Biomedical subjects

M Kollai

Publications and source records attributed to M Kollai.

At least 19 recordsLinked to original sources

PubMed2006

Exhaled breath condensate pH standardised for CO2 partial pressure.

Exhaled breath condensate (EBC) pH is considered to reflect the acid-base balance of the airways. Current pH measurements do not take into account the effect of CO2. The aim of the present study was to determine the effect of condensate CO2 partial pressure on pH and to provide a more precise mode of EBC pH determination. Condensate pH and CO2 partial pressure were measured in parallel from 12 healthy volunteers and 12 asthmatics using a blood gas analyser in neat, argon de-aerated and CO2-loaded samples. The regression analysis was used to test the relationship between pH and CO2, and to calculate the pH at a CO2 level of 5.33 kPa (physiological alveolar CO2 partial pressure). Reproducibility of different pH readings was compared using the Bland-Altman test. Condensate CO2 concentration was variable both in neat and argon de-aerated samples. There was a close negative logarithmic relationship between CO2 and pH. Calculation of pH at a CO2 level of 5.33 kPa provided reproducibility approximately six times as good as that of the currently used measurements. Condensate CO2 partial pressure influences pH measurements. Determination of pH at a standard CO2 level provides the most reproducible condensate pH values to date.

Acid-Base Equilibrium↗

PubMed2006

Determinants of baroreflex function in juvenile end-stage renal disease.

Arterial baroreflex sensitivity (BRS) is markedly reduced in middle-aged patients with end-stage renal disease (ESRD), due to the combined effects of aging, arterial stiffening, and autonomic neuropathy. Much less is known about the effects of ESRD on arterial baroreflex in juvenile patients. Therefore, we investigated baroreflex function and its relation to carotid artery elasticity and heart rate variability in children and young adults with ESRD. We studied 42 subjects (9-30 years): 14 patients on maintenance hemodialysis (HD), 14 renal transplant recipients (RT), and 14 healthy control subjects (C). Baroreflex function was determined by pharmacological (BRS) and spontaneous (sequence and spectral indices) techniques. Carotid artery elasticity was characterized by stiffness index beta. Heart rate variability was assessed using time and frequency domain measures. Data are expressed as mean+/-s.d. BRS was markedly reduced in HD as compared to C (10.0+/-4.2 vs 25.7+/-5.9 ms/mm Hg); spontaneous indices were reduced to similar extent. Carotid artery stiffness was approximately 50% higher in HD than in C and was inversely related to BRS. Heart rate variability was also compromised in HD, and was directly related to spontaneous indices. No significant differences existed in any of these variables between RT and C. Decreased baroreflex function in juvenile HD is partly due to loss of carotid artery elasticity and partly due to impaired heart rate variability. Renal transplantation may partly prevent impairment or improve compromised baroreflex function in young patients with ESRD.

Adolescent↗

PubMed2006

Increase of carotid artery stiffness and decrease of baroreflex sensitivity in exfoliation syndrome and glaucoma.

AIM: To investigate the distensibility of the common carotid artery (CCA), baroreflex sensitivity (BRS) and its relation to plasma homocysteine concentration in exfoliation syndrome or exfoliation glaucoma (XFS/XFG). METHODS: Homocysteine concentrations were measured in 30 XFS/XFG patients and 18 age matched controls. In 21 patients and 17 controls the end diastolic diameter of the CCA and pulsatile distension were measured and BRS was calculated. RESULTS: There was no significant difference between the groups in sex distribution, age, heart rate, blood pressure, systemic diseases, or medication. In XFS/XFG patients homocysteine concentration was significantly elevated (unpaired t test, p = 0.023), and CCA stiffness was higher (p<0.05), while strain, cross sectional compliance coefficient, distensibility, and BRS were significantly reduced compared to the controls (Mann-Whitney U test, p< or =0.013 for each parameter). In XFS/XFG patients a positive correlation was found between age and plasma homocysteine level (Pearson's correlation, r = 0.490, p = 0.007), and a negative correlation between age and BRS (Kendall's correlation r = -0.374, p = 0.021), as well as between homocysteine concentration and BRS (Kendall's correlation r = -0.377, p = 0.024). No correlation was seen between these variables in the control group. CONCLUSIONS: These results suggest a pathological large artery function as well as altered parasympathetic vascular control in XFS/XFG which increases with age and with higher homocysteine concentration.

Aged↗

PubMed2005

Adenosine level in exhaled breath increases during exercise-induced bronchoconstriction.

In asthmatic patients, airway obstruction provoked by exercise challenge is accompanied by an increase in plasma adenosine level. In this study, the current authors investigated if exercise-induced bronchoconstriction was associated with local changes of adenosine concentration in the airways. Oral exhaled breath condensate (EBC) collection (5-min duration) and forced expiratory volume in one second (FEV1) measurements were performed at rest (baseline) and 4-8 times after treadmill exercise challenge in healthy and asthmatic subjects. Adenosine concentration in EBC was determined by HPLC. Observations indicated that physical exercise results in bronchoconstriction together with a significant increase of adenosine level in EBC in asthmatic patients (mean+/-sd maximal fall in FEV1 27+/-13%; associated increase in adenosine 110+/-76% as compared to baseline), but not in healthy control subjects. Exercise-induced changes in adenosine concentration correlated significantly with the fall in FEV1 values in asthmatic patients. In conclusion, the observed increase in adenosine concentration of oral exhaled breath condensate most probably reflects changes in the airways during exercise-induced bronchoconstriction. Due to its known bronchoconstrictor property in asthma, adenosine may contribute to the development of bronchospasm.

Adenosine↗

PubMed2002

Impaired baroreflex function during pregnancy is associated with stiffening of the carotid artery.

OBJECTIVE: The baroreflex sensitivity and the distensibility of the carotid artery were measured during normotensive pregnancy to test the hypothesis that changes in baroreflex sensitivity are related to carotid artery stiffening. DESIGN: Data were obtained from pregnant subjects during each trimester (T1, T2, T3; n = 23) and postpartum (n = 11). End-diastolic diameter and pulsatile distension of the carotid artery were measured with an ultrasound wall-tracking system, and the distensibility coefficient was calculated. Spontaneous fluctuations in cardiac interval and systolic pressure were used to determine baroreflex sensitivity. RESULTS: Both distensibility coefficient and baroreflex sensitivity were reduced from T1 to T3 (5.1 +/- 1.6 vs. 3.7 +/- 0.9 10(-3)/mmHg and 10.1 +/- 2.9 vs. 5.7 +/- 1.8 ms/mmHg, respectively). Baroreflex sensitivity and carotid distensibility coefficient were linearly related in each subject (r = 0.62 +/- 0.12). Augmentation index and return time changes indicated a global increase in arterial distensibility. CONCLUSIONS: Stiffening of the carotid artery significantly contributes to the impairment of baroreflex sensitivity during pregnancy, and represents a region specific change as global arterial distensibility was found to increase during pregnancy.

Adult↗

PubMed2001

Comparison of aortic arch and carotid sinus distensibility in humans--relation to baroreflex sensitivity.

We compared aortic arch (AA) and carotid sinus (CS) distensibility, and determined the relationship between baroreflex sensitivity (BRS) and distensibility coefficients of AA and CS (DCAA and DCCS, respectively). In 47 healthy 19-71-year-old subjects, AA and CS end-diastolic diameter (D) and pulsatile distension (delta D) was measured with ultrasound and arterial pressure by sphygmomanometer and Finapres. DC was calculated as 2delta D/(D x delta P), where delta P is the pulse pressure. BRS was determined by the sequence method. Data are given as mean +/- S.D.; significance was set at p < 0.05. DCAA and DCCS were linearly related across subjects (r = 0.80, p < 0.001). No difference between DCAA and DCCS (3.8 +/- 1.4 x 10(-3) and 4.2 + 2.2 x 10(-3) mm Hg(-1), respectively) was found for all subjects (paired t-test). However, at ages < 35 years, DCCS exceeded DCAA, whereas this relation was reversed at ages > 35 years. Age accounted for 53% of variability in DCAA and 73% of variability in DCCS. BRS was related to DC (linear regression), with the BRS-DCAA relation being steeper and closer (r = 0.73, p < 0.001) than the BRS-DCCS relation (r = 0.54, p < 0.05). It is suggested that aortic baroreceptors may have a dominant role in heart rate control.

Adult↗

PubMed2000

Measurement of aortic arch distension wave with the echo-track technique.

The aim of this study was to use the echo-track method for measuring aortic arch diameter, distension waveform and elastic parameters. Data were obtained from 50 healthy volunteers of 32 +/- 15 y (mean +/- 1 SD). The aortic arch was interrogated from the suprasternal position with M-mode ultrasonography using a 3.5-MHz transducer; diameter and distension waves were determined by means of an echo-track algorithm (WTS, Pie Medical); arterial blood pressure was measured in the arm with sphygmomanometry. Aortic arch diameter, distension, distensibility and compliance were 24.55 +/- 2.99 mm, 2199 +/- 726 micrometer, 3.9 +/- 1.4. 10(-3) mmHg(-1) and 1.86 +/- 0.61 mm(2). mmHg(-1), respectively. Intrasession, interobserver and intersession variability was less than 10%, 10% and 18%, respectively. It is concluded that aortic arch distension wave can be recorded noninvasively with acceptable reproducibility, allowing assessment of aortic elastic parameters, and yielding insight into pressure wave reflection within the arterial system.

Adult↗

PubMed2000

Assessment of the viscosity of the pulmonary artery wall.

Large artery wall viscosity reduces the efficiency of heart/vessel coupling. The aim of the present study was to assess pulmonary artery wall viscosity through comparison of the static (Dst) and dynamic distensibility (Ddyn) of the vessel wall. Right pulmonary artery pressure and diameter was measured in 13 patients and eight healthy volunteers. Ddyn was calculated as the relative change in end-diastolic diameter induced by the pressure pulse, and Dst as the relative change in mean diameter induced by the change in mean pressure during steady-state exercise. Dst did not differ significantly from Ddyn (mean+/-SD 22.8+/-19.2 versus 21.0+/-18.3 10(-3) mmHg(-1)), as tested by paired t-test and analysis of covariance, with age as covariant. End-diastolic diameter increased, whereas Dst and Ddyn decreased as a function of age (r=-0.69 and -0.67, respectively; p<0.01 for both). Ddyn did not change from rest to exercise in spite of a 23+/-16-beats-min(-1) increase in cardiac frequency. Pulmonary artery wall viscosity was negligible and no increase in wall viscosity occurred during cardioacceleration.

Adult↗

PubMed1999

Exhaled carbon monoxide concentration increases after exercise in children with cystic fibrosis.

Oxidative stress and hypoxia, which may occur in cystic fibrosis patients (CF) at rest and may be worsened by exercise, induce the expression of heme oxygenase (HO)-1, resulting in increased carbon monoxide (CO) formation. We tested that exhaled CO level (eCO) was higher in CF patients than in healthy subjects, and that exercise increased CO production. Exhaled CO was measured electrochemically in 15 CF patients and 15 control subjects at rest (T0), immediately (T1) and 60 minutes after a symptom-limited incremental bicycle exercise test (T60). Arterial oxygen saturation (TcO2) was monitored transcutaneously. Data are given as mean+/-SEM. Baseline eCO was 1.90+/-0.26 ppm in the control and 1.93+/-0.27 ppm in the CF group. In both groups eCO was lower at T1 than at rest. In the control group eCO was also low at T60, but in the CF group it was increased compared to baseline level at this timepoint. Exercise caused oxyhemoglobin desaturation in CF patients which was related to the increase in eCO measured at T60 (r=0.67, p<0.01). Our findings suggest that exercise modulates the level of exhaled CO partly by worsening oxygenation in CF patients.

Adolescent↗

PubMed1998

Changes in left ventricular contractility with the phase of respiration.

The end-systolic wall stress (sigma(es))-velocity of circumferential fiber shortening (V(cfsc)) relation was defined during the respiratory cycle, in order to obtain a totally noninvasive measure of left ventricular contractility. Eight young, healthy subjects were studied with echocardiography and calibrated carotid pulse tracings, while performing slow paced breathing. Left ventricular sigma(es) vs. V(efsc) relation was determined by fitting linear regression line to data points obtained at different times during the respiratory cycle. Data are given as mean+/-1SD. Left ventricular sigma(es) and V(efsc) exhibited small but significant changes during the respiratory cycle: sigma(es) was highest in late inspiration (56.9+/-4.8 g/cm2) and lowest in late expiration (49.2+/-3.7 g/cm2); inversely, V(cfsc) was lowest during late inspiration (1.18+/-0.17 circ/s) and highest during late expiration (1.34+/-0.20 circ/s). The relation was significant in each subject (r = -0.64+/-0.13) and remained inverse and significant, when it was determined separately for inspiration and expiration (r = -0.61+/-0.17 and -0.68+/-0.12, respectively). At identical end-systolic wall stress, the velocity of shortening was greater during inspiration then expiration, suggesting that contractility was reduced during the expiratory phase. The reduced expiratory contractility might reflect increased vagal influence on the ventricular myocardium.

Adult↗

PubMed1998

Elevated circulating adenosine level potentiates antigen-induced immediate bronchospasm and bronchoconstrictor mediator release in sensitized guinea pigs.

BACKGROUND: Adenosine causes bronchoconstriction in asthmatic patients, and it is also accepted that adenosine influences histamine release from activated human mast cells and basophils in vitro. OBJECTIVE: In this study we tested the hypothesis that adenosine potentiates both the airway narrowing and the release of bronchoconstrictor mediators induced by ovalbumin challenge in sensitized guinea pigs. METHODS: After ovalbumin sensitization, 4 groups were studied: control group, adenosine group (ADO), ovalbumin group (OA), and adenosine plus ovalbumin group (ADO + OA). Changes in airway resistance were assessed from continuously recorded pulmonary insuffilation pressure (PIP). The concentration of histamine, PGD2, and thromboxane B2 were determined from bronchoalveolar lavage fluids. RESULTS: Adenosine alone (6 mg/kg intravenously) did not influence baseline values of PIP and the mediator concentrations; however, ovalbumin (10 mg/kg intravenously) increased both the PIP and the levels of the measured mediators compared with the control and ADO groups. When ovalbumin challenge was preceded by adenosine administration, both PIP and mediator levels were significantly enhanced compared with values obtained after simple ovalbumin provocation (ADO + OA vs OA: P <.05). CONCLUSION: These results suggest that adenosine potentiates the airway narrowing induced by ovalbumin challenge and that this effect may develop through facilitation of the release of bronchoconstrictor mediators during the immediate airway response.

Adenosine↗

PubMed1997

Effect of vasoactive drugs on carotid diameter in humans.

We studied whether vasoactive drugs used to determine baroreflex sensitivity influence baroreceptor firing by affecting carotid sinus smooth muscle or simply by stretching the sinus wall through changes in pressure. In six young healthy subjects, the diameter of the carotid artery and its change with arterial pulse were measured with ultrasonography. Blood pressure was measured by Finapres. Phenylephrine and nitroglycerin doses were injected intravenously to raise and lower pressure by approximately 15-25 mmHg. Carotid dimensions increased in all subjects during the phenylephrine-induced rise and decreased during the nitroglycerin-induced fall in pressure. Diastolic diameter changed more than systolic diameter; changes were significantly different from the control value (assessed by single-factor analysis of variance and Scheffé's post hoc test). The systolic pressure-diameter relationship appeared to be nonlinear, with a steeper slope above than below baseline, and contributed significantly to the nonlinearity of the R-R interval-systolic pressure relationship. It is concluded that during drug-induced changes in blood pressure, baroreceptor activity in humans is influenced more by passive stretch than by local smooth muscle contraction.

Adult↗

PubMed1996

Relation between baroreflex sensitivity and carotid artery elasticity in healthy humans.

We investigated whether physiological variability in arterial baroreflex sensitivity (BRS) was related to differences in carotid elastic behavior among 19 young healthy subjects (age 18-26 yr). The diameter of the carotid artery (D) and its change during the arterial pulse (delta D) were monitored by a phase-locked echotracking device (UT-4 Hokanson), and pulse pressure (delta P) was measured in the brachial artery by sphygmomanometry. Distensibility coefficient (DC) for the common carotid artery was calculated using the formula DC = (2 x delta D/D)/delta P. Dynamic elastic parameters such as the maximum and mean rate of carotid artery expansion and the dominant harmonic frequency of the diameter curve were also determined. BRS was assessed by regressing R-F.intervals against systolic blood pressure, monitored by finger arterial pressure (FINAPRES), during an elevation of pressure, induced by intravenous bolus injection of phenylephrine. Using correlation and stepwise regression analysis, we found that BRS was significantly related to carotid artery distensibility (r = 0.778, P < 0.001) but was not related to any of the dynamic parameters of carotid pulsation.

Adult↗

PubMed1995

Heart rate variability after complete autonomic blockade in man.

In a number of studies, using the autoregressive model for frequency domain analysis of R-R interval fluctuations, the low frequency (LF) component (centered at about 0.1 Hz) is claimed to index sympathetic activity level. The aim of this study was to investigate the mediation mechanism of the LF component by pharmacological blockade. Our results support earlier findings, obtained with the use of fast Fourier transformation, that in supine subjects spectral components of R-R interval variability at around 0.1 Hz are mediated mainly by cholinergic mechanisms. Therefore, the use of the LF component as sympathetic index appears questionable.

Adult↗

PubMed1995

Relation between bronchial and cardiac vagal tone in healthy humans.

A generally increased vagal nervous activity was suggested to exist in bronchial asthma; however, this contention has never been fully tested. Before studying vagal activity in asthma, we raised the question if there existed any relation between vagal outflows to different target organs in the physiologic state. The specific aim of this study was to determine the relation between the resting level of bronchial and cardiac vagal activity in healthy volunteers. Bronchial and cardiac vagal tone were measured in 12 subjects as the change of airway resistance (Raw) and heart period (HP) in response to complete cholinergic blockade. It was found that after intravenous atropine administration, Raw was reduced from 1.30 +/- 0.41 cm H2O/L/s to 0.51 +/- 0.22 cm H2O/L/s and HP was reduced from 789 +/- 84 ms to 506 +/- 41 ms. All the values are given as mean +/- SD. Both the bronchial and cardiac responses exhibited considerable interindividual variability, but there was no significant correlation between them (R = 0.22, p = 0.50). It was concluded that under resting conditions, vagal control of bronchial tone and HP were not related in healthy human subjects.

Adult↗

PubMed1994

Relation between tonic sympathetic and vagal control of human sinus node function.

BACKGROUND: Clinical conditions, such as heart failure or myocardial infarction are associated with enhanced sympathetic and reduced parasympathetic activity as compared to normal controls. The reciprocal alteration in cardiac autonomic tone likely contributes to the electrical instability of the myocardium. Little information is available on the relation between sympathetic and vagal cardiac control in healthy human subjects. METHODS AND RESULTS: Heart period changes in response to autonomic blockades were measured in 16 young, healthy human subjects. Adrenergic and cholinergic blockades were induced by i.v. propranolol (0.2 mg/kg) and atropine (0.04 mg/kg) in two opposite orders on two occasions; interindividual correlations were performed between the R-R interval responses to propranolol and to atropine obtained under the various blockade conditions, and the magnitude of the responses were compared by a drug x order two factorial ANOVA design. It was found, that previous adrenergic blockade did not reduce the extent of cardioacceleration produced by subsequent cholinergic blockade and that the R-R interval responses to atropine and to subsequently given propranolol did not share significant variance across subjects (r = 0.22, P = 0.234). Also, no interindividual correlation was found between the R-R interval responses to propranolol and to atropine, with the influence of the other, respective, autonomic division already blocked (r = 0.42, P = 0.114). CONCLUSIONS: Under resting conditions, activity levels of cardiac vagal and sympathetic outflows are not related across young, healthy human subjects and peripheral interaction is not manifest between the autonomic divisions.

Adrenergic Fibers↗

PubMed1994

Cardiac vagal hyperactivity in adolescent anorexia nervosa.

Adolescent anorexia nervosa, a psychiatric disease with high mortality, is often associated with bradycardia. We studied the vagal control of sinus node function in anorexic subjects, to investigate the mechanism of anorexic bradycardia. Cardiac vagal tone was determined in a group of 11 adolescent anorexic girls and in 11 age- and height-matched controls. Cardiac vagal tone in the anorexic patients was measured as the change in R-R interval in response to complete cholinergic blockade; in addition, non-invasive indices of cardiac vagal tone and baroreflex sensitivity were determined in both anorexic and control subjects. Cardiac vagal tone in anorexic subjects was 465 +/- 52 (SE) ms, about 30% higher than values reported for healthy subjects. Vagal tone values were directly related to percent weight loss (R = 0.69, P = 0.017). Non-invasive indices of both cardiac vagal activity and baroreflex sensitivity were significantly higher in the anorexic group as compared to controls; the percent increase of cardiac vagal tone, however, exceeded the increase of baroreflex sensitivity. Cardiac vagal hyperactivity significantly contributes to the bradycardia of anorexic subjects. The excess vagal activity is only partly explained by enhanced baroreflex sensitivity.

Adolescent↗

PubMed1994

Relation between baroreflex sensitivity and cardiac vagal tone in humans.

The extent of dependence of cardiac vagal tone on arterial baroreceptor input has been studied in 12 healthy, young adult subjects. Cardiac vagal tone was defined as the chang in R-R interval after complete cholinergic blockade by atropine. Baroreflex sensitivity was determined with the "Oxford-method": R-R interval was regressed against systolic pressure. The interindividual correlation between cardiac vagal tone and baroreflex sensitivity for falling pressures was found to be significant, but not close (R = 0.81, P = 0.002). In each subject, the baroreflex regression line for falling pressures was extrapolated to the post-atropine R-R interval level; 50 mmHg was considered as minimum and 80 mmHg as maximum threshold level for the integrated baroreflex. From the relation between the individual regression lines and the minimum and maximum threshold levels, it was concluded that cardiac vagal tone could be generated by both baroreflex-dependent and -independent mechanisms, the ratio of which varies in different individuals, with the baroreflex-dependent mechanism being the dominant factor.

Adult↗