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B Pannier

Publications and source records attributed to B Pannier.

71 records · Page 4Linked to original sources

Non-invasive ultrasonic study of maximal aortic blood acceleration in patients with borderline and sustained essential hypertension.

Using a pulsed Doppler method to evaluate the aortic velocity curve transcutaneously, the maximal aortic blood acceleration was evaluated in normal subjects and in age-matched patients with borderline and sustained essential hypertension. Maximal aortic blood acceleration was significantly elevated in patients with borderline hypertension and remained within the normal range in patients with sustained hypertension. Since maximal aortic blood acceleration is relatively insensitive to preload and afterload, these findings might give indirect information on the contractile state of the myocardium in patients with hypertension.

Adult↗

Flow-dependent vasodilation of the brachial artery in essential hypertension: preliminary report.

Brachial artery haemodynamics including brachial artery diameter and local blood flow velocity were studied in 10 normotensive subjects and 10 age-matched hypertensive patients. A bidimensional pulsed Doppler system was used at rest, during a 2-min period of distal circulatory occlusion and during reactive hyperaemia. The kinetics of changes in blood flow velocity and brachial artery diameter were determined during successive and reproducible manoeuvres. The two parameters decreased significantly during distal artery occlusion in both groups. During reactive hyperaemia, blood velocity reached similar maximal values in both groups and brachial artery diameter increased significantly in both normotensives and hypertensives. Changes in the brachial artery diameter during reactive hyperaemia were positively and significantly correlated to changes in blood flow velocity recorded at the same level. No significant difference was found between normotensives and hypertensives. This study has provided a demonstration of velocity-dependent variations in the diameter of a large artery in humans; the results suggest that velocity-dependent vasodilation of the brachial artery is not impaired in essential hypertension.

Blood Flow Velocity↗

Reversion of cardiac hypertrophy and reduced arterial compliance after converting enzyme inhibition in essential hypertension.

Blood pressure, forearm arterial hemodynamics (with a pulsed Doppler flowmeter), and echocardiographic parameters were studied in 16 patients with sustained essential hypertension before and 3 months after administration of the converting enzyme inhibitor perindopril. In a single-blind study versus placebo, it was shown that perindopril significantly reduced blood pressure (p less than 0.01), whereas there was an increase in brachial blood flow (p less than 0.01) because of a simultaneous increase in blood flow velocity (p less than 0.01) and arterial diameter (p less than 0.01). During a 5-minute period of wrist occlusion, blood flow velocity was reduced to a greater extent with perindopril than with placebo (p less than 0.001), whereas corresponding reductions in arterial diameter were equivalent, indicating that the increase in diameter after perindopril could not be explained simply on the basis of flow-dependent dilatation. During active treatment, brachial artery compliance increased (p less than 0.01) and pulse wave velocity decreased (p less than 0.01), whereas there was no change in the tangential tension of the arterial wall, defined as the product of mean arterial pressure and arterial diameter. Four weeks after treatment was stopped, blood pressure and forearm arterial hemodynamics returned toward baseline values. Cardiac mass was significantly decreased after perindopril (p less than 0.01) and remained decreased 4 weeks after cessation of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Effects of beta-blockers on hemodynamics of the forearm after tobacco stimulation].

In mild hypertension, a betablocker treatment could reduce cardiovascular events. But in smoking men the benefit disappears and this interaction is unexplained. In 6 healthy non smoking men, we studied the effects of acute oral administration of propranolol (80 mg) pindolol (15 mg) and placebo after cigarette smoking (CS) (two cigarettes within 10 minutes). In a double blind cross over randomized study, arterial pressure and heart rate (HR) were recorded within 20 minutes after CS. Brachial artery diameter (D), Local vascular Resistance (RL), Local arterial Compliance (CL) and pulse wave velocity (VOP) were determined non invasively (using a pulsed doppler system) before and 20 mn after CS. Under placebo, mean arterial pressure (PAM), HR and RL increased significantly after CS (+9.2 +/- 3 mmHg, +4.5 +/- 3 b/mn and +36 +/- 14 per cent, respectively). These modifications were not different after propranolol, pindolol or placebo (ANOVA). Arterial distensibility (CL) was decreased after CS and this alteration was not prevented by beta-blockers. Brachial artery diameter was not modified after CS. Our results demonstrate that acute treatment with non selective beta-blockers with or without sympathomimetic intrinsic activity does not prevent haemodynamic modifications induced by cigarette smoking.

Adrenergic beta-Antagonists↗

[Pulse wave velocity and ambulatory blood pressure in essential arterial hypertension].

Cardiovascular morbidity and mortality of hypertensive patients is mainly related to lesions of large arteries. Arterial distensibility estimated by carotid-femoral pulse wave velocity (PWV) was evaluated in 22 patients with sustained essential hypertension, together with three different methods of blood pressure (BP) measurement: mercury sphygmomanometer, semi-automatic BP recording using the Dinamap apparatus and 24 H ambulatory BP monitoring using the Spacelabs Monitor (5200). Table shows that, while PWV was not correlated with BP measured by mercury sphygmomanometer, it was strongly and positively correlated with BP measured by the other procedures. The best correlation coefficient was noted for the systolic BP measured in the Day Time (7 h-22 h) by the ambulatory method. This study shows that BP Monitoring correlates more strongly than clinic or casual BP with indices of target organ damage. (Table: see text).

Adult↗

[Pulse pressure and echocardiographic parameters in essential arterial hypertension].

UNLABELLED: We measured systolic, diastolic, mean (MAP) and pulsed (PP) arterial pressures (Dinamap 845 XT), carotid femoral pulse wave velocity (PWV) and cardiac parameters (echocardiography) to evaluate myocardiac mass and indexed cardiac mass to body surface area (IM) in 47 subjects (11 normotensives and 36 with sustained essential hypertension). Hypertensives were allocated between two groups with same age, weight and height, same mean arterial pressure (119.8 +/- 9.1 mmHg, 119.7 +/- 11.9 mmHg, NS) and PWV (11.90 +/- 2.20 m/s, 12.51 +/- 1.83 m/s, NS): group I (22 subjects) with pulsed pressure less than 60 mmHg, group II (14 subjects) with pulsed pressure greater than or equal to 60 mmHg. (Table: see text). Newman-Keuls between group I and group II: p less than 0.01 for cardiac mass and IM, p less than 0.001 for PP. Cardiac mass (p less than 0.01) and indexed mass to body surface area (p less than 0.01) were greater in group II (with pp greater than or equal to 60 mmHg) than in group I. CONCLUSION: arterial hypertension is linked with left ventricular hypertrophy which is increased when pulsed pressure is enhanced. This fact could give evidence of importance of pulsatory work in cardiac consequence of hypertension.

Adult↗

[Non-invasive measurement by Doppler pulse of cardiac output and maximal aortic acceleration in essential arterial hypertension].

Three groups of 11 male subjects with the same mean age were studied: normotensives (group I), patients with sustained essential hypertension (group II) and patients with borderline hypertension (group III). M-mode echocardiography provided a measure of aortic root systolic diameter (D) and left ventricular mass index (LVMi, g/m2). We have used a 4 MHz pulsed doppler velocity meter with spectral analysis to measure instantaneous ascending aortic blood velocity. Measurements values were averaged during 10 s and included: stroke volume (SV, cm3 = integrated velocity over one cardiac cycle.aortic cross sectional area (3.14D2/4)), cardiac output (CO, cm3 = SV.heart rate), systemic vascular resistance (SVR, mmHg/cm3.s-1 = MAP/co) and maximal aortic acceleration (MA, cm/s2). (Table: see text). Stroke volume and cardiac output were similar in three groups. SVR was higher in group II than in group I. The myocardial contractility appreciated from the maximal aortic acceleration (Bennett et al, Cardiovasc Res 1984; 18: 632-8) was increased in patients with borderline hypertension and remained within the normal range in patients with sustained essential hypertension despite and increase in cardiac mass.

Adult↗

[Flow-dependent vasodilation of the brachial artery in the normotensive and essential hypertensive patient].

Brachial artery hemodynamics including brachial artery diameter (D), local blood flow velocity (V) and local volumic blood flow, was studied in 10 normotensive subjects (NT) and 10 age-matched hypertensive patients (HT) (50 +/- 4 vs 43 +/- 4 years; m +/- SEM; NS), using a bidimensional pulsed doppler system at rest (control period), during a 2 (or 4) mn-period of distal circulatory occlusion (DO) and during the following reactive hyperemia (RH). Kinetics of change in blood flow velocity and diameter were determined during successive and reproducible manoeuvres. V and D decreased significantly during DO. During RH (1) V reached similar maximum values in both groups (after 2 mn DO: NT: from 2.4 +/- 1.1 to 19.0 +/- 6.9 cm/s; HT: from 2.9 +/- 0.8 to 17.2 +/- 7.6 cm/s) and (2) D increased significantly in both groups (after 2 mn DO: NT: from 0.395 +/- 0.016 to 0.450 +/- 0.025 cm; p less than 0.001; HT: from 0.408 +/- 0.018 to 0.467 +/- 0.018 cm; p less than 0.001), reaching levels significantly higher than during the control period. The brachial artery vasodilation observed in both groups (NT: +12 +/- 3 p. 100; HT: +15 +/- 3 p. 100 of initial diameter) was significantly greater (p less than 0.001), than the reproducibility of the diameter measurement (3 +/- 1 p. 100). Mean arterial pressure and heart rate dit not change during the whole investigation. Increasing the duration of DO from 2 to 4 mn further enhanced the reactive blood flow velocity but did not change the magnitude of the reactive brachial artery vasodilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Current treatment regimen in essential arterial hypertension].

The introduction in the treatment of arterial hypertension of angiotensin-converting enzyme inhibitors and calcium inhibitors, as well as the results of extensive multicentric therapeutic trials, suggest that the prescription of antihypertensive drugs will be profoundly altered in the forthcoming years. The "step by step" approach will be abandoned, and each patient will receive one or two drugs chosen for being the most selective and most suitable for his case. These more personalized long-term treatments will be better tolerated, and the greater patient's compliance will make them more effective drugs to the underlying pathology (smoking habits, blood lipid disorders, early arterial lesions) the antihypertensive treatment will have a greater reducing effect on cardiovascular morbidity and mortality.

Antihypertensive Agents↗

Duration of action of bisoprolol after cessation of a 4 week treatment and its influence on pulse wave velocity and aortic diameter: a pilot study in hypertensive patients.

A pilot study was performed in hypertensive patients (a) to investigate the duration of blood pressure reduction produced by the new beta blocker bisoprolol (10 mg o.d.) after cessation of a 4 week treatment using non-invasive 24 hour ambulatory blood pressure measurements, (b) to study the effects of the drug on large arteries using non-invasive brachio-radial pulse wave velocity and aortic abdominal diameter measurements 3 hours after the last dose of a 4 week treatment. In comparison with the results obtained before treatment a significant reduction of blood pressure and heart rate was observed up to the 40th hour after treatment was terminated. The finding may be relevant for further evaluation of withdrawal phenomena produced by beta-blocking agents. The antihypertensive effect of bisoprolol was associated with significant decreases in brachio-radial pulse wave velocity (from 10.4 +/- 0.4 to 8.6 +/- 0.4 m s-1) and in aortic abdominal diameter (from 18.2 +/- 1.0 to 17.5 +/- 1.3 mm) indicating an increase in arterial distensibility. Further studies are needed to substantiate these observations and to reveal their mechanisms of action.

Adrenergic beta-Antagonists↗

Changes in arterial distensibility produced by converting enzyme inhibitors in hypertensive humans.

Converting enzyme inhibitors enhance arterial compliance in hypertensive humans. The enhancement is due not only to an increase in arterial diameter and volume but also to an increase in arterial distensibility. The latter effect reflects the drug action on arterial smooth muscle tone rather than the lower stretch due to the blood pressure reduction. The improvement in the buffering function of large arteries in hypertensives may contribute to produce a more important decrease in systolic pressure and a better reversion of cardiac hypertrophy.

Angiotensin-Converting Enzyme Inhibitors↗

[Index of arterial and venous compliance and echocardiographic parameters in essential permanent arterial hypertension].

Forearm venous tone (FVT), carotido-femoral pulse wave velocity (PWV), and left ventricular end diastolic diameter (LVD), left ventricular posterior wall thickness (LVPWT), myocardiac mass (MM), measured by echography were evaluated on 25 subjects with sustained essential hypertension and 30 normotensive subjects with same age and same sex. For the overall population, FVT is positively correlated with LVD (r = 0.45, p less than 0.001), with LVPWT (r = 0.37, p less than 0.01) and with MM (r = 0.55, p less than 0.001). PWV is not correlated with LVD but is positively correlated with LVPWT (r = 0.48, p less than 0.001) and with MM (r = 0.40, p less than 0.01). Stroke volume is positively correlated with FVT (r = 0.42, p less than 0.01), but not with PWV. This study shows that in a population of normals and sustained essential hypertensive subjects: i) indexes of venous compliance are correlated with myocardial thickness, myocardiac mass, left ventricular diameter and stroke volume, while ii) indexes of arterial compliance are only correlated with myocardial thickness. Thus, the modifications of arterial and venous compliance observed in sustained essential hypertension influence cardiac structure and function.

Adult↗

Hemodynamic effects of the anti-hypertensive agent ketanserin in hypertension in man.

The hemodynamic changes caused by ketanserin, an anti-hypertensive agent with S2-serotonergic receptor and alpha 1-adrenoceptor blocking properties, are reviewed in patients with essential hypertension. The hemodynamic profile associates a decrease in total peripheral resistance, an unchanged cardiac output, and a modest reflex cardiac stimulation. Whether the drug reverses the other hemodynamic abnormalities of essential hypertension, such as reduced arterial and venous compliances and increased cardiac mass, remains largely unknown. Evaluation of the changes in arterial and venous systems will be important in the view that the pharmacological profile of ketanserin could be involved in the modifications of the arterial wall observed in hypertension and atherosclerosis.

Blood Pressure↗

[Comparison between the ambulatory and occasional determination of the blood pressure].

In this study, we have attempted to determine the link between the occasional measurement of the blood pressure with an Hg sphygmomanometer and the ambulatory pressure, considering different recording periods during the nyctemer. The mean values of the period 8-10 A.M. and more generally of the diurnal period (7 am-10 pm) are close to the values occasionally observed, contrary to the night values and the values of the entire 24 hours. The heart frequency is always well correlated to the mean ambulatory frequency, for the entire period studied. The systolic and mean arterial pressure are also well correlated. On the contrary, there is no meaning when the diurnal period (7 am-10 pm) is reduced to the period of diurnal activity (7 am-7 pm). There is a very strong correlation between the values of the systolic, diastolic, and mean pressures observed during 24 hours and the morning period (8-10 am), giving the impression that this period could be a good reflection of the ambulatory blood pressure of the 24 h.

Adult↗

Dose-related changes in the mechanical properties of the carotid artery in WKY rats and SHR following relaxation of arterial smooth muscle.

Acute converting enzyme inhibition relaxes arterial smooth muscle and increases arterial compliance in several models of animal and human hypertension. However, it is unknown whether the doses needed for the relaxation of large arteries are similar to those inducing arteriolar relaxation and blood pressure (BP) decrease. To answer this question, we used a previously described model of the in situ carotid artery to determine the pressure-volume relationship over a range of transmural pressures from 25 to 200 mm Hg in normotensive rats (WKY) and spontaneously hypertensive rats (SHR). The pressure-volume relation was determined after an acute single oral administration of either a placebo or the converting enzyme inhibitor quinapril given at two different doses (0.3 or 3 mg/kg). At the end of each experiment, the total relaxation of arterial smooth muscle was achieved after a local administration of potassium cyanide (KCN). In the WKY placebo group, from 25 to 100-125 mm Hg transmural pressure, carotid compliance increased and reached a maximum value at 100-125 mm Hg (i.e. close to the operating range of systemic mean BP of the animals), and decreased thereafter. In the SHR placebo group, carotid compliance was significantly lower than in the WKY placebo group for transmural pressure up to 125 mm Hg, and thereafter was equal or even higher; the maximum value of compliance was reached at 125-150 mm Hg transmural pressure, i.e. substantially less than the operating range of the systemic mean BP of the SHR placebo (180 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Body composition and left ventricular geometry].

Left ventricular mass and cardiac output are, particularly in obesity, correlated with fat free body mass. We assessed the relationship between ventricular geometry and fat body mass in treated hypertensives with or without normalization of blood pressure We investigated 175 patients (age: 57 +/- 15 years, M/F: 111/64, Mean blood pressure (MBP): 111 +/- 18 mmHg, BMI: 27.02 +/- 3.70 kg/m2: 20.3-39.6 kg/m2) with measure of body composition (impedancemetry Analycor2) and echographic left ventricular mass (adjusted to height2.7: mass2.7). Multiple correlation with adjustment to age and MBP were performed in men (M) and in women (W). Mass2.7 is correlated with fat mass percentage in men (R partial R: 5.6, p=0.02). LV diastolic diameter is correlated with fat free body mass while interventricular septum is correlated with fat body mass but only in men. In summary, in hypertensives not selected on BMI or BP, fat body mass is weakly correlated to ventricular wall thickness in men, probably mediated by sympathetic tone, while fat free body mass is related to ventricular volume in both gender probably through the water volume particularly in vascular bed. In conclusion, both components of body composition are differently, and weakly, linked to ventricular geometry in hypertensive patients.

Adult↗