Wavelet transform analysis to assess oscillations in pial artery pulsation at the human cardiac frequency.

Pial artery adjustments to changes in blood pressure (BP) may last only seconds in humans. Using a novel method called near-infrared transillumination backscattering sounding (NIR-T/BSS) that allows for the non-invasive measurement of pial artery pulsation (cc-TQ) in humans, we aimed to assess the relationship between spontaneous oscillations in BP and cc-TQ at frequencies between 0.5 Hz and 5 Hz. We hypothesized that analysis of very short data segments would enable the estimation of changes in the cardiac contribution to the BP vs. cc-TQ relationship during very rapid pial artery adjustments to external stimuli. BP and pial artery oscillations during baseline (70s and 10s signals) and the response to maximal breath-hold apnea were studied in eighteen healthy subjects. The cc-TQ was measured using NIR-T/BSS; cerebral blood flow velocity, the pulsatility index and the resistive index were measured using Doppler ultrasound of the left internal carotid artery; heart rate and beat-to-beat systolic and diastolic blood pressure were recorded using a Finometer; end-tidal CO2 was measured using a medical gas analyzer. Wavelet transform analysis was used to assess the relationship between BP and cc-TQ oscillations. The recordings lasting 10s and representing 10 cycles with a frequency of ~1 Hz provided sufficient accuracy with respect to wavelet coherence and wavelet phase coherence values and yielded similar results to those obtained from approximately 70cycles (70s). A slight but significant decrease in wavelet coherence between augmented BP and cc-TQ oscillations was observed by the end of apnea. Wavelet transform analysis can be used to assess the relationship between BP and cc-TQ oscillations at cardiac frequency using signals intervals as short as 10s. Apnea slightly decreases the contribution of cardiac activity to BP and cc-TQ oscillations.

[Evaluation of reproducibility of plethysmographic indices according to body posture, choice of forearm and method of measurement]. / Ocena powtarzalnosci wskazników pletyzmograficznych w zaleznosci od pozycji ciala, wyboru badanej konczyny oraz metody pomiaru.

The aim of the study was the analysis of the influence: a) body position (sitting vs. supine), b) choice of the arm (dominant vs. nondominant), c) variant of the method (classic vs. automatic) on plethysmographic indices describing forearm blood flow repeatability (arterial inflow--AI, fast blood flow--FBF, venous outflow VO, venous capacitance--VC). The study group included subjective healthy men, aged from 22 to 60 years. Individuals with body mass index (BMI) > 35 kg/m2 or treated pharmacologically weren't been included into examination. The indices of the forearm blood flow were calculated from the plethysmographic curve using the graphic technique: venous capacitance (VC), arterial inflow (AI), fast blood flow (FBF) and venous outflow (VO). We used relative repeatability coefficient (RRC) and coefficient of variation (CV) for assessing repeatability of obtained parameters. Repeatability of plethysmographic indices was better in supine position than in sitting one. RRC was respectively for supine vs. sitting position for VO: 0.41 vs. 0.68, for VC: 0.42 vs. 0.52 and for AI: 0.57 vs. 0.65. Plethysmographic indices VO, VC, AI were characterised by better repeatability when the exams were performed on the dominant arm. RRC was respectively for dominant vs. nondominant arm for VO: 0.68 vs. 0.71, for VC: 0.52 vs. 0.64 and for AI: 0.65 vs. 0.71. Coefficient of variation of arterial inflow assessed by conventional, automatic and by fast inflow was respectively 20%, 23% and 17%. The long-term repeatability of FBF estimated by RRC was 0.76 whereas CV yielded 17%. The same coefficient of variation was obtained when short-term repeatability was estimated-mean value CV was 17%, after rejection extremal values 11%. In conclusion the best repeatability was obtained when measurements were performed with automatic variant of method, in supine position, on dominant arm.

[Amyloid heart disease diagnosed with echocardiography]. / Amyloidoza serca rozpoznana echokardiograficznie.

A sixty years old woman with amyloid heart disease has been presented. Postural hypotension was the main symptom in this case. Pneumonia and the developing congestive heart failure was the cause of death. Only the last echocardiographic examination: hypertrophied interventicular septum with a peculiar speckled appearance of myocardium, together with low voltage electrocardiography made possible to confirm this diagnosis. It was shown in this case, how difficult it is to diagnose amyloid heart disease. Low ejection fraction together with diastolic abnormalities is usually a forecast of bad prognosis.

[Polymorphism of the ACE gene and left ventricular morphology and function in patients with borderline, mild and moderate hypertension]. / Polimorfizm genu ACE a morfologia i funkcja lewej komory serca u chorych z nadcisnieniem tetniczym granicznym, lagodnym i umiarkowanym.

It has been reported that the allel D of an insertion/deletion (I/D) polymorphism of the angiotensin I converting enzyme (ACE) gene is associated with the conditions of increased cardiovascular risk, including the left ventricular hypertrophy and the dysfunction. We examined the relation between the genotype of ACE gene and the left ventricular function in normotensives and in borderline, mild and moderate hypertensives. We investigated 128 subjects, 47 first-diagnosed untreated hypertensives and 81 normotensives. The M-mode and Doppler echocardiography were used to quantify LV mass and function. The insertion/deletion ACE polymorphism was identified using polymerase chain reaction. Left ventricular indexes of the morphology and function were analyzed. We compared ambulatory blood pressure profiles between all genotypes in both groups. There were no significant differences in indexes of the left ventricular hypertrophy in studied normotensives and borderline to mild hypertensives. Our results indicate that allel I might be associated with selected parameters of diastolic function, while allel D with selected parameters of systolic function, of the left ventricle. Results of this study suggest also probable relation between allel D and variability of the diastolic arterial pressure in both investigated groups.