Browsing by Subject "heart function test"

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    Blood pressure and ejection fraction changes due to ultrafiltration in hemodialysis
    (2006) Kursat S.; Aysel S.; Alici T.; Tezcan U.K.
    Background: Nocturnal hypertension (NH) is an unsolved problem in hemodialysis (HD) patients. The effect of ultrafiltration (UF) on NH and myocardial performance has not been systematically investigated in HD patients. Methods: Seventeen reverse-dipper (RD) HD patients were subjected to intensified UF. Before and after UF, echocardiographic and blood pressure (BP) measurements were taken. Results: Excluding daytime diastolic BP, all BP parameters (mmHg), namely daytime systolic BP (138.1 ± 15.1; 131.1 ± 12.5), night-time systolic BP (150.4 ± 17.6; 125.3 ± 16.5), night-time diastolic BP (87.3 ± 10.3; 76.5 ± 11.6), daytime pulse pressure (56.1 ± 7.6; 50.5 ± 5), night-time pulse pressure (63.3 ± 9.4; 48.7 ± 7), significantly decreased (p<0.001 for all comparisons). Thirteen patients converted to non-dipper and two patients converted to dippers, whereas two patients remained on RD. Unit for measurement of diameters was mm. Ejection fractions (EF) increased (51.23 ± 9.01; 64.05 ± 7.23, p<0.001), left atrial diameters (LAD) decreased (35 ± 8.29; 32.05 ± 7.12, p<0.001), the vena cava inferior collapse index increased (VCICI) [24.82 ± 8.20 (%); 51.76 ± 9.65 (%), p<0.001], left ventricular end-systolic (LVES) and diastolic diameters (LVED) decreased (3.19 ± 0.60; 2.77 ± 0.51, p<0.001; 4.39 ± 0.65; 4.18 ± 0.56, p=0.002, respectively). Percentage reduction in night-time diastolic BP correlated with the percentage reduction in LAD (p=0.038). Percentage reduction in night-time pulse pressure correlated with the percentage increase in EF (p<0.013). Similarly, percentage reductions in night-time systolic BP, night-time diastolic BP and night-time mean BP correlated with the percentage reduction in LVESD (p=0.014, p<0.001 and p=0.001, respectively). Conclusions: NH in HD patients is a volume dependent phenomenon. Improved night-time BP parameters have a more profound effect on myocardial function than daytime BP parameters. © Società Italiana di Nefrologia.
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    Effect of losartan on excercise tolerance and echocardiographic parameters in patients with mitral regurgitation
    (2008) Sekuri C.; Utuk O.; Bayturan O.; Bigle A.; Kurban Z.; Tavli T.
    Objectives. The aim of this study was to assess the effects of losartan treatment on exercise tolerance and echocardiographic parameters in patients with mitral regurgitation (MR) secondary to mitral valve prolapse or rheumatic heart disease. Methods. Twenty-seven patients (14 males, 13 females, mean age 51±11, range 21-76) with moderate MR due to mitral valve prolapse or rheumatic heart disease were examined by means of Doppler echocardiography. The subjects were submitted to treadmill exercise tests using the modified Bruce protocol at baseline, after six hours and after the six-week treatment period to be evaluated based on their exercise tolerance. Mitral Regurgitant Volume (MRV), effective regurgitant orifice diameter, left atrial volume, left ventricle (LV) end-diastolic volume index, LV end-systolic volume index, LV ejection fraction (LVEF), left ventricle mass index were calculated at baseline and after six weeks of treatment with single dose of losartan (50 mg/ day). Results. Total treadmill exercise time increased from 477.7±147.9 to 535.7±149.0 seconds after six hours (p<0.01) and to 559.6±142.8 seconds after six weeks of treatment.Also, metabolic equivalent values increased following six hours of first dose and six weeks of losartan treatment (from 10.9±2.9 to 11.8±3.1,p=0.006 and 12.4±3.1, p=0.002; respectively). However, peak exercise systolic blood pressure (BP) was reduced after six hours and six weeks of treatment, and resting diastolic BP did not change after six hours but reduced at the end of the treatment period. MR volume decreased significantly from 29.3±14.1 ml to 25.1±14.8 ml, (p=0.025) without significant change in regurgitant orifice diameter (0.72±0.37 cm vs. 0.66±0.37 cm, p=NS), left atrium diameter and area while LVEF increased from 51.70±13.37 to 54.11-11.75 (p=0.015) with losartan. Conclusion. We conclude that the angiotensin II receptor antagonist losartan improves exercise tolerance and echocardiographic parameters in patients with moderate MR.