Authors assessed the prognostic value of some simple, routinely used non-invasive parameters in dilated cardiomyopathy. Fifty patients, 43 male and 7 female, mean NYHA class 2.3, treated with digitalis, diuretics and vasodilators, were tested. Mean follow up time was 24 months. The evaluated parameters were as follows: maximal exercise capacity, heart rate, systolic blood pressure, as well as rate-pressure product at peak exercise, their increase during the test, fractional shortening measured by M-mode echocardiography, mean pulmonary capillary wedge pressure estimated by apexcardiography and clinical grade of heart failure (NYHA class). Exercise test was multistage, symptom limited, maximal upright bicycle ergometer test. Both one-way and multivariate analysis showed that except of fractional shortening all of the evaluated parameters related significantly to the survival. According to the one-way analysis maximal exercise capacity, rate-pressure product and systolic blood pressure at peak exercise as well as the estimated value of mean pulmonary capillary wedge pressure proved to be the strongest prognosticators. Multivariate analysis showed that the prognostic value of the rate-pressure product at peak exercise and that of the estimated mean pulmonary capillary wedge pressure proved to be additive, their combined consideration resulted in the highest accuracy of prediction.
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J Am Heart Assoc
January 2025
Department of Medicine, Division of Cardiology Emory University School of Medicine Atlanta GA USA.
Background: Acute psychological stress may induce physiological changes predisposing individuals to adverse health outcomes through hemodynamic and vascular effects. We studied the association between the aggregated stress-induced changes in hemodynamic and vascular function tests with adverse cardiovascular outcomes in patients with coronary artery disease, after adjusting for sociodemographic and clinical factors.
Methods And Results: Individuals with stable coronary artery disease from 2 prospective cohort studies were studied.
J Pain Res
January 2025
Department of Anesthesiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, People's Republic of China.
Background: Postoperative sore throat (POST) is a significant adverse effect after endotracheal intubation, especially with double-lumen endotracheal tubes (DLTs). Ultrasound-guided internal branch of the superior laryngeal nerve block (US-guided iSLNB) presents a potential intervention for POST. In this first randomized controlled trial to date, we aimed to investigate the effects of US-guided iSLNB, with or without perineural dexmedetomidine, on the incidence and severity of POST following DLTs.
View Article and Find Full Text PDFAm Surg
January 2025
Department of Medicine, Ziauddin Medical College, Karachi, Pakistan.
Aims: The purpose of this systematic review was to assess the safety and effectiveness of beta antagonists for improving clinical care in burn patients, compared to placebo.
Methods: Articles from randomized-controlled trials were identified by a literature search on PubMed and Cochrane. We included relevant trials involving patients with burn.
J Anaesthesiol Clin Pharmacol
August 2024
Department of Anesthesia, RNT Medical College, Udaipur, Rajasthan, India.
Background And Aims: An exaggerated hemodynamic response to endotracheal intubation is observed in hypertensive patients, and its attenuation proves challenging. The role of oral ivabradine, a unique heart rate-lowering drug with a favorable hemodynamic profile, is not yet studied. The aim of this study was to evaluate the effect of oral ivabradine on the attenuation of hemodynamic response to endotracheal intubation in hypertensive surgical patients assessed by rate pressure product (RPP), which is a very reliable indicator of myocardial oxygen demand.
View Article and Find Full Text PDFExp Physiol
December 2024
Division of Cardiology, Stavanger University Hospital, Stavanger, Norway.
Endurance exercise is associated with increased life duration and improved life quality. Paradoxically, high exercise intensity is also associated with increased coronary artery calcification (CAC) and a small but significant increased risk of adverse cardiac events during exercise. The mechanisms underlying the development of CAC during prolonged high-intensity endurance exercise are unknown.
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