Electrocardiography ; Humans ; Hypertension ; diagnosis ; physiopathology ; Hypertrophy, Left Ventricular ; diagnosis ; physiopathology

BACKGROUNDIdiopathic pulmonary fibrosis (IPF) is a lethal chronic interstitial lung disease (ILD) of unknown cause and having a variable and unpredictable course. This study aimed to summarize the clinical features and follow-up outcomes and to identify potential factors useful for the assessment of prognosis in IPF.

METHODSTwo hundred and ten patients hospitalized and diagnosed as IPF in our unit from January 1999 to June 2007 were enrolled into this study. The baseline demographic, clinical, radiologic and physiologic characteristics were summarized. Clinical follow-up data until February 2010 were collected, and the median survival time and 1-, 2-, and 5-year survival rates, as well as the influences of the summarized baseline variables on the prognosis were analyzed.

RESULTSThe age at diagnosis as IPF was (64 ± 10) years, the duration before diagnosis of 106 patients (50%) was shorter than 2 years, and 73% were males. One hundred and forty-five patients (69%) had a history of smoking with a median pack-year of 18. Eighty-nine patients (42%) had emphysema and 62 patients (29%) pulmonary arterial hypertension (PAH). One hundred and twenty-four patients were followed up, of which 99 patients died from various causes including respiratory failure related to IPF (93%). The follow-up period was (21 ± 23) months. The median survival time was 38 months. The 1-, 2-, and 5-year survival rates were 61%, 52%, and 39%, respectively. Multivariate analysis showed clubbing, PAH, duration from initial onset to diagnosis, and forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) were independent prognostic indicators of IPF.

CONCLUSIONIPF patients who have clubbing, PAH, a higher FEV1/FVC, and a short duration from initial onset to diagnosis have a poorer outcome.

Aged ; Emphysema ; diagnosis ; mortality ; physiopathology ; Female ; Humans ; Hypertension, Pulmonary ; diagnosis ; pathology ; physiopathology ; Idiopathic Pulmonary Fibrosis ; diagnosis ; mortality ; physiopathology ; Male ; Middle Aged

BACKGROUNDFibrosing mediastinitis (FM) is a rare disease. FM is thought to be related to prior granulomatous mediastinal infection, such as histoplasmosis or tuberculosis. The majority of cases have been reported in endemic regions for histoplasmosis. The characteristics of cases of FM in China, where the prevalence of tuberculosis is high, have not been reported. We analyzed the clinical, imaging, and bronchoscopic features of Chinese patients with FM to promote awareness of this disease.

METHODSBetween January 2005 and June 2015, twenty patients were diagnosed with FM in our hospital. Medical records and follow-up data were collected. Imaging and biopsy findings were reviewed by radiologists and pathologists.

RESULTSA total of 20 patients were analyzed (8 males and 12 females). The age ranged from 43 to 88 years with a mean age of 69.5 years. Previous or latent tuberculosis was found in 12 cases. Clinical symptoms included dyspnea (18/20), cough (17/20), expectoration (7/20), and recurrent pneumonia (3/20). Chest computed tomography scans showed a diffuse, homogeneous, soft tissue process throughout the mediastinum and hila with compression of bronchial and pulmonary vessels. Calcification was common (15/20). Pulmonary hypertension was present in 9 of 20 cases. Diffuse black pigmentation in the bronchial mucosa was frequently seen on bronchoscopy (12/13). The patients' response to antituberculosis treatment was inconsistent.

CONCLUSIONSFM in Chinese patients is most likely associated with tuberculosis. Some characteristics of FM are different from cases caused by histoplasmosis.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; China ; Female ; Histoplasmosis ; complications ; diagnosis ; Humans ; Hypertension, Pulmonary ; diagnosis ; physiopathology ; Male ; Mediastinitis ; diagnosis ; etiology ; physiopathology ; Middle Aged ; Sclerosis ; diagnosis ; etiology ; physiopathology ; Tuberculosis ; diagnosis ; physiopathology

This article is to overview the literature of syndrome differentiation of traditional Chinese medicine on hypertension. According to the theory of disease in combination with syndrome, we concluded syndrome types of hypertension in four aspects, including national standards, industry standards, teaching standards and personal experience. Meanwhile, in order to provide new methods and approaches for normalized research, we integrated modern testing methods and statistical methods to analyze syndrome differentiation for the treatment of hypertension.
Humans ; Hypertension ; classification ; diagnosis ; epidemiology ; physiopathology ; therapy ; Medicine, Chinese Traditional ; methods ; standards ; Reference Standards

OBJECTIVETo evaluate transient deceleration wave intensity (W2) of carotid artery on left ventricular diastolic function.

METHODS40 patients with hypertension and 43 healthy volunteers were enrolled and W2 of carotid artery of the both sides were measured. The parameters of left ventricular diastolic function by traditional and tissue Doppler imaging and NT-proBNP (N-terminal probrain natriuretic peptide) were measured.

RESULTS(1) W2 is not different between two sides of carotid artery. W2 in hypertension was lower than the control, especially in left side(1126 +/- 996 mmHg x m/s3 vs 1690 +/- 1126 mmHg x m/s3, P < 0.01). (2) The correlation of W2 and else parameters were analyzed. There were notably decreasing in left ventricular diastolic function of the hypertensive group than the control, for example, the ratio of peak velocity of early filling of mitral flow to peak early diastolic motion velocity of mitral annulus (E/Em, 9.37 +/- 3.32 vs 7.39 +/- 1.83, P < 0.01) and NT-proBNP (94.6 +/- 48.5 vs 45.2 +/- 13.8, P < 0.01). (3) The correlation analysis showed negative relation between W2 and E/Em (r = - 0.46, P < 0.05) and negative relation between W2 and NT-proBNP (r = -0.21, P < 0.05).

CONCLUSIONNew carotid W2 by non-invasive technology for hemodynamics is a deserving parameter in early evaluating left ventricular diastolic function.

Adult ; Carotid Artery, Common ; physiopathology ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Ventricular Dysfunction, Left ; diagnosis ; physiopathology ; Ventricular Function, Left

Hypertension is a significant medical and public health issue which puts an enormous burden on health care resources and the community. It is a chronic medical condition in which the systemic arterial blood pressure (BP) is elevated. Serious complications including cardiovascular and cerebrovascular diseases would be preventable if the rise in BP with age could be prevented or diminished. The majority of hypertensive patients require long-term treatment. Oral antihypertensive drugs, lifestyle modification including exercise and dietary modification are milestones for hypertension therapy. However, the control rate of hypertension hasn't reached the expected requirements currently. "Three lows" status quo, just low awareness, low treatment, and low control, are still the major problems confronting modern medicine. Recently, uncontrolled factors of blood pressure are widely concerned, which include insomnia, constipation, mood disorders, exogenous, etc. What's more, the control strategies of hypertension should not only pay close attention to "patient's high blood pressure", but also to "hypertensive patient". Therefore, the treatment of uncontrolled factors of blood pressure plays an important role in hypertensive therapy, which could be further research priorities.
Aged ; Antihypertensive Agents ; therapeutic use ; Blood Pressure ; drug effects ; Diagnosis, Differential ; Essential Hypertension ; Female ; Humans ; Hypertension ; diagnosis ; drug therapy ; physiopathology ; Male ; Middle Aged

The signal of flash visual evoked potential (FVEP) is very weak, and often submerges into strong noise environment, like spontaneous electroencephalogram (EEG) signal, so effective de-noising methods should be taken to extract FVEP waveform exactly. In this paper, based upon the frequency feature of FVEP, we use average technology and multi-resolution wavelet transform to filter spontaneous EEG signals, and FVEP can be extracted effectively as a result. While the potential latency corresponding to the N2 wave in the FVEP waveform picked-up is related to intracranial pressure (ICP), the Non-invasive detection of ICP can be realized.
Electroencephalography ; Evoked Potentials, Visual ; physiology ; Humans ; Intracranial Hypertension ; diagnosis ; physiopathology ; Monitoring, Physiologic ; instrumentation ; methods ; Signal Processing, Computer-Assisted ; Wavelet Analysis

BACKGROUNDImpaired coronary flow reserve (CFR) in patients with hypertension may be caused by epicardial coronary stenosis or microvascular dysfunction. Antihypertensive treatment has been shown to improve coronary microvascular dysfunction. The aim of this study was to evaluate the impact of uncontrolled blood pressure (BP) on diagnostic accuracy of CFR for detecting significant coronary stenosis.

METHODSA total of 98 hypertensive patients scheduled for coronary angiography (CAG) due to chest pain were studied. Of them, 45 patients had uncontrolled BP (defined as the office BP ≥ 140/90 mmHg (1 mmHg = 0.133 kPa) in general hypertensive patients, or ≥ 130/80 mmHg in hypertensive individuals with diabetes mellitus), and the remaining 53 patients had well-controlled BP. CFR was measured in the left anterior descending coronary artery (LAD) during adenosine triphosphate-induced hyperemia by non-invasive transthoracic Doppler echocardiography (TTDE) within 48 hours prior to CAG. Significant LAD stenosis was defined as > 70% luminal narrowing. Diagnostic accuracy of CFR for detecting significant coronary stenosis was analyzed with a receiver operating characteristic analysis.

RESULTSCFR was significantly lower in patients with uncontrolled BP than in those with well-controlled BP (2.1 ± 0.6 vs. 2.6 ± 0.9, P < 0.01). Multivariate linear regression analysis of the study showed that the value of CFR was independently associated with the angiographically determined degree of LAD stenosis (β = -0.445, P < 0.0001) and the presence of uncontrolled BP (β = -0.272, P = 0.014). With a receiver operating characteristic analysis, CFR < 2.2 was the optimal cut-off value for detecting LAD stenosis in all hypertensive patients (AUC 0.83, 95%CI 0.75 - 0.91) with a sensitivity of 75%, a specificity of 78%, and an accuracy of 77%. A significant reduction of diagnostic specificity was observed in patients with uncontrolled BP compared with those with well-controlled BP (67% vs. 93%, P = 0.031).

CONCLUSIONSCFR measurement by TTDE is valuable in the diagnosis of significant coronary stenosis in hypertensive patients. However, the diagnostic specificity is reduced in patients with uncontrolled BP.

Aged ; Blood Pressure ; physiology ; Coronary Circulation ; physiology ; Coronary Stenosis ; diagnosis ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged

Although the detection of intracranial pressure (ICP) is an important precondition for diagnosing intracranial diseases, yet the detection method prevalently used in clinical practice is still invasive. This study is aimed at finding a non-invasive method for effective detection of the variation of patient's ICP so as to release the patient from bodily pain and to provide the doctor with evidences for giving medicine. Based on analyzing and comparing several existing non-invasive ICP detection methods, we have found the linear relationship of flash visual evoked potential (FVEP) with intracranial medium and high pressure by using the statistics obtained from a number of clinical experiments. The FVEP can be picked up effectively by independent component analysis, while the potential latency corresponding to the wave crest of III wave in the VEP waveform picked-up is linearly related to intracranial pressure, thus obtaining ICP from the III wave of FVEP is possible.
Evoked Potentials, Visual ; physiology ; Humans ; Intracranial Hypertension ; diagnosis ; physiopathology ; Intracranial Pressure ; physiology ; Monitoring, Physiologic ; methods ; Signal Processing, Computer-Assisted

Tei-Index is a useful echocardiographic parameter for evaluating global cardiac function. Conventionally, a value and b value, which the calculation of Tei index is based on, are measured in different cardiac cycle. Therefore, accuracy of Tei index is damaged by cycle dependent variation, especially in patients with arrhythmia. The newly established Dual Doppler modality allows a synchronous measurement of both a value and b value. This study was aimed to explore the value of Tei index measured by Dual Doppler in cardiac function estimation in patients with hypertension. One hundred and forty patients with hypertension were recuited and divided into three groups according to cardiac function. The a value and b value were generated from the transmitral and transaortic flow spectrum of the same cardiac cyle by Dual Doppler modality. The results showed that Tei index was significantly higher in the cardiac dysfunction group than in the control group. There was a high correlation between Tei index and NYHA cardiac performance. Tei index measured by Dual Doppler modality is a highly reproducible parameter with high sensitivity and specificity for cardiac function estimation, even for patients with arrthymia.
Adult ; Aged ; Echocardiography, Doppler, Color ; Female ; Humans ; Hypertension ; complications ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnosis ; etiology ; physiopathology ; Ventricular Function ; Young Adult