%) ‑ exceeded 95%, which is regarded as arterial hypertension (1st main group) in 20 children (32.8%) ‑ was within 25‑75 percentile corridor, corresponds to the normal level (control group). According to thermography, the average highest temperature of the back surface of the distal phalanges in these children was 29.7 ± 0.8 ° C, and ranged from 25.7 ° C to 32.1 ° C. In children from the control group, the average highest temperature was 30, 7 ± 0, 7º s and ranged from 28.9º s to 32.1º C. The highest temperature was recorded on the phalanx of the 3rd finger in 17 (85.0%) children, on the phalanx of the 2nd finger ‑ in 2 children (10 0%) and one child (5.0%) ‑ on the phalanx of the 4th finger, the lowest ‑ on the phalanx of the 5th finger. In children with hypertension, a decrease in the maximum fusion temperature on the dorsal surface of the hand was observed, and a shift in the area of the highest fusion on the index finger compared to children in the control group, who had this area mostly on the middle finger. Children with hypertension also exhibited a change in the thermographic pattern of the hand with a decrease in heat radiation in the 4th and 5th fingers, unlike children in the control group.Conclusions. 1. Children with arterial hypertension have features of a thermal picture, which are manifested by a decrease in the maximum temperature of thermionic emission, which, obviously, is associated with an increase in peripheral resistance of blood flow and a slowdown of blood flow in capillaries. The expansion of the maximum zone and the dominance of thermal radiation on the index finger, unlike children with normal levels of blood pressure, can be regarded as a diagnostic sign of arterial hypertension. 2. Children with hypertension according to the results of thermography should be assigned to the risk group for the development of arterial hypertension. 3. Risk factors that worsen heat radiation include microcirculation disorders (a decrease in the linear density of capillaries), as well as overweight and lack of exercise in schoolchildren. 4. Infrared thermography can be recommended as one of the methods for the early diagnosis of arterial hypertension in children.

Non-invasive evaluation of macro- and microhemodynamic changes during induction of general anesthesia - A prospective observational single-blinded trial.

Hypotension and bradycardia are known side effects of general anesthesia, while little is known about further macro- and microhemodynamic changes during induction. Intriguing is furthermore, why some patients require no vasopressor medication to uphold mean arterial pressure, while others need vasopressor support. Determination of macro- and microhemodynamic changes during induction of general anesthesia. We enrolled 150 female adults scheduled for gynaecological surgery into this prospective observational, single-blinded trial. Besides routinely measuring heart rate (HR) and mean arterial blood pressure (MAP), the non-invasive technique of thoracic electrical bioimpedance was applied to measure cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke volume variability (SVV) and index of myocardial contractility (ICON) before induction of anesthesia, 7 times during induction, and, finally, after surgery in the recovery room. Changes in microcirculation were assessed using sidestream dark field imaging to establish the perfused boundary region (PBR), a validated gauge of glycocalyx health. Comparisons were made with Friedman's or Wilcoxon test for paired data, and with Mann-Whitney-U test for unpaired data, with post-hoc corrections for multiple measurements by the Holm-Bonferroni method. 83 patients did not need vasopressor support, whereas 67 patients required therapy (norepinephrine, atropine or cafedrine/theodrenaline) to elevate MAP values to ≥70mmHg during induction, 54 of these receiving norepinephrine (NE) alone. Pre-interventional (basal) values of CO, CI, ICON, SV and SVV were all significantly lower in the group of patients later requiring NE (p < 0.04), whereas HR and MAP were identical for both groups. HR, MAP and CO decreased from baseline to 12 min after induction of general anesthesia in both the patients without and those with NE support. Heart rate decreased significantly by about 25% in both groups (-19 to -21 bpm). The median individual decrease of MAP amounted to -26.7% (19.7/33.3, p < 0.001) and -26.1% (11.6/33.2, p < 0.001), respectively, whereas for CO it was -40.7% (34.1/50.1, p < 0.001) and -43.5% (34.8/48.7). While these relative changes did not differ between the two groups, in absolute values there were significantly greater decreases in CO, CI, SV and ICON in the group requiring NE. Noteably, NE did not restore ICON or the other cardiac parameters to levels approaching those of the group without NE. PBR was measured in a total of 84 patients compiled from both groups, there being no intergroup differences. It increased 6.4% (p < 0.001) from pre-induction to the end of the operation, indicative of damage to microvascular glycocalyx. Non-invasive determination of CO provides additional hemodynamic information during anesthesia, showing that induction results in a significant decrease not only of MAP but also of CO and other cardiac factors at all timepoints compared to baseline values. The decrease of CO was greater than that of MAP and, in contrast to MAP, did not respond to NE. There was also no sign of a positive inotropic effect of NE in this situation. Support of MAP by NE must consequently result from an increase in peripheral arterial resistance, posing a risk for oxygen supply to tissue. In addition, general anesthesia and the operative stimulus lead to an impairment of the microcirculation.