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The cardiovascular system in cystic fibrosis.

Available evidence indicates that cystic fibrosis causes widespread involvement of the cardiovascular system. Aside from the heart, unusual aberrations have been observed in the bronchial arteries, the aorta, and the systemic capillaries. Of all cardiovascular complications, cor pulmonale is the most serious. Recognition of a significant degree of cor pulmonale is generally possible on the basis of the severity of the underlying disease. Although echocardiography and radionuclide angiography are valuable research tools in the study of cor pulmonale in cystic fibrosis, they add little, from a practical standpoint, to the management of the patient. The basis of cor pulmonale is hypoxemia and unless this is relieved, no enduring effect can be expected from therapy directed toward the heart. Inasmuch as cystic fibrosis is a progressive disease, cor pulmonale is also progressive. At best, cardiac treatment represents a delaying action that may provide more time to combat an intercurrent infection.

Adolescent↗

Step response analyses of the cardiovascular system and their application to the measurement of systemic and pulmonary vein compliances.

A theoretical analysis of the step response in the closed cardiovascular system induced by a sudden shift of the right cardiac output curve predicted that if the relations of the right heart output (COr) and the total systemic capillary flow (CFs) to the systemic venous pressure (Psv) are linear, then the time course of Psv change will become monoexponential with a time constant T given by T = Csv/(Gr + Gs), where Csv is the systemic vein compliance and Gr and Gs are the conductances of the transient COr-Psv and CFs-Psv relationships. A similar prediction was obtained for the time constant T of the pulmonary vein pressure (Ppv) response to the step change in the left cardiac output (COl) curve, pulmonary vein compliance (Cpv) and the conductances of the COl curve, and the pulmonary capillary flow (CFp) curve against Ppv. The actual Psv or Ppv changes following sudden alteration of the COr or COl curve by inflation and deflation of the balloon in the right or left atrium revealed monoexponential time courses. Semilogarithmic plots of the transient vein pressure changes yielded correlation coefficients of -0.995 +/- 0.006 (means +/- SD) in 11 curves for Psv and 0.977 +/- 0.017 in 16 curves for Ppv (P less than 0.01). The assumed linearity of dynamic COr and COl curves was confirmed by beat by beat COr-Psv and COl-Ppv relationships during the step responses, except for the first few beats immediately after the balloon maneuver. The linearity of the dynamic CFs curve was examined by measuring CFs with a double-step balloon maneuver so as to cause rapid equilibrium between COr and CFs at varied moments of the transient process. The correlation coefficient between CFs and Psv thus obtained was 0.98 +/- 0.04 (P less than 0.01). A similar linearity of the dynamic CFp-Ppv relationship was suggested from their steady-state curves. The values of Csv calculated from the experimental data were 1.70 +/- 0.12 ml/mmHg/kg body wt in 11 curves and those of Cpv were 0.13 +/- 0.03 ml/mmHg/kg in 15 curves. These results are mostly consistent with those previously reported.

Animals↗

Cardiovascular system of offsprings of hypertensive rats with defective nitric oxide production.

The question was addressed of how nitric oxide synthase (NO synthase) inhibition-induced hypertension in rat parents would affect the cardiovascular system in their offsprings. Two experimental groups were set up: Group I -- offsprings of parents who had both been administered NO synthase inhibitor L-nitro-arginine methyl ester (L-NAME 40 mg/kg/day) for 5 weeks, the treatment of dams continued till week 12. Group II -- offsprings fed by dams administered L-NAME after delivery only for a period of 4 weeks. Control age-matched offsprings formed the third group. Blood pressure and heart rate in parents and in 3-week-old offsprings were determined noninvasively. In the offsprings, body and heart weight were measured and the heart/body weight ratio (HW/BW) was calculated. The NO synthase activity, and also ornithine decarboxylase activity as a marker of polyamine production, were determined in the heart. The acetylcholine-induced relaxation of aortic rings was also followed. A marked blood pressure increase with a tendency to a decreased heart rate was found in the offsprings of Group I. A significant decrease in heart weight and body weight with a decreased HW/BW ratio indicated cardiac hypotrophy that contrasted with the decrease in NO synthase activity and increase in ornithine decarboxylase activity in the heart. Noteworthy was also the finding of completely preserved relaxation of the aorta to acetylcholine. Offsprings of Group II were similarly characterized by significantly higher blood pressure, a tendency to decreased heart rate, a decrease in heart weight, but not of the HW/BW ratio. The contrasting findings of heart weight decrease on the one hand and NO synthase activity decrease and ornithine decarboxylase increase on the other, were also found in this group. Full relaxation of the aorta to acetylcholine was preserved. It can be concluded that remarkable alterations in the cardiovascular system were found in offsprings of hypertensive NO compromised parents.

Acetylcholine↗

[The autonomic regulation of the cardiovascular system in subjects with the autonomic dystonia syndrome subjected to ionizing radiation exposure as a result of the accident at the Chernobyl Atomic Electric Power Station].

180 males in the age of 21-50, all the participants of Chernobyl accident consequences liquidation were examined. In all individuals vegetative dystonia (VD) syndrome was diagnosed (total radiation doses 0.1-1.0 Grey according to D. Erwin method). It was established that VD syndrome differed in these persons by pronounced stages of disorders manifestation as well as by polymorphism of vegetative disturbances. These findings testify central and peripheral vegetative nervous system parts involvement. In 40.2% of cases in individuals which were examined in rest and in 56.2% after dosed physical loading the functional disorders of vegetative cardiovascular system regulation of vagal type mainly (76.5%) were revealed. Clear correlation was not observed between vegetative disorders and radiation dose value. The estimation of contribution of each of the possible pathogenic factors (exactly stressogenic, radioactive and others) in vegetative disturbances development is not possible now.

Adult↗

The physical dimensions of the human neonatal cardiovascular system.

To establish a data base for studies which seek to model and simulate the human perinatal cardiovascular system, we dissected three stillborn, full-term infants and measured the length, internal diameter, and wall thickness of over 1000 blood vessel segments. Cumulatively, these segments represent the major and minor vessels of the systemic and pulmonary circulation at birth. Statistical analysis showed that the methods used to obtain these physical dimensions were highly consistent and that storage of tissue samples in 10 percent formaldehyde solution caused a linear shrinkage of approximately 6.3 percent. A topological code was developed to illustrate the network relationships of blood vessel segments. An example of data utilization based on the topological code is presented and discussed.

Biomedical Engineering↗

Association of working hours with biological indices related to the cardiovascular system among engineers in a machinery manufacturing company.

A field survey of 278 engineers (20-59 years) in a machinery manufacturing company was conducted to investigate the association of working hours with biological indices related to the cardiovascular system (heart rate variability, blood pressure and serum levels of magnesium, dehydroepiandrosterone sulfate and cholesterol). Average working hours (defined as <"hours at workplace" + "half a commuting time">) and sleeping hours in this study were 60.2 +/- 6.3 hr/week and 6.6 +/- 0.8 hr/day respectively. There were no significant relationships between working hours and biological indices related to the cardiovascular system, but sleeping hours was closely related to working hours negatively. Furthermore, the serum DHEA-S level was significantly related to sleeping hours positively. Combining these two results, it appeared that long working hours might lower the serum DHEA-S level due to the reduction of sleeping hours.

Adult↗

[Evaluation of the effects of occupational noxae on the cardiovascular system].

BACKGROUND: Working conditions and the environment may contribute to the multi-factorial aetiology of cardiovascular disease. OBJECTIVES: To provide a critical assessment of epidemiological and clinical methods and tools for evaluating the effects of occupational pathogenic noxae on the cardiovascular system. METHODS: A review was made of epidemiological and clinical studies published in the main scientific journals of occupational medicine and cardiology, in the period 1980-2003. Data sources were electronic medical data bases and conference proceedings. RESULTS AND CONCLUSION: Collecting case histories by means of free or questionnaire-structured interviews, observing specific physical signs, detecting changes in blood chemistry parameters and identifying morphological or functional abnormalities in the heart and vessels are all useful approaches. Some blood chemistry parameters that may be modified by occupational exposure or by particular conditions arising from work organization are cholesterol, triglycerides, apolipoproteins A and B, platelets, fibrinogen, factor VIIc, fibrinolysis products, plasminogen tissue activating factor, complement and glycated hemoglobin. They can all be measured easily and quickly and provide an estimate of the risk of cardiovascular disease. As high blood pressure is closely correlated to heart disease, blood pressure levels can be monitored in a working population using a standard mercury sphygmomanometer. Electronic measurement before and after a work shift and 24 hour Holter monitoring help reduce the "white coat effect" and provide further useful information. Occupational risk factors such as toxins (metals, solvents, pesticides), electromagnetic fields, extreme temperatures, noise, radiation and psychophysical stress can affect the cardiac neuro-autonomic balance of the exposed workers and cause cardiovascular abnormalities. These can be detected by long-term ECG monitoring, and are revealed as reduced heart rate variability and prolonged QT interval. Recently non-invasive systems have been adopted to detect cardiovascular lesions that are usually due to atherosclerosis. In occupational and environmental studies ultrasound measurement of intima-medial carotid thickness and brachial artery reactivity have been used to determine the effects of exposure to carbon disulfide and passive smoking. Occupational Medicine has yet to include the use of the very expensive electron-beam computed tomography for a rapid and non-invasive study of coronary artery disease.

Arrhythmias, Cardiac↗

[The cardiovascular system in students born in the Middle Ob region].

The students of a northern pedagogical institute, whose age was 17-20 years, who had been born and permanently lived under uncomfortable climatic conditions of the Middle Ob Region, were examined. For evaluation of the cardiovascular system, hemodynamic parameters were determined, ECG readings were recorded and the values of cardiointervalogms were analyzed. The findings suggest that there are specific features in the status and performance of the cardiovascular system of young males and females aged 17-20 years, the natives of the Middle Ob Region. These include no age-related lower heart rate; a predominance of sympathetic effects on cardiovascular regulation; and myocardial functional changes.

Adolescent↗

The relationship between mercury from dental amalgam and the cardiovascular system.

The findings presented here suggest that mercury poisoning from dental amalgam may play a role in the etiology of cardiovascular disorders. Comparisons between subjects with and without amalgam showed amalgam-bearing subjects had significantly higher blood pressure, lower heart rate, lower hemoglobin, and lower hematocrit. Hemoglobin, hematocrit, and red blood cells were significantly lower when correlated to increased levels of urine mercury. The amalgam subjects had a greater incidence of chest pains, tachycardia, anemia, fatigue, tiring easily, and being tired in the morning. The data suggest that inorganic mercury poisoning from dental amalgam does affect the cardiovascular system.

Blood Pressure↗

[Effect of metipranolol on the cardiovascular system of the rabbit in vivo during spontaneous and paced heart rhythm].

The effects of i.v. administration of metipranolol (Trimepranol, Biotika; 0.03; 0.15 and 0.3 mg.kg-1) and saline (1.0 ml.kg-1) on the cardiovascular system of rabbits in vivo have been determined under the conditions of the paced and non-paced heart. The administration of saline in the control group led to a mild decrease of dP/dtmax, minute blood flow through the abdominal aorta and slowing-down the cardiac frequency without significant changes in blood pressure in a. femoralis and stroke blood flow through the abdominal aorta. No practically important differences between the paced and non-paced conditions were found. The administration of Trimepranol led to a significant, dose dependent decrease in dP/dtmax, which was less expressed in the paced heart (in comparison with the non-paced heart) after the lowest dose of the drug; no such a difference was found after higher doses of Trimepranol. Reactions of blood pressure (no significant changes) and minute blood flow through the abdominal aorta (a mild decrease) to the administration of Trimepranol were similar both in the paced and in non-paced heart. A significant slowing-down of the spontaneous cardiac frequency after Trimepranol was dose-dependent and, in relation to this fact, a significant increase in stroke blood flow through the abdominal aorta was found. On the basis of the above-mentioned results, it is possible to conclude that the paced heart conditions do not unfavourably influence the effects of Trimepranol on the cardiovascular system of rabbits in vivo.

Animals↗

Differential Distribution of Bradykinin B(2) Receptors in the Rat and Human Cardiovascular System.

-Bradykinin, a major vasodilator peptide, plays an important role in the local regulation of blood pressure, blood flow, and vascular permeability; however, the cellular distribution of the major bradykinin B(2) receptor in the cardiovascular system is not precisely known. Immunoblot analysis with an anti-peptide antibody to the bradykinin B(2) receptor or chemical cross-linkage with [(125)I]Tyr(0)-bradykinin revealed a band of 69+/-3 kDa at varying intensity in the homogenates of the endothelium and tunica media of the rat aorta and endocardium. Immunostaining showed that the B(2) receptor is abundant in the endothelial linings of the aorta, other elastic arteries, muscular arteries, capillaries, venules, and large veins, where it localizes preferentially to the luminal face of the endothelial cells. In marked contrast, small arterioles (ie, the principal blood-pressure regulating vessels) of the mesenterium, heart, urinary bladder, brain, salivary gland, and kidney had a different staining pattern in which B(2) receptor was prominent in the perivascular smooth muscle cells of the tunica media. A similar distribution pattern was found in mouse as well as in human tissues, indicating that the particular distribution pattern of the B(2) receptor in arterioles is not a species-specific phenomenon. During development, the distribution of B(2) receptor in the heart changes; for example, in the heart of newborn rats, the B(2) receptor was abundant in the myocardium, whereas in the adult heart, the receptor was present in the endocardium of atria, atrioventricular valves, and ventricles but not in the myocardium. Thus, B(2) receptors are localized differentially in different parts of the cardiovascular system: the arterioles have smooth muscle-localized B(2) receptors, and large elastic vessels have endothelium-localized receptors.

Journal Article↗

Angiotensin receptors in the cardiovascular system.

The angiotensin II receptors mediate the effects of the renin-angiotensin system, which has an important role in cardiovascular (patho)physiology. Four types of angiotensin receptors are known, of which the type 1 (AT1) and the type 2 (AT2) receptors are the most important. Stimulation of the AT1 receptor leads to a cascade of signalling pathways in several cell types, which finally leads to processes such as vasoconstriction, inflammation and proliferation. These processes are of great importance in various cardiovascular diseases, including hypertension, atherosclerosis and ventricular hypertrophy. The AT2 receptor is expressed mainly in the fetal stage. In adults, the AT2 receptor is minimally expressed under normal circumstances. Its role in the adult cardiovascular system is not well established, but its effects seem to oppose those of the AT1 receptor. This overview discusses the pathophysiological role of the angiotensin II receptors in various cardiovascular diseases with the emphasis on the signal transduction of the AT1 and the AT2 receptors.

Arteriosclerosis↗

Effect of working hours on biological functions related to cardiovascular system among salesmen in a machinery manufacturing company.

A field survey of 71 salesmen (22-60 years) in a machinery manufacturing company was conducted to investigate the effect of working hours on biological functions related to the cardiovascular system. The subjects were divided into four groups by age, and those in each age group were further divided into shorter (SWH) and longer (LWH) working hour subgroups by weekly working hours. Rates of complaints of subjective fatigue for LWH were significantly higher than those for SWH on the whole. Although the mean amplitude of respiratory sinus arrhythmia at rest decreased with age, no significant difference between SWH and LWH was found in this function. Systolic blood pressure for LWH was significantly higher than that for SWH in the 50-60 year group. The serum total cholesterol level for LWH was significantly lower than that for SWH in the 40-49 year group. Comparison of biological functions related to cardiovascular system was also made between fatigue complaint and no-complaint subgroups. Significant differences were found between the two subgroups: systolic blood pressure was higher and the total cholesterol level was lower in the fatigue complaint subgroups. Summarizing our results, it appeared that long working hours might increase systolic blood pressure and lower the total cholesterol level due to fatigue.

Adult↗