A new method for quantitative assessment of the atrial contribution to ventricular ejection in sequentially paced patients is described. The atrial contribution (AC) has been defined as the pulse pressure decrement (invasive arterial measurement by a canulla inserted into the brachial artery), expressed in percent of the control pulse pressure, induced by switching off the atrium activating impulse for one beat In 17 patients, the AC was found to be atrioventricular (AV) interval dependent, the measurements were well reproducible (the mean difference between two measurements at different times was 93 %, S.D. 8.4). For the AV interval of 170 ms, it was found to be 29.3 % (+8.9) in patients with the sick sinus syndrome, 27.0 % (+3.2) in patients with complete AV block and only 10.8 % (+2.1) a in patient with complete AV block and heart dysfunction.
An increase in the renal resistive index (RRI) in patients with essential hypertension (EH) predicts deterioration in renal function. In patients with EH, changes in hemodynamic parameters significantly affect the RRI. This study aimed to define changes in Ambulatory Blood Pressure Monitoring (ABPM) parameters that are significantly associated with a change in RRI in patients with EH. We evaluated ABPM and the RRI in 96 patients with EH without organ extrarenal changes at baseline and after two years of follow-up. The relationships between changes in ABPM parameters and the RRI over the period were evaluated. After two years of follow-up, the increase in RRI was consequential. Simultaneously, 24-h systolic blood pressure increased significantly and 24-h diastolic blood pressure decreased. In the whole group and in the group with calculated cystatin C clearance (eGFRcyst) ≥90 ml/min/1.73 m2 , the change in RRI significantly negatively correlated with the change in the ratio of 24-h diastolic to systolic blood pressure (D/S ratio), but also with the change in 24-h pulse blood pressure. However, in patients with eGFRcyst˂90 ml/min/1.73 m2 , only the change in the 24-h D/S ratio significantly correlated with the change in RRI. Based on the backward stepwise regression analysis, the change in RRI was significantly dependent only on the change in 24-h D/S ratio and not on the change in 24-h pulse pressure. A change in the ratio of diastolic to systolic pressure better reflects a change in RRI than a change in pulse pressure.
A high pulse pressure (PP) is a marker of increased artery stiffness and represents a well-e stablished independent predictor for cardiovascular morbidity and mortality. The objective of the research was to determine whether invasively measured central aortic PP was related to the presence and severity of coronary artery disease. In total 1075 consecutive stable male patients undergoing diagnostic coronary angiography with a preserved left ventricular function were included. Diseased coronary vessel (DCV) was defined by the presence of >50 % stenosis. Men were divided into 3 groups according to the increased value of PP. The average PP in the tertiles was 47.8±7.1 vs. 67.0±4.9 vs. 91.3±12.8 mm Hg (p<0,01). The si gnificant differences of DCV was found among tertiles (1.51±1.11 vs 1.80±1.04 vs. 1.99±0.98 DCV, p<0.01). Aortic PP together with age and hyperlipoproteinemia were found as factors with an independent relationship to DCV according to multivariate linear regression. In conclusions the increased value of aortic PP in the male population is independently connected with more severe atherosclerosis evaluated by the significant number of DCV., J. Pařenica ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy