血液透析血压及其变异性与患者预后的相关性分析

目的:探讨血液透析前后和血液透析过程中血压及其变异性与患者预后的相关性。方法:选取沈阳军区总医院血液透析中心2010年1月1日至2013年12月31日收治的维持性血液透析患者,收集并对比随访期内生存及死亡患者的自然信息及临床资料,评估血液透析过程中患者血压及其变异程度与患者预后的关系。结果:共有269例患者纳入研究,经过4年随访共死亡83(30.86%)例。死亡组年龄显著大于存活组(64.92±13.24岁比49.89±12.86岁,P=0.000),而透析年限显著短于存活组(2.60±2.56年比7.25±4.14年,P=0.000)。死亡组透析前SBP(P=0.001)、DBP(P=0.000)、MAP(P=0.000)均显著高于存活组。两组间透析后SBP、DBP、MAP比较均无显著差异。死亡组△SBP(P=0.026)、△DBP(P=0.001)、△MAP(P=0.001)幅度显著大于存活组。死亡组透析前SBP变异率显著高于存活组(P=0.001);死亡组透析后SBP变异率(P=0.000)、DBP变异率(P=0.014)、MAP变异率(P=0.005)均高于存活组。死亡组每次透析前各时间点间SBP变异率(0.12±0.04 mm Hg比0.09±0.03 mm Hg,P=0.000)与MAP变异率(0.10±0.03mm Hg比0.09±0.03 mm Hg,P=0.001)显著高于非死亡组。结论:维持性血液透析患者透析前血压、透析前后血压改变幅度、透析前后血压变异率、每次透析各时间点间血压变异率等与全因死亡相关。     

Usefulness of circadian amplitude of blood pressure in predicting hypertensive cardiac involvement.

Twenty-four-hour blood pressure (BP) profiles of 56 patients diagnosed as 'hypertensive' by WHO criteria were analyzed by the fit of a 24-hour cosine curve according to the single cosinor method. A left ventricular mass index (LVMI) was also assessed by two-dimensional echocardiography on each patient as a gauge of target organ involvement. LVMI and the BP MESOR correlates positively for systolic, S (r = 0.324), mean arterial, MA (r = 0.334) and diastolic, D (r = 0.267) BP (P less than 0.05), yet no statistically significant linear correlation between LVMI and the circadian BP amplitude (one-half of predictable change) was found. When a second-degree polynomial regression was fitted to the circadian BP amplitudes, an association was found (SBP: R2 = 0.138, P = 0.02; MAP: R2 = 0.167, P = 0.01; DBP: R2 = 0.128, P less than 0.01). The corresponding curves were characterized by peaks in the circadian amplitudes of SBP, MAP and DBP around a value of LVMI between 110 and 120 g/m2. For further scrutiny, three subgroups had been formed on the basis of literature, a priori with respect to the LVMI (group 1: LVMI less than 100); group 2: 100 less than LVMI less than 130; group 3: 130 less than LVMI). For MESORs, there was no difference between groups 1 and 2, whereas the MESOR of group 3 were larger than the other two groups. The circadian BP amplitudes of group 2 were larger than those of the other two groups for SBP, MAP and DBP. An increasing LVMI precedes a definitive increase of BP MESOR and coincides with an increase in the circadian BP amplitude; thus an increase in extent of circadian changes can alert the self-monitoring population of a target organ involvement.     

Myocardial function defined by strain rate and strain during alterations in inotropic states and heart rate

For porcine myocardium, ultrasonic regional deformation parameters, systolic strain (epsilon(sys)) and peak systolic strain rate (SR(sys)), were compared with stroke volume (SV) and contractility [contractility index (CI)] measured as the ratio of end-systolic strain to end-systolic wall stress. Heart rate (HR) and contractility were varied by atrial pacing (AP = 120-180 beats/min, n = 7), incremental dobutamine infusion (DI = 2.5-20 microg. kg(-1). min(-1), n = 7), or continuous esmolol infusion (0.5 mg. kg(-1). min(-1)) + subsequent pacing (120-180 beats/min) (EI group, n = 6). Baseline SR(sys) and epsilon(sys) averaged 5.0 +/- 0.4 s(-1) and 60 +/- 4%. SR(sys) and CI increased linearly with DI (20 microg. kg(-1). min(-1); SR(sys) = 9.9 +/- 0.7 s(-1), P < 0.0001) and decreased with EI (SR(sys) = 3.4 +/- 0.1 s(-1), P < 0.01). During pacing, SR(sys) and CI remained unchanged in the AP and EI groups. During DI, epsilon(sys) and SV initially increased (5 microg. kg(-1). min(-1); epsilon(sys) = 77 +/- 6%, P < 0.01) and then progressively returned to baseline. During EI, SV and epsilon(sys) decreased (epsilon(sys) = 38 +/- 2%, P < 0.001). Pacing also decreased SV and epsilon(sys) in the AP (180 beats/min; epsilon(sys) = 36 +/- 2%, P < 0.001) and EI groups (180 beats/min; epsilon(sys) = 25 +/- 3%, P < 0.001). Thus, for normal myocardium, SR(sys) reflects regional contractile function (being relatively independent of HR), whereas epsilon(sys) reflects changes in SV.     

The relationship of age, body mass index and waist circumference with blood pressure in Bengalee Hindu male jute mill workers of Belur, West Bengal, India

A cross-sectional study of 150 adult Bengalee Hindu male jute mill workers of Belur, a suburb of Kolkata, West Bengal, India, was undertaken to study the relationship of age, body mass index (BMI) and waist circumference (WC) with systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure. The mean age and the BMI of the subjects were 40.7 years (S.D. = 15.2) and 23.2 kg/m2 (S.D. = 3.2), respectively. The mean SBP, DBP and MAP were 124.7 mmHg (S.D. = 7.8), 81.5 mmHg (S.D. = 5.7) and 95.9 mmHg (S.D. = 6.1), respectively. Age had similar significant (p < 0.001) correlations with BMI and WC. Age and WC were significantly correlated (p < 0.001) with all the three blood pressure variables. In general, the correlations of BMI with SBP (r = 0.24, p < 0.01), DBP (r = 0.15, n.s.) and MAP (r = 0.19, p < 0.05) were weaker. Age controlled multiple regression analyses demonstrated that BMI did not have a significant effect of any blood pressure variable. However, WC had a significant impact (p < 0.0001) on SBP (t = 7.068), DBP (t = 5.190) and MAP (t = 6.387), even after adjusting for the effect of age. Moreover, even after age adjustment, percent variations in SBP (20.7%), DBP (12.5%) and MAP (17.2%) explained by WC were high. This significant impact (p < 0.0001) of WC on SBP (t = 9.426), DBP (t = 8.349) and MAP (t = 9.642) remained even after controlling for the combined effects of age and BMI.     

不同麻醉方法对二氧化碳气腹致应激激素和循环功能的影响

目的：观察比较全麻和全麻复合硬膜外麻醉在腹腔镜胆囊切除术（LC）时,对CO2气腹致应激激素和循环功能的影响。方法：40例LC患者随机分为全麻组（A组,n=20）和全麻复合硬膜外麻醉组（B组,n=20）,连续监测SBP、DBP、MAP、HR、ECG、SpO2、PETCO2,记录两组患者麻醉前（T1）、插管后（T2）、气腹后10min（T3）、气腹后20min（T4）和放气后10min（T5）的SBP、DBP、MAP、HR、同时抽静脉血测定血糖（Glu）、血浆皮质醇（Cor）、促肾上腺皮质激素（ACTH）和血管紧张素-Ⅱ（AT-Ⅱ）。结果：T1时两组所有检测值比较差异无显著性（P＆gt;0.05）;在T2、T3、T4、T5时A组SBP、DBP、MAP值明显升高,B组较基础值下降,组间差异显著（P＆lt;0.05）;气腹建立后A组HR,Glu、Cor、ACTH、AT-Ⅱ明显上升（P＆lt;0.05）,B组无显著变化（P＆gt;0.05）,（除ACTH外）组间差异显著（P＆lt;0.05）。结论：全麻复合硬膜外麻醉用于LC手术时,能相对更好的的抑制CO2气腹所致应激激素的升高,使循环更稳定。     

Influence of polymorphism of glutathione S-transferase M1 on systolic blood pressure of normotensive individuals

Studies have indicated that systolic (SBP) and diastolic (DBP) blood pressure are multi-factorial traits and significantly heritable. The aims of the present study are to assess whether the glutathione S-transferase M1 (GSTM1) and T1 (GSTT1) genotypes are associated with SBP and DBP of normotensive subjects and to ascertain whether the level of SBP and DBP given exposure to cigarette smoking is modified by the specific genetic polymorphisms of GSTM1 and GSTT1. This cross-sectional study was conducted on 140 subjects (49 females and 91 males) (mean age+/-SD: 38.7+/-14.7). The genotypes were determined using a polymerase chain reaction based method. Individuals were stratified according to the mean values of DBP and SBP, lower than or maximally same as the mean value defines as group I and higher than the mean value defines as group II. The logistic regression analyses were used. The best models fitted by logistic regression analysis for variables were associated with SBP and DBP. For analysis the combination of genotypes, sex, and smoking behavior was used as qualitative variables, and age, body mass index (BMI), and heart rate were used as covariates. Combination of "present-GSTT1, null-GSTM1" genotype (OR=0.001, 95% CI=0.00-0.439, P=0.025), heart rate (OR=1.065, 95% CI=1.018-1.114, P=0.006), and interaction between BMI and combination of "present-GSTT1, null-GSTM1" (OR=1.319, 95% CI=1.058-1.644, P=0.014) was associated with SBP. There was no association between either combination genotypes of GSTs or interaction of genotypes and smoking behavior on DBP. The present results suggest that the GSTM1 gene is one of the candidate genes that alter the baseline of SBP in normotensive individuals.     

Pulse transit time measured from the ECG: an unreliable marker of beat-to-beat blood pressure.

The arterial pulse-wave transit time can be measured between the ECG R-wave and the finger pulse (rPTT), and has been shown previously to have a linear correlation with blood pressure (BP). We hypothesized that the relationship between rPTT, preejection period (PEP; the R-wave/mechanical cardiac delay), and BP would vary with different vasoactive drugs. Twelve healthy men (mean age 22 yr) were studied. Beat-to-beat measurements were made of rPTT (using ECG and photoplethysmograph finger probe), intra-arterial radial pressure, PEP (using cardiac bioimpedance), and transit time minus PEP (pPTT). Four drugs (glyceryl trinitrate, angiotensin II, norepinephrine, salbutamol) were administered intravenously over 15 min, with stepped dosage increase every 5 min and a 25-min saline washout between agents. All subjects in all conditions had a negative linear correlation (R2 = 0.39) between rPTT and systolic BP (SBP), generally constant between different drugs, apart from four subjects who had a positive rPTT/SBP correlation with salbutamol. The 95% limits of agreement between measured and rPTT-predicted SBP were +/-17.0 mmHg. Beat-to-beat variability of rPTT showed better coherence with SBP variability than it did with heart rate variability (P < 0.001). PEP accounted for a substantial and variable proportion of rPTT (12-35%). Diastolic (DBP) and mean arterial BP (MAP) correlated poorly with rPTT (R2 = 0.02 and 0.08, respectively) but better with pPTT (rPTT corrected for PEP, R2 = 0.41 and 0.45, respectively). The 95% limits of agreement between measured and pPTT-predicted DBP were +/- 17.3 mmHg. In conclusion, the negative correlation between rPTT and SBP is generally constant, even with marked hemodynamic perturbations. However, the relationship is not reliable enough for rPTT to be used as a surrogate marker of SBP, although it may be useful in assessing BP variability. DBP and MAP cannot be predicted from rPTT without correction for PEP. The significant contribution of PEP to rPTT means that rPTT should not be used as a marker of purely vascular function.     

Non-invasive blood pressure measurement in Yucatan miniature swine using tail cuff sphygmomanometry

A relatively new non-invasive method using a photo-electric flow sensor in non-heated animals, was evaluated for its accuracy in measuring systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in 40-90 Kg normotensive and hypertensive Yucatan miniature swine. Directly measured SBP, DBP and electronically averaged MAP were recorded from chronic arterial catheters simultaneously with indirect pressures, cuff pressure and tail blood flow under various conditions. In all of the tests tail cuff SBP estimation averaged within 5% of directly measured SBP. The correlation of the two methods was significant (r = .95, P less than 0.01). Over a 60 to 202 mmHg range of blood pressure induced pharmacologically or due to DOCA hypertension, the tail cuff SBP was within 4-10% of directly measured SBP. The tail cuff method was also used to determine DBP and MAP. DBP determined from the tail cuff record was found consistently to underestimate the direct measured DBP by approximately 17%. The two methods were correlated (r = .87 P less than 0.01). The measured tail cuff MAP generally underestimated the direct MAP by approximately 5%. The correlation of directly measured MAP and tail cuff methods was significant (r = .72, P less than 0.01). These results indicated that this system may be used to accurately assess blood pressure in miniature swine.     

Circadian pattern of blood pressure,heart rate,and double product in liver glycogen storage disease

The objective of this study was to determine systolic, diastolic, and mean arterial blood pressure (SBP, DBP, and MAP), heart rate (HR), double-product (DP: SBP x HR), and activity levels and their 24h pattern in liver glycogen storage disease (LGSD) patients. A case series of 12 (11 pediatric and one adult) diurnally active LGSD (seven type I, three type III, and two type IX) subjects were simultaneously assessed by 24h ambulatory blood pressure monitoring and wrist actigraphy. Nine subjects were judged to be hypertensive based on the criterion of an elevated 24h mean SBP and/or DBP being elevated beyond reference standards or the SBP and/or DBP load (percentage of time BP exceeds normal values) being greater than 25%. Two of the three other subjects, not viewed as hypertensive based on their 24h average SBP or DBP, exhibited daytime or nighttime SBP and/or DBP load hypertension. Each study variables displayed statistically significant (p < 0.001) group circadian rhythmicity. The SBP, DBP, and MAP displayed comparable 24h patterns of appreciable amplitude (total peak-trough variation equal to 17.7, 23.6, and 19.6%, respectively, of the 24h mean) with highest values (orthophase) occurring approximately 11 h after the commencement of daytime activity. The sleep-time trough (bathyphase) occurred approximately 4.5 h before morning awakening. The statistically significant (p < 0.006) circadian rhythms of HR (amplitude equal to 33.2% of the 24h mean) and DP (amplitude equal to 49.4% of the 24h mean) peaked earlier, approximately 7.4 h into the daytime activity span. The sleep-time trough occurred approximately 3 h before morning awakening. The 24h pattern in the cardiovascular variables was correlated with the 24h pattern of activity, with r ranging from 0.50 for DBP to 0.39 for HR.     

Chronic angiotensin II infusion attenuates the renal sympathoinhibitory response to acute volume expansion

In this study the hypothesis was tested that chronic infusion of ANG II attenuates acute volume expansion (VE)-induced inhibition of renal sympathetic nerve activity (SNA). Rats received intravenous infusion of either vehicle or ANG II (12 ng. kg(-1). min(-1)) for 7 days. ANG II-infused animals displayed an increased contribution of SNA to the maintenance of mean arterial pressure (MAP) as indicated by ganglionic blockade, which produced a significantly (P < 0.01) greater decrease in MAP (75 +/- 3 mmHg) than was observed in vehicle-infused (47 +/- 8 mmHg) controls. Rats were then anesthetized, and changes in MAP, mean right atrial pressure (MRAP), heart rate (HR), and renal SNA were recorded in response to right atrial infusion of isotonic saline (20% estimated blood volume in 5 min). Baseline MAP, HR, and hematocrit were not different between groups. Likewise, MAP was unchanged by acute VE in vehicle-infused animals, whereas VE induced a significant bradycardia (P < 0.05) and increase in MRAP (P < 0.05). MAP, MRAP, and HR responses to VE were not statistically different between animals infused with vehicle vs. ANG II. In contrast, VE significantly (P < 0.001) reduced renal SNA by 33.5 +/- 8% in vehicle-infused animals but was without effect on renal SNA in those infused chronically with ANG II. Acutely administered losartan (3 mg/kg iv) restored VE-induced inhibition of renal SNA (P < 0.001) in rats chronically infused with ANG II. In contrast, this treatment had no effect in the vehicle-infused group. Therefore, it appears that chronic infusion of ANG II can attenuate VE-induced renal sympathoinhibition through a mechanism requiring AT(1) receptor activation. The attenuated sympathoinhibitory response to VE in ANG II-infused animals remained after arterial barodenervation and systemic vasopressin V(1) receptor antagonism and appeared to depend on ANG II being chronically increased because ANG II given acutely had no effect on VE-induced renal sympathoinhibition.     

Role of small conductance calcium-activated potassium channels expressed in PVN in regulating sympathetic nerve activity and arterial blood pressure in rats

Small conductance Ca(2+)-activated K(+) (SK) channels regulate membrane properties of rostral ventrolateral medulla (RVLM) projecting hypothalamic paraventricular nucleus (PVN) neurons and inhibition of SK channels increases in vitro excitability. Here, we determined in vivo the role of PVN SK channels in regulating sympathetic nerve activity (SNA) and mean arterial pressure (MAP). In anesthetized rats, bilateral PVN microinjection of SK channel blocker with peptide apamin (0, 0.125, 1.25, 3.75, 12.5, and 25 pmol) increased splanchnic SNA (SSNA), renal SNA (RSNA), MAP, and heart rate (HR) in a dose-dependent manner. Maximum increases in SSNA, RSNA, MAP, and HR elicited by apamin (12.5 pmol, n = 7) were 330 ± 40% (P < 0.01), 271 ± 40% (P < 0.01), 29 ± 4 mmHg (P < 0.01), and 34 ± 9 beats/min (P < 0.01), respectively. PVN injection of the nonpeptide SK channel blocker UCL1684 (250 pmol, n = 7) significantly increased SSNA (P < 0.05), RSNA (P < 0.05), MAP (P < 0.05), and HR (P < 0.05). Neither apamin injected outside the PVN (12.5 pmol, n = 6) nor peripheral administration of the same dose of apamin (12.5 pmol, n = 5) evoked any significant changes in the recorded variables. PVN-injected SK channel enhancer 5,6-dichloro-1-ethyl-1,3-dihydro-2H-benzimidazol-2-one (DCEBIO, 5 nmol, n = 4) or N-cyclohexyl-N-[2-(3,5-dimethyl-pyrazol-1-yl)-6-methyl-4-pyrimidin]amine (CyPPA, 5 nmol, n = 6) did not significantly alter the SSNA, RSNA, MAP, and HR. Western blot and RT-PCR analysis of punched PVN tissue showed abundant expression of SK1-3 channels. We conclude that SK channels expressed in the PVN play an important role in the regulation of sympathetic outflow and cardiovascular function.     

The relationship of family income,family size,age and circumferences with blood pressure in the female students of the Bahauddin Zakariya University,Multan, Pakistan

In a randomly selected sample of 600 female students of the Bahauddin Zakariya University, Multan, Pakistan, belonging to different socioeconomic groups, age, family income and family size were recorded and measurements were made of arm, waist, neck and total circumferences, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP). The correlation coefficients between different independent (age, family income, family size, arm, waist, neck and total circumference) and dependent variables (SBP, DBP and MAP) showed that age had a strong association (p < 0.001) with all types of blood pressure, whereas the correlation coefficient of family income and family size was significant with SBP (p < 0.05) and non-significant with DBP and MAP. Moreover, all the circumferences had strong relationship (p 0.05 at least) with blood pressure. The regression coefficients of age were highly significant for SBP, DBP and MAP, whereas these were non-significant (p > 0.05) for family income and family size. The regression coefficients for arm and waist were significant (p < 0.05), whereas these were highly significant (p < 0.01 at least) for neck and total circumferences. The neck had a 0.46 mm Hg/cm with SBP, 0.41 mm Hg/cm for DBP and 0.44 Hg/cm for MAP, and these were highest among the circumferences.     

CIRCADIAN PATTERN OF BLOOD PRESSURE,HEART RATE,AND DOUBLE PRODUCT IN LIVER GLYCOGEN STORAGE DISEASE

The objective of this study was to determine systolic, diastolic, and mean arterial blood pressure (SBP, DBP, and MAP), heart rate (HR), double-product (DP: SBP×HR), and activity levels and their 24h pattern in liver glycogen storage disease (LGSD) patients. A case series of 12 (11 pediatric and one adult) diurnally active LGSD (seven type I, three type III, and two type IX) subjects were simultaneously assessed by 24h ambulatory blood pressure monitoring and wrist actigraphy. Nine subjects were judged to be hypertensive based on the criterion of an elevated 24h mean SBP and/or DBP being elevated beyond reference standards or the SBP and/or DBP load (percentage of time BP exceeds normal values) being greater than 25%. Two of the three other subjects, not viewed as hypertensive based on their 24h average SBP or DBP, exhibited daytime or nighttime SBP and/or DBP load hypertension. Each study variables displayed statistically significant (p<0.001) group circadian rhythmicity. The SBP, DBP, and MAP displayed comparable 24h patterns of appreciable amplitude (total peak–trough variation equal to 17.7, 23.6, and 19.6%, respectively, of the 24h mean) with highest values (orthophase) occurring ～11 h after the commencement of daytime activity. The sleep-time trough (bathyphase) occurred ～4.5 h before morning awakening. The statistically significant (p<0.006) circadian rhythms of HR (amplitude equal to 33.2% of the 24h mean) and DP (amplitude equal to 49.4% of the 24h mean) peaked earlier, ～7.4 h into the daytime activity span. The sleep-time trough occurred ～3 h before morning awakening. The 24h pattern in the cardiovascular variables was correlated with the 24h pattern of activity, with r ranging from 0.50 for DBP to 0.39 for HR.     

Hemodynamic effects of pacing-induced tachycardia in valvular aortic stenosis.

The hemodynamic effects of tachycardia were studied in 13 patients with valvular aortic stenosis. Observations were made during sinus rhythm (average heart rate 80 beats/min) and two periods (P1 and P2) when atrial pacing increased the heart rate to 109 and 131 beats/min respectively. The cardiac index did not change, but the left ventricular stroke work index fell from 61.8 to 39.5 g X m/m2 (p less than 0.001) as the heart rate increased. The left ventricular end-diastolic pressure averaged 18 mm Hg during sinus rhythm and fell to about 11.5 mm Hg at P1 and P2 (p less than 0.001). The brachial arterial systolic pressure did not change during pacing, but the left ventricular systolic pressure fell from 208 mm Hg to 201 mm Hg during P1 (p less than 0.05) and 193 mm Hg during P2 (p less than 0.001). The mean systolic aortic valve gradient averaged 64 mm Hg during sinus rhythm and fell to 51 mm Hg during P2 (p less than 0.001), and the peak aortic valve gradient fell from 82 to 69 mm Hg during P2 (p less than 0.001). The left ventricular ejection time fraction increased from 26.9% during sinus rhythm to 31.9% during P1 (p less than 0.05) and 34.7% during P2 (p less than 0.005). Because of the prolonged left ventricular ejection time fraction and smaller stroke volume, a smaller pressure gradient developed across the stenosed valve at higher heart rates. The pacing test was of little value in assessing left ventricular function and thus is not useful during invasive investigations of valvular aortic stenosis.     

Non-invasive measurement of blood pressures in the Yucatan micropig (Sus scrofa domestica), with and without midazolam-induced sedation

Current literature suggests that the effects of midazolam, a water-soluble benzodiazepine, on blood pressure in swine are minimal. The hypothesis of the study reported here was that a light sedative dose would induce a decrease in blood pressure in this species. Healthy female Yucatan Micropigs (n = 20), 16 to 30 (mean, 22) kg, aged four six months, were individually placed in a humane restraint sling and allowed to acclimate. Systolic (SBP), diastolic (DBP), and mean (MBP) blood pressures (mmHg) and heart rate (HR; beats per min [bpm]) were measured by use of oscillometry. The pressure cuff was placed at the base of the tail, and five sets of values were recorded at five-min intervals, beginning at 10 and ending 30 min after cuff placement. Following a three- to four-day rest period, this procedure was repeated with the addition of a dose of 0.5 mg of midazolam HCl/kg of body weight given intramuscularly at the time of cuff placement. A paired one-way Student's t-test was used to compare the means of the five measures between control and midazolam treatment. Mean (+/- SD) differences for SBP, DBP, MBP, and HR were 18.9 (+/- 3.97), 17.8 (+/- 5.27), and 18.6 (+/- 5.09) mmHg and 20.7 (+/- 3.73) bpm, respectively. All four parameters were significantly reduced in the midazolam-sedated group (P < 0.001). The maximal decrease in SBP, DBP, and MBP occurred at 15 and 20 min after dosing. Mean values based on the means of the five measures were 128 (+/- 12.6), 80 (+/- 9.4), and 99 (+/- 9.2) mmHg and 135 (+/- 17.4) bpm, and 109 (+/- 15.4), 63 (+/- 12.6), and 80 (+/- 13.6) mmHg and 115 (+/- 15.5) bpm for SBP, DBP, MBP, and HR in the control (n = 20) and midazolam (n = 20) groups, respectively. The control values can serve as normal oscillometric values for this age, sex, and breed of Micropig. We conclude that midazolam, given intramuscularly at a sedative dosage, negatively affects cardiovascular parameters measured by use of a blood pressure cuff, in sexually mature female Micropigs, compared with values in untreated pigs, which is similar to reports for humans.     

Adiposity,central body fat distribution and blood pressure among young Bengalee adults of Kolkata,India: sexual dimorphism

A cross-sectional study of 174 men and 153 women of Bengalee ethnicity was undertaken to compare levels of adiposity, central body fat distribution and blood pressure. The mean age of both the sexes were similar (men = 20.1 years; women = 20.0 years). Significantly more women (n = 42, 27.5%) were overweight (body mass index, BMI > or = 25.0 kg/m2) as compared with men (19, 10.9%). Men were significantly taller and heavier. They also had significantly greater mean waist (WC) and mid upper arm (MUAC) circumferences compared with women. On the other hand, women had significantly (p < 0.001) greater mean BMI, biceps (BSF), triceps (TSF) and subscapular (SSF) skinfolds. The mean values of systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure were significantly greater among men. These significant differences existed even after controlling for BMI. Regression analyses revealed that sex had significant effect on all these variables even after controlling for BMI. Correlation studies showed that WC was found to be much more strongly correlated than BMI with SBP, DBP and MAP, in both sexes. However, when the effect of WC (along with BMI) was also controlled for, there was no significant sex difference in blood pressure.     

Exercise intensity influences cardiac baroreflex function at the onset of isometric exercise in humans.

We sought to examine the influence of exercise intensity on carotid baroreflex (CBR) control of heart rate (HR) and mean arterial pressure (MAP) at the onset of exercise in humans. To accomplish this, eight subjects performed multiple 1-min bouts of isometric handgrip (HG) exercise at 15, 30, 45 and 60% maximal voluntary contraction (MVC), while breathing to a metronome set at eupneic frequency. Neck suction (NS) of -60 Torr was applied for 5 s at end expiration to stimulate the CBR at rest, at the onset of HG (<1 s), and after approximately 40 s of HG. Beat-to-beat measurements of HR and MAP were recorded throughout. Cardiac responses to NS at onset of 15% (-12 +/- 2 beats/min) and 30% (-10 +/- 2 beats/min) MVC HG were similar to rest (-10 +/- 1 beats/min). However, HR responses to NS were reduced at the onset of 45% and 60% MVC HG (-6 +/- 2 and -4 +/- 1 beats/min, respectively; P < 0.001). In contrast to HR, MAP responses to NS were not different from rest at exercise onset. Furthermore, both HR and MAP responses to NS applied at approximately 40s of HG were similar to rest. In summary, CBR control of HR was transiently blunted at the immediate onset of high-intensity HG, whereas MAP responses were preserved demonstrating differential baroreflex control of HR and blood pressure at exercise onset. Collectively, these results suggest that carotid-cardiac baroreflex control is dynamically modulated throughout isometric exercise in humans, whereas carotid baroreflex regulation of blood pressure is well-maintained.     

Relationships between the extent of apnea-induced bradycardia and the vascular response in the arm and leg during dynamic two-legged knee extension exercise

Our aim was to test the hypothesis that apnea-induced hemodynamic responses during dynamic exercise in humans differ between those who show strong bradycardia and those who show only mild bradycardia. After apnea-induced changes in heart rate (HR) were evaluated during dynamic exercise, 23 healthy subjects were selected and divided into a large response group (L group; n = 11) and a small response group (S group; n = 12). While subjects performed a two-legged dynamic knee extension exercise at a work load that increased HR by 30 beats/min, apnea-induced changes in HR, cardiac output (CO), mean arterial pressure (MAP), arterial O(2) saturation (Sa(O(2))), forearm blood flow (FBF), and leg blood flow (LBF) were measured. During apnea, HR in the L group (54 ± 2 beats/min) was lower than in the S group (92 ± 3 beats/min, P < 0.05). CO, Sa(O(2)), FBF, LBF, forearm vascular conductance (FVC), leg vascular conductance (LVC), and total vascular conductance (TVC) were all reduced, and MAP was increased in both groups, although the changes in CO, TVC, LBF, LVC, and MAP were larger in the L group than in the S group (P < 0.05). Moreover, there were significant positive linear relationships between the reduction in HR and the reductions in TVC, LVC, and FVC. We conclude that individuals who show greater apnea-induced bradycardia during exercise also show greater vasoconstriction in both active and inactive muscle regions.     

Intrarenal infusion of bradykinin elicits a pressor response in conscious rats via a B2-receptor mechanism.

Bradykinin (BK) is a peptide known to activate afferent nerve fibers from the kidney and elicit reflex changes in the cardiovascular system. The present study was specifically designed to test the hypothesis that bradykinin B2 receptors mediated the pressor responses elicited during intrarenal bradykinin administration. Pulsed Doppler flow probes were positioned around the left renal artery to measure renal blood flow (RBF). A catheter, to permit selective intrarenal administration of BK, was advanced into the proximal left renal artery. The femoral artery was cannulated to measure mean arterial pressure (MAP). MAP, heart rate (HR), and RBF were recorded from conscious unrestrained rats while five-point cumulative dose-response curves during an intrarenal infusion of BK (5-80 microg x kg(-1) x min(-1)) were constructed. Intrarenal infusion of BK elicited dose-dependent increases in MAP (maximum pressor response, 26+/-3 mmHg), accompanied by a significant tachycardia (130+/-18 beats/min) and a 28% increase in RBF. Ganglionic blockade abolished the BK-induced increases in MAP (maximum response, -6+/-5 mmHg), HR (maximum response 31+/-14 beats/min), and RBF (maximum response, 7+/-2%). Selective intrarenal B2-receptor blockade with HOE-140 (50 microg/kg intrarenal bolus) abolished the increases in MAP and HR observed during intrarenal infusion of BK (maximum MAP response, -2+/-3 mmHg; maximum HR response, 15+/-11 beats/min). Similarly, the increases in RBF were prevented after HOE-140 treatment. In fact, after HOE-140, intrarenal BK produced a significant decrease in RBF (22%) at the highest dose of BK. Results from this study show that the cardiovascular responses elicited by intrarenal BK are mediated predominantly via a B2-receptor mechanism.     

Role of pertussis toxin-sensitive G protein in metabolic vasodilation of coronary microcirculation

We have previously demonstrated that pertussis toxin (PTX)-sensitive G protein (G(PTX)) plays a major role in coronary microvascular vasomotion during hypoperfusion. We aimed to elucidate the role of G(PTX) during increasing metabolic demand. In 18 mongrel dogs, coronary arteriolar diameters were measured by fluorescence microangiography using a floating objective. Myocardial oxygen consumption (MVO(2)) was increased by rapid left atrial pacing. In six dogs, PTX (300 ng/ml) was superfused onto the heart surface for 2 h to locally block G(PTX). In eight dogs, the vehicle (Krebs solution) was superfused in the same way. Before and after each treatment, the diameters were measured during control (130 beats/min) and rapid pacing (260 beats/min) in each group. Metabolic stimulation before and after the vehicle treatment caused 8.6 +/- 1. 8 and 16.1 +/- 3.6% dilation of coronary arterioles <100 microm in diameter (57 +/- 8 microm at control, n = 10), respectively. PTX treatment clearly abolished the dilation of arterioles (12.8 +/- 2. 5% before and 0.9 +/- 1.6% after the treatment, P < 0.001 vs. vehicle; 66 +/- 8 microm at control, n = 11) in response to metabolic stimulation. The increases in MVO(2) and coronary flow velocity were comparable between the vehicle and PTX groups. In four dogs, 8-phenyltheophylline (10 microM, superfusion for 30 min) did not affect the metabolic dilation of arterioles (15.3 +/- 2.0% before and 16.4 +/- 3.8% after treatment; 84.3 +/- 11.0 microm at control, n = 8). Thus we conclude that G(PTX) plays a major role in regulating the coronary microvascular tone during active hyperemia, and adenosine does not contribute to metabolic vasodilation via G(PTX) activation.