The Experts below are selected from a list of 154836 Experts worldwide ranked by ideXlab platform
Andrei V Krassioukov - One of the best experts on this subject based on the ideXlab platform.
-
Cardiovascular Function in individuals with incomplete spinal cord injury a systematic review
Topics in Spinal Cord Injury Rehabilitation, 2013Co-Authors: Christopher R West, Austin Bellantoni, Andrei V KrassioukovAbstract:Spinal cord injury (SCI) affects 250,000 individuals in North America, with approximately 11,000 new cases per annum.1 The lifetime health costs of an individual with cervical SCI can be as high as $3.3 million.2 Much of this cost is related to the treatment of secondary complications arising from the SCI. One of the most debilitating secondary consequences of SCI is alterations in autonomic Cardiovascular control that, combined with paralysis, predispose individuals with SCI to a higher incidence of Cardiovascular disease (CVD).3 This predisposition to CVD not only results in early mortality but also reduces quality of life. It is now well recognized that the extent of impairment in Cardiovascular Function is related to the neurological level of injury,4 whereby persons with cervical/high-thoracic injuries exhibit a greater impairment in Cardiovascular Function and an earlier onset of CVD than those with low-thoracic/lumbar injuries. Injury to the cervical/ upper thoracic cord disrupts descending input to the sympathetic preganglionic neurons that control the critical splanchnic bed resulting in neurogenic shock during the early stages of SCI and long-lasting resting hypotension post injury.5 Loss of supraspinal tonic inhibitory input to the sympathetic preganglionic neurons provides an environment in which sensory-evoked reflexes can cause unopposed below-lesion sympathetic activation, leading to profound vasoconstriction and consequent episodes of hypertension. This condition, termed autonomic dysreflexia (AD), affects up to 90% of individuals with motor complete cervical SCI6 and can lead to a sequelae of Cardiovascular effects, such as myocardial infarction,7 intracranial hemorrhage,8 and even death.9 Whilst the relationship between lesion level and Cardiovascular dysFunction is well established, the relationship between the severity (ie, completeness) of SCI and Cardiovascular control is less clear. Historically, completeness of injury has referred to motor/sensory (neurological) completeness of injury, as assessed during the well-established neurological examination that is conducted in accordance with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI).10 More recently, however, a number of researchers have started to investigate the concept of autonomic completeness of SCI and its effect on various bodily Functions following injury. There is still no consensus on the best method to assess autonomic completeness of injury. Recently, International Standards to Document remaining Autonomic Functions after SCI (ISAFSCI) have been developed and revised.11 It is now recommended that this assessment form is used as an adjunct with the ISNCSCI. These ISAFSCI standards, however, provide a simple documentation of autonomic dysFunction after SCI, rather than assessment of autonomic completeness of injury. Hence, there is still no assessment of autonomic completeness of injury in the clinical SCI setting, nor is there a clear understanding of the relationship between autonomic and neurological completeness of injury. A better understanding of such relationships will assist researchers in the development of appropriate levels of stratification within their studies and will assist clinicians in understanding the unique Cardiovascular profiles of individuals with varying severities of SCI. The purpose of this systematic review is to investigate the relationship between Cardiovascular Function and neurological and autonomic completeness of injury.
-
International spinal cord injury Cardiovascular Function basic data set
Spinal Cord, 2010Co-Authors: Andrei V Krassioukov, M S Alexander, C J Mathias, A-k Karlsson, W Donovan, Fin Biering-sørensenAbstract:Objective: To create an International Spinal Cord Injury (SCI) Cardiovascular Function Basic Data Set within the framework of the International SCI Data Sets. Setting: An international working group. Methods: The draft of the data set was developed by a working group comprising members appointed by the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the executive committee of the International SCI Standards and Data Sets. The final version of the data set was developed after review by members of the executive committee of the International SCI Standards and Data Sets, the ISCoS scientific committee, ASIA board, relevant and interested international organizations and societies, individual persons with specific interest and the ISCoS Council. To make the data set uniform, each variable and each response category within each variable have been specifically defined in a way that is designed to promote the collection and reporting of comparable minimal data. Results: The variables included in the International SCI Cardiovascular Function Basic Data Set include the following items: date of data collection, Cardiovascular history before the spinal cord lesion, events related to Cardiovascular Function after the spinal cord lesion, Cardiovascular Function after the spinal cord lesion, medications affecting Cardiovascular Function on the day of examination; and objective measures of Cardiovascular Functions, including time of examination, position of examination, pulse and blood pressure. The complete instructions for data collection and the data sheet itself are freely available on the websites of both ISCoS ( http://www.iscos.org.uk ) and ASIA ( http://www.asia-spinalinjury.org ).
-
international spinal cord injury Cardiovascular Function basic data set
Spinal Cord, 2010Co-Authors: Andrei V Krassioukov, Annkatrin Karlsson, M S Alexander, William H Donovan, C J Mathias, Fin BieringsorensenAbstract:To create an International Spinal Cord Injury (SCI) Cardiovascular Function Basic Data Set within the framework of the International SCI Data Sets. An international working group. The draft of the data set was developed by a working group comprising members appointed by the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the executive committee of the International SCI Standards and Data Sets. The final version of the data set was developed after review by members of the executive committee of the International SCI Standards and Data Sets, the ISCoS scientific committee, ASIA board, relevant and interested international organizations and societies, individual persons with specific interest and the ISCoS Council. To make the data set uniform, each variable and each response category within each variable have been specifically defined in a way that is designed to promote the collection and reporting of comparable minimal data. The variables included in the International SCI Cardiovascular Function Basic Data Set include the following items: date of data collection, Cardiovascular history before the spinal cord lesion, events related to Cardiovascular Function after the spinal cord lesion, Cardiovascular Function after the spinal cord lesion, medications affecting Cardiovascular Function on the day of examination; and objective measures of Cardiovascular Functions, including time of examination, position of examination, pulse and blood pressure. The complete instructions for data collection and the data sheet itself are freely available on the websites of both ISCoS ( http://www.iscos.org.uk ) and ASIA ( http://www.asia-spinalinjury.org ).
Dane A Crossley - One of the best experts on this subject based on the ideXlab platform.
-
the effects of embryonic hypoxic programming on Cardiovascular Function and autonomic regulation in the american alligator alligator mississippiensis at rest and during swimming
Journal of Comparative Physiology B-biochemical Systemic and Environmental Physiology, 2018Co-Authors: William Joyce, Tiffany E Miller, Ruth M Elsey, Tobias Wang, Dane A CrossleyAbstract:Reptilian embryos naturally experience fluctuating oxygen levels in ovo, and developmental hypoxia has been established to have long-term impacts on Cardiovascular Function in vertebrates. In the present study, we investigated the impact of developmental 21% (normoxia) and 10% O2 (hypoxia) on juvenile (4-year-old) American alligator Cardiovascular Function in animals at rest and during swimming. In both experimental groups, combined right aortic and right subclavian blood flow approximately doubled during swimming. Carotid blood flow increased during swimming in the hypoxia-programmed animals only, and both carotid and left aortic blood flow reached higher values in swimming hypoxic-programmed animals compared to the normoxic group. However, pulmonary blood flow, which increased two to threefold during swimming (in both groups), was higher in normoxic-programmed animals at both rest and swimming. The differences between programming groups were preserved after cholinergic blockade (atropine), but reduced by adrenergic receptor antagonists (propranolol and phentolamine). Propranolol and phentolamine also blunted the incremental increases in blood flows during swimming, which was especially clear in the hypoxia-programmed animals. Alteration in adrenergic control and relative cardiac size (which was increased in hypoxic-programmed alligators) may account for the differences between the experimental groups.
-
chronic captopril treatment reveals the role of ang ii in Cardiovascular Function of embryonic american alligators alligator mississippiensis
Journal of Comparative Physiology B-biochemical Systemic and Environmental Physiology, 2018Co-Authors: Casey A Mueller, Kevin B Tate, Dane A CrossleyAbstract:Angiotensin II (ANG II) is a powerful vasoconstrictor of the renin–angiotensin system (RAS) that plays an important role in Cardiovascular regulation in adult and developing vertebrates. Knowledge of ANG II’s contribution to developmental Cardiovascular Function comes from studies in fetal mammals and embryonic chickens. This is the first study to examine the role of ANG II in Cardiovascular control in an embryonic reptile, the American alligator (Alligator mississippiensis). Using chronic low (~ 5-mg kg embryo−1), or high doses (~ 450-mg kg embryo−1) of captopril, an angiotensin-converting enzyme (ACE) inhibitor, we disrupted the RAS and examined the influence of ANG II in Cardiovascular Function at 90% of embryonic development. Compared to embryos injected with saline, mean arterial pressure (MAP) was significantly reduced by 41 and 72% under low- and high-dose captopril treatments, respectively, a greater decrease in MAP than observed in other developing vertebrates following ACE inhibition. Acute exogenous ANG II injection produced a stronger hypertensive response in low-dose captopril-treated embryos compared to saline injection embryos. However, ACE inhibition with the low dose of captopril did not change adrenergic tone, and the ANG II response did not include an α-adrenergic component. Despite decreased MAP that caused a left shifted baroreflex curve for low-dose captopril embryos, ANG II did not influence baroreflex sensitivity. This study demonstrates that ANG II contributes to Cardiovascular Function in a developing reptile, and that the RAS contributes to arterial blood pressure maintenance during development across multiple vertebrate groups.
Antonio Miguel Cruz - One of the best experts on this subject based on the ideXlab platform.
-
comparison of Cardiovascular Function and quality of recovery in isoflurane anaesthetised horses administered a constant rate infusion of lidocaine or lidocaine and medetomidine during elective surgery
Equine Veterinary Journal, 2010Co-Authors: Alexander Valverde, E Rickey, Melissa D Sinclair, Eva Rioja, J Pedernera, A Hathway, Antonio Miguel CruzAbstract:Summary Reasons for performing study: The effects of lidocaine combined with medetomidine or lidocaine alone on Cardiovascular Function during anaesthesia and their effects on recovery have not been thoroughly investigated in isoflurane-anaesthetised horses. Objectives: To determine the effects of an intraoperative i.v. constant rate infusion of lidocaine combined with medetomidine (Group 1) or lidocaine (Group 2) alone on Cardiovascular Function and on the quality of recovery in 12 isoflurane-anaesthetised horses undergoing arthroscopy. Hypothesis: The combination would depress Cardiovascular Function but improve the quality of recovery when compared to lidocaine alone in isoflurane-anaesthetised horses. Methods: Lidocaine (2 mg/kg bwt i.v. bolus followed by 50 µg/kg bwt/min i.v.) or lidocaine (same dose) and medetomidine (5 µg/kg bwt/h i.v.) was started 30 min after induction of anaesthesia. Lidocaine administration was discontinued 30 min before the end of surgery in both groups, whereas medetomidine administration was continued until the end of surgery. Cardiovascular Function and quality of recovery were assessed. Results: Horses in Group 1 had longer recoveries, which were of better quality due to better strength and overall attitude during the recovery phase than those in Group 2. Arterial blood pressure was significantly higher in Group 1 than in Group 2 and this effect was associated with medetomidine. No significant differences in cardiac output, arterial blood gases, electrolytes and acid-base status were detected between the 2 groups. Conclusions and potential relevance: The combination of an intraoperative constant rate infusion of lidocaine and medetomidine did not adversely affect Cardiovascular Function in isoflurane-anaesthetised horses and improved the quality of recovery when compared to an intraoperative infusion of lidocaine alone.
A Wurtz - One of the best experts on this subject based on the ideXlab platform.
-
pectus excavatum repair improves Cardiovascular Function at maximal exercise by facilitating heart filling
European Journal of Cardio-Thoracic Surgery, 2013Co-Authors: Remi Neviere, Anju Duva Pentiah, David Montaigne, A WurtzAbstract:The recent article by Tang et al. [1] supports the idea that Nuss repair improves cardiopulmonary exercise Function in teenagers with moderate-to-severe pectus excavatum (PEx). We would like to congratulate the authors for this study and emphasize the relevance of this research, as well as their results, by making some brief remarks. First, the authors circumvented the difficulties in measuring cardiac output during exercise by using a gas-rebreathing technique, which has been previously validated in exercise testing conditions [2]. The authors demonstrated that Nuss-operated teenagers significantly increased their cardiac index at submaximal exercise. Postoperative increase of maximum exercise cardiac index was attributed in this study to enlargement of the thoracic dimension in the anterior–posterior plane facilitating heart filling and/or their better aerobic fitness due to increased physical activity. Second, Tang et al. [1] mentioned some of the study limitations, including the influence of growth and changes in sport habits on maximal exercise capacity. We feel that another important issue may be the misinterpretation of the relationship between cardiac performance and exercise limitation. Indeed, in healthy individuals, exercise tolerance is limited by the Cardiovascular response and the degree of physical fitness, whereas no ventilation limitation is typically achieved [3]. In this setting, cardiac output is thus driven by oxygen demand, which increases with peripheral muscular exercise. In the Tang et al. study, teenagers experienced no changes in maximum oxygen uptake after Nuss repair, whereas cardiac output increased, which was mainly the result of increased maximal heart rate. One could interpret these findings as evidence of Cardiovascular maladaptation, i.e. tachycardia, due to postoperative deconditioning. In a recent study [4], we confirm that PEx open repair [5] also can beneficially impact maximal exercise capacity in young adults. Although we did not directly measure the cardiac index, our results suggested that improved aerobic capacity was accompanied by increased oxygen pulse, a surrogate of stroke volume. We speculated that better postoperative aerobic capacity was directly related to improved haemodynamic conditions because such improvements were also observed in a series of athletes who experienced long-term, constant and heavy training protocols before and after PEx repair. Mechanisms by which Cardiovascular Function improves after PEx repair remain elusive. Normalization of thoracic geometry by PEx surgery can restore the adequate development of negative pulmonary pressure that is necessary to enhance venous return, heart filling and cardiac output. Consistently, we recently demonstrated that PEx repair improved the capacity of the inspiratory muscle system to generate intrathoracic negative pressure [6]. We speculated that postoperative increased respiratory pump efficacy to generate negative pulmonary pressure and to enhance venous return facilitates better Cardiovascular adaptation at maximal exercise.
-
pectus excavatum repair improves respiratory pump efficacy and Cardiovascular Function at exercise
The Journal of Thoracic and Cardiovascular Surgery, 2013Co-Authors: Remi Neviere, Lotfi Benhamed, Anju Duva Pentiah, A WurtzAbstract:The action of the respiratory muscle during inspiration expands the chest, which lowers the pressure in the thoracic cavity. The lower pressure allows for increased venous return, heart filling, and cardiac output, the so-called respiratory blood pump. Chest deformity such as pectus excavatum (PEx) can alter the development of negative pulmonary pressure, which could explain the impaired Cardiovascular Function. Because Cardiovascular Function is the limiting factor for oxygen delivery to the tissues at maximal exercise, we hypothesized that the reduced aerobic capability in patients with PEx could be the result of impaired inspiratory muscle strength to generate negative pulmonary pressure, thus limiting venous return and cardiac output. Specifically, we tested whether PEx deformity would be associated with reduced respiratory muscle strength, as evaluated by the maximal inspiratory pressures, and whether surgery would improve the aerobic capacity by the increased respiratory pump efficacy and better Cardiovascular adaptation.
Christopher R West - One of the best experts on this subject based on the ideXlab platform.
-
Cardiovascular Function in individuals with incomplete spinal cord injury a systematic review
Topics in Spinal Cord Injury Rehabilitation, 2013Co-Authors: Christopher R West, Austin Bellantoni, Andrei V KrassioukovAbstract:Spinal cord injury (SCI) affects 250,000 individuals in North America, with approximately 11,000 new cases per annum.1 The lifetime health costs of an individual with cervical SCI can be as high as $3.3 million.2 Much of this cost is related to the treatment of secondary complications arising from the SCI. One of the most debilitating secondary consequences of SCI is alterations in autonomic Cardiovascular control that, combined with paralysis, predispose individuals with SCI to a higher incidence of Cardiovascular disease (CVD).3 This predisposition to CVD not only results in early mortality but also reduces quality of life. It is now well recognized that the extent of impairment in Cardiovascular Function is related to the neurological level of injury,4 whereby persons with cervical/high-thoracic injuries exhibit a greater impairment in Cardiovascular Function and an earlier onset of CVD than those with low-thoracic/lumbar injuries. Injury to the cervical/ upper thoracic cord disrupts descending input to the sympathetic preganglionic neurons that control the critical splanchnic bed resulting in neurogenic shock during the early stages of SCI and long-lasting resting hypotension post injury.5 Loss of supraspinal tonic inhibitory input to the sympathetic preganglionic neurons provides an environment in which sensory-evoked reflexes can cause unopposed below-lesion sympathetic activation, leading to profound vasoconstriction and consequent episodes of hypertension. This condition, termed autonomic dysreflexia (AD), affects up to 90% of individuals with motor complete cervical SCI6 and can lead to a sequelae of Cardiovascular effects, such as myocardial infarction,7 intracranial hemorrhage,8 and even death.9 Whilst the relationship between lesion level and Cardiovascular dysFunction is well established, the relationship between the severity (ie, completeness) of SCI and Cardiovascular control is less clear. Historically, completeness of injury has referred to motor/sensory (neurological) completeness of injury, as assessed during the well-established neurological examination that is conducted in accordance with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI).10 More recently, however, a number of researchers have started to investigate the concept of autonomic completeness of SCI and its effect on various bodily Functions following injury. There is still no consensus on the best method to assess autonomic completeness of injury. Recently, International Standards to Document remaining Autonomic Functions after SCI (ISAFSCI) have been developed and revised.11 It is now recommended that this assessment form is used as an adjunct with the ISNCSCI. These ISAFSCI standards, however, provide a simple documentation of autonomic dysFunction after SCI, rather than assessment of autonomic completeness of injury. Hence, there is still no assessment of autonomic completeness of injury in the clinical SCI setting, nor is there a clear understanding of the relationship between autonomic and neurological completeness of injury. A better understanding of such relationships will assist researchers in the development of appropriate levels of stratification within their studies and will assist clinicians in understanding the unique Cardiovascular profiles of individuals with varying severities of SCI. The purpose of this systematic review is to investigate the relationship between Cardiovascular Function and neurological and autonomic completeness of injury.