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MeSH: Arteries-physiopathology

99 záznamů v Medvik Filtry

Článek

Žilní onemocnění je oknem do srdce

Medical tribune. 2023 ; 19 (14) : B6-B7. [pub] 20230627

ISSN 1214-8911
Medvik
Zdroj

MeSH
arterie patofyziologie MeSH
ateroskleróza farmakoterapie patofyziologie MeSH
kardiovaskulární nemoci * etiologie farmakoterapie MeSH
klinická studie jako téma MeSH
kongresy jako téma MeSH
lidé MeSH
trombóza farmakoterapie patofyziologie MeSH
vény patofyziologie MeSH
žilní insuficience farmakoterapie MeSH
Check Tag
lidé MeSH
Publikační typ
novinové články MeSH

Článek online

The Effect of Artificial Pulsatility on the Peripheral Vasculature in Patients With Continuous-Flow Ventricular Assist Devices

Canadian journal of cardiology. 2021 ; 37 (10) : 1578-1585. [pub] 20210606

Can J Cardiol
ISSN 1916-7075
Medvik
Zdroj

BACKGROUND: Implantation of left-ventricular assist systems (LVASs) has become the standard of care for advanced heart failure (HF). The absence of pulsatility in previous devices contributes to vascular and endothelial dysfunction related to atherosclerotic or vascular complications. We hypothesized that the artificial pulsatility provided by the HeartMate 3 (HM3) (Abbott, Chicago, IL) LVAS would exert a favourable effect on the vasculature. METHODS: In 32 patients implanted with HM3 (5 female patients, mean age 55 ± 13.6 years), the reactive hyperemia index (RHI) and peripheral augmentation index (AI), markers of endothelial function and arterial stiffness, were measured with an EndoPAT2000 before and in the third and sixth month after implantation. RHI and AI data from 30 HeartMate II (HM II) (Abbott) recipients in the third and sixth month after implantation, from 15 patients with advanced HF without LVASs and from 13 healthy volunteers were also analyzed. RESULTS: In HM3 recipients, the mean RHI significantly decreased at 3 and 6 months after implantation. The RHI was substantially lower at baseline than that of healthy or the HF reference group. Increasing AI values, indicating worsening arterial stiffness, were also observed. Similar trends were observed in HM II recipients between the third and sixth months but with higher absolute values of RHI and AI. CONCLUSIONS: We detected impaired vascular function in HM3 patients and provided additional evidence on the negative effect of low pulsatility on vascular function after LVAS implantation. The results suggest that the artificial pulsatility of the HM3 does not avert the progression of endothelial dysfunction.

MeSH
arterie patofyziologie MeSH
časové faktory MeSH
cévní endotel patofyziologie MeSH
cévní rezistence fyziologie MeSH
funkce levé komory srdeční fyziologie MeSH
lidé středního věku MeSH
lidé MeSH
následné studie MeSH
podpůrné srdeční systémy * MeSH
prospektivní studie MeSH
srdeční komory patofyziologie MeSH
srdeční selhání patofyziologie terapie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
pozorovací studie MeSH
práce podpořená grantem MeSH

Článek

Non-invasive assessment of arterial pulsatility in patients with continuous-flow left ventricular assist devices

The International Journal of Artificial Organs. 2020 ; 43 (2) : 99-108. [pub] 20190814

Int. J. Artif. Organs (Testo stamp.)
ISSN 1724-6040
Medvik
Zdroj

INTRODUCTION: Long-term use of continuous-flow left ventricular assist devices may have negative consequences for autonomic, cardiovascular and gastrointestinal function. It has thus been suggested that non-invasive monitoring of arterial pulsatility in patients with a left ventricular assist device is highly important for ensuring patient safety and longevity. We have developed a novel, semi-automated frequency-domain-based index of arterial pulsatility that is obtained during suprasystolic occlusions of the upper arm: the 'cuff pulsatility index'. PURPOSE: The purpose of this study was to evaluate the relationship between the cuff pulsatility index and invasively determined arterial pulsatility in patients with a left ventricular assist device. METHODS: Twenty-three patients with a left ventricular assist device with end-stage heart failure (six females: age = 65 ± 9 years; body mass index = 30.5 ± 3.7 kg m-2) were recruited for this study. Suprasystolic occlusions were performed on the upper arm of the patient's dominant side, from which the cuff pressure waveform was obtained. Arterial blood pressure was obtained from the radial artery on the contralateral arm. Measurements were obtained in triplicate. The relationship between the cuff pressure and arterial blood pressure waveforms was assessed in the frequency-domain using coherence analysis. A mixed-effects approach was used to assess the relationship between cuff pulsatility index and invasively determined arterial pulsatility (i.e. pulse pressure). RESULTS: The cuff pressure and arterial blood pressure waveforms demonstrated a high coherence up to the fifth harmonic of the cardiac frequency (heart rate). The cuff pulsatility index accurately tracked changes in arterial pulse pressure within a given patient across repeated measurements. CONCLUSIONS: The cuff pulsatility index shows promise as a non-invasive index for monitoring residual arterial pulsatility in patients with a left ventricular assist device across time.

MeSH
arterie patofyziologie MeSH
asistovaná cirkulace přístrojové vybavení metody MeSH
diagnostické techniky kardiovaskulární MeSH
krevní tlak fyziologie MeSH
lidé středního věku MeSH
lidé MeSH
podpůrné srdeční systémy * MeSH
pulz metody MeSH
pulzatilní průtok fyziologie MeSH
reprodukovatelnost výsledků MeSH
senioři MeSH
srdeční selhání * patofyziologie terapie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH

Článek

Endovaskulární léčba arteriálního poranění vzniklého při ortopedické operaci
[Endovascular treatment of iatrogenic arterial injury following lower limb orthopedic surgery]

Česká radiologie. 2019 ; 73 (1) : 19-23.

Čes. radiol.
ISSN 1210-7883
Medvik
Zdroj

Dvěma kazuistikami bychom rádi prezentovali možnost endovaskulárního řešení obávaných a potenciálně devastujících iatrogenních arteriálních poranění během ortopedických operací při náhradě kyčelního a kolenního kloubu. V prvním případě se jednalo o rekonstrukční výkon pomocí stentgraftu pro pseudoaneurysma popliteální arterie, které vzniklo při náhradě kolenního kloubu endoprotézou. V průběhu výkonu byl implantován samoexpandibilní stentgraft s dobrým výsledkem. Druhý případ popisuje léčbu pacientky, která byla poraněna při reoperaci periprotetické fraktury náhrady kyčelního kloubu. Tato reoperace byla komplikována trombózou povrchové stehenní tepny a následnou manifestací krvácení po trombektomii. Metodou volby byla implantace samoexpandibilního stentgraftu. Přes úspěšnou léčbu iatrogenní komplikace pacientka zanedlouho zemřela na orgánové selhání z důvodu neokluzivní střevní ischemie. Endovaskulární terapie iatrogenních arteriálních poranění je vysoce účinnou a bezpečnou metodou a měla by být zvažována jako možnost první volby.

Our two case reports represent endovascular treatment of feared and potentially devastating iatrogenic arterial injuries during orthopedic surgery of the hip and knee. First case describes an endovascular reconstruction of pseudoaneurysm of popliteal artery after total knee replacement. A selfexpandable stentgraft was implanted via endovascular approach and no other complications appeared postoperatively. Second case conveys a story of female patient with total hip endoprosthesis complicated by periprosthetic fracture. Upcoming operation resulted in superficial femoral artery occlusion, which was treated with thrombaspiration and selfexpandable stentgraft implantation. This patient however, owing to overall frailty, expired later by causes unrelated with endovascular procedure. Our paper briefly points that endovascular treatment is highly effective and safe method and should be considered as the option of the first choice.

MeSH
arterie patofyziologie MeSH
chybná zdravotní péče MeSH
endovaskulární výkony * metody MeSH
iatrogenní nemoci MeSH
lidé MeSH
ortopedické výkony * škodlivé účinky MeSH
rány a poranění MeSH
senioři MeSH
výkony cévní chirurgie metody MeSH
Check Tag
lidé MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
kazuistiky MeSH

Článek

Effects of metabolic syndrome on arterial function in different age groups: the Advanced Approach to Arterial Stiffness study

Journal of hypertension. 2018 ; 36 (4) : 824-833. [pub] -

J Hypertens
ISSN 1473-5598
Medvik
Zdroj

OBJECTIVE: The aim of the Advanced Approach to Arterial Stiffness study was to compare arterial stiffness measured simultaneously with two different methods in different age groups of middle-aged and older adults with or without metabolic syndrome (MetS). The specific effects of the different MetS components on arterial stiffness were also studied. METHODS: This prospective, multicentre, international study included 2224 patients aged 40 years and older, 1664 with and 560 without MetS. Patients were enrolled in 32 centres from 18 European countries affiliated to the International Society of Vascular Health & Aging. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI) and the carotid-femoral pulse wave velocity (CF-PWV) in four prespecified age groups: 40-49, 50-59, 60-74, 75-90 years. In this report, we present the baseline data of this study. RESULTS: Both CF-PWV and CAVI increased with age, with a higher correlation coefficient for CAVI (comparison of coefficients P < 0.001). Age-adjusted and sex-adjusted values of CF-PWV and CAVI were weakly intercorrelated (r = 0.06, P < 0.001). Age-adjusted and sex-adjusted values for CF-PWV but not CAVI were higher in presence of MetS (CF-PWV: 9.57 ± 0.06 vs. 8.65 ± 0.10, P < 0.001; CAVI: 8.34 ± 0.03 vs. 8.29 ± 0.04, P = 0.40; mean ± SEM; MetS vs. no MetS). The absence of an overall effect of MetS on CAVI was related to the heterogeneous effects of the components of MetS on this parameter: CAVI was positively associated with the high glycaemia and high blood pressure components, whereas lacked significant associations with the HDL and triglycerides components while exhibiting a negative association with the overweight component. In contrast, all five MetS components showed positive associations with CF-PWV. CONCLUSION: This large European multicentre study reveals a differential impact of MetS and age on CAVI and CF-PWV and suggests that age may have a more pronounced effect on CAVI, whereas MetS increases CF-PWV but not CAVI. This important finding may be due to heterogeneous effects of MetS components on CAVI. The clinical significance of these original results will be assessed during the longitudinal phase of the study.

Článek online

A simple method of incorporating the effect of the Uniform Stress Hypothesis in arterial wall stress computations

Acta of Bioengineering and Biomechanics. 2018 ; 20 (4) : 59-67.

Acta Bioeng Biomech
ISSN 1509-409X
Medvik
Zdroj

PURPOSE: Residual stress has a great influence on the mechanical behaviour of arterial wall. Numerous research groups used the Uniform Stress Hypothesis to allow the inclusion of the effects of residual stress when computing stress distributions in the arterial wall. Nevertheless, the available methods used for this purpose are very computationally expensive, due to their iterative nature. In this paper we present a new method for including the effects of residual stress on the computed stress distribution in the arterial wall. METHODS: The new method, by using the Uniform Stress Hypothesis, enables computing the effect of residual stress by averaging stresses across the thickness of the arterial wall. RESULTS: Being a post-processing method for the computed stress distributions, the proposed method is computationally inexpensive, and thus, better suited for clinical applications than the previously used ones. CONCLUSIONS: The resulting stress distributions and values obtained using the proposed method based on the Uniform Stress Hypothesis are very close to the ones returned by an existing iterative method.