Hemodynamic Assessment Using Pressure-Volume (PV) During Mechanical Circulatory Support
Issue:
Volume 1, Issue 4, November 2015
Pages:
70-77
Received:
17 October 2015
Accepted:
7 November 2015
Published:
3 December 2015
Abstract: Mechanical circulatory support devices (MCS), namely percutaneous ventricular assist devices (pVAD) are temporarily introduced to support circulation in hemodynamically compromised patients and also during mid to high risk coronary artery procedures. Their multiple responsibilities include maintaining an adequate systemic blood pressure and cardiac output to provide satisfactory end-organ perfusion in unloading of the failing ventricle, and to temporary lower myocardial contractility while reducing myocardial oxygen demand supporting favorable ventricular remodeling. To timely and quantitatively assess hemodynamics during pVAD circulatory support post-cardiogenic shock or acute myocardial infarction (MI), pressure-volume (PV) measurements are becoming progressively more appreciated as they can longitudinally evaluate the status of the support. Hemodynamically, importance of constant circulatory interrogations by PV during pVAD support lies in its capacity to “fine-tune” the device for a specific patient to work in synergy with the ailing organ. In this review basic characteristics of a diagnostic value of pressure-volume during pVAD hemodynamic support will be discussed fostering conversation about the necessity of e.g. combining pump flow with load-independent indices creating indexes that can be used to further characterize pump unloading in relation to innate cardiac contractility during axial or centrifugal flow support. Additionally, discussion about central hemodynamics during different flow support will be provided evaluating pVADs to assess its ability to work in synergy and to anticipate potential difficulties that might occur during the procedure. Brief description of recent efforts to combine PV exam with pump flow during circulatory support using pVAD and the concept of pressure-volume area (PVA) and myocardial oxygen consumption (mVO2) during unloading will be also discussed.
Abstract: Mechanical circulatory support devices (MCS), namely percutaneous ventricular assist devices (pVAD) are temporarily introduced to support circulation in hemodynamically compromised patients and also during mid to high risk coronary artery procedures. Their multiple responsibilities include maintaining an adequate systemic blood pressure and cardiac...
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The Possible Protective Effects of Inegy versus Cinnamon Oil on the Aorta of Albino Rats with Experimentally Induced Hyperlipidemia
Moushira M. Safi,
Maha W. Abou-Nazel,
Fardous S. Karawya,
Amira M. Omar
Issue:
Volume 1, Issue 4, November 2015
Pages:
78-91
Received:
31 October 2015
Accepted:
9 December 2015
Published:
15 January 2016
Abstract: Background: hypercholesterolemia is a predominant risk factor for atherosclerosis. The clinical complications of atherosclerosis could be suppressed when plasma lipids are lowered by hypocholesterolemic agents. The aim of this research is to assess the possible protective effect of the drug Inegy versus cinnamon oil on the histological structure of the abdominal aorta of rats with experimentally induced hyperlipidemia. Materials & Methods: the animals were divided into 2 groups (control and experimental group). Group I (control group) was divided into: subgroup I a; received standard diet only, subgroup Ib received Inegy 10 mg/kg body weight / day orally and subgroup Ic received cinnamon oil orally. Group II (The experimental group) was divided into: subgroup II, which received a high fat high cholesterol (HFHC) diet, subgroup II b received simultaneously both HFHC diet and Inegy and subgroup II c which received simultaneously both HFHC diet and cinnamon oil. After 3 months blood samples were collected from all rats for cholesterol and triglyceride estimation and fresh specimens were taken from the abdominal aorta of each rat and processed for; light microscopic, immunohistochemical and morphometric studies. Results: Significant increase of serum cholesterol and triglyceride levels in hyperlipidemic rats (subgroup II a) was detected. Moreover, evident structural changes in the form of endothelial irregularity, focal loss and shedding of large areas of denuded endothelium were illustrated. It was associated with adhesion of mononuclear leukocytes and increased foam macrophages. Examination of histological sections of the abdominal aorta of (subgroups II b and II c) showed pronounced amelioration of the structural changes depicted in the aorta of the hyperlipidemic subgroup. Conclusion: HFHC diet induced evident biochemical, histological and immunohistochemical changes in the rat aorta. It was also concluded that both Inegy and cinnamon oil offered good protection against the histopathological changes induced by HFHC diet. There were no statistical significant differences between the protective effect of both agents as regards the biochemical and morphometric results.
Abstract: Background: hypercholesterolemia is a predominant risk factor for atherosclerosis. The clinical complications of atherosclerosis could be suppressed when plasma lipids are lowered by hypocholesterolemic agents. The aim of this research is to assess the possible protective effect of the drug Inegy versus cinnamon oil on the histological structure of...
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