Results obtained by the modern automatic blood pressure (BP) monitors using oscillometric method [5] are highly dependent on conditions of cardiovascular system of the monitored person. Especially, with people who suffer from cardiovascular diseases (e.g. atherosclerosis) the resulting values differ significantly from those measured by the traditional auscultation method. A reasonable solution for improvement of quality of oscillometric method could be a sophisticated intelligent BP measuring system which applies for evaluation of BP more complex approach taking into account the monitored person's condition of patient cardiovascular system (CS) i.e. the hemodynamic parameters of CS (e.g. heart rate, stroke volume, total peripheral resistance, systemic arterial compliance, pulse wave velocity, augmentation index etc.). Such a system has to be based on appropriate models of the considered diseases which are validated on real life data. For that purpose, we have started to build a database of real-life oscillometric pulsations waveforms (OPW) complemented by the values of "auscultation" blood pressure measurements and additional relevant information about the considered patients (age, sex, etc.) as well as their diagnosis. This data collection requires a special HW device for measurement of the OPW--we have developed such a device and it has been validated in Czech Certified Metrological Centre. Our OPW monitor is connected through the T-pieces and tubes to the cuff, mercury sphygmomanometer and automatic "oscillometric" blood pressure monitor.

• MeSH
• Blood Pressure Monitoring, Ambulatory instrumentation   methods   MeSH
• Databases, Factual MeSH
• Hemodynamics MeSH
• Cardiovascular Diseases physiopathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Blood Pressure Monitors * MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH

OBJECTIVES: This study compared Doppler and oscillometric (PetMAP+) devices (with or without proprietary optimisations) for the non-invasive measurement of blood pressure in conscious cats. METHODS: Twenty-three cats were enrolled; however, five were excluded as fewer than five measurements were obtained for each assessment. All measurements were obtained according to American College of Veterinary Internal Medicine consensus guidelines. Oscillometric device modes A and B were operated according to the manufacturer's guidelines. Doppler and oscillometric devices were used alternately as the first device. RESULTS: Systolic arterial blood pressure (SAP) measurements were obtained by Doppler (SAPd) and oscillometry; the mean of each set of five values was used for statistical analysis. There was a significant difference between SAPd and SAP measurements in oscillometric modes A (P <0.001) and B (P <0.001). While both modes measured SAP higher than SAPd, B had a smaller bias (+15.72 mmHg) and narrower limits of agreement (LOA). There was also a significant difference between SAPd and mean arterial pressure (MAP) on oscillometric modes A (P = 0.002) and B (P <0.001). Both modes' MAP readings were lower than SAPd and oscillometric A MAP was closer to SAPd (-14.94 mmHg), with a smaller bias and narrower LOA. CONCLUSIONS AND RELEVANCE: The findings support that Doppler and oscillometric devices cannot be used interchangeably, with or without proprietary optimisations. Methodology should always be taken into account and reference intervals (RIs) need to be defined for the different methodologies. Until methodology-specific RIs are published, definitive diagnosis of hypertension and sub-staging of patients with kidney disease according to the International Renal Interest Society guidelines remains challenging.

• Keywords
• Feline, NIBP, blood pressure, hypertension, indirect,
• MeSH
• Cats MeSH
• Blood Pressure MeSH
• Blood Pressure Determination * veterinary   MeSH
• Blood Pressure Monitors MeSH
• Oscillometry veterinary   MeSH
• Ultrasonography, Doppler veterinary   MeSH
• Ultrasonics * MeSH
• Animals MeSH
• Check Tag
• Cats MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Before arterial cannulation for invasive blood pressure monitoring, clinical decision-making depends on non-invasive blood pressure in critically ill patients. Whether non-invasive blood pressure is comparable to invasive measurement is not clearly elucidated. We address this issue as it relates to the use of norepinephrine in patients with cardiogenic shock. METHODS: We analysed invasive and non-invasive blood pressure in 85 patients admitted to the Coronary-Care Unit for cardiogenic shock. We compared initial blood pressure measurement (just after radial artery cannulation) and blood pressure taken during the first 72 hours after admission. Invasive blood pressure was used as the reference method. RESULTS: Initial invasive mean and systolic arterial pressures were in a good agreement with oscillometric blood pressure; mean differences were -0.4 ± 8.8 and +6.1 ± 14.4 mmHg with correlation coefficients of 0.76 and 0.74. Doses of norepinephrine were significant negative determinants of invasive/oscillometric blood pressure differences. The invasive/oscillometric mean arterial pressures and SBP differences were +0.1 ± 3.4 and 7.6 ± 1.6 mmHg in patients treated with nothing or a maximum norepinephrine dose of 0.6 µg/kg/min. However, treatment with very high doses of norepinephrine was associated with a steep rise in mean arterial pressures and SBP invasive/oscillometric differences (-9.5 ± 3.3 and -8.5 ± 5.2 mmHg). In a total of 967 sets of blood pressure measurements, invasive/oscillometric differences were relatively stable across blood pressure categories, with the exception of measurements assessed after very high norepinephrine doses. CONCLUSIONS: Non-invasive BP is a sufficient substitute for invasive measurement in cardiogenic shock patients, with the exception of those receiving very high doses of norepinephrine.

• MeSH
• Arterial Pressure MeSH
• Shock, Cardiogenic physiopathology   MeSH
• Catheterization MeSH
• Blood Pressure drug effects   MeSH
• Critical Illness MeSH
• Middle Aged MeSH
• Humans MeSH
• Blood Pressure Determination methods   MeSH
• Monitoring, Physiologic MeSH
• Norepinephrine administration & dosage   pharmacology   MeSH
• Oscillometry methods   MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Vasoconstrictor Agents administration & dosage   pharmacology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Names of Substances
• Norepinephrine MeSH
• Vasoconstrictor Agents MeSH

BACKGROUND: Stage 1 hypertension influences acute cardiovascular responses to resistance exercises and post-exercise recovery. We examined whether the order of exercises, particularly in agonist-antagonist pairings, can alter these cardiovascular responses. This study compares systolic and diastolic blood pressure responses during agonist and agonist-antagonist paired sets of upper and lower-body resistance exercises with a load of 75% repetition maximum in individuals with normotension and stage 1 hypertension. METHODS: A cross-sectional study enrolled 47 participants with sedentary jobs, comprising 30 normotensive individuals (47.8 ± 5.9 years, height 174.8 ± 10.2 cm, weight 77.7 ± 15.4 kg, BMI 25.3 ± 3.6 kg/m2) and 17 hypertensive individuals (54.3 ± 6.0 years, 177.6 ± 11.3 cm, 89.8 ± 16.4 kg, BMI 28.5 ± 4,5 kg/m2). Acute cardiovascular parameters were measured using an arteriograph, a non-invasive device designed to assess vascular stiffness and cardiovascular health, after each set of resistance training. RESULTS: No significant differences in systolic blood pressure changes were found between the resistance training methods and aerobic exercise when comparing normotensive and hypertensive individuals. However, significant increases in systolic blood pressure were observed during lower-body exercises (11.3-24.7 mmHg for normotensives and 11.7-24.1 mmHg for hypertensives, p < 0.05). Hypertensive individuals showed slightly higher increases during lower-body supersets (p < 0.05). Regarding diastolic blood pressure, significant decreases were noted during upper-body resistance training for both groups, especially for normotensives (-10.6 to -13.7 mmHg, p < 0.05). CONCLUSIONS: Agonist and agonist-antagonist paired set resistance training for both lower and upper-body exercises resulted in similar blood pressure changes in individuals with normotension and stage 1 hypertension. These findings suggest that both methods may have comparable cardiovascular effects across blood pressure. TRIAL REGISTRATION: The study was registered on ClinicalTrials.gov (NCT06047678). Registration date: 31 August 2023.

• Keywords
• Acute cardiovascular responses, Blood pressure, Blood pressure changes, Hypertension, Resistance training,
• Publication type
• Journal Article MeSH

Two experiments were conducted to explore the usefulness of the Penaz method for non-invasive, continuous finger blood pressure measurements during mental stress testing. In the first study, blood pressure was measured with the Penaz method, in the second it was measured intra-arterially. Two different subject groups were used. In both experiments the same mental task, a memory search and counting task, was used. Experimental effects, consisting of rest-task differences in heart rate and blood pressure, its (spectral) variability and the coherence between fluctuations in the two signals (e.g. baroreflex sensitivity) are compared for the two measuring methods. Experimental effects on mean pressure values, spectral variability measures and baroreflex sensitivity are similar for the two types of measurement. Effects on mean pressure are smaller in the finger pressure indices. It is concluded that the Penaz instrument can provide us with a useful method for studying cardiovascular reactivity in mental stress research.

• MeSH
• Adult MeSH
• Mental Processes physiology   MeSH
• Blood Pressure physiology   MeSH
• Humans MeSH
• Blood Pressure Determination MeSH
• Adolescent MeSH
• Fingers blood supply   MeSH
• Regional Blood Flow physiology   MeSH
• Heart Rate physiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: The use of goal directed fluid protocols in intermediate risk patients undergoing hip or knee replacement was studied in few trials using invasive monitoring. For this reason we have implemented two different fluid management protocols, both based on a novel totally non-invasive arterial pressure monitoring device and compared them to the standard (no-protocol) treatment applied before the transition in our academic institution. METHODS: Three treatment groups were compared in this prospective study: the observational (CONTROL, N = 40) group before adoption of fluid protocols and two randomized groups after the transition to protocol fluid management with the use of the continuous non-invasive blood pressure monitoring (CNAP®) device. In the PRESSURE group (N = 40) standard variables were used for restrictive fluid therapy. Goal directed fluid therapy using pulse pressure variation was used in the GDFT arm (N = 40). The influence on the rate of postoperative complications, on the hospital length of stay and other parameters was assessed. RESULTS: Both protocols were associated with decreased fluid administration and maintained hemodynamic stability. Reduced rate of postoperative infection and organ complications (22 (55 %) vs. 33 (83 %) patients; p = 0.016; relative risk 0.67 (0.49-0.91)) was observed in the GDFT group compared to CONTROL. Lower number of patients receiving transfusion (4 (10 %) in GDFT vs. 17 (43 %) in CONTROL; p = 0.005) might contribute to this observation. No significant differences were observed in other end-points. CONCLUSION: In our study, the use of the fluid protocol based on pulse pressure variation assessed using continuous non-invasive arterial pressure measurement seems to be associated with a reduction in postoperative complications and transfusion needs as compared to standard no-protocol treatment. TRIAL REGISTRATION: ACTRN12612001014842.

• MeSH
• Arterial Pressure physiology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Arthroplasty, Replacement, Hip adverse effects   methods   MeSH
• Monitoring, Intraoperative adverse effects   methods   MeSH
• Postoperative Complications diagnosis   etiology   prevention & control   MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Fluid Therapy methods   MeSH
• Arthroplasty, Replacement, Knee adverse effects   methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Randomized Controlled Trial MeSH

Epilepsy, affecting over 50 million people globally, presents a significant neurological challenge. Effective prevention of epileptic seizures relies on proper administration and monitoring of Anti-Seizure Medication (ASMs). Therapeutic Drug Monitoring (TDM) ensures optimal dosage adjustment, minimizing adverse effects and potential drug interactions. While traditional venous blood collection for TDM may be stressful, emerging alternative sampling methods, particularly Dried Blood Spot (DBS) or oral fluid offer less invasive way of sampling. This study aimed to develop and validate an analytical method for the determination of lamotrigine in such alternative samples. The sample, either DBS or oral fluid, was subjected to extraction, evaporation, and reconstitution in 15 % acetonitrile containing 0.1 % formic acid. A Kinetex C18 Polar column was used for liquid chromatographic separation and MS in ESI+ mode was used for detection and quantitation of lamotrigine using an isotopically labelled internal standard according to EMA guidelines. The calibration range of the developed method enables the determination of lamotrigine in the concentration range of 1-30 μg/mL in DBS and 0.5-20 μg/mL in oral fluid. Oral fluid and DBS samples from patients treated with lamotrigine analysed by the developed method were compared to plasma concentrations measured by the hospital's accredited laboratory. Preliminary results indicate a promising potential for these alternative matrices in clinical TDM applications. By offering a less invasive sampling approach, this method improves the accessibility and safety of pharmacotherapy for epilepsy patients. The results of this study lay the foundation for further clinical applications by implementing alternative matrix TDM, which may significantly advance personalized care in epilepsy management.

• Keywords
• Alternative matrix, Antiepileptics, Dried blood spot, Lamotrigine, Quantification, Saliva, Validation,
• MeSH
• Anticonvulsants * analysis   blood   MeSH
• Chromatography, Liquid methods   MeSH
• Epilepsy drug therapy   MeSH
• Calibration MeSH
• Liquid Chromatography-Mass Spectrometry MeSH
• Lamotrigine * analysis   blood   MeSH
• Humans MeSH
• Limit of Detection MeSH
• Drug Monitoring * methods   MeSH
• Reproducibility of Results MeSH
• Saliva * chemistry   MeSH
• Tandem Mass Spectrometry methods   MeSH
• Dried Blood Spot Testing * methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Validation Study MeSH
• Names of Substances
• Anticonvulsants * MeSH
• Lamotrigine * MeSH

Noninvasive techniques are routinely used for assessment of tissue effects of lung ventilation. However, comprehensive studies of the response time of the methods are scarce. The aim of this study was to compare the response time of noninvasive methods for monitoring of gas exchange to sudden changes in the composition of the inspired gas. A prospective experimental study with 16 healthy volunteers was conducted. A ventilation circuit was designed that enabled a fast change in the composition of the inspiratory gas mixture while allowing spontaneous breathing. The volunteers inhaled a hypoxic mixture, then a hypercapnic mixture, a hyperoxic mixture and finally a 0.3% CO mixture. The parameters with the fastest response to the sudden change of O2 in inhaled gas were peripheral capillary oxygen saturation (SpO2) and regional tissue oxygenation (rSO2). Transcutaneous oxygen partial pressure (tcpO2) had almost the same time of reaction, but its time of relaxation was 2-3 times longer. End-tidal carbon dioxide (EtCO2) response time to change of CO2 concentration in inhaled gas was less than half in comparison with transcutaneous carbon dioxide partial pressure (tcpCO2). All the examined parameters and devices reacted adequately to changes in gas concentration in the inspiratory gas mixture.

• Keywords
• near infrared spectroscopy, non-invasive respiratory monitoring, pulse oximetry, transcutaneous monitoring,
• MeSH
• Humans MeSH
• Carbon Dioxide chemistry   MeSH
• Oximetry MeSH
• Reaction Time MeSH
• Blood Gas Monitoring, Transcutaneous methods   MeSH
• Respiration, Artificial methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Carbon Dioxide MeSH

Czech physiologist Penaz tried to overcome limitations of invasive pulse-contour methods (PCM) in clinical applications by a non-invasive method (finger mounted BP cuff) for continuous arterial waveform detection and beat-to-beat analysis. This discovery resulted in significant interest in human physiology and non-invasive examination of hemodynamic parameters, however has limitations because of the distal BP recording using a volume-clamp method. Thus, we propose a validation of beat-to-beat signal analysis acquired by novel a brachial occlusion-cuff (suprasystolic) principle and signal obtained from Finapres during a forced expiratory effort against an obstructed airway (Valsalva maneuver). Twelve healthy adult subjects [2 females, age = (27.2 ± 5.1) years] were in the upright siting position, breathe through the mouthpiece (simultaneously acquisition by brachial blood pressure monitor and Finapres) and at a defined time were asked to generate positive mouth pressure for 20 s (Valsalva). For the purpose of signal analysis, we proposed parameter a “Occlusion Cuff Index” (OCCI). The assumption about similarities between measured signals (suprasystolic brachial pulse waves amplitudes and Finapres’s MAP) were proved by averaged Pearson’s correlation coefficient (r- = 0.60, p < 0.001). The averaged Pearson’s correlation coefficient for the comparative analysis of OCCI between methods was r- = 0.88, p < 0.001. The average percent change of OCCI during maneuver: 8% increase, 19% decrease and percent change of max/min ratio is 35%. The investigation of brachial pulse waves measured by novel brachial blood pressure monitor shows positive correlation with Finapres and the parameter OCCI shows promise as an index, which could describe changes during beat-to-beat cardiac cycles.

• Keywords
• cuff, non-invasive, occlusion, pulse wave,
• MeSH
• Pulse Wave Analysis * MeSH
• Brachial Artery * physiology   MeSH
• Adult MeSH
• Blood Pressure physiology   MeSH
• Humans MeSH
• Blood Pressure Determination methods   MeSH
• Young Adult MeSH
• Fingers MeSH
• Heart Rate MeSH
• Feasibility Studies MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

AIMS: Right ventricular apical pacing has a detrimental effect on left ventricular (LV) function. More optimal pacing site may be found by invasive measurement of LV mechanical performance during pacing from different RV pacing sites. We aimed to investigate the effect of RV pacing lead location on invasive indices of LV mechanical performance. METHODS AND RESULTS: Patients undergoing catheter ablation for persistent atrial fibrillation were enrolled. Single-site endocardial pacing from the lateral LV region was periodically switched to pacing from the mapping catheter navigated to different RV sites within the three-dimensional electroanatomical RV map. SystIndex, DiastIndex, and PPIndex were defined as the ratio of LV dP/dtmax, LV dP/dtmin, and arterial pulse pressure during RV pacing to corresponding values from adjacent periods of LV pacing. Haemodynamic data were analysed in 18 RV segments created by dividing RV horizontally (basal, mid, and apical portion), vertically (inferior, mid, and superior portion) and frontally (septum and free wall). Eight patients (58 ± 7 years; 2 females; 26 ± 4 RV pacing sites per patient) were enrolled into the study. Compared with LV pacing, the best RV pacing values of SystIndex and DiastIndex were achieved in basal-mid-septal segment (+6.9%, P = 0.02 and +3.4%, P = 0.36, respectively) while the best PPIndex was obtained in superior-mid-septal segment of RV (+4.5%, P = 0.02). All indices were fairly concordant showing significant improvement of haemodynamics during RV pacing in the direction from free wall to septum, from apex to base, and from inferior to superior segments. CONCLUSION: The best LV mechanical performance was achieved by RV septal pacing in the non-apical mid-to-superior segments.

• Keywords
• Electroanatomical mapping, Haemodynamics of pacing, Optimal pacing site, Resynchronization, Right ventricular pacing,
• MeSH
• Time Factors MeSH
• Diastole * MeSH
• Electrophysiologic Techniques, Cardiac MeSH
• Electrocardiography MeSH
• Atrial Fibrillation diagnosis   physiopathology   surgery   MeSH
• Ventricular Function, Left * MeSH
• Ventricular Function, Right * MeSH
• Cardiac Pacing, Artificial methods   MeSH
• Catheter Ablation MeSH
• Blood Pressure MeSH
• Middle Aged MeSH
• Humans MeSH
• Ventricular Septum physiopathology   MeSH
• Predictive Value of Tests MeSH
• Heart Ventricles physiopathology   MeSH
• Systole * MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH