<div><b>Background:</b> Bradycardia and hypotension are complications commonly occurring during general anesthesia in small animals. Intraoperative hypotension has been found to be associated with adverse postoperative consequences. </div><div><br></div><div><b>Objectives: </b>The objectives of his study were first, to determine the incidence of bradycardia, hypotension, and bradycardia with hypotension in dogs undergoing general anesthesia, and second, to identify the risk factors associated with these three complications. The third objective was to evaluate the relationship between these three intraoperative complications and the recovery quality in these dogs.</div><div><br></div><div><b>Methods and Materials:</b> A retrospective cohort study was performed using anesthetic records from 250 dogs undergoing general anesthesia between May 23, 2018 and October 1, 2018 at the Purdue University Veterinary Teaching Hospital. Intraoperative bradycardia was defined as heart rate < 60 beats/min for at least two consecutive readings at 5 minutes apart. Hypotension was defined as mean arterial pressure (MAP) < 60 mmHg or a systolic arterial pressure (SAP) < 80 mmHg for at least two consecutive readings. A univariate analysis followed by multiple logistic regression was performed to build the model for bradycardia, hypotension, and bradycardia with hypotension. The relationships between the three complications and the recovery quality were analyzed using the Pearson’s chi-square test.</div><div><br></div><div><b>Results:</b> The study found that out of the 250 dogs, 114 (45.6%) developed bradycardia, 113 (45.2%) developed hypotension, and 32 (12.8%) dogs developed bradycardia with hypotension. The use of dexmedetomidine-based tranquilizers/sedatives, longer duration of anesthesia, and subjection to orthopedic and neurologic surgical procedures were all identified as risk factors for the dogs to develop bradycardia. The use of acepromazine-based tranquilizers/sedatives, young and old age dogs, and dogs subjected to neurologic surgery were associated with the development of intraoperative hypotension. When the length of the anesthesia increased, the chance for developing bradycardia with hypotension increased. There was no significant association between these intraoperative complications and the recovery quality.</div><div><b><br></b></div><div><b>Conclusions:</b> We found a high incidence of bradycardia or hypotension while a much lower incidence of bradycardia with hypotension in the anesthetized dogs. The risk factors for bradycardia were the use of dexmedetomidine-based tranquilizers/sedatives, the longer duration of anesthesia, and the performance of orthopedic surgery and neurosurgery. The risk factors for hypotension included the use of acepromazine-based tranquilizers/sedatives, the older or younger age of dogs, and the performance of neurosurgery. The risk factor for bradycardia with hypotension was the longer duration of anesthesia. While these adverse events developed intraoperatively, we could not identify a direct influence of these complications on the recovery quality. </div><div><br></div>

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Florida, 1984. / Description based on print version record. Typescript. Vita. Includes bibliographical references (leaves 125-142).

No description available.

Bradyarrhythmias are common clinical findings consisting of physiologic and pathologic conditions (sinus node dysfunction and atrioventricular [AV] conduction disturbances). Bradyarrhythmias can be benign, requiring no treatment; however, acute unstable bradycardia can lead to cardiac arrest. In patients with confirmed or suspected bradycardia, a thorough history and physical examination should include possible causes of sinoatrial node dysfunction or AV block. Management of bradycardia is based on the severity of symptoms, the underlying causes, presence of potentially reversible causes, presence of adverse signs, and risk of progression to asystole. Pharmacologic therapy and/or pacing are used to manage unstable or symptomatic bradyarrhythmias.

Made available in DSpace on 2015-05-14T12:59:58Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 4258055 bytes, checksum: ee74f99507084e08e3e09b960fa1630d (MD5) Previous issue date: 2014-03-04 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Previous studies have show that the organic nitrate tetrahydrofurfuryl (NTHF) induces vasorelaxation in mesenteric artery rings with involvement of the NO-sGC-PKG pathway. This study evaluated the action of NTHF on cardiovascular parameters in spontaneously hypertensive (SHR) and Wistar Kyoto (WKY) rats, investigating: the nitric oxide (NO) release, acute toxicity, the NTHF effect on blood pressure and heart rate, its vasorelaxant effect and its ability to induce tolerance. NTHF increased NO levels in rat aortic smooth muscle cells (SMC) and cardiomyocites. In acute toxicity studies, a high single dose from NTHF showed low toxicity. In normotensive animals, NTHF induced hypotension after oral administration of NTHF, and bradycardic and hypotensive effects following administration of this nitrate. These results were similar that found using nitroglycerine (NTG). In addition, these effects were not altered by pretreatment with hexamethonium, a ganglionic blocker. However the treatment with methylene blue, a sGC inhibitor, promoted attenuation of both hypotensive and bradycardic effects, suggesting the involvement of the sGC pathway in these effects. In mesenteric artery rings from SHR and WKY rats precontracted with phenylephrine, NTHF induced concentration dependent vasodilatation in both intact and removed endothelium. This result suggests that the vasorelaxant effect is an endothelium derived relaxation factors (EDRFs) independent mechanism. Furthermore, in the presence of NO° scavenging (PTIO) or ODQ, a sGC inhibitor, the vasorelaxation induced by NTHF was decreased, indicating the involvement of NO-sGC pathway in this response in both SHR and WKY. In the presence of cyanamide, an aldehyde dehydrogenase (mtALDH) inhibitor, the vasorelaxant effect was diminished, suggesting that NTHF is metabolized by this enzyme. After exposure to depolarizing agent KCl, the nitrate effect was significantly attenuated, a characteristic of substances which acts by K+ channels activation. This effect was confirmed after using tetraetylamonium (TEA), a K+ channels inhibitor. In normotensive rats treated with NTHF, the acute administration of NTHF promoted bradycardia and hypotension were are not changed in relation to which those observed in vehicle-treated animals, suggesting that organic nitrate did not induce in vivo tolerance. In vitro tolerance was evaluated in both mesenteric artery rings from animals pretreated with NTHF as well as rings previously exposed to isolated concentrations of NTHF. The vasorelaxant effect was not modified by pretreatment or exposure to NTHF, unlike that observed with NTG. In rings treated with NTG, the effect induced by NTHF was not modified, indicating that NTHF did not promote in vitro tolerance. The results demonstrated that NTHF promoted hypotensive and bradycardic effects in both SHR and WKY rats, with involvement of sGC enzyme; NTHF induced a vasorelaxant effect with participation of NO-sGC-PKG pathway and K+ channels. These effects seem to be mediated by NO release from cardiomyocites and SMC. Finally this study will help to advance the field towards clinical trials, since NTHF caused low toxicity and this nitrate was devoid of in vivo and in vitro tolerance. / Estudos anteriores demonstraram que o nitrato orgânico tetra-hidrofurfurílico (NTHF), promoveu efeito vasorrelaxante em artéria mesentérica de ratos normotensos, com envolvimento da via NO-sGC-PKG. O objetivo deste trabalho foi avaliar os efeitos cardiovasculares induzidos pelo NTHF em ratos espontaneamente hipertensos (SHR) e normotensos Wistar Kyoto (WKY), investigando: a liberação de óxido nítrico (NO), a toxicidade aguda, o efeito do NTHF sobre pressão arterial (PA) e frequência cardíaca (FC), o efeito vasodilatador desse composto, além de sua capacidade em induzir tolerância. Em células musculares lisas vasculares (CMLV) de aorta de rato e cardiomiócitos, NTHF promoveu aumento dos níveis de NO. Na avaliação da toxicidade aguda, NTHF foi administrado por via oral numa dose elevada, e nestas condições o nitrato orgânico apresentou baixa toxicidade. Em animais normotensos, NTHF promoveu hipotensão quando administrado por via oral e efeito hipotensor e bradicárdico após a administração intravenosa, semelhante ao observado pelo gliceril trinitrato (GTN). Este efeito não foi alterado pelo prétratamento com hexametônio, um bloqueador nicotínico ganglionar. Porém, o tratamento com azul de metileno, inibidor da enzima ciclase de guanilil solúvel (sGC), promoveu diminuição da resposta, indicando a participação da sGC nos efeitos hipotensor e bradicárdico. Em animais WKY e SHR NTHF promoveu efeito hipotensor e bradicárdico. Em anéis de artéria mesentérica de ratos SHR e WKY, pré-contraídos com fenilefrina, NTHF promoveu vasodilatação concentraçãodependente, com endotélio vascular intacto ou removido, sugerindo um efeito independente da liberação dos fatores relaxantes derivados do endotélio (EDRFs). Na presença do sequestrador de NO radicalar (PTIO) ou do inibidor seletivo da sGC (ODQ), o efeito vasorrelaxante do NTHF foi atenuado, indicando a participação da via NO-sGC tanto em SHR quanto WKY. Na presença de cianamida, um inibidor da enzima aldeído desidrogenase mitocondrial (mtALDH), o efeito vasorrelaxante foi atenuado, indicando que o nitrato é metabolizado por esta enzima. Após a exposição ao agente despolarizante KCl e após adição de tetraetilamônio (TEA), inibidor de canais para K+, o efeito do NTHF foi diminuído. Em animais normotensos prétratados com NTHF, a administração aguda de NTHF hipotensão e bradicardia, comparáveis às observadas no grupo controle, sugerindo que o NTHF não induz tolerância in vivo. A tolerância in vitro foi avaliada em artéria mesentérica de animais tratados previamente com NTHF, quando previamente expostos a concentrações isoladas do nitrato. O efeito vasorrelaxante não foi modificado pelo tratamento ou exposição prévia ao NTHF. Efeito contrário ao obtido com GTN. Em anéis prétratados com GTN, o efeito induzido pelo NTHF não foi modificado, sugerindo que o nitrato em estudo não promove tolerância in vitro. Os resultados demonstram que o NTHF promoveu efeito hipotensor e bradicárdico em animais normotensos e hipertensos, com envolvimento da enzima sGC; apresentou efeito vasorrelaxante, com participação da via NO-sGC-PKG e também de canais para K+. Esses efeitos parecem ser mediados por meio da liberação de NO tanto em CMLV quanto em cardiomiócitos. Por fim, NTHF evidencia um potencial clínico por apresentar baixa toxicidade e não induzir tolerância in vivo e in vitro

abstract: Infants born before 37 weeks of pregnancy are considered to be preterm. Typically, preterm infants have to be strictly monitored since they are highly susceptible to health problems like hypoxemia (low blood oxygen level), apnea, respiratory issues, cardiac problems, neurological problems as well as an increased chance of long-term health issues such as cerebral palsy, asthma and sudden infant death syndrome. One of the leading health complications in preterm infants is bradycardia - which is defined as the slower than expected heart rate, generally beating lower than 60 beats per minute. Bradycardia is often accompanied by low oxygen levels and can cause additional long term health problems in the premature infant.The implementation of a non-parametric method to predict the onset of brady- cardia is presented. This method assumes no prior knowledge of the data and uses kernel density estimation to predict the future onset of bradycardia events. The data is preprocessed, and then analyzed to detect the peaks in the ECG signals, following which different kernels are implemented to estimate the shared underlying distribu- tion of the data. The performance of the algorithm is evaluated using various metrics and the computational challenges and methods to overcome them are also discussed. It is observed that the performance of the algorithm with regards to the kernels used are consistent with the theoretical performance of the kernel as presented in a previous work. The theoretical approach has also been automated in this work and the various implementation challenges have been addressed. / Dissertation/Thesis / Masters Thesis Electrical Engineering 2020

Symptomatic sinus bradycardia, due to either sick sinus syndrome or vagotonia, can be familial, affecting several members of a family. We report an 18-year-old male patient with palpitations and limited exercise capacity who was noted to have severe sinus bradycardia. His resting heart rate was 40/min, with normal PR and corrected QT intervals, and sinus pauses up to 6 seconds during sleep. Exercise treadmill test and pharmacologic autonomic blockade during electrophysiologic studies abolished the bradycardia, suggestive of vagotonia rather than intrinsic sinus node dysfunction. This patient's father and a female cousin had a similar clinical history but associated with syncope and severe sinus bradycardia. The mode of transmission appeared to be autosomal dominant. All three have permanent demand pacemakers implanted and are asymptomatic.

Substance P (SP) evokes bradycardia that is mediated by cholinergic neurons in experiments with isolated guinea pig hearts. This project investigates the negative chronotropic action of SP in vivo. Guinea pigs were anesthetized with urethane, vagotomized and artificially respired. Using this model, IV injection of SP (32 nmol/kg/50 μl saline) caused a brief decrease in heart rate (-30 ± 3 beats/min from a baseline of 256 ± 4 beats/min, n = 27) and a long-lasting decrease in blood pressure (-28 ± 2 mmHg from baseline of 51 ± 5 mmHg, n = 27). The negative chronotropic response to SP was attenuated by muscarinic receptor blockade with atropine (-29 ± 9 beats/min before vs -8 ± 2 beats/min after treatment, P = 0.0204, n = 5) and augmented by inhibition of cholinesterases with physostigmine (-23 ± 6 beats/min before versus -74 ± 20 beats/min after treatment, P = 0.0250, n = 5). Ganglion blockade with chlorisondamine did not diminish the negative chronotropic response to SP. In another series of experiments, animals were anesthetized with sodium pentobarbital or urethane and studied with or without vagotomy. Neither anesthetic nor vagotomy had a significant effect on the negative chronotropic response to SP (F3,24 = 1.97, P = 0.2198). Comparison of responses to 640 nmol/kg nitroprusside and 32 nmol/kg SP demonstrated that the bradycardic effect of SP occurs independent of vasodilation. These results suggest that SP can evoke bradycardia in vivo through stimulation of postganglionic cholinergic neurons. Copyright (C) 1999 Elsevier Science Inc.

Aims: Previous work provided indirect evidence that the neurotrophic factor neurturin (NRTN) is required for normal cholinergic innervation of the heart. This study used nrtn knockout (KO) and wild-type (WT) mice to determine the effect of nrtn deletion on cardiac cholinergic innervation and function in the adult heart. Methods and results: Immunohistochemistry, confocal microscopy, and quantitative image analysis were used to directly evaluate intrinsic cardiac neuronal development. Atrial acetylcholine (ACh) levels were determined as an indirect index of cholinergic innervation. Cholinergic function was evaluated by measuring negative chronotropic responses to right vagal nerve stimulation in anaesthetized mice and responses of isolated atria to muscarinic agonists. KO hearts contained only 35% the normal number of cholinergic neurons, and the residual cholinergic neurons were 15% smaller than in WT. Cholinergic nerve density at the sinoatrial node was reduced by 87% in KOs, but noradrenergic nerve density was unaffected. Atrial ACh levels were substantially lower in KO mice (0.013 ± 0.004 vs. 0.050 ± 0.011 pmol/μg protein; P < 0.02) as expected from cholinergic neuron and nerve fibre deficits. Maximum bradycardia evoked by vagal stimulation was reduced in KO mice (38 ± 6% vs. 69 ± 3% decrease at 20 Hz; P < 0.001), and chronotropic responses took longer to develop and fade. In contrast to these deficits, isolated atria from KO mice had normal post-junctional sensitivity to carbachol and bethanechol. Conclusion: These findings demonstrate that NRTN is essential for normal cardiac cholinergic innervation and cholinergic control of heart rate. The presence of residual cardiac cholinergic neurons and vagal bradycardia in KO mice suggests that additional neurotrophic factors may influence this system.