Ambulatory blood pressure monitoring and analysis of cardiovascular variability. Ambulatory blood pressure monitoring and analysis of cardiovascular variability
Development and validation of blood pressure monitoring devices; development of mathematical models and systems for the analysis of blood pressure variability over 24 hours;
Blood pressure variability and Clinical significance of ambulatory blood pressure
Assessment by 24 hour intra-arterial and non-invasive blood pressure monitoring of blood pressure and heart rate variabilities in normotensive and hypertensive subjects. Investigation of the central and reflex mechanisms involved in the determination of this phenomenon. Description of this alterations of blood pressure and heart rate variabilities (as well as of their mechanisms of production) in essential hypertension and other cardiovascular diseases
Studies on the clinical value of ambulatory blood pressure, focussing on the comparison of the relationship of 24h average blood pressure with target organ damage as compared to clinic blood pressure. Studies on the possible clinical importance of blood pressure variability. Studies on the hemodynamic description of the white-coat effect.
Investigation on the changes in neural cardiovascular control induced by several cardiovascular drugs and on the effect of several antihypertensive agents on ambulatory blood pressure and blood pressure variability.
Dynamic power spectral analysis and time domain analysis of blood pressure and heart rate variability
Description of blood pressure spectral powers over the 24 hours in normotensive and hypertensive subjects, following identification of a new method of dynamic (segment-to-segment) analysis of power spectrum data.
Identification, development and application of a method to obtain all frequency components (from the slowest to the fastest frequencies) of blood pressure and heart rate variability over the 24 hours (broad-band spectral analysis) and use of this method to describe in a refined fashion variability changes in animal models of hypertension, aging, essential hypertension and cardiovascular diseases. Demonstration of the specificity and feasibility of different approaches to dynamic baroreflex assessment, i.e. the sequence method and the alpha-coefficient based on blood pressure and heart rate powers at 0.1Hz (see below).
New techniques to measure blood pressure
Validation studies on the Finapres technique to measure non-invasively beat-to-beat blood pressure and on its newer developments (Finometer). Development and further validation of the Portapres technique for ambulatory continuous non-invasive blood pressure measurements. Application to finger blood pressure waveforms of filtering and level correction algorithms and investigation on the ability by these techniques to be suitable to sophysticated signal analysis such as power spectrum and sequence analysis, wide-band spectral analysis, etc.
Telemedicine and patients' home management
Development and testing of tools for integrated patients' care at home, including home blood pressure monitoring devices, ECG teletransmission, wireless technologies, wearable sensors (e.g. ECG recording T-shirt, etc…), development of managing procedures.
Sleep and cardiovascular system
Analysis of cardiac and systemic vascular changes induced by REM and slow-wave sleep in normal subjects and in patients with sleep disordered breathing, congestive heart failure, obesity, neural disease (e.g. LSA) and hypertension. Investigation of the mechanisms responsible for these, focussing on the interaction between central factors, sino-aortic reflexes, spinal muscle reflexes and local autoregulatory phenomena. Demonstration of the differences and similarities of the sleep-induced cardiovascular alterations in normotension and hypertension. Focus on sleep as a model to study normal and deranged neural cardiovascular control in man.
Studies on neural control of circulation in the laboratory and over the 24 hours
Refinement of laboratory techniques for the analysis of neural control of circulation. Development and tuning of computer techniques to dynamical baroreflex analysis (the sequence technique, alpha coefficient, ARMA modeling) having the advantage over the classical laboratory techniques of avoiding any external intervention on the subjects under evaluation and exploring daily life baroreflex modulation.
Studies on the relationship between baroreflex sensitivity and behaviour (day vs night, emotions, etc.), the antioscillatory and prooscillatory role of the baroreflex on blood pressure and heart rate respectively; and the daily life baroreflex alterations in hypertension and aging. Investigation of early autonomic cardiac dysfunction in diabetes mellitus and in other pathological conditions.
Space research
Studies on the effects of prolonged microgravity during real and simulated space flights on hemodynamic variables and cardiovascular control mechanisms.
Effects of gravitational stress on neural control of circulation and on blood pressure and heart rate variability
Respiration training
Effects of device guided slow breathing on cardiovascular parameters, neural control mechanisms and cardiovascular performance in normal subjects and in patients with different cardiovascular, pulmonary and systemic diseases.
Effects of high altitude on cardiovascular regulation and respiratory patterns
Effects of acute and prolonged exposure to high altitude and to normobaric hypoxia on cardiorespiratory function, on blood pressure and heart rate variability, on baroreflex sensitivity, on endothelial function and oxydative stress. Studies on the mechanisms and the prevention of high altitude pulmonary edema.
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