A software package for non-invasive, real-time beat-to-beat monitoring of stroke volume, blood pressure, total peripheral resistance and for assessment of autonomic functionAn updated and improved software version for Windows 95/NT and the complete biosignal electronics (ECG, ICG, beat-to-beat and oscillometric blood pressure and pulse oxymetry) will be supplied in a compact instrument by: CNSystems Medical Equipment Inc. Heinrichstrasse 22 A-8010 Graz, Austria, Europe. Tel: +43/316/3631-0; Fax: +43/316/36

Gratze, Gerfried; Fortin, Jürgen; Holler, Albert; Grasenick, K.; Pfurtscheller, Gert; Wach, Paul; Schönegger, J.; Kotanko, Peter; Skrabal, F.

doi:10.1016/s0010-4825(98)00005-5

Cited by 133 publications

(27 citation statements)

References 24 publications

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“…Data were sampled at a rate of 1,000 Hz and stored on a hard disc for later analysis. Continuous BP monitoring followed the Penaz principle from either the index or middle finger of the right hand and was calibrated to oscillometric brachial BP measurements on the contralateral arm without perturbations caused by the calibration signal (Gratze et al, 1998). We used height-adjustable tables for reliable horizontally aligned placement of BP cuffs, i.e., table heights were adjusted to the height of the right atrium (forth-intercostal space), in order to avoid misleading BP readings based on deviations from heart level.…”

Section: Methodsmentioning

confidence: 99%

Substantial Inter-Subject Variability in Blood Pressure Responses to Glucose in a Healthy, Non-obese Population

Monnard

Fellay²,

Scerri

et al. 2017

Front. Physiol.

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Aim: A large inter-subject variability in the blood pressure (BP) response to glucose drinks has been reported. However, the underlying factors remain elusive and we hypothesized that accompanying changes in glucose metabolism affect these BP responses.Methods: Cardiovascular and glycemic changes in response to a standard 75 g oral-glucose-tolerance-test were investigated in 30 healthy, non-obese males. Continuous cardiovascular monitoring, including beat-to-beat BP, electrocardiographically deduced heart rate and impedance cardiography, was performed during a 30 min baseline and continued up to 120 min after glucose ingestion. Blood samples were taken at baseline, 30, 60, 90, and 120 min for the assessment of glucose, insulin and c-peptide. Additionally, we evaluated body composition by using validated bioelectrical impedance techniques.Results: Individual overall changes (i.e., averages over 120 min) for systolic BP ranged from −4.9 to +4.7 mmHg, where increases and decreases were equally distributed (50%). Peak changes (i.e., peak averages over 10 min intervals) for systolic BP ranged from −1.3 to +9.5 mmHg, where 93% of subjects increased systolic BP above baseline values (similar for diastolic BP) whilst 63% of subjects increased peak systolic BP by more than 4 mmHg. Changes in peak systolic BP were negatively associated with the calculated Matsuda-index of insulin sensitivity (r = −0.39, p = 0.04) but with no other evaluated parameter including body composition. Moreover, besides a trend toward an association between overall changes in systolic BP and total fat mass percentage (r = +0.32, p = 0.09), no association was found between other body composition parameters and overall BP changes.Conclusion: Substantial inter-subject variability in BP changes was observed in a healthy, non-obese subpopulation in response to an oral glucose load. In 63% of subjects, peak systolic BP increased by more than a clinically relevant 4 mmHg. Peak systolic BP changes, but not overall BP changes, correlated with insulin sensitivity, with little influence of body composition.

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Section: Methodsmentioning

confidence: 99%

Substantial Inter-Subject Variability in Blood Pressure Responses to Glucose in a Healthy, Non-obese Population

Monnard

Fellay²,

Scerri

et al. 2017

Front. Physiol.

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“…10 After a resting period in supine position of at least 30 min, three bolus injections of Phenylephrine (2–4 µg/kg) were given intravenously at intervals of 10 min to raise systolic blood pressure by 15–40 mmHg. 4 A regression line was fit between data pairs of blood pressure and R-R intervals.…”

Section: Methodsmentioning

confidence: 99%

Risk of arrhythmic death in ischemic heart disease: a prospective, controlled, observer‐blind risk stratification over 10 years

Pezawas

Diedrich

Robertson

et al. 2017

Eur J Clin Investigation

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Background Risk of arrhythmic death is considered highest in ischemic heart disease with severe left ventricular ejection fraction (LVEF) reduction. Non-invasive testing should improve decision-making of prophylactic defibrillator (ICD) implantation. Methods and Results We enrolled 120 patients with ischemic heart disease and LVEF <50% and 30 control subjects without ischemic heart disease and normal LVEF. An initial assessment, a second assessment after 3 years, and a final follow-up comprised of: pharmacological baroreflex testing (BRS), short-term spectral (low frequency (LF) to high frequency (HF) ratio) and long-term time domain analysis of heart rate variability (SDNN), exercise Microvolt T-wave alternans (MTWA) and others. The median follow-up was 7.5 years. Resuscitated cardiac arrest and arrhythmic death due to ventricular arrhythmias ≥ 240/min was observed in 18% and 15% of patients, respectively. Cardiac death was observed in 28% of patients. The incidence of arrhythmic death and resuscitated cardiac arrest was identical in patients with ischemic heart disease with LVEF <30% and ≥30%. No significant difference between subgroups with LVEF of <30%, 30% to 39% and ≥40% was found either. MTWA, BRS, SDNN and LF to HF ratio failed to identify patients at risk of arrhythmic death in a multiple regression model. Conclusions Ischemic heart disease patients with LVEF <30% and ≥30% face the same risk of arrhythmic death. Stratification techniques fail to identify high risk patients. Therefore, the current practice to constrain prophylactic ICDs to patients with severely reduced LVEF seems to be insufficient.

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“…17 After a resting period in supine position of at least 30 min, three bolus injections of Phenylephrine (2–4 µg/kg) were given intravenously at intervals of 10 min to raise systolic blood pressure by 15–40 mmHg. 18 A regression line was fit between data pairs of blood pressure and R-R intervals.…”

Section: Methodsmentioning

confidence: 99%

Multiple Autonomic and Repolarization Investigation of Sudden Cardiac Death in Dilated Cardiomyopathy and Controls

Pezawas

Diedrich

Winker

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Background Prophylactic defibrillator implantation is recommended in dilated, nonischemic heart disease and left ventricular ejection fraction of ≤0.30 to 0.35. Noninvasive testing should improve accuracy in decision making of prophylactic defibrillator implantation. Methods and Results We enrolled 60 patients (median age 57 years) with dilated cardiomyopathy and LVEF ≤0·50, and 30 control subjects (median age 59) with LVEF>0·50. The protocol included an initial assessment, a second assessment after 3 years, and a final follow-up: pharmacological baroreflex testing (BRS), short-term spectral analysis of heart rate variability (LF/HF), and long-term time domain analysis (SDNN), exercise Microvolt T-wave alternans (MTWA) and signal-averaged ECG, and corrected QT-time. The median follow-up was 7 years. Endpoints were cardiac death, resuscitated cardiac arrest and arrhythmic death. Cardiac death was observed in 21 patients. Resuscitated cardiac arrest and arrhythmic death due to ventricular tachyarrhythmias (VTs) ≥ 240/min was observed in 7 and 10 patients, respectively. In the single time point analysis, MTWA, BRS and SDNN at initial testing added significant information regarding cardiac death. MTWA added information on resuscitated cardiac arrest or arrhythmic death at multiple time points (P<0·001). False negative MTWA results were seen in 8% of patients. Conclusions Non-invasive testing and LVEF could not reliably identify those DCM patients at risk of fatal VTs. Therefore, the strategy to confine prophylactic ICD implantation to DCM patients with severely reduced LV function should be reconsidered.

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Cited by 133 publications

References 24 publications

Substantial Inter-Subject Variability in Blood Pressure Responses to Glucose in a Healthy, Non-obese Population

Substantial Inter-Subject Variability in Blood Pressure Responses to Glucose in a Healthy, Non-obese Population

Risk of arrhythmic death in ischemic heart disease: a prospective, controlled, observer‐blind risk stratification over 10 years

Multiple Autonomic and Repolarization Investigation of Sudden Cardiac Death in Dilated Cardiomyopathy and Controls

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