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PubMed2000

The influence of the hand circulation on the assessment of venous distensibility of the human forearm with venous occlusion plethysmography.

AIMS: To determine the influence of the hand circulation on the determination of venous distensibility with venous occlusion plethysmography. METHODS: In a randomised study, duplicate measurements of forearm venous distensibility, with and without a wrist cuff, were made over occlusion periods of 3 and 12 min in eight volunteers. Treatments were compared with paired Student's t-tests and differences are presented as 95% confidence intervals (CI). Intra-subject variability was assessed with analysis of variance. RESULTS: Non-significant differences in increases in forearm volume between the occlusions with and without wrist cuff were found for the 3 min occlusion (CI: -0.4, + 0.2%) and the 12 min occlusion period (CI: -0.7, + 0.2%). However, the coefficient of variation was lower with the use of a wrist cuff; after 3 min occlusion (12% vs 19%) and after 12 min of occlusion (14% vs 24%). Forearm volume after 12 min of venous occlusion was 0.5% (CI: + 0.4, + 0.7) higher than after 3 min. CONCLUSIONS: Although venous distensibility was equal when assessed with and without wrist cuff, exclusion of the hand circulation reduces intraindividual variability. Equilibrium in forearm volume is not reached after 3 min period of venous occlusion, as often assumed. The magnitude of the additional increase after prolonged occlusion stresses the need for well-controlled studies.

Adult↗
PubMed1998

Calf vein compliance increases following bed rest after aortocoronary bypass surgery.

Early post-operative ambulation (< 3 days) is expected to decrease the risk of venous thrombosis, whereas late ambulation (> 7 days) increases the risk of orthostatic hypotension. The effect of post-operative bed rest on calf vein compliance was studied before (D - 1) and 7 days (D + 7) after aortocoronary bypass surgery in 50 patients (41 men and nine women, 65 +/- SD 10 years). Calf vein compliance was measured by strain gauge plethysmography and stepwise increases in thigh congestive pressure from 20 to 60 mmHg. Calf compliance [median (25 percentile-75 percentile)] increased significantly by 48% from D - 1 to D + 7 [0.044 (0.039-0.051) vs. 0.065 (0.048-0.083) ml (100 ml mmHg)-1, P < 0.001]. This increase was reflected as increased calf volume for the 50 mmHg [D-1 2.10 (1.75-2.65) vs. D + 7 2.60 (1.70-3.00) ml 100 ml-1, P < 0.01] and 60 mmHg [D - 1 2.50 (2.10-2.95) vs. D + 7 3.20 (2.30-4.00) ml 100 ml-1, P < 0.001] occlusion pressure levels. The associated pathologies (diabetes and arterial hypertension) and NYHA grades had no significant influence on the increase in compliance. Among the vasoactive therapeutic regimens, calcium channel blockers contributed significantly to the increased calf compliance, but only on D-1. The increase in venous compliance following aortocoronary bypass surgery is multifactorial but should be considered for prophylactic management of these patients.

Aged↗
PubMed2000

Membrane cholesterol content modulates activation of volume-regulated anion current in bovine endothelial cells.

Activation of volume-regulated anion current (VRAC) plays a key role in the maintenance of cellular volume homeostasis. The mechanisms, however, that regulate VRAC activity are not fully understood. We have examined whether VRAC activation is modulated by the cholesterol content of the membrane bilayer. The cholesterol content of bovine aortic endothelial cells was increased by two independent methods: (a) exposure to a methyl-beta-cyclodextrin saturated with cholesterol, or (b) exposure to cholesterol-enriched lipid dispersions. Enrichment of bovine aortic endothelial cells with cholesterol resulted in a suppression of VRAC activation in response to a mild osmotic gradient, but not to a strong osmotic gradient. Depletion of membrane cholesterol by exposing the cells to methyl-beta-cyclodextrin not complexed with cholesterol resulted in an enhancement of VRAC activation when the cells were challenged with a mild osmotic gradient. VRAC activity in cells challenged with a strong osmotic gradient were unaffected by depletion of membrane cholesterol. These observations show that changes in membrane cholesterol content shift VRAC sensitivity to osmotic gradients. Changes in VRAC activation were not accompanied by changes in anion permeability ratios, indicating that channel selectivity was not affected by the changes in membrane cholesterol. This suggests that membrane cholesterol content affects the equilibrium between the closed and open states of VRAC channel rather than the basic pore properties of the channel. We hypothesize that changes in membrane cholesterol modulate VRAC activity by affecting the membrane deformation energy associated with channel opening.

Animals↗
PubMed2003

Determination of aortic compliance from magnetic resonance images using an automatic active contour model.

The possibility of monitoring changes in aortic elasticity in humans has important applications for clinical trials because it estimates the efficacy of plaque-reducing therapies. The elasticity is usually quantified by compliance measurements. Therefore, the relative temporal change in the vessel cross-sectional area throughout the cardiac cycle has to be determined. In this work we determined and compared the compliance between three magnetic resonance (MR) methods (FLASH, TrueFISP and pulse-wave). Since manual outlining of the aortic wall area is a very time-consuming process and depends on an operator's variability, an algorithm for the automatic segmentation of the artery wall from MR images through the entire heart cycle is presented. The reliable detection of the artery cross-sectional area over the whole heart cycle was possible with a relative error of about 1%. Optimizing the temporal resolution to 60 ms we obtained a relative error in compliance of about 7% from TrueFISP (1.0 x 1.0 x 10 mm3, signal-to-noise ratio (SNR) > 12) and FLASH (0.7 x 0.7 x 10 mm3, SNR > 12) measurements in volunteers. Pulse-wave measurements yielded an error of more than 9%. In a study of ten volunteers, a compliance between C = 3 x 10(-5) Pa(-1) and C = 8 x 10(-5) Pa(-1) was determined, depending on age. The results of the TrueFISP and the pulse-wave measurements agreed very well with one another (confidence interval of 1 x 10(-5) Pa(-1)) while the results of the FLASH method more clearly deviated from the TrueFISP and pulse-wave (confidence interval of more than 2 x 10(-5) Pa(-1)).

Algorithms↗
PubMed1996

Alteration of peripheral vasodilatory reserve capacity after cardioversion of atrial fibrillation.

In atrial fibrillation, exercise capacity is often reduced. This is usually ascribed to a decreased cardiac output as compared with sinus rhythm. Very few studies, however, have focused on changes in the peripheral blood flow during atrial fibrillation as a potential mechanism for exercise limitation. The aim of the present study was to determine the effect of conversion of atrial fibrillation to sinus rhythm on peripheral blood flow. Calf blood flow, using an electrocardiogram-triggered venous occlusion plethysmograph, and peak oxygen consumption (peak VO2), using treadmill exercise testing, were studied in 28 patients with chronic atrial fibrillation eligible for electrical cardioversion. Measurements were performed before cardioversion, and repeated 1 day and 1 month thereafter. Calf blood flow at rest, maximal calf blood flow, and minimal calf vascular resistance during the hyperaemic response immediately following 700 J of calf exercise were determined plethysmographically. One day and 1 month after cardioversion, 23 and 14 patients were still in sinus rhythm, respectively. In patients who still had sinus rhythm after 1 month, maximal calf blood flow increased from 33.7 +/- 12 to 40.0 +/- 13 ml. 100 ml-1.min-1 (P < 0.01) and minimal calf vascular resistance fell from 3.2 +/- 0.9 to 2.7 +/- 0.7 mmHg. ml-1. 100 ml-1. min-1 (P < 0.01); peak VO2 increased from 21.3 +/- 4 to 24.2 +/- 5 ml. min-1. kg-1 (P < 0.001). Calf blood flow at rest did not improve. In contrast, no significant changes in maximal calf blood flow, minimal calf vascular resistance and peak VO2 occurred in patients who had atrial fibrillation 1 month after cardioversion. A significant correlation was found between changes in maximal calf blood flow and peak VO2 1 month after cardioversion (r = 0.53, P < 0.01). One day after cardioversion, no changes in calf blood flow or peak VO2 were found, either in patients with sinus rhythm or atrial fibrillation. In conclusion, transition from chronic atrial fibrillation to sinus rhythm is associated with a (delayed) improvement in maximal calf blood flow, minimal calf vascular resistance, and peak VO2. Our findings suggest that increase in vasodilatory reserve capacity may contribute to the improvement of exercise capacity after cardioversion of atrial fibrillation.

Aged↗
PubMed1997

The effects of cross-linked hemoglobin on regional vascular conductance in dogs.

Hemoglobin (Hgb) solutions cause systemic vasoconstriction, which might limit their use as intraoperative blood substitutes. This constriction is thought to be caused by interaction between Hgb and nitric oxide (NO). To determine whether alpha-alpha cross-linked hemoglobin (XL-Hgb) interferes with NO-mediated vasodilation caused by acetylcholine (ACh) and sodium nitroprusside (NTP), we infused these compounds into the femoral, superior mesenteric, and circumflex coronary arteries of anesthetized dogs (n = 6) before and after partial exchange transfusion with XL-Hgb. Additional animals (n = 6) were studied after treatment with 5% albumin. XL-Hgb administration increased mean arterial pressure (MAP) from 81 +/- 5 to 112 +/- 8 (P < 0.05). Albumin reduced MAP from 84 +/- 4 mm Hg to 76 +/- 4 mm Hg (P < 0.05). Vascular conductance after XL-Hgb decreased in the femoral artery, was not changed in the mesenteric bed, and increased modestly in the coronary artery (from 0.19 +/- 0.03 to 0.26 +/- 0.02 mL x mm Hg(-1) x min(-1), P < 0.05). After albumin, conductance was unchanged in the femoral artery and increased in the mesenteric artery. Conductance also increased in the coronary bed (from 0.25 +/- 0.02 to 0.49 +/- 0.03 mL x mm Hg(-1) x min(-1), P < 0.05). The vasodilator response to ACh in the femoral or mesenteric beds was either unaffected or augmented by either XL-Hgb or albumin. In the coronary bed, XL-Hgb blunted the dilator responses to ACh and NTP, while albumin augmented the coronary dilator responses to ACh. In five additional dogs, the NO synthase inhibitor N(G)-monomethyl L-arginine caused MAP to increase from 85 +/- 4 to 90 +/- 8 mm Hg and blunted the coronary dilator responses to ACh by approximately 25%. Subsequent XL-Hgb administration caused a further increase in MAP to 112 +/- 19 mm Hg (P < 0.05) and also further blunted ACh-mediated vasodilator responses in the coronary circulation. XL-Hgb has complex effects on the circulatory system, including a reduction in the vasodilator responses to ACh and NTP in canine coronary arteries in vivo. The potential impact of these events on patients with significant coexisting disease is unclear.

Acetylcholine↗
PubMed1992

Alpha-adrenergic and serotonergic receptors and forearm venous compliance in normal human subjects.

The effect of alpha-adrenergic and serotonergic receptor agonists and antagonists on forearm venous capacitance and vascular resistance was studied in normal subjects. Venous volumes were significantly decreased by phenylephrine, an alpha 1-adrenoceptor agonist, and norepinephrine, which stimulates both alpha 1- and alpha 2-adrenoceptors, but not by the alpha 2-adrenoceptor agonist clonidine. Vascular resistance was increased significantly by all three agonists. Both the alpha 2-adrenoceptor antagonist yohimbine and the alpha 1-adrenoceptor antagonist prazosin attenuated the venoconstrictor and vasoconstrictor response to norepinephrine, indicating that both adrenoceptors are present. 5-Hydroxytryptamine significantly decreased venous volumes, while vascular resistance was not affected. Ketanserin, a 5-HT2 and alpha 1-adrenoceptor antagonist, attenuated the venous volume responses to 5-hydroxytryptamine and phenylephrine. It is concluded that there are alpha 1- and alpha 2-adrenoceptors and 5-HT2 receptors in the forearm venous system. However, vasoactive doses of clonidine are not venoconstricting. Forearm veins are sensitive to doses of 5-hydroxytryptamine, which do not change vascular resistance compared to alpha-adrenoceptor agonists, which affect both.

Adrenergic alpha-Agonists↗
PubMed2002

Relationship between arterial distensibility and low-frequency power spectrum of blood pressure in spontaneously hypertensive rats.

The aim of this study was to determine in spontaneously hypertensive rats (SHRs) whether a significant association may be observed between the low-frequency component of blood pressure variability (BPV) and arterial distensibility and to evaluate the role of the autonomic nervous system in this relationship. Doxazosin (1 mg/kg/d s.c.), flesinoxan (1 mg/kg/d s.c.), and urapidil (30 mg/kg/d s.c.) were infused over 24 h in SHRs. Blood pressure was recorded in conscious rats and BPV was characterized by spectral analysis. The distensibility-pressure curves for the carotid artery were determined by an ultrasonic echo-tracking device in anesthetized rats. Untreated SHRs had higher mean arterial pressure (MAP) and low-frequency MAP but a lower distensibility than normotensive Wistar-Kyoto rats. In SHRs inhibition of the autonomic nervous system by peripheral blockade of alpha1-adrenoceptors (doxazosin, 1 mg/kg, or urapidil, 30 mg/kg) or centrally mediated reduction of sympathetic tone (flesinoxan, 1 mg/kg) reduced MAP and low-frequency MAP in the conscious state and increased carotid operational distensibility in the anesthetized state. In these SHRs, we observed a negative association between low-frequency MAP and operational distensibility ( r = -0.48, p < 0.01). From multiple regression analysis, MAP and low-frequency MAP, but not drug treatment, influenced arterial distensibility. Our study in SHRs provides evidence for a strong association between increased low-frequency MAP and reduced arterial distensibility, with a common modulation provided by the autonomic nervous system via the alpha 1 -adrenergic receptor component and central nervous system.

Adrenergic alpha-Antagonists↗
PubMed1997

Effect of prolonged hypothermic ischemia and reperfusion on oxygen consumption and total mechanical energy in rat myocardium: participation of mitochondrial oxidative phosphorylation.

BACKGROUND: To reduce ischemia-reperfusion injury of hearts in open heart surgery and transplantation, it is important to know the critical period of ischemia in which donor hearts can sustain their function satisfactorily. Cardiac function has been deduced from oxygen consumption (VO2) and mechanical parameters such as pressure-volume area (PVA). Inhibited mitochondrial oxidative phosphorylation during ischemia indicates that ATP production is uncoupled from VO2. Therefore, both mitochondrial oxidative phosphorylation and total mechanical energy should be examined to evaluate cardiac function after ischemia and reperfusion. METHODS: Isolated rat hearts were stored in Euro-Collins solution at 4 degrees C for 8, 12, and 24 hr and reperfused in a working mode with a modified Krebs-Henseleit bicarbonate solution. PVA and VO2 were examined in isovolumic contraction, and ventricular contractility and total mechanical energy were assessed, respectively, by the end-systolic elastance (Ees) and PVA. Mitochondrial oxidative phosphorylation in the presence of succinate and mitochondrial lipid peroxide levels were estimated in similarly treated rat hearts. RESULTS: Ees was decreased by ischemia without significant difference. The VO2 to PVA ratio remained linear, although VO2 at null PVA and the VO2 to PVA ratio significantly increased after 12 hr of ischemia. Mitochondrial oxidative phosphorylation was decreased significantly by reperfusion after 12 hr of ischemia. Mitochondrial lipid peroxide levels were increased significantly after 12 hr of ischemia. CONCLUSIONS: In isolated rat hearts, decreased efficiency for energy conversion from consumed oxygen to cardiac performance occurs between 8 and 12 hr of hypothermic ischemia, which was coincident with disturbed mitochondrial oxidative phosphorylation, to which lipid peroxidation may contribute.

Animals↗
PubMed1997

Automatic tracking of the aorta in cardiovascular MR images using deformable models.

We present a new algorithm for the robust and accurate tracking of the aorta in cardiovascular magnetic resonance (MR) images. First, a rough estimate of the location and diameter of the aorta is obtained by applying a multiscale medial-response function using the available a priori knowledge. Then, this estimate is refined using an energy-minimizing deformable model which we define in a Markov-random-field (MRF) framework. In this context, we propose a global minimization technique based on stochastic relaxation, Simulated annealing (SA), which is shown to be superior to other minimization techniques, for minimizing the energy of the deformable model. We have evaluated the performance and robustness of the algorithm on clinical compliance studies in cardiovascular MR images. The segmentation and tracking has been successfully tested in spin-echo MR images of the aorta. The results show the ability of the algorithm to produce not only accurate, but also very reliable results in clinical routine applications.

Algorithms↗
PubMedDate not supplied

Reproducibility of arterial compliance and carotid wall thickness measurements in normal subjects.

1. Non-invasive techniques to measure indices of arterial function and wall thickness are frequently used as surrogate markers of cardiovascular disease. Reproducibility of measurements of arterial compliance has been infrequently reported and little is known about the interrelationships of the various indices in vivo. 2. The present study was designed to assess reproducibility and interrelationships of indices of systemic arterial compliance, pulse wave velocity, carotid compliance and intima-media thickness (IMT). 3. Fifty healthy volunteers (20 male and 30 female: aged 20-70 years, mean 46.5 years), participated in the present study. Each subject was studied on two occasions by the same investigators, using an identical protocol at an interval of 1-5 weeks (mean 2.5 weeks) without lifestyle change. 4. There were no significant differences between visits for any recorded general data, except resting blood pressure, which was lower on the second occasion. There were no systematic differences within each pair over the range of measurements for any of the variables. Bland-Altman plots of repeatability of changes in indices showed that the mean values between visits were not significantly different. All indices of central arterial compliance were significantly related to age and IMT. 5. Thus, under controlled experimental conditions, there was satisfactory repeatability of measurements of indices of both intrinsic and functional arterial mechanical properties (central and carotid arterial compliance and IMT). This type of information will permit the construction of sample size tables for clinical trials using these indices. 6. Central arterial compliance may be an important determinant of IMT.

Adult↗
PubMed1999

Higher systemic arterial compliance is associated with greater exercise time and lower blood pressure in a young older population.

OBJECTIVES: Arterial compliance is an important therapeutic target in older individuals in whom stiffening of the proximal arterial circulation is thought to underlie systolic hypertension and increased cardiac work. We have shown previously that arterial compliance is related to aerobic fitness and that it is increased in young (20 to 35 years old), previously sedentary individuals by a 4-week period of moderate aerobic training. The extent to which compliance relates to exercise performance in a random selection of young older patients has not been reported previously. Therefore, we examined the interrelationship between systemic arterial compliance (SAC) and time to cessation of exercise during a standard treadmill exercise test in an older population. DESIGN: A cross-sectional survey. METHODS: SAC was estimated at rest using simultaneous recordings of ascending aortic flow and carotid applanation tonometry in 43 subjects aged 67 +/- 7 years (mean +/- SD; 24 men and 19 women). Treadmill exercise testing was performed using a modified Bruce protocol. Aerobic capacity was assessed as Heart Rate-Blood Pressure product and exercise tolerance as total treadmill time. RESULTS: SAC and exercise tolerance were related to gender, with men exhibiting greater exercise reserve and higher SAC than women. There was a significant positive correlation between SAC and time to cessation of exercise (r = .34; P = .03), with a negative correlation between SAC and resting heart rate-blood pressure product (r = -.66; P < .001). SAC was correlated with height and blood pressure. Exercise tolerance was related to height (P < .02). CONCLUSIONS: These data indicate a positive association between SAC and fitness level in healthy older people and an inverse association between SAC and systolic blood pressure. Our findings are consistent with either (1) acquisition of a more compliant circulation and lower blood pressure through more physical activity or (2) that a more compliant arterial circulation and lower blood pressure permit greater athletic performance.

Aged↗
PubMed1999

Vascular compliance as a measure of biological age.

OBJECTIVES: To determine the measure of vascular compliance most closely related to age. DESIGN: A review of 22 studies relating aortic compliance to age and a discussion of other factors related to vascular compliance. MEASUREMENTS: Aortic compliance, elastic modulus, postmortem aortic changes, pulse wave velocity in the aorta, common carotid, lower limb and upper limb. RESULTS: 1. Aortic compliance and carotid artery compliance is closely related to age; 2. Compliance in the peripheral arteries, in 16 reports, appears less closely related to age; 3. There is evidence that aortic compliance is related to hypertension, cardiac function, and left ventricular hypertrophy and can be increased by exercise, hormonal therapy, antioxidant and antihypertensive treatment; and 4. Vascular compliance is more closely related to chronological age than other measures such as skin inelasticity, greying of hair, baldness etc. CONCLUSIONS: Because of the close relationship between aortic and carotid compliance and chronological age, deviation from the age-predicted norm (biological age) may prove to be a good predictor of cardiovascular pathology.

Aging↗
PubMed1995

Primary neural involvement in renal haemodynamic and functional responses to prolonged stimulation of atrial receptors in anaesthetized dogs.

To determine the precise contributory role of neural and humoral factors in the efferent mechanism of the atrial receptor-renal reflex, we have examined the effects of prolonged (45 min) stimulation of left atrial receptors on renal haemodynamics and function simultaneously in both kidneys (right kidney intact and left kidney denervated) of anaesthetized dogs. Aortic pressure in these dogs was held constant by means of an arterial reservoir connected to the aorta; heart rate changes were prevented by blocking beta 1-adrenoceptor activity with atenolol (2 mg kg-1 i.v.). Localized stimulation of atrial receptors in six dogs increased renal blood flow (6 +/- 2%), creatinine clearance (11 +/- 4%), urine flow (9 +/- 3%), sodium excretion (14 +/- 7%) and osmolal excretion (10 +/- 4%), and decreased free water clearance (14 +/- 7%) in intact kidneys, but led to no changes in denervated kidneys. In an additional four dogs, cooling the vagus nerves to 6-7 degrees C or cutting them in the neck abolished the renal responses to stimulation of atrial receptors in these stabilized preparations. These data clearly demonstrate that the renal responses to prolonged stimulation of atrial receptors are primarily mediated via myelinated vagal afferents and renal sympathetic efferents.

Animals↗
PubMedDate not supplied

In vivo measurement of real-time aortic segmental volume using the conductance catheter.

The goal of this investigation was to determine if the conductance catheter technique for chamber volume measurement could be applied in vivo to determine real-time phasic aortic segmental volume. A four-electrode conductance catheter was used to measure time-varying resistance of the descending thoracic aorta in open-chest, anesthetized dogs. Resistance was converted to segmental volume and the slope correction factor (alpha) and parallel conductance volume (Vp) were determined. The results showed excellent linear correlation between conductance and sonomicrometric segmental volume. The correction factors alpha and Vp were found to be empirically related to average vessel diameter. The relatively high values for the slope correction factor (alpha=4.59+/-0.17 SEM) were found to be primarily related to low-resistivity shunt paths probably originating in the periadventitial aortic wall and to a lesser extent to changes in flow-induced increases in blood resistivity, hematocrit, catheter position, and other adjacent tissue resistivity. The results demonstrate that correction factors empirically derived from measurements of mean aortic diameter could be used to determine absolute real-time phasic segmental volume, cross-sectional area, or diameter. The conductance technique may possess the same potential for determining aortic mechanical properties which has already been demonstrated for determining ventricular mechanical properties.

Animals↗
PubMed2001

Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index.

Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40%, respectively; P < 0.001) in cirrhotic patients (n = 49) than in control subjects (n = 19), and a close correlation between C(1) and SV/PP was found in both cirrhotic patients (r = 0.86, P < 0.001) and control subjects (r = 0.96, P < 0.001). Univariate analysis showed significant relations between C(1) and SV/PP on one side and age, sex, body weight, portal pressure, systemic hemodynamics, biochemical variables, and severity of disease on the other. In the multiple-regression analysis, sex, age, mean arterial blood pressure, systemic vascular resistance, and biochemical variables were significant independent predictors of SV/PP (P < 0.005-0.00001). In conclusion, arterial compliance is elevated in cirrhosis. A simplified SV/PP index seems to reflect abnormalities in the arterial compliance of these patients.

Algorithms↗