Dissertations / Theses on the topic 'Heart disease'
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Holt, Jim. "Heart Disease." Digital Commons @ East Tennessee State University, 2003. https://dc.etsu.edu/etsu-works/6509.
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Quigley, Gillian Margaret. "Inflammation of the heart in heart disease." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/inflammation-of-the-heart-in-heart-disease(eae19e58-aeb4-4673-924e-1dbd1c831fec).html.
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Heart failure patients have dysfunction of the cardiac conduction system that contributes to a high burden of arrhythmias including atrial fibrillation and sudden cardiac death. Heart failure has been associated with the inflammatory response, but it is unknown if inflammation is playing a role in the remodelling of the cardiac conduction system in heart failure. Inflammation has been shown to be present in the myocardium from failing hearts and it is known to have detrimental effects on cardiac function, inducing fibrosis, remodelling of ion channels and even arrhythmias. However, the effect of inflammation on the cardiac conduction system has not been investigated. The aims of this study were to determine if there is an increase of pro-inflammatory cytokines and inflammatory cells in the cardiac conduction system in heart failure. In addition, to identify if there is possible inflammation-associated fibrosis and apoptosis in the cardiac conduction system in heart failure. To test these aims, three models of heart failure were used: a rat model of pulmonary arterial hypertension, a rabbit model of congestive heart failure and a rat model of myocardial infarction. In the rat model of pulmonary arterial hypertension there was a bradycardia, a prolongation of the QT interval, and an increase in the atrioventricular and ventricular refractory periods, suggesting electrical remodelling in these animals. The rats with pulmonary arterial hypertension displayed an increase in pro-inflammatory cytokines such as interleukins 1β and TGFβ in the right side of the heart, including the sinoatrial node and right Purkinje fibres of the cardiac conduction system. In addition, in these areas, there was an increase in components of the extracellular matrix, including fibronectin, collagen I and vimentin. Histology revealed regions of non-myocyte nuclei, only in the right ventricle of the rats with pulmonary arterial hypertension. Immunohistochemistry demonstrated patches of CD68 and vimentin expression (markers for macrophages and fibroblasts, respectively) in the right side of the heart in these animals. TUNEL staining also revealed an increase in apoptosis in the right side of the heart. In the rabbit model of congestive heart failure, the region most affected by inflammation was the right atrium, while few changes were measured in the ventricles or cardiac conduction system. Although these results are surprising, it is suggested that the atria could be more sensitive to the physical stretch produced in this model. In the rat model of myocardial infarction, there were regions of non-myocyte nuclei in the border zone. This region also had increases in pro-inflammatory and fibrosis markers. In conclusion, this work has presented the novel finding that there can be inflammation in the cardiac conduction system in heart failure. This could be contributing to the arrhythmias seen in heart failure patients. This could possibly lead the way to anti-inflammatories as a possible novel therapeutic for heart failure patients.
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Rix, Louise Katharine. "Biochemistry of heart disease." Thesis, University of Oxford, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.334889.
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Misner, Scottie. "Heart Disease in Women." College of Agriculture and Life Sciences, University of Arizona (Tucson, AZ), 1999. http://hdl.handle.net/10150/146457.
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4 pp.Heart disease, or cardiovascular disease (CVD), includes stroke and coronary heart disease, which are serious disorders of the heart and blood vessel system. Heart disease is the leading cause of illness and death in North American women. This publication addresses what kind of heart diseases affect women and how to live the heart-healthy way.
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Brown, Jessie Ann. "RUNX2 in Embryonic Heart Development and Heart Disease." Thesis, The University of Arizona, 2011. http://hdl.handle.net/10150/144250.
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Zapanta, Laurence (Laurence F. ). "Heart rate variability in mice with coronary heart disease." Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/34118.
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Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2005.Includes bibliographical references (leaves 69-71).
Heart rate variability (HRV), the beat-to-beat fluctuation of the heart rate, is a non-invasive test that measures the autonomic regulation of the heart. Assessment of HRV has been shown to predict the risk of mortality in patients after an acute myocardial infarction. Recently, the Krieger lab at MIT developed genetically engineered double knockout (dKO) mice that develop coronary artery disease accompanied by spontaneous myocardial infarctions and die at a very young age. This thesis investigated whether HRV could function as a prognostic indicator in the dKO mouse. A novel method for estimating physiological state of the mouse from the electrocardiogram using an innovative activity index was developed in order to compare HRV variables at different times while controlling for physiologic state. Traditional time and frequency domain variables were used to assess the prognostic power of HRV. Results have shown that none of the HRV variables were helpful in predicting mortality in the dKO mice. Mean heart rate showed some prognostic power, but it was not consistent in all the dKO mice. Finally, the activity index developed in this thesis provided a reliable metric for activity in mice as validated by a camera with motion detection.
by Laurence Zapanta.
S.M.
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Pratt, Rebekah Janet. "Broken hearts and the heart broken : living with, and dying from, heart failure in Scotland." Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/8273.
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Heart failure is a common and serious chronic condition, which can be as ‘malignant’ as most forms of cancer (Stewart, MacIntyre, Hole, Capewell, & McMurray, 2001). Recent estimates are that around 40,000 men and 45,000 women are living with heart failure in Scotland (Stewart, MacIntyre, Capewell, & McMurray, 2003). Heart failure is significantly influenced by socioeconomic factors, with people on lower incomes being more likely to develop, and die faster from, heart failure (McAlister et al, 2004). There is a growing body of research on the experience of living with heart failure, however, none provides serious consideration of the role of socioeconomic factors in impacting the experience of heart failure, and some qualitative research may actually obscure such factors. There were two main aims in this thesis. One was to explore how qualitative research methods can better consider the relationship between experience and broader context, such as the influence of socio-economic factors on health. The other aim was to examine the experiences of people as they live with and die from heart failure in ways that situate their accounts in the broader context of their lives. An initial research study, on which I was the main researcher, focused on the experiences of 30 people living with advanced heart failure. These people, their carers and key health professionals were interviewed, where possible, three times over a six months period. This thesis re-examines that study, focusing on 20 of those participants, for which a total of 122 interviews were conducted. I used a dialogical approach to see whether the socioeconomic context of heart failure for these respondents, could be captured through exploring experiences, performance, relationships, discourses and institutional practices, the social processes that mediate the relationship between socioeconomic disadvantage and chronic diseases were explored. This offers important learning in relation to the experience of living with heart failure, along with the experience of providing care. The findings highlight the need to broaden our view of chronic illness beyond biomedical approaches, and grow our methodological approaches along with that, in order to develop knowledge and practice that has relevance for people who live with and die from heart failure.
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Field, Mark Leonard. "Biochemical basis of heart disease." Thesis, University of Oxford, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.386788.
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Rowlinson, Giselle Victoria. "Connexins in congenital heart disease." Thesis, Imperial College London, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.550483.
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Gap junctions are clusters of transmembrane channels, composed of connexins (Cx), that facilitate electrical and chemical communication between the cytoplasmic compartments of contiguous cells. Three connexins are expressed in cardiac myocytes, Cx40, Cx43 and Cx45. Targeted deletion of these connexin genes in mice results in cardiac malformations and conduction abnormalities. From this background, the question arises as to whether connexins play a role in human congenital heart disease. Atrial and ventricular tissue samples were studied from patients undergoing cardiac surgery. Immunoconfocal microscopy and western blot analysis of atrial tissue revealed that expression of CX40 and CX43 in children and adults with congenital heart disease is the same as that in the normal adult atrium, irrespective of the underlying malformation. Normal adult ventricular working myocytes express only CX43. Study of control ventricular samples in children confirmed that, as in adults, CX43 only is expressed. However, immunoconfocal microscopy of samples from patients with right ventricular outflow obstruction (tetralogy of Fallot and double chambered right ventricle) revealed that in addition to CX43, CX40 is also highly expressed. Expression is heterogeneous and CX40 is eo-localised with CX43. Quantitative western blot analysis showed that up to 10% of the total connexin expressed in these samples is CX40. As patients re-operated following previous repair (with markedly different underlying haemodynamics) still demonstrated high CX40 expression in the working myocardium, these results suggest that a lack of normal CX40 repression during development leads to heart malformations . . Gap junction channels formed from each connexin isofonn have distinctive biophysical properties. Connexin eo-expression further alters these properties. To investigate the functional consequences of the connexin eo-expression patterns observed in the ventricular samples, in vitro cell models were used. Intercellular communication was assessed using cell-to-cell Lucifer Yellow dye transfer in an inducible RLE cell line and conducjion properties were studied in an atrial myocyte (HL-l) cell line. The findings are consistent with the idea that altered function arising from abnormal embryonic connexin expression is a contributor to some types of human cardiac malformation.
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Grech, Victor. "Congenital heart disease in Malta." Thesis, University College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.286359.
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Brouilette, Scott Wayne. "Telomeres and coronary heart disease." Thesis, University of Leicester, 2004. http://hdl.handle.net/2381/29899.
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Using mean telomere length as a marker of biological age, I show that: 1. Subjects with premature myocardial infarction (MI) have significantly shorter telomeres than age-sex matched, healthy, controls. The mean telomere length in MI subjects was similar to controls almost 11 years older. 2. Healthy young adult children of families with a strong history of premature MI have shorter telomeres than age matched children of families without such a history. 3. Shorter telomere lengths are associated with increase risk of subsequent CHD events in a prospective study. This analysis was carried out on samples collected in the West of Scotland Coronary Prevention Study (WOSCOPS). This randomised blinded trial was designated to examine the benefits of statin treatment on preventing CHD and showed a 30% reduction of events in those treated with pravastatin. Interestingly, my analysis showed that this benefit of statin is only seen in those subjects at higher risk of CHD based on their telomere length.;As the final part of the thesis I carried out a quantitative linkage trait (QTL) analysis in sib-pairs in an attempt to identify genetic loci regulating telomere length. I report the mapping of a major QTL on chromosome 12 that determines almost 50% of the inter-individual variation in mean telomere length.;These findings support a novel "telomere" hypothesis of CHD. They indicate that telomere biology is intimately linked to the genetic aetiology and pathogenesis of CHD. Specifically, the findings suggest that (i) those individuals born with shorter telomeres may be at increased risk of CHD (ii) rather than individual genes, a more global structural property of the genetic material may explain the familial basis of CHD (iii) variation in telomere length may explain, in part, the variable age of onset of CHD. The findings provide several new avenues for future research.
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Khetyar, Maher. "Genetics of congenital heart disease." Thesis, St George's, University of London, 2017. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.754064.
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Congenital Heart Disease (CHD) is the leading non-infectious cause of death among children less than one year. CHD is genetically heterogeneous, but analysis of large multi-generational families has led to the identification of a number of genes for CHD. In this project I investigated the molecular genetic basis of CHD in a large Kuwaiti family with clinically diagnosed truncus arteriosus. Using a homozygosity mapping approach I identified a region of interest on chromosome 8p21. I proceeded to sequence candidate genes in this region. One of the novel genes identified was predicted to be the human homolog of mouse Nkx2.6, a gene encoding a homeobox transcription factor expressed in the sinus venosa and the myocardium of the outflow tract in the developing mouse heart. Sanger sequencing identified a Phel51Leu mutation which segregated with disease in the family. Next I investigated whether mutations in Nkx2.6, or the related gene Nkx2.5, were a common cause of type I truncus arteriosus in 12 unrelated individuals. However I found no mutations, suggesting the pattern of inheritance in this phenotype is likely to be complex and potentially multifactorial. Finally I investigated the molecular genetic basis of another congenital heart defect known as Patent Ductus Arteriosus (PDA) in a multigenerational Kuwaiti family with six affected members. A condition known as Char Syndrome is characterized by a combination of major features one of which is PDA and can be caused by mutations in the TFAP2B gene which encodes the Transcription Factor AP-2 Beta. I therefore hypothesised that mutations in TFAP2B may also be responsible for PDA in the Kuwaiti family. I identified a predicted splice site variant in this gene that segregated with disease status. A full clinical history and physical examination confirmed that no affected members of this family have any of the remaining features of Char Syndrome suggesting that mutations in TFAP2B can also cause isolated PDA.
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Mohamed, Kotit Susy Natalia. "Rheumatic heart disease in Egypt." Thesis, Imperial College London, 2012. http://hdl.handle.net/10044/1/9752.
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Rheumatic Heart Disease remains one of the most neglected cardiac conditions in children and young adults around the world. The pathogenesis is complex and remains elusive, and the clinical characteristics vary around the world. This thesis concentrates on different aspects of the disease in Egypt, where it is known to have a high incidence. The methodology included epidemiological studies in school children in Aswan and investigation of RHD in a population with history of RF, using newly developed echocardiographic criteria. Concomitantly, the pattern of immune response in RF and RHD was determined in serum and excised valves. In this series RF presents in children and young adults, as well as adults, (0.2-44 years, 10.69 ± 6.24) with polyarthritis being the most common clinical presentation (87.9%) and recurrences of RF being very common (98.2%). RHD affected 23 in 1000 school children in Aswan with over 90% of the cases being subclinical and developed in up to 69.2% of the individuals with history of RF, predominantly as mitral regurgitation. Risk factors for the development and severity of RHD were shown to be low disease awareness, non-compliance to penicillin prophylaxis or a regimen of longer than 15-days. Resistance to antibiotic regimens, including Penicillin and Vancomicin seems to lead to development and recurrences of RF in Egypt. This series showed the presence of immune activation and ongoing immunological reaction in an apparently quiescent phase of the disease with distortion of normal valvular architecture, histology and composition. This work has served to define the epidemiology, pattern of disease, immune reponse and predisposing factors in a population with no previous data, also contributing to the improvement of the echocardiographic diagnostic criteria. Standardization of the criteria will allow comparison of prevalence in different areas and improve case detection.
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Claesson, Maria. "Women's hearts : ischaemic heart disease and stress management in women." Doctoral thesis, Umeå : Department of Public Health and Clinical Medicine, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-725.
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Rose, Edward Leslie. "Coronary heart disease in patients with peripheral vascular disease." Thesis, University of Oxford, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305544.
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Heiser, Claire Anne. "Personality predictors of coronary heart disease." Thesis, Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/50027.
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Fifty percent of the diagnosed cases of coronary heart disease in the United States are of unknown etiology. This study proposed that five personality traits— achievement, dominance, aggression, succorance and Critical Parent—differentiate individuals with coronary heart disease manifestations. The ultimate goal of this research was to formulate a predictive profile of at-risk individuals of developing coronary heart disease.
Cardiac rehabilitation units' participants from across the United States were recruited as subjects. Randomly selected cardiac rehabilitation units were sent an initial letter inquiring whether their staff would be willing to participate in the study by administering the instruments to their participants. Eight units from each of the 50 states were contacted. A total of fourteen units agreed to participate. One hundred sixty-nine subjects completed the Demographic Data Questionnaire and the Adjective Check List.
Five scale scores, representing the five personality differentials, were analyzed. Comparison of the male subject population (n=135) and the male normative population (n=198) revealed no significant differences in terms of the five traits. Comparison of diagnostic subgroups of the subject population also revealed no significant differences.
It was concluded that the subject population did not differ significantly from the normative population in terms of the five traits assess by the instrument used. The goal of a predictive profile was not realized due to this lack of findings.Master of Science
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Engelman, Zoar Jacob. "Arrhythmic substrates in structural heart disease." Thesis, University of Auckland, 2011. http://hdl.handle.net/2292/9508.
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Mortality due to structural heart disease (SHD) remains high despite advances in clinical therapies. The aim of this thesis is to elucidate how structural remodeling in heart disease may lead to the development of potentially life threatening arrhythmias. This objective was advanced by the combined use of mathematical modelling and an experimental model of myocardial infarction (MI). The computer model was used to investigate possible electrical effects of tissue remodelling associated with SHD. Heterogeneous discontinuities resembling patchy fibrosis were incorporated into a 2D array of coupled myocytes with uniform electrical properties. It was shown that structural discontinuities alone can alter dynamic instability and provide a rate-dependant substrate for electrical reentry. This challenges the wide-spread notion that dynamic instability of this kind is due to changes in cellular electrical properties. Experimental studies were carried out in sheep with healed reperfusion MI. Intramural electrical activation in the infarct border zone (BZ) was recorded with a high density mapping array. Novel techniques were developed that enable the spread of activation in this region to be reconstructed in 3D at higher resolution than has previously been possible. Heart structure was also reconstructed in 3D using magnetic resonance imaging and serial histology. Intracardiac left ventricular mapping was carried out simultaneously. The BZ substrate was characterised by systematic intramural pacing. This confirmed that activation delay, consistent with tortuous electrical pathways, is the origin of apparently slow conduction in the BZ. Stimulus-site specific, low-level activation in the BZ was followed by uniform propagation around the infarct boundary at relatively normal conduction velocities. Electrical activity in the intramural BZ was recorded during induction and maintenance of ventricular tachycardia (VT). BZ activation delays were amplified during VT induction and in some cases contributed substantially to the cycle length during VT. For the first time, complex intramural activation patterns were tracked through the BZ during reentry. In general, local intramural and endocardial activation patterns were non-stationary during VT despite relatively monomorphic limb-lead electrocardiograms. This signifies a heterogeneous substrate capable of supporting multiple arrhythmic circuits.
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O'Sullivan, Christine Ann. "Electromechanical changes in ischaemic heart disease." Thesis, Imperial College London, 2006. http://hdl.handle.net/10044/1/8251.
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In coronary artery disease,. resting electrical and mechanical function of the left ventricle may vary according to different presentations. Stress or exercise in these patients results in electrical disturbances, which may havc mechanical consequences. The objectives ofthis thesis were: I) to assess the effect of the presence and location of Q wave myocardial infarction on left ventricular segmental mechanical function and identify patterns ofdisturbances. 2) to study the acute implications of induction of localised myocardial infarction at the proximal ventricular septum on ventricular performance. 3) to determine the effect of pharmacological stress on left and right ventricular behaviour in patients with coronary artery disease. AIl patients were studied by Doppler echocardiography using conventional measurements, as well as detailed assessment of long axis function and 12 lead surface EeG's. The foHowing groups ofpatients were studied: a). 72 patients with old Q wave MI; 35 anterior and 37 inferior. b) 54 patients with old anterior MI; 39 Q wave and 15 non-Q wave MI. c) 20 symptomatic patients with hypertrophic obstructive cardiomyopathy before and after non-surgical septal reduction therapy. d) . 27 patients with coronary artery disease, at rest and during dobutamine stress to assess left ventricular fune:tion. e) 33 patients with triple coronary artery disease at rest and at peak dobutamine stress to assess right ventricular function. The normal septal Q wave was' absent in 94% of anterior and 8% of inferior MI patients. Long axis amplitude and shortening and lengthening velocities were globaIly reduced in anterior and inferior myocardial infarction and the onset of shortening and lengthening were delayed by 30-40ms and 20-30 ms respectively in the two patient groups. Post ejection ~hortening was localised to the septum in the majority of patients with anterior myocardial infarction, but was generalised in patients with inferior infarction. 1) The normal septal Q wave was absent in 10% of control subjects and in 46% of patients with non-Q wave myocardial infarction. Q wave anterior MI was associated with a scarred septum and dilated LV cavity. Long axis amplitude was not different from normal in non-Q wave-infarction, but its onset ofshortening and lengthening was delayed by 20ms. Post ejection shortening occurred more frequently in Q wave infarction (76%) compared with non-Q wave infarction (21 %). These .abnormalities were localised to the left rand septal sites in non-Q wave infarction in contrast to their global distribution in Q wave infarction. . 2) Induction of localised upper septal myocardial infarction with alcohol resulted in broadening of the QRS (by 35ms), RBBB in 80% of patients, development of reduced septal long axis amplitude, and accentuated post ejection shortening at the septal long axis site. 3) In contrast to controls, dobutamine stress results in progressive broadening of QRS duration and prolongation of the QTc interval in patients with coronary artery disease, with corresponding reductions in long axis amplitude of motion and peak lengthening .velocity. 4) In patients with triple vessel coronary disease, dobutamine stress results in right ventricular long axis ischaemic disturbances similar to those seen on the left. Failure ofright ventricular long axis amplitude to increase by 2 mm was 88% specific for detecting right ventricular ischaemic dysfunction, which also correlated with the attenuated cardiac output at peak stress r= 0.56, p
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Danesh, John. "Chronic infection and coronary heart disease." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326020.
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Kounali, Daphne. "Early growth and coronary heart disease." Thesis, University of Southampton, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.436926.
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Sharma, Vishal. "Natriuretic peptides in valvular heart disease." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/23463.
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Plasma natriuretic peptide concentrations rise in response to either atrial or ventricular wall stretch and have been found to be useful in the diagnosis and assessment of patients with congestive cardiac failure. Although previous studies have suggested that plasma natriuretic peptides may offer some prognostic information in patients with valvular heart disease, it is unclear whether concentrations reflect disease severity and how plasma concentrations vary across different valve lesions. The aim of this research was to identify the factors that affect natriuretic peptide releases in valvular heart disease (VHD) and to investigate whether natriuretic peptides can be used in clinical practice to identify those patients who may benefit from early intervention. Plasma brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) concentrations were measured in patients with normal left ventricular (LV) systolic function and isolated VHD (mitral regurgitation, MR, n=33; aortic regurgitation, AR, n=39; aortic stenosis, AS, n=34; mitral stenosis, MS, n=30), and age and sex matched controls (n=39) immediately prior to exercise stress echocardiography. Peptide levels were compared against age and sex matched controls and against markers of severity for each valve lesions and across different valve lesions. Compared to controls, patients with all types of VHD had elevated plasma BNP concentrations [(MR median 35(inter quartile range 23-52), AR 34(22-45), AS 31(22-60), MS 58(34-90); controls 24(16-33) pg/mL; p < 0.01 for all]. LV end diastolic volume index varied by valve lesion; [MR (mean ± standard deviation 77±14), AR (91±28), AS (50±17), MS (43±11), controls (52±13) mL/m2; p < 0.0001]. There were no associations between LV volume and BNP. Left atrial (LA) area index varied [MR (18±4cm2/m2), AR (12±2), AS (11±3), MS (19±6), controls (11±2); p < 0.0001], but correlated with plasma BNP concentrations: MR (r=0.42,p=0.02), MS (r=0.86,p < 0.0001), AR (r=0.53,p=0.001), AS (r=0.52, p=0.002). Higher plasma BNP concentrations were associated with increased pulmonary artery pressure and reduced exercise capacity. Despite adverse cardiac remodelling, 81(60%) patients had a BNP concentration within the normal range. In patients with MS BNP was strongly associated with left atrial area index (r=0.86; p < 0.0001) and a BNP level of greater than 2 times the upper limit of normal identified patients who fulfilled guideline criteria for intervention (Area under the curve (AUC) 0.87 [0.74,0.99], p =0.006) and lower exercise capacity (AUC 0.82 [0.67,0.97]; p=0.004). In AR patients significant remodelling could occur whilst BNP remained within the normal range and in general BNP appeared less useful in assessing disease severity. However raised levels of BNP was associated with more severe AR as assessed by left ventricular outflow tract:AR Jet area ratio (r=0.43 p=0.0007). AR patients with an abnormal BNP had signs of early LV dysfunction on exercise with a lower LV longitudinal strain rate post exercise compared to AR patients with a normal BNP (0.68±0.31 vs. 1.06±0.45 1/sec; p=0.02). In MR patients, higher plasma BNP concentrations were associated with larger left atrial area index (r=0.42, p=0.02), higher pulmonary artery pressure (r=0.53, p=0.002) and a lower exercise time (r=-0.60, p=0.0002). BNP was not associated with any marker of left ventricular size or function in MR. These findings suggest that despite significant LV remodelling, plasma BNP concentrations are often normal in patients with VHD. Consequently, plasma BNP concentrations should be interpreted with caution when assessing patients with VHD. However natriuretic peptide levels offer complementary information to the standard assessment of patients with VHD and an unexplained finding of an elevated BNP in an otherwise asymptomatic patient should prompt further investigation.
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Taylor, Carolyn W. "Breast cancer radiotherapy and heart disease." Thesis, University of Oxford, 2008. http://ora.ox.ac.uk/objects/uuid:c9dda3ca-8cb3-4a38-938d-0b75b4f6471d.
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Introduction: Some past breast cancer radiotherapy regimens led to an increased risk of death from heart disease. Although heart dose from breast cancer radiotherapy has generally reduced over the past few decades, there may still be some cardiac risk. Estimation of future risk for women irradiated today requires both measurement of their cardiac dose and dose-response relationships, which depend on cardiac dosimetry of past regimens, in conjunction with long-term follow-up data. Methods: Virtual simulation and computed tomography 3-dimensional treatment planning on a representative patient were used to estimate mean heart and coronary artery doses for women irradiated since 1950 in 71 randomised trials in the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) overview. Patient-to-patient variability in cardiac dose was assessed. Heart and coronary artery doses were also calculated for breast cancer radiotherapy regimens used since the 1950s in Sweden. Cardiac doses from contemporary (year 2006) radiotherapy were assessed for 55 patients who received tangential breast cancer irradiation at a large UK radiotherapy centre. The maximum heart distance (i.e. the maximum distance between the anterior cardiac contour and the posterior tangential field edges) was measured for the left-sided patients, and its value as a predictor of cardiac doses assessed. Results: Mean heart dose for women irradiated in the EBCTCG trials varied from <1 to 18 Gray, and mean coronary artery dose from <1 to 57 Gray. Patient-to-patient variability was moderate. Mean heart dose for women irradiated in Sweden since the 1950s varied from <1 to 24 Gray, and mean coronary artery dose from <1 to 46 Gray. Heart dose from tangential irradiation has reduced over the past four decades. However, mean heart dose for left-sided patients irradiated in 2006 was 2 Gray and around half of them still received >20 Gray to parts of the heart and left anterior descending coronary artery. For these patients, maximum heart distance was a reliable predictor of cardiac doses. For the other patients, mean heart dose varied little and was usually less than 2 Gray. Conclusions: Cardiac doses from breast cancer radiotherapy can be estimated reliably and are now available for use in deriving dose-response relationships in the EBCTCG data and in a Scandinavian case-control study. Cardiac dose has reduced over the past four decades. Therefore the cardiac risk is also likely to have reduced. Nevertheless, for some patients, parts of the heart still receive >20 Gray in the year 2006.
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Zdravkovic, Slobodan. "Coronary heart disease in Swedish twins : quantitative genetic studies /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-771-5/.
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Jones, David Gareth. "Interventional electrophysiology in advanced heart disease atrial fibrillation and heart failure." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/10946.
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The optimal therapy for atrial fibrillation (AF) associated with heart failure (HF) is unclear. Drug-based rhythm control has not proved clinically beneficial. Catheter ablation-based rhythm control improves cardiac function in HF patients, but impact on physiological performance has not been formally evaluated in a randomised trial. A randomised trial was designed and conducted, comparing catheter ablation with rate control in adults with symptomatic heart failure, radionuclide left ventricular ejection fraction (EF) ≤35%, and persistent AF. The primary outcome was change in peak oxygen consumption (VO2) at cardiopulmonary exercise test. Secondary endpoints included change in quality of life (Minnesota), 6-minute walk, BNP, and EF. Patients were followed-up for 12 months, and results analysed by intention-to-treat. 52 patients (63±9y, EF 24±8%, VO2 17.3±5.1ml/kg/min) were randomised, 26 to each arm. In the ablation arm, at 12 month follow up, 88% maintained SR, with a single procedure success of 69%. In the rate control arm, rate criteria were achieved in 96% at 12 months. At 12 months, peak VO2 had increased by 2.13 (95%CI -0.1 to 4.36) ml/kg/min in the ablation arm, compared with a decrease (-0.94ml/kg/min, 95%CI -2.21 to 0.32) under rate control: mean benefit of ablation +3.07ml/kg/min, 95% CI 0.56-5.59, p=0.018. The change appeared progressive, with a difference of only 0.79ml/kg/min at 3 months (95% CI -1.01 to 2.60, p=0.38). Compared with rate control, ablation reduced 12-month Minnesota score (p=0.019) and BNP (p=0.045), and showed trends toward increased 6 min walk distance (p=0.095) and EF (p=0.055). LA size fell significantly after ablation (p=0.001). Catheter ablation of persistent AF in patients with HF, with the ablation strategy achieving sinus rhythm in the majority, improves prognostically important objective cardiopulmonary exercise performance, symptoms and neurohormonal status. The effects are clear at 1 year but less distinct earlier, suggesting a period of cardiac remodelling and recovery.
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Tinati, Mohammad Ali. "Time-frequency and time-scale analysis of phonocardiograms with coronary artery disease before and after angioplasty /." Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09pht587.pdf.
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Wrigley, Martha J. "Engaging families with a premature family history of heart disease : a primary prevention study for coronary heart disease." Thesis, University of Southampton, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.485524.
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This thesis focuses upon a preventative approach for people with a familial history of premature coronary heart disease. The research study had two aims; firstIy to understand the experience of individuals when their parent or sibling had been diagnosed with heart disease; secondly to develop and evaluate a primary prevention health promotion programme for these people. The thesis provides unique insight into their personal experiences of living with tIris familial diagnosis and gives details of how this population can be identified and involved successfully in a health promotion programme. The study was conducted in a district general hospital; 28 people were recruited of whom 20 participants completed the two year study. Narrative interviews were conducted at the beginning and end of the study, providing insight into people's personal experience. Salutogenesis is the theoretical framework in which the narratives are discussed; from these health resources are identified which can enhance people's progress and maintenance for a healthy lifestyle. The health promotion programme has established, developed and evaluated a nurseled and doctor supported primary pjevention strategy. Education and support was provided in the programme for individuals and families. The participants' physical and behavioural changes were reviewed six monthly, for two years. People are aware of risk factors associated with heart disease, but still seek professional support and advice in relation to their own lifestyle and behaviour. Individual lifestyle changes were achieved by most participants, which translated into significant findings for blood pressure and alcohol consumption; positive changes were seen in physical activity, smoking, diet and psychosocial stress. There were no improvements in lipid profiles. The need for a preventatiye approach in health care, which includes primordial and primary prevention for heart disease, is discussed. The issues in this thesis are reflective upon current government focus to develop preventative health services which actively engage with people as integral to this process. The thesis discusses coronary heart disease, the roles of prevention and health promotion, and identifies health resources for people at high-risk of future cardiovascular problems.
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Bissessor, Naylin. "Complex Heart Valve Disease: Functional Capacity and Natriuretic Peptides Predict Outcomes in mixed and Multiple Heart Valve Disease." Thesis, Griffith University, 2013. http://hdl.handle.net/10072/367217.
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Chronic mixed and multiple heart valve disease constitutes a complex group of cardiac pathologies that are prevalent world wide causing significant mortality and morbidity. The American Heart Association and the European Society of Cardiology concede in their guidelines that little data exists in the international literature on this important subject. Patients tend to adopt a sedentary lifestyle in order to cope with this illness and avoid symptoms causing a steady decline in functional capacity. A physically active lifestyle
is imperative for a good quality of life and cardiovascular wellness. Significant functional impairment through disease portends an adverse prognosis.
Functional capacity impairment can be objectively measured through formal cardiopulmonary exercise testing through determining the peak oxygen consumption (peakVO2). Exercise intolerance may suggest significant underlying symptoms especially in asymptomatic or mildly symptomatic states with severe heart valve lesions. The onset of symptoms is central to the decision to operate and surgical valve replacement. The peakVO2
measurement is the international gold standard of functional aerobic capacity and is widely used in heart failure and cardiac transplant to predict prognosis and outcome. The role of peakVO2 has not been evaluated in complex heart valve disease.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medical Science
Griffith Health
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McCafferty, Kieran. "Novel cardioprotective strategies for the uraemic heart." Thesis, Queen Mary, University of London, 2011. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8725.
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Cardiovascular disease is the leading cause of death in patients with underlying chronic kidney disease (CKD). Up to one third of patients presenting with an acute coronary syndrome have CKD stage 3-5. Outcomes following acute myocardial infarction in patients with underlying CKD remain poor. CKD patients are routinely excluded from clinical trials in novel cardioprotective strategies resulting in a paucity of prospective data on which to base guidelines for clinical practice. The aims of this work were to: • Establish and characterise two models of chronic uraemia in rodents: the subtotal nephrectomy model and the adenine diet model. • Determine the effects of underlying chronic uraemia on myocardial ischaemia tolerance. • Examine pharmacological cardioprotective strategies in the context of underlying uraemia using a PARP inhibitor • Investigate the cardioprotective effects of ischaemic conditioning in the context of uraemia. Ischaemic preconditioning and postconditioning protocols were used in both uraemic and non-uraemic animals in a model of acute myocardial infarction. • Preliminary work, using standard molecular biological techniques, was carried out in order to confirm the putative survival pathways responsible for the effect of preconditioning. • Investigate the effect of combining early and late remote ischaemic preconditioning to identify whether summation of these strategies could provide additional tissue protection in a model of acute kidney injury. The results demonstrate that both models develop a uraemic phenotype. Subtotal nephrectomy animals exhibit reduced ischaemia tolerance. PARP inhibition as a pharmacological post conditioning agent was shown to be ineffective at conferring tissue protection, whereas both ischaemic preconditioning and postconditioning were effective cytoprotective strategies in both non-uraemic and uraemic animals. Furthermore, additional benefit was seen when early and late remote preconditioning were summated in a rodent model of acute kidney injury. This work provides a basis for future clinical trials in cardioprotection in the context of underlying CKD.
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Toren, Enoch Wolter van den. "Dihydropyridines in heart disease studies with isradipine /." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 1991. http://irs.ub.rug.nl/ppn/293021511.
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Bagés, Nuri. "Psychosocial risk factors and coronary heart disease." [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 2000. http://arno.unimaas.nl/show.cgi?fid=6899.
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Sartipy, Ulrik. "Left ventricular reconstruction in ischemic heart disease /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-028-2/.
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Henareh, Loghman. "Impaired glucose tolerance in ischemic heart disease /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-445-7/.
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Rydell, Karlsson Monica. "Knowledge acquisition in patients with heart disease /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-257-6/.
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Chandola, Tarani. "Social inequality in coronary heart disease outcomes." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.285007.
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Abozguia, Khalid. "Metabolic alterations in patients with heart disease." Thesis, University of Birmingham, 2010. http://etheses.bham.ac.uk//id/eprint/690/.
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Despite major advances in therapies, chronic heart failure (CHF) and hypertrophic cardiomyopathy (HCM) are still associated with significant morbidity and mortality. These patients often have a significant limitation in their exercise capacity. We showed that there are widespread abnormalities of both systolic and diastolic function in HCM patients. These abnormalities contribute significantly to exercise limitation observed in these patients. Furthermore, we showed that HCM manifest a myocardial energy defieciency which was accompanied by a slowing of the energy-dependent early diastolic LV active relaxation during exercise. The present study supports the hypothesis that HCM is, at least in part, a disease of energy deficiency. Consistent with this hypothesis, we showed that metabolic modulation by perhexiline augmented myocardial energetics, and normalised diastolic ventricular filling which translated into significant subjective (improved symptoms) and objective (increased exercise capacity [peak VO2]) clinical improvement in HCM patients. These findings suggest that metabolic modulators, such as perhexiline, have the potential role in the management of patients with symptomatic non obstructive HCM, a condition for which there are currently limited therapeutic options. However, large scale longterm studies are still required to examine the effects of these agents on morbidty and mortality in these patients.
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Freitag, Daniel Franz. "Inflammatory pathways and coronary heart disease risk." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648461.
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Dobson, Rebecca. "Carcinoid heart disease : biochemical and echocardiographic assessment." Thesis, University of Liverpool, 2016. http://livrepository.liverpool.ac.uk/3003352/.
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Introduction: Carcinoid heart disease is a para-neoplastic complication of neuroendocrine tumours, occurring in patients with carcinoid syndrome. Due perhaps to its rarity, there is conflicting evidence in the literature with regard to the optimum method of diagnosis and assessment of the condition. The aim of this thesis is to quantify the variation in clinical practice with regard to carcinoid heart disease and to identify the optimum biochemical and echocardiographic methods for the screening, diagnosis and assessment of progression of the condition. Methods: Patients were prospectively recruited from specialist neuroendocrine clinics in the North of England and underwent evaluation of their symptoms, disease burden, biochemical markers, and transthoracic echocardiography. Results: Wide variation in the screening and clinical management of carcinoid heart disease was identified. A total of 239 patients were recruited to the study and the prevalence of carcinoid heart disease was 21%. From a panel of biomarkers, N-terminal pro brain natriuretic peptide (NTproBNP) and plasma 5-hydroxyindoleacetic acid (5HIAA) were the most sensitive and specific biomarkers for the presence of carcinoid heart disease. All previously described echocardiographic scoring systems discriminated highly between those with/without carcinoid heart disease, with no single score performing significantly better than another. The complexity of the scoring systems varied considerably, with the simplest scoring system better suited for screening and the more complex systems most useful for pre-surgical assessment. A disease progression rate of 9% was demonstrated, with a further 22% of patients dying during the study. Plasma 5HIAA was the greatest predictor of disease progression and death. Conclusion: There is considerable heterogeneity across the UK and Ireland in multiple aspects of screening and management of carcinoid heart disease. NTproBNP and plasma 5HIAA should be used to screen for the disease with transthoracic echocardiography reserved for those with elevated biomarkers. A simple echocardiographic scoring system should be used to screen for the disease, with the more complex scoring systems reserved for those patients with established disease. Biomarkers can also be used to predict risk of disease progression and death.
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Гордіна, Марина Андріївна, Марина Андреевна Гордина, and Maryna Andriivna Hordina. "Vitamin D deficiency and coronary heart disease." Thesis, Сумський державний університет, 2013. http://essuir.sumdu.edu.ua/handle/123456789/33551.
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Coronary heart disease (CHD) is the result of the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium with oxygen and nutrients. The WHO estimated that in 2002, 12.6% of deaths worldwide were from CHD.
When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/33551
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Springer, David Brian. "Mobile phone-based rheumatic heart disease detection." Thesis, University of Oxford, 2015. https://ora.ox.ac.uk/objects/uuid:5ec8c818-dafb-4571-8198-97607f8d0451.
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Rheumatic heart disease (RHD), the permanent damage of the heart valves caused by an untreated 'strep throat' infection, is the leading cause of cardiovascular mortality and morbidity in children and young adults worldwide. Simple penicillin treatment after the early diagnosis of RHD can stop recurring bouts of the condition, which lead to the most severe valvulopathy, and ultimately, heart failure. However, RHD is an under-diagnosed condition in the developing world, as such a diagnosis requires, at a minimum, a trained clinician to perform auscultation to detect pathological heart sounds. Trained medical personnel are scarce in the countries where RHD is most prevalent. A low-cost, mobile phone-based automatic diagnostic tool offers a potential solution, allowing a non-medically trained individual to screen for RHD in those countries. An essential feature of such a device is feedback on the signal quality of heart sound recordings. The first major contribution of this thesis is the investigation of features and algorithms for the automatic signal quality assessment of heart sound recordings. These algorithms are able to differentiate between good- and poor-quality recordings in over 80% of cases when using both a low-cost mobile phone-based stethoscope and an electronic stethoscope. Once the quality of recordings is ensured, the positions of the first and second heart sounds need to be located in a process called segmentation. This thesis extends the state-of-the art hidden semi-Markov models by: investigating additional features; extending the Viterbi algorithm; incorporating logistic regression into the model to form a hybrid generative-discriminative model; and investigating a discriminative duration-dependent probabilistic model - a conditional random field. These extensions are found to outperform the state-of-the-art method. Lastly, the period between the first and second heart sounds can be analysed for the presence of a pathological murmur. This thesis presents automated systolic murmur classification algorithms based on wavelet and mel-frequency cepstral coefficient-based features along with denoising via cycle averaging. These algorithms outperform three methods from the literature when detecting valvulopathy, while also outperforming a cardiologist and commercial software when detecting RHD in mobile phone-based heart sound recordings.
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Kunutsor, Setor Kwadzo. "Markers of liver dysfunction and risk of coronary heart disease." Thesis, University of Cambridge, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708216.
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Du, Ying. "Ischemic and pharmacological preconditioning of rat myocardium : effects on ischemia-reperfusion injury /." View abstract or full-text, 2005. http://library.ust.hk/cgi/db/thesis.pl?BICH%202005%20DU.
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Ho, Lai-yi Ada. "Does social support influence coronary heart disease prognosis? : a meta-analysis /." Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/b39724116.
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Huang, Xiao Hui. "Protective effects of sodium tanshinone II A sulfonate against sunitinib induced cardiotoxicity in H9c2 cell and zebrafish." Thesis, University of Macau, 2014. http://umaclib3.umac.mo/record=b3132193.
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Dorn, Karen LaVonne Toft. "Circulatory, hormonal, and metabolic effects of arbutamine compared to exercise in persons with known or suspected coronary artery disease /." This resource online, 1994. http://scholar.lib.vt.edu/theses/available/etd-06062008-164634/.
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Liu, Jing. "Roles of heat shock protein 70 and testosterone in delayed cardioprotection of preconditioning." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B37190660.
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Shuper, V. A. "Clinical features of chronic obstructive pulmonary disease combined with ischemic heart disease." Thesis, БДМУ, 2017. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17112.
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Savatteri, Giuseppe. "Enviromental factors influencing heart diseases." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2020.
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È importante individuare strategie e meccanismi per sfruttare le opportunità offerte dalla digitalizzazione in ambito sanitario delle attività e dalla gestione dei Big Data per migliorare efficienza, monitoraggio, prevenzione e cura delle patologie. possibilità di applicazione della medicina di precisione, refertazione in anatomia patologica e automazione della raccolta dati.
Il lavoro di tesi è incentrato sulle problematiche legate alle malattie cardio-cerebrovascolari e la loro correlazione con il territorio con cui i soggetti interagiscono.
È stato realizzato un nuovo sistema di monitoraggio del territorio che possa individuare possibili legami tra la composizione del territorio, in termini di opere pubbliche e private, e lo stato di salute delle persone.
Un apposito insieme di dati viene fornito al modello di modello di machine learning, basato sulle reti neurali e provvederà ad operare nell'estrazione di possibili correlazioni tra la tipologia di edifici e la percentuale di soggetti a rischio cardiovascolare.
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MONTEIRO, MAYLA COSMO. "A HEART FOR TWO: THE CONGENITAL HEART DISEASE IN THE MOTHER-BABY RELATIONSHIP." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2003. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=4350@1.
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CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOO presente estudo tem por objetivo a compreensão do papel da mãe na relação com o bebê cardiopata. Baseado na teoria winnicottiana, mostra ser o meio-ambiente facilitador elemento fundamental para uma relação boa o bastante ou deficitária. Para a realização da pesquisa, utilizou-se entrevistas semi-estruturadas e aplicação de desenho sobre a relação mãe-bebê. Entrevistou-se 4 mães de bebês cardiopatas, com idades de 0 a 12 meses. Os resultados revelaram temas relacionados à forma como as mães se adaptam à situação de ter um filho com uma cardiopatia congênita, ao impacto causado na família, aos sentimentos e atitudes maternos e ao medo de perder o bebê. A partir disto, este estudo propõe que, tal como o bebê, a mãe precisa ser cuidada e apoiada. Para tal, é essencial cuidar também de seu meio-ambiente, representado pelo marido, pelos filhos, pela família e pelos amigos. O tipo de relação estabelecida entre a mãe e o bebê dependerá dos cuidados recebidos desse meioambiente.
The objective of the present work is to understand the mother s role in its relation with the baby with congenital heart disease. Based on Winnicott s theory, it shows that the facilitating environment is the fundamental element for a good enough relationship or a not good enough one. An interview guide was used to collect the data, which has a semi-structured conversational format; mother-baby relationship s drawing were used too. Four mothers of babies (from 1 to twelve months old) with congenital heart disease had been interviewed. The results revealed themes related to the way these mothers get used to the situation of having a baby with congenital heart disease; to the impact caused in the family; to the maternal feelings and attitudes and to the fear of the baby s death. From these results, this study proposes that, just like the baby, the mother needs to be cared and supported. For this, it is essential to take care of the mother s environment too, represented by her husband, by her children, by her family and by her friends. The type of the relationship established between the mother and the baby will depend on the care taken by this environment.
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Argyriou, Eleni. "Impaired HDL cholesterol response to monounsaturated fat in men with coronary heart disease : dietary response in men with heart disease /." Title page and abstract only, 1995. http://web4.library.adelaide.edu.au/theses/09HS/09hsa695.pdf.
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Cao, Fei. "Chlamydia pneumoniae, toll-like receptors and pathogenesis of atherosclerotic heart disease." View the abstract Download the full-text PDF version (on campus access only), 2007. http://etd.utmem.edu/ABSTRACTS/2007-022-Cao-index.html.
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Thesis (Ph.D. )--University of Tennessee Health Science Center, 2007.Title from title page screen (viewed on May 16, 2008 ). Research advisor: Gerald I. Byrne, Ph.D. Document formatted into pages (xi, 114 p. : ill.). Vita. Abstract. Includes bibliographical references (p. 65-107).