寒冷压力测试和轻链氨基粉症中矛盾的血压降低
Raphael Patras1, Georgios Georgiopoulos1, Foteini Theodorakakou1
1Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
概括
患有AL氨基粉症的患者在冷压力测试 (CPT) 中表现出矛盾的血管扩张. 在CPT后降低血压反应预测AL氨基粉症患者的死亡率和心脏问题.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 在瘤学瘤学.
背景情况:
- 患有AL氨基粉症的患者在通过冷压测试 (CPT) 通过同情刺激时表现出矛盾的血管扩张.
- 这种血管扩张反应在AL氨基粉症中的临床意义尚不清楚.
研究的目的:
- 在CPT期间调查AL氨基粉症患者矛盾血管扩张的临床相关性.
- 评估血压对CPT的反应与患者的结果之间的关联,包括死亡率和治疗反应.
主要方法:
- 在CPT前后测量了周围和中心的缩和腹缩血压,113名以前未接受过治疗的AL粉样化症患者和10名健康对照.
- 血压变化在基线和治疗开始后12个月被评估,记录了所有原因和心血管死亡率.
主要成果:
- 在CPT后,中心缩血压 (CSBP6min) 和外周腹缩血压 (DBP6min) 的降低比例与全因和心血管死亡率的增加显著相关.
- %CSBP6min证明了迈奥阶段以外的增量预后价值,与神经/心脏功能障碍和心肌透相关.
- 12个月后%CSBP6min进一步下降表明血液治疗反应较差.
结论:
- 在CPT后6分钟内,中央缩血压的百分比降低 (%CSBP6min) 是AL氨基粉症的有价值的非侵入性标志物.
- %CSBP6min与心脏功能障碍,生存率降低和血液治疗反应有关.
相关概念视频
01:17Measurement of Blood Pressure
2.7K
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
2.7K
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
2.3K
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
2.3K
01:28Special considerations while measuring blood pressure
1.2K
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
1.2K
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
2.4K
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
2.4K
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
928
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
928
01:25Antihypertensive Drugs: Direct Renin Inhibitors
1.3K
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
1.3K