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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixteen men with previously untreated diastolic blood pressure of 100-120 mm Hg were studied hemodynamically at rest supine and sitting and during a 100 W bicycle exercise. Blood pressure (BP) was recorded intra-arterially, and cardiac output (CO) by the dye-dilution method. After initial study, patients were treated with tiapamil in increasing doses (300-600 mg b.i.d., with a mean daily dose of 980 mg). The patients were restudied and then changed to felodipine (5-10 mg b.i.d., with a mean daily dose of 15 mg). Casual (cuff) BP at rest sitting was as follows: end placebo, 166/105 mm Hg; 1 year of tiapamil, 148/92 mm Hg; 1 year of felodipine, 139/86 mm Hg. Pretreatment hemodynamic results at rest sitting were as follows: BP, 169/105 mm Hg; MAP, 129 mm Hg; cardiac index (CI), 2.43 L/min/m2; total peripheral resistance index (TPRI), 4,305 dyn s/cm-5/m2. Both drugs reduced systolic (SAP), diastolic (DAP), and mean (MAP) arterial pressure significantly in all situations. BP reduction seemed to be more pronounced on felodipine than on tiapamil. Felodipine reduced MAP by 15% at rest supine, 14% at rest sitting, and 11% during exercise. The BP reduction was entirely due to reduction in TPRI (15, 16, and 13%, respectively). CI as well as stroke index (SI) and heart rate (HR) were unchanged. Tiapamil did not reduce TPRI significantly and the fall in BP was due to a combination fall in TPRI and CI.
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PMID:Chronic hemodynamic effects of tiapamil and felodipine in essential hypertension at rest and during exercise. 169 26

Propofol, in both its new oil-in-water emulsion and the former cremophor-EL solution, is known to produce significant decreases in arterial blood pressure. The aim of this study was to obtain a precise hemodynamic profile of anesthesia induction with propofol under conditions of daily routine (additional 70% nitrous oxide) and to evaluate the influence of (1) premedication with lormetazepam and (2) additional i.v. injection of fentanyl. Forty patients (ASA classes I and II) were randomly assigned to one of four groups (A, B, C, and D). Anesthesia was induced with a sleep dose of propofol (mean: 2.4 mg/kg) and the patient was ventilated with 30% O2 and 70% N2O via a face mask. In groups B and D, 3 micrograms/kg fentanyl were injected immediately prior to propofol injection. Patients in groups A and B received no premedication. Patients in groups C and D received 2 mg lormetazepam on the evening prior to the anesthetic and 1 mg 2 h prior to the anesthetic orally. The following parameters were determined immediately prior to induction of anesthesia and 1, 3, 5, 8, and 10 min after the start of the propofol injection: heart rate (HR), mean arterial blood pressure (MAP), mean pulmonary artery pressure (PAP), central venous pressure (CVP), pulmonary occlusion pressure (POP), cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR). In all four groups a slight decrease in HR and SVR occurred while a marked decrease in arterial blood pressure (SAP, MAP, DAP) and cardiac output was seen. PAP and preload pressures showed no significant changes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hemodynamics under propofol-nitrous oxide anesthesia: effects of premedication with lormetazepam and of additional fentanyl]. 289 30

In connection with a mass screening of the Bergen population 93 patients with essential hypertension and 48 normotensive controls were studied in 1965-66. Blood pressure (BP) was recorded intraarterially, cardiac output (CO), by dilution method, heart rate (HR) by ECG and oxygen consumption (VO2) by Douglas bag/Scholander technique. Studies were performed during rest and 50, 100 and 150 watt steady state exercise. The most important initial findings were: Although CO and HR were higher in the youngest hypertensive group (17-29 yrs) than in normotensive age matched controls VO2 was also increased and no true luxury perfusion was demonstrated. Exercise stroke index (SI) did not increase to the same level as in normotensives and total peripheral resistance index (TPRI) during exercise was increased. Cross-sectional data showed a reduction in SI and CI and an increase in TPRI with increasing age - at rest as well as during exercise. 10-year follow-up: 28 subjects initially below 40 years were completely untreated. During the first 10 years there was a fall in CI and SI of approximately 15% and TPRI increased by 20%. The same changes were seen at rest as well as during exercise. Resting blood pressure was practically unchanged. Nearly all patients greater than 40 yrs were treated. 20-year follow-up: Between the 10 year and 20 year follow-up DAP rose to 100 mmHg or more in most of the subjects less than 40 yrs and treatment had to be started. Generally diuretics, betablockers or a combination of the 2 were used. Before the 20 year follow-up, treatment was withdrawn for 2 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hemodynamics in essential hypertension at rest and during exercise--a 20-year follow-up study. 325 Mar 16

Six healthy males were exposed to 20 mm Hg lower body negative pressure (LBNP) for 8 min followed by 40 mm Hg LBNP for 8 min. Naloxone (0.1 mg.kg-1) was injected intravenously during a 1 h resting period after which the LBNP protocol was repeated. Systolic, mean, and diastolic arterial blood pressures (SAP, MAP, DAP), and central venous pressure (CVP) were obtained using indwelling catheters. Cardiac output (CO), forearm blood flow (FBF), heart rate (HR), left ventricular ejection time (LVET), and electromechanical systole (EMS) were measured non-invasively. Pulse pressure (PP), stroke volume (SV), total peripheral resistance (TPR), forearm vascular resistance (FVR), systolic ejection rate (SER), pre-ejection period (PEP), PEP/LVET and indices for the systolic time intervals (LVETI, EMSI, PEPI) were calculated. During the second LBNP exposure, only two parameters differed from the pre-injection values: DAP at LBNP = 40 mm Hg increased from 60.0 +/- 4.8 mm Hg to 64.8 +/- 4.1 mm Hg (N = 4, p less than 0.02) and LVETI at LBNP = 20 mm Hg increased from 384.4 +/- 5.2 ms to 396.8 +/- 6.2 ms (N = 6, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Human cardiovascular reactions to simulated hypovolaemia, modified by the opiate antagonist naloxone. 339 65

The relation between left ventricular mean systolic pressure (LVSP) determined by planimetric integration and systolic and diastolic pressure measured in a peripheral artery (SAP and DAP) was calculated using data published by Ross & Braunwald in 1964. The relation was LVSP = SAP-0.32 +/- 0.06 (s.d.) X (SAP-DAP). The formula SAP- 0.32 (SAP-DAP) was used to calculated LVSP, and the correlation between measured and calculated LVSP was found to be 0.91 (P less than 0.001). It is concluded that LVSP can be calculated with reasonable accuracy from measurements of arterial pressure in patients without aortic stenosis. At present three different formulas are in use for the calculation of left ventricular stroke work index (LVSWI). The pressure work is defined as SAP, LVSP or mean arterial pressure minus mean pulmonary capillary wedge pressure or left ventricular end diastolic pressure. This makes comparisons between different studies with respect to LVSWI difficult or impossible.
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PMID:The calculation of left ventricular stroke work index. 377 49

the autonomic sympathetic reflexes to sustained handgrip, upright tilt and the Valsalva maneuver, were tested in 26 patients with labile and 26 with fixed essential hypertension. Sustained handgrip increased systolic (SAP), diastolic (DAP) and mean arterial (MAP) pressure, heart rate (HR), cardiac index (CI), tension time index (TTI) (p less than .01), and had no effect on total peripheral resistance index (TPRI) and left ventricular ejection rate index (LVERI) in both groups of patients. However, the response to upright tilt and the Valsalva maneuver was different in the two groups. Upright tilt in labile hypertensives increased DAP, MAP, HR, and TPRI (p less than .001); decreased CI, stroke index (SI) and LVERI (p less than .01) and had no effect on SAP. In fixed hypertensives, it decreased SAP, MAP, CI, SI and LVERI (p less than .001); increased HR (p less than .01) and had no effect on DAP, and TPRI. The diastolic pressure overshoot of the Valsalva maneuver was attenuated in fixed hypertensives compared to labile (p less then .001). Additionally, when the percent changes from control in DAP, MAP, HR and TPRI to sustained handgrip and upright tilt between the two groups were compared, only differences to upright tilt between the two groups were observed. The results of this investigation suggest that upright tilt and the Valsalva maneuver might serve as better predictors of autonomic reflexes in hypertensive patients than the grip test.
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PMID:Hemodynamic correlates of autonomic reflexes in patients with labile and fixed hypertension. 733 96

We have measured haemodynamic responses to induction of anaesthesia, laryngoscopy and intubation in 103 mild-moderate hypertensive patients (83 patients (diastolic pressures < or = 110 mm Hg) currently receiving one of four monotherapies (ACE inhibitors, group A; beta adrenoceptor blocking drugs, group B; calcium channel antagonists, group C; diuretics, group D) and 24 were untreated hypertensive patients). Anaesthesia was induced with fentanyl 1.5-2.0 micrograms kg-1 and thiopentone 3-5 mg kg-1. Tracheal intubation was facilitated by vecuronium 0.1 mg kg-1 and anaesthesia maintained with enflurane and nitrous oxide in oxygen. Systolic and diastolic pressures (SAP, DAP) were measured at 1-min intervals by a non-invasive oscillometric method and cardiac output (CO) and stroke volume (SV) by thoracic bioimpedance. Induction of anaesthesia was associated with a decrease in SAP, DAP and CO in groups A-D (P < 0.05). Heart rate (HR) decreased in groups A and D (P < 0.01) and systemic vascular resistance (SVR) decreased in groups A and B (P < 0.05). SAP and HR increased in all groups after laryngoscopy and intubation (P < 0.01) as did SVR in groups A, B and D (P < 0.02). CO was unaltered. Similar changes occurred in the untreated hypertensive patients, although nine of 24 patients exhibited HR > or = 100 beat min-1 after laryngoscopy and intubation. Comparison of the changes in SAP, DAP, CO and SVR with time showed no differences in the five treatment groups; changes in HR were significantly less in group B compared with the other groups (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Does the choice of antihypertensive therapy influence haemodynamic responses to induction, laryngoscopy and intubation? 794 53

We have studied the haemodynamic effects of a bolus injection of propofol 2 mg kg-1 in 20 patients with good ventricular function undergoing aortocoronary bypass surgery. Heart rate and systolic and diastolic systemic (SAP, DAP) and pulmonary arterial pressures, central venous pressure, pulmonary artery wedge pressure, cardiac output (CO), right ventricular ejection fraction, systemic (SVR) and pulmonary vascular resistances and left ventricular stroke work index (LVSWI) were measured before and at 1, 3, 5, 10, 20 and 30 min after the administration of propofol. At 1 min, maximum decreases were detected in SAP (-26%, P < 0.001), DAP (-17%, P < 0.001), SVR (-22% P < 0.001) and LVSWI (-23%, P < 0.001). The other variables studied showed no significant variations at any time during the study. We conclude that propofol reduces systemic arterial pressure by a decrease in SVR, but not in CO or ventricular filling pressures.
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PMID:Haemodynamic effects of propofol during coronary artery bypass surgery. 813 70

KT3-671, a nonpeptide AT1 receptor antagonist, was administered to 20-week-old stroke-prone spontaneously hypertensive rats (SHRSP) daily for 3 weeks. Its effects on systolic, mean, and diastolic arterial blood pressure (SAP, MAP, DAP), heart rate and locomotor activity were investigated with radiotelemetry. A clear diurnal variation in blood pressure, heart rate, and locomotor activity was observed in synchrony with the light cycle. KT3-671 at a daily dose of 10 mg/kg orally (p.o), produced a significant and consistent reduction in blood pressure, preventing the development of hypertension. KT3-671 reduced SAP more than DAP, suggesting that it may affect both vascular tone and cardiac output. Although KT3-671 did not affect diurnal rhythms in heart rate and locomotor activity, it did cause a slight but significant reduction in heart rate. The MAP determined 23 h after the administration of KT3-671 showed a significant reduction from the day 2 of therapy to the day 3 after discontinuation of therapy, suggesting a long duration of antihypertensive action. There was no rebound increase in blood pressure after discontinuation of KT3-671 therapy. These results suggest that KT3-671 may be potentially useful in the therapy of hypertension.
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PMID:Effect of repeated administration of KT3-671, a nonpeptide AT1 receptor antagonist, on diurnal variation in blood pressure, heart rate, and locomotor activity in stroke-prone spontaneously hypertensive rats as determined by radiotelemetry. 890 3

This study was performed to determine the cardiovascular responses to isoflurane in euthyroid and hypothyroid dogs. Four healthy mixed-breed dogs were studied prior to thyroidectomy (PRE), 6 months after thyroidectomy (HYP), and after 2 months of oral supplementation with 1-thyroxine (SUP). Heart rate (HR), cardiac output (Q), stroke volume (SV), systolic, diastolic, mean arterial blood pressure (SAP, DAP, MAP), and total peripheral resistance (TPR) were determined in awake dogs and in the same dogs when end-tidal isoflurane concentration were 1.28%, 1.92%, and 2.56%. Ventilation was controlled in anesthetized dogs and PACO2 maintained between 38 to 42 mm Hg. Isoflurane caused significant (P < .05) dose-dependent reduction in Q, SV, SAP, DAP, and MAP in the PRE, HYP, and SUP dogs. Cardiac output was lower in the HYP dogs than in the PRE or SUP dogs during awake measurement. TPR was increased in the awake HYP dogs compared with the PRE or SUP dogs. During anesthesia, HYP dogs tended to have lower Q, SV, SAP, and MAP PRE or SUP groups, but the only significant reduction was SAP during 1.5 MAC. The cardiovascular responses to isoflurane in hypothyroid dogs are similar to euthyroid animals with a dose-dependent depression in Q, SV, and arterial pressure.
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PMID:Cardiovascular effects of 1.0, 1.5, and 2.0 minimum alveolar concentrations of isoflurane in experimentally induced hypothyroidism in dogs. 892 95


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