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Cardiovascular system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
8.2. The interval between aortic and pulmonary valve closure sounds is increased on inspiration in the normal patient because ofdescent of the diaphragm,prolongation of left ventricular systole.sinus arrhythmia.prolongation of right ventricular systole.a rise in pulmonary artery pressure.
Evaluation of Autonomic Failure
Published in David Robertson, Italo Biaggioni, Disorders of the Autonomic Nervous System, 2019
B) Several techniques have been proposed to analyze sinus arrhythmia. The most routinely used method implies finding the difference between the maximum and minimum heart rate recorded during deep breathing at a rate of six breaths per minute (Ewing et al., 1981). Recording of the R-R variation in the mornings after an overnight fast in a quiet atmosphere has been recommended. Continuous EKG and breathing recording is necessary. Minimal and maximal heart rate are calculated from the shortest and longest R-R interval on the electrocardiographic tracing.
Electrocardiography and arrhythmias
Published in Neil Herring, David J. Paterson, Levick's Introduction to Cardiovascular Physiology, 2018
Neil Herring, David J. Paterson
Sinus arrhythmia is the normal, regular physiological slowing of the heart during expiration and speeding up during inspiration. Sinus arrhythmia is especially marked in children and young adults. The inspiratory tachycardia partially compensates for a fall in left ventricular stroke volume during inspiration. The latter is due to a fall in left ventricle filling as inspiration expands the pulmonary vascular bed.
Pancreatic exocrine insufficiency in diabetes is associated with autonomic dysfunction
Published in Scandinavian Journal of Gastroenterology, 2021
Dag André Sangnes, Elisabeth Sandvik Bergmann, Rose Marie Moss, Trond Engjom, Eirik Søfteland
Fifty-nine patients were included in the study: 32 (54%) women, 31 (53%) type 1 diabetes with a median age of 53 (15) years. Clinical characteristics are given in Table 1. We identified 12 cases with faecal elastase <200 µg/g (five of these were <100 µg/g), giving a 20% point prevalence of PEI. Two cases withdrew from the study prior to autonomic testing, which were performed on 10 cases and 13 controls. Subsequently, two of the cases had to be excluded due to previously unknown cardiac arrhythmias: One due to frequent (>10%) premature ventricular activities, making heart rate variability analysis by our device impossible. The other due to sinus arrhythmia, with heart rate variability values in the extreme outlier range. A detailed inclusion flow chart is presented in Figure 2. Use of medications was comparable in the two groups: three cases and two controls were on anti-platelets and three cases and four controls on statins. Further, one participant in each group used beta-blockers, whereas four cases and four controls were on other antihypertensives.
A randomized, controlled, multicenter clinical trial to evaluate the efficacy and safety of oral sitafloxacin versus moxifloxacin in adult patients with community-acquired pneumonia
Published in Current Medical Research and Opinion, 2021
Ying Li, Demei Zhu, Yiqiang Peng, Zhaohui Tong, Zhuang Ma, Jinfu Xu, Shenghua Sun, Huaping Tang, Qingyu Xiu, Yongjie Liang, Xiongbiao Wang, Xiaoju Lv, Yuanrong Dai, Yingqun Zhu, Yuejin Qu, Kaifeng Xu, Yijiang Huang, Shiman Wu, Guoxiang Lai, Xi Li, Xiaowen Han, Zegang Yang, Jifang Sheng, Zhuola Liu, Hui Li, Yiqiang Chen, Huili Zhu, Yingyuan Zhang
Drug-related AEs in this study included clinical AEs, laboratory abnormalities and abnormal ECG findings. In the sitafloxacin 100 mg qd group, the incidence of drug-related clinical AEs was 16.4% (19/116); the most frequently reported one was dizziness (4.3%). The incidence of drug-related laboratory abnormalities was 8.6% (10/116), mainly increased platelet count (2.6%). Drug-related abnormal ECG finding (sinus arrhythmia) was found in 2 patients. In the sitafloxacin 100 mg bid group, the incidence of drug-related clinical AEs was 20.2% (23/114), mainly nausea and diarrhea (both 3.5%). The incidence of drug-related laboratory abnormalities was 12.3% (14/114), mainly ALT elevation (7.0%), followed by AST elevation and γ-glutamyltransferase increase (both 2.6%). Drug-related abnormal ECG findings were found in 2 patients (sinus bradycardia, supraventricular extrasystole). In the moxifloxacin group, the incidence of drug-related clinical AEs was 20.9% (23/110), mainly nausea (8.2%), dizziness (5.5%), fatigue (4.5%) and vomiting (3.6%). The incidence of drug-related laboratory abnormalities was 8.2% (9/110), mainly AST elevation (3.6%) and ALT elevation (2.7%). Drug-related abnormal ECG findings (sinus bradycardia) were found in 3 patients (Table 6).
Heart rate as cardiovascular risk factor
Published in Postgraduate Medicine, 2020
The heart rate is modulated by branches of the autonomic system that through informations obtained by peripheral receptors activate responses to maintain cardiovascular homeostasis and to adapt the cardiovascular system to the needs of daily life activities. The most important system is that of arterial baroreceptors. The baroreceptors activation induced by increase in blood pressure induces a sympathetic inhibition and an increase in vagal activity with consequent reduction in heart rate, vasodilation, and contractility reduction. On the contrary, the baroreceptor deactivation induces a sympathetic activation and a vagal inhibition [6]. The cardiorespiratory interaction, through different receptors located in the lungs and atria, is also able to induce changes in heart rate related with respiratory activity [7]. The central factors, however, appear to be more important and the respiratory sinus arrhythmia mainly reflects changes in vagal efferent activity [8]. As regards to the neuroendocrine systems that are activated through the increased sympathetic tone is necessary to mention the renin-angiotensin-aldosterone system, inflammation, endothelial dysfunction, and oxidative stress [6,9]