Dissertationen: „Contrôle cardiovasculaire“

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Al, Omar Sally. „Systèmes de contrôle cardiovasculaire et respiratoire et leur interaction en période néonatale“. Thesis, Rennes 1, 2017. http://www.theses.fr/2017REN1S103/document.

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Les objectifs de cette thèse sont: i) de mettre au point de nouvelles techniques adaptées à la période néonatale d'analyse automatique des signaux physiologiques cardiaque (ECG) et respiratoire (RESP) afin d'étudier la variabilité de la fréquence cardiaque (VFC) et respiratoire (VFR), ainsi que les interrelations cardiorespiratoires; ii) de les valider et de les utiliser sur des modèles ovins pour mieux comprendre les altérations du contrôle cardiorespiratoire dans des différentes situations expérimentales. Durant les expérimentations, les agneaux étaient non sédationnés et libres de leurs mouvements, ce qui rend le traitement des signaux ECG et RESP enregistrés durant plusieurs heures difficile, à cause des artefacts. D'abord, une chaîne de traitement semi-automatique des signaux a été proposée. Elle comprend l'élimination automatique des périodes artefactuelles, l'extraction des séries temporelles des segments propres de l'ECG et du signal RESP, l'application d'un test de stationnarité sur ces séries temporelles pour extraire les segments stationnaires et le calcul de différents indices de la VFC et la VFR obtenus en appliquant des analyses linéaires et non linéaires. Ces analyses ont été complétées par la mesure des interrelations cardiorespiratoires. Cette chaîne de traitement a permis d'étudier les effets de trois situations expérimentales sur le contrôle cardiorespiratoire. La première situation cherche à étudier l'exposition d'agneaux nouveau-nés à la fumée de cigarette durant les deux premières semaines de vie. Une importante altération des interrelations cardiorespiratoires a été mise en évidence, surtout au niveau de l'arythmie sinusale respiratoire et du couplage cardioventilatoire. Ce résultat inédit donne un éclairage nouveau sur la physiopathologie des effets de l'exposition à la fumée de cigarette en période néonatale, incluant en particulier le syndrome de la mort subite du nourrisson. La deuxième situation expérimentale examine l'hyperbilirubinémie (HB) des agneaux prématurés. Une HB modérée a été induite durant 17h par injection intraveineuse de bilirubine. Les effets de l'HB modérée sur la VFC, la VFR et les interrelations cardiorespiratoires ont été évalués sur 7 heures d'enregistrement au moment de l'HB (J0) et 72h plus tard (J3), après normalisation de la bilirubinémie. À J0, une augmentation de la variabilité accompagnée d'une augmentation des indices fréquentiels de la VFC a été observée indiquant une coactivation sympathovagale. Tous ces effets ont disparu à J3. Une diminution de la fréquence respiratoire a été retrouvé avec une augmentation de la VFR; ces effets étaient maintenus jusqu'à J3. Une augmentation de l'arythmie sinusale respiratoire, de la synchronisation et du nombre de RR dans une inspiration et une expiration a été observée. Ces deux derniers effets étaient toujours présents au jour 3. La troisième situation expérimentale concerne l'application nasale d'une pression positive continue (PPC) de 6 cmH2O à des agneaux nouveau-nés sains pendant 6 heures. Une augmentation de la fréquence cardiaque a été observée avec diminution des indices temporels et fréquentiels de la VFC et augmentation de la complexité des intervalles RR. De plus, un ralentissement de la respiration a été montré avec allongement de la durée de l'expiration et diminution de la VFR indiquant une stabilisation de la respiration. Enfin, la seule altération des interrelations cardiorespiratoires retrouvée était une augmentation du nombre de RR dans le cycle respiratoire attribuable à l'augmentation de la fréquence cardiaque et à la diminution de la fréquence respiratoire. L'interprétation des résultats a été approfondie en utilisant une approche à base de modèles pour représenter le comportement des systèmes cardiovasculaire, respiratoire et du baroréflexe artériel dans les conditions expérimentales. Celle-ci permet d'accéder à des variables physiologiques difficilement observables durant les expérimentations
The objectives of this thesis are: i) to develop new techniques, adapted to the neonatal period, for the automatic analysis of cardiac (ECG) and respiratory (RESP) signals in order to study heart rate variability (HRV), respiratory rate variability (RRV), as well as cardiorespiratory interrelations; ii) to validate these techniques and use them on neonatal ovine models to better understand alterations in the cardiorespiratory control in experimental situations mimicking exposure to postnatal environmental tobacco smoke, hyperbilirubinemia in the premature infant and continuous positive airway pressure application. In the different experimental situations, the lambs were without sedation and moving freely; this makes the treatment of ECG and RESP signals recorded for several hours difficult because of artifacts. As a first step, a semi-automated signal processing approach has been proposed. It includes the automatic elimination of artefactual periods, the extraction of time series from the clean segments of the ECG and RESP signals, the performance of a stationarity test in order to extract stationary segments, the application of linear (in time and frequency domains) and nonlinear HRV and RRV analysis as well as the calculation of cardiorespiratory interrelations indices. This approach was validated and allowed to study the effects of three different experimental conditions on cardiorespiratory control. The first condition explored the effects of exposing newborn lambs to postnatal environmental tobacco smoke (ETS) for the first two weeks of life. Significant impairment of cardiorespiratory interrelations was demonstrated, particularly for respiratory sinus arrhythmia and cardioventilatory coupling. This novel result sheds new light on the physiopathology of the effects of ETS exposure in the neonatal period, particularly for sudden infant death syndrome. The second experimental situation corresponds to hyperbilirubinemia (HB) of premature lambs. Moderate HB was induced for 17h by intravenous injection of bilirubin. The effects of moderate HB on HRV, RRV and cardiorespiratory interrelationships were assessed over 7 hours of recording during acute HB (D0) and after 72h (D3), following normalization of bilirubinemia. On D0, an increase in HRV accompanied by an increase in frequency indices of HRV was observed, indicating sympathovagal coactivation. These effects were absent on D3. A decreased respiratory rate and an increase in RRV were noted on D0; these effects were maintained until D3. The study of cardiorespiratory interrelations showed an increase in respiratory sinus arrhythmia, phase synchronization and the number of RRs in inspiration and expiration. The latter effects were still observed on day 3. The third experimental situation concerns the nasal application of a continuous positive pressure (CPAP) of 6 cmH2O in healthy neonatal lambs for 6 hours. An increase in heart rate associated with a decrease in temporal and frequency indices of HRV and an increase in RR interval complexity was observed. In addition, we observed a decrease in respiratory rate accompanied by a prolonged expiration and a decreased RRV, indicating a stabilization of breathing. Finally, no alterations of cardiorespiratory interrelations were observed excepted an increase in the number of RRs in the respiratory cycle explained by the increased heart rate and decreased respiratory rate. To further understand these results, a model of cardiorespiratory coupling comprising three compartments mimicking the functioning of the cardiovascular and respiratory systems and the arterial baroreflex, was adapted to the conditions of the experiment. Results obtained with the model allowed to gain access to variables that were not measured during the experiments

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André, Lucas. „Couplage excitation-métabolisme-contraction dans le coeur sain et insuffisant : mécanismes physiopathologiques, influence d'une pollution atmosphérique et stratégies préventives“. Thesis, Montpellier 1, 2010. http://www.theses.fr/2010MON1T006/document.

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Bien que les progrès thérapeutiques aient permis de freiner la progression des maladies cardio-vasculaires (CV), mais surtout d'améliorer leur prévention et par conséquent de réduire la survenue d'accidents CV, ces maladies devraient rester les premières causes mondiales de décès dans les prochaines années. Cet état des lieux épidémiologique illustre donc des insuffisances concernant à la fois la prévention, mais également la prise en charge du risque CV. Ce travail de thèse s'est alors intéressé à la compréhension des mécanismes physiopathologiques de l'insuffisance cardiaque ischémique (ICi), maladie CV la plus répandue, afin de proposer des stratégies préventives limitant le remodelage cardiaque délétère ; ainsi qu'à l'étude de la pollution atmosphérique comme potentiel facteur de risque CV. Le couplage excitation-métabolisme-contraction (E-M-C), qui sous-tend la fonction de la pompe cardiaque, s'adapte en réponse à différents stimuli par une modification des interrelations spatiales et temporelles complexes entre activités électriques, énergétiques et mécaniques. Ces modifications à différents niveaux peuvent initier un remodelage délétère évoluant vers une altération du fonctionnement, voire une défaillance chronique, du myocarde.Ce travail de thèse met en évidence un découplage entre les activités mitochondriales et contractiles, à l'origine d'un déséquilibre des homéostasies ioniques et redox, responsables des dysfonctions cardiaques étudiées dans des contextes d'ICi et d'exposition en milieu pollué au CO. Ainsi, une approche thérapeutique, visant à restaurer les fonctions mitochondriales et à rétablir le couplage E-M-C cardiaque, pourrait être considérée afin de préserver au mieux la fonction myocardique. Ce travail de thèse permet alors une meilleure compréhension des mécanismes physiopathologiques de l'ICi, et identifie la pollution atmosphérique comme facteur de risque CV à considérer en clinique afin de mieux prévenir le risque CV
Abstract non available

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Comet, Marie-Anne. „Implication des récepteurs 5-HT2 et 5-HT3 de la sérotonine dans le contrôle de la fonction cardiovasculaire au niveau du noyau du tractus solitaire“. Paris 5, 2005. http://www.theses.fr/2005PA05P631.

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La sérotonine localisée au niveau du noyau du tractus solitaire (NTS) joue un rôle clé, via ses récepteurs 5-HT2 et 5-HT3, dans le contrôle des paramètres cardiovasculaires : l'activation des récepteurs 5-HT2 du NTS entraîne une bradycardie, une hypotension et la facilitation de la bradycardie du baroréflexe, alors que celle des récepteurs 5-HT3 du NTS provoque une hypertension et l'inhibition de la bradycardie du baroréflexe. Cependant, le rôle fonctionnel de ces deux récepteurs était inconnu. Les résultats de ma thèse ont démontré que les récepteurs 5-HT3 du NTS intervenaient dans l'inhibition GABAergique de la bradycardie du baroréflexe (aortique et/ou carotidien) pendant une situation de stress, via une interaction fonctionnelle avec les récepteurs NK1 locaux lorsque le baroréflexe est uniquement d'origine aortique. Nous avons ensuite mis en évidence l'implication des récepteurs 5-HT2A dans la facilitation de la bradycardie du baroréflexe pendant les périodes de post-stress
The serotonin located in the nucleus tractus solitarius (NTS) plays un key role in the control of the cardiovascular parameters through these 5-HT2 and 5-HT3 receptors. Indeed, 5-HT2 receptors activation produces bradycardia, hypotension and the facilitation of the baroreflex bradycardia when the 5-HT3 receptors stimulation induces hypertension and inhibition of the baroreflex bradycardia. However, the functional role of these serotonergic receptors should be elucidated. Our results showed first that one of the functional role of the 5-HT3 receptors is to be involved in the GABAergic inhibition of the bradycardia of the aortic or carotid sinus baroreflex during stressfull condition. This inhibitory effect is supported by a functional interaction with the NTS NK1 receptors only with the aortic baroreflex. Then, we demonstrated that one of the role of NTS 5-HT2 receptors is to be involved in the facilitation of the baroreflex bradycardia during post stress period

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Bennia, Fatiha. „Le risque cardiovasculaire : l'environnement de diffusion des facteurs de risque modifiables“. Thesis, Aix-Marseille, 2015. http://www.theses.fr/2015AIXM5060/document.

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La santé est une construction dynamique et multifactorielle qui a une dimension individuelle et une dimension sociale. Cette dernière peut avoir un effet direct ou indirect sur les comportements des individus et sur leurs choix de vie. L’étude de Framingham a révélé que le risque cardiovasculaire était multifactoriel et donc son estimation devait être globale. Mais les méthodes d’estimation du risque cardiovasculaire ne prennent pas en compte l’environnement de vie des individus qui favoriserait le développement des facteurs de risque modifiables. A travers ce travail, nous mettons en lumière les caractéristiques de l'environnement de diffusion des facteurs de risque cardiovasculaires modifiables : métaboliques et comportementales. Depuis des décennies, la région Nord enregistre pour les maladies cardiovasculaires des taux élevés de mortalité globale et prématurée. Nous nous sommes interrogés sur les déterminants de cette situation de la région Nord, en la comparant aux autres régions françaises, et en explorant le lien entre un risque cardiovasculaire élevé et une situation économique défavorable. Dans ce but, nous avons étudié le lien entre la distribution du risque cardiovasculaire et la distribution du revenu, en employant des critères normatifs basés sur la notion de dominance sociale en termes de pauvreté.Ce travail permet d’analyser les connaissances en rapport avec l’environnement de vie des individus et ainsi une meilleure compréhension des mécanismes de diffusion des facteurs de risque modifiables, ce qui s’inscrit dans une double perspective, réduire l’incidence et la prévalence des maladies cardiovasculaires et diminuer les inégalités sociales de santé
Health is a dynamic and multifactor construction which has both an individual and a social dimension. The latter may have a direct or indirect effect on the behaviour of individuals and their life choices. The Framingham study has revealed that cardiovascular risk is multifactorial and, as such, its estimate should be global. However, the assessment of global cardiovascular risk methods do not take into account the living environment of individuals, which would factor the development of modifiable risk factors. Through this work, we highlight the characteristics of the environment of dissemination of modifiable cardiovascular risk factors: metabolic and behavioural. Since decades, the North region of France has, for cardiovascular diseases, a high level of global and premature mortality. We are asked about the determinants of the situation of this region, by comparing it to other French regions and by exploring the link between a high cardiovascular risk and an unfavourable economic situation. Thus, we are interested in the link between the distribution of cardiovascular risk and the distribution of income, using normative criteria based on the concept of expected social dominance in terms of poverty. Shedding a light on factors favouring the occurrence of cardiovascular problems and analyzing the knowledge about the individual’s life environment allows a better understanding of the mechanisms of diffusion of the modifiable risk factors, with a double objective to lower the incidence and prevalence of cardiovascular diseases and to reduce the social inequalities in health

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Marais, Michaël. „Adaptation cardiovasculaire aux vols spatiaux : interaction des stimulations otolithiques et visuelles avec le contrôle baroréflexe de la circulation chez l'homme“. Caen, 2011. http://www.theses.fr/2011CAEN3048.

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Les boucles baroréflexes représentent les principaux effecteurs de la régulation à court-terme du système cardiovasculaire. Toutefois, de nombreuses études ont démontré que le système otolithique était capable de modifier l’activité du système nerveux sympathique pour induire des variations dans la vasomotricité périphérique chez l’Homme. Notre hypothèse est que la régulation du système cardiovasculaire ferait appel à un système intégrant différentes afférences neurosensorielles avec les afférences barosensibles afin de réguler la pression artérielle. Afin de mettre à jour ce système complexe de régulation, nous avons démontré au cours de ces différents travaux que les afférences visuelles peuvent induire des modifications cardiovasculaires (en présence et en l’absence d’afférences otolithiques). De plus, nos études lors d’un protocole d’alitement prolongé nous ont permis de mettre en évidence des altérations dans les réponses cardiovasculaires provoquées par des stimulations otolithiques et visuelles. Nous pouvons donc en déduire que les systèmes otolithique et visuel interviennent très probablement dans le déconditionnement cardiovasculaire. Ce phénomène se traduit, entre autres, par une intolérance orthostatique et une diminution de la sensibilité du baroréflexe carotidien. Nos résultats démontrent que les afférences otolithiques ont un effet inhibiteur sur la réponse cardiaque et vasculaire du baroréflexe carotidien, en décubitus dorsal. L’ensemble de nos résultats démontrent donc que les afférences visuelles et otolithiques sont intégrées avec les afférences barosensibles pour assurer une bonne régulation du système cardiovasculaire
Baroreflex loops are the main effectors of the cardiovascular short-term regulation. However, numerous studies have shown that the otolithic system was able to modify the activity of the sympathetic nervous system to induce changes in peripheral vasomotricity in humans. Our hypothesis is that regulation of the cardiovascular system would use a system that integrates different neurosensory afferents with barosensitive afferents to regulate blood pressure. To update this complex system of regulation, we have demonstrated in these works that visual afferents may induce cardiovascular changes (in presence and absence of otolithic afferents). Furthermore, our studies during a prolonged bed rest protocol allowed us to identify alterations in cardiovascular responses induced by otolithic and visual stimuli. We can therefore conclude that otolithic and visual systems involved most likely in cardiovascular deconditioning. This is reflected, among other things, orthostatic intolerance and decreased sensitivity of carotid baroreflex. Our results demonstrate that otolithic afferents have an inhibitory effect on the response of cardiac and vascular carotid baroreflex in the supine position. Thus, all our results demonstrate that visual and otolithic afferents are integrated with barosensitive afferents to ensure proper regulation of the cardiovascular system

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Hogie, Manuela. „Rôle de l'endothéline endogène dans le contrôle du tonus vasculaire dans des situations physiologiques ou physiopathologiques“. Rouen, 1998. http://www.theses.fr/1998ROUES088.

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L'endothéline est un puissant vasoconstricteur pour lequel un rôle majeur a été évoqué dans diverses pathologies cardiovasculaires. Le développement d'outils pharmacologiques tels les antagonistes spécifiques ETa ou mixtes des récepteurs de l'endothéline permet d'évaluer ce rôle. Ainsi, l'utilisation de ces antagonistes nous a permis de déterminer que l'endothéline endogène participe au maintien du tonus vasculaire à l'état basal chez le rat. Cependant son activité est perpétuellement masquée, d'une part par le tonus vasodilatateur du NO, et d'autre part par l'activité du système rénine-angiotensine. Pour ce qui concerne la pathologie, nous avons pu montrer par l'utilisation du bosentan, antagoniste mixte des récepteurs de l'endothéline, que ce peptide ne paraissait pas jouer un rôle dans la lésion endothéliale coronaire ou myocytaire dans un modèle d'ischémie avec reperfusion chez le rat. Au contraire, dans un modèle d'insuffisance cardiaque réalisé chez le rat, le traitement chronique par le bosentan exerce des effets bénéfiques à la fois sur la survie des animaux, sur les paramètres hémodynamiques et sur la structure et la fonction cardiaques. Ainsi l'endothéline paraît jouer un rôle prépondérant et complémentaire à celui du système rénine-angiotensine dans la régulation du tonus vasculaire, notamment dans des situations physiopathologiques chroniques. Les antagonistes de l'endothéline paraissent donc constituer un traitement d'avenir dans les pathologies cardiovasculaires.

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Cornolo, Jérémy. „Effets de l'entraînement et de l'hypoxie sur le contrôle neurovégétatif de la fonction cardiovasculaire évalué par la variabilité de la fréquence cardiaque“. Paris 13, 2005. http://www.theses.fr/2005PA132042.

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L'hypoxie aiguë et l'entraînement en endurance ont des effets opposés sur le système neurovégétatif et la fonction cardiovasculaire. Le modèle " living high-training low " (LHTL) pourrait limiter ces adaptations liées à l'entraînement en endurance seul. Un stage LHTL (16 h/j, 2500-3000m, 13 jours) limite la baisse de la fréquence cardiaque (FC) et de la modulation sympathique sur le cœur liée à l'entraînement alors que les résistances vasculaires et la pression artérielle sont augmentées (Etude 1). Ces adaptations semblent principalement dues à l'exposition à l'hypoxie (Etude 2). Des effets rémanents de l'hypoxie ont pu se prolonger jusqu'au début de la séance d'entraînement suivante et s'additionner avec la réponse à l'exercice. Il est peu probable que les effets de l'entraînement aérobie du stage LHTL se soient additionnés avec la réponse à l'hypoxie (Etude 3). L'analyse de la variabilité de la FC semble bien adaptée à l'évaluation du contrôle neurovégétatif lors d'études de terrain.

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Netzer, Florence. „Contrôle des réflexes cardiovasculaires pendant la réaction de défense : rôle du noyau cunéiformis et des neurones sérotoninergiques bulbaires“. Paris 5, 2009. http://www.theses.fr/2009PA05P645.

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L’homéostasie cardiovasculaire est maintenue par un ensemble de réflexes (le baroréflexe, le réflexe de Bezold-Jarisch et le chémoréflexe) qui induisent une bradycardie, modulées en fonction des conditions environnementales. En effet, les conduites de fuite ou d’attaque, déclenchées en réponse à certains stimuli stressant (la réaction de défense), s’accompagnent d’une inhibition de la bradycardie du baroréflexe. Chez le rat anesthésié, nous avons montré que la bradycardie du réflexe de Bezold-Jarisch et du chémoréflexe étaient aussi inhibées pendant la réaction de défense, cette inhibition étant sous-tendue par l’activation des récepteurs 5-HT3, NK1 et GABAA localisés dans le noyau du tractus solitaire (NTS). Nos travaux ont permit de d’identifier les neurones sérotoninergiques de la région B3 (Raphé magnus et Noyaux latéraux paragigantocellulaires) comme la source de sérotonine libérée dans le NTS pendant la réaction de défense et activant les récepteurs 5-HT3 à l’origine de l’inhibition des bardycardies réflexes. Enfin nous avons montré, pour la première fois, que le Noyau Cunéiformis (Cnf) participait à l’inhibition des bradycardies réflexes pendant la réaction de défense. Puis par une approche neuroanatomique et pharmacologique nous avons identifié les projections activatrices directes du Cnf sur une structure clé de la réaction de défense, la colonne dorsolatérale de la substance grise périaqueductale
The cardiovascular reflexes are regulatory mechanism devoted to maintain constant blood pressure. During the stress reactions the cardiovagal component of the reflexes are inhibited. Activation of the dorsolateral periaqueductal grey (dlPAG) induces the defence reaction and the inhibition of the reflex bradycardia thought activation of the 5-HT3, NK1 and GABAA receptors in the NTS. Our experiment showed that the B3 group was the origin of serotonin released in the NTS during the defence reaction. We found that the nucleus cuneiformis (Cnf) is involved in this cardiac reflex modulation following the same pathway. In addition we found massive afferents from the Cnf reached the dlPAG

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Montandon, Gaspard. „Conséquences à long terme de la caféine administrée en période néonatale sur le développement du contrôle respiratoire du rat : étude des plasticités du contrôle respiratoire, de la fonction cardiovasculaire et de la régulation du sommeil“. Thesis, Université Laval, 2008. http://www.theses.ulaval.ca/2008/25709/25709.pdf.

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Agbangla, Nounagnon Frutueux. „Vieillissement, contrôle exécutif et exercice physique : Étude des corrélats neurophysiologiques par la spectroscopie proche de l'infrarouge“. Thesis, Poitiers, 2017. http://www.theses.fr/2017POIT5035.

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Le déclin cognitif qui s'observe au cours du vieillissement se réduirait grâce à une bonne condition physique cardiorespiratoire. Dans le cadre de cette thèse, les corrélats neurophysiologiques sous-jacents de cet effet prophylactique de la condition physique cardiorespiratoire ont été explorés par le biais de la spectroscopie proche de l'infrarouge qui permet de mesurer de manière non invasive l'activité hémodynamique cérébrale. Les objectifs sont d'une part, d'investiguer les effets de la complexité de la tâche, de l'âge et de la condition physique cardiorespiratoire sur l'évolution des indicateurs de la performance cognitive, de la perception subjective de la difficulté et de l'activité hémodynamique cérébrale. D'autre part, d'examiner les relations fonctionnelles qui pourraient exister entre ces différents indicateurs. A travers trois études utilisant différentes tâches exécutives dont nous avons manipulé le niveau de complexité, nous avons mesuré ces différents indicateurs chez des jeunes adultes et des seniors à haut et faible niveaux de VO2max. Les résultats obtenus ont montré dans un premier temps que l'activité hémodynamique, la performance cognitive ainsi que la perception subjective de la difficulté augmentent significativement en fonction de la complexité de la tâche exécutive. Ceci démontre la sensibilité des différents indicateurs à la manipulation de la complexité cognitive. De plus, l'avancée en âge induit une réduction des performances cognitives et de l'activité hémodynamique mais pas de la perception subjective de la difficulté. Dans un deuxième temps, nos résultats ont indiqué que la condition physique cardiorespiratoire est liée à une augmentation des performances exécutives ainsi que de l'activité hémodynamique, seulement chez les seniors et pour certaines tâches; les bénéfices étant limités à la fonction de mise à jour de la mémoire de travail. Enfin, dans un troisième temps, les résultats de l'ensemble de nos travaux ont montré un lien possible entre l'activité hémodynamique et la performance cognitive seulement chez les jeunes adultes et les seniors à haut niveau de VO2max lorsque la tâche expérimentale est particulièrement complexe, donc lorsque la charge cognitive est élevée. En somme, ce travail de thèse a permis d'apporter des supports de compréhension des mécanismes neurophysiologiques sous-jacents aux effets prophylactiques de la condition physique cardiorespiratoire, sur le déclin de la mise à jour de la mémoire de travail, au cours du vieillissement normal
The cognitive decline that occurs during aging would be reduced by a high level of cardiorespiratory fitness. In this thesis, the underlying neurophysiological correlates of this prophylactic effect of cardiorespiratory fitness have been explored by near-infrared spectroscopy, which allows non-invasive measurement of cerebral hemodynamic activity. The objectives are firstly, to investigate the effects of task complexity, age and cardiorespiratory fitness level on the evolution of different indicators of cognitive performance, subjective perception of task difficulty and cerebral hemodynamic activity. Secondly, to examine the functional relationships that might exist between these different indicators. Throughout three experimental studies using different tasks involving executive control processes, whose level of complexity was manipulated, we measured these different indicators in young adults and seniors with high and low levels of VO2max. The results obtained showed that hemodynamic activity, cognitive performance and subjective perception of difficulty increase significantly as a function of the complexity of the cognitive tasks. This demonstrates the sensitivity of the different indicators to the manipulation of cognitive complexity. Furthermore, advancing in age induces a reduction in cognitive performance and hemodynamic activity but not in the subjective perception of difficulty. Also, our results indicated that cardiorespiratory fitness is linked to an increase in executive performance as well as in hemodynamic activity, only in seniors and for some tasks; the benefits being limited to the updating of working memory. Finally, the overall results have shown a possible link between hemodynamic activity and cognitive performance selective to young adults and seniors with a high level of VO2max when the experimental task is particularly complex; thus when the cognitive load is high. In sum, this work provides support for the understanding of the neurophysiological mechanisms underlying the prophylactic effects of cardiorespiratory fitness on the decline of the updating of working memory during normal aging

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Ollivier, Maëlle. „Implication du système nerveux autonome sympathique dans la sclérose latérale amyotrophique“. Electronic Thesis or Diss., Bordeaux, 2025. http://www.theses.fr/2025BORD0022.

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La sclérose latérale amyotrophique (SLA) a été initialement définie par Jean-Martin Charcot en 1869 comme une maladie affectant exclusivement les motoneurones. Elle est maintenant reconnue comme une maladie neurodégénérative multisystémique, présentant une hétérogénéité clinique, génétique et neuropathologique. Malgré les avancées croissantes dans la compréhension de la maladie de Charcot, peu de traitements sont aujourd’hui disponibles pour freiner ou arrêter la progression de la maladie. Bien que divers symptômes liés à des dysfonctionnements du système nerveux autonome (SNA) aient été décrits, peu de projets de recherche s’interrogent sur son implication dans le développement de la SLA. Les travaux de cette thèse ont eu pour but d’étudier les altérations du système nerveux sympathique autonome dans la SLA, en utilisant le modèle de souris SOD1G93A. Nous nous sommes plus particulièrement intéressés aux neurones sympathiques préganglionnaires (SPNs) du SNA qui partagent de nombreuses caractéristiques moléculaires et fonctionnelles communes avec les motoneurones. Les SPNs constituent le dernier relais spinal de la commande autonome. En combinant des techniques génétiques, biochimiques, anatomiques avec des approches télémétriques et comportementales, nous avons montré que des altérations du SNA étaient présentes chez la souris SOD1 dans des stades présymptomatiques de la maladie
Amyotrophic lateral sclerosis (ALS) was initially defined by Jean-Martin Charcot in 1869 as a disease exclusively affecting motor neurons. It is now recognized as a multisystem neurodegenerative disease with clinical, genetic, and neuropathological heterogeneity. Despite significant progress in understanding Charcot's disease, few treatments are currently available to slow or halt its progression. Although various symptoms related to autonomic nervous system (ANS) dysfunctions have been described, few research projects have explored its role in the development of ALS. The work presented in this thesis aimed to study alterations in the sympathetic autonomic nervous system in ALS, using the SOD1G93A mouse model. We specifically focused on the sympathetic preganglionic neurons (SPNs) of the ANS, which share numerous molecular and functional characteristics with motor neurons. SPNs represent the final spinal relay of autonomic control. By combining genetic, biochemical, anatomical techniques with telemetry and behavioral approaches, we demonstrated that alterations in the ANS are present in SOD1 mice at presymptomatic stages of the disease

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Belacel, Ouari Milia. „Contrôle de la voie de l’AMPc vasculaire par les phosphodiestérases en situation physiopathologique“. Thesis, Université Paris-Saclay (ComUE), 2016. http://www.theses.fr/2016SACLS504/document.

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L’AMPc est un second messager exerçant un rôle vasculoprotecteur majeur, par ses effets relaxants et inhibiteurs de la prolifération et de la migration cellulaires. Les concentrations intracellulaires d’AMPc sont finement régulées par leur synthèse via les adénylates cyclases et leur dégradation par les phosphodiestérases (PDEs). Nous avons évalué l’impact de l’environnement cellulaire sur la voie de signalisation couplée au récepteur β-adrénergique (β-AR/AMPc/PDE) dans les cellules musculaires lisses vasculaires (CMLVs), ainsi que les altérations potentielles de celle-ci en situation pathologique d’insuffisance cardiaque (IC).Notre première étude montre que dans les CMLs d’aorte de rat en culture, adoptant un phénotype synthétique, la voie de signalisation β-AR/AMPc/PDE est hautement modulée par la densité cellulaire Ainsi, une faible densité cellulaire est associée à une régulation négative de l’expression fonctionnelle du récepteur β1-AR, à une activité hydrolytique des PDEs-AMPc plus faible et à des concentrations d’AMPc intracellulaire plus élevées que celles observées dans des cellules confluentes.Notre deuxième étude montre que dans l’aorte de rat, l’IC est associée à une dysfonction endothéliale (DE), une hyperréactivité aux agents contractants et une altération de la fonction et de l’expression des PDEs-AMPc. Nos résultats suggèrent que l’altération de la voie du NO/GMPc suite à la DE conduit à une hyper-activation de la PDE3, qui masque la fonction de la PDE4 et altère la relaxation β-AR.L’ensemble de ce travail met en évidence le rôle critique de l'environnement cellulaire dans le contrôle de la voie β-AR/AMPc/PDE des CMLVsMots clés : Muscle lisse vasculaire, récepteur β-adrénergique, AMPc, phosphodiestérases, densité cellulaire, insuffisance cardiaque
CAMP is second messenger which plays a prominent vasculoprotective role by its relaxing effects and inhibition of cell proliferation and migration. Intracellular cAMP level is regulated by its synthesis by adenylate cyclase and its degradation by phosphodiesterases (PDEs). We evaluated the influence of cellular environment on signaling pathway coupled to β-adrenoceptors (β-AR/cAMP/PDE) on vascular smooth muscle cells (VSMCs), as well as potential alterations in heart failure (HF).The first study showed that in cultured rat aortic SMCs exhibiting synthetic phenotype, the β-AR/cAMP/PDE signaling pathway is highly modulated by the cellular density.Thus, the low density state being associated to a downregulation of the β1-AR, a lower cAMP-PDE activity and a higher basal [cAMP]i compared to confluent cells.Our second study showed that in rat aorta, HF is associated with endothelial dysfunction, hyper-reactivity to contractile agents and an alteration of function and expression of cAMP-PDEs. Our results suggest that NO/cGMP pathway alteration following the ED in HF leads to hyper-activation of PDE3 which masks PDE4 function and alters β-adrenoceptor relaxationThus, our works highlights the critical role of the cellular environment in controlling the vascular β-AR signaling.Keywords: Vascular smooth muscle, β-adrenoceptor, cAMP, phosphodiesterases, cellular density, heart failure

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Letourneau, Manon. „Rôle du système vasculaire dans le contrôle de l'hématopoïèse chez la drosophile : étude de la voie de signalisation fibroblast growth factor“. Thesis, Toulouse 3, 2018. http://www.theses.fr/2018TOU30159.

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Chez les mammifères adultes, les cellules souches et les progéniteurs hématopoïétiques (CSPH) présents dans la moelle osseuse sont à l'origine de la production des cellules sanguines tout au long de la vie. L'auto-renouvellement, la prolifération et la différenciation des CSPH sont sous le contrôle d'un microenvironnement cellulaire spécifique appelé " niche ". Deux niches sont identifiés dans la moelle osseuse : une niche endostéale et vasculaire. Les processus moléculaires contrôlant les communications cellulaires entre les niches et les HSPC sont complexes et demeurent mal connues. Du fait de la conservation des facteurs de transcription et des voies de signalisations entre les mammifères et la drosophile, l'organe hématopoïétique de la drosophile : la glande lymphatique s'est avéré être un excellent modèle pour étudier les communications cellulaires entre les niches et les CSPH. La glande lymphatique est accolée au tube cardiaque (système vasculaire), qui contrôle la morphologie et la fonction du PSC (Posterior Signaling Center), un centre de signalisation contrôlant la différenciation des cellules immunitaires/sanguines dans la glande lymphatique. Au cours de mes travaux de thèse, j'ai réalisé un crible fonctionnel in vivo, pour déterminer si indépendamment de son effet sur le PSC, les cellules du tube cardiaque étaient capables de contrôler directement l'homéostasie de la glande lymphatique. La réalisation de ce crible m'a permis d'identifier quatre ligands produits par les cellules du tube cardiaque et requis au maintien des progéniteurs hématopoïétiques dans la glande lymphatique, notamment le ligand Branchless de la voie de signalisation FGF (Fibroblast Growth Factor). La perte de fonction du ligand FGF/Branchless dans le tube cardiaque ou du récepteur FGF/Breathless dans les progéniteurs hématopoïétiques entraine une différenciation accrue et une diminution du pool de progéniteurs dans la glande lymphatique. Mes résultats indiquent que le tube cardiaque a un rôle équivalent à une niche pour contrôler l'hématopoïèse dans la glande lymphatique et que la voie de signalisation FGF joue un rôle clé dans ces communications cellulaires. [...]
In adult mammals, hematopoietic stem cell and progenitors (HSPC) are present in the bone marrow and produce all blood cell type along the life. Renewal, proliferation and differentiation of the HSPC are tightly control by a specific microenvironment called the "niche", composed by an endosteal and a vascular niche. Molecular processes controlling cellular communications between niches and HSPC are complex and remain poorly understood. Since many transcription factors and signalization pathway are conserved in controlling hematopoiesis both in mammals and Drosophila, the Drosophila hematopoietic organ: the lymph gland became an excellent model to decipher cellular communications between the niche and HSPC. The lymph gland is aligned the cardiac tube (vascular system), which control the size and the function of the PSC (Posterior Signaling Center). The PSC is a signaling center controlling the differentiation of immune/blood cells in the lymph gland. During my PhD, I performed an in vivo functional screen to determine whether independently of its role on the PSC, cardiac cells were able to control directly the lymph gland homeostasis. The realization of this screen, allowed me to identify four ligands produced by cardiac tube cells and required to maintain lymph gland hematopoietic progenitors. One of this ligand is a FGF (Fibroblast Growth Factor) ligand Branchless. Knock down of FGF/branchless ligand in cardiac tube cells or FGF/Breathless receptor in hematopoietic progenitors lead to an increase in immune cells differentiation at the expense of the progenitor pool. My results establish that the cardiac tube plays a role similar to a niche in controlling lymph gland homeostasis and the FGF pathway plays a key role in this cellular communication. [...]

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Bellengier, Cécilia. „Identification du rôle du récepteur nucléaire Rev-erb-α dans la néovascularisation de la plaque d'athérosclérose“. Electronic Thesis or Diss., Université de Lille (2022-....), 2024. http://www.theses.fr/2024ULILS081.

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Malgré des décennies d'administration de traitements hypocholestérolémiants, de stratégies de prévention et d'efforts de recherche, les maladies cardiovasculaires, principalement causées par l'athérosclérose, restent la principale cause de décès dans le monde. De nouvelles thérapies sont donc indispensables pour réduire le risque cardiovasculaire résiduel et prévenir les événements athéro-thrombotiques. Plus que la sténose de la lumière artérielle, il est désormais admis que l’instabilité et la rupture de la plaque d'athérome sont les événements les plus délétères au cours de l’athérogenèse. Parmi les processus déclenchant l'instabilité de la plaque, il a été montré que la néovascularisation intraplaque accélère la croissance de la lésion, induit sa rupture et atténue les bénéfices des traitements hypocholestérolémiants comme les statines chez l'Homme. Il est intéressant de noter que l'administration locale de modulateurs de l'angiogenèse réduit non seulement la taille des lésions mais aussi la survenue d’événements cardiovasculaires aigus chez l'Homme, ce qui souligne la pertinence de ces approches thérapeutiques dans le contexte de la prévention de l’instabilité de la plaque. Cependant, les inhibiteurs actuels de l'angiogenèse sont utilisés de manière systémique et entraînent des événements cardiovasculaires secondaires indésirables, ce qui plaide en faveur de l'identification de nouvelles cibles pharmacologiques.Utilisant une approche transcriptomique sur les cellules circulantes issues de patients diabétiques à haut et faible risque cardiovasculaire, avec des expériences de microdissection sur endartériectomies humaines, nous avons déterminé que la faible expression de REV-ERBα est associée à des plaques d'athérosclérose avancées et vascularisées chez l’Homme. Dans le fond pro-athérogénique LDLr-/-, la déficience en Rev-erbα accélère la progression et la complexification de la plaque chez les souris âgées de 18 mois, nourries en régime standard. En utilisant une technique d’imagerie de l'organe entier sur l’artère brachiocéphalique, nous avons observé que ces souris LDLr-/-Rev-erbα-/- présentent un réseau de vaisseaux intraplaques plus développé, complexe et immature que les souris LDLr-/-Rev-erbα+/+. De manière intéressante, à ce réseau vasculaire intraplaque semblent aussi associés des noyaux vasculogéniques. En outre, la délétion de Rev-erbα dans notre modèle pro-athérogène est également corrélée à une induction du programme pro-angiogénique ainsi qu’à l’expression de gènes impliqués dans la sélection du phénotype endothélial « tip/stalk-cell » et de gènes associés aux capacités migratoires, prolifératives et de détection de l’hypoxie des cellules progénitrices endothéliales ; Ces cellules étant respectivement impliquées dans la formation et la croissance des vaisseaux ainsi que dans les processus vasculogéniques. En effet, la déficience de Rev-erbα augmente non seulement, ex vivo le bourgeonnement vasculaire à partir d’anneaux aortiques stimulés par VEGF mais aussi in vivo le développement du plexus vasculaire rétinien du nouveau-né. En conclusion, nous avons identifié le récepteur nucléaire Rev-erb-α comme un inhibiteur de la néovascularisation intraplaque chez la souris et l'Homme, et par conséquent REV-ERB-α semble représenter une cible pharmacologique putative pour stabiliser la plaque, en particulier chez les patients à haut risque cardiovasculaire
Despite decades of lipid-lowering treatments, prevention strategies, and research efforts, cardiovascular diseases, mainly caused by atherosclerosis, remain the leading cause of death worldwide. New therapies are therefore essential to lower the residual cardiovascular risk and prevent atherothrombotic events. More than stenosis of the arterial lumen, it is now accepted that atherosclerotic plaque instability and rupture are the most deleterious events during atherogenesis. Among the processes triggering plaque instability, intraplaque neovascularization has been shown to accelerate lesion growth, induce rupture, and attenuate the benefits of lipid-lowering treatments such as statins in humans. Interestingly, local administration of angiogenesis modulators, via anti-VEGF eluting stents, reduces not only lesion size and the presence of intraplaque neovascularization, but also the occurrence of acute cardiovascular events in humans. This emphasizes the relevance of such therapeutic approaches in preventing plaque instability. However, current angiogenesis inhibitors are used systemically and are associated with major cardiovascular events, arguing for the identification of new pharmacological targets. Using a transcriptomic approach on circulating cells from high- and low-cardiovascular-risk diabetic patients, with microdissection experiments on human endarterectomies, we determined that a low expression of the nuclear receptor and transcription inhibitor REV-ERBα is associated with advanced and vascularized atherosclerotic plaques in humans. This suggests a role for REV-ERB-α not only in preventing plaque instability but also intraplaque neovascularization.Indeed, in 18-month-old LDLr-/- mice fed a chow diet, Rev-erbα deficiency accelerates plaque progression and complexification. Using a whole organ imaging technique on the brachiocephalic artery, we observed that these LDLr-/-Rev-erbα-/- mice exhibit a more developed, complex, and immature intraplaque vessel network than LDLr-/-Rev-erbα+/+ mice. Interestingly, this intraplaque vascular network is also associated with the presence of vasculogenic nuclei. At the molecular level, the Rev-erbα deficiency in our pro-atherogenic model is also correlated with an induction of the pro-angiogenic program, as well as with the expression of genes involved in the selection of the endothelial “tip/stalk-cell” phenotypes and genes associated with the migratory, proliferative and hypoxia-sensing capacities of the endothelial progenitor cells; these cells being respectively involved in vessel formation and growth, and in vasculogenic processes. Indeed, Rev-erbα deficiency not only increases the ex vivo vascular sprouting from VEGF-stimulated aortic rings but also accelerates the in vivo retinal vascular plexus development. In conclusion, we have identified the nuclear receptor Rev-erb-α as an inhibitor of angiogenesis and intraplaque neovascularization in mice and humans. Therefore, REV-ERB-α represents a putative pharmacological target for stabilizing the atherosclerotic plaque to prevent acute cardiovascular events, particularly in high-risk patients

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Piechel, Lise. „Rôle du récepteur nucléaire Rev-erbα dans le contrôle de la fonction des cellules musculaires lisses au cours de l'athérosclérose“. Electronic Thesis or Diss., Université de Lille (2022-....), 2024. http://www.theses.fr/2024ULILS078.

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Les maladies cardiovasculaires, principalement causées par l'athérosclérose, demeurent la première cause de mortalité dans le monde. L'athérosclérose est une maladie inflammatoire chronique de la paroi vasculaire provoquée par l'internalisation de lipides dans l'espace sous-endothéliale. Cette accumulation anormale déclenche l'infiltration de leucocytes et l'activation des cellules musculaires lisses (CML). Plus que l'obstruction des vaisseaux, l'instabilité et la rupture des plaques sont considérées comme les événements les plus délétères à l'origine d'infarctus du myocarde par exemple. Les deux principaux processus responsables de l'instabilité des plaques sont la calcification vasculaire et la néovascularisation intraplaque. La calcification vasculaire consiste en une minéralisation de la plaque d'athérosclérose sous forme de micro-calcifications et de macro-calcifications. Si cette dernière a été considérée comme stabilisatrice, elle diminue aussi l'élasticité des vaisseaux contribuant à l'hypertension, à la sténose aortique et à la vulnérabilité des plaques. Quant à la néovascularisation intraplaque, elle résulte de la formation de zones hypoxiques intraplaques qui provoque la formation de néovaisseaux immatures et perméables. L'angiogenèse intraplaque favorise la progression des plaques et accroît le risque de rupture. Nous cherchons à identifier ici les mécanismes responsables de ces deux phénomènes. La compréhension des mécanismes sous-jacents pourrait en effet ouvrir la voie à de nouvelles cibles thérapeutiques.Grâce à une approche multi-omics, nous avons identifié le récepteur nucléaire Rev-erbα comme un facteur clé particulièrement dérégulé dans les cellules de patients diabétiques ayant un haut risque cardiovasculaire comparé aux cellules de patients diabétiques avec un bas risque cardiovasculaire. Rev-erbα est un inhibiteur de la transcription, activé par des ligands naturels ou synthétiques, impliqué dans la régulation du métabolisme lipidique et de la réponse inflammatoire. Par ailleurs, des expériences de microdissection laser réalisées sur des endartériectomies humaines montrent que l'expression de REV-ERBα est plus faible dans les zones calcifiées et vascularisées suggérant un rôle protecteur de REV-ERBα.Dans un modèle de souris LDLr-/- âgées de 18 mois, la délétion de Rev-erbα accélère la progression et la complexité de la plaque. Par ailleurs, une analyse transcriptomique menée sur les aortes de ces souris révèle que les gènes associés aux voies de la calcification vasculaire et de l'angiogenèse intraplaque sont particulièrement enrichis lorsque Rev-erbα est délété suggérant que Rev-erbα protégerait contre l'athérosclérose, la calcification vasculaire et la néovascularisation.La déficience en Rev-erbα favorise en effet le développement de l'athérosclérose, augmente le dépôt de calcium et induit la différenciation ostéoblastique des CML. Cet effet sur la différenciation ostéoblastique des CML est amplifié en présence de cytokines pro-inflammatoires in vitro. Des analyses transcriptomiques réalisées sur CML en cours de différentiation nous ont permis d'identifier la hyaluronidase Cemip comme facteur important dans le rôle que joue Rev-erbα sur la différenciation ostéoblastique.Par ailleurs, l'analyse d'artères brachiocéphaliques par 3DISCO montre que l'absence de Rev-erbα favorise le développement d'un réseau vasculaire intraplaque plus complexe et immature que chez les souris contrôles. Au niveau moléculaire, il semblerait que Rev-erbα contrôle l'expression et de la sécrétion de facteurs pro-angiogéniques de façon cellule-spécifique.En conclusion, Rev-erbα apparaît comme un régulateur clé de la calcification vasculaire et de la sécrétion des facteurs pro-angiogéniques par les cellules de la plaque. Ces résultats permettent d'identifier Rev-erbα comme une nouvelle cible thérapeutique prometteuse pour réduire le risque cardiovasculaire résiduel chez les patients à très haut risque cardiovasculaire
Cardiovascular disease, mainly caused by atherosclerosis, remains the leading cause of death worldwide. Atherosclerosis is a chronic inflammatory disease of the vascular wall caused by the internalization of lipids into the subendothelial space. This abnormal accumulation triggers leukocyte infiltration and smooth muscle cell (SMC) activation. More than vascular occlusion, plaque instability and rupture are considered to be the most deleterious events at the origin of myocardial infarction, for exemple. The two main processes responsible for plaque instability are vascular calcification and intraplaque neovascularization. Vascular calcification is the mineralization of atherosclerotic plaque in the form of micro-calcifications and macro-calcifications. While the latter is considered stabilizing, it also reduces vascular elasticity and contributes to hypertension, aortic stenosis, and plaque vulnerability. Intraplaque neovascularization results from the formation of intraplaque hypoxic zones, leading to the formation of immature, permeable neovessels. Intraplaque angiogenesis promotes plaque progression and increases the risk of rupture. Our aim is to identify the mechanisms responsible for these two phenomena. Understanding the underlying mechanisms may provide new therapeutic targets.Using a multi-omics approach, we identified the nuclear receptor Rev-erbα as a key factor deregulated in cells from diabetic patients at high cardiovascular risk compared to cells from diabetic patients at low cardiovascular risk. Rev-erbα is a natural or synthetic ligand-activated transcription inhibitor involved in the regulation of lipid metabolism and inflammatory response. Furthermore, laser microdissection experiments performed on human endarterectomies show that REV-ERBα expression is lower in calcified and vascularized areas, suggesting a protective role for REV-ERBα.In an 18-month-old LDLr-/- mouse model, deletion of Rev-erbα accelerates plaque progression and complexity. Furthermore, transcriptomic analysis of aortas from these mice revealed that genes associated with vascular calcification and intraplaque angiogenesis pathways are enriched when Rev-erbα is deleted, suggesting that Rev-erbα protects against atherosclerosis, vascular calcification and neovascularization. Rev-erbα deficiency promotes the development of atherosclerosis, increases calcium deposition and induces osteoblastic differentiation of SMC. This effect on osteoblastic differentiation of SMC is enhanced in the presence of pro-inflammatory cytokines in vitro. Transcriptomic analyses performed on differentiating SMC allowed us to identify the hyaluronidase Cemip as an important factor in the role of Rev-erbα in osteoblastic differentiation. Furthermore, 3DISCO analysis of brachiocephalic arteries shows that the absence of Rev-erbα promotes the development of a more complex and immature intraplaque vascular network than in control mice. At the molecular level, Rev-erbα appears to control the expression and secretion of pro-angiogenic factors in a cell-specific manner.In conclusion, Rev-erbα appears to be a key regulator of vascular calcification and secretion of pro-angiogenic factors by plaque cells. These results identify Rev-erbα as a promising new therapeutic target for reducing residual cardiovascular risk in patients at very high cardiovascular risk

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Fernández, Valverde Diana Elizabeth. „Estimación del riesgo cardiovascular en población española adulta y control de los factores de riesgo en pacientes con enfermedad cardiovascular establecida“. Doctoral thesis, Universitat Rovira i Virgili, 2021. http://hdl.handle.net/10803/673091.

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Introducció: La malaltia cardiovascular (MCV) és la principal causa de morbimortalitat a nivell mundial. Objectius -Desenvolupar una funció predictiva del risc cardiovascular (RCV) de per vida. -Avaluar les conseqüències clíniques d'utilitzar les taules SCORE/SCORE OP a Espanya. -Avaluar el control dels factors de RCV en pacients amb ECV establerta. Metodologia Estudi1. Estudi de cohorts. Van participar treballadors (18-65 anys) visitats entre 2004-2007. El 70% de la cohort es va utilitzar per a desenvolupar l'equació, el 30% restant per a validar-la. Estudi2: Estudi transversal. Van participar subjectes sense antecedents de ECV entre 65-85 anys, amb registres vàlids de pressió arterial sistòlica (PAS) i colesterol total (CT). Estudi3: Estudi transversal, europeu. Es van seleccionar subjectes de 18-85 anys d'edat amb MCV establerta entre els 6 mesos i els 3 anys després del diagnòstic. Resultats Estudi1: van participar 762.054 subjectes, edat mitjana: 35,48 anys, 71,14% homes. Intervenen en el model: ocupació, tabaquisme, diabetis mellitus, tractament antihipertensiu i hipolipemiant, PAS, CT; en homes, a més: consum d'alcohol, índex de massa corporal, antecedents familiars de malaltia coronària precoç , malaltia renal i pressió arterial diastòlica. Estudi2: Es van incloure 3.425 pacients. Un 25,46% tenien risc alt segons SCORE i 22,90% segons SCORE OP. Utilitzant el SCORE tractaríem amb hipolipemiantes un 16,43% dels individus , mentre que i amb SCORE OP només 13,45%. Estudi3: Van participar 973 pacients, 32,4% dones, 14% fumadors, 32% inactius físicament, 30% amb hàbits alimentaris poc saludables. 75% va aconseguir un bon control de la pressió arterial (<140/80mmHg), només un 23% controlaven el c-LDL (<70 mg/dl). Les dones estaven infratractades. Conclusions El model per a calcular el RCV per a tota la vida va mostrar una discriminació i calibratge satisfactoris. Les taules SCORE OP identifiquen menys pacients d'alt risc el que implica tractar menys. Un alt percentatge de pacients amb ECV establerta no modifiquen el seu estil de vida, ni aconsegueixen els objectius terapèutics.
Introducción La enfermedad cardiovascular (ECV) es la principal causa de morbimortalidad a nivel mundial. Objetivos -Desarrollar una función predictiva del riesgo cardiovascular (RCV) de por vida. -Evaluar las consecuencias clínicas de utilizar las tablas SCORE/SCORE OP en España. -Evaluar el control de los factores de RCV en pacientes con ECV establecida. Metodología Estudio1. Estudio de cohortes. Participaron trabajadores (18-65 años) visitados entre 2004-2007. El 70% de la cohorte se utilizó para desarrollar la ecuación, el 30% restante para validarla. Estudio2: Estudio transversal. Participaron sujetos sin antecedentes de ECV entre 65-85 años, con registros válidos de presión arterial sistólica (PAS) y colesterol total (CT). Estudio3: Estudio transversal, europeo. Se seleccionaron sujetos de 18-85 años de edad con ECV establecida entre los 6 meses y los 3 años después del diagnóstico. Resultados Estudio1: participaron 762.054 sujetos, edad media: 35,48 años, 71,14% varones. Intervienen en el modelo: ocupación, tabaquismo, diabetes mellitus, tratamiento antihipertensivo e hipolipemiante, PAS, CT; en varones, además: consumo de alcohol, índice de masa corporal, antecedentes familiares de enfermedad coronaria precoz, enfermedad renal y presión arterial diastólica. Estudio2: Se incluyeron 3.425 pacientes. Un 25,46% tenían riesgo alto según SCORE y un 22,90% según SCORE OP. Utilizando el SCORE trataríamos con hipolipemiantes un 16,43% de los individuos, mientras que con SCORE OP sólo un 13,45%. Estudio3: Participaron 973 pacientes, 32,4% mujeres, 14% fumadores, 32% inactivos físicamente, 30% con hábitos alimenticios poco saludables. 75% alcanzó un buen control de la presión arterial (<140/80mmHg), sólo un 23% controlaban el c-LDL (<70 mg/dl). Conclusiones El modelo para calcular el RCV de por vida mostró una discriminación y calibración satisfactoria. Las tablas SCORE OP identifican menos pacientes de alto riesgo lo que implica tratar menos. Un alto porcentaje de pacientes con ECV establecida no modifican su estilo de vida, ni alcanzan los objetivos terapéuticos.
Introduction Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide. Objectives -To develop a predictive function of lifetime cardiovascular risk (CVR). -To assess the impact of using SCORE / SCORE OP tools in Spain. -To assess the control of CVR factors in patients with established CVD. Methods Study1: Cohort study. Workers (18-65 years old) visited between 2004-2007 participated. 70% of the cohort was used to develop the equation, the remaining 30% was used as the validation cohort. Study2: Cross-sectional study. Subjects without history of CVD between 65-85 years of age participated, with valid records of systolic blood pressure (SBP) and total cholesterol (TC). Study3: European cross-sectional study. Subjects aged 18-85 years with established CVD between 6 months and 3 years after diagnosis were selected. Results Study1: 762,054 subjects were included, mean age: 35.48 years, 71.14% male. The final model included: occupation, smoking, diabetes mellitus, antihypertensive and lipid-lowering treatment, SBP, TC; in men, in addition it was included: alcohol consumption, body mass index, family history of early coronary disease, renal failure and diastolic blood pressure. Study2: 3,425 patients were included. 25.46% were at high risk using SCORE and 22.90% using SCORE OP. Using the SCORE we would treat with lipid-lowering drugs 16.43% of the individuals, while using with the SCORE OP only 13.45%. Study3: 973 patients participated, 32.4% women, 14% smokers, 32% physically inactive, 30% with unhealthy eating habits. 75% and 23% achieved good blood pressure control (<140/80mmHg), and good LDL-c control (<70mg/dl), respectively. Women were under-treated. Conclusions The model to calculate the lifetime CVR showed satisfactory discrimination and calibration. SCORE OP tables identify fewer high-risk patients, which means treating less older patients, thus avoiding overtreatment. A high percentage of patients with established CVD do not modify their lifestyle and do not reach the therapeutic goals.

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Giménez, Álvarez Margarita. „Sistemas de infusión subcutánea continua de insulina y de monitorización contínua de la glucosa en la Diabetes de tipo 1. Perfil de riesgo cardiovascular de los pacientes con control lábil por hipoglucemias recurrentes y graves“. Doctoral thesis, Universitat de Barcelona, 2012. http://hdl.handle.net/10803/107701.

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Los pacientes con Diabetes tipo 1 (DM1) e hipoglucemias graves de repetición presentan de manera generalizada una alteración en la percepción y la respuesta sintomática ante las mismas. La utilización de sistemas de infusión subcutánea contínua de insulina mejora ambas alteraciones y estas mejoras se producen sin objetivarse un deterioro en el control glucémico evaluado por hemoglobina glucosilada (HbA1c) junto con una mejoría en los parámetros de variabilidad glucémica. Asimismo, su uso se asocia a una mejoría en la calidad de vida de estos pacientes. Inclusive en un grupo de pacientes jóvenes con DM1, la presencia de un mayor grado de aterosclerosis preclínica se asocia fundamentalmente a la edad y a la duración de la enfermedad. Las alteraciones pueden observarse en diferentes territorios vasculares y se asocian a defectos en la función endotelial. Aquellos pacientes con un mayor grado de aterosclerosis preclínica tienden a presentar peores perfiles de control metabólico y de parámetros de inflamación crónica. Los episodios repetidos de hipoglucemia confieren además de lo ya mencionado, un peor pronóstico cardiovascular a estos pacientes.
Title: “Continuous subcutaneous insulin infusion and continuous glucose monitoring systems in Type 1 Diabetes. Cardiovascular risk profile in patients with labile glycemic control due to repeated severe hypoglycemia” Short running title: “Hypoglycemia and atherosclerosis in Type 1 Diabetes” Abstract: Type 1 diabetic (T1D) patients with repeated severe hypoglycemic episodes usually show a reduced ability to recognize hypoglycemic signs and symptoms. The use of continuous subcutaneous insulin infusion not only improves both alterations but also is associated with a non deletereous effect in metabolic control evaluated in terms of glycated hemoglobin (HbA1c) and with an improvement in glycemic variability. Moreover, the use of these systems is associated with an improvement in self-reported quality-of-life. Even in a group of young adult patients with T1D, the presence of atherosclerosis is mostly related to age and disease duration. Both endothelial dysfunction and structural damage in different territories might be present in these subjects. Patients with higher degrees of atherosclerosis present worse glycemic control and alterations in different inflammation parameters. Repeated episodes of hypoglycemia are also associated with a worse cardiovascular prognosis in these subjects.

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Risdon, Sydney. „Consommation d’édulcorants intenses non-caloriques et santé cardiométabolique : effets sur le contrôle glycémique et la fonction vasculaire chez le rongeur Sucralose and cardiometabolic health: current understandingfrom receptorsto clinical investigations Artificial sweeteners impair endothelial vascular reactivity: Preliminary results in rodents Is fasting blood glucose a reliable parameter to investigate the effect of non-nutritive sweeteners on glucose metabolism? Digestive n-6 Lipid Oxidation, a Key Trigger of Vascular Dysfunction and Atherosclerosis in the Western Diet: Protective Effects of Apple Polyphenols“. Thesis, Avignon, 2021. http://www.theses.fr/2021AVIG0719.

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Les édulcorants ont été progressivement introduits dans l'alimentation humaine dans le but, de réduire l'apport calorique mais aussi de limiter les répercussions sur les niveaux de glycémie, tout en préservant le gout sucré, élément essentiel du plaisir gustatif. Plusieurs travaux de recherche ont néanmoins suggéré, contrairement aux intentions premières, que cette consommation d’édulcorants quotidienne pouvait participer à augmenter le risque de devenir obèse ou diabétique mais aussi le risque de mortalité cardiovasculaire. Dans ce contexte, l’objectif de ce travail de thèse a été d’identifier les effets d’une consommation chronique de boissons contenant des édulcorants de synthèse et non caloriques, seuls ou en synergie, sur le contrôle glycémique et la physiologie vasculaire, afin de comprendre le risque accru d’évènements cardiovasculaires observé chez les consommateurs fréquents d’édulcorants. Ainsi, nous avons pu mettre en évidence chez le rongeur la sensibilité du tissu vasculaire à l’exposition de l’acésulfame de potassium (Ace-K) et du sucralose, sensibilité qui semble indépendante de l’activation des récepteurs du gout sucré. De manière intéressante, les effets vasomoteurs de ces édulcorants sont apparus antagonistes l’un envers l’autre. Les études actuelles suggèrent également l’implication des édulcorants dans la survenue de facteurs de risque cardiovasculaire tel que l’obésité. Toutefois dans notre modèle, la consommation de sucralose dans le cadre d’un régime gras a permis au contraire de limiter les altérations de ce régime sur l’accumulation de tissu adipeux et sur le contrôle de la glycémie, mais également de potentialiser la réponse vasodilatatrice artérielle chez les souris. Ainsi, nos résultats démontrent l’importance d’identifier les conséquences propres directes (sur les cellules du tissu vasculaire) et indirectes (modulation des facteurs de risque cardiovasculaires) de chaque molécule sur la physiologie vasculaire. Néanmoins, des études supplémentaires sont nécessaires afin d’évaluer les effets spécifiques de chaque molécule sur cette balance vasomotrice
Artificial sweeteners have been extensively introduced into human diets with the objective of decreasing caloric intake and normalize the levels of blood glucose, while preserving an essential element of taste pleasure, the sweet taste. Nevertheless, several studies have suggested that a daily and sustained consumption of sweeteners could contribute to the increased risk of becoming obese or diabetic but also to the increased cardiovascular mortality risk. In this context, the objective of this work was to identify the effects of chronic consumption of beverages containing synthetic and non-caloric sweeteners on glycemic control and vascular physiology. Thus, we were able to demonstrate in rodents the sensitivity of vascular tissue to acesulfame potassium (Ace-K) and sucralose exposure that appears to be independent of sweet taste receptor activation. Interestingly, the vasomotor effects of these artificial sweeteners appeared to be antagonistic to each other. Current studies also suggest the involvement of artificial sweeteners in the occurrence of cardiometabolic disease such as obesity. Surprisingly, in our model, the consumption of sucralose appears to limit the deleterious effects of a high fat diet on body composition and glycemic control. The sucralose consumption even potentiated the vasodilatory arterial response in our mice model. Thus, according to the effects observed on glucose homeostasis, our results demonstrate the importance of identifying the specific direct (on vascular tissue cells) and indirect (modulation of cardiovascular risk factors) consequences of each molecule on vascular physiology. Nevertheless, further studies are needed to evaluate the specific effects of each molecule on this vasomotor balance

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Almeida, Raitany Costa de 1977. „Hipertensão arterial sistêmica e outros fatores de risco cardiovascular em uma amostra da população de Porto Velho - RO = comparação urbana versus ribeirinha = Hypertesion and other cardiovascular risk factors in a sample of the population of Porto Velho - RO : urban area versus riverside area“. [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311543.

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Orientador: Otávio Rizzi Coelho
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-26T20:39:44Z (GMT). No. of bitstreams: 1 Almeida_RaitanyCostade_D.pdf: 3902239 bytes, checksum: 8a2cfd7f0667fa050bead8f4ebaf4e95 (MD5) Previous issue date: 2015
Resumo: Hipertensão arterial sistêmica (HAS) é uma importante causa evitável de morbidade e mortalidade cardiovascular. Vários estudos apontam para o aumento de sua prevalência no mundo e baixo controle pressórico, mas existem poucos dados referentes as comunidades ribeirinhas. Esta pesquisa compara a prevalência, consciência, tratamento e controle de HAS entre população urbana e ribeirinha em Porto Velho, região Amazônica, assim como avalia outros fatores de risco cardiovascular. Foi conduzido um estudo transversal, fundamentado em inquérito domiciliar em indivíduos de 35 a 80 anos, recrutados entre julho e dezembro de 2013. Realizado entrevista com questionário padronizado, medidas de pressão arterial (PA), peso, altura e circunferência abdominal (CA). HAS foi definido através de indivíduos que relataram ter a doença, ou prescritos para uso de medicações anti-hipertensivas ou aqueles que tinham PA sistólica ? 140 mmHg ou PA diastólica ? 90 mmHg, na média de duas medidas usando dispositivo digital automático. Consciência foi baseada em autorrelatos, tratamento no uso de medicamento anti-hipertensivo, e controle foi definido quando indivíduos apresentavam PA menor do que 140/90 mmHg. Foi calculado índice de massa corpórea (IMC) e CA para avaliação de obesidade e obesidade abdominal. Também foi avaliado, através de autorrelatos, a taxa de diabetes, dislipidemia, tabagismo. Entre 1410 participantes, 750 (53,19%) tinham HAS e 473 (63,06%) eram cientes do diagnóstico. Daqueles que tinham consciência do diagnóstico, a maioria 404 (85.41%) recebia tratamento farmacológico, mas a taxa de controle foi baixa. As percentagens de prevalência e tratamento foram maiores na área urbana, respectivamente, (55,48% vs. 48,87%)(p=0,02) e (61,25% vs. 52,30%)(p<0,01). A consciência de HAS foi maior na área ribeirinha (61,05% vs. - 67,36%)(p<0,01), mas as taxas de controle, tanto entre todos os hipertensos quanto naqueles que faziam tratamento farmacológico, foram similares, respectivamente, (22,11% vs. 23,43%)(p=0,69) e (33,88% vs. 34,32%) (p=0,77). Não houve diferença significativa no sobrepeso (40,93% vs. 40,28%)(p=0,73); obesidade (19,10% vs 19,63%)(p=0,68) e tabagismo (18,56% vs. 16,76%)(p=0,09). Cerca de metade dos participantes apresentavam HAS. A prevalência foi mais alta nos urbanos, mas a diferença para os ribeirinhos foi pequena. Dos indivíduos hipertensos, tanto na área urbana quanto ribeirinha, menos de um quarto tinham HAS controlada
Abstract: High blood pressure (hypertension) is a major preventable cause of cardiovascular morbidity and mortality. Several studies indicate to the increase its prevalence in the world and low control rate, but there are few data on the riverside communities. This research compares the prevalence, awareness, treatment and control of hypertension between urban and riverside population in Porto Velho, the Amazon region, as well as evaluating other cardiovascular risk factors. A cross-sectional study was conducted, based on a household survey in individuals 35-80 years recruited between July and December 2013. Directed interview with standardized questionnaire, blood pressure measurements (PA), weight, height and waist circumference (WC). Hypertension was defined by individuals who reported having the disease, or prescribed for use of antihypertensive medications or those who had systolic blood pressure ? 140 mmHg or diastolic BP ? 90 mmHg, the mean of two measurements using automatic digital device. Awareness was based on self-reports, treatment in the use of antihypertensive medication, and control was defined as a BP ? 140/90 mm Hg. We calculated body mass index (BMI) and WC for assessing obesity and abdominal obesity. We also assessed through self-report, the rate of diabetes, dyslipidemia, smoking. Among 1410 participants, 750 (53.19%) had hypertension and 473 (63.06%) were aware of their diagnosis. Of those who were aware of the diagnosis, 404 (85.41%) received pharmacological treatment, but the control rate was low. The percentages of prevalence and treatment were higher in urban areas, respectively (55.48% vs. 48.87%) (p = 0:02) and (61.25% vs. 52.30%) (p <0.01). Awareness was higher in the riverside area (61.05% vs. 67.36%) (p <0.01), but control rates, both among all hypertensive patients and in those who were pharmacological treatment were similar, respectively, (22.11% vs . 23.43%) (p = 0.69) and (33.88% vs. 34.32%) (p = 0.77). - There was no significant difference in the overweight (40.93% vs. 40.28%) (p = 0.73); obesity (19.10% vs. 19.63%) (p = 0.68) and smoking (18.56% vs. 16.76%) (p = 0.09). Hypertension prevalence was higher in the urban population than in the riverside population. Of the hypertensive individuals in both areas, < 25% had controlled blood pressure
Doutorado
Clinica Medica
Doutor em Clínica Médica

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Vani, Gannabathula Sree. „Hiperhomocisteinemia e o risco cardiovascular“. Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/46/46131/tde-02122015-124049/.

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Nível elevado de homocisteína (Hcy) no plasma é considerado fator de risco de doença cardiovascular. Consumo reduzido de vitaminas B6, B12 e ácido fólico tem sido relacionado com hiperhomocisteinemia. O objetivo desse estudo foi verificar o consumo de vitaminas B6, B12 e ácido fólico nas populações urbana e rural, bem como a correlação dos níveis plasmáticos dessas vitaminas com os níveis plasmáticos de Hcy. Também determinamos os níveis séricos de lipídeos e avaliamos o risco cardiovascular das populações frente a hiperlipemia. O consumo de B6 e ácido fólico é maior na população urbana, com p=0,00 e p=0,04 respectivamente, sendo o consumo de B12 maior na população rural, com p=0,47. As correlações são significativamente negativa entre Hcy e as vitaminas B12 e ácido fólico . A população rural apresenta Hcy com valor médio de 16,5±9,2µmol/L, classificada como hiperhomocisteinemia moderada, e a população urbana 12,8±5,5 µmol/L, o qual está dentro da faixa de referência. O valor médio de LDL sérica é maior na população urbana (3,4±0,8mmoI/L) do que na população rural (2,8±0,9mmoI/L), com valor de p=0,00. Como fator de risco cardiovascular, consideramos Hcy plasmática >14µmol/L e LDL sérica >3,38mmol/L. Neste caso, 41,4% da população rural e 7,4% população urbana apresentam Hcy maior que 14µmol/L. O inverso ocorre em relação a LDL, onde 43,2% da população urbana e 11% na população rural apresentam níveis acima de 3,38mmol/L. Concluímos que o risco cardiovascular decorrente de hiperhomocisteinemia é maior na população rural que na urbana e este risco poderia reduzir mediante o consumo de vitaminas.
Elevated levels of plasma homocysteine (Hey) are considered a risk factor for cardiovascular diseases. Low intake of vitamins 86, 812 and folic acid have been related to hyperhomocysteinemia. The purpose of the present study is to determine the consumption of the vitamins B6, B12 and folic acid in two Brazilian urban and rural populations, along with the plasmatic levels of these vitamins and plasmatic homocysteine. In addition, the serum levels of lipids have been determined to evaluate the cardiovascular risk in the two populations regarding their hyperlipidemie comdition. The consumption of B6 and folic acid is higher in the urban population (p=0.00 and p=0.04 respective/y), while the consumption of B12 is not significantly different (p=0.47). There is a negative correlation between B12 and folic acid with Hcy. The rural population shows mean Hcy value of 16.5±9.2µmol/L and is classified as having moderate hyperhomocysteinemia, while for the urban population, the mean value is 12.8±5.5µmol/L and is well within the normal range. The mean value of the serum LDL is higher in the urban population (3.4±0.8mmol/L) compared to the rural population (2.8±0.9mmol/lL) with a significance of p=0.00. Plasma Hcy values >14µmol/L and serum LDL >3.38mmol/L were considered as the risk factors for cardiovascular disease. With in the reference values, 41.4% of the rural population and 7.4% of the urban population showa Hcy as a risk factor. For LDL, the inverse is true, i.e 43.2% of urban and 11% of the rural population are at risk. We conclude that the cardiovascular risk arising from hyperhomocysteinemia is higher in the rural population and that this can be reduced by increased consumption of vitamins.

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Cruz, Paula Lazara. „Ação do resveratrol sobre proteoglicanos de membrana presentes no músculo cardíaco em modelo animal de cardiomiopatia diabética“. Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-06022017-095212/.

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Introdução: Ratos com diabetes induzido por estreptozotocina (STZ) apresentam alterações nos proteoglicanos Sindecan-4 e Glipican-1 no tecido cardíaco concomitantes à instalação da disfunção diastólica, evento precoce que culmina na cardiomiopatia diabética. O uso de resveratrol (RSV) em modelos animais foi capaz de melhorar a função cardíaca e o controle autonômico. Espera-se que o tratamento com esse flavonoide atue nos níveis alterados dos proteoglicanos em animais diabéticos. Objetivo: Avaliar o efeito do RSV nos parâmetros cardiovasculares e na expressão dos proteoglicanos no músculo cardíaco. Materiais e Métodos: Foram avaliados ratos Wistar machos, com doze semanas de vida, divididos em 4 grupos: controle (C, N=8); controle + RSV (CR, N=8); diabetes STZ + nicotinamida (D, N=8) e diabetes STZ + nicotinamida + RSV (DR, N=8). Foram dosados os níveis séricos de glicose, de triglicérides e foi feito o teste de resistência à insulina. Registros diretos das curvas de pressão arterial foram realizados para a análise da variabilidade da frequência cardíaca (VFC) e variabilidade da pressão arterial sistólica (VPAS) no domínio do tempo e da frequência. A sensibilidade barorreflexa foi avaliada por meio de drogas vasoativas e a função cardíaca foi avaliada por ecocardiografia de alta resolução. A localização das proteínas no tecido cardíaco foi feita por imunohistoquímica. Análise estatística utilizada: ANOVA post test Student Newman-Keuls. p < 0,05. Resultados: O peso corporal dos grupos C e CR aumentou significativamente do inicio ao final do protocolo, enquanto os grupos D e DR mantiveram seu peso inicial. A concentração de glicose sérica e dos triglicerídeos, os grupos C e CR não demonstraram diferença ao longo do protocolo, enquanto os grupos D e DR demonstraram significante aumento ao final do protocolo. Os valores de concentração de insulina, do teste de tolerância à insulina e do índice de Lee foram menores nos grupos D e DR quando comparados aos grupos C e CR. A pressão arterial sistólica foi menor nos grupos diabéticos quando comparado aos grupos controles (C e CR) o mesmo acontecendo para os valores da frequência cardíaca. A pressão arterial diastólica apresentou valores semelhantes entre os grupos C e CR e o grupo DR, somente o grupo D apresentou queda quando comparado aos outros três grupos, a pressão arterial media apresentou esse mesmo comportamento. Não foram observadas diferenças para a sensibilidade barorreflexa tanto para a resposta bradicárdica como para a resposta taquicárdica entre os grupos. Nas avaliações da VFC foi observado o aumento do Intervalo de Pulso (IP) nos grupos D e DR quando comparados aos grupos C e CR, mas foram semelhantes entre os grupos controles e diabéticos (C vs. CR e D vs. DR, respectivamente). Na VPAS os grupos D e DR apresentaram diminuição tanto no desvio padrão (DP PAS) quanto na variância (VAR PAS) quando comparados aos grupos C e CR, não houve diferença entre os grupos controles e diabéticos (C vs. CR e D vs. DR, respectivamente). A disfunção diastólica foi detectada no grupo D. A expressão das proteínas Glypican-1 e Syndecan- 4, foram significantemente maiores no grupo D quando comparada aos demais grupos e menos expressas no grupo DR quando comparada aos demais grupos. Conclusões: A administração de RSV reverteu tanto alterações morfológias como a função cardíaca global que voltou a apresentar valores muito próximos aos valores de normalidade, sem alterar as condições hemodinâmicas e autonômicas
Introduction: Streptozotocin-induced rats model show changes in proteoglycans sindecan-4 and glipican-1 in cardiac tissue concomitantly with installation of diastolic dysfunction, which is an early event that culminates in diabetic cardiomyopathy. The use of resveratrol (RSV) in animal models showed the improvement of cardiac function and autonomic control. It is expected that the treatment with this flavonoid act on altered levels of proteoglycans in diabetic rats. Objective: To evaluate the effects of resveratrol in cardiovascular parameters and the expression of proteoglycans in cardiac muscle. Material and Methods: Male Wistar rats (12 weeks old) were allocated into 4 groups: control (C, N=8), controle+RSV (CR, N=8), Diabetes STZ + nicotinamide (D, N=8) and diabetes STZ+ nicotinamide + RSV (DR, N=8). Serum levels of glucose, insulin resistance test and triglycerides were measured in order to evaluate diabetes. Arterial blood pressure records were measured in order to analyze the heart rate variability (HRV) and systolic blood pressure variabilities in frequency and time domain. The baroreflex sensivity was evaluated by vasoactive drugs infusion and the evaluation of cardiac function by high resolution echocardiography. The location of the proteins in the heart tissue was performed by immunohistochemistry. Statistics and performed analysis used: ANOVA post test Student Newman-Keuls. p < 0,05. Results: Our results showed that the body weight of groups C and CR increased significantly from the beginning to the end of the protocol, while the groups D and DR continued to have the initial weight. Regarding serum glucose concentration and triglycerides, there were no statistically significant differences between group C and CR while the group D and DR increased significantly at the end of the protocol. The values of insulin concentration, insulin tolerance test and the Lee index were lower in groups D and DR when compared to groups C and CR. The hemodynamic parameters demonstrated that systolic blood pressure was lower in diabetic groups when compared to control groups (C and CR) as well as the heart rate values. Interestingly, diastolic blood pressure showed similar values between groups C, CR and group DR. The group D decreased its diastolic blood pressure when compared to the other groups, as well as the blood pressure mean. There were no significant differences either to baroreflex sensivity, bradicardiac response and tachycardia between both groups. The evaluation of heart rate variability (HRV) showed an increase of pulse interval (PI) in groups D and DR when compared to groups C and CR. The evaluation of systolic blood pressure variability of the groups D an DR showed a decrease in both the standard deviation (SD PAS) and variance when compared to groups C and CR and there were no differences between the diabete groups and the control (C vs CR and D vs DR respectively). The diastolic disfunction was detected in group D. The Glypican-1 and Syndecan-4 protein expression were significantly higher in group D when compared to the other groups and less expressed in group DR when compared to the other groups. Conclusion: The administration of RSV reversed both morphological changes and the global cardiac function, which showed very close values to the normal range values, without changing the hemodynamic and autonomic conditions

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Mateus, Pedro Miguel de Sousa. „Importância do método de seguimento de doentes coronários no controlo dos fatores de risco cardiovascular e na prevenção de eventos adversos cardiovasculares“. Master's thesis, Faculdade de Medicina da Universidade do Porto, 2011. http://hdl.handle.net/10216/63820.

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Mateus, Pedro Miguel de Sousa. „Importância do método de seguimento de doentes coronários no controlo dos fatores de risco cardiovascular e na prevenção de eventos adversos cardiovasculares“. Dissertação, Faculdade de Medicina da Universidade do Porto, 2011. http://hdl.handle.net/10216/63820.

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Sanches, Iris Callado. „Controle cardiovascular em fêmeas ooforectomizadas diabéticas: efeitos do treinamento físico dinâmico aeróbio, resistido ou combinado“. Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-07112012-095519/.

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O treinamento físico aeróbico induz atenuação de disfunções cardiometabólicas que acometem mulheres menopausadas e/ou diabéticas. Entretanto, estudos envolvendo treinamento resitido ou combinado (aeróbio + resistido) são escassos e controversos. Dessa forma, os objetivos do presente estudo foram avaliar os efeitos metabólicos, cardiovasculares e autonômicos da privação dos hormônios ovarianos na presença ou não de diabetes induzido por estreptozotocina em ratas, bem os efeitos do treinamento físico aeróbio dinâmico, resistido dinâmico, ou combinado nesta condição. Ratas Wistar (200-220g) foram dividas em um grupo controle sedentário (ES), um grupo diabético sedentário (DS) e 5 grupos ooforectomizados (retirada bilateral dos ovários) (n=8), sendo um euglicêmico sedentário (EOS) e os demais diabéticos (estreptozotocina, 50 mg/kg, iv): sedentário (DOS), submetido a treinamento físico (TF) aeróbio em esteira (DOTA), a TF resistido em escada (DOTR), ou a TF combinado, em escada e esteira em dias alternados (DOTC). Após as 8 semanas de TF, a função e a morfometria cardíaca foram avaliadas pelo ecocardiograma e, no dia seguinte, os animais foram canulados para registro da pressão arterial (PA) e avaliação da sensibilidade barorreflexa (SB). A análise da variabilidade da frequência cardíaca (FC) e da PA sistólica (PAS) foi realizada no domínio do tempo e da frequência. Os resultados demonstraram aumento de 9% no peso corporal e 10% na PA, e redução de SB (21% nas respostas taquicárdicas) no grupo EOS. Os animais diabéticos apresentaram redução de 19% no peso corporal e na capacidade física (22% no teste máximo em esteira e 19% na carga máxima na escada); redução de 8% na massa e 18% na espessura relativa da parede do ventrículo esquerdo (VE), aumento de 11% na cavidade do VE, de 31% no tempo de relaxamento isovolumétrico e 34% no índice de desempenho miocárdico; além de redução de na PA, na FC, na SB e na banda AF-IP. A associação de diabetes com ooforectomia induziu exacerbação de algumas disfunções, como aumento de 9% na glicemia e de 20% no índice de desempenho miocárdico (IDM); redução de 14% na velocidade de encurtamento do VE e 14% na FC (DOS vs. DS). O treinamento induziu aumento de 77% na capacidade de corrida no grupo DOTA, aumento de 60% na carga máxima no DOTR, e aumento em ambos os parâmetros no DOTC (75% na corrida e 58% na carga máxima). Todos os animais treinados apresentaram reversão da hipotensão e da bradicardia de repouso, associadas a aumento na VAR-IP (DOTA: 79%, DOTR: 79%, DOTC: 65%), normalização da banda de BF-IP, e redução no índice de desempenho miocárdico (DOTA: 16%, DOTR: 15%, DOTC: 31%) (vs. DOS). Os grupos DOTA e DOTC (mas não o DOTR) apresentaram maior SB (respostas taquicárdicas e bradicárdicas), atenuação das alterações morfométricas do VE, e na variabilidade da PA sistólica (vs. DOS). Além disso, o grupo DOTR apresentou aumento de 14% na massa, e redução de 14% na velocidade de encurtamento do VE e de 15% no IDM em relação ao grupo DOS. O grupo DOTC demonstrou redução adicional de 18% no IDM e em relação ao DOTA. A mortalidade foi maior no grupo DOS em comparação aos grupos treinados. Concluindo, os resultados evidenciam que o treinamento físico dinâmico aeróbio, resistido ou combinado induziu benefícios na capacidade física, cardíacos, hemodinâmicos e autonômicos após a privação dos hormônios ovarianos em ratas diabéticas. No entanto, o treinamento físico combinado promoveu efeitos adicionais em relação aos treinamentos aeróbio ou ao resistido nesta condição.
Aerobic exercise training induces attenuation of cardiometabolic disorders that affect postmenopausal and/or diabetic women. However, there few and controversial studies involving resistance or combined training (aerobic + resistance) in these conditions. Thus, the objectives of this study were to evaluate the metabolic, cardiac, hemodynamic and autonomic effects of ovarian hormones deprivation in the healthy and streptozotocin-induced diabetic rats, as well as the effects of dynamic aerobic, resistance or combined exercise training in this condition. Female Wistar rats (200-220g) were divided into (n = 8 each group) a sedentary control group (ES), a sedentary diabetic group (SD) and 5 ovariectomized groups (bilateral ovaries removal): sedentary euglycemic (EOS), sedentary diabetic (DOS), trained diabetic by an aerobic protocol on a treadmill (DOTA), by a resistance protocol in ladder (DOTR), or by a combined protocol in ladder+treadmill on alternate days (DOTC). After 8 weeks of training, cardiac morphometric and function were evaluated by echocardiography. On the next day, the animals were cannulated to arterial pressure (AP) recording and baroreflex sensitivity (BS) evaluation. Heart rate (HR) and systolic AP variability were analyzed in the time and frequency domains. The results showed increased of 9% in body weight and 10% in AP, and BS (21% in tachycardic responses) reduction in the EOS group. Diabetic animals showed a reduction of 19% in body weight and in physical capacity (22% in the maximal test on a treadmill and 19% in the maximum load on the ladder), reduction of 8% in mass and of 18% in relative wall thickness of the left ventricle (LV), increase of 11% in LV cavity, 31% in the isovolumetric relaxation time and 34% in myocardial performance index (MPI); in addition to reduction in AP, in HR, BS, and in PI-HF band. The association of diabetes with ovariectomy induced exacerbation of some dysfunctions, such as increased of 9% in blood glucose and 20% in MPI, reduction of 14% in the LV velocity of shortening and 14% in HR (DOS vs. DS). Exercise training induced an increase of 77% in the run capacity in the DOTA group, 60% in the maximum load in DOTR group, and increases in both parameters in DOTC (75% in run and 58% in the maximum load). All trained animals showed reversal of hypotension and bradycardia at rest DOTA: 79%, DOTR: 79%, DOTC: 65%), associated with increased HR variance and normalization of the LF band of pulse interval (PI), and reduced MPI (DOTA: 16%, DOTR: 15%, DOTC: 31%) (vs. DOS). The DOTA and DOTC groups (but not DOTR) had higher BS (tachycardic and bradycardic responses), and attenuation in the LV morphometric changes and in SAP variability (vs. DOS). Furthermore, the DOTR group showed an increase of 14% in mass and a reduction of 14% in LV velocity of shortening and of 15% in MPI in relation to DOS group. The DOTC group showed additional reduction of 18% in MPI and in relation to DOTA. Mortality was higher in DOS group when compared to trained group. In conclusion, the results showed that dynamic aerobic, resistance or combined exercise training induced benefits in physical capacity, cardiac, hemodynamic and autonomic parameters after ovarian hormone deprivation in diabetic rats. However, the combined exercise training promoted additional effects than aerobic or resistance training in this condition.

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CHAOUCHE-TEYARA, KAMEL. „Role des recepteurs 5-ht#2 dans le controle cardiovasculaire“. Paris 6, 1994. http://www.theses.fr/1994PA066784.

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La classification des recepteurs 5-ht souffre, depuis plusieurs decennies, du manque d'agonistes et/ou d'antagonistes selectifs pour certains de ces recepteurs. C'est le cas des recepteurs 5-ht#2 et des recepteurs 5-ht#1. Ce travail a ete realise afin de mieux comprendre le role des recepteurs 5-ht#2 dans le controle cardiovasculaire chez le rat. La caracterisation pharmacologique du 1-(2,5-dimethoxy-4-iodo-phenyl)-2-aminopropane (doi) et de l'-methyl-5-ht a permis, dans un premier temps, de montrer que le doi se comporte comme un agoniste partiel pour les recepteurs 5-ht#2, alors que l'-methyl-5-ht se comporte comme un agoniste plein pour ces memes recepteurs. Les resultats obtenus, dans un second temps, ont montre que les effets vasculaires et cardiaques du doi et de l'-methyl-5-ht ne sont pas similaires et mettent en jeu des recepteurs 5-ht differents: 5-ht#2 (5-ht#2#a) et/ou 5-ht#1#c (5-ht#2#c). L'etude des effets hemodynamiques regionaux montre que le doi et l'-methyl-5-ht augmentent les rpt par stimulation des recepteurs 5-ht#2#a et/ou 5-ht#2#b et que l'ensemble des territoires etudies participe a cette augmentation avec, cependant, une predominance de certains territoires (territoires renal) sur d'autres (mesenterique, train posterieur). Les resultats obtenus permettent egalement d'incriminer les recepteurs 5-ht#2#a et/ou 5-ht#2#b centraux dans le controle des resistances vasculaires regionales notamment squelettique et musculaire

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Kellett, Daniel Otto. „Central serotonergic control of cardiovascular reflexes“. Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1446450/.

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Central serotonergic neurones control reflex parasympathetic outflow to the heart, airways and bladder in a number of species, and different 5-HT receptor subtypes are involved in this effect. 5-HTiA and 5-HT3 receptors in the brainstem facilitate these reflexes, whilst 5-HTiB/id, 5-HT2 and 5-HT4 receptors inhibit them. Recently, central 5-HT7 receptors have been implicated in bladder reflexes. Experiments on anaesthetised rats showed that the selective 5-HT7 receptor antagonists SB-269970 and SB-656104, given intracisternally (i.e.), attenuated cardiopulmonary, baroreflex and chemoreflex bradycardias. Similarly, the selective 5-HTia receptor antagonist WAY-100635 attenuated cardiopulmonary and chemoreflex (but not baroreflex) bradycardia, whilst robalzotan and (-)-pindolol (antagonists at 5-HTiA receptors) had no effect on cardiopulmonary and baroreflex bradycardias respectively. Chemical stimulation of presumed serotonergic cell bodies in raphe magnus/pallidus evoked a bradycardia that could not be attenuated either by 5-HT receptor antagonists (given i.v.) or by prior 5-HT depletion. The latter did, however, significantly attenuate cardiovascular reflex sensitivity. Activation of nucleus tractus solitarius (NTS) neurones by the vagus was inhibited by the iontophoretic AMP A receptor antagonist DNQX or by topical SB-269970. Subsequent histology suggested that 5-HT containing terminals do not make close appositions with these neurones. Preliminary data demonstrate that SB-269970 (given i.e.) effectively attenuates the cardiopulmonary reflex in awake rats, but has variable effects on the chemoreflex. The data suggest that 5-HT7 receptors in the NTS are crucially involved in the central transmission of reflex bradycardias, at least in rats. The role of the 5-HTia receptor is less clear-cut than in the rabbit, and may reveal a species difference. The origin of 5-HT activating these receptors is unlikely to be the medullary raphe neurones, but may be primary afferents terminating in the NTS. Since recent ultrastructural evidence shows 5-HT terminals and NTS cardiovascular neurones are often separated by astroglial leaflets, astrocytes may be involved in serotonergic-glutamatergic signalling.

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Farias, Dyego Anderson Alves de. „Controle da pressão arterial em hipertensos acompanhados no âmbito da Atenção Primária à Saúde“. Universidade Federal da Paraíba, 2014. http://tede.biblioteca.ufpb.br:8080/handle/tede/6551.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
The systemic arterial hypertension (SAH) affects approximately one third of individuals worldwide and is considered one of the diseases more common in the Brazilian population. Due to its high prevalence, hypertension is seen as a major risk factor for cardiovascular disease. The main objective of the study was to evaluate the control of blood pressure (BP) in hypertensive accompanied (1 year, 2 years and 3 years) by the Family Health Teams (FHS) of João Pessoa (JP) and Campina Grande (CG) during the period 2009-2011. This was an observational, retrospective population-based cohort. The BP control was assessed by comparing the mean systolic and diastolic blood pressure of hypertensive PAs grouped by follow-up time in years, by analysis of variance (ANOVA) and Analysis of Covariance (ANCOVA). In another step the perception and knowledge of hypertensive (followed by three years in the city of JP) on the disease and treatment, using a qualitative approach based on the analysis of the Collective Subject Discourse (CSD) was evaluated. In monitoring groups and the two counties there was a profile of hypertensive women, elderly, white or brown, low schooling, retired with uncontrolled blood pressure. No significant differences between the mean systolic and diastolic APs for hypertensive municipalities JP and CG was observed, as well as no differences were found between the means of monitoring groups in years. Statistical evidence (p-value 0.0062) that the follow-up time is related to blood pressure levels were found. The analyzes suggest that the longer follow-up by the user, the less discrepancy (pressure levels) between control and no control of the PA. In the qualitative phase was observed on reasonable knowledge of hypertensive disease, the treatment and control forms. Despite efforts by the government and health teams, it was found that the control of blood pressure levels, and as a consequence, the reduction of morbidity and mortality have not yet reached adequate levels. Alert to the need to review and change in the tracking system of hypertensive as recommended by the Ministry of Health transcends easier access to the drug, ie to seek an effective follow-up treatment, prevention and control of complications associated with SAH.
A hipertensão arterial sistêmica (HAS) afeta aproximadamente um terço dos indivíduos em todo o mundo e é considerada uma das doenças mais presentes na população brasileira. Devido a sua alta prevalência, a HAS é vista como principal fator de risco para doenças cardiovasculares. O objetivo principal do estudo foi avaliar o controle da pressão arterial (PA) em hipertensos acompanhados (1 ano, 2 anos e 3 anos) pelas Equipes de Saúde da Família (ESFs) dos municípios de João Pessoa (JP) e Campina Grande (CG) durante o período de 2009 a 2011. Tratou-se de um estudo observacional, de coorte retrospectiva e de base populacional. O controle da PA foi avaliado por meio da comparação das médias das PAs sistólicas e diastólicas dos hipertensos agrupados por tempo de acompanhamento em anos, através da Análise de Variância (ANOVA) e Análise de Covariância (ANCOVA). Em outra etapa foi avaliada a percepção e o conhecimento dos hipertensos (acompanhados por três anos no município de JP) sobre a doença e o tratamento, utilizando-se da abordagem qualitativa a partir da análise do Discurso do Sujeito Coletivo (DSC). Nos grupos de acompanhamento e para os dois municípios observou-se um perfil de hipertensos do sexo feminino, idosos, brancos ou pardos, de baixa escolaridade, aposentados, com níveis pressóricos não controlados. Observou-se que não existem diferenças significativas entre as médias das PAs sistólicas e diastólicas para os hipertensos dos municípios de JP e CG, como também não foram encontradas diferenças entre as médias dos grupos de acompanhamento em anos. Foram encontradas evidências estatísticas (p-valor 0,0062) de que o tempo de acompanhamento tem relação com os níveis pressóricos. As análises sugerem que quanto maior o tempo de acompanhamento pelo usuário, menor a discrepância (dos níveis pressóricos) entre o controle e não controle da PA. Na etapa qualitativa observou-se razoável conhecimento dos hipertensos sobre a doença, o tratamento e as formas de controle. Apesar dos esforços do governo e das equipes de saúde, verificou-se que o controle dos níveis pressóricos, e como consequência, a redução da morbimortalidade ainda não atingiram patamares adequados. Alerta-se para a necessidade de avaliação e alterações no sistema de acompanhamento dos hipertensos já que o preconizado pelo Ministério da Saúde transcende a facilitação do acesso ao medicamento, ou seja, buscar um acompanhamento efetivo do tratamento, prevenção e controle de complicações associadas a HAS.

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Buehler, Anna Maria. „Controle glicêmico intensivo versus controle glicêmico convencional em pacientes portadores de diabetes melito tipo II: revisão sistemática e meta-análise de ensaios clínicos randomizados“. Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/42/42137/tde-10012011-104820/.

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Dados prévios ja demostram que o controle intensivo da glicemia diminui o risco de eventos microvasculares em pacientes com diabetes mellitus. No entanto, seu efeito cardiovascular é incerto. Nós sumarizamos os dados de estudos das principais bases de dados. 2 revisores extraíram dados de estudos randomizados de pacientes com diabetes tipo 2, que visavam 2 níveis de intensidade da glicemia. Investigou-se as retinopatia, neuropatias, nefropatias, mortalidade cardiocascular e total, infarto do miocárdio (IAM), acidente vascular cerebral, amputação de membros e episódios de hipoglicemia. Realizamos a meta-análise para obter o risco relativo (RR). Foram incluídos 7 estudos com 27.814 pacientes. O controle intensivo reduziu o RR de IAM e amputação, além progressão da retinopatia, incidência de neuropatia periférica, incidência e progressão de nefropatia e microalbuminúria. Entretanto, dobrou o risco de episódios de hipoglicemia. Não houve diferenças quanto à mortalidade e outros resultados. Conclui-se que controle intensivo reduziu o risco de alguns eventos, sem reduzir a mortalidade, porém as custas do dobro da incidência de de hipoglicemia.
Previous data already show that intensive glucose control reduces the risk of microvascular events in patients with diabetes mellitus. However, its cardiovascular effect is uncertain. We summarize data from studies of the major databases. 2 reviewers extracted data from randomized studies of patients with type 2 diabetes, aimed at two intensity levels of blood glucose. We investigated the retinopathy, neuropathy, nephropathy, and total mortality cardiocascular, myocardial infarction (IAM), stroke, limb amputation and episodes of hypoglycemia. We conducted a meta-analysis to obtain the relative risk (RR). We included seven studies with 27.814 patients. The intensive control reduced the RR of IAM, and amputation, and progression of retinopathy, incidence of peripheral neuropathy, incidence and progression of nephropathy and microalbuminuria. However, it doubled the risk of hypoglycemia. There were no differences in mortality and other outcomes. We conclude that intensive control reduced the risk of some events without reducing mortality, but the expense of twice the incidence of hypoglycemia.

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Souza, Alinne Alice Dias de Araujo. „Doen?a periodontal e angina pectoris est?vel: um estudo caso-controle“. Universidade Federal do Rio Grande do Norte, 2009. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17050.

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The search which it aim was to analyze the Periodontal Disease as a risk factor for the development of the Stable Angina Pectoris. For that, 120 patients (52 blokes and 68 wenches ), ages ranging from 40 to 65 years old, and attended to the Hemodinamic?s Sector of the Natal Hospital Center, showing the historic of Angina Pectoris to accomplishment of cinecoronariografhy. Before the accomplishment of this exam, the patients were submitted to interview, to investigate the possible risk factors for the Cardiovascular diseases , and it was followed of clinical periodontal examination to evaluate the presence of Periodontal Disease. After the cinecoronariography, the patients who presented diagnosis of important arterial obstruction (above 70%) were enrolled to the case grup. However the individuals with arteries free of obstruction, or obstrution below 30%, were considered without historic of Cardiovascular disease and therefore enrolled for the control grup. The groups were paired by the variables age and gender. From the analysis of the results, a did not observed statisticment the significant association between the presence of the Periodontal Disease, probing depth, periodontal attachment level, severity and extension index of the Periodontal Disease, besides the visible plaque index (VPI) an gingival bleeding index (GBI) regarding to the existence of Stable Angina Pectoris. Nevertheless , it was identified statisticment the significant association between the sistemic arterial hypertension , seric level of total cholesterol, LDL, HDL and triglycerides, showing all of them, classic risk factors appointed by the literature. Therefore, it was conclued that Periodontal Disease did not represent association with the StableAngina Pectoris at least among the studied population
Este trabalho teve como objetivo avaliar a doen?a periodontal como fator de risco para o desencadeamento da angina pectoris est?vel. Para tanto, foram examinados 120 pacientes (52 homens e 68 mulheres), com idade entre 40 e 65 anos, que compareceram ao Setor de Hemodin?mica do Natal Hospital Center, com hist?rico de Angina Pectoris e que foram submetidos ? cinecoronariografia. Antes da realiza??o de tal exame, os pacientes foram entrevistados para investiga??o de poss?veis fatores de risco ?s doen?as cardiovasculares, seguida de exame cl?nico periodontal para avalia??o dos par?metros relacionados ? doen?a periodontal. Ap?s a realiza??o da cinecoronariografia, os pacientes que apresentaram diagn?stico de obstru??o arterial importante, acima de 70%, foram arrolados para o grupo caso. J? os indiv?duos com art?rias isentas de obstru??es ou obstru??es inferiores a 30%, foram considerados sem hist?rico de doen?a cardiovascular e, portanto, arrolados para o grupo controle. Os grupos foram emparelhados pelas vari?veis idade e g?nero. A partir da an?lise dos resultados, n?o observouse associa??o estatisticamente significativa entre a presen?a da doen?a periodontal, da profundidade de sondagem, do n?vel de inser??o periodontal, dos ?ndices de extens?o e severidade da doen?a periodontal, al?m do ?ndice de de sangramento gengival, em rela??o ? exist?ncia de angina pectoris est?vel. No entanto, identificou-se associa??o estatisticamente significativa entre a hipertens?o arterial sist?mica, o n?vel s?rico de colesterol total, de LDL, de HDL e de triglicer?deos, compreendendo estes os fatores de risco cl?ssicos para a doen?a cardiovascular apontados pela literatura. Portanto, conclui-se que a doen?a periodontal n?o constitui fator de risco para o desencadeamento da angina pectoris est?vel nesta popula??o estudada

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Philbois, Stella Vieira. „Estudo dos efeitos da Síndrome dos Ovários Policísticos sobre o controle autonômico cardiovascular, com enfoque na sensibilidade barorreflexa e na variabilidade da frequência cardíaca e da pressão arterial - análises pelos métodos linear e não-linear“. Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17152/tde-26042018-115231/.

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A Síndrome dos Ovários Policísticos (SOP) afeta uma grande parcela da população feminina em idade reprodutiva. Além das alterações morfológicas, hormonais e metabólicas, essas mulheres também apresentam uma alta prevalência de obesidade e alterações no controle autonômico cardiovascular de acordo com a literatura, principalmente modificações na modulação autonômica da variabilidade da frequência cardíaca (VFC). No entanto, pouco sabemos sobre outros parâmetros do controle autonômico, como a variabilidade da pressão arterial (VPA) e a sensibilidade barorreflexa (SBR). Portanto, o principal objetivo do estudo foi investigar em mulheres com a SOP as alterações na modulação autonômica da VPA e na SBR, bem como avaliar se essas alterações são decorrentes da SOP ou do aumento da gordura corporal. Para tanto, foram estudadas 30 mulheres voluntárias eutróficas (IMC ? 25 kg/m2) sem a SOP e 60 mulheres voluntárias com a SOP divididas em dois grupos: eutróficas (IMC ? 25 kg/m2; N=30) e obesas (IMC ? 30 kg/m2; N=30). Todas as mulheres foram submetidas aos seguintes protocolos; coleta de sangue para hemograma completo; avaliação antropométrica e avaliação de parâmetros metabólicos e hormonais em repouso; registro de parâmetros hemodinâmicos e cardiorrespiratórios em repouso e durante o exercício físico; análise da VFC e da VPA; e análise da SBR espontânea. A comparação entre os grupos eutróficos com e sem SOP não apresentou qualquer diferença nos parâmetros autonômicos avaliados. No entanto, a comparação entre os grupos SOP mostrou que o grupo SOP obeso apresentou menores valores de VO2 e testosterona, e maiores valores de triglicerídeos e da pressão arterial em relação ao grupo SOP eutrófico. Quanto aos parâmetros autonômicos, os grupos obeso e eutrófico não diferiram na análise da VPA. Entretanto, o grupo SOP obeso apresentou menores valores da SBR espontânea e das oscilações de baixa frequência (LF) da VFC em unidades absolutas. Por fim, nossos resultados sugerem que a obesidade pouco alterou a VFC em mulheres com SOP, entretanto reduziu sensivelmente a SBR espontânea. Esses achados podem estar associados com diferenças hormonais encontradas nessas mulheres, como os níveis séricos de testosterona mais elevados no grupo eutrófico.
Polycystic Ovarian Syndrome (PCOS) affects a large proportion of the female population at reproductive age. In addition to morphological, hormonal and metabolic alterations, these women also present a high prevalence of obesity and alterations in cardiovascular autonomic control according to the literature. Mainly modifications in the autonomic modulation of heart rate variability (HRV). However, we do not know much about other parameters of autonomic control, such as blood pressure variability (APV) and baroreflex sensitivity (SBR). Therefore, the main objective of the study was to investigate in women with PCOS changes in the autonomic modulation of APV and SBR, as well as to assess whether these alterations are due to PCOS or increased body fat. In order to do, 30 eutrophic non-PCOS voluntary women (BMI ? 25 kg / m2) and 60 voluntary PCOS women who were studied in two groups: PCOS eutrophic (BMI ? 25 kg / m2, N = 30) and PCOS obese women (BMI ? 30 kg / m2, N = 30). All the women were submitted to the following protocols; collection of blood for complete blood count; anthropometric evaluation and evaluation of metabolic and hormonal parameters at rest; recording of hemodynamic and cardiorespiratory parameters at rest and during physical exercise; analysis of HRV, APV and spontaneous SBR analysis. The comparison between the eutrophic PCOS and nonPCOS groups showed no difference in the autonomic parameters evaluated. However, the comparison between the PCOS groups showed that the PCOS obese group presented lower values of VO2 and testosterone, and higher triglyceride values and blood pressure in relation to the PCOS eutrophic group. Regarding the autonomic parameters, the PCOS obese and eutrophic groups did not differ in the APV analysis. However, the PCOS obese group presented lower values of spontaneous SBR and low frequency oscillations (LF) of HRV in absolute units. Finally, our results suggest that obesity did not significantly alter HRV in women with PCOS, but it significantly reduced spontaneous SBR. These findings may be associated with hormonal differences found in these women, such as higher serum testosterone levels in the PCOS eutrophic group.

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Davies, Lewis Ceri. „Cardiovascular control mechanisms in chronic heart failure“. Thesis, Imperial College London, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.397946.

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Ward, Jonathan Robert. „Toll-like receptor control of cardiovascular inflammation“. Thesis, University of Sheffield, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.425206.

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Furlan, Ana Kaline Pereira Damasceno. „Diferenciação dos perfis hemodinâmicos e autonômicos cardiovasculares em mulheres jovens e de meia idade pós-menopausa“. Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17152/tde-05012017-125234/.

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A fase da vida adulta entre 35 e 60 anos, também denominada de meia idade, compreende o período em que os principais sistemas biológicos apresentam importantes declínios funcionais. Nas mulheres, especificamente, é a fase marcada pelo climatério que tem como principal evento a ocorrência da menopausa. Esse evento fisiológico de importância hormonal e reprodutiva está associado em muitas mulheres ao expressivo aumento da prevalência de doenças cardiovasculares, muitas vezes associadas e precedidas por prejuízos na função autonômica cardiovascular. Nesse sentido, a avaliação da funcionalidade autonômica cardíaca é muito importante como conduta para estratificação de risco cardiovascular. De fato, a análise da variabilidade da frequência cardíaca (VFC) é muito utilizada, entretanto a metodologia segue um protocolo padrão que não leva em consideração situações fisiológicas importantes, como é o caso da reorganização da modulação autonômica cardíaca após o estresse induzido pelo exercício. Adicionalmente, a literatura tem optado por ferramentas lineares em detrimento das não lineares na avaliação da VFC. Nesse caso, a proposta do presente estudo foi avaliar e comparar a função autonômica cardíaca em mulheres jovens (GJ: 21 a 30 anos) e de meia idade pósmenopausa (GMI: 45 a 60 anos) por meio da análise linear (análise espectral) e não linear (análise simbólica) da variabilidade da frequência cardíaca em três momentos distintos (em repouso na posição supina, durante o tilt teste e durante o período de recuperação pós teste cardiopulmonar submáximo). O GMI apresentou menores valores de VO2pico (24 ± 1.0 vs 39 ± 1.3 ml.kg. min-1) frequência cardíaca basal (71 ± 2 vs 81 ± 2 bpm) e maiores valores da pressão arterial média (91 ± 2 vs 81 ± 1 mmHg) em relação ao GJ. Também apresentou maior modulação simpática e menor modulação vagal da FC na posição supina, entretanto somente evidenciado pela análise linear. Durante o tilt test as respostas do GMI foram menos proeminentes quando comparado com o GJ. Nesse caso, as avaliações linear e não linear apresentaram resultados semelhantes. Por fim, a análise da VFC durante o período de recuperação mostrou que o GMI apresentou recuperação da modulação autonômica vagal mais rápida evidenciada em ambas análises, linear e não linear. Em conclusão, a avaliação da modulação autonômica cardíaca mostrou que em repouso as mulheres jovens apresentam um predomínio do componente autonômico vagal, enquanto as mulheres de meia idade pós-menopausa apresentam um predomínio simpático. Por sua vez, o tilt test mostrou que a resposta autonômica das mulheres jovens é mais intensa, entretanto na reorganização após o exercício físico as mulheres de meia idade apresentaram maior velocidade no reestabelecimento da modulação vagal. As causas são incertas, porém podem ser decorrentes da redução dos hormônios ovarianos, bem como do processo de envelhecimento por estabelecimento de uma menor complexidade nos sistemas fisiológicos envolvidos.
The stage of adulthood between 35 and 60, also known as middle-aged, covers the period in which the main biological systems have important functional decline. In women, specifically, it is the stage marked by climacteric whose main event the occurrence of menopause. This physiological event of hormonal and reproductive importance is associated in many women to the significant increase in the prevalence of cardiovascular disease, often associated and preceded by losses in cardiovascular autonomic function. In this sense, the evaluation of cardiac autonomic functionality is very important as practice for cardiovascular risk stratification. In fact, the analysis of heart rate variability (HRV) is widely used, however the methodology follows a standard protocol that does not take into account important physiological situations, such as the reorganization of cardiac autonomic modulation after exercise-induced stress. Additionally, the literature has opted for linear tools instead of linear no evaluation of HRV. In this case, the purpose of this study was to evaluate and compare the cardiac autonomic function in young women (GJ: 21 to 30 years) and half postmenopausal age (GMI: 45-60 years) through the linear analysis (spectral analysis ) and non-linear (symbolic analysis) of heart rate variability at three different times (at rest in the supine position during the tilt test and during the recovery period after submaximal cardiopulmonary test). The GMI showed lower values of peak VO2 (24 ± 1.0 vs 39 ± 1.3 ml.kg. min-1) basal heart rate (71 ± 2 vs 81 ± 2 bpm) and higher mean arterial pressure (91 ± 2 vs 81 ± 1 mm Hg) compared to GJ. Also showed higher sympathetic modulation and lower vagal modulation of HF in the supine position, however only evidenced by linear analysis. During the tilt test responses GMI were less prominent compared to GJ. In this case, the linear and nonlinear tools showed similar results. Finally, the analysis of HRV after submaximal cardiopulmonary test showed that the GMI recovered faster autonomic modulation, shown in both analyzes, linear and non-linear. In conclusion, the evaluation of cardiac autonomic modulation showed that resting young women have a predominance of vagal autonomic component, while women half postmenopausal age present a sympathetic predominance. In turn, the tilt test showed that the autonomic response of young women is more intense, but the autonomic reorganization after exercise, the middle-aged women have faster the reestablishment of vagal modulation. The reasons are unknown, but may be due to the reduction in ovarian hormones, as well as the aging process by establishing less complex physiological mechanisms.

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Cartolano, Flavia de Conti. „Efeito do ácido graxo ômega 3 sobre a composição corporal, controle glicêmico e risco cardiovascular de indivíduos adultos e idosos“. Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/6/6138/tde-14122015-123925/.

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Introdução: Os benefícios dos ácidos graxos poli-insaturados ômega 3 (w-3) no metabolismo lipídico e na saúde cardiovascular são amplamente aceitos. Entretanto, o impacto do w-3 na composição corpórea, na homeostase da glicose e consequente modificação do risco cardiovascular não tem sido foco dos desfechos primários da maioria dos estudos clínicos. Objetivo: Avaliar o impacto da suplementação de w-3 sobre a composição corporal, o controle glicêmico e o nível de risco cardiovascular em indivíduos adultos. Métodos: A partir de uma sub-amostra do estudo CARDIONUTRI (estudo clínico, randomizado, controlado e duplo cego com seguimento de 2 meses) foram selecionados 86 indivíduos (grupo w-6, 3g de óleo de girassol/d) e 88 indivíduos (grupo w-3, 3g de óleo de peixe/d 60 por cento EPA/DHA). O efeito das intervenções foi monitorado nos tempos basal e T=8 (oito semanas). Nestes períodos foram coletadas informações demográficas, clínicas, atividade física, dieta, antropométricas e de composição corporal. Amostras de sangue foram coletadas após jejum de 12h e a partir do plasma/soro foram avaliados glicemia, insulina, colesterol total e associado a LDL e HDL, triacilgliceróis e as apolipoproteína AI e B utilizando métodos comerciais. O nível de risco cardiovascular dos indivíduos foi estimado pelo Escore de Risco de Framingham (ERF). Os resultados do efeito do tempo, da intervenção e das interações entre parâmetros monitorados e os desfechos foram analisados por meio do programa SPSS 20.0, sendo o nível de significância adotado de p<0,05. Resultados: A maioria dos indivíduos inclusos era do sexo feminino e da raça branca, sem diferença entre os grupos. As doenças mais prevalentes em ambos os grupos foram a hipertensão arterial, o diabetes mellitus e as dislipidemias. Não foram observadas mudanças de glicemia e insulina de jejum, HOMA-IR e HOMA 2- por cento S, com a suplementação de w-3, exceto nos indivíduos com risco cardiovascular intermediário, segundo o ERF. Em relação aos parâmetros antropométricos e de composição corporal, a população feminina do grupo w-3 apresentou redução do percentual de massa gorda ao longo do tempo e intervenção, assim como, foi também observada tal redução entre os indivíduos com alto risco cardiovascular. Não foi contatada variação na distribuição do ERF, apesar da melhora de seus componentes (colesterol total e HDL-C). Conclusões: A suplementação com w-3 promoveu redução de insulina e HOMA-IR nos indivíduos com ERF intermediário. Observou ainda efeito benéfico na redução do percentual de gordura corporal entre as mulheres e indivíduos com ERF alto, assim como na diminuição do colesterol total e aumento da HDL-C.
Introduction: The benefits of polyunsaturated omega 3 (n-3) on lipid metabolism and cardiovascular health fatty acids are widely accepted. However, the impact of n-3 in body composition, glucose homeostasis and consequent modification of cardiovascular risk has not been the focus of the primary outcomes of most clinical trials. Aim: To evaluate the impact of n-3 supplementation on body composition, glycemic control and the level of cardiovascular risk in adults. Methods: From a subsample of CARDIONUTRI study were selected (clinical, randomized, controlled, double blind study with follow-up of 2 months) 86 patients (group n-6, 3g of sunflower oil/d) and 88 individuals (n-3 group, 3g fish oil/d - 60 per cent EPA/DHA ). The effect of the interventions was monitored at baseline and T = 8 (eight weeks). In these periods were collected demographic information, clinical, physical activity, diet, anthropometric and body composition. After 12h fasting, blood samples were collected and, from plasma/serum, were evaluated glucose, insulin, total cholesterol, cholesterol associated with LDL and HDL, triacylglycerol, apolipoprotein AI and B using standard methods. The level of cardiovascular risk of individuals was estimated by the Framingham Risk Score (FRS). The results of the effect of the time of the intervention and the interactions between monitored parameters and outcomes were analyzed using the SPSS 20.0 program and the level of significance of p < 0.05. Results: The majority of individuals included were female and white, with no difference between groups. The most prevalent diseases in both groups were hypertension, diabetes mellitus and dyslipidemia. No change was observed in glucose and fasting insulin, HOMA-IR and HOMA 2- per cent S, with supplementation with n-3, except in patients with intermediate cardiovascular risk, according to the FRS. Regarding the anthropometric and body composition parameters, the n-3 group showed a reduction in the percentage of fat mass among females over time and intervention, as was also observed that reduction among individuals at high cardiovascular risk. There was no variation in the distribution of the ERF, despite the improvement of its components (total cholesterol and HDL-C). Conclusions: Supplementation with n-3 promoted reduction of insulin and HOMA-IR in subjects with intermediate FRS. It noted beneficial effect in reducing the percentage of body fat among women and individuals with high FRS, as well as decreased total cholesterol and increased HDL-C.

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Filho, Francisco Flávio Costa. „Controle dos níveis pressóricos em pacientes hipertensos nos municípios de São Paulo e Campinas: um grande estudo transversal“. Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/98/98131/tde-04102017-134607/.

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INTRODUÇÃO: A hipertensão arterial sistêmica é a principal causa evitável de morbimortalidade cardiovascular no mundo contemporâneo, principalmente nos países de baixa renda. Avaliações populacionais das taxas de sucesso no controle dessa entidade precisam ser instituídas e continuamente realizadas. A compreensão do comportamento epidemiológico da hipertensão arterial sistêmica em coortes contemporâneas é importante para o planejamento de novas medidas de intervenção populacional. O presente estudo visa, como objetivo primário, a avaliar a eficácia no controle da hipertensão arterial sistêmica e a determinar preditores independentes associados ao melhor controle pressórico, em uma população de hipertensos sob tratamento medicamentoso derivada do Mutirão de Avaliação de Risco Cardiovascular. Como objetivo secundário, o estudo visa a avaliar a taxa de sujeitos sem diagnóstico prévio de hipertensão arterial sistêmica que apresentam a primeira medida pressórica alterada, assim como a determinar os preditores independentes desse achado. MÉTODOS: Estudo observacional, transversal, em que foram avaliados os participantes do Mutirão de Avaliação de Risco Cardiovascular dos municípios de São Paulo e Campinas. Foram incluídos nessa análise sujeitos com mais de 18 anos de idade, residentes nos municípios de São Paulo e Campinas. Para responder ao objetivo primário, foram analisados hipertensos com diagnóstico prévio e uso de medicamento anti-hipertensivo. Para responder ao objetivo secundário, foram analisados os sujeitos sem diagnóstico prévio de hipertensão e que não estavam em uso de medicações anti-hipertensivas. Utilizou-se análise multivariada para identificar preditores associados ao controle pressórico. RESULTADOS: Identificou-se 43.647 sujeitos hipertensos em uso de medicação, sendo que 40,9% destes estavam com níveis pressóricos controlados, considerando a meta de pressão arterial sistólica < 140 mmHg e pressão arterial diastólica < 90 mmHg. Entre os hipertensos não controlados, 42,5% apresentaram hipertensão arterial sistêmica em estágios II ou III (pressão arterial sistólica > 160 mmHg ou pressão arterial diastólica > 100 mmHg). Em análise multivariada, mostraram-se preditores independentes para melhor controle pressórico: idade < 60 anos [razão de chance (RC) 1,14, intervalo de confiança (IC) 95% 1,09-1,18], atividade física de moderada intensidade (RC 1,18, IC 95% 1,13-1,23), antecedente de doença cardiovascular (RC 1,09, IC 95% 1,04-1,13) e ingesta de frutas diariamente (RC 1,05, IC 95% 1,01-1,10). Mostraram-se preditores para controle pressórico inadequado: sexo masculino (RC 0,69, IC 95% 0,66-0,72), diabetes (RC 0,83, IC 95% 0,80-0,87), etnia negra (RC 0,88, IC 95% 0,83-0,94) ou parda (RC 0,92, IC 95% 0,87-0,97) em relação à branca e obesidade (RC 0,73, IC 95% 0,70-0,76). Entre 45.021 participantes sem diagnóstico prévio de hipertensão arterial sistêmica, 27,6% apresentaram a primeira medida pressórica elevada (pressão arterial > 140 x 90 mmHg). Mostraram-se preditores independentes para esse achado: sexo masculino (RC 2,05, IC 95% 1,96-2,15), idade > 60 anos (RC 1,88, IC 95% 1,78-1,98), etnia negra (RC 1,15, IC 95% 1,06-1,24) ou parda (RC 1,11, IC 95% 1,06-1,17) em relação à branca, obesidade (RC 2,08, IC 95% 1,98-2,19), diabetes (RC 1,09, IC 95% 1,01-1,18), antecedente de doença cardiovascular (RC 0,91, IC 95% 0,87-0,96) e atividade física de moderada intensidade (RC 0,87, IC 95% 0,83-0,92). CONCLUSÕES: Menos da metade dos hipertensos em tratamento estavam com seus níveis pressóricos controlados. Preditores independentes associados ao controle pressórico foram identificados, sendo três deles modificáveis. Estratégias populacionais devem ser implantadas para o controle efetivo desse importante fator de risco cardiovascular.
INTRODUCTION: Systemic arterial hypertension is the leading avoidable cause of cardiovascular morbidity and mortality in the contemporary world, mainly in low-income countries. Population evaluation of efficient strategies for blood pressure control should be implemented, and continually evaluated. Epidemiological understanding of systemic arterial hypertension in large cohorts plays important role for planning new interventions in the population level. The study objective is to evaluate the effectiveness of blood pressure control and to determine independent predictors, associated with better blood pressure control, in hypertensive patients on medical treatment from the Cardiovascular Risk Assessment in Sao Paulo and Campinas. The secondary objective is to access the rate of patients without previous diagnosis of systemic arterial hypertension in whom the blood pressure measurement is above recommended values, as well as determining independent predictors related with this finding. METHODS: The study design is an observational cross-sectional strategy in the municipalities of São Paulo and Campinas. Patients over the age of 18 living in São Paulo and Campinas, with previous diagnosis of systemic arterial hypertension and use of anti-hypertensive were included. Patients without previous diagnosis of hypertension and not using anti-hypertensive medication were also included. It was conducted a multivariate analysis to identify independent predictors associated with blood pressure control. RESULTS: We identified 43,647 hypertensive subjects on anti-hypertensive treatment. Of these 17,835 (40.9%) had controlled blood pressure levels, considering a target systolic blood pressure <140 mmHg and diastolic blood pressure < 90 mmHg. Among patients with uncontrolled hypertension, 42.5% were categorised as stage II or III hypertension (systolic blood pressure >=160 mmHg or diastolic BP >=100 mmHg). In a multivariate analysis, the following independent predictors were identified indicating better blood pressure control: age< 60 years [odds ratio (OR) 1.14, confidence interval (CI) 95% 1.09-1.18], moderate physical activity (OR 1.18, CI 95% 1.13-1.23), pre-existing atherosclerotic cardiovascular disease (OR 1.09, CI 95% 1.04-1.13) and daily consumption of fruit (OR 1.05, CI 95% 1.01-1.10). Predictors of poorer BP control were male sex (OR 0.69, CI 95% 0.66-0.72), diabetes mellitus (OR 0.83, CI 95% 0.80-0.87), African ethnicity (OR 0.88, CI 95% 0.83-0.94) or mixed African ethnicity (OR 0.92, CI 95% 0.87- 0.97) when compared to Caucasian ethnicity, obesity (OR 0.73, CI 95% 0.70-0.76). Among 45,021 participants without previous diagnosis of hypertension, 27.6% presented abnormal levels of blood pressure at the first measurement (BP >= 140/90 mmHg). The following independent predictors were identified: male sex (OR 2.05, CI 95% 1.96-2.15), age > 60 years (OR 1.88 CI 95% 1.78-1.98), African ethnicity (OR 1.15, CI 95% 1.06-1.24) or mixed African ethnicity (OR 1.11, CI 95% 1.06-1.17) when compared to Caucasian, obesity (OR 2.08, CI 95% 1.98-2.19), diabetes (OR 1.09, CI 95% 1.01-1.18), previous history of cardiovascular disease (OR 0.91, CI 95% 0.87-0.96) and moderate physical activity (OR 0.87, CI 95% 0.83-0.92). CONCLUSIONS: Less than half of hypertensive patients in treatment had controlled blood pressure. Independent predictors associated with blood pressure control were identified and three of them are modifiable. Population strategies should be implemented for effective control of this clinically relevant cardiovascular risk factor.

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Pinto, Cristiano José Mendes. „Redução do escore de risco de Framingham dos pais por meio de um programa de educação em saúde para os filhos em escola pública“. Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5167/tde-14082018-093502/.

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O controle das doenças cardiovasculares depende da adoção de hábitos de vida saudáveis e redução dos fatores de risco. Esforços têm sido feitos para normatizar os pilares da prevenção das doenças cardiovasculares em adultos e crianças, contudo, as estratégias de trabalho nesta área ainda não estão consolidadas e exigem novos estudos, especialmente entre crianças e pais de escolas públicas, com o perfil socioeconômico da população brasileira. O objetivo geral deste estudo foi avaliar se a implantação de uma intervenção pedagógica multidisciplinar para educação em saúde cardiovascular em escolas públicas, visando incorporar conceitos de prevenção primária para DCV entre estudantes de 6 a 10 anos de idade, pode contribuir para a diminuição do escore de risco de Framingham (ERF) dos seus respectivos pais e mães, no período de um ano. Trata-se de um estudo de intervenção, com duração de um ano, realizado em duas escolas públicas de ensino fundamental na cidade de Campo Limpo Paulista, estado de São Paulo. Na escola do grupo controle, o acompanhamento dos sujeitos utilizou uma abordagem preventiva tradicional por meio de folhetos informativos, com orientações para cuidados com a saúde e diminuição do risco cardiovascular, que eram enviados aos pais na agenda escolar das crianças. No grupo intervenção, além dos folhetos informativos, durante o ano letivo, as crianças desta escola foram submetidas a uma intervenção sobre educação em saúde cardiovascular, com atividades semanais visando incorporar conceitos de prevenção primária da aterosclerose. A coleta de dados foi realizada em dois momentos da pesquisa: antes de iniciar a intervenção - em fevereiro de 2012 e após a conclusão do programa de intervenção, em dezembro do mesmo ano. Ao final do estudo, a amostra totalizou 418 pais e mães, sendo 216 no grupo controle e 202 no grupo intervenção. No grupo controle, ao final de pesquisa, somente a glicose apresentou melhora significante (p=0,003), e os fatores de risco com piora significante foram: IMC (p=0,012), triglicérides(p=0,003), HDL-colesterol (p < 0,001) e ERF (p=0,001). No grupo intervenção, houve melhora significante (p < 0,001) em três fatores de risco: pressão arterial sistólica, pressão arterial diastólica e glicose. Os fatores de risco com piora estatisticamente significante foram o LDL-colesterol (p=0,008) e o HDL-colesterol (p < 0,001). A análise dos sujeitos com ERF alto ou intermediário, ou seja, com maior risco cardiovascular, revelou redução significativa no grupo intervenção (p=0,031): no início da pesquisa havia 27 pais e mães nessa classificação e ao final do estudo somente 21. No grupo controle, este número era igual a 15 no início e igual a 20 no final, uma variação que não foi estatisticamente significante. Pode-se constatar que o programa de educação em saúde cardiovascular, entre estudantes de 6 a 10 anos de idade em escola pública, contribuiu para a diminuição do risco cardiovascular dos pais e mães do grupo intervenção
Controlling cardiovascular diseases depends on the adoption of healthy life habits and the reduction of risk factors. Efforts have been made to standardize the pillars of cardiovascular heart disease (CHD) prevention in adults and children; however, work strategies in this area are not yet consolidated. Therefore, new studies are necessary, particularly among public school children and their parents, that include the socioeconomic profile of the Brazilian population. The general objective of this study was to evaluate whether the implementation of a multidisciplinary pedagogical intervention for cardiovascular health education in public schools that aimed to incorporate concepts of primary CHD prevention among students aged 6 to 10 years can contribute to decreasing the Framingham cardiovascular risk (FCR) of their respective fathers and mothers within one year. This one-year intervention study was conducted at two public elementary schools in the city of Campo Limpo Paulista, state of São Paulo. At the control group school, a traditional preventive approach was used that included information leaflets with guidelines regarding health care and the reduction of cardiovascular risk. These leaflets were sent to parents in the children\'s school. In the intervention group, in addition to the information leaflets, during the school year, the children of this school underwent an intervention of cardiovascular health education, with weekly activities aimed at incorporating the concepts of primary prevention of atherosclerosis. The data collection was performed at two main points during the study: before starting the intervention, in February of 2012, and after the conclusion of the intervention program, in December of the same year. At the end of the study, 418 fathers and mothers comprised the sample, with 216 in the control group and 202 in the intervention group. At the end of the study, the control group showed a significant improvement only in glucose levels (p = 0.003), whereas the following risk factors worsened significantly: BMI (p = 0.012), triglycerides (p = 0.003), HDL-cholesterol (p < 0.001) and FCR (p = 0.001). The intervention group showed a significant improvement (p < 0.001) in three risk factors: systolic blood pressure, diastolic blood pressure and glucose levels. The risk factors that worsened significantly were LDL-cholesterol (p = 0.008) and HDL-cholesterol (p < 0.001). The analysis of subjects with high or intermediate FRS, that is, with a higher cardiovascular risk, showed a significant reduction in the intervention group (p = 0.031): at the beginning of the study, there were 27 fathers and mothers in this classification, whereas only 21 remained at the end of the study. In the control group, there were 15 parents with a high or intermediate FRS at the beginning of the study and 20 at the end; this change was not statistically significant. In conclusion, the cardiovascular health education program conducted among students aged 6 to 10 years in a public school contributed to the reduction of cardiovascular risk in the parents and mothers of the intervention group

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Silva, Joel Abreu da. „Avaliação da importância dos diuréticos no controlo da hipertensão arterial“. Master's thesis, [s.n.], 2013. http://hdl.handle.net/10284/4470.

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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas
As doenças cardiovasculares são atualmente a principal causa de morte a nível mundial. Factores como a idade, a hereditariedade, o sedentarismo, as dietas ricas em gorduras e sal, o tabagismo, o excesso de consumo de álcool, as dislipidémias e a hipertensão arterial aumentam o risco de desenvolver este tipo de doenças. A hipertensão arterial, ou seja, o constante aumento da pressão arterial acima dos valores considerados normais, é uma das doenças crónicas mais comuns em todo o mundo, sobretudo nos países mais desenvolvidos. Existem determinados factores de risco que estão associados à hipertensão, como por exemplo, a alimentação rica em sal, o sedentarismo e a síndrome metabólica (obesidade, dislipidémias e diabetes). O objetivo deste trabalho de investigação centra-se num grupo específico de fármacos utilizado na prática clinica para o controlo e prevenção da HTA, que são os diuréticos. Neste estudo avalia-se esta classe de fármacos exaustivamente, analisando numa fase inicial os diferentes grupos farmacológicos e descrevendo as suas principais características designadamente a sua estrutura química, o seu mecanismo de ação, a sua farmacocinética, as indicações terapêuticas, as toxicidade, os efeitos adversos, as contra-indicações e as principais interações destes fármacos. Após esta análise inicial e conhecimento destes fármacos, serão analisados os benefícios e as desvantagens na terapêutica relativamente a outras classes medicamentosas utilizados no tratamento da HTA, baseado na análise de estudos elaborados por organizações reconhecidas e creditadas internacionalmente, que auxiliam na estruturação das orientações gerais dirigidas à terapêutica da HTA. De modo a reforçar a importância do controlo da hipertensão, elaborar-se-á uma abordagem deste parâmetro de saúde, descrevendo os principais fatores e as patologias associadas à HTA, enumerando medidas preventivas e de controlo dos valores de PA. Cardiovascular diseases are the leading cause of death worldwide. Factors such as age, heredity, inactivity, diets high in fat and salt, smoking, excessive alcohol consumption, dislipidémias and hypertension increase the risk of developing such diseases. Hypertension corresponds to the constant increase in blood pressure above the normal range, is one of the most common chronic diseases worldwide, especially in developed countries. There are certain risk factors that are associated with hypertension, for instance, the salt-rich food, sedentary lifestyle and metabolic syndrome (obesity, dislipidémias and diabetes). The objective of this research work focuses on a specific group of drugs used in clinical practice in the prevention and control of hypertension, which are diuretics. In this study we evaluate this class of drugs thoroughly, understand at an early stage the different pharmacological groups, describing its main traits, including their chemical structure, mechanism of action, pharmacokinetics, therapeutic indications, toxicity, adverse effects , contraindications and key interactions of these drugs. After the initial analysis and knowledge of these drugs, you want to understand the benefits and disadvantages of diuretics in therapy in relation to other classes of medications used in hypertension treatment, evaluating and obtaining information, accurate and insightful, the studies prepared by health organizations recognized and credited internationally, to assist in structuring the general guidelines for treatment of hypertension. To increase the importance of hypertension control, draw up a study of this health parameter, describing the main factors and complications of hypertension, enumerating preventive measures and control of BP values.

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Silva, Maria do Socorro de França. „Avaliação dos efeitos do 2-nitrato-1,3- dibutoxipropano (NDBP) sobre o sistema cardiovascular“. Universidade Federal da Paraíba, 2012. http://tede.biblioteca.ufpb.br:8080/handle/tede/6741.

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Previous studies have shown that the 2-nitrate-1,3-dibuthoxypropan (NDBP), an organic nitrate synthesized from glycerin, induced vasorelaxation in mesenteric artery of rats through activation of the NO-cGMP-PKG pathway and K+ channels, in addition, caused hypotension and bradycardia in normotensive conscious rats. The current research aimed to investigate the effects of the NDBP on cardiovascular system in rats, evaluating the NO release in rat smooth muscle cell culture, the ability of NDBP to induce tolerance to vasodilatation and the effect of the acute administration of the compound on autonomic control of blood pressure and heart rate of normotensive and hypertensive rats, using in vitro and in vivo approaches. For biochemical determination aortic rat smooth muscle cell culture (ARSMC) was used and the pharmacological experiments were developed using Wistar rats or spontaneously hypertensive (SHR) and normotensive Wistar Kyoto (WKY) rats. The NDBP caused concentration-dependent increases in NO levels in ARSMC. In addition, NDBP produced no change in the vasorelaxation induced by the NDBP when the rings were pre-incubated with the NDBP (10 μM or 100 μM), suggesting that the NDBP did not induce tolerance. In vivo experiments, SHR rats were significantly hypertensive compared with WKY rats. The acute administration of the NDBP (1, 5, 10, 15 and 20 mg/kg, i.v.) caused a biphasic response: hypotension and bradycardia followed by hypertension and tachycardia in WKY and SHR rats. The blockade of muscarinic receptors with atropine (2 mg/kg) blunted the bradycardia induced by NDBP (15 mg/kg) and reduced the hypotension in WKY and SHR. However, the pressor response to the compound was potentiated. Furthermore, vagotomy almost abolished the bradycardia in WKY and SHR. Moreover, hexamethonium (30 mg/kg), a nicotinic ganglionic blocker, reduced both bradycardia and pressor response in WKY and SHR. The administration of methylene blue (4 mg/kg), a soluble guanylyl cyclase (sGC) blocker, attenuated the hypotension and bradycardia induced by the NDBP (15 mg/kg) in WKY. Similar event occurred in SHR animals. In conclusion, the NDBP releases NO in ARSMC, and was unable to induce tolerance to its vasorelaxant effect, however, the cardiovascular effects of NDBP are mainly mediated by the central action of the compound, resulting in changes on autonomic function of spontaneously hypertensive and normotensive rats.
Relatos prévios demonstraram que o 2-nitrato-1,3-dibutoxipropano (NDBP), um nitrato orgânico sintetizado a partir da glicerina, induziu vasodilatação em anéis de artéria mesentérica cranial isolada de rato mediante a ativação da via NO-GMPc- PKG, bem como dos canais para K+ e, adicionalmente, causou hipotensão e bradicardia em ratos normotensos não-anestesiados. O estudo atual teve como objetivo investigar os efeitos do NDBP sobre o sistema cardiovascular em ratos, avaliando a liberação de NO eliciada pelo NDBP em células musculares lisas vasculares, a capacidade do NDBP induzir tolerância ao vasorrelaxamento e o efeito da administração aguda do composto sobre o controle autonômico de animais normotensos e hipertensos, por meio de abordagens in vitro e in vivo. Nos experimentos bioquímicos foi utilizada a cultura de células musculares lisas de aorta de rato (CMLAR) e, nos experimentos farmacológicos foram utilizados ratos Wistar ou ratos espontaneamente hipertensos (SHR) e normotensos Wistar Kyoto (WKY). Foi observado que o NDBP causou um aumento concentração-dependente nos níveis de NO em CMLAR. Além disso, não houve alteração no efeito vasodilatador do NDBP quando os anéis de artéria mesentérica foram previamente expostos ao NDBP, nas concentrações de 10 μM ou 100 μM, sugerindo que o nitrato orgânico em estudo não induziu tolerância. Nos experimentos in vivo, foi constatado que a pressão média basal dos animais espontaneamente hipertensos foi significantemente maior que a do grupo normotenso. A administração aguda do NDBP (1, 5, 10, 15 e 20 mg/kg, i.v.) induziu uma resposta bifásica: hipotensão e bradicardia seguidas de hipertensão e taquicardia, em ratos SHR e WKY. O bloqueio dos receptores muscarínicos pela atropina (2 mg/kg) atenuou a bradicardia induzida pelo NDBP (15 mg/kg), reduzindo também a hipotensão em WKY e SHR. Entretanto, a resposta pressora ao composto foi potencializada. A secção bilateral do nervo vago praticamente aboliu a bradicardia em WKY e SHR. Adicionalmente o hexametônio (30 mg/kg), um bloqueador nicotínico ganglionar, reduziu tanto a bradicardia quanto a resposta pressora em ambos os grupos. A administração do azul de metileno (4 mg/kg), um bloqueador da ciclase de guanilil solúvel (CGs), atenuou as repostas hipotensora e bradicárdica induzida pelo NDBP (15 mg/kg) em ratos WKY. Evento similar aconteceu nos animais SHR. Esses resultados sugerem que o NDBP libera NO em CMLAR, sendo incapaz de induzir tolerância ao seu efeito vasorrelaxante, entretanto, os efeitos cardiovasculares do NDBP são mediados, principalmente, pela ação central do composto, resultando em alterações na função autonômica de ratos normotensos e espontaneamente hipertensos.

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Journeay, William Shane. „Thermoregulatory and nonthermoregulatory interaction in human cardiovascular control“. Thesis, University of Ottawa (Canada), 2003. http://hdl.handle.net/10393/26496.

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Purpose. Study #1 examined the responses to facial immersion under states of altered cardiac filling. Study #2 sought to examine changes in postexercise hemodynamics and skin blood flow (SkBF) when lower blood pooling was manipulated using lower body pressure. Methods. Study #1---Six male subjects participated. They performed 30-s apneic facial immersions under: LBNP, LBPP, during post-exercise hypotension (PEH); & Control. MAP, HR, and SkBF were measured. Study #2---Subjects were exposed to LBNP, LBPP; or no pressure after 15-mins of cycle exercise at 70% of VO2 peak. HR, CO, SV, MAP, TPR, & SkBF, skin and esophageal temperature were recorded. Conclusions. Study #1---Cardiac parasympathetic response during facial immersion can be attenuated when cardiac filling is compromised. Study #2---(1) LBPP accelerates recovery of baseline hemodynamics while LBNP exacerbates the postexercise hemodynamic state relative to control. (2) Altering postexercise hemodynamics via LBPP may affect thermal responses.

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Howden, Reuben. „Tolerance to orthostatic stress and human cardiovascular control“. Thesis, De Montfort University, 2002. http://hdl.handle.net/2086/4812.

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Tomlinson, Kerry C. „Central and peripheral cardiovascular control in diabetic rats“. Thesis, University of Nottingham, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.330088.

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Maida, Karina Delgado. „Estudo da associação do treinamento físico aeróbio com diferentes terapias farmacológicas sobre as adaptações autonômicas cardíacas em ratos espontaneamente hipertensos (SHR)“. Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17152/tde-04012017-102527/.

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Nós investigamos em ratos espontaneamente hipertensos (SHR) jovens (28 semanas) e velhos (52 semanas) os efeitos hemodinâmicos e autonômicos cardiovasculares promovidos por diferentes terapias anti-hipertensivas farmacológicas associadas ao treinamento físico aeróbio. Para tanto, ratos SHR de 18 semanas de idade (N=128) foram alocados em quatro grandes grupos (N=32): tratado com água (Grupo Veículo); tratado com Enalapril; tratado com Losartan; e tratado com Amlodipina. Cada grupo foi subdivido em dois menores grupos (N=16) tratados durante 10 ou 34 semanas, sendo que metade de cada grupo (N=08) era também submetido ao treinamento físico aeróbio por meio da natação pelo mesmo período de tempo (10 ou 34 semanas). No penúltimo dia de tratamento todos os animais tiveram canuladas a artéria e veia femorais para registro da pressão arterial (PA) e injeção de drogas, respectivamente. 24 horas após a avaliação autonômica cardiovascular foi realizada por meio de diferentes abordagens; avaliação do balanço simpato/vagal por meio do duplo bloqueio autonômico cardíaco com atropina e propranolol; análise da variabilidade da frequência cardíaca (VFC) e pressão arterial sistólica (VPAS) por meio da análise espectral; e análise da sensibilidade barorreflexa (SBR) espontânea. Todos os tratamentos promoveram redução da PA, entretanto, nos grupos jovens, o tratamento com Enalapril promoveu as maiores reduções, independentemente do treinamento físico, enquanto que nos grupos velhos, a associação do treinamento físico ao Enalapril promoveu efeito adicional na redução da PA. Em relação ao controle autonômico cardiovascular, o tratamento com Amlodipina promoveu maiores adaptações benéficas no grupo de SHR sedentários jovens quando comparado às demais drogas, caracterizados pelo predomínio do tônus autonômico vagal, aumento da variância na VFC, além de aumento na SBR. Embora o treinamento físico tenha promovido algumas adaptações benéficas quando aplicado sozinho, não foi capaz de potencializar os achados observados para a Amlodipina. O tratamento com Enalapril ou Losartan promoveu menores adaptações autonômicas cardiovasculares quando administrado em SHR sedentários em comparação à Amlodipina, entretanto quando o Enalapril foi associado ao treinamento físico observamos sensível melhora no controle autonômico cardiovascular nos diferentes parâmetros avaliados, inclusive a redução das oscilações de baixa frequência (LF; 0,75-2.5Hz) na VPAS, além de aumento na SBR. Contrariamente, a Amlodipina sozinha não modificou os parâmetros autonômicos cardiovasculares nos SHR velhos, cabendo ao Enalapril e ao Losartan promoverem melhores efeitos quando aplicados sozinhos nesses animais. O treinamento físico também promoveu adaptações autonômicas benéficas nos SHR velhos, e em alguns parâmetros, como a VFC, as adaptações foram ainda melhores. Surpreendentemente, quando associado à Amlodipina, as adaptações foram ainda mais expressivas, com significativa atenuação do tônus autonômico simpático, redução da modulação simpática e aumento da modulação vagal na VFC, além de redução nas oscilações de LF na VPAS e aumento da SBR. Em conclusão, nos animais jovens, a Amlodipina foi mais eficaz na promoção de adaptações autonômicas cardiovasculares benéficas, enquanto que o Enalapril apresentou resultados autonômicos semelhantes somente quando associado ao treinamento físico aeróbio. Por sua vez, nos animais velhos, a Amlodipina teve pouco efeito sobre o controle autonômico cardiovascular, enquanto que o Enalapril e o Losartan foram mais eficazes. Nesse caso, nossos achados indicam que o envelhecimento representa um fator determinante que interfere no controle autonômico cardíaco e atenua os efeitos dos diferentes tratamentos farmacológicos. Por fim, o treinamento físico apresenta um papel fundamental no tratamento da hipertensão arterial, participando desse processo como um catalizador dos efeitos autonômicos cardiovasculares promovidos pelo tratamento farmacológico, tanto em SHR jovens, quando associado ao Enalapril, quanto em SHR velhos, quando associado à Amlodipina.
We investigated in spontaneously hypertensive rats (SHR) young (28 weeks) and old (52 weeks) hemodynamic and autonomic cardiovascular effects caused by different pharmacological antihypertensive therapy associated with aerobic exercise. For that purpose, 18-weeks-old SHR (N = 128) were divided into four groups (N = 32): Water treated (Vehicle Group); treated with Enalapril; treated with Losartan; and treated with Amlodipine. Each group was subdivided into two smaller groups (N = 16) treated for 10 or 34 weeks, with half of each group (N = 08) was also subjected to physical training through swimming the same period of time (10 or 34 weeks). On the last day of treatment all animals were cannulated the femoral artery and vein to record blood pressure (AP) and injection of drugs, respectively. 24 hours after cardiovascular autonomic assessment was performed by means of different approaches; evaluation of sympathetic / vagal balance through double cardiac autonomic blockade with atropine and propranolol; analysis of heart rate variability (HRV) and systolic blood pressure (SAPV) by means of spectral analysis; and analysis of spontaneous baroreflex sensitivity (BRS). All treatments promoted AP reduction, however, in youth groups, treatment with Enalapril promoted the greatest reductions, regardless of physical training, while in the older groups, the association of physical training to Enalapril promoted additionally reduce AP. Regarding the cardiovascular autonomic control, treatment with Amlodipine produced greater beneficial adaptations in sedentary young group compared to other drugs, characterized by the predominance of vagal autonomic tone, increased variance in HRV, and increase in BRS. While physical training has promoted some beneficial adjustments when used alone, it was unable to potentiate the findings observed for Amlodipine. Treatment with Enalapril and Losartan promoted lower cardiovascular autonomic adaptations when administered in sedentary SHR compared to Amlodipine, however when Enalapril was associated with physical training we observed significant improvement in cardiovascular autonomic control in the different evaluated parameters, including the reduction of low-frequency oscillations (LF; 0,75-2.5Hz) in SAPV, besides an increase in the BRS. In contrast, Amlodipine alone did not modify the cardiovascular autonomic parameters in the old SHR, leaving the Enalapril and Losartan promote better effects when applied alone in these animals. Physical training also promoted beneficial autonomic adaptations in old SHR, and in some parameters, such as HRV, adjustments were even better. Surprisingly, when combined with Amlodipine, adaptations have been even more significant, with significant attenuation of the sympathetic autonomic tone, decreased sympathetic modulation and increased vagal modulation on HRV as well as reduction in the LF oscillations in SAPV and increased BRS. In conclusion, in young animals Amlodipine was more effective in promoting beneficial cardiovascular autonomic adaptations, while Enalapril showed similar autonomic results only when combined with aerobic exercise. In turn, in old animals Amlodipine had little effect on the cardiovascular autonomic control, while Losartan and Enalapril were more effective. In this case, our findings indicate that aging is a factor that interferes with cardiac autonomic control and mitigate the effects of different pharmacological treatments. Finally, physical training has a key role in the treatment of hypertension, participating in this process as a catalyst of cardiovascular autonomic effects caused by drug treatment in both, young SHR, when combined with Enalapril, as in old SHR, when associated with Amlodipine.

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Kuinchtner, Gabriela Castro. „ASSOCIAÇÃO ENTRE RISCO CARDIOVASCULAR E CONTROLE AUTONÔMICO CARDÍACO EM PORTADORES DE HIV“. Universidade Federal de Santa Maria, 2015. http://repositorio.ufsm.br/handle/1/5855.

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Introduction: The increase of cardiovascular disease risk has been demonstrated in subjects with HIV infection. The dysfunction in the regulation of the autonomic system has been identified as a mechanism underlying to cardiac death in this group of patients. This study aimed to analyze the association between cardiovascular risk and cardiac autonomic control in patients with HIV. Methods: The sample consisted of 25 patients with HIV, of both genders, in use of antiretroviral therapy and with undetectable viral load, treated on the of Infectious Diseases Ambulatory, from the University Hospital of Santa Maria (HUSM), between August and December of 2014. Patients with cardiovascular disease, metabolic, respiratory, neurological or kidney were excluded. The cardiovascular risk was assessed by Framingham score, used to estimate the probability of cardiovascular events in ten years. The cardiac autonomic control was assessed by measuring the heart rate variability, analyzing the following variables: 1) in the time domain were measured SDNN, triangular index (overall variability) and rMSSD (parasympathetic activity); 2) in the frequency domain understood the low frequency components (LF; sympathetic activity) and high frequency (HF; parasympathetic activity), both normalized, and the LF/HF ratio (sympatho-vagal balance). Results: The sample (12 women and 13 men) had a mean age of 48.7±10.9 years, body mass index of 25.7±5.1 kg/m2, heart rate of 72.1±13.4 bpm, respiratory rate of 16.3±3.8 bpm, systolic blood pressure of 125.2±18.7 mmHg and diastolic 83.3±12.2 mmHg. The average time since diagnosis of the disease was 10.2±5.0 years, the medication time of 7.2±4.2 years and the CD4 count of 628.6±223.8 mm3 of blood. The score obtained in the Framingham score was 9.5±5.1 and the risk of cardiovascular events was 9.5±7.9%, with 7 patients classified as low risk, 14 as intermediate risk and 4 as high cardiovascular risk. The Framingham score presented a correlation with the medication time (r=0.53), with the LFnu component (r=0.45) and with the ratio LF/HF (r=0.44), but it was inversely correlated with SDNN (r=-0.43), rMSSD (r=-0.47) and with the triangular index (r=-0.49). The risk of cardiovascular events was positively correlated with the medication time (r=0.54), with the LFnu component (r=0.45) and with the ratio LF/HF (r=0.45), but had negative correlation with SDNN (r=-0.40), rMSSD (r=-0.43) and the triangular index (r=-0.48). Conclusion: Patients with HIV classified into different bands of Framingham score, presented association between cardiovascular risk and increased sympathetic activity, decreased parasympathetic activity and sympatho-vagal balance. This demonstrates that even in patients with undetectable viral load, cardiovascular autonomic dysfunctions may be associated with cardiovascular risk in ten years. These findings point to the importance of routine assessments of cardiovascular autonomic nervous system in this population.
Introdução: o aumento do risco de doença cardiovascular tem sido demonstrado em sujeitos com infecção por HIV. A disfunção na regulação do sistema autônomo tem sido apontada como mecanismo subjacente a morte cardíaca nesse grupo de pacientes. Este estudo objetivou analisar a associação entre risco cardiovascular e controle autonômico cardíaco em portadores de HIV. Métodos: a amostra foi composta por 25 pacientes com HIV, de ambos os sexos, em uso de antirretrovirais e com carga viral não detectável, oriundos do Ambulatório de Doenças Infecciosas do Hospital Universitário de Santa Maria (HUSM), entre agosto e dezembro de 2014. Pacientes com doença cardiovascular, metabólica, respiratória, neurológica ou renal foram excluídos. O risco cardiovascular foi avaliado pelo Escore de Framingham, utilizado para estimar a probabilidade de eventos cardiovasculares em dez anos. O controle autonômico cardíaco foi avaliado pela medida da variabilidade da frequência cardíaca, analisando-se as seguintes variáveis: 1) no domínio do tempo foram mensurados o SDNN, índice triangular (variabilidade global) e rMSSD (atividade parassimpática); 2) o domínio da frequência compreendeu os componentes de baixa frequência (LF; atividade simpática) e de alta frequência (HF; atividade parassimpática), ambos normalizados, e a relação LF/HF (balanço simpato-vagal). Resultados: a amostra (12 mulheres e 13 homens) apresentavam idade média de 48,7±10,9 anos, índice de massa corporal de 25,7±5,1 kg/m2, frequência cardíaca de 72,1±13,4 bpm, frequência respiratória de 16,3±3,8 rpm, pressão arterial sistólica de 125,2±18,7 mmHg e diastólica de 83,3±12,2 mmHg. O tempo médio de diagnóstico da doença foi de 10,2±5,0 anos, o tempo de medicação de 7,2±4,2 anos e a contagem de CD4 de 628,6±223,8 mm3 de sangue. A pontuação obtida no Escore de Framingham foi de 9,5±5,1 e o risco de eventos cardiovasculares foi de 9,5±7,9%, sendo 7 pacientes classificados como baixo risco, 14 como risco intermediário e 4 como alto risco cardiovascular. A pontuação do Escore de Framingham apresentou correlação com o tempo de medicação (r= 0,53), com o componente LFnu (r=0,45) e com a relação LF/HF (r=0,44), mas correlacionou-se inversamente com o SDNN (r=-0,43), rMSSD (r=-0,47) e com o índice triangular (r=-0,49). O risco de eventos cardiovasculares esteve correlacionado positivamente com o tempo de medicação (r=0,54), com o componente LFnu (r=0,45) e com a relação LF/HF (r=0,45), porém, apresentou correlação negativa com o SDNN (r=-0,40), rMSSD (r=-0,43) e com o índice triangular (r=-0,48). Conclusão: Pacientes portadores de HIV, classificados em diferentes faixas do Escore de Framingham, apresentam associação entre o risco cardiovascular e o aumento da atividade simpática, redução da atividade parassimpática e do balanço simpato-vagal. Isso demonstra que, mesmo em pacientes com carga viral não detectável, as disfunções autonômicas cardiovasculares podem estar associadas ao risco cardiovascular em dez anos. Estes achados apontam para a importância de avaliações rotineiras do sistema nervoso autonômico cardiovascular nesta população.

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Mosqueda-Garcia, Agustin Rogelio. „The role of beta-endorphin in central cardiovascular control /“. Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=75445.

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The role of $ beta$-endorphin in the cardiovascular depressor response elicited by clonidine or by electrical stimulation of the nucleus tractus solitarii (NTS) was studied in awake as well as anesthetized rats. The opiate antagonists, naloxone or naltrexone, inhibited the hypotensive and bradycardic effects of clinidine in spontaneously hypertensive rats (SHR), in normotensive and steroid-salt hypertensive Sprague-Dawley (S-D) rats, but not in normotensive Wistar Kyoto (WKY) rats. The brain ACTH/$ beta$-endorphin fibre system originating in the arcuate nucleus was eliminated by neonatal treatment with monosodium glutamate (MSG). MSG-treatment abolished the naloxone-sensitive component of the effects of clonidine in SHR, while the naloxone-resistant effects of clonidine in WKY were not affected. Intra-NTS microinjection of clonidine (5 nmol) decreased blood pressure and heart rate, and these effects were inhibited by previous intra-NTS injection of dl- but not d-naloxone (270 pmol) in both SHR and normotensive S-D rats. Intra-NTS injection of $ beta$-endorphin (0.3 pmol) also reduced blood pressure and heart rate in both rat strains. In SHR, the effects of both clonidine and $ beta$-endorphin were inhibited by ICI 174864, a selective $ delta$ receptor antagonist, but not by $ beta$-funaltrexamine, a selective $ mu$ receptor antagonist (270 pmol, intra-NTS). In contrast, in normotensive S-D rats only the $ mu$ and not the $ delta$ antagonist was an effective inhibitor. In S-D rats made hypertensive by prolonged treatment with a mineralocorticoid and salt, the pattern of inhibition was the same as in SHR. The depressor baroreflex response was elicited by electrical stimulation of the NTS. In SHR, intra-NTS injection of an antiserum to $ beta$-endorphin inhibited, while an antiserum to met-enkephalin potentiated the hypotensive and bradycardic response to NTS stimulation. In similar experiments in WKY rats, the antisera were ineffective.
These findings are interpreted to indicate that the cardiovascular effects of clonidine involve release of $ beta$-endorphin and subsequent stimulation of opiate receptors in the NTS. The most likely source of $ beta$-endorphin is nerve terminals whose cell bodies are in the arcuate nucleus. The released $ beta$-endorphin acts on $ mu$ receptors in normotensive or $ delta$ receptors in hypertensive rats, with no evidence for the additional involvement of peripheral opiate receptors. (Abstract shortened with permission of author.)

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Jones, Alexander. „Prenatal development and later neuroendocrine control of cardiovascular function“. Thesis, University of Southampton, 2006. https://eprints.soton.ac.uk/345066/.

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Hemsley, A. G. „A study of exercise, cardiovascular neural control & ageing“. Thesis, Exeter and Plymouth Peninsula Medical School, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.700612.

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Mchowat, Jane. „Cardiovascular control by central beta-adrenoceptors in the rat“. Thesis, University of Bath, 1987. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380621.

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Costa, Sofia Maria Soares da. „Cardiovascular impact of cytotoxicity and aging in protein aggregation“. Master's thesis, Universidade de Aveiro, 2017. http://hdl.handle.net/10773/22488.

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Mestrado em Bioquímica
A estrutura nativa das proteínas, decorrente do folding proteico, constitui um pré-requisito para a sua funcionalidade. No entanto, vários fatores promovem o folding incorreto (misfolding) de proteínas, causando a sua agregação. Recentemente, o misfolding e a agregação de proteínas têm sido associados às doenças cardiovasculares, que representam a principal causa de morte em todo o mundo. De forma a impedir a formação de agregados proteicos potencialmente tóxicos, os cardiomiócitos desenvolveram sistemas de controlo de qualidade proteica. Contudo, o seu comprometimento potencia a acumulação de proteínas disfuncionais na forma de agregados. Neste contexto, e tendo em consideração o papel do envelhecimento e da doxorrubicina (Doxo) no aumento do risco para o desenvolvimento de doenças cardiovasculares, será importante esclarecer a associação entre cada um destes fatores de risco e a agregação proteica. Deste modo, procuramos otimizar uma metodologia de enriquecimento de agregados proteicos provenientes de ventrículo esquerdo (VE) de um modelo animal de envelhecimento e de um modelo animal de cardiotoxicidade induzida pela Doxo, visando identificar as proteínas presentes nestes agregados por GeLC-MS/MS. A técnica de isolamento de frações enriquecidas em agregados proteicos foi otimizada com sucesso em ambos os modelos animais. A análise por GeLC-MS/MS permitiu a identificação de 1279 e 1260 proteínas no VE de ratos WKY novos e velhos, respetivamente. A análise diferencial revelou que 15 e 18 proteínas apresentavam níveis mais elevados nos agregados do grupo novos e velhos, respetivamente. Entre as proteínas presentes em maior quantidade nos ratos envelhecidos destacam-se aquelas relacionadas com a contração cardíaca (miosina-6 e miosina-7), o folding mediado pelas chaperonas (TRiC) e sistemas proteolíticos (catepsina D). Em relação ao modelo animal de cardiotoxicidade, 274 proteínas foram identificadas no grupo controlo e 267 no grupo Doxo. A análise diferencial revelou que apenas uma proteína, a glicoproteína rica em histidina (fragmento), apresentava níveis mais elevados nos agregados de animais tratados com Doxo. Esta proteína está envolvida na regulação de vários processos biológicos, como a inflamação e a angiogénese, sugerindo um possível papel da mesma na cardiotoxicidade induzida pela Doxo. A identificação destas proteínas bem como o conhecimento da sua relevância biológica fornece informações valiosas sobre o comprometimento da homeostasia das proteínas, tanto no envelhecimento como em condições de cardiotoxicidade. Desta forma, estudos futuros serão necessários para elucidar sobre o impacto real da agregação destas proteínas no envelhecimento cardíaco e em condições de cardiotoxicidade, bem como potenciais alvos terapêuticos.
Native structure of proteins, acquired by protein folding, is required for them to function properly. However, several factors promote incorrect protein folding (misfolding), causing their aggregation. Recently, protein misfolding and aggregation have been associated with cardiovascular diseases, the leading cause of death worldwide. In order to avoid the generation of potentially toxic protein aggregates, cardiomyocytes have developed protein quality control systems. However, failure of these systems promotes the accumulation of abnormal protein aggregates. In this context, and taking into account the burden of aging and doxorubicin (Doxo) for cardiovascular diseases progression, it will be important to clarify the association between these two risk factors and protein aggregation. Therefore, we aimed to optimize the methodology for protein aggregates enrichment from left ventricle (LV) of aging and Doxo-induced cardiotoxicity animal models, and also to identify the proteins presented in these aggregates by GeLC-MS/MS. In both animal models, the technique for isolation of protein aggregates-enriched fractions was successfully optimized. GeLC-MS/MS analysis allowed the identification of 1279 and 1260 proteins in young and aged WKY LV, respectively. Differential protein analysis revealed that 15 and 18 proteins were presented at higher amounts in young and aged groups, respectively. Among proteins with greater amounts in aged rats, we highlighted those related to cardiac contraction (myosin-6 and myosin-7), chaperone-mediated protein folding (TRiC) and proteolytic systems (cathepsin D). Regarding the animal model of cardiotoxicity, 274 proteins were identified in the control group and 267 in the Doxo group. Differential protein analysis revealed that only one protein, histidine-rich glycoprotein (fragment), was presented in higher amounts in aggregates from Doxo-treated animals. This protein is involved in the regulation of several biological processes, such as inflammation and angiogenesis, suggesting that it can play a role in Doxo-induced cardiotoxicity. The identification of these proteins as well as the knowledge of their biological relevance provides valuable information about protein homeostasis impairment, both in aging and in cardiotoxicity conditions. Therefore, future studies are necessary to elucidate the real impact of the aggregation of these proteins on cardiac aging and cardiotoxicity conditions, as well as potential therapeutic targets.

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Rocha, Rafaela Pereira. „Ácidos gordos polinsaturados no controlo e prevenção de doenças cardiovasculares“. Bachelor's thesis, [s.n.], 2015. http://hdl.handle.net/10284/5345.

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Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciada em Ciências da Nutrição
Introdução: Nos últimos anos tem sido observado um aumento de interesse por parte das comunidades científicas pelos ácidos gordos polinsaturados (PUFAs), especialmente pelos ácidos gordos ómega-3, designadamente, os ácidos eicosapentaenóico (EPA) e docosahexaenóico (DHA) encontrados em peixes e em óleo de peixe. Este interesse está fortemente relacionado com os possíveis efeitos que estes exercem no controlo e na prevenção de doenças cardiovasculares (DCV). As evidências de que ingestões adequadas de fontes alimentares que contenham estes ácidos gordos (AG) ou a sua suplementação, têm sido numerosas em relação aos efeitos cardioprotetores, demonstrando uma relação inversa com a prevalência de doenças cardiovasculares. A fonte alimentar mais rica em ácidos gordos polinsaturados n-3 de cadeia longa são os peixes gordos e a necessidade do seu consumo deve ser melhor divulgada e também promovida junto da população. Objetivo: Realizar uma revisão bibliográfica de estudos observacionais ou intervencionais e de artigos de revisão e/ou atualização que estabelecem relações entre os efeitos dos ácidos gordos polinsaturados nas doenças cardiovasculares. Métodos: A revisão da literatura foi feita através das bases de dados Pubmed e B-on e através do livro “Anatomia & Fisiologia” no período de tempo compreendido entre julho e setembro de 2015. Resultados: O aporte de 500 mg/dia dos ácidos eicosapentanóico (EPA) e docosahexanóico (DHA) leva a efeitos benéficos para o organismo humano, nomeadamente, ao nível das doenças cardiovasculares. A razão n-6/n-3 deve ser, preferencialmente, de 5:1 a 10:1. Como são ácidos essenciais, ou seja, ácidos que o ser humano não tem a capacidade metabólica de sintetizar, devem ser ingeridos através da alimentação. Os ácidos gordos n-3 produzem metabolitos anti-inflamatórios (eicosanoides) que levam à diminuição da pressão arterial, à diminuição do teor de triglicerídeos, à prevenção da agregação plaquetária, à diminuição do risco de tromboses, à prevenção de arritmias e à diminuição do risco de enfarte do miocárdio e de morte súbita. Conclusões: O consumo de ácidos gordos polinsaturados n-3 está relacionado com a diminuição do risco de doenças cardiovasculares e, consequentemente, com a diminuição do risco de morte por estas patologias. Os peixes gordos e os óleos de peixe são uma excelente fonte deste tipo de ácidos e são o alimento de excelência associado à prevenção destes problemas. Para que o aparecimento destas patologias seja evitado, recomenda-se o aporte de 500 mg/dia de EPA e DHA, sendo este valor facilmente atingido com o consumo de duas refeições de peixe por semana. No entanto, nos últimos anos têm surgido estudos que documentam um modesto benefício dos AG n-3 na prevenção de eventos cardíacos, enfarte do miocárdio, morte súbita cardíaca e morte por todas as causas em amostras de populações distintas. Não obstante, a suplementação de AG n-3, em indivíduos com historial de DCV, atua na diminuição do risco de enfarte do miocárdio e no risco de morte súbita cardíaca.
Introduction: Most recently, there has been an increase interest from the scientific community in polyunsaturated fatty acids (PUFAs), especially the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fish and fish oil. This interest is strongly related to the possible effects on the control and prevention of cardiovascular disease (CVD). The evidence that adequate intakes of dietary sources of fatty acids (FA) or its supplementation, have been numerous in relation to the cardioprotective effects, demonstrating an inverse relationship with the prevalence of cardiovascular disease. The richest dietary source of n-3 polyunsaturated fatty acids are fatty fish and its consumption should be better publicized and also promoted among the population. Objective: A literature review of observational or interventional studies and review and original articles that establish relations between the effects of polyunsaturated fatty acids and cardiovascular diseases was conducted. Methods: The literature review was performed using the databases PubMed and B-on and through the book "Anatomy & Physiology" in the time period between July and September 2015. Results: The ingestion of 500 mg/day of eicosapentaenoic acid (EPA) and docosahexaenoic (DHA) leads to beneficial effects, particularly in cardiovascular diseases. The ratio n-6/n-3 should preferably be from 5: 1 to 10: 1. As is an essential fatty acids, ie, fatty acids that humans must ingest through the diet because cannot synthesize them. The n-3 fatty acids produce anti-inflammatory metabolites (eicosanoids) that lead to low blood pressure, decreased triglyceride content, prevention of platelet aggregation, reduced risk of thrombosis, prevention of arrhythmias and reduced risk of myocardial infarction and sudden death. Conclusion: The consumption of n-3 polyunsaturated fatty acids is associated with a decreased risk of cardiovascular diseases and, consequently, with a reduced risk of death due to these diseases. Fatty fish and fish oils are an excellent source of such acids and are the food of excellence associated with the prevention of these diseases. To avoid these disorders, it is recommended a supply 500 mg/day of EPA and DHA that is readily achieved with the consumption of two fish meals per week. However, in recent years there have been studies documenting a modest benefit of n-3 FA in the prevention of cardiac events, myocardial infarction, sudden cardiac death and death from all causes in different population samples. However, supplementation with n-3 FA in individuals with a history of CVD, acts on reducing the risk of myocardial infarction and the risk of sudden cardiac death.

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St, Lambert Jane Helen Denise. „Action of adenosine at the level of the nucleus tractus solitarii in the hypothalamic defence response“. Thesis, University College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.362875.

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