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Hypertension (Dallas, Tex. : 1979) Sep 2021Hypertension is a potent cardiovascular risk factor with deleterious end-organ effects and is especially prevalent among patients with chronic kidney disease. The SPRINT... (Review)
Review
Hypertension is a potent cardiovascular risk factor with deleterious end-organ effects and is especially prevalent among patients with chronic kidney disease. The SPRINT (Systolic Blood Pressure Intervention Trial) enrolled patients at an elevated cardiac risk including patients with mild to moderate chronic kidney disease and found that an intensive systolic blood pressure goal of <120 mm Hg significantly reduced the rates of adverse cardiovascular events and all-cause mortality and nonsignificantly reduced the rates of probable dementia; these results were consistent whether one had chronic kidney disease or not. However, results of intensive blood pressure therapy on chronic kidney disease progression were inconclusive, and there was an increased risk of incident chronic kidney disease and acute kidney injury, but the declines in kidney function appear to be hemodynamically driven and reversible. Overall, an intensive blood pressure target is effective in reducing cardiovascular disease and all-cause mortality and may reduce the risk of probable dementia in patients with mild to moderate chronic kidney disease. More studies are needed to determine its long-term effects on kidney function.
Topics: Aged; Aged, 80 and over; Cardiovascular Diseases; Female; Glomerular Filtration Rate; Humans; Hypertension; Male; Middle Aged; Renal Insufficiency, Chronic; Systole
PubMed: 34365808
DOI: 10.1161/HYPERTENSIONAHA.121.16505 -
Current Cardiology Reviews Nov 2013A significant clinical problem is patients presenting with exercise-limiting dyspnoea, sometimes with associated chest pain, in the absence of detectable left... (Review)
Review
A significant clinical problem is patients presenting with exercise-limiting dyspnoea, sometimes with associated chest pain, in the absence of detectable left ventricular (LV) systolic dysfunction, coronary artery disease, or lung disease. Often the patients are older, female, and have isolated basal septal hypertrophy (BSH), frequently on a background of mild hypertension. The topic of breathlessness in patients with clinical heart failure, but who have a normal ejection fraction (HFNEF) has attracted significant controversy over the past few years. This review aims to analyse the literature on BSH, identify the possible associations between BSH and HFNEF, and consequently explore possible pathophysiological mechanisms whereby clinical symptoms are experienced.
Topics: Cardiomyopathy, Hypertrophic; Diastole; Dyspnea; Heart Septum; Humans; Hypertrophy; Stroke Volume; Systole; Ultrasonography
PubMed: 24313643
DOI: 10.2174/1573403x09666131202125424 -
Hypertension (Dallas, Tex. : 1979) Apr 2017
Topics: Diastole; Heart; Heart Failure; Humans; Systole
PubMed: 28223470
DOI: 10.1161/HYPERTENSIONAHA.116.08849 -
California Medicine Mar 1961In phonocardiography the second heart sound is important in appraisal of congenital heart disease and pulmonary hypertension because it reflects the duration of right...
In phonocardiography the second heart sound is important in appraisal of congenital heart disease and pulmonary hypertension because it reflects the duration of right ventricular systoles. The systolic murmur in patients with intracardiac shunt decreases as pulmonary hypertension develops, and may eventually disappear completely as the pulmonary pressure reaches systemic level. Reference tracings in phonocardiography are useful for showing the interrelationship of the various cardiac sounds and murmurs.
Topics: Heart Defects, Congenital; Heart Murmurs; Heart Sounds; Humans; Hypertension, Pulmonary; Phonocardiography; Systole; Systolic Murmurs
PubMed: 13722948
DOI: No ID Found -
Current Problems in Cardiology Feb 2023We hypothesized that an interpretable gradient boosting machine (GBM) model considering comorbidities, P-wave and echocardiographic measurements, can better predict... (Review)
Review
We hypothesized that an interpretable gradient boosting machine (GBM) model considering comorbidities, P-wave and echocardiographic measurements, can better predict mortality and cerebrovascular events in mitral regurgitation (MR). Patients from a tertiary center were analyzed. The GBM model was used as an interpretable statistical approach to identify the leading indicators of high-risk patients with either outcome of CVAs and all-cause mortality. A total of 706 patients were included. GBM analysis showed that age, systolic blood pressure, diastolic blood pressure, plasma albumin levels, mean P-wave duration (PWD), MR regurgitant volume, left ventricular ejection fraction (LVEF), left atrial dimension at end-systole (LADs), velocity-time integral (VTI) and effective regurgitant orifice were significant predictors of TIA/stroke. Age, sodium, urea and albumin levels, platelet count, mean PWD, LVEF, LADs, left ventricular dimension at end systole (LVDs) and VTI were significant predictors of all-cause mortality. The GBM demonstrates the best predictive performance in terms of precision, sensitivity c-statistic and F1-score compared to logistic regression, decision tree, random forest, support vector machine, and artificial neural networks. Gradient boosting model incorporating clinical data from different investigative modalities significantly improves risk prediction performance and identify key indicators for outcome prediction in MR.
Topics: Humans; Mitral Valve Insufficiency; Ventricular Function, Left; Stroke Volume; Systole; Stroke
PubMed: 36261105
DOI: 10.1016/j.cpcardiol.2022.101464 -
Journal of Cardiothoracic Surgery Aug 2016Treatment with the intraaortic balloon pump (IABP) is the most common form of mechanical support for the failing heart. Augmentation of diastolic pressure during balloon... (Review)
Review
Treatment with the intraaortic balloon pump (IABP) is the most common form of mechanical support for the failing heart. Augmentation of diastolic pressure during balloon inflation contributes to the coronary circulation and the presystolic deflation of the balloon reduces the resistance to systolic output. Consequently, the myocardial work is reduced. The overall effect of the IABP therapy is an increase in the myocardial oxygen supply/demand ratio and thus in endocardial viability.This is an overall synopsis of what we need to know regarding IABP. Furthermore, this review article attempts to systematically delineate the pathophysiology linked with the hemodynamic consequences of IABP therapy. The authors also look at the future of the use of the balloon pump and conclude that the positive multi-systemic hemodynamic regulation during IABP treatment should further justify its use.
Topics: Blood Pressure; Coronary Circulation; Heart Failure; Hemodynamics; History, 20th Century; History, 21st Century; Humans; Intra-Aortic Balloon Pumping; Systole
PubMed: 27487772
DOI: 10.1186/s13019-016-0513-0 -
Scientific Reports Jun 2019We introduce a novel paradigm to unobtrusively and optically measure blood pressure (BP) without calibration. The algorithm combines photoplethysmography (PPG) waveform...
We introduce a novel paradigm to unobtrusively and optically measure blood pressure (BP) without calibration. The algorithm combines photoplethysmography (PPG) waveform analysis and biometrics to estimate BP, and was evaluated in subjects with various age, height, weight and BP levels (n = 1249). In the young population (<50 years old) with low, medium and high systolic blood pressures (SBP, <120 mmHg; 120-139 mmHg; ≥140 mmHg), the fitting errors are 6.3 ± 7.2, -3.9 ± 7.2 and -20.2 ± 14.2 mmHg for SBP respectively; In the older population (>50 years old) with the same categories, the fitting errors are 12.8 ± 9.0, 0.5 ± 8.2 and -14.6 ± 11.5 mmHg for SBP respectively. A simple personalized calibration reduces fitting errors significantly (n = 147), and good peripheral perfusion helps to improve the fitting accuracy. In conclusion, PPG may be used to calculate BP without calibration in certain populations. When calibrated, it shows great potential to serially monitor BP fluctuation, which can bring tremendous economic and health benefits.
Topics: Adult; Aged; Biometry; Blood Pressure; Blood Pressure Determination; Calibration; Humans; Middle Aged; Perfusion; Photoplethysmography; Systole
PubMed: 31197243
DOI: 10.1038/s41598-019-45175-2 -
Physiological Measurement Feb 2019Evaluate a method for the estimation of the nocturnal systolic blood pressure (SBP) dip from 24 h blood pressure trends using a wrist-worn photoplethysmography (PPG)...
OBJECTIVE
Evaluate a method for the estimation of the nocturnal systolic blood pressure (SBP) dip from 24 h blood pressure trends using a wrist-worn photoplethysmography (PPG) sensor and a deep neural network in free-living individuals, comparing the deep neural network to traditional machine learning and non-machine learning baselines.
APPROACH
A wrist-worn PPG sensor was worn by 106 healthy individuals for 226 d during which 5111 reference values for blood pressure (BP) were obtained with a 24 h ambulatory BP monitor and matched with the PPG sensor data. Features based on heart rate variability and pulse morphology were extracted from the PPG waveforms. Long- and short term memory (LSTM) networks, dense networks, random forests and linear regression models were trained and evaluated in their capability of tracking trends in BP, as well as the estimation of the SBP dip.
MAIN RESULTS
Best performance for estimating the SBP dip were obtained with a deep LSTM neural network with a root mean squared error (RMSE) of 3.12 [Formula: see text] 2.20 [Formula: see text] mmHg and a correlation of 0.69 [Formula: see text]. This dip was derived from trend estimates of BP which had an RMSE of 8.22 [Formula: see text] 1.49 mmHg for systolic and 6.55 [Formula: see text] 1.39 mmHg for diastolic BP (DBP). While other models had similar performance for the tracking of relative BP, they did not perform as well as the LSTM for the SBP dip.
SIGNIFICANCE
The work provides first evidence for the unobtrusive estimation of the nocturnal SBP dip, a highly prognostic clinical parameter. It is also the first to evaluate unobtrusive BP measurement in a large data set of unconstrained 24 h measurements in free-living individuals and provides evidence for the utility of LSTM models in this domain.
Topics: Adolescent; Adult; Blood Pressure Determination; Circadian Rhythm; Deep Learning; Female; Humans; Male; Middle Aged; Models, Statistical; Photoplethysmography; Signal Processing, Computer-Assisted; Systole; Young Adult
PubMed: 30699397
DOI: 10.1088/1361-6579/ab030e -
International Journal of Environmental... Sep 2022Various factors may alter the risk for cardiovascular disease in adults with Down syndrome (Ds), yet few studies have examined differences in cardiac physiology in this...
Various factors may alter the risk for cardiovascular disease in adults with Down syndrome (Ds), yet few studies have examined differences in cardiac physiology in this population. Previous research suggested lower systolic and diastolic function, but inconsistent methodologies and younger samples warrant research in adults with Ds. Our aim is to compare the cardiac structure and function of adults with Ds to age- and sex-matched adults without Ds. Echocardiography was used to assess systolic function, diastolic function, and cardiac structure in = 19 adults (Ds = 9, control = 10). Regarding cardiac structure, adults with Ds had increased left ventricular posterior wall thickness at end-systole compared to adults without Ds ( = 0.007). Regarding systolic and diastolic function, adults with Ds were found to have lower septal peak systolic annular velocity (S') ( = 0.026), lower lateral and septal mitral annular early diastolic velocity (E') ( = 0.007 and = 0.025, respectively), lower lateral peak mitral annular late diastolic velocity (A') ( = 0.027), and higher lateral and septal mitral annular early systolic velocity to diastolic velocity ratios (E/e') ( = 0.001 and = 0.001, respectively). Differences in both cardiac structure and function were found when comparing adults with Ds to matched adults without Ds. Most of the differences were indicative of worse diastolic function.
Topics: Adult; Diastole; Down Syndrome; Echocardiography; Humans; Mitral Valve; Systole; Ventricular Function, Left
PubMed: 36231610
DOI: 10.3390/ijerph191912310 -
BMJ (Clinical Research Ed.) Oct 2002
Topics: Age Factors; Aged; Blood Pressure; Cardiovascular Diseases; Humans; Hypertension; Middle Aged; Risk Factors; Systole
PubMed: 12399325
DOI: 10.1136/bmj.325.7370.917