An experimental study of vascular dynamics by an acceleration plethysmogram using artificial circulation devices

Plethysmogram has been widely known as a conventional non-invasive simple method to obtain information on peripheral circulatory kinetics. We made a quantitative assessment of the relationships between the various circulatory parameters, using the simple conventional measurement method of treating acceleration plethysmograms (the second derivatives of digital plethysmograms) as indicators of peripheral circulation kinetics. We designed a prototype model peripheral circulatory circuit, using an artificial heart, for the purpose of clarifying the relationship between physical factors and plethysmograms. In our models of the peripheral circulatory system, we made use of various types of matching silicon tubes, as well as canine carotid arteries, as substitutes for human arteries. We evaluated the mechanical characteristics, such as the pressure and volume characteristics of the silicon tubes and canine carotid arteries. Plethysmogram alterations were measured using a photoelectric digital plethysmogram. When we examined the acceleration plethysmogram b/a values, which indicate blood vessel extensibility and hardness, and the d/a values, which we were able to use as an index of peripheral circulatory kinetics, it was clear from out model testing that canine carotid arteries displayed b/a values that were closest to those found in the human fingertip; among artificial tubes, the closest was a tube with a diameter of 4 mm (0.18 mm in thickness). The b/a values of all types of tubes declined when the compliance of the arterial system was increased, and it was confirmed through model testing that b/a values are an indicator of blood vessel extensibility.     

Noninvasive, automatic 24-h ambulatory blood pressure monitoring in normotensive subjects

The reliability of noninvasive, automatic blood pressure monitoring is not yet clearly established. A 24-h ambulatory blood pressure profile was obtained in 9 healthy, normotensive subjects with an automatic, noninvasive device. The blood pressure profile showed the typical circadian pattern with lower systolic and diastolic values during sleep, although pulse pressure was fairly constant (about 40 mm Hg). The systolic blood pressure rose steeply in the early morning hours--before waking up. The results were compared with simultaneous hourly readings using the auscultatory method. There were no statistically significant differences between the automatic and auscultatory readings, 13 of the 18 mean values at different time points being within 2 mm Hg of each other. All the auscultatory means fell within the 95% confidence limits of those measured hourly by the automatic method. Although the automatic method seemed to be reliable compared with the auscultatory method, its sensitivity to motion artifacts is a disadvantage in a truly ambulatory setting.     

The mechanical properties of the rabbit and human cornea

The extensibility of rabbit and human corneas was measured by raising the pressure within the intact globe of the eye and measuring the displacements of two very small mercury drops on the corneal surface. The human cornea showed a negligible extensibility under low stresses. The rabbit tissue, however, underwent a 9% strain under low pressures with a curvilinear relationship between stress and strain. At higher pressures the relationship was linear, and the tissue showed some creep. The low pressure stress-strain relationship of the rabbit could not be explained on the basis that the collagen fibrils were being straightened out from an initial set in a sinusoidal wave. When the stroma was isolated from Descemet's membrane, it showed a negligible low pressure extensibility in rabbit and man. On the other hand, isolated Descemet's membrane was very extensible in both species. The difference between them in the behavior of the intact cornea seems to lie in the relative initial strain in the stroma and Descemet's membrane.     

Human cardiovascular reactions to simulated hypovolaemia, modified by the opiate antagonist naloxone

Six healthy males were exposed to 20 mm Hg lower body negative pressure (LBNP) for 8 min followed by 40 mm Hg LBNP for 8 min. Naloxone (0.1 mg.kg-1) was injected intravenously during a 1 h resting period after which the LBNP protocol was repeated. Systolic, mean, and diastolic arterial blood pressures (SAP, MAP, DAP), and central venous pressure (CVP) were obtained using indwelling catheters. Cardiac output (CO), forearm blood flow (FBF), heart rate (HR), left ventricular ejection time (LVET), and electromechanical systole (EMS) were measured non-invasively. Pulse pressure (PP), stroke volume (SV), total peripheral resistance (TPR), forearm vascular resistance (FVR), systolic ejection rate (SER), pre-ejection period (PEP), PEP/LVET and indices for the systolic time intervals (LVETI, EMSI, PEPI) were calculated. During the second LBNP exposure, only two parameters differed from the pre-injection values: DAP at LBNP = 40 mm Hg increased from 60.0 +/- 4.8 mm Hg to 64.8 +/- 4.1 mm Hg (N = 4, p less than 0.02) and LVETI at LBNP = 20 mm Hg increased from 384.4 +/- 5.2 ms to 396.8 +/- 6.2 ms (N = 6, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)     

Hemoglobin functions in the blood of Bufo marinus

The effects of three physical-chemical factors, temperature, hydrogen ion concentration, and partial pressure of oxygen, on the respiratory functions of blood of the toad (Bufo marinus) have been studied. Measurements of oxygen affinity of hemoglobin in whole blood were measured tonometrically by a method devised for small quantities of blood. At pH 7.40 and 25°C blood was found to be 50% saturated with oxygen at a partial pressure of 44 mm Hg of oxygen. The Bohr effect was measured at various temperatures and found to be about one-half that found for mammalian blood. Carbon dioxide content of toad blood changes only slightly in the oxygenated and reduced states. Thus the “Haldane” effect parallels the small Bohr effect. Toad blood was found to have average hematocrit values of 37% for erythrocytes and average hemoglobin values of 11 gm/100 ml per cubic millimeter of blood. The respiratory functions of the blood of the toad conform to the pattern of respiratory mechanisms available for gas exchange between the environment and tissues of the organism.     

Morphometric variables related to metabolic profile in captive chimpanzees (Pan troglodytes)

Obesity is a risk factor for several diseases including type 2 diabetes and cardiovascular disease. The aim of this study was to compare the relationships of waist circumference and body weight with circulating markers of metabolic, cardiovascular, and hepatic function in chimpanzees (Pan troglodytes). After a 12-h fast, blood was collected from 39 adult captive chimpanzees for measurement of serum glucose, BUN, creatinine, albumin, cholesterol, ALT, AST, ALP, total and direct bilirubin, triglyceride, and insulin, and waist circumference and body weight were measured. Waist circumference was positively correlated with systolic and diastolic blood pressure, glucose, insulin resistance as estimated by the homeostatic model assessment method, and albumin in female chimpanzees and with triglyceride in female and male chimpanzees. Body weight was correlated significantly with systolic and diastolic blood pressure in female chimpanzees and triglyceride in male chimpanzees. Male chimpanzees were heavier and had lower diastolic blood pressure, greater creatinine, albumin, AST, ALP, total bilirubin, and direct bilirubin values than did female chimpanzees. The relationships between waist circumference and blood pressure and triglyceride are consistent with those reported in humans and other primate species. In conclusion, our study is the first work to demonstrate a relationship between waist circumference and metabolic risk factors in chimpanzees. Results demonstrated that waist circumference was associated with more metabolic risk factors than was body weight, particularly in female chimpanzees.     

Distributions of sensory spots in the hand and two-point discrimination thresholds in the hand, face and mouth in dental students.

Densities of pressure, pain and temperature spots in the back of the hand in 551 students and two-point discrimination thresholds in the hand, the face and the mouth in 684 students were measured. The mean numbers of pressure, pain, warm and cold spots in the back of the hand were 24.7/cm2, 130.5/cm2, 3.4/cm2 and 9.1/cm2, respectively. The mean thresholds of two-point discrimination were 1.7 mm in the tip of the tongue, 2.4 mm in the upper lip, 5.5 mm in the lower jaw, 7.5 mm in the palm, 8.8 mm in the forehead, and 11.8 mm in the back of the hand. There were mostly no differences between males and females in the values of sensory spots and two-point discrimination thresholds.     

Retinal pulse wave velocity measurement using spectral‐domain optical coherence tomography

The human eyes provide a natural window for noninvasive measurement of the pulse wave velocity (PWV) of small arteries. By measuring the retinal PWV, the stiffness of small arteries can be assessed, which may better detect early vascular diseases. Therefore, retinal PWV measurement has attracted increasing attention. In this study, a jump‐scanning method was proposed for noninvasive measurement of retinal PWV using spectral‐domain optical coherence tomography (SD‐OCT). The jump‐scanning method uses the phase‐resolved Doppler OCT to obtain the pulse shapes. To realize PWV measurement, the jump‐scanning method extracts the transit time of the pulse wave from an original OCT scanning site to another through a transient jump. The measured retinal arterial PWV of a young human subject with normal blood pressure was in the order of 20 to 30 mm/s, which was consistent with previous studies. As a comparison, PWV of 50 mm/s was measured for a young human subject with prehypertension, which was in accordance with the finding of strong association between retinal PWV and blood pressure. In summary, it is believed the proposed jump‐scanning method could benefit the research and diagnosis of vascular diseases through the window of human eyes.      

Vitamin E, membrane fluidity, and blood pressure in hypertensive and normotensive rats

Vitamin E treatment was found to lower blood pressure, and increase membrane fluidity in rats. The objectives of this study were to investigate the effects of the antioxidant, vitamin E, on the blood pressure and erythrocyte membrane fluidity in spontaneously hypertensive (SHR) and normotensive (WKY) rats. Membrane fluidity was assessed using spin labeling technique and electron paramagnetic resonance (EPR) spectroscopy. Two different spin labels were used in this study, 5-doxylstrearic acid (5-SASL) and 16-doxylstearic acid (16-SASL). The rats were given vitamin E, 3 days/week for 3 weeks and blood pressure was measured once weekly, using the tail-cuff method. Subsequently, blood was taken via heart puncture and erythrocytes were prepared for spin labeling. The fluidity of the membrane in the nonpolar region of erythrocytes from hypertensive rats was found quite different from that of normal rats as judged by the spectra of 16-SASL. The values of maximum splitting parameter of the EPR spectra of the spin label 5-SASL incorporated in erythrocyte membrane from both SHR and WKY rats, and the effects of vitamin E on membrane fluidity were compared. The maximum splitting parameter calculated from EPR spectra was larger for SHR than WKY rats. Additionally, the maximum splitting parameter calculated for vitamin E treated SHR and WKY rats were lower than those of their respective controls. As expected, the blood pressure of the SHR rats was found to be higher than that of the WKY rats. Vitamin E treated SHR and WKY rats showed significantly lower blood pressure than their controls.     

Differences Between Right and Left Arm Blood Pressures in the Elderly

Recommendations vary on whether blood pressures should be measured in the right or in the left arm because no frequency distributions for a pressure difference between the arms exist. We took a total of 12 blood pressure determinations in both arms of 174 elderly persons and analyzed the data by a least-squares components of variance method. The mean difference between the arms (right minus left) was 0.93 mm of mercury for systole and 0.70 mm of mercury for diastole. For systole the proportion of persons having arm pressure differences exceeding 10 mm of mercury is 1.4% and that exceeding 7.5 mm of mercury is 6.5%. For most people, the pressure difference between the arms is small.     

Pressure probe and isopiestic psychrometer measure similar turgor

Turgor measured with a miniature pressure probe was compared to that measured with an isopiestic thermocouple psychrometer in mature regions of soybean (Glycine max [L.] Merr.) stems. The probe measured turgor directly in cells of intact stems whereas the psychrometer measured the water potential and osmotic potential of excised stem segments and turgor was calculated by difference. When care was taken to prevent dehydration when working with the pressure probe, and diffusive resistance and dilution errors with the psychrometer, both methods gave similar values of turgor whether the plants were dehydrating or rehydrating. This finding, together with the previously demonstrated similarity in turgor measured with the isopiestic psychrometer and a pressure chamber, indicates that the pressure probe provides accurate measurements of turgor despite the need to penetrate the cell. On the other hand, it suggests that as long as precautions are taken to obtain accurate values for the water potential and osmotic potential, turgor can be determined by isopiestic psychrometry in tissues not accessible to the pressure probe for physical reasons.     

Effects of age, sex, and physical fitness on responses to local cooling

The response to local cooling was estimated by the cold hand test (5 degrees C for 2 min) and the cold face test (0 degrees C with 66 km.h-1 wind for 2 min). Heart rate, blood pressure, and skin temperature were measured before, during, and after the tests. The increase in blood pressure (cold hand test) and the fall in Tsk (cold face test) were reduced in trained subjects. Similarly older subjects (53-60 yr of age) responded less to a cold hand test than younger subjects aged 20-40. However, the bradycardia caused by the cold face test was more pronounced in the older subjects. The responses to the cold hand and cold face tests were the same for male and female subjects. During the 2 min after the test, blood pressure and heart rate fell below initial values in the female group but not in the male. It is concluded that, besides adaptation to cold, individual factors such as age, sex, and physical fitness also have a relative importance in the responses to local cooling.     

Treatment of vasospastic disease with prostaglandin E1.

Prostaglandin E1, a vasodilator and potent inhibitor of platelet aggregation, was administered to 26 patients with severe vasospastic disease of the hands. Patients tolerated infusions well and reported appreciable symptomatic improvement. Five of eight ischaemic ulcers healed in six weeks. Non-invasive studies of blood flow were used to observe haemodynamic changes during and after infusions. The Doppler-derived radial artery pulsatility index fell from 8.8 +/- 0.6 to 4.6 +/0 0.5 (mean +/- SEM), indicating hand vasodilatation. This fall was maintained 24 hours after infusion (5.9 +/- 0.9), but the index had returned to normal values at two weeks. The amplitude of finger pulse volume recordings increased (5.6 +/- 0.7 mm to 23.8 +/- 3.4 mm) and was raised two and six weeks after infusion (13.5 +/- 2.1 mm). Hand temperature measured by infrared radiometry also increased (27.4 +/- 0.7 degrees C to 31.2 +/- 1.2 degrees C). Intensity of digital vasospasm induced by cold water challenge was not objectively affected by prostaglandin E1 despite an increased finger temperature after infusion. Nevertheless, patients reported less frequent and severe attacks. Prostaglandin E1 given by central venous infusion is a safe new vasoactive agent that can produce appreciable symptomatic improvement by increasing digital perfusion, which may last for several weeks after treatment. Further study will define its mode of action and its place in the management of peripheral vascular disease.     

Early effect of Crotalus durissus terrificus venom on kidney circulation

Local blood flow was measured in renal cortex (1 mm below cortical surface) by means of the hydrogen clearance method in urethanized rats. Recording of blood pressure from femoral artery was performed. Crotalus durissus terrificus venom injection (one mg/kg i.v.) significantly decreased cortical blood flow at 10 min, without a significant arterial pressure modification. Posterior injection of mannitol 200 mg induced a significant increase in cortical blood flow, although initial values were not reached. Electron microscopy showed thromboses in the glomerular capillaries 35 minutes after venom injection. It is suggested that the precocious effect of this venom on renal cortical blood flow may be instrumental in the development of the renal acute insufficiency induced by Crotalus durissus terrificus venom.     

Method of studying the reactions of single vessels in situ

A new method of continuous measurement of vascular resistance has been proposed for studying the reactivity of single blood vessels. According to the method, blood flows through the artery, then through a rigid tube, serving as a reference resistance, and a flow control system and then returns back to the animal. The parameter of interest is pressure drop along the artery to reference resistance ratio. The method permits the study of practically intact vessels with diameters to 0.3 mm. Changes in blood viscosity have but a slight effect on the results of the measurement.     

Comparison of performance of various sphygmomanometers with intra-arterial blood-pressure readings.

Seven types of sphygmomanometer were used in random order on each of nine hypertensive patients and the readings compared with simultaneous intra-arterial blood-pressure recordings. All the devices gave significantly different values for systolic pressure, and only two measured diastolic pressure without significant error. Systolic pressure was consistently underestimated (range 31-7 mm Hg), and all but one instrument overestimated diastolic pressure (range 10-2 mm Hg). The variability of readings was least with the standard mercury sphygmomanometer and the random-zero machine, while with some of the more automated devices single readings were in error up to -68/33 mm Hg. The strong correlations found between intra-arterial and cuff systolic pressures with all devices tested and significant correlations for diastolic pressure with all but one device indicate that, with one possible exception, the sphygmomanometers would give accurate results where a change in blood pressure was the main concern.     

Separate hemodynamic roles for chloride and sodium in deoxycorticosterone acetate-salt hypertension

It has been reported that both sodium and chloride ions must be ingested to induce the elevated blood pressure of deoxycorticosterone acetate (DOCA)-salt-sensitive hypertension. This study was designed to determine the separate roles of the sodium and chloride ions in the altered hemodynamics underlying the high blood pressure. DOCA pellets (75 mg) were implanted in uninephrectomized rats and the animals were then fed one of four diets: (i) high sodium chloride, (ii) high sodium-low chloride, (iii) high chloride-low sodium, or (iv) low sodium chloride. Blood pressures were measured weekly by tail-cuff plethysmography for 5 weeks and the animals were then subjected to a terminal experiment to measure cardiac output by thermodilution technique, renal blood flow by electromagnetic flow probe, and direct arterial pressure. Blood pressure in the DOCA-high NaCl group was significantly greater (P less than 0.05) compared with that of the DOCA-low NaCl group (160 +/- 3 mm Hg vs 124 +/- 2 mm Hg, respectively) at 5 weeks after treatment; all other groups were not significantly different from the DOCA-low NaCl group. Cardiac output was significantly greater in DOCA-treated rats consuming diets high in sodium (44 +/- 2 ml/min/100 g) or sodium chloride (40 +/- 2 ml/min/100 g) compared with animals consuming low sodium chloride (31 +/- 2 ml/min/100 g; P less than 0.01 for each comparison). Direct intraarterial blood pressure and renal blood flow were used to calculate renal vascular resistance. Renal vascular resistance was increased in those DOCA-treated rats consuming diets high in chloride (42 +/- 3 mm Hg/ml/min/100 g) and high sodium chloride (54 +/- 3 mm Hg/ml/min/100 g) compared with rats consuming low sodium chloride (30 +/- 3 mm Hg/ml/min/100 g; P less than 0.01 for each). It appears that elevations in cardiac output are associated with increased dietary sodium and act in synergy with the elevations in renal vascular resistance associated with increased dietary chloride. Increases in both cardiac output and renal vascular resistance are involved in the maintenance of elevated blood pressure in the DOCA-salt-sensitive model of hypertension.     

Reference cardiopulmonary values in normal dogs

The purpose of this project was to collate canine cardiopulmonary measurements from published and unpublished studies in our laboratory in 97 instrumented, unsedated, normovolemic dogs. Body weight; arterial and mixed-venous pH and blood gases; mean arterial, pulmonary arterial, pulmonary artery occlusion, and central venous blood pressures; cardiac output; heart rate; hemoglobin; and core temperature were measured. Body surface area; bicarbonate concentration; base deficit; cardiac index; stroke volume index, systemic and pulmonary vascular resistance indices; left and right cardiac work indices; alveolar partial pressure of oxygen (pO2) ; alveolar-arterial pO2 gradient (A-apO2); arterial, mixed-venous, and pulmonary capillary oxygen content; oxygen delivery; oxygen consumption; oxygen extraction; venous admixture; arterial and mixed-venous blood CO2 contents; and CO2 production were calculated. In the 97 normal, resting dogs, mean arterial and mixed-venous pH were 7.38 and 7.36, respectively; partial pressure of carbon dioxide (pCO2), 40.2 and 44.1 mm Hg, respectively; base-deficit, -2.1 and -1.9 mEq/liter, respectively; pO2, 99.5 and 49.3 mm Hg, respectively; oxygen content, 17.8 and 14.2 ml/dl, respectively; A-a pO2 was 6.3 mm Hg; and venous admixture was 3.6%. The mean arterial blood pressure (ABPm), mean pulmonary arterial blood pressure (PAPm), pulmonary artery occlusion pressure (PAOP) were 103, 14, and 5.5 mm Hg, respectively; heart rate was 87 beats/min; cardiac index (CI) was 4.42 liters/min/m2; systemic and pulmonary vascular resistances were 1931 and 194 dynes.sec.cm-5, respectively; oxygen delivery, consumption and extraction were 790 and 164 ml/min/m2 and 20.5%, respectively. This study represents a collation of cardiopulmonary values obtained from a large number of dogs (97) from a single laboratory using the same measurement techniques.     

Abdominal compartment syndrome in polytrauma

Authors inform about the group of 8 patients with abdominal compartment syndrome (ACS) occurred as a complication in large blunt injury of abdominal cavity. To the ACS diagnose, the measurement of intracystic pressure is used routinely, whose values correlate fully with values of intraabdominal pressure (IAP). In case of increasing values of IAP over 25 mm Hg with positive clinical signs of ACS, authors indicate decompression laparotomy with temporary closing of abdominal cavity by sterile plastic foil or Ethizip. This preventive temporary laparostomy is recommended also in serious injuries of abdominal cavity in patients with fatal haemorrhage, treated by the method of staged laparotomy with tamponade of abdominal cavity and with massive blood and volume resuscitation.     

Material properties of the ovine mitral valve anterior leaflet in vivo from inverse finite element analysis

We measured leaflet displacements and used inverse finite-element analysis to define, for the first time, the material properties of mitral valve (MV) leaflets in vivo. Sixteen miniature radiopaque markers were sewn to the MV annulus, 16 to the anterior MV leaflet, and 1 on each papillary muscle tip in 17 sheep. Four-dimensional coordinates were obtained from biplane videofluoroscopic marker images (60 frames/s) during three complete cardiac cycles. A finite-element model of the anterior MV leaflet was developed using marker coordinates at the end of isovolumic relaxation (IVR; when the pressure difference across the valve is approximately 0), as the minimum stress reference state. Leaflet displacements were simulated during IVR using measured left ventricular and atrial pressures. The leaflet shear modulus (G(circ-rad)) and elastic moduli in both the commisure-commisure (E(circ)) and radial (E(rad)) directions were obtained using the method of feasible directions to minimize the difference between simulated and measured displacements. Group mean (+/-SD) values (17 animals, 3 heartbeats each, i.e., 51 cardiac cycles) were as follows: G(circ-rad) = 121 +/- 22 N/mm2, E(circ) = 43 +/- 18 N/mm2, and E(rad) = 11 +/- 3 N/mm2 (E(circ) > E(rad), P < 0.01). These values, much greater than those previously reported from in vitro studies, may result from activated neurally controlled contractile tissue within the leaflet that is inactive in excised tissues. This could have important implications, not only to our understanding of mitral valve physiology in the beating heart but for providing additional information to aid the development of more durable tissue-engineered bioprosthetic valves.