Reducing The Burden Of Orthostatic Intolerance - Delineating Mechanisms And Improving Therapy
Funder
National Health and Medical Research Council
Funding Amount
$411,735.00
Summary
Orthostatic intolerance (OI) represents a heterogenous group of complex disorders which are poorly understood and lack effective treatment. They are frequently disabling and may severely impact on quality of life. In the proposed project, we will undertake a systematic investigation of _sympathetic nervous system� in OI patients and assess the clinical effect of a drug _L-DOPS� in subjects suffering from OI.
Opposite poles of blood pressure disorders will be tested. The first is low blood pressure disorders causing blackouts while standing. My hypothesis is that the mechanism is subnormal reflex sympathetic nervous system responses (the sympathetic nervous system is the stimulant division of the automatic branch of the nervous system(. The second focus is patients with severe high blood pressure, with high sympathetic activity, who I will treat with a device silencing the nerves of the kidneys.
Facilitating The Increase In Pulmonary Blood Flow At Birth
Funder
National Health and Medical Research Council
Funding Amount
$617,729.00
Summary
Pulmonary hypertension in newborn infants is a significant problem that is very difficult to treat because we do not understand how blood flow through the lungs increases at birth. We have recently shown that currently believed mechanisms controlling blood flow at birth are incorrect and additional factors exist. Our experiments will determine factors that affect blood flow through the lungs at birth. This information will be used to improve the care of newborns with pulmonary hypertension.
An Integrated Approach To Inotropic Support In Preterm Neonates
Funder
National Health and Medical Research Council
Funding Amount
$694,449.00
Summary
Poor cardiovascular function in preterm babies can lead to inadequate blood flow to the brain and brain injury. Current treatments to improve heart function are often ineffective. This study will examine the effects of treatment on different parts of the cardiovascular system, and how these effects interact. It will identify reasons for the lack of effectiveness and provide insight which will help to design better treatments for preterm babies.
Gastric, Small Intestinal And Cardiovascular Mechanisms Of Postprandial Hypotension.
Funder
National Health and Medical Research Council
Funding Amount
$701,521.00
Summary
A fall in blood pressure after a meal (known as postprandial hypotension) is an important clinical problem, particularly in the elderly, and is associated with an increase in the incidence of falls, stroke, as well as mortality. The mechanisms responsible for postprandial hypotension are not well understood and current therapies are less than optimal. The studies proposed in the current application have important implications for the management of postprandial hypotension.
Plasmapheresis As A Novel Treatment Of Postural Tachycardia Syndrome: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$97,081.00
Summary
We aim to conduct a randomized controlled trial to test our hypothesis that the removal of autoantibodies (through plasmapheresis) will reduce the severity of symptoms in patients with postural tachycardia syndrome. We will be measuring symptom scores, cardiovascular fitness on exercise testing, heart rate and blood pressure responses during valsalva and orthostatic stress as well as the metabolic profiles and presence of autoantibodies in the blood of patients participating in the trial.
Pathophysiology Of Postprandial Hypotension In The Elderly - Role Of Gastric And Small Intestinal Mechanisms
Funder
National Health and Medical Research Council
Funding Amount
$471,176.00
Summary
A fall in blood pressure after a meal (known as postprandial hypotension) is an important clinical problem, particularly in the elderly, occurring in ~50% of nursing home residents and ~30% of healthy older subjects. Postprandial hypotension is associated with a substantial increase in the incidence of falls, stroke, as well as mortality. The mechanisms responsible for the fall in blood pressure after a meal are not well understood, although changes in gastrointestinal blood flow and the release ....A fall in blood pressure after a meal (known as postprandial hypotension) is an important clinical problem, particularly in the elderly, occurring in ~50% of nursing home residents and ~30% of healthy older subjects. Postprandial hypotension is associated with a substantial increase in the incidence of falls, stroke, as well as mortality. The mechanisms responsible for the fall in blood pressure after a meal are not well understood, although changes in gastrointestinal blood flow and the release of gut hormones, have been implicated. While ingestion of carbohydrate, particularly glucose, has been reported to decrease blood pressure most potently, there is inadequate and conflicting information about the effects of other nutrients such as fat and protein. Current therapies are less than optimal. Studies by our research group have established that the fall in blood pressure in response to meals is related to the rate at which nutrients enter the small intestine ie the fall in blood pressure is greater when the stomach empties more quickly. In contrast, gastric distension reduces the fall in blood pressure. Hence, treatment could be directed at facilitating gastric distension and-or slowing the rate of nutrient delivery into the small intestine. Our previous studies have not included any assessment of changes in blood flow to the gut after meals, or of the interaction between gastric distension and small intestinal mechanisms, and have involved healthy older subjects and patients with type 2 (non-insulin dependent) diabetes rather than individuals with known postprandial hypotension. We now have the capacity to measure blood flow in the gut with ultrasound. The studies proposed in the current application represent a logical development from our previous work and have important implications for the management of postprandial hypotension.Read moreRead less