Assessment of effects of differences in trunk posture  during Fowler&amp;rsquo;s position on hemodynamics and cardiovascular regulation in older and younger subjects

Kubota, Satoshi; Endo, Yutaka; Kubota, Mitsue; Shigemasa, Tomohiko

doi:10.2147/cia.s132399

Cited by 17 publications

(16 citation statements)

References 30 publications

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“…During the recovery period, the pressor response was greater and more long-lasting in the older participants whereas their logRSA and logBRS were lower as reported previously ( 18 , 27 , 35 ). It has been reported that the pressor response is more significant because of decreased vascular compliance in the aged ( 36 , 37 ).…”

Section: Discussionsupporting

confidence: 82%

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The Pressor Response to the Drinking of Cold Water and Cold Carbonated Water in Healthy Younger and Older Adults

et al. 2022

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Purpose: Water drinking has been proposed for the treatment of orthostatic hypotension because it can increase blood pressure in patients. This study aimed to investigate whether drinking water with a cold or carbonation stimulus would cause a more effective pressor response, and whether it would be greater in older than in younger adults.Methods: We assessed blood pressure and heart rate from non-invasive arterial pressure (a volume-clamp method) and type II electrocardiography in 13 healthy young adults (6 females, 7 males; mean age, 19.9 ± 1.1 years) and nine healthy older adults (all females; mean age, 71.4 ± 4.2 years) who drank 200 mL of cold, cold carbonated, and room temperature water.Results: The pressor response to the drinking of cold and cold carbonated water was greater than that to room temperature water in both younger and older participants (p < 0.05; changes in systolic blood pressure of room temperature water, cold water and cold carbonated water in young: 15.31 ± 9.66, 22.56 ± 11.51 and 32.6 ± 17.98 mmHg, respectively; changes in systolic blood pressure of room temperature water, cold water and cold carbonated water in elderly: 21.84 ± 14.31, 41.53 ± 19.82 and 48.16 ± 16.77 mmHg, respectively). In addition, the pressor response to cold and cold carbonated water was persistent during the recovery period by about 5–10 mmHg (p < 0.05). Furthermore, the pressor response during the drinking and recovery periods was greater in the older than in the younger participants (p < 0.05).Conclusion: Our data suggest that even smaller amounts of water are able to elicit a sustained pressor response, in particular if the water is cold and carbonated. We speculate that the pressor effect may render cold and carbonated water an appropriate first aid method against certain forms of acute hypotension.

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Section: Discussionsupporting

confidence: 82%

“…BRS was calculated using Nevrokard BRS software (Nevrokard, Izola, Slovenia). RSA and BRS were log-transformed in accordance with a previous study (27,28).…”

Section: Data Analysis and Statisticsmentioning

confidence: 99%

The Pressor Response to the Drinking of Cold Water and Cold Carbonated Water in Healthy Younger and Older Adults

et al. 2022

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“…8 However, as shown in the previous studies, a head-up posture was associated with relatively subtle decrease in SV by only 8-14%. [8][9][10] Although the head-up posture can be considered a model of preload reduction, the expected haemodynamic consequences are insufficient to adequately evaluate the preload-reducing effect on the cardiovascular system.…”

Section: Haemodynamic Response To Postural Stressmentioning

confidence: 50%

Easy‐to‐use preload stress echocardiography by using combined dynamic postural stress can identify high‐risk patients with heart failure with reduced ejection fraction

et al. 2021

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Aims Haemodynamic assessment during stress testing is not commonly performed in patients with heart failure with reduced ejection fraction (HFrEF) because of its invasiveness, lower feasibility, and safety concerns. This study aimed to assess the haemodynamic characteristics of patients with HFrEF in response to non-invasive preload stress during dynamic postural alterations achieved by combining both semi-sitting position and passive leg-lifting and to evaluate whether combined postural stress could be used for risk stratification in these patients. Methods and results For this study, 101 patients with HFrEF and 35 age-matched and sex-matched healthy controls were prospectively recruited. After all standard echocardiographic measurements were obtained in the left decubitus position, all subjects underwent postural stress testing, which consisted of changing from semi-sitting position to passive leg-lifting. During a median follow-up period of 12.2 months, 21 (21%) patients developed adverse cardiovascular events. In patients without adverse cardiovascular events, the stroke volume index (SVi) significantly changed from 28 ± 8 to 35 ± 10 mL/m 2 (P < 0.001) during combined postural stress. By contrast, ΔSVi during combined dynamic postural stress was significantly smaller in patients with cardiovascular events than in those without events (ΔSVi 3.4 ± 4.0 vs. 6.4 ± 3.8 mL/m 2 , P = 0.002), which indicated severely diseased heart operated on a relatively flat portion of the Frank-Starling curve. In a multivariate Cox proportional hazard analysis, ΔSVi (hazard ratio 0.81, P = 0.02) was an independent predictor of future adverse cardiovascular events. Conclusions The combined assessment of dynamic postural stress is a non-invasive, simple, quick, and easy-to-use clinical tool for assessing preload reserve and risk stratification in HFrEF patients.

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“…Fowler's position, in which the patient's head is placed at a 45-degree angle to the table, is often used to accommodate patients comfortably (Kubota et al, 2017). This position reduces central uid volume owing to decreased venous return from the periphery, which prevents worsening heart failure (HF) (Gheorghiade et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

T Ransradial Peripheral Vascular Intervention Using Fowler’s Position and Terumo R2P System for Patients With Heart Failure

Nakamura

Sato

Endo

2021

Preprint

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BackgroundPositioning a patient on the catheterization table is important for proper cardiac or respiratory function during peripheral vascular interventions (PVIs). Fowler’s position, where the patient’s head is a 45-degree angle, is more effective in reducing venous blood volume returning to the heart from the periphery compared to the supine position. The Terumo R2P® system has been developed for transradial PVI.Case presentationTwo patients with heart failure (HF) underwent lower-extremity PVI in Fowler’s position to prevent worsening HF. Because their head position was opposite the C-arm of the X-ray machine, the left radial artery was selected as the access site. The Terumo R2P® system was used for transradial PVI. We successfully treated superficial artery diseases with long shaft balloons and rapid-exchange Terumo R2P® Misago® stents. ConclusionsAlthough lower-extremity PVI using Fowler’s position and the Terumo R2P® system has several limitations, including device availability and technical complexity, it may be effective for particular patients who have higher risk of worsening HF in the supine position.

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Assessment of effects of differences in trunk posture during Fowler’s position on hemodynamics and cardiovascular regulation in older and younger subjects

Cited by 17 publications

References 30 publications

The Pressor Response to the Drinking of Cold Water and Cold Carbonated Water in Healthy Younger and Older Adults

The Pressor Response to the Drinking of Cold Water and Cold Carbonated Water in Healthy Younger and Older Adults

Easy‐to‐use preload stress echocardiography by using combined dynamic postural stress can identify high‐risk patients with heart failure with reduced ejection fraction

T Ransradial Peripheral Vascular Intervention Using Fowler’s Position and Terumo R2P System for Patients With Heart Failure

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