The Experts below are selected from a list of 119103 Experts worldwide ranked by ideXlab platform
Susan W. Denfield - One of the best experts on this subject based on the ideXlab platform.
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Intermediate follow-up of pediatric heart transplant recipients with elevated pulmonary Vascular Resistance index
Journal of the American College of Cardiology, 1994Co-Authors: Robert J. Gajarski, Jeffrey A. Towbin, O. Howard Frazier, Price Jk, Kenneth O. Schowengerdt, Branislav Radovancevic, J. Timothy Bricker, Susan W. DenfieldAbstract:Objectives. This study examined perioperative and intermediate outcomes in pediatric cardiac transplant recipients who had elevated pulmonary Vascular Resistance indexes preoperatively. Background. Elevated pulmonary Vascular Resistance was associated with poor outcome in previous studies and constitutes a relative contraindication to transplantation. Few studies have evaluated this poor outcome risk factor in pediatric patients. Methods. To evaluate outcomes of nonneonatal transplant recipients, records were reviewed and divided into Group I (preoperative pulmonary Vascular Resistance index ≥6 units·m2) and Group II (pulmonary Vascular Resistance index 0.75). Intensive care unit stay was 11.5 days in Group I and 15.1 days in Group II (p = 0.20). Infection rate was 38% in both groups (p > 0.80). Arrhythmias occurred in 90% of Group I and 42% of Group II (p 0.80). Conclusions. Group I patients did not require significantly oversized donors, restricted donor locations or longer intensive care unit stays or have higher infection rates; however, arrhythmias were more frequent. Pulmonary Resistance index normalized early after transplantation. Pulmonary Vascular reactivity may be more important for survival than absolute Resistance index.
Kirk H Shelley - One of the best experts on this subject based on the ideXlab platform.
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the relationship between the photoplethysmographic waveform and systemic Vascular Resistance
Journal of Clinical Monitoring and Computing, 2007Co-Authors: Aymen A Awad, Ala S Haddadin, Hossam Tantawy, Tarek M Badr, Robert G Stout, David G Silverman, Kirk H ShelleyAbstract:Objective The objective of this study was to determine the relationship between systemic Vascular Resistance (SVR), finger & ear photoplethysmographic measurements in 14 adult patients undergoing coronary artery bypass grafting (CABG).
Ernst Pilger - One of the best experts on this subject based on the ideXlab platform.
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The effect of the K+ agonist nicorandil on peripheral Vascular Resistance
International journal of cardiology, 2005Co-Authors: Marianne Brodmann, Ulrike Lischnig, Andreas Lueger, Gerhard Stark, Ernst PilgerAbstract:Abstract Background The vasoactive effect of nicorandil on coronary arteries is well known. Nicorandil exerts its vasodilatory effect through a dual mechanism of action: involving on the one hand cyclic guanosine monophosphate (c GMP) as a nitrovasodilatator, and on the other hand, acting as a potassium channel opener. Objective To address the question if nicorandil works in peripheral arteries, its effect on peripheral Vascular Resistance was evaluated in isolated perfused guinea pig hind limbs. Methods A catheter was inserted via the distal aorta and common iliac artery. Perfusion pressure was monitored under constant perfusion with Tyrode's solution, therefore changes in perfusion pressure represent changes in Vascular Resistance. After stabilization precontraction of the peripheral Vascular bed was achieved with noradrenaline 3 μM and nicorandil was added in concentrations of 1, 10 and 100 μM. The effect of nicorandil (1, 10 and 100 μM) was tested in the presence of l-NAME and glybenclamide. Results A significant reduction of Vascular peripheral Resistance was already achieved at a concentration of 1 μM nicorandil (30.3±6.1%, mean S.E.M., p Peripheral Vascular Resistance was less but nearly comparable reduced by nicorandil (100 μM) if the endothelial NO effect was inhibited by l-NAME (58.6±18.6%) or if the ATP-dependent potassium channels were blocked by glybenclamide (56.4±14.6%). Conclusions In peripheral arteries the nitrovasodilator effect of nicorandil is nearly comparable to the potassium agonistic effect, and the concentration, which is necessary to reduce peripheral Vascular Resistance significantly, is comparable with dosages necessary for reduction of coronary Resistance.
Luca A. Vricella - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Vascular Resistance index and mortality after paediatric heart transplant.
Cardiology in The Young, 2014Co-Authors: Bryan G Maxwell, Chinwe C. Ajuba-iwuji, Eugenie S. Heitmiller, Ahmad Y Sheikh, Luca A. VricellaAbstract:Although some prior studies have provided evidence to question the historical belief that pulmonary Vascular Resistance index ⩾6 Wood Units×m2 should be a contraindication to heart transplantation in children, no national analyses specific to the modern area have addressed this question. Data were analysed for paediatric heart transplant recipients from 1 January, 2002 to 1 September, 2012 (n=699). The relationship between pulmonary Vascular Resistance and all-cause 30-day mortality was evaluated using univariate and multivariate analyses. The 30-day mortality included 10 patients (1.43%), which is lower than in the previous analyses. Receiver operating curve analysis of pulmonary Vascular Resistance index as a predictor of mortality yielded a cut-off value of 3.37 Wood Units×m2, but the area under the curve and specificity of this threshold was weaker than in previous analyses. Whereas pulmonary Vascular Resistance index treated as a dichotomised variable was a significant predictor of mortality in univariate (odds ratio 4.92, 95% confidence interval 1.04-23.33, p=0.045) and multivariate (odds ratio 5.26, 95% confidence interval 1.07-25.80, p=0.041) analyses, pulmonary Vascular Resistance index treated as a continuous variable was not a significant predictor of mortality in univariate (p=0.12) or multivariate (p=0.11) analyses. The relationship between pulmonary Vascular Resistance and post-heart transplant mortality in children is less convincing in this analysis of a comprehensive, contemporary database than in previous series. This suggests the possibility that modern improvements in the management of post-transplant right ventricular dysfunction have mitigated the contribution of pulmonary hypertension to early mortality.
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Pulmonary Vascular Resistance index and mortality after paediatric heart transplant
Cardiology in the young, 2014Co-Authors: Bryan G Maxwell, Chinwe C. Ajuba-iwuji, Eugenie S. Heitmiller, Ahmad Y Sheikh, Luca A. VricellaAbstract:BACKGROUND Although some prior studies have provided evidence to question the historical belief that pulmonary Vascular Resistance index ⩾6 Wood Units×m2 should be a contraindication to heart transplantation in children, no national analyses specific to the modern area have addressed this question. METHODS Data were analysed for paediatric heart transplant recipients from 1 January, 2002 to 1 September, 2012 (n=699). The relationship between pulmonary Vascular Resistance and all-cause 30-day mortality was evaluated using univariate and multivariate analyses. RESULTS The 30-day mortality included 10 patients (1.43%), which is lower than in the previous analyses. Receiver operating curve analysis of pulmonary Vascular Resistance index as a predictor of mortality yielded a cut-off value of 3.37 Wood Units×m2, but the area under the curve and specificity of this threshold was weaker than in previous analyses. Whereas pulmonary Vascular Resistance index treated as a dichotomised variable was a significant predictor of mortality in univariate (odds ratio 4.92, 95% confidence interval 1.04-23.33, p=0.045) and multivariate (odds ratio 5.26, 95% confidence interval 1.07-25.80, p=0.041) analyses, pulmonary Vascular Resistance index treated as a continuous variable was not a significant predictor of mortality in univariate (p=0.12) or multivariate (p=0.11) analyses. CONCLUSIONS The relationship between pulmonary Vascular Resistance and post-heart transplant mortality in children is less convincing in this analysis of a comprehensive, contemporary database than in previous series. This suggests the possibility that modern improvements in the management of post-transplant right ventricular dysfunction have mitigated the contribution of pulmonary hypertension to early mortality.
Robert J. Gajarski - One of the best experts on this subject based on the ideXlab platform.
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Intermediate follow-up of pediatric heart transplant recipients with elevated pulmonary Vascular Resistance index
Journal of the American College of Cardiology, 1994Co-Authors: Robert J. Gajarski, Jeffrey A. Towbin, O. Howard Frazier, Price Jk, Kenneth O. Schowengerdt, Branislav Radovancevic, J. Timothy Bricker, Susan W. DenfieldAbstract:Objectives. This study examined perioperative and intermediate outcomes in pediatric cardiac transplant recipients who had elevated pulmonary Vascular Resistance indexes preoperatively. Background. Elevated pulmonary Vascular Resistance was associated with poor outcome in previous studies and constitutes a relative contraindication to transplantation. Few studies have evaluated this poor outcome risk factor in pediatric patients. Methods. To evaluate outcomes of nonneonatal transplant recipients, records were reviewed and divided into Group I (preoperative pulmonary Vascular Resistance index ≥6 units·m2) and Group II (pulmonary Vascular Resistance index 0.75). Intensive care unit stay was 11.5 days in Group I and 15.1 days in Group II (p = 0.20). Infection rate was 38% in both groups (p > 0.80). Arrhythmias occurred in 90% of Group I and 42% of Group II (p 0.80). Conclusions. Group I patients did not require significantly oversized donors, restricted donor locations or longer intensive care unit stays or have higher infection rates; however, arrhythmias were more frequent. Pulmonary Resistance index normalized early after transplantation. Pulmonary Vascular reactivity may be more important for survival than absolute Resistance index.
