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Rodríguez-Chagolla J, Cartas-Rosado R, Lerma C, Infante-Vázquez O, Martínez-Memije R, Becerra-Luna B, Pérez-Grovas H. Low-Intensity Intradialytic Exercise Attenuates the Relative Blood Volume Drop Due to Intravascular Volume Loss during Hemodiafiltration. Blood Purif 2021; 50:180-187. [PMID: 33454709 DOI: 10.1159/000509273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 06/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patients in hemodiafiltration (HDF) eliminate volume overload by ultrafiltration. Vascular volume loss is among the main mechanisms contributing to adverse events such as intradialytic hypotension. Here, we hypothesize that the intradialytic exercise (IDEX) is an intervention that could improve the acute response of physiological mechanisms involved during vascular volume loss. To test this hypothesis, we evaluated the hemodynamic response to mild aerobic exercise during HDF. METHODS Nineteen end-stage renal disease (ESRD) patients (11 women: 40 ± 10.8 years old, and 8 men: 42 ± 21 years old) receiving HDF thrice a week, with 6 months of previous physical conditioning, participated in this study. Three HDF sessions were scheduled for each patient: 1 resting in supine position, 1 resting in sitting position, and 1 doing aerobic exercise. The first 2 sessions were taken as control. The ultrafiltration rate was set to 800 mL/h in each session. The hemodynamic response was monitored through the relative blood volume (RBV), and cardiovascular variables measured noninvasively by photoplethysmography. Adequacy variables such as Kt/V and percentage reduction of urate, urea, creatinine (Cr), and phosphate were also monitored. FINDINGS The decrease rate of the RBV was smaller in the session with IDEX compared to the sessions with no exercise. No differences were found neither in the cardiovascular variables nor in the adequacy variables among the 3 sessions. There were no hypotension events during the session with exercise, and 8 events during the sessions without exercise (p = 0.002). DISCUSSION Mild exercise during HDF decreased the RBV drop and was associated with less hypotension events. The lack of differences in the hemodynamic variables suggests an adequate acute response of cardiovascular compensation variables to intradialytic hypovolemia.
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Affiliation(s)
- José Rodríguez-Chagolla
- Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.,Department of Nephrology, Centro Médico ISSEMYM Arturo Montiel Rojas, Toluca City, Mexico
| | - Raúl Cartas-Rosado
- Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico,
| | - Claudia Lerma
- Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Oscar Infante-Vázquez
- Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Raúl Martínez-Memije
- Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Brayans Becerra-Luna
- Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Hector Pérez-Grovas
- Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
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Ponce-Martínez X, Colin-Ramirez E, Sánchez-Puerto P, Rivera-Mancía S, Cartas-Rosado R, Infante-Vázquez O, Vallejo-Allende M, Vargas-Barrón J. Bread Consumption Is Associated with Elevated Blood Pressure among Adults Living in Mexico City⁻A Sub-Analysis of the Tlalpan 2020 Study. Nutrients 2018; 10:nu10121969. [PMID: 30551575 PMCID: PMC6316157 DOI: 10.3390/nu10121969] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/03/2018] [Accepted: 12/11/2018] [Indexed: 01/19/2023] Open
Abstract
Excessive dietary sodium is associated with elevated blood pressure (EBP). Bread products are identified as one of the main sources of daily sodium intake. The objective of this cross-sectional study was to evaluate the association between bread and others cereal products consumption with EBP. Frequency intake of a standard serving of bread and other cereal products was recorded and categorized as: ≤3 times/month or never (reference category group) and ≥ once/week. EBP was defined as systolic blood pressure (SBP) ≥120 mmHg and/or diastolic blood pressure (DBP) ≥80 mmHg. Raw and adjusted odds ratios (OR) for the association between consumption of the studied food products and blood pressure status were estimated. Overall, 2011 participants aged 37.3 ± 9.1 years old were included. In the models adjusted for relevant covariates, consumption of one piece of bolillo or telera (OR = 1.39; 95% CI = 1.01–1.89) ≥ once/week was associated with an increased risk of EBP, compared to the reference category. Also, participants consuming one bowl of high-fiber breakfast cereal once/week were less likely to have EBP (OR = 0.73; 95% CI = 0.53–0.98). Initiatives to reduce sodium levels in bread products such as bolillo and telera are needed in Mexico to help manage the cardiovascular risk at the population level.
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Affiliation(s)
- Xochitl Ponce-Martínez
- Sociomedical Research Department, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
| | - Eloisa Colin-Ramirez
- Sociomedical Research Department, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
- Cátedras CONACYT, National Council of Science and Technology, Mexico City 03940, Mexico.
| | - Paulina Sánchez-Puerto
- Sociomedical Research Department, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
| | - Susana Rivera-Mancía
- Sociomedical Research Department, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
- Cátedras CONACYT, National Council of Science and Technology, Mexico City 03940, Mexico.
| | - Raúl Cartas-Rosado
- Electromechanical Instrumentation Department, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
| | - Oscar Infante-Vázquez
- Electromechanical Instrumentation Department, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
| | - Maite Vallejo-Allende
- Sociomedical Research Department, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
| | - Jesús Vargas-Barrón
- Division of Research, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
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Colín-Ramírez E, Rivera-Mancía S, Infante-Vázquez O, Cartas-Rosado R, Vargas-Barrón J, Madero M, Vallejo M. Protocol for a prospective longitudinal study of risk factors for hypertension incidence in a Mexico City population: the Tlalpan 2020 cohort. BMJ Open 2017; 7:e016773. [PMID: 28760800 PMCID: PMC5642768 DOI: 10.1136/bmjopen-2017-016773] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Systemic hypertension (HTN) is a common risk factor for cardiovascular disease. In Mexico, HTN prevalence has increased over time and is currently 31%. Nonetheless, information about the country's HTN incidence and its associated risk factors is scarce. Understanding this condition is a priority for identifying the scope of primary prevention. The main objective of this study is to evaluate the effect of traditional and non-traditional risk factors on the incidence of HTN in a cohort of healthy Mexico City residents under biannual follow-up for 10 years. METHODS AND ANALYSIS A prospective longitudinal study is proposed in which clinically healthy residents of Mexico City between 20 and 50 years old will be recruited; the participants will be evaluated every 2 years over a period of 10 years or until they develop HTN. Evaluations regarding sociodemographic, clinical, anthropometric, biochemical, diet, physical activity, stress, sleep quality, alcohol and tobacco consumption factors will be performed. The participants will be recruited from the 16 municipalities of Mexico City through promotional strategies aimed at the community and will be clinically evaluated at a tertiary care institution, Instituto Nacional de Cardiología Ignacio Chávez (National Institute of Cardiology Ignacio Chavez), located in Mexico City, Mexico. Sample size estimated for this study is 3436, and the Cox proportional hazards model will be used to estimate HRs for the association between explanatory variables and HTN using both raw and adjusted data. ETHICS AND DISSEMINATION This study was approved by the Institutional Bioethics Committee of the Instituto Nacional de Cardiología Ignacio Chávez (National Institute of Cardiology Ignacio Chavez) under number 13-802. Findings from this study will be disseminated through scientific papers and research conferences.
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Affiliation(s)
- Eloisa Colín-Ramírez
- National Council for Science and Technology (CONACYT) – National Institute of Cardiology ‘Ignacio Chávez’, Juan Badiano 1, Sección XVI, Mexico City, Mexico
| | - Susana Rivera-Mancía
- National Council for Science and Technology (CONACYT) – National Institute of Cardiology ‘Ignacio Chávez’, Juan Badiano 1, Sección XVI, Mexico City, Mexico
| | - Oscar Infante-Vázquez
- Department of Electromechanical Instrumentation, National Institute of Cardiology ‘Ignacio Chávez’ Juan Badiano 1, Sección XVI, Mexico City, Mexico
| | - Raúl Cartas-Rosado
- National Council for Science and Technology (CONACYT) – National Institute of Cardiology ‘Ignacio Chávez’, Juan Badiano 1, Sección XVI, Mexico City, Mexico
| | - Jesús Vargas-Barrón
- Division of Research, National Institute of Cardiology ‘Ignacio Chávez’ Juan Badiano 1, Sección XVI, Mexico City, Mexico
| | - Magdalena Madero
- Department of Nephrology, National Institute of Cardiology ‘Ignacio Chávez’ Juan Badiano 1, Sección XVI, Mexico City, Mexico
| | - Maite Vallejo
- Department of Social Medicine Research, National Institute of Cardiology ‘Ignacio Chávez’, Juan Badiano 1, Sección XVI, Mexico City, Mexico
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Becerra-Luna B, Martínez-Memije R, Cartas-Rosado R, Infante-Vázquez O. [Increase in the effectiveness of identifying peaks and feet of the photoplethysmographic pulse to be reconstructed it using adaptive filtering]. Arch Cardiol Mex 2016; 87:61-71. [PMID: 27956339 DOI: 10.1016/j.acmx.2016.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/09/2016] [Accepted: 10/04/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To improve the identification of peaks and feet in photoplethysmographic (PPG) pulses deformed by myokinetic noise, through the implementation of a modified fingertip and applying adaptive filtering. METHOD PPG signals were recordedfrom 10 healthy volunteers using two photoplethysmography systems placed on the index finger of each hand. Recordings lasted three minutes andwere done as follows: during the first minute, both handswere at rest, and for the lasting two minutes only the left hand was allowed to make quasi-periodicmovementsin order to add myokinetic noise. Two methodologies were employed to process the signals off-line. One consisted on using an adaptive filter based onthe Least Mean Square (LMS) algorithm, and the other includeda preprocessing stage in addition to the same LMS filter. Both filtering methods were compared and the one with the lowest error was chosen to assess the improvement in the identification of peaks and feet from PPG pulses. RESULTS Average percentage errorsobtained wereof 22.94% with the first filtering methodology, and 3.72% withthe second one. On identifying peaks and feet from PPG pulsesbefore filtering, error percentages obtained were of 24.26% and 48.39%, respectively, and once filtered error percentageslowered to 2.02% for peaks and 3.77% for feet. CONCLUSIONS The attenuation of myokinetic noise in PPG pulses through LMS filtering, plusa preprocessing stage, allows increasingthe effectiveness onthe identification of peaks and feet from PPG pulses, which are of great importance for medical assessment.
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Affiliation(s)
- Brayans Becerra-Luna
- Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México
| | - Raúl Martínez-Memije
- Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México
| | | | - Oscar Infante-Vázquez
- Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México.
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Cadena-Méndez M, Escalante-Ramírez B, Azpiroz-Leehan J, Infante-Vázquez O. VO2 and VCO2 variabilities through indirect calorimetry instrumentation. Springerplus 2013; 2:688. [PMID: 24422180 PMCID: PMC3884081 DOI: 10.1186/2193-1801-2-688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 12/10/2013] [Indexed: 11/10/2022]
Abstract
The aim of this paper is to understand how to measure the VO2 and VCO2 variabilities in indirect calorimetry (IC) since we believe they can explain the high variation in the resting energy expenditure (REE) estimation. We propose that variabilities should be separately measured from the VO2 and VCO2 averages to understand technological differences among metabolic monitors when they estimate the REE. To prove this hypothesis the mixing chamber (MC) and the breath-by-breath (BbB) techniques measured the VO2 and VCO2 averages and their variabilities. Variances and power spectrum energies in the 0-0.5 Hertz band were measured to establish technique differences in steady and non-steady state. A hybrid calorimeter with both IC techniques studied a population of 15 volunteers that underwent the clino-orthostatic maneuver in order to produce the two physiological stages. The results showed that inter-individual VO2 and VCO2 variabilities measured as variances were negligible using the MC while variabilities measured as spectral energies using the BbB underwent 71 and 56% (p < 0.05), increase respectively. Additionally, the energy analysis showed an unexpected cyclic rhythm at 0.025 Hertz only during the orthostatic stage, which is new physiological information, not reported previusly. The VO2 and VCO2 inter-individual averages increased to 63 and 39% by the MC (p < 0.05) and 32 and 40% using the BbB (p < 0.1), respectively, without noticeable statistical differences among techniques. The conclusions are: (a) metabolic monitors should simultaneously include the MC and the BbB techniques to correctly interpret the steady or non-steady state variabilities effect in the REE estimation, (b) the MC is the appropriate technique to compute averages since it behaves as a low-pass filter that minimizes variances, (c) the BbB is the ideal technique to measure the variabilities since it can work as a high-pass filter to generate discrete time series able to accomplish spectral analysis, and (d) the new physiological information in the VO2 and VCO2 variabilities can help to understand why metabolic monitors with dissimilar IC techniques give different results in the REE estimation.
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Affiliation(s)
- Miguel Cadena-Méndez
- Centro de Investigación en Instrumentación e Imagenología Médica, Departamento de Ing Eléctrica, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, DF México ; Departamento de Procesamiento de Señales, Facultad de Ingeniería, Universidad Nacional Autónoma de México, Ciudad Universitaria, Tlalpan, Mexico City, DF México ; Research Center in Instrumentation and Medical Imaging, Departamento de Ingeniería Eléctrica, Universidad Autónoma Metropolitana-Iztapalapa, San Rafael Atlixco 186 Iztapalapa, Distrito Federal, CP 09340 Mexico City, México
| | - Boris Escalante-Ramírez
- Departamento de Procesamiento de Señales, Facultad de Ingeniería, Universidad Nacional Autónoma de México, Ciudad Universitaria, Tlalpan, Mexico City, DF México
| | - Joaquín Azpiroz-Leehan
- Centro de Investigación en Instrumentación e Imagenología Médica, Departamento de Ing Eléctrica, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, DF México
| | - Oscar Infante-Vázquez
- Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, DF México
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Balderas-Munoz K, Castillo-Martínez L, Orea-Tejeda A, Infante-Vázquez O, Utrera-Lagunas M, Martínez-Memije R, Keirns-Davis C, Becerra-Luna B, Sánchez-Vidal G. Improvement of ventricular function in systolic heart failure patients with oral L-citrulline supplementation. Cardiol J 2012; 19:612-7. [DOI: 10.5603/cj.2012.0113] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Becerra-Luna B, Dávila-García R, Salgado-Rodríguez P, Martínez-Memije R, Infante-Vázquez O. [Monitor of ECG signal and heart rate using a mobile phone with Bluetooth communication protocol]. Arch Cardiol Mex 2012; 82:197-203. [PMID: 23021355 DOI: 10.1016/j.acmx.2012.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 03/23/2012] [Accepted: 04/17/2012] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To develop a portable signal monitoring equipment for electrocardiography (ECG) and heart rate (HR), communicated with a mobile phone using the Bluetooth (BT) communication protocol for display of the signal on screen. METHODS A monitoring system was designed in which the electronic section performs the ECG signal acquisition, as well as amplification, filtering, analog to digital conversion and transmission of the ECG and HR using BT. Two programs were developed for the system. The first one calculates HR through QRS identification and sends the ECG signals and HR to the mobile, and the second program is an application to acquire and display them on the mobile screen. RESULTS We developed a portable electronic system powered by a 9 volt battery, with amplification and bandwidth meeting the international standards for ECG monitoring. The QRS complex identification was performed using the second derivative algorithm, while the programs allow sending and receiving information from the ECG and HR via BT, and viewing it on the mobile screen. The monitoring is feasible within distances of 15 m and it has been tested in various mobiles telephones of brands Nokia®, Sony Ericsson® and Samsung®. CONCLUSIONS This system shows an alternative for mobile monitoring using BT and Java 2 Micro Edition (J2ME) programming. It allows the register of the ECG trace and HR, and it can be implemented in different phones.
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Affiliation(s)
- Brayans Becerra-Luna
- Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México D.F., México
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Sánchez-Torres G, Infante-Vázquez O, Sánchez-Miranda G, de León-Peña A, Martínez Memije R. Mechanical factors of cardiovascular risk in systemic arterial hypertension. A new sign of arterial rigidity. Arch Cardiol Mex 2003; 73:261-70. [PMID: 14959450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
UNLABELLED ANTECEDENT: By means of sphygmokinetocardiography (SKCG) we developed and arterial rigidity index (ARI) which measure the pulse wave aortic carotid reflexion time over the left ventricular ejection time (LVET). This index, together with the pulse wave velocity (PWV) and the pulse pressure (PP) are indicators of arterial stiffness. In this paper we measured these index in 27 systemic artery hypertension. Cases (group A, GA), with and without left ventricular hypertrophy (subgroups: A1 SGA1, n = 13, and A2, SGA2, n = 14), respectively, and 28 normotensive cases (group B, GB). PROTOCOL In two occasions: after 3 minutes of sitting position (SP) and after 3 minute of logging in an upright position (UP), blood pressure, ARI, PP, PWV (aortic-hand finger distance/aorto-hand finger pulse time) and R-IV interval (electrocardiographic R wave-left early ventricular kinetocardiography deflexion) were measured. RESULTS Demography was similar in GA and GB. Systolic, diastolic and pulse pressure were significantly higher in GA vs GB. LVET (ms) was lower in GA vs GB in SP (268 +/- 42 vs 274 +/- 40, p < 0.001, respectively) and higher postexercise UP (280 +/- 42 vs 244 +/- 46, p < 0.001). PWV m/s were higher in SP in GA vs GB (9.8 +/- 2.8 vs 7.4 +/- 1.2, p < 0.001, respectively) and in UP (10.1 +/- 1.9 vs 7.9 +/- 9, p < 0.001, respectively). ARI was lower in UP in GA vs GB (0.48 +/- 0.3 vs 0.80 +/- 0.3, p < 0.003). Correlation index of PP vs SBP, vs DBP and vs PWV were significant in SP and in UP. Height had a significant correlation vs ARI in SP and UP (r = 0.60, p < 0.01, and r = 0.42, p < 0.05, respectively). CONCLUSION PWV is increased in GA vs GB patients. The ARI index is lower in GA vs GB cases in post exercise. PWV and PP showed a statistical significant correlation; height vs ARI had also a significant correlation: SKCG is a new method, that uses a not commercially instrument, which should have clinical application.
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Affiliation(s)
- Gustavo Sánchez-Torres
- Instituto Nacional de Cardiología Ignacio Chávez INCICH, Juan Badiano 1, Col. Sección XVI, Tlalpan 14080, México D.F.
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