Pulse最新文献

{"title":"From Heartbreak to Heart Disease: A Narrative Review on Depression as an Adjunct to Cardiovascular Disease.","authors":"Jahanzeb Malik,&nbsp;Hamid Sharif Khan,&nbsp;Faizan Younus,&nbsp;Muhammad Shoaib","doi":"10.1159/000516415","DOIUrl":"https://doi.org/10.1159/000516415","url":null,"abstract":"<p><p>Patients with cardiovascular disease (CVD) commonly have subclinical depression and are often delayed in their diagnosis. Literature suggests an increased association of depression and adverse cardiovascular events like myocardial infarction and heart failure. Prevalence of depression in developed countries is approximately 16.6%, and it confers higher cardiovascular mortality even after attrition bias and confounding factors are eliminated. Pharmacological and cognitive-behavioral therapy have been extensively studied, and are generally safe and effective in alleviating depressive symptoms in patients with CVD. However, their impact on cardiovascular outcomes is still unclear. Results of randomized controlled trials have shown antidepressants, especially selective serotonin reuptake inhibitors, to be safe and effective for healing a \"broken heart.\" This review outlines the prevalence of depression in patients with CVD, the pathophysiological mechanism causing cardiovascular events with depression, and a link between depression and CVD. There is a wealth of literature explaining the precursor of CVD in depression, and like all chronic diseases, inflammation seems to be the culprit in this case as well.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 3-4","pages":"86-91"},"PeriodicalIF":2.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000516415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39220870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a Diagnostic Methodology of Cardiac Systems Based on the Proportions of Entropy in Normal Patients and with Different Pathologies.","authors":"Javier Rodríguez,&nbsp;Signed Prieto,&nbsp;Elveny Laguado,&nbsp;Frank Pernett,&nbsp;Magda Villamizar,&nbsp;Edinson Olivella,&nbsp;Fredy Angarita,&nbsp;Giovanni de la Cruz,&nbsp;Carlos Morales,&nbsp;Mónica Castro","doi":"10.1159/000515699","DOIUrl":"https://doi.org/10.1159/000515699","url":null,"abstract":"<p><strong>Introduction: </strong>Dynamical systems theory, probability, and entropy were the substrate for the development of the diagnostic and predictive methodology of adult heart dynamics.</p><p><strong>Objective: </strong>To apply a previously developed methodology from dynamical systems, probability, and entropy in both normal and pathological subjects.</p><p><strong>Methods: </strong>Electrocardiographic records were selected from 30 healthy subjects and 200 with different pathologies, with a length of least 18 h. Numerical attractors from dynamical attractors and the probability of occurrence of ordered pairs of consecutive heart rates were built. A calculation of entropy and its proportions was performed and statistical analysis was conducted.</p><p><strong>Results: </strong>The normal patients' heart dynamics were evaluated according to the methodology of entropy proportions, highlighting that there are differences in normal patients with different pathologies. There was maximal level of sensitivity, specificity, and diagnostic agreement.</p><p><strong>Conclusion: </strong>Proportional entropy constitutes a diagnostic and predictive method of heart systems, and may be useful as a tool to objectively diagnose and perform the follow-up of normal and pathological cases.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 3-4","pages":"114-119"},"PeriodicalIF":2.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000515699","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39222233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Heart Rate Variability and Fragmented QRS for Determination of Subclinical Cardiac Involvement in Beta-Thalassemia Major.","authors":"Mozhgan Parsaee,&nbsp;Amir Farjam Fazelifar,&nbsp;Elham Ansaripour,&nbsp;Azita Azarkeyvan,&nbsp;Behshid Ghadrdoost,&nbsp;Ashraf Charmizadeh,&nbsp;Mohaddeseh Behjati","doi":"10.1159/000505556","DOIUrl":"https://doi.org/10.1159/000505556","url":null,"abstract":"<p><strong>Background: </strong>Iron accumulation leads to increased susceptibility to cardiovascular diseases in thalassemia major (TM) patients. Depressed heart rate variability (HRV) and development of arrhythmia are among the manifestations of subclinical cardiac involvement in TM cases. Determination of subclinical cardiac involvement is essential for preventive measures. Thus, we aimed to evaluate the best method for identification of subclinical cardiac dysfunction in TM cases.</p><p><strong>Materials and methods: </strong>In this prospective study, 45 TM and 45 non-TM cases, who were referred for cardiac evaluation, were enrolled. Exclusion criteria included non-sinus rhythm and overt cardiac disease. TM cases underwent cardiac MRI, electrocardiography (ECG), and Holter monitoring. TM cases were divided into two groups of normal versus iron overload with a cardiac T2* of more or less than 20 ms, respectively. The non-TM cases underwent only ECG and Holter monitoring.</p><p><strong>Results: </strong>We observed no significant difference regarding HRV between normal versus iron overload TM and non-TM cases. Higher rates of premature atrial complex, low limb voltage, low atrial rhythm, as well as minimum and average HR with lower QRS duration and PR interval were detected in TM versus non-TM cases (<i>p</i> value <0.05).</p><p><strong>Conclusions: </strong>We observed a higher prevalence of low limb voltage and low atrial rhythm in TM cases versus non-TM cases. Indeed, the role of fragmented QRS (fQRS) for subclinical detection of cardiac disease in TM cases is still so controversial and needs more evaluation. Application of HRV and fQRS in this regard may need to be performed at the right time point after initiation of blood transfusion, but this needs to be determined.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"15-20"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Classification of Arrhythmogenic Right Ventricular Cardiomyopathy.","authors":"Yulia Lutokhina,&nbsp;Olga Blagova,&nbsp;Alexander Nedostup,&nbsp;Svetlana Alexandrova,&nbsp;Anna Shestak,&nbsp;Elena Zaklyazminskaya","doi":"10.1159/000505652","DOIUrl":"https://doi.org/10.1159/000505652","url":null,"abstract":"<p><strong>Introduction: </strong>Commonly accepted clinical classification of arrhythmogenic right ventricular cardiomyopathy (ARVC) is still not developed.</p><p><strong>Objective: </strong>To study the clinical forms of ARVC.</p><p><strong>Methods: </strong>Fifty-four patients (38.7 ± 14.1 years, 42.6% men) with ARVC. Follow-up period: 21 (6-60) months. All patients underwent electrocardiography, 24 h-Holter monitoring, echocardiography, and DNA diagnostic. Magnetic resonance imaging was performed in 49 patients.</p><p><strong>Results: </strong>According to the features of clinical course of ARVC, 4 clinical forms were identified. (I) Latent arrhythmic form (<i>n</i> = 27) - frequent premature ventricular contractions and/or nonsustained ventricular tachycardia (VT) in the absence of sustained VT and syncope; characterized by absence of fatal arrhythmic events. (II) Manifested arrhythmic form (<i>n</i> = 11) - sustained VT/ventricular fibrillation; the high incidence of appropriate implantation of cardioverter-defibrillator (ICD) interventions (75%) registered. (III) ARVC with progressive chronic heart failure (CHF, <i>n</i> = 8) as the main manifestation of the disease; incidence of appropriate ICD interventions was 50%, mortality rate due to CHF was 25%. (IV) Combination of ARVC with left ventricular noncompaction (<i>n</i> = 8); characterized by mutations in desmosomal or sarcomere genes, aggressive ventricular arrhythmias, appropriate ICD interventions in 100% patients. Described 4 clinical forms are stable in time, do not transform into each other, and they are genetically determined.</p><p><strong>Conclusions: </strong>The described clinical forms of ARVC are determined by a combination of genetic and environmental factors and do not transform into each other. The proposed classification could be used in clinical practice to determine the range of diagnostic and therapeutic measures and to assess the prognosis of the disease in a particular patient.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"21-30"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight into Atrial Fibrillation in LVAD Patients: From Clinical Implications to Prognosis.","authors":"Nicolò Sisti,&nbsp;Giulia Elena Mandoli,&nbsp;Carlotta Sciaccaluga,&nbsp;Serafina Valente,&nbsp;Sergio Mondillo,&nbsp;Matteo Cameli","doi":"10.1159/000506600","DOIUrl":"https://doi.org/10.1159/000506600","url":null,"abstract":"<p><p>The use of left ventricular assist devices (LVADs), whether for destination therapy or bridge to transplantation, has gained increasing validation in recent years in patients with advanced heart failure. Arrhythmias can be the most challenging variables in the management of such patients but the main attention has always been focused on ventricular arrhythmias given the detrimental impact on mortality. Nevertheless, atrial fibrillation (AF) is the most common rhythm disorder associated with advanced heart failure and may therefore characterize the LVADs' pre- and postimplantation periods. Indeed, the consequences of AF in the population suffering from standard heart failure may require a more comprehensive evaluation in the presence of or in sight of an LVAD, making the AF clinical management in these patients potentially complex. Several studies have been based on this subject with different and often conflicting results, leaving many questions unresolved. The purpose of this review is to summarize the main pieces of evidence about the clinical impact of AF in LVAD patients, underlining the main implications in terms of hemodynamics, thromboembolic risk, bleeding and prognosis. Therapeutic considerations about the clinical management of these patients are also made according to the latest evidence.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"2-14"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000506600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38536547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Pulse Wave Velocity, Ankle-Brachial Index, and Malondialdehyde in Older Adults with or without Metabolic Syndrome.","authors":"Ruchada Sri-Amad,&nbsp;Nawiya Huipao,&nbsp;Piyapong Prasertsri,&nbsp;Thapanee Roengrit","doi":"10.1159/000505838","DOIUrl":"https://doi.org/10.1159/000505838","url":null,"abstract":"<p><p>Metabolic syndrome is an important health problem associated with both subclinical atherosclerosis and an increased risk of cardiovascular disease and it leads to an elevated total mortality. Aortic pulse wave velocity (aPWV) is widely used for noninvasive assessment of arterial stiffness. Ankle-brachial index (ABI) predicts peripheral arterial disease (PAD) of the lower extremities. In addition, malondialdehyde (MDA) is thought to be involved in the development of arterial stiffness. The present study aimed to: (1) compare aPWV, ABI, and MDA between participants with MetS and those without MetS and (2) investigate the correlation of aPWV and ABI with the components of MetS and MDA. A total of 48 Thai elderly subjects were divided into 2 groups (MetS and non-MetS) according to the parameters set by the International Diabetes Federation (IDF). aPWV and ABI were measured using the VaSera VS-1500 system (Fukuda Denshi Co., Tokyo, Japan). MDA was determined by spectrophotometry. aPWV and MDA were significantly higher in the MetS group compared to the participants in the non-MetS group (9.33 ± 2.72 vs. 7.95 ± 1.37 m/s, <i>p</i> = 0.03, and 0.74 ± 0.71 vs. 0.45 ± 0.20 μmol, <i>p</i> = 0.02, respectively). However, ABI did not differ between the groups. Analysis of the risk factors of aPWV in each group revealed that there were no statistical associations between the components of MetS and MDA and aPWV in both the MetS and the non-MetS groups. A high aPWV is more prevalent among patients with MetS than among those without MetS. Monitoring of aPWV might help to explore potential detection of vascular damage in the elderly.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"31-39"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting Left Ventricular Dyssynchrony and Mechanical Reserve in Asymptomatic Normotensive Subjects with Early Type 2 Diabetes Mellitus.","authors":"Ragab A Mahfouz,&nbsp;Elshaimaa A Seaoud,&nbsp;Radwa A Elbelbesy,&nbsp;Islam E Shehata","doi":"10.1159/000506712","DOIUrl":"https://doi.org/10.1159/000506712","url":null,"abstract":"<p><strong>Background: </strong>Most diabetic patients have silent ischemia and cardiac dysfunction that is usually observed in the late phase of the disease when it becomes clinically obvious. We hypothesized that left ventricular dyssynchrony (LVdys) (or dispersion) is an early marker of myocardial involvement in asymptomatic early type 2 diabetes mellitus (T2DM) patients. Therefore, we aimed to detect early markers of myocardial dysfunction in early T2DM using LVdys and left ventricular mechanical reserve (LVMR).</p><p><strong>Methods: </strong>We examined 91 consecutive subjects with early T2DM with speckle tracking imaging to evaluate LVdys and with dobutamine stress to evaluate LVMR (defined as left ventricular mechanical reserve global longitudinal strain [LVMR_GLS] ≥2%). Our patients were divided into two groups according to LVdys: group 1 with LVdys (<i>n</i> = 49), and group 2 without LVdys (<i>n</i> = 42).</p><p><strong>Results: </strong>We found that 49 (54%) subjects in our cohort had resting LVdys (standard deviation of tissue synchronization of the 12 left ventricular segments [Ts-SD-12] ≥34.2 ms). GLS and strain rate were comparable at rest between patients with and without LVdys. On the other hand, LVMR was blunted in those with LVdys (<i>p</i> < 0.001). We found that HbA1c, high-sensitivity C-reactive protein, and left atrial volume index were inversely correlated with LVMR. Multivariate analysis showed that LVdys was the strongest predictor (<i>p</i> < 0.001) of blunted LVMR. Using receiver operating characteristic curve analysis, we found that a Ts-SD-12 ≥36.5 ms was the best cutoff value to predict blunted LVMR (area under the curve = 0.89, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The LVdys (Ts-SD-12) cutoff ≥36.5 ms was the optimal value for prediction of impaired LVMR and might be an early marker of subclinical cardiac dysfunction and risk stratification of subjects with asymptomatic early T2DM with preserved left ventricular ejection fraction.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"47-56"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000506712","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Platelet/Lymphocyte Ratio and Neutrophil/Lymphocyte Ratio in Predicting High-Risk Heart Score in Patients Admitted with Non-ST Elevation Acute Coronary Syndrome.","authors":"Elshaimaa Seaoud,&nbsp;Ahmed Abdel Hakim Abdelaal Mohamed,&nbsp;Moataz A Elkot","doi":"10.1159/000508592","DOIUrl":"https://doi.org/10.1159/000508592","url":null,"abstract":"<p><strong>Background: </strong>For cardiologists, management of acute chest pain continues to be a challenge. Physicians struggle to avoid unnecessary admissions and at the same time not to miss high-risk patients needing urgent intervention. Therefore, diagnostic strategies focus on identifying patients in whom an acute coronary syndrome can be safely ruled out based on findings from history, physical examination, and early cardiac marker measurement. The HEART score, a clinical prediction rule, was developed to provide the clinician with a simple and reliable predictor of cardiac risk.</p><p><strong>Aim: </strong>This study aimed to investigate the role of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) as independent laboratory biomarkers when associated with the HEART risk score.</p><p><strong>Method: </strong>A cross-sectional study of 120 patients who attended the emergency department with acute chest pain. NLR and PLR were both measured. In addition, the HEART score was the valid instrument used in evaluating and risk stratifying patients into low-, intermediate-, and high-risk group.</p><p><strong>Results: </strong>There was a positive correlation between the HEART score and the mean PLR and NLR (<i>p</i> = 0.000*). PLR and NLR were found to be significantly higher in the high-risk HEART score group (<i>p</i> = 0.05 and 0.0001*, respectively). A PLR of 115.5 and above had a sensitivity of 73% and specificity of 78%, while an NLR of 3.95 and above had a sensitivity of 75% and specificity of 86% to detect high-risk HEART score patients.</p><p><strong>Conclusion: </strong>PLR and NLR proved to be a useful tool to identify high-risk patients when validated against the HEART score.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"66-74"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000508592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure Variability and Atrial Fibrillation in Patients with Acute ST Segment Elevation Myocardial Infarction: The Relation with Left Atrial Electromechanical Delay - A 1-Year Follow-Up Study.","authors":"Ragab A Mahfouz,&nbsp;Mohamed El-Shetry,&nbsp;Abdelfattah Frere,&nbsp;Mohamed Safwat","doi":"10.1159/000507792","DOIUrl":"https://doi.org/10.1159/000507792","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between 24-h blood pressure variability (BPV) and atrial electromechanical delay (EMD) in patients with ST segment elevation myocardial infarction (STEMI) who developed new-onset atrial fibrillation (NOAF).</p><p><strong>Materials and methods: </strong>A total of 175 STEMI patients (age 56.6 ± 10.5 years) who underwent primary percutaneous coronary intervention were subjected to in-hospital 24-h ambulatory BP monitoring, comprehensive echocardiography, and assessment of atrial EMD. The parameters of BPV analyzed were: (a) 24-h standard deviation (SD), (b) the coefficient of variation, and (c) the average of the daytime and nighttime SDs weighted for the duration of the daytime and nighttime interval (SD_dn <i>)</i>.</p><p><strong>Results: </strong>Based on the median of BPV index (SD_dn) = 9.5 mm Hg of all participants, patients were stratified into low and high variability groups (SD_dn: 7.1 ± 1.5 vs.13.5 ± 2.9; <i>p</i> < 0.001). Of the 175 patients with STEMI, 29 (16.7%) patients developed NOAF; 26 (28.9%) were in the high variability group and 3.5% were in the low variability group (<i>p</i> < 0.001). Echocardiographic data showed that the left atrial volume index (<i>p</i> < 0.01) and E/e' ratio (<i>p</i> < 0.001) were significantly higher in patients with high BPV. Inter and intra-atrial EMD were significantly increased in the high variability group compared to the low variability group (<i>p</i> < 0.001). With multiple linear analysis, there was significant correlation between SD_dn and intra-left atrial and inter-atrial EMD (<i>p</i> < 0.001 and <0.01, respectively). Cox regression analysis revealed that SD_dn and intra-atrial EMD were independent predictors for NOAF in patients with STEMI (OR = 3.75 and 02.72, respectively; <i>p</i> < 0.001). ROC analysis revealed that SD_dn ≥12.8 was the optimal cut-off value for predicting NOAF during follow-up.</p><p><strong>Conclusions: </strong>Short-term BPV was associated with NOAF during the 1-year follow-up in patients with STEMI. In addition, BPV was correlated significantly with atrial EMD. Herein, BPV was predicted to be an early predictor of NOAF in patients with STEMI.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"57-65"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000507792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure during Blood Collection and the Implication for Absolute Cardiovascular Risk Assessment.","authors":"Niamh Chapman,&nbsp;Dean S Picone,&nbsp;Rachel E Climie,&nbsp;Martin G Schultz,&nbsp;Mark R Nelson,&nbsp;James E Sharman","doi":"10.1159/000506646","DOIUrl":"https://doi.org/10.1159/000506646","url":null,"abstract":"<p><strong>Background: </strong>Blood collection and blood pressure (BP) measurements are routinely performed during the same consultation to assess absolute cardiovascular disease (CVD) risk. This study aimed to determine the effect of blood collection on BP and subsequent calculation of the absolute CVD risk.</p><p><strong>Methods: </strong>Forty-five participants aged 58 ± 9 years (53% male) had systolic BP (SBP) measured using clinical guideline methods (clinic SBP). Then, on a separate visit, BP was measured immediately before, during, and after blood collection. Absolute CVD risk scores were calculated (Framingham equation) using SBP from each measurement condition and compared.</p><p><strong>Results: </strong>The prevalence of low (<10%), moderate (10-15%), and high (≥15%) absolute CVD risks among the participants was 67%, 22%, and 11%, respectively, using clinic SBP. SBP values before and during blood collection were significantly higher compared to values after blood collection (130 ± 18 and 132 ± 19 vs. 126 ± 18 mm Hg; <i>p</i> = 0.010 and <i>p</i> = 0.003, respectively). However, there were no significant differences between clinic SBP (128 ± 18 mm Hg) and blood collection SBP (<i>p</i> = 0.99) or the absolute CVD risk scores (7.3 ± 6.5; 7.6 ± 5.9; 7.7 ± 6.1; and 7.1 ± 5.7%, respectively; <i>p</i> = 0.995 for all). The mean intraclass correlation (95% CI) indicated good agreement between absolute CVD risk scores calculated with clinic SBP and each blood collection SBP (0.86 [95% CI 0.74-0.92], 0.85 [95% CI 0.71-0.91], and 0.87 [95% CI 0.76-0.93], respectively; <i>p</i> < 0.001, for all).</p><p><strong>Conclusion: </strong>Absolute CVD risk calculation is not affected by use of SBP measurements recorded at the time of blood collection. Therefore, it is acceptable to collect blood and measure BP during the same consultation for absolute CVD risk assessment.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"40-46"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000506646","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}