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Use of the pressure wire method for measuring pulmonary arterial pressures in patients with pulmonary atresia
- Jorge L. Haddad, Gustavo C. Novaes, Geraldo L. Figueiredo, Daniel C. Lemos, Leon G. R. Macedo, Igor M. Lago, Rafael B. Pavão, André V. Badran, Moysés O. Lima-Filho, Paulo H. Manso, José A. Marin-Neto
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- Journal:
- Cardiology in the Young / Volume 25 / Issue 1 / January 2015
- Published online by Cambridge University Press:
- 15 January 2014, pp. 102-109
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Objective: The objective of the study was to analyse the use of the pressure wire for the acquisition of intravascular pulmonary pressures in the presence of pulmonary atresia and systemic-dependent pulmonary blood flow. Methods: In this study, we included patients with pulmonary atresia and systemic-dependent pulmonary circulation referred for diagnostic catheterisation for evaluation of pulmonary pressures during the period from April, 2012 to April, 2013. The systemic-pulmonary collateral arteries were selectively catheterised, and in the absence of a critical stenosis angiographically determined; the pressure wire was introduced in these arteries to reach the main pulmonary artery, and/or lobar, and segmental branches. Aortic and pulmonary pressures were simultaneously obtained. We evaluated the feasibility and safety of the method. Results: We studied 10 patients (age 21 days to 11 years). In all of them, the pressures of pulmonary circulation – main artery, and/or lobar, and segmental branches – were successfully measured with the pressure wire. Of eight patients with indication for Rastelli surgery, the pulmonary pressures were considered normal in five, and slightly increased in three. In two patients requiring univentricular correction – total cavopulmonary anastomosis – the diastolic pressure was increased (20 mmHg). All procedures were performed without haemodynamic instability, cardiac arrhythmia, systemic saturation reduction, death, or any other complication. Conclusion: Measurement of pulmonary vascular pressures using the pressure wire in small patients with pulmonary atresia is safe and effective. It allows the acquisition of reliable pressure curves, even in the presence of small vessels, bending and tortuosity, without the risk usually associated with the use of conventional diagnostic catheters.
Effects of ginger and cranberry extracts on the physiological response to exercise and markers of inflammation in horses
- N R Liburt, K H McKeever, J M Streltsova, W C Franke, Mary E Gordon, H C Manso Filho, D W Horohov, R T Rosen, C T Ho, A P Singh, N Vorsa
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- Journal:
- Comparative Exercise Physiology / Volume 6 / Issue 4 / November 2009
- Published online by Cambridge University Press:
- 22 February 2010, pp. 157-169
- Print publication:
- November 2009
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This study hypothesized that ginger (Zingiber officinale) and cranberry (Vaccinium macrocarpon) extracts would alter the physiological response to exercise as well as markers of muscle damage, and mRNA expression for the inflammatory cytokines tumour necrosis factor-α (TNF-α), interferon-γ (IFN-γ) and interleukin-6 (IL-6) after an exhaustive bout of exercise in horses. Nine unfit Standardbred mares (age 10 ± 4 years, ~450 kg) completed three graded exercise tests (GXTs) in a crossover design, where they were assigned to the initial order of treatment in a randomized fashion. The GXTs were conducted between 07.00 and 12.00 hours, 7 days apart. Mares received either water (2 l), cranberry (~30 g in 2 l of water) or ginger (~30 g in 2 l of water) extract 1 h prior to testing. Blood samples were taken prior to dosing (pre-exercise), at the end of each step of the GXT, at the end of the exercise and at 2, 5 and 30 min, 1, 2, 4 and 24 h post-GXT. Plasma total protein (TP) concentration and haematocrit (HCT) were analysed immediately following the tests. Analysis of creatine kinase (CK) and aspartate aminotransferase (AST) was done commercially. There was no effect of treatment (P>0.05) on VO2max, run-time to fatigue, core temperature, TP or HCT. CK was substantially elevated (P < 0.05) in the ginger group at 4 h post-GXT. All CK levels returned to baseline 24 h post-GXT. No change (P>0.05) was noted in AST. A slight increase (P < 0.05) in CK was seen in all groups at 2 h post-GXT. The cranberry group had significantly lower TNF-α mRNA expression than the control and ginger groups. Ginger appeared to influence (P < 0.05) the upregulation and expression of IFN-γ mRNA at 30 min post-GXT, but, more strikingly, significantly decreased recovery time defined as the time for VO2 to recover from the peak observed at fatigue to a post-exercise plateau (ginger = 101 ± 3 s, water = 130 ± 14 s, cranberry = 131 ± 16 s). No effect of treatment or exercise (P>0.05) was seen on IL-6 mRNA expression. Results suggest that cranberry extract blunts the upregulation and expression of TNF-α mRNA, while ginger extract reduces cardiovascular recovery time in horses completing a short, exhaustive bout of exercise.
Maternal and foetal heart rates during exercise in horses
- Robert A. Lehnhard, Hélio C. Manso Filho, Robert C. Causey, Malcolm Watford, Kenneth H. McKeever
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- Journal:
- Comparative Exercise Physiology / Volume 6 / Issue 1 / February 2009
- Published online by Cambridge University Press:
- 02 June 2009, pp. 43-48
- Print publication:
- February 2009
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This study tested two hypotheses. First, that moderate exercise would alter maternal and foetal heart rate (HR) in the horse. Second, that pregnancy would alter the HR, plasma cortisol and plasma lactate response to moderate exercise in mares. Six unfit, pregnant Standardbred mares (6–19 years) underwent two incremental graded exercise tests (GXT). The first GXT was performed at approximately 9 months of gestation, which represents c. 80% of the total pregnancy time, and the second GXT at approximately 6 months post-parturition. During the GXT, mares ran on a treadmill up a fixed 6% incline completing three 1 min steps at velocities of 4, 6 and 7 m s− 1. Maternal HR was obtained via both electrocardiograph (ECG) and the ventricular waveform obtained from a micromanometer catheter. Data were recorded at rest, at 4, 6 and 7 m s− 1 of the GXT and at 0, 1, 2, 3, 4 and 5 min post-GXT. Foetal HR rate was measured via ECG before, immediately after and at 1, 2, 3, 4 and 5 min post-GXT. Radioimmunoassay (RIA) kits were used to measure plasma cortisol concentration in samples collected before the GXT, immediately after exercise and after 5 min of recovery. Plasma lactate concentrations (LA) were measured at rest, at 4, 6 and 7 m s− 1 and at 5 min post-GXT. Plasma cortisol concentrations were measured using RIA and the samples collected at rest, immediately after and at 5 min post-GXT. Exercise caused no change (P>0.05) in foetal HR. Maternal HR, plasma LA and plasma cortisol concentration were greater (P < 0.05) during the post-parturient GXT compared with the pre-parturition GXT. Body weight (mean ± SE) was lower after parturition (570 ± 20 vs. 505 ± 22 kg; P < 0.05). Consequentially, there were differences (P < 0.05) in work rate (watts) at each step of the GXT (1557 ± 53 vs. 1381 ± 60; 2339 ± 80 vs. 2071 ± 90; and 2571 ± 121 vs. 2416 ± 105 W). These data suggest that mares benefit from greater cardiovascular efficiency during pregnancy. Additionally, the lack of a change in foetal HR suggests that the unborn foal is not stressed during moderate maternal exercise.