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1

Leite, Wanderley André. "Sobre a Dinâmica Cardiovascular". Universidade Federal de Pernambuco, 2005. https://repositorio.ufpe.br/handle/123456789/5644.

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Estuda-se a dinâmica do sistema cardiovascular à luz de modelos matemáticos de sistemas dinâmicos. Apresenta-se os elementos básicos da fisiologia cardiovascular, do ponto de vista do controle autonômico, com a introdução de parâmetros condicionantes desse controle, dentro do paradigma da simplicidade. O leito arterial é representado por uma equação diferencial ordinária de primeira ordem (modelo Windkessel de dois elementos), de onde foram elaborados os parâmetros. O desenvolvimento do modelo teve como filosofia básica a elaboração de procedimentos de apoio ao diagnóstico das disfunções do sistema cardiovascular que pudessem fazer uso de exames complementares simples e corriqueiros, como a aferição da pressão arterial e da freqüência cardíaca. Buscou-se aumentar o potencial destes testes na prática clínica. A Ecocardiografia, o exame de Hölter-24h, a Monitorização Ambulatorial da Pressão Arterial de 24 horas, o Eletrocardiograma, a Série Bioquímica, entre outros exames, foram usados, ora como padrões ouro, ora como marcadores das diversas disfunções do sistema, entre estas a hipertrofia ventricular esquerda, a diabetes e as arritmias. Os resultados foram vindicados por intermédio de uma base de dados com 3.035 (três mil e trinta e cinco) indivíduos
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2

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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3

Miranda, Gabriela Cristina Oliveira de. "Estresse em pacientes com cardiopatias hospitalizados: estudo descritivo". Universidade Federal Fluminense, 2016. https://app.uff.br/riuff/handle/1/3020.

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Mestrado Acadêmico em Ciências do Cuidado em Saúde
O estresse é um fator associado ao desenvolvimento de inúmeras enfermidades psíquicas e orgânicas, dentre as quais as cardiopatias. Esse estudo aborda como se caracteriza o estresse no paciente cardiopata hospitalizado e tem como objetivos caracterizar o perfil de pacientes com cardiopatias hospitalizados e descrever os resultados da aplicação da escala fatorial de estresse em pacientes cardiopatas hospitalizados. Trata-se de estudo quantitativo e descritivo, realizado no período de junho a novembro de 2015 com 30 pacientes com cardiopatias internados em enfermarias de clinica médica de um hospital universitário no Estado do Rio de Janeiro por meio de análise documental de prontuários e aplicação da escala fatorial de estresse. Para análise dos dados utilizou-se o programa Microsoft Excel® seguido de análise estatística simples. Os dados são apresentados em tabelas, expressos em frequência (n) e percentual (%) para dados categóricos e média ± DP para dados numéricos. Dos 30 participantes do estudo, 16 (53,33%) são mulheres e 14 (46,66%) homens, na faixa etária média de 51,9 anos, sendo 12 (40,00%) casados, 28 (93,33%) com filhos, 9 (30,00%) tendo como fonte de rendimentos a aposentadoria, 17 (56,66%) negros, 14 (46,66%) de origem nos municípios de Niterói e 14 (46,66%) São Gonçalo, 19 (63,33%), tendo como doença cardiovascular de maior prevalência a hipertensão. Quanto aos resultados da aplicação da escala fatorial de estresse, houve predominância de sintomas físicos relacionados ao sistema cardiovascular, com taquicardia 14 (46,66%), aumento de pressão arterial 19 (63,00%), e sintomas respiratórios, com aumento da frequência respiratória 15 (50,00%), dificuldades para respirar 14 (47,00%%) e cansaço constante 18 (60,00%). Sobre os sintomas psicológicos houve predominância de redução na capacidade de concentração 15 (50,00%), mudanças bruscas de humor 17 (56,66%), irritabilidade fácil 15 (50,00%), maior nervosismo 21 (70,00%) e desleixo com a aparência 14 (46,66%). Em analise da associação do estresse com a cardiopatia constatou-se que para cada uma, isoladamente, os sintomas físicos e psicológicos se apresentaram de modo diferenciado, demonstrando a necessidade de estudos direcionados para cada tipo de cardiopatia apresentadas pelos participantes. A aplicação da escala fatorial de estresse evidenciou que a presença do fator de risco estresse possui repercussões físicas e psicológicas que podem interferir na evolução do tratamento de pacientes cardiopatas hospitalizados
Stress is a factor associated with the development of numerous psychic and organic diseases, among which the heart diseases. This study describes how stress is characterized in the hospitalized cardiopathy patient and aims to characterize the profile of patients with hospitalized cardiopathy and to describe the results of the application of the factorial stress scale in hospitalized patients with a heart disease. This is a quantitative and descriptive study, conducted in the period from June to November 2015 with 30 patients with heart diseases admitted to a medical clinic in a university hospital in the State of Rio de Janeiro through documentary analysis of medical records and application of the factorial stress scale. For data analysis, the Microsoft Excel® program was used, followed by simple statistical analysis. Data is presented in charts expressed in frequency (n) and percentage (%) for categorical data and mean ± SD for numerical data. Of the 30 participants in the study, 16 (53.33%) were women and 14 (46.66%) were men, with average of 51.9 years old, 12 (40.00%) being married, 28 (93.33 (56.66%) black, 14 (46.66%) of origin in the boroughs of Niterói and 14 (46.66%) São Gonçalo, 19 (63.33%) with hypertension being the most prevalent cardiovascular disease. Regarding the results of the application of the factorial stress scale, there was predominance of physical symptoms related to the cardiovascular system with tachycardia 14 (46.66%), increased blood pressure 19 (63.00%), and respiratory symptoms, with increased respiratory frequency 15 (50.00%), shortness of breath 14 (47.00%) and constant fatigue 18 (60.00%). About the psychological symptoms, there was predominance of reduction in the ability to concentrate 15 (50.00%), abrupt mood changes 17 (56.66%), easy irritability 15 (50.00%), greater nervousness 21 (70.00%) and sloth with appearance 14 (46.66%). In an analysis of the association of stress with heart disease, it was observed that for each one, the physical and psychological symptoms were presented in a different way, showing the need for studies directed to each type of heart disease presented by the participants. The application of the factorial stress scale showed that the presence of the stress risk factor has physical and psychological repercussions that may interfere in the evolution of the treatment of hospitalized cardiac patients
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4

Guo, Xiaohui. "Effects of Total Polyphenol Intakes on Cardiovascular Disease Risk Factors in an Elderly Population at High Cardiovascular Risk". Doctoral thesis, Universitat de Barcelona, 2016. http://hdl.handle.net/10803/399542.

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There is a consensus that CVD has been the leading cause of death worldwide in recent decades, and it is predicted that will raise from 17.5 million in 2012 to 22.2 million in 2030. Besides, CVD is a heavy economic burden on the health care system at both global and national scales. For the primary prevention, prediction models based on established risk factors are useful tools in the prevention of CVD. In this study, the cardiovascular risk factors among the elderly population have been assessed, which used to set up associations between total polyphenol intakes from a Mediterranean diet and prevention of CVD. The Mediterranean diet is a nutritional recommendation that has recently shown beneficial effects on human health. Numerous studies have demonstrated there is a negative association between consumption of the Mediterranean diet and the prevalence of CVD. The evidence concerning the potential mechanisms of action which underlie the cardio-protective effects may be attributed to a high amount of dietary fiber, vitamins, folic acid, natural antioxidants, monounsaturated fat; moderate amounts of animal protein, moderate amount of alcohol mainly in the form of wine; and low amount of saturated and trans fat. However, only limited studies have focused on the observed protection from the most abundant antioxidants in nature, polyphenol. Therefore, in this study, we hypothesized that a high dietary polyphenol intakes, recorded by urinary polyphenol excretion, could be associated with low CVD risk parameters, diabetes, and obesity in an elderly population with high cardiovascular risk. Traditional methods of obtaining information on polyphenol intakes, such as from dietary recalls, FFQs, and databases on the polyphenol content of foods, are not accurate enough to reflect polyphenol concentration after metabolism. To solve this problem, we used excretion of urine as a reliable and effective biomarker to track polyphenol after digestion. High glucose levels, TG concentration, DBP are classic cardiovascular risk factors for developing of CVD. In this thesis, we found significant inverse correlations between changes in TPE and plasma TG concentration, glucose concentration, and DBP after adjustment for potential confounders after a 5-year of intervention. Overweight and obesity are also important risk factors for developing of CVD. Inverse correlations were observed between TPE at 5 years of follow-up and BW, BMI, WC and WHtR after adjustment for potential confounders, indicating higher polyphenol intakes improve body weight managements. Prevalence of T2D is positively associated with incidence of CVD. We found a high intake of total polyphenols, calculated by FFQs and the Phenol-Explorer database, was associated with a reduced risk of diabetes in elderly people at high risk of CVD. To conclude, we suggest that a high consumption of polyphenol-rich foods in the frame of a Mediterranean diet could potentially help to reduce multiple risk factors of CVD.
Las enfermedades cardiovasculares (CVD) representan la principal causa de mortalidad en el mundo. Numerosos estudios han demostrado una asociación negativa entre el consumo de la dieta mediterránea y la prevalencia de las CVD. Sin embargo, sólo algunos estudios se han centrado en evaluar la protección que pueden ejercer los polifenoles. En este trabajo se propuso la siguiente hipótesis de que una ingesta elevada de polifenoles a través de la dieta, podría estar asociada a una disminución de parámetros de bajo riesgo de CVD, diabetes y obesidad en una población de edad avanzada con alto riesgo de enfermedades cardiovasculares. Se observó que una alta ingesta de polifenoles totales, calculado por las encuestas de frecuencia de consumo (FFQ) y la base de datos de Phenol-Explorer, se asoció con un menor riesgo de diabetes en personas de edad avanzada con alto riesgo de CVD. Los métodos tradicionales para obtener las informaciones de la ingesta de polifenoles, como los recordatorios de la dieta, las encuestas de frecuencia de consumo y bases de datos, no son suficientemente precisos. Para resolver este problema, se utilizó la además la excreción de los polifenoles en la orina (TPE) como un biomarcador fiable, robusto y eficaz para realizar un seguimiento del consumo de polifenoles. Hemos observado correlaciones inversas significativas entre los cambios en la concentración plasmática de TPE a los 5 años de seguimiento y triglicéridos plasmáticos, la concentración de glucosa y la presión sanguínea diastólica después de ajustar por posibles factores de confusión. El sobrepeso y la obesidad también son importantes factores de riesgo cardiovascular. Se observaron correlaciones inversas entre TPE a los 5 años de seguimiento y peso corporal (BW), índice de masa corporal (BMI), circunferencia de la cintura (WC) y cintura a la altura (WHtR) después del ajuste por posibles factores de confusión. Para concluir, se sugiere que un alto consumo de alimentos con alto contenido en polifenoles en el marco de una dieta mediterránea podría reducir múltiples factores de riesgo de CVD.
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Duarte, Carla Susana Soares. "Reabilitação Cardiovascular". Master's thesis, Instituto de Ciências Biomédicas Abel Salazar, 2008. http://hdl.handle.net/10216/21004.

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Blackwelder, Reid B. "Cardiovascular Medicine". Digital Commons @ East Tennessee State University, 2000. https://dc.etsu.edu/etsu-works/6922.

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Duarte, Carla Susana Soares. "Reabilitação Cardiovascular". Dissertação, Instituto de Ciências Biomédicas Abel Salazar, 2008. http://hdl.handle.net/10216/21004.

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Serrano, Novillo Clara. "Biology of the cardiovascular Kv7.1 functional complex". Doctoral thesis, Universitat de Barcelona, 2020. http://hdl.handle.net/10803/668686.

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Voltage gated K+ channels (Kv) are transmembrane proteins that allow the pass-thorugh of potassium ions, regulating the electrochemical gradient of the cell membrane. This way, they modulate several physiological processes, such as proliferation, migration or cell volume. Of particular interest in this dissertation is their role in excitable cells, were they control several key functions. The relevance of this ion channels is evidenced when mutations or alterations in the proper functioning of Kv channels causes severe pathologies, including cardiovascular or neuronal diseases, autoimmune affectations or cancer. Kv channels are tetramers of 4 α subunits with 6 transmembrane segments each one, that associate to form the pore and generate a functional channel. The wide functional diversity of currents is due to a vast number of modulations: heterotetramerization of α subunits, splicing variants, post-translational modifications or the association with regulatory subunits. The last ones include KCNE family, which co-assemble with the channel and modulate its electrophysiological, pharmacological or physiological properties. Kv7.1 associates with KCNE1 in cardiomyocytes to generate IKs cardiac repolarizing currents, in charge of finishing the cardiac action potential. Their assembly and traffic to the plasma membrane have been subject of discussion over the last years, with two opposite schools claiming an association early in the biogenesis versus a independent traffic to the plasma membrane, were both proteins would diffuse to assemble. We aimed in the present work to shed a light to this controversial topic. Kv channels have also been described in vascular smooth muscle, were they set the resting membrane potential and, therefore, control vascular tone. Kv7.1, Kv7.4 and Kv7.5 have been detected in different veins and arteries, were aberrations in their expression promote physiological alterations, but the specific role of each subunit remains unknown. In this scenario, the proposed objectives for the current PhD dissertation included the study of Kv7.1-KCNE1 complex, its assembly and traffic mechanisms. We hypothesized an unconventional secretion for the complex and suggest ER-PM junctions as the potential trafficking system. Therefore, we aim to characterize this structures and their implication in Kv7.1 membrane targeting. Finally, due to its implication in proliferation, their importance in cardiovascular system and their known role in some cancers, we studied the changes in the expression of Kv channels in endothelial-derived vascular tumors. We have been able to solve the traffic controversy of Kv7.1-KCNE1 complexes as they are not assembled early in their biogenesis. While KCNE1 is using the conventional secretion pathway, Kv7.1 takes an unconventional route that skips Golgi. Upon co-assembly, Kv7.1 redirects KCNE1 to this unconventional pathway. Moreover, we have proved that this non-conventional route are indeed ER-PM junctions, which also host the assembly of the complex. The molecular interactors of the channel during its ER-PM junction targeting have also been analysed during this PhD thesis, unravelling a complex and dynamic proteomic context. In addition, we have described for the first time the expression of Kv1.3, Kv1.5, Kv7.1 and Kv7.5 in endothelial cells of human veins and arteries. A remodelling of this composition is observed in different vascular cancers, related with the malignancy of the tumor in some of the cases.
Els canals de potassi dependents (Kv) regulen processos fisiològics molt importants, com la proliferació, la migració o el volum cel·lular. La seva rellevància es posa de manifest amb les diferents patologies associades a alteracions en la expressió dels canals, incloent malalties cardiovasculars, cerebrals, autoimmunes o càncer. Es tracta de proteïnes transmembrana formades per l’associació de 4 subunitats α que s’uneixen per formar el por. La gran varietat de diversitat funcional és deguda a la capacitat de heterotetramerització dels canals, variants d’splicing, modificacions post-traduccionals o la associació a subunitats reguladores KCNE, entre d’altres. En cardiomiòcits, Kv7.1 s’associa a KCNE1 per generar les corrents IKs, encarregades de la repolarització del potencial cardíac. La seva associació i tràfic són tema de debat des de fa anys, amb dues escoles defensant idees oposades. La primera, que les dues proteïnes s’associen en les fases inicials de la biogènesi; la segona, que trafiquen independent cap a la membrana, on difondran per trobar-se. Els Kv també s’han detectat a musculatura vascular llisa, on mantenen el potencial de repòs i controlen així el to vascular. Kv7.1, Kv7.4 i Kv7.5 es troben en diferents venes i arteries, on una expressió aberrant provoca alteracions fisiològiques. Tot i així, el seu paper concret encara es desconeix. En la present tesi doctoral hem comprovat que Kv7.1 i KCNE1 utilitzen vies diferents per arribar a la membrana plasmàtica. KCNE1 viatja per la via convencional, mentre que Kv7.1 utilitza una ruta no convencional que escapa del Golgi. Quan co-expressats, Kv7.1 redirigeix KCNE1 cap aquesta via alternativa. Hem demostrat que aquesta via són les ER-PM junctions, que també són el compartiment on la seva associació té lloc. Els interactors moleculars del canal durant el seu tràfic cap a ER-PM junctions també s’ha estudiat durant aquest treball. A més a més, hem descrit per primer cop l’expressió de Kv1.3, Kv1.5, Kv7.1 i Kv7.5 en l’endoteli de venes i artèries humanes. Hem vist un remodelatge en aquesta expressió en diferents càncers vasculars, en alguns casos relacionat amb la malignitat del tumor.
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Maa, Ming-Hokng 1977. "Alterations in cardiovascular regulation and function assessed using cardiovascular system identification". Thesis, Massachusetts Institute of Technology, 2000. http://hdl.handle.net/1721.1/86525.

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Thesis (S.B. and M.Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2000.
Includes bibliographical references (p. 65-67).
by Ming-Hokng Maa.
S.B.and M.Eng.
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Pitcher, Alex. "Cardiovascular manifestations of Marfan syndrome : insights from advanced cardiovascular magnetic resonance". Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:e47f70d4-a777-4c1d-8bb4-3758231ef38a.

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Marfan syndrome (MFS) is the commonest inherited disorder of connective tissue and is associated with a high risk of potentially life-threatening complications, including aortic aneurysm, dissection and rupture, and, perhaps, ventricular disease. This work describes the prospective application of advanced cardiovascular magnetic resonance techniques to the aorta and heart of consecutive, unselected subjects with MFS, and to appropriately matched control populations. Comprehensive 3D visualisation of blood flow in the entire thoracic aorta of subjects with MFS was achieved using a time-resolved phase-contrast magnetic resonance technique with 3-directional velocity encoding (4D flow), demonstrating a high prevalence of major flow disturbance (87 ± 12%), compared to controls (28 ±18%), localising to those regions of the aorta known to be most prone to aortic dissection (sinuses of Valsalva and proximal descending aorta). Wall shear stress, recently identified as a potentially important determinant of aneurysm progression and rupture, was interrogated in these datasets at the sinuses of Valsalva (SOV), ascending aorta (AA), arch, and proximal (PDA) and distal descending aorta (DDA), using the 4D flow datasets, and was shown to be significantly reduced at each location (SOV -15%; AA -12%; Arch -17%; PDA -18%; and DDA -14%, p<0.05 for each), in subjects with MFS compared to healthy subjects. 4D flow datasets were used to generate relative pressure maps in healthy subjects and in subjects with several aortic diseases. A novel method for the separate evaluation of the components of relative pressure was applied, revealing marked differences in the relative contribution of the components of pressure (unsteady > convective >> viscous), and characteristic differences between subjects in overall relative pressure, and its components. Left ventricular volumes and function were evaluated in subjects with MFS, and did not differ significantly from healthy subjects in the absence of significant valvular regurgitation and / or shunt. Left ventricular end-diastolic volume varied markedly with degree of regurgitation (r=0.75, p=0.0001). The mechanistic implications of these findings, and the potential role of these techniques in the evaluation of cardiovascular disease, are discussed.
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Kylintireas, Ilias. "The use of cardiovascular magnetic resonance for the evaluation of cardiovascular risk". Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.533860.

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Patil, Ninad Mohan. "Artificial neural networks for cardiovascular risk, cardiovascular fitness and ankle-brachial index". Scholarly Commons, 2005. https://scholarlycommons.pacific.edu/uop_etds/616.

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Artificial Neural Networks are biologically inspired computational methodologies that can perfom multifactorial analyses. In recent years, they have been evaluated for medical decision support, with varying degrees of success. The preliminary part of my thesis deals with evaluating whether an Artificial Neural Network can be trained to approximate a cardiovascular risk stratification algorithm by Rifai et al. My subsequent work involves training the network on a population-based cross-sectional dataset with the objective of categorizing Ankle-Brachial Index and Maximal Oxygen Consumption. These are indicators of the severity of lower extremity atherosclerosis and the level of cardiovascular fitness respectively. NeuralSIM®, a commercially available Artificial Neural Network, was trained using C-reactive protein and Total Cholesterol/HDL Cholesterol ratio as input parameters, and the relative risk stratum for future myocardial infarctions or stroke as output. For the Ankle-Brachial Index and the cardiovascular fitness networks, data was obtained from the National Health and Nutrition Examination Survey. The network for cardiovascular fitness was compared with an algorithm published by Jackson et al. The network was able to approximate the cardiovascular risk stratification algorithm by Rifai et al closely with correlation coefficients of0.95 in men and 0.93 in women respectively. The network to screen for low cardiovascular fitness had a sensitivity of 83% and a specificity of 78%, with an overall accuracy of 81%. The Ankle-Brachial Index network demonstrated a high level of specificity (86.3%) for estimating abnonnal values but a very low sensitivity (30%). Artificial neural networks showed encouraging results for potential use as decision-support tools. One significant limitation is that the importance of individual parameters or the exact function cannot be ascertained easily. There is a need to address this issue in future software development.
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Fedrizzi, Daniela. "Estudo dos fatores de risco cardiovascular na acromegalia". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2008. http://hdl.handle.net/10183/15931.

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Mejía, Lancheros Cília. "Impact of psychological and social factors on cardiovascular risk in an adult population at high cardiovascular risk". Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/290844.

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Antecedentes: Las enfermedades cardiovasculares (ECV) siguen siendo la principal causa de morbi-mortalidad y discapacidad en el mundo. Aunque España tiene una de las tasas de morbimortalidad cardiovascular más bajas, las ECV continúan siendo la principal causa de muerte. Así mismo, la prevalencia de factores de riesgo cardiovascular clásicos, como la hipertensión, la diabetes, la dislipemia y la obesidad en la población general es alta. Las causas que conducen a padecer una ECV son multifactoriales, y varios factores de riesgo y estilos de vida poco saludables están frecuentemente involucrados. En las últimas tres décadas, la evidencia científica ha mostrado que condiciones socioeconómicas y psicológicas desfavorables a nivel individual y ecológico están directa e indirectamente relacionadas con la prevalencia de estilos de vida poco saludables, un perfil alto de riesgo cardiovascular, la incidencia y un peor pronóstico de las ECV. A pesar de ello, los mecanismos por los cuales estas condiciones pueden afectar la salud cardiovascular no están completamente establecidos. En España, el papel de esas circunstancias en el riesgo cardiovascular ha sido poco estudiado. Objetivo General: La presente tesis tiene como objetivo estudiar el papel de la depresión, la posición socioeconómica y el apoyo social sobre tres aspectos del riesgo cardiovascular: (1) el tratamiento recibido en la prevención primaria cardiovascular; (2) el grado de control y los valores de la presión arterial; y (3) el aumento del riesgo de sufrir infarto agudo de miocardio (IAM), accidente cerebrovascular (AC) y muerte cardiovascular en una población adulta con de alto riesgo cardiovascular, en España (participantes en el estudio PREDIMED). Métodos: tres estudios fueron llevados a cabo en 7447 adultos con alto riesgo cardiovascular, sin ECV al inicio de los estudios. Un estudio transversal se llevó a cabo para evaluar (1) la relación entre el nivel socioeconómico y las desigualdades en recibir tratamiento para la prevención cardiovascular primaria; y (2) para evaluar el efecto de la depresión tratada y no tratada en los valores de la presión arterial. Un estudio prospectivo longitudinal (seguimiento medio de 4,8 años) se realizó para determinar si la depresión, el nivel educativo bajo, y un bajo apoyo social contribuían a aumentar el riesgo de sufrir IMA, AC y muerte por ECV. Otras características como el sexo, edad, IMC, comorbilidad cardiovascular, estilos de vida al inicio del estudio fueron también consideradas en todos los estudiados realizados. Resultados: En cuanto al impacto de los factores psicológicos y socioeconómicos sobre los tres aspectos de riesgo cardiovascular estudiado, se encontró: (1) los participantes con medio y bajo nivel de educación fueron tratadas de forma similar para la hipertensión (OR (IC95%): nivel educativo medio (NEM): 0.75 (0.56 a 1.00), nivel educativo bajo (NEB): 0.85 (0.65-1.10); diabetes (NEM: 0.86 (0.61 a 1.22), NEB: (0.90 (0.67 a 1.22), y dislipidemia (NEM: 0.93 (0.75 a 1.15), NEB: 0.99 (0.82 a 1,19) comparados con aquellos con nivel educativo alto; (2) participante hipertensos con depresión no tratada (OR (IC95%): 1.28 (1.06 a 1.55), y tratada (1.30 (1.03-1.65) mostraron mejor control de la presión arterial que aquellos sin depresión; (3) participantes con nivel educativo bajo presentaron mayor riesgo de accidente cerebrovascular (HR (IC 95%): 1.83 (1.09 a 3.09) comparados con aquellos con un nivel educativo superior Conclusiones: en la población estudiada, (1) no se observaron diferencias socioeconómicas en el tratamiento recibido en prevención cardiovascular primaria; (2) en los pacientes hipertensos con alto riesgo cardiovascular, el control de la presión arterial fue mejor en las personas diagnosticadas con depresión, en comparación con aquellos sin depresión.; y (3) los participantes con bajo nivel educativo tenían un mayor riesgo de accidente cerebrovascular. La depresión y el bajo apoyo social no se asociaron con la incidencia de ECV.
Background: Cardiovascular diseases (CVDs) remain the leading cause of morbimortality and disability in the world. Although Spain has one of the lowest cardiovascular morbimortality rates worldwide, CVDs continue to be the main cause of death. In addition the prevalence of classic cardiovascular risk factors such as hypertension, diabetes, dyslipidaemia and obesity in the general population is high. Causes leading to cardiovascular diseases are multifactorial and several modifiable and non-modifiable risk factors are involved. In the last three decades, the scientific evidence has shown that socioeconomic and psychological disadvantaged conditions at individual and ecological levels are directly and indirectly related with prevalence of unhealthy lifestyles, poor cardiovascular profile, and incidence and worsening progression of CVDs. However, the mechanisms or pathways through which these conditions lead to adverse cardiovascular outcomes are not completely clear. In Spain, the role of those circumstances in the cardiovascular risk has been scarcely studied. General Objective: The present thesis is aimed at studying the role of socioeconomic position, depression and social support on three topics of the cardiovascular risk.: (1) the treatment received in primary cardiovascular prevention; (2) the degree of control and the values of blood pressure; and (3) the increased risk of suffering primary major cardiovascular events (acute myocardial infarction, stroke and cardiovascular death) in an adult population with high cardiovascular risk (PREDIMED study participants), living in Spain. Methods: This thesis is composed of three research studies carried out on 7447 adults at high cardiovascular risk, free of CVDs at baseline. A cross-sectional study was carried out to assess (1) the relationship between the socioeconomic status and inequalities in receiving treatment for primary cardiovascular prevention; and (2) to assess the effect of treated and untreated depression on blood pressure values. A prospective cohort study (average follow up of 4.8 years) was performed to determine whether depression, lower educational level and weak social support contributed to increase the risk of suffering myocardial infarction, stroke, and death from CVDs. Other characteristics such as sex, age, BMI, cardiovascular comorbidity, lifestyles at study baseline, were also taken into account in the studies performed. Results: Regarding the impact of the psychological and socioeconomic factors on the three aspects of cardiovascular risk studied, it was found: (1) participants with low and middle education level were similarly treated for hypertension (OR (95% CI): middle education level (MEL): 0.75 (0.56-1.00), low educational level (LEL): 0.85 (0.65-1.10); diabetes (MEL: 0.86 (0.61-1.22), LEL: (0.90 (0.67-1.22), and dyslipidaemia (MEL: 0.93 (0.75-1.15), LEL: 0.99 (0.82-1.19) if compared with those at high education level; (2) hypertensive participants with not treatment (OR (95% CI): 1.28 (1.06-1.55), and treatment (OR (95% CI): 1.30 (1.03-1.65) for depression shown better blood pressure control than those without depression; (3) Participant with low education presented higher risk of suffering stroke (HR (95% CI): 1.83 (1.09–3.09) ) compared with those with high education. Conclusions: in the studied population, (1) socioeconomic differences did not affect the treatment prescribed for primary cardiovascular prevention; (2) among hypertensive patients at high cardiovascular risk, the control of blood pressure was better in those diagnosed with depression compared to those without depression; and (3) participants with low educational level had a higher risk of stroke. Depression and low social support were not associated with CVD incidence.
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Alventosa, i. Zaidin Marina. "Bloqueig de branca dreta i morbimortalitat cardiovascular". Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/668092.

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INTRODUCCIÓ: El bloqueig de branca dreta (BBD) és una de les alteracions electrocardiogràfiques més freqüents. La significació clínica que pot tenir el BBD en pacients sans sense evidència de malaltia cardiovascular coneguda és controvertida des de fa anys. La majoria d’estudis observen un augment d’esdeveniments cardiovasculars però sense resultats estadísticament significatius o només significatius per un esdeveniment concret. OBJECTIUS: PRINCIPAL: Estimar si la presència del BBD en població general sense malaltia cardiovascular augmenta la morbimortalitat cardiovascular. ESPECÍFICS: - Determinar el risc relatiu de patir esdeveniments cardiovasculars en pacients amb BBD respecte a pacients amb ECG normal. - Determinar el risc relatiu de patir mortalitat en pacients amb BBD respecte als pacients amb ECG normal. SECUNDARIS: - Estimar la prevalença de BBD i les característiques de la població que el presenta. - Estimar la incidència de BBD. - Estudiar la concordança diagnòstica del BBD entre metgesses d’Atenció Primària i un cardiòleg. MATERIAL I MÈTODES: Estudi de cohorts retrospectiu realitzat en 29 centres d’Atenció Primària de l’àrea metropolitana de Barcelona (Barcelona Ciutat, Barcelonès Nord i Maresme) POBLACIÓ DIANA: Pacients de més de 49 anys, sense malaltia cardiovascular a l’inici de l’estudi i amb un ECG llegible i sense alteracions (excepte el bloqueig de branca dreta) RESULTATS: S’han inclòs 2981 pacients, el 58% dones (n=1729) amb una edat mitjana de 65,9 anys (DE 8.8). El 92,2% (n=2752) té un ECG normal (ECG-N), 4,6 %(n=134) un BBD incomplet i un 3,2% (n=95) un BBD complet. Els subjectes han estat seguits una mitjana de 5 anys. Els factors associats a la presència del BBD complet són el sexe masculí (OR=3,8, IC95% 2,4-6,1) i l’edat (OR=1,05 per any, IC95% 1,03-1,08). El BBD complet s’associa a un augment de mortalitat per qualsevol causa (HR 2,60 IC 95% 1,65-4,09) i al bloqueig bifascicular (HR 21,40, IC95% 7,18-63,80). A l’ajustar per edat, sexe i comorbiditats prevalent només el bloqueig bifascicular s’ha mantingut estadísticament significatiu (p<0.001). Els pacients amb BBD complet han presentat més esdeveniments cardiovasculars respecte els pacients amb un ECG normal com la fibril·lació auricular, l’arteriopatia perifèrica, accidents vasculocerebrals i la insuficiència cardíaca, però els resultats no han estat estadísticament significatius. Els pacients amb BBD incomplet que han progressat a bloqueig complet han presentat un augment d’insuficiència cardíaca i d’insuficiència renal respecte els pacients que sempre tenen un ECG normal, un bloqueig incomplet o bé un bloqueig complet. La incidència del BBD incomplet ha estat de 3,5 casos per 1000 persones-any (n=15) (IC95% 2,0-5,8) i del BBD complet de 4.3 casos per per 1000 persones-any (n=19) (IC95% 2,6-6,7) A nivell de la concordança, s’ha estudiat 160 pacients diagnosticats pel seu metge d’Atenció Primària de BBD. El 54% són homes amb una edat mitjana de 64,8 anys. La concordança del diagnòstic del BBD incomplet entre els 5 investigadors (4 metgesses d’Atenció Primària i 1 cardiòleg) ha obtingut un índex Kaapa de 0,71 i de 0,85 entre les 4 investigadores d’Atenció Primària. L’índex Kappa pel diagnòstic de BBD complet entre els 5 investigadors ha estat de 0,93 i entre les investigadores d’Atenció Primària de 0,96. Els paràmetres amb més discordança diagnòstica entre els investigadors són la duració i morfologia del complex QRS, possiblement perquè la lectura dels ECG s’ha realitzat de forma manual. CONCLUSIONS: La presència del BBD complet s’associa a més edat i al sexe masculí. El bloqueig complet augmenta la mortalitat per qualsevol causa i l’aparició de nous esdeveniments cardiovasculars però sense obtenir resultats estadísticament significatius. Els pacients amb bloqueig incomplet que han progressat a bloqueig complet han presentat més esdeveniments cardiovasculars.
BACKGROUND: Right bundle branch block (RBBB) is one of the most common electrocardiographic abnormalities. The objective of this research is to establish the prevalence and incidence of RBBB in the general population without a cardiovascular history and to determine whether the presence of RBBB in a general healthy population increases cardiovascular morbidity and mortality compared with patients with a normal ECG. METHODS: A retrospective cohort study. RESULTS: We included 2981 patients,58% were women. The mean (SD) age was 65.9(8.8). Of the sample,92.2%(n=2752) had a normal ECG,4.6%(n=134) incomplete right bundle branch block (iRBBB) and 3.2%(n=95) complete right bundle branch block (cRBBB). The subjects were followed for a mean of 5 years. The factors associated with the appearance of cRBBB were male sex (odds ratio [OR],3.8;95%CI,2.4-6.1) and age (OR,1.05 per year;95%CI,1.03-1.08). cRBBB was associated with an increase in all- cause mortality (hazard ratio [HR],2.60; 95% CI,1.65-4.09) and bifascicular block (HR,21.40;95%CI7.18-63.80). When the results were adjusted for age, sex and prevalent comorbidities, only bifascicular block maintained a statistically significant association with cRBBB (P < 0.001). Patients with iRBBB had more cardiovascular events such as atrial fibrillation, peripheral arterial disease, cerebrovascular accident and heart failure but the results were not statistically significant. Patients with iRBBB who progressed to cRBBB showed a higher incidence of heart failure and chronic kidney disease than patients who always had a normal ECG, iRBBB or cRBBB. CONCLUSION: cRBBB is more common in men and elderly patients. cRBBB tends to increase all-cause mortality and the appearance of cardiovascular events, but the results were not statistically significant. Patients with iRBBB who progressed to cRBBB had more cardiovascular events.
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16

Escurriol, Martínez Verònica. "Fitoesterols i salut cardiovascular". Doctoral thesis, Universitat de Barcelona, 2009. http://hdl.handle.net/10803/2258.

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La dieta és un important determinant de la salut i la seva rellevància és evident degut al paper preventiu o causal que pot representar en el desenvolupament de determinades malalties. Els fitoesterols són components essencials d'una dieta rica en vegetals com la dieta Mediterrània. La ingesta d'aquests compostos augmenta les seves concentracions en sèrum, reflex del consum d'una dieta habitual saludable. Però les xifres incrementades de fitoesterols en sang també s'han relacionat amb un augment del risc de patir malaltia cardiovascular en alguns estudis, tot i que la bibliografia és contradictòria.
Els treballs de recerca de la present tesi estan orientats a ampliar el coneixement de la implicació dels fitoesterols de la dieta i el sèrum sobre el perfil lipídic, els factors de risc cardiovascular i la malaltia cardíaca coronària, així com a investigar els factors socials que influencien el consum d'una dieta rica en fitoesterols.

Els 4 treballs presentats són:

1. "Serum sterol responses to increasing plant sterol intake from natural foods in the Mediterranean diet" on es va avaluar l'efecte hipocolesterolemiant d'un augment de la ingesta de fitoesterols amb la dieta en un subgrup d'individus de l'estudi de prevenció cardiovascular primària PREvención con DIeta MEDiterránea (PREDIMED), al cap d'un any d'intervenció dietètica.
2. "Phytosterol plasma concentrations and coronary heart disease in the prospective Spanish EPIC cohort " en el qual es va avaluar, en un estudi de caos i controls en la cohort espanyola de l'estudi EPIC, l'associació entre les concentracions de fitoesterols del plasma i la incidència de malaltia cardíaca coronària després de 10 anys de seguiment.
3. "Plasma phytosterols are inversely associated with the metabolic syndrome and its components" on es va investigar les associacions entre els esterols nocolesterol plasmàtics i els components de la síndrome metabòlica, inclòs la pròpia síndrome, en una població de pacients dislipèmics i en subjectes sans de la població espanyola de l'estudi EPIC.
4. Article 4: "Plant sterol intake and education level in the Spanish EPIC cohort" en el qual es va investigar l'associació entre el nivell assolit d'educació,
com a mesura de la posició socioeconòmica, el gènere i la ingesta de nutrients, mitjançant un anàlisi transversal de la cohort espanyola de l'estudi EPIC.

La conclusió global d'aquestes treballs va ser que els fitoesterols del sèrum són marcadors d'una dieta saludable com la que es consumia preferentment a Espanya als anys 90 en les classes socials més populars. Aquests components es relacionen amb la reducció del colesterol observada després del consum d'aliments naturals rics en fitoesterols i s'associen inversament a les característiques del síndrome metabòlic. Els resultats dels estudis presentats en aquesta tesi suggereixen una reinterpretació del significat de les concentracions de fitoesterols circulants. En persones que segueixen una dieta mediterrània sense suplements de fitoesterols, els fitoesterols circulants son marcadors de l'abundància de productes vegetals en la dieta i s'associen a un perfil cardiometabòlic saludable i a un menor risc de desenvolupar malaltia cardíaca coronària, en lloc de ser biomarcadors d'un risc cardiovascular augmentat.
PhD project: "Phytosterols and cardiovascular disease"

Diet is an important health determinant and phytosterols are essential components of a plant-food based diet as Mediterranean diet. The consumption of these components increase its concentrations in plasma reflecting an habitual healthy diet. On the other hand, increased plasma phytosterol levels have been related with an increase of cardiovascular risk, although bibliography is contradictory.
Works presented in this project are focused on the study of diet and plasma phytosterols and its effects on lipid profile, cardiovascular risk factors and cardiovascular disease, and also social factors that influence the consumption of a diet rich in phytosterols.

The 4 works presented in this project are:
1. "Serum sterol responses to increasing plant sterol intake from natural foods in the Mediterranean diet"
2. "Phytosterol plasma concentrations and coronary heart disease in the prospective Spanish EPIC cohort "
3. "Plasma phytosterols are inversely associated with the metabolic syndrome and its components"
4. Article 4: "Plant sterol intake and education level in the Spanish EPIC cohort"

The global conclusion of this work is that serum phytosterols are markers of an habitual healthy diet such as the diet that was generally consumed in Spain during 90's between people with lower socioeconomic level. These components are related with the reduction of cholesterol levels after consuming natural food rich in phytosterols and are associated inversely with metabolic syndrome and cardiovascular disease.
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17

Levick, Scott P. "Inflammation and cardiovascular remodelling /". [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19090.pdf.

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18

Henderson, Louise M. Rosamond Wayne D. "Alcohol and cardiovascular disease". Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2006. http://dc.lib.unc.edu/u?/etd,492.

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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2006.
Title from electronic title page (viewed Oct. 10, 2007). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology, School of Public Health." Discipline: Epidemiology; Department/School: Public Health.
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19

Yuyun, Matthew F. "Albuminuria and cardiovascular disease". Thesis, University of Cambridge, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440608.

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Dimech, Julian. "Cardiovascular actions of somatostatin". Thesis, University of Cambridge, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390259.

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Griffin, Maura Bernadette. "Ultrasound and cardiovascular risk". Thesis, Imperial College London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.404414.

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Parker, Joanne Elizabeth. "Cardiovascular effects of calcitonin". Thesis, Nottingham Trent University, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.236285.

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Woolard, Jeanette. "Cardiovascular effects of sibutramine". Thesis, University of Nottingham, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.395457.

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Chen, Chun-Cheng Richard 1977. "Automated cardiovascular system identification". Thesis, Massachusetts Institute of Technology, 2000. http://hdl.handle.net/1721.1/81537.

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Thesis (S.B. and M.Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2000.
Includes bibliographical references (p. 64-65).
by Chun-Cheng Chen.
S.B.and M.Eng.
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25

Grytsiuk, M. І. "Life and cardiovascular diseases". Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18306.

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Agyemang, Edmund Adjei, Priscilla Okoh y K. O. Bobkovych. "Cardiovascular Diseases in Ghana". Thesis, «Інновації в медицині»: Тези доповідей 85-ої науково-практичної конференції студентів і молодих вчених із міжнародною участю (м. Івано-Франківськ, 24-25 березня 2016 р.). – м. Івано-Франківськ, 2016, 2016. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/11247.

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Furthermore about 10% of the adult populations are tobacco smokers and 5-7% - obesity. All these data positively show why the occurrence of cerebrovascular diseases in Ghana is a rampant and should be of concern to all stakeholders.
Кафедра пропедевтики внутрішніх хвороб
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27

Abdi, Faduma Najmo Abdulrahman y K. O. Bobkovych. "Cardiovascular diseases in Somalia". Thesis, «Інновації в медицині»: Тези доповідей 85-ої науково-практичної конференції студентів і молодих вчених із міжнародною участю (м. Івано-Франківськ, 24-25 березня 2016 р.). – м. Івано-Франківськ, 2016, 2016. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/11248.

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Although the incidence has declined there appeared some fears that the aging population is increasing number of cases. As with other cardiovascular disease heart failure occurs more commonly in eastern and northern Somalia than in the south and southwest Somalia. The number of sufferers is probably declining. In 2010 the special rights to compensation of heart failure medication about 43 000 Somalis were given.
Кафедра пропедевтики внутрішніх хвороб
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28

Devine, Raymond David. "Tumor Induced Cardiovascular Dysfunction". The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1448969937.

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29

Rodgers, Laurel Speilman. "Mechanisms of Cardiovascular Development". Diss., The University of Arizona, 2009. http://hdl.handle.net/10150/194478.

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Epithelial to mesenchymal transition (EMT) is an essential process during embryogenesis for the development of organ systems, including the heart and its vasculature. The development of both coronary vessels and heart valves depends on EMT. In this dissertation, we first present data demonstrating that increasedoligosaccharide hyaluronan (o-HA) levels after EMT induction within atrioventricular (AV) valves leads to a decrease in EMT due to the induction of VEGF expression. Regulated EMT inhibition prevents the formation of hyperplastic valves. Next, we show that the proepicardium, which provides the precursor cells required for epicardial and coronary vessel development, migrates to the developing heart via direct contact of multicellular proepicardial villi to the developing myocardium. This shifts the paradigm from a migration consisting of floating cysts to one of direct contact and differential adhesion forces to form the initial epicardium. A subset of epicardial cells undergoes EMT, migrates into the developing heart, and differentiates into cardiac fibroblast, vascular endothelial, and smooth muscle cells. In order to more effectively study epicardial EMT in vitro, we developed several new methods for the in vitro study of coronary vessel development. We developed an improved protocol for isolating embryonic myocyte cells, for use in co-cultures with epicardial cells. This co-culture system allows investigation into the effects of myocyte derived soluble factors uponepicardial EMT and mesenchymal cell differentiation. We also present a protocol for isolating epicardial clonal colonies from an epicardial cell line derived from the ImmortoMouse. These clones provided direct evidence that the epicardium is a heterogeneous population of cells. These unique clones allow for to study into specific epicardial cell lineages and phenotypes. Finally, we provide data defining the expression of Wnts within the developing heart and the role may play during epicardial EMT. We conclude that canonical Wnts are both necessary and sufficient to inhibit epicardial EMT. These results provide the first direct evidence for a role of Wnt proteins during coronary vessel development. Collectively our results provide significant advancements in our understanding of EMT regulation during cardiac development.
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Ferrán, Pérez Beatriz. "Identificación y caracterización de genes regulados por NOR-1 (Neuron-derived Orphan Receptor-1): implicación en el remodelado vascular y la diferenciación celular". Doctoral thesis, Universitat de Barcelona, 2016. http://hdl.handle.net/10803/396643.

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Las enfermedades cardiovasculares constituyen la primera causa de muerte a nivel mundial. El común denominador de las enfermedades cardiovasculares de componente isquémico es la aterosclerosis. La complicación trombótica de las placas ateroscleróticas puede ocasionar eventos clínicos como el infarto agudo de micardio o los accidentes cerebrovasculares. En la evolución de esta patología juegan un papel clave las células musculares lisas de la pared vascular, que experimentan cambios importantes en su fenotipo y en su patrón de expresión génica. En la regulación de dichos cambios participa la familia de receptores nucleares NR4A. Los receptores NR4A (NOR-1, Nurr1 y Nur77) están codificados por genes de respuesta temprana, cuya expresión se induce por estímulos mitogénicos, pro-inflamatorios y pro-aterogénicos. Nuestro grupo identificó a NOR-1 (NR4A3) como un factor de transcripción implicado en la cardiopatía isquémica y en la migración, la proliferación y la supervivencia de las células vasculares. Actualmente se desconoce la identidad de la mayoría de los genes diana de NOR-1. Los objetivos principales de este proyecto fueron la identificación de genes regulados por NOR-1 a nivel vascular y la caracterización de los mecanismos moleculares por los cuales este receptor regula su expresión. En estudios de expresión génica diferencial en células musculares lisas que sobre-expresaban los receptores NR4A, identificamos un conjunto de genes cuya expresión se modulaba significativamente. Mediante diferentes estrategias confirmamos a MYOM1, A2M y SMPX como potenciales genes diana de NOR-1. MYOM1 codifica para la miomesina 1, una proteína implicada en la contracción de las fibras musculares. La alfa-2 macroglobulina (A2M) es una anti-proteinasa de amplio espectro presente en el plasma de los vertebrados. La regulación de A2M tiene lugar mediante la unión de los receptores NR4A a un elemento NBRE presente en su promotor. Los receptores NR4A modulan la actividad de las metaloproteinasas MMP-2 y MMP-9 a través de diferentes mecanismos, entre ellos mediante la inducción de la expresión de A2M. Además evidenciamos que la A2M se expresa de forma relevante en las células musculares de la capa media de las arterias humanas. Por su parte, el gen SMPX (Small Muscle Protein X-linked) codifica para una proteína asociada al citoesqueleto que se expresa sobre todo en células de músculo esquelético y cardíaco. La regulación de SMPX por NOR-1 se produce a través de un elemento NBRE no canónico. La diferenciación de mioblastos humanos de músculo esquelético (HSMM) a miotubos incrementa la expresión y los niveles de SMPX de forma dependiente de NOR-1. El silenciamiento de NOR-1, pero no el de SMPX, inhibe el proceso de diferenciación de las células HSMM.
Cardiovascular diseases are the leading cause of death worldwide. Atherosclerosis is a common factor among ischemic cardiovascular disorders. Thrombotic complication of atherosclerotic plaques can cause clinical events such as acute myocardial infarction and strokes. Smooth muscle cells of the vascular wall play a key role in this pathology, experiencing significant changes in their phenotype and gene expression pattern during the course of the disease. The NR4A nuclear receptors family is involved in the regulation of such changes. The NR4A receptors (NOR-1, Nur77 and Nurr1) are encoded by early response genes, whose expression is induced by mitogenic, pro-inflammatory and pro-atherogenic stimuli. Our group identified NOR-1 (NR4A3) as a transcription factor involved in ischemic cardiopathy and in the migration, proliferation and survival of vascular cells. However, most of the genes targeted by NOR-1 are thus far unknown. Therefore, the main objectives of this project were to identify genes regulated by NOR-1 at the vascular level, and to characterize the molecular mechanisms by which this receptor regulates gene expression. By studying the genes differentially expressed in smooth muscle cells overexpressing NR4A receptors, we identified a set of genes whose expression was significantly shifted. Among those genes, we confirmed MYOM1, A2M and SMPX as potential targets of NOR-1. MYOM1 encodes myomesin 1, a protein involved in the contraction of muscle fibers. Alpha-2-macroglobulin (A2M) is a broad spectrum anti-proteinase present in the plasma of vertebrates. A2M is regulated by NR4A receptor, through the binding to an NBRE element present in the A2M promoter. NR4A receptors modulate the activity of MMP-2 and MMP-9 metalloproteinases through different mechanisms, including the induction of A2M expression. Furthermore, we evidence that A2M is significantly expressed in muscle cells of human arteries. Regarding SMPX (Small Muscle Protein X-linked), it encodes a cytoskeleton-associated protein, specifically expressed in skeletal and cardiac muscle cells. SMPX regulation by NOR-1 occurs through a non-canonical NBRE element. The SMPX expression is increased in a NOR-1 dependent manner during the differentiation of human skeletal myoblasts (HSMM) to myotubes. Silencing of NOR-1, but not of SMPX, inhibits the differentiation of HSMM.
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31

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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32

Freitas, Roberta Maria Carvalho de. "Fatores psicossociais que influenciam na adesão a um programa de reabilitação cardiovascular". Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/59/59137/tde-21102013-155518/.

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As Doenças Cardiovasculares (DCV) são importantes causas de morte, morbidade e incapacidade e têm etiologia complexa e multifatorial. Estão relacionadas a fatores de riscos como estilo de vida e padrões de comportamentos. Entre as terapêuticas está a Reabilitação Cardiovascular (RCV), caracterizada por programas de treinamento físico supervisionado, visando diminuir a mortalidade por DCV e garantir melhores condições físicas, mental e social. O sucesso da RCV depende da adesão do paciente, o que se constitui num desafio para as equipes multidisciplinares de saúde. O presente estudo objetivou definir características sóciodemográficas e psicológicas de pacientes de um programa de RCV e avaliar fatores sociais, clínicos e psicológicos que poderiam influenciar na adesão à reabilitação. Participaram do estudo 72 pacientes, entre fevereiro de 2008 a agosto de 2009. Os participantes foram avaliados ao ingressarem na RCV e quando abandonavam ou completavam seis meses de tratamento. Considerou-se adesão participar do programa por um período de seis meses. Foram utilizadas entrevistas estruturadas, Inventário de Sintomas de Stress para Adultos de Lipp, Inventário Beck de Depressão e Questionário de Avaliação de Qualidade de vida (SF-36). Para a análise dos dados foi utilizado o método de Regressão Logística. Verificou-se que 50% dos participantes abandonaram a RCV. O cálculo do Odds Ratio mostrou que pacientes que estavam trabalhando/em atividade apresentaram 7,2 vezes maior risco de abandono à reabilitação do que participantes que estavam afastados/recebendo auxílio doença (OR 7,2; IC95%; 1,4-38,3). Com o ajustamento entre as variáveis sóciodemográficas, observou-se que participantes que tinham de oito a 10 anos de estudo mostraram menor chance de abandono em relação aos que tinham até sete anos de estudo (ORaj 0,04; IC95%; 0,01-0,56) e pacientes que residiam entre 50km e 100km do local de tratamento apresentaram menor chance de abandono em relação aos que residiam no local de tratamento ou até 50km do mesmo (ORaj 0,2; IC95%; 0,0-0,09). Não foram verificadas associações entre as variáveis clínicas e abandono à RCV. Ter expectativas negativas ou incertezas quanto aos benefícios do exercício físico mostrou associação com abandono, ao ingressar na RCV (OR 3,5; IC95%; 1,3-9,7). O conhecimento insuficiente sobre o motivo do tratamento (OR 4,4; IC95%; 1,4-13,5) e a atribuição de causalidade da doença a fatores não modificáveis (OR 3,8; IC95%; 1,2-11,8) foram associados com abandono, ao longo do tempo. Pacientes que não percebiam o suporte social recebido em relação à prática do exercício físico apresentaram 3,3 vezes maior risco de abandono em relação aos que percebiam esse suporte, ao ingressar na RCV (OR 3,3; IC95%, 1,2-9,5) e os participantes que não aumentaram contatos sociais durante a RCV apresentaram maior risco de abandono em relação aos que aumentaram (OR 5,2; IC95%. 1,8-15,0). Pacientes que apresentavam sintomas cognitivos/afetivos de depressão mostraram 3,9 vezes maior risco de abandono em relação aos que não apresentavam esses sintomas (OR 3,9; IC95%; 1,4-10,9). Não foi identificada associação entre sintomas de estresse e abandono à RCV. Verificou-se que participantes que aderiram apresentaram melhores 8 escores nos domínios Aspectos Físicos e Saúde Mental quando comparados com os que abandonaram a reabilitação. Pacientes que apresentavam história de sedentarismo demonstraram 3,6 vezes maior risco de abandono que pacientes que já praticavam exercícios ao ingressar na RCV (OR 3,6; IC95%; 1,1-11,4). Os resultados obtidos neste estudo podem ser utilizados para aumentar a adesão em programas de RCV.
Cardiovascular Diseases (CVD) are major causes of death, morbidity and disability, whose etiology is multifactorial and complex. They are related to risk factors such as lifestyle and behavior patterns. Among the treatments is the Cardiovascular Rehabilitation (CR), characterized by programs of supervised physical training in order to reduce CVD mortality and ensure better physical, mental and social conditions. The success of the CR depends on the patient\'s adherence, which constitutes a challenge for multidisciplinary health teams. This study aimed to describe sociodemographic and psychological characteristics of patients in a CR program and evaluate social, clinical and psychological factors that might influence adherence to rehabilitation. The study included 72 patients between February 2008 and August 2009. Participants were evaluated at entry to the CR and when abandoned or completed six months of treatment. It was considered adherence patient´s participation in the program for a six months period. Structured interviews, Lipp\'s Inventário de Sintomas de Stress para Adultos, Beck Depression Inventory and Medical Outcomes Study 36-Item, Short Form Survey (SF-36) were used. For the data analysis it was used the logistic regression method. It was found that 50% of participants dropped out of CR. Odds Ratio calculation showed that patients who were working/active had 7.2 greater risk of dropping out of rehabilitation than participants who were in health license/receiving financial health support (OR 7.2, CI 95%, 1.4 - 38.3). Analyses were adjusted for sociodemographic variables. It was found that participants who had eight to 10 years of study were less likely to drop out than those who had up to seven years of education (OR 0.04, CI 95%, 0.01 - 0.56) and patients who lived between 50km and 100km from the place of treatment were less likely to drop out than those who lived in the place of treatment or up to 50km away from it (OR 0.2, CI 95%, 0.0 - 0.09). It was not found relation between clinical variables and dropping out the CR. Negative expectations and uncertainties about the benefits of physical exercise when starting CR were associated with dropping out (OR 3.5, CI 95%, 1.3 - 9.7). Insufficient knowledge about the reason for treatment (OR 4.4, CI 95%, 1.4 - 13.5) and causal attribution of disease to non-modifiable factors (OR 3.8, CI 95%, 1.2 - 11.8) were associated with abandonment, over time. Patients who did not perceive the social support received regarding physical exercise had 3.3 times greater risk of dropping out than those who perceived this support by joining the CR (OR 3.3, CI 95%, 1.2 - 9.5) and participants who did not increase social contacts during the CR had a higher risk of dropping out than those who increased their social contacts (OR 5.2, CI 95%, 1.8 - 15.0). Patients with cognitive/affective depression symptoms showed 3.9 times greater risk of dropping out compared to those without these symptoms (OR 3.9, CI 95%, 1.4 - 10.9). No association was found between stress symptoms and CR abandonment. It was found that participants who joined the program had better scores for Role Physical and Mental Health compared to those leaving rehabilitation. Patients who had 10 a history of physical inactivity when starting CR showed 3.6 times greater risk of dropout than patients who already practiced exercises (OR 3.6, CI 95%,1.1 - 11.4). The results of this study may be used to increase adherence to CR programs.
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33

García, Cañadilla Patricia. "Multiscale cardiovascular analysis and simulations for the understanding of intra-uterine cardiovascular remodelling". Doctoral thesis, Universitat Pompeu Fabra, 2015. http://hdl.handle.net/10803/310949.

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Cardiovascular diseases are nowadays one of the major causes of death in developed countries. Besides the already known risk factors such as lifestyle and genetics, there is a growing evidence that adverse remodelling during prenatal life presents a risk factor for some cardiovascular diseases at later life. Recent studies have demonstrated that fetuses with intra-uterine growth restriction show cardiovascular remodelling at organ, vascular and also cellular and subcellular level, and moreover these changes persist postnatally. However this is a complex mechanism that needs to be further investigated. Currently, Doppler ultrasonography is one of the techniques most used to assess the fetal cardiovascular status and to study the heart and vascular remodelling in clinical practice. However, some of underlying hemodynamic and vascular changes cannot be assessed clinically and more sophisticated techniques are needed. Computational modelling of biological systems arises as a powerful tool to overcome this challenge, to support clinicians and to improve the understanding of different pathologies. In this thesis we proposed the use of computational models of fetal circulation, of cardiac cells and also image-processing tools, to improve the understanding of intra-uterine cardiac remodelling that takes place at different scales of the fetal cardiovascular system, and also to estimate the patient-specific hemodynamic properties that cannot be directly assessed from clinical measurements. The results arising from this thesis demonstrate that computational models are able to improve the understanding and detection of the intra-uterine cardiovascular remodelling by means of patient-specific simulations.
Les malalties cardiovasculars són avui en dia una de les principals causes de mortalitat en països desenvolupats. Deixant de banda els factors de risc relacionats amb l'estil de vida i la genètica, existeix una creixent evidència de què la remodelació adversa durant la vida prenatal esdevé un factor de risc per a algunes malalties cardiovasculars en l'edat adulta. S'ha demostrat que els fetus amb restricció de creixement intrauterina mostren signes de remodelació cardiovascular tant a nivell d'òrgan, vascular com a nivell cel•lular i subcel•lular, i molts cops aquests canvis persisteixen postnatalment. No obstant, és tracta d'un mecanisme complex que necessita ser investigat en profunditat. Actualment, l'ecografia Doppler és una de les tècniques més empradres per avaluar l'estat cardiovascular fetal i per estudiar la remodelació tant cardiaca com vascular durant la pràctica clínica. No obstant, alguns dels canvis hemodinàmics i vasculars subjacents no es poden avaluar clínicament, requerint de tècniques més sofisticades. El modelatge computacional de sistemes biològics es presenta com un potent instrument per superar aquest repte, per donar suport als metges i millorar la comprensió de les diferents patologies. En aquesta tesi es presenta per una banda l'ús de models computacionals tant de la circulació fetal com també de la cèl•lula cardíaca i la utilització d'eines de processat d'imatge amb la finalitat de millorar la comprensió de la remodelació cardiovascular intrauterina que té lloc a diferents escales del sistema cardiovascular fetal, i estimar les propietats hemodinàmiques específiques de cada pacient, les quals no es poden extreure directament a partir de mesures clíniques. Els resultats derivats d'aquesta tesi demostren que els models computacionals són capaços de millorar la comprensió i la detecció de la remodelació cardiovascular intrauterina mitjançant simulacions específiques del pacient.
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34

Frazier, Elizabeth C. "Gender differences in cardiovascular risk indicators and cardiovascular disease among veterans with PTSD". Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2008p/frazier.pdf.

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35

Hooper, Justin Shane. "Cardiovascular Effects Evoked by Airway Nociceptive Reflexes in Healthy and Cardiovascular Diseased Rats". Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6258.

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Acute inhalation of airborne pollutants alters cardiovascular function and has been shown to have its greatest affects on individuals with pre-existing cardiovascular disease. Evidence suggests that pollutant-induced activation of airway sensory nerves via the gating of ion channels is critical to these systemic responses. Here, we have investigated the cardiovascular responses evoked by inhalation of AITC (TRPA1 agonist) and capsaicin (TRPV1 agonist) in healthy Sprague Dawley (SD) and Wistar Kyoto (WKY) rats, and cardiovascular diseased Spontaneously Hypertensive (SH) rats. Inhalation of the agonists by healthy SD and WKY rats caused significant bradycardia, atrio-ventricular (AV) block and prolonged PR-Intervals. Inhalation of TRP agonists caused differential cardiovascular responses in the cardiovascular diseased SH rats, such that the TRP agonists evoked brady-tachy with AV block and premature ventricular contractions (PVCs). Bradycardic responses to AITC were inhibited by the TRP channel blocker ruthenium red and the muscarinic antagonist atropine, but atropine did not prevent the tachycardic responses seen in the SH rats. Adrenergic inhibition with atenolol prevented the tachycardic responses, but did not prevent the bradycardic responses evoked by AITC in the SH rats. In healthy rats, AITC inhalation also caused a biphasic blood pressure response: a brief hypertensive phase followed by a hypotensive phase, while evoking hypertension in the SH rats. Atropine accentuated the hypertensive phase in all animals, while preventing the hypotension in the healthy animals. In all animals, AITC-evoked heart rate responses were not abolished by terazosin, the [U+F061]1 adrenoceptor inhibitor, which prevented the hypertensive responses. Anesthetics had profound effects on AITC-evoked bradycardia and AV block, which was abolished by urethane, ketamine and isoflurane. Nevertheless, AITC inhalation caused bradycardia and AV block in paralyzed and ventilated rats following pre-collicular decerebration. In conclusion, we provide evidence that activation of TRP channels expressed on nociceptive airway sensory nerves causes significant cardiovascular effects in healthy rats via reflex modulation of the autonomic nervous system (ANS), and that these effects are exacerbated in cardiovascular diseased rats.
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36

Collins, Dylan Raymond James. "Cardiovascular risk scoring for the prevention of cardiovascular disease in low-resource settings". Thesis, University of Oxford, 2017. http://ora.ox.ac.uk/objects/uuid:839de6e8-6cf6-4482-a352-201f4a595d56.

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The aim of this thesis was to examine the use of total cardiovascular risk scoring for the prevention of cardiovascular disease (CVD) in low-resource settings. While risk scoring is popular in high-income countries, the overarching hypothesis was that it was sub-optimal for the prevention of CVD in low-resource settings. To achieve its aim, this thesis first synthesised evidence through a systematic review of systematic reviews on the impact of total CVD risk scoring on important patient outcomes. Second, it developed an R package to calculate World Health Organisation/International Society of Hypertension (WHO/ISH) CVD risk scores for all epidemiological subregions of the world. Third, using mixed methods and intensive fieldwork, it evaluated the practical implementation of WHO/ISH CVD risk scores in Médecins Sans Frontières clinics for Syrian refugees in Jordan. Lastly, it explored the potential to simplify CVD risk scores by replacing cholesterol information with body mass index using a contemporary CVD risk cohort from New Zealand. Overall, the findings showed that CVD risk scoring is sub-optimal for low-resource settings due to a lack of evidence of effectiveness, its difficulty to implement and test, and its potential to be simplified. Focus should be shifted towards conducting high quality randomised trials in low-resource settings, using simplified risk scores that can be completed in a single consultation, and further implementation studies in primary health care. With this in mind, cardiovascular risk scoring as a pivotal intervention for the prevention of CVD in low-resource settings should be judiciously compared to other alternatives, and if implemented, closely monitored for its impact on health outcomes.
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37

Vatrapu, Rami reddy. "Contribution à l'étude de la régulation de l'activité cardiaque chez Drosophila melanogaster". Thesis, Aix-Marseille 2, 2010. http://www.theses.fr/2010AIX22030/document.

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L’objectif général de ma thèse concerne l’étude de la régulation de l’activité cardiaque chez Drosophila melanogaster. Différentes questions ont été abordées : i) la régulation par le pH de l’activité cardiaque à travers l’étude d’un Transporteur du Bicarbonate dépendant du Na+, NDAE1 ; ii) l’implication du canal TRP Painless dans la mécanosensibilité du cœur ; iii) l’élaboration de tests quantitatifs permettant de mesurer le vieillissement cardiaque chez la mouche adulte. Le Na+-Driven Anion Exchanger (NDAE1) constitue l’unique transporteur chez la Drosophile capable de transporter le Bicarbonate dépendant du Na+, alors que l’on trouve dans le génome des mammifères 7 de ces transporteurs appartenant à la famille SLC4. NDAE1 permet l’échange de protons et de Cl- avec le Na+ et HCO3- et agit de manière réversible. Etant donné l’importance potentielle et reconnue de ce type d’échangeur durant certaines pathologies cardiaques intervenant par exemple lors d’épisodes d’ischémie-reperfusion, j’ai analysé sa fonction dans l’activité cardiaque. De manière surprenante, l’inactivation du gène spécifiquement dans le tube cardiaque par interférence à l’ARN n’a aucun effet sur les paramètres mesurables de l’activité cardiaque dans des conditions basales d’élevage, ni sur la viabilité. En revanche, la fonction de NDAE1 peut être révélée dans des conditions de stress où l’on déséquilibre l’homéostasie des ions transportées dans l’échange dépendant de nDAE1. Ainsi, une acidose provoquée dans les individus privés de la fonction de NDAE1 génère de très fortes arythmies, qui sont moins présentes dans les animaux de type sauvage, et conduisent à des arrêts cardiaques définitifs. En outre, arythmies et arrêts cardiaques sont irréversibles quand le pH physiologique est restoré, contrairement aux contrôles qui retrouvent complètement leur activité cardiaque normale. De même l’activité de NDAE1 est requise pour mieux résister aux stress provoqués par l’absence de Na+, de Cl- et de HCO3- dans le milieu extracellulaire et d’adapter à un choc osmotique. En outre, j’ai mis en évidence une forte interaction génétique de ndae1 avec ncx, qui code pour l’échangeur Sodium-Calcium, et dont la fonction est de réguler l’homéostasie calcique et sodique. Cette étude constitue la première démonstration in vivo de la fonction cardiaque des Transporteurs du Bicarbonate dépendant du Na+. J’ai d’autre part contribué à l’étude de la réponse des cardiomyocytes aux stress mécaniques et participé à la démonstration que Painless, un canal TRPA de la Drosophile, était requis pour cette réponse. Finalement, dans le cadre du programme « Identification of genetic markers of cardiac aging in Drosophila », j’ai cherché à proposer des tests capables de mesurer le déclin des performances cardiaques avec l’âge. Parmi ceux-ci, le plus prometteur consiste en une quantification des arythmies mesurée par l’analyse in vivo détaillée des battements cardiaques
Mechanotransduction modulates cellular functions as diverse as migration, proliferation, differentiation and apoptosis. It is crucial for organ development and homeostasis and leads to pathologies when defective. However, despite considerable efforts made in the past, the molecular basis of mechanotransduction remains poorly understood.Here, we have investigated the genetic basis of mechanotransduction in Drosophila. We show that the fly heart senses and responds to mechanical forces by regulating cardiac activity. In particular, pauses in heart activity are observed under acute mechanical constraints in vivo. We further confirm by a variety of in situ tests that these cardiac arrests constitute the biological force-induced response.In order to identify molecular components of the mechanotransduction pathway, we carried out a genetic screen, based on the dependence of cardiac activity upon mechanical constraints and identified Painless, a TRPA channel. We observe a clear absence of in vivo cardiac arrest following inactivation of painless and further demonstrate that painless is autonomously required in the heart to mediate the response to mechanical stress. Furthermore, direct activation of Painless is sufficient to produce pauses in heartbeat, mimicking the pressure-induced response. Painless thus constitutes part of a mechanosensitive pathway that adjusts cardiac muscle activity to mechanical constraints.This constitutes the first in vivo demonstration that a TRPA channel can mediate cardiac mechanotransduction. Furthermore, by establishing a high-throughput system to identify the molecular players involved in mechanotransduction in the cardiovascular system our study paves the way for understanding the mechanisms underlying a mechanotransduction pathway
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38

Collado, Nieto Silvia. "Enfermedad cardiovascular en hemodiálisis: análisis de la prevalencia y relevancia de los factores de riesgo cardiovascular". Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/668019.

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Los pacientes en hemodiálisis presentan un riesgo CV muy elevado y la mortalidad por esta causa es entre 10 y 20 veces superior a la de la población general. La elevada prevalencia de los factores de riesgo CV clásicos no explicapor si sola este elevado riesgo, por lo que se ha postulado que factores nuevos y propios de la insuficiencia renal crónica contribuirían a incrementar este riesgo CV. OBJETIVOS PRINCIPALES: 1. Analizar la prevalencia de enfermedad CV en una población de pacientes prevalentes en hemodiálisis. 2. Analizar los factores de riesgo CV clásicos y nuevos asociados a enfermedad CV en esta población. 3. Analizar el valor pronóstico de la aterosclerosis carotídea sobre la morbimortalidad CV. 4. Analizar el valor pronóstico de marcadores del metabolismo óseo-mineral no habituales (osteoprotegerina –OPG- o fetuina-A) sobre la mortalidad total o la morbimortalidad CV. ANÁLISIS Y MÉTODOS: Estudio multicéntrico, transversal y prospectivo durante 6 años, en el que se incluyeron 265 pacientes adultos prevalentes con ERC terminal con una mediana en diálisis de 32.5 meses (68.3% hombres), edad media 60.7±16.2 años, prevalencia de ECV (53.2%) y de enfermedad vascular no cardiaca (25.3%). Destaca la ECV subclínica y una elevada prevalencia de los nuevos factores de riesgo CV. 85 pacientes (32.1%) fueron trasplantados y hubieron 90 éxitus (34%). De éstos, 44.4% fueron por eventos CV y se detectaron 96 eventos CV. En el análisis de supervivencia Kaplan-Meier, la presencia de ECV prevalente y los nuevos eventos CV se asociaron a mortalidad total (p=0.001 y p<0.001) y a mortalidad CV (p=0.049 y p< 0.001). En el análisis multivariado se evidenció una asociación independiente entre mortalidad y ECV previa (HR:0.48,p=0.022), la intensidad de la comorbilidad asociada (índice de Charlson >7 puntos (HR:4.57,p=0.005), y la malnutrición-inflamación evaluada con marcadores clásicos como la albúmina <40 g/l (HR:4.85,p<0.001), o la PCR (HR:1.14,p=0.029), y otros marcadores emergentes como la troponina-I (HR:4.9,p=0.024), niveles de OPG (HR:1.07,p=0.006) o IL-18 (HR:1.0,p=0.011). 1.- Papel predictor de la enfermedad carotídea aterosclerótica. Se confirma una prevalencia de aterosclerosis carotídea más elevada que en otras series (83.6%) y el predominio de placas, sobretodo calcificadas (72.7%). La presencia de éstas, y no el GIM carotídeo, se asoció a nuevos eventos CV fatales y no fatales así como mayor mortalidad. La presencia de placas calcificadas fue predictora tanto de nuevos eventos CV (p=0.03), como de mayor mortalidad total y CV, lo que sugiere el valor predictivo adicional de la calcificación de la placa en pacientes en hemodiálisis. La mayoría de nuestros pacientes presentaban CAD severa (grados 3-4) de nuestra estratificación. El GIM carotídeo se ha asociado con la presencia de ECV prevalente, con algunos factores tradicionales de riesgo CV (edad, sexo masculino, tabaquismo) y con la presión del pulso pero no con otros factores o marcadores de desnutrición-inflamación. 2.- Asociación de niveles séricos de osteoprotegerina con mortalidad, aterosclerosis y función cardíaca. Demostramos que niveles elevados de OPG, pero no de fetuina-A, se asocian con un aumento de la mortalidad, marcadores de aterosclerosis subclínica y la función cardíaca, pero no con biomarcadores de metabolismo óseo-mineral. El tercil más alto de OPG se asoció con la mortalidad global (p=0.005), así como una mayor, aunque no significativa incidencia de eventos CV (p=0.967) y mortalidad CV (p=0.08). En el análisis multivariado, la mortalidad total se asoció con tertiles más altos de OPG (HR:1.957,p=0.018), edad (HR:1.031,p=0.036), historia de tabaquismo (HR:2.122,p=0.005), Índice de Comorbilidad de Charlson (HR:1.254, p=0.004), troponina-I (HR:3.894, p=0.042), IL-18 (HR:1.061,p<0.001) y niveles de albumina (HR:0.886,p<0.001). En el análisis de bootstrapping de regresión de Cox, el mejor punto de corte de OPG para predecir mortalidad total fue de 17.69 pmol/l. CONCLUSIONES: La severidad de la enfermedad aterosclerótica carotídea es un predictor de eventos CV y la presencia de placas carotídeas calcificadas es predictor de eventos y de mortalidad CV, mientras que el grosor intima-media carotídeo no lo fue en nuestra serie. Los niveles elevados de OPG, pero no de fetuina-A, se asociaron con mayor mortalidad global en hemodiálisis y con marcadores de aterosclerosis subclínica y de disfunción cardíaca, pero no con biomarcadores del metabolismo óseo-mineral.
Hemodialysis patients have a very high CV risk and mortality, 10-20 times higher than general population. Classical CV risk factors not explain this high CV risk, so it has been postulated that new factors would contribute to increase it. AIMS: 1. Analyze the prevalence of CV disease in a population of prevalent patients on hemodialysis. 2. Analyze classical (Framingham) and new CV hemodialysis risk factors associated with CV disease. 3. Analyze the prognostic value of carotid atherosclerosis on CV morbidity and mortality. 4. Analyze the prognostic value of non-usual bone mineral metabolism markers (osteoprotegerin -OPG- or fetuin-A) on total mortality or CV morbidity and mortality. ANALYSIS AND METHODS: Multicentric, cross-sectional and prospective study over 6 years, including 265 prevalent patients with CKD and a median of 32.5 months in dialysis (68.3% men, 60.7±16.2 years), prevalence of CVD (53.2%) and non-cardiac vascular disease (25.3%). RESULTS: 85 patients (32.1%) were transplanted and there were 90 deaths (34%), 44.4% were due to CV events, and were detected 96 new CV events. In Kaplan-Meier survival analysis, the presence of prevalent CVD and the new CV events were associated with total mortality (p=0.001 and p<0.001) and CV mortality (p=0.049 and p<0.001). The multivariate analysis showed an independent association between mortality and previous CVD (HR:0.48, p=0.022), Charlson Comorbidity Index >7 points (HR:4.57, p=0.005), and malnutrition-inflammation evaluated with classical markers such as albumin <40 g/l (HR:4.85, p<0.001) or CRP (HR:1.14, p=0.029), and other emerging biomarkers such as troponin-I (HR:4.9, p=0.024), OPG levels (HR:1.07, p=0.006) or IL-18 (HR:1.0, p=0.011). 1- Predictor role of carotid atherosclerotic disease. We confirm a higher prevalence of carotid atherosclerosis (83.6%) and calcified plaques (72.7%), compared with other series. The presence of calcified plaques was predictive of both new CV events (p=0.03) and higher total mortality and CV, suggesting the additional predictive value of plaque calcification in hemodialysis. Carotid IMT has been associated with the presence of prevalent CVD, some traditional CV risk factors (age, male sex, smoking) and with pulse pressure but not with events, mortality or malnutrition-inflammation biomarkers. 2- Association of serum levels of OPG with mortality, atherosclerosis and cardiac function. We show that elevated levels of OPG, but not fetuin-A, are associated with increased mortality, subclinical atherosclerosis markers and cardiac function, but not with bone-mineral biomarkers. Highest tertile of OPG was associated with overall mortality (p=0.005), as well as a higher, but not significant, incidence of CV events and CV mortality. In multivariate analysis, total mortality was associated with higher tertiles of OPG (HR:1.957, p=0.018), age (HR:1.031, p=0.036), smoking history (HR:2.122, p=0.005), Charlson Comorbidity Index (HR:1.254, p=0.004), troponin-I (HR:3.894, p=0.042), IL-18 (HR:1.061, p<0.001) and albumin levels (HR:0.886, p<0.001). In the Cox regression bootstrapping analysis, the best cut-off point for OPG to predict total mortality was 17.69 pmol /l. CONCLUSIONS: The severity of carotid atherosclerotic disease and the presence of calcified carotid plaques is a predictor of CV events and mortality. OPG levels but not fetuin-A, were associated with higher overall mortality and with subclinical atherosclerosis markers and cardiac dysfunction, but not with bone-mineral biomarkers.
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39

Ng, Kuen-to. "The gender difference and association between social position and cardiovascular risk factors in Hong Kong /". View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38030354.

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Umbria, Vivancos Miriam. "ADN mitocondrial i risc cardiovascular". Doctoral thesis, Universitat Autònoma de Barcelona, 2019. http://hdl.handle.net/10803/667225.

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En el últims anys, diversos estudis s’han enfocat cap a l’enteniment del paper dels determinants genètics nuclears i, en menor mesura, mitocondrials, en les malalties cardiovasculars per a prevenir esdeveniments clínics. Malgrat que la majoria dels estudis han intentat predir el risc cardiovascular mitjançant l’ús de puntuacions de risc genètic basades en variants nuclears, fins ara cap estudi ha dut a terme una puntuació de risc utilitzant el genoma mitocondrial. Els objectius plantejats en aquesta tesi són els següents: 1) analitzar el comportament de la mortalitat i morbiditat hospitalària de les malalties cardiovasculars de major rellevància a l’estat Espanyol; 2) determinar l’existència d’una possible associació entre la variació de la regió control del genoma mitocondrial i la susceptibilitat a desenvolupar un infart de miocardi o un accident cerebrovascular i 3) valorar si la incorporació de les variants mitocondrials a una puntuació de risc genètic, emprant marcadors nuclears, millora la capacitat de discriminació i predicció del risc cardiovascular. La metodologia així com la presentació dels resultats i la discussió s’han organitzat en 4 capítols dirigits a respondre els diversos objectius. En el capítol 1 s’ha realitzat un estudi epidemiològic descriptiu que respon a la necessitat d’actualitzar, a nivell nacional, les dades de mortalitat i morbiditat dels principals subtipus de malaltia cardiovascular, per edat i sexe, en totes les comunitats autònomes d’Espanya al llarg dels últims 15 anys. Els resultats obtinguts mostren que les malalties cardiovasculars continuen sent una de les principals causes de morbimortalitat a Espanya; no obstant, també s’observa una disminució de les taxes de mortalitat estandarditzades per edat. Tenint això en ment, s’ha plantejat analitzar l’ADN mitocondrial en individus residents a Castella i Lleó provinents d’un estudi transversal, observacional i descriptiu. Per aquest motiu, en el capítol 2 d’aquesta tesi s’ha investigat l’associació entre els haplogrups mitocondrials i dues malalties cardiovasculars, l’infart de miocardi i l’accident cerebrovascular, així com els factors de risc cardiovasculars clàssics. Les dades obtingudes van mostrar evidències suggestives de que l’haplogrup H pot actuar com un factor de risc genètic per a l’infart de miocardi. A més, en relació als factors de risc clàssics, els resultats també suggerien una funció beneficiosa de l’haplogrup J contra la hipertensió. En el capítol 3, per a la mateixa població de Castella i Lleó, es va analitzar el paper de les mutacions fixades i en heteroplasmia de la regió control de l’ADN mitocondrial que podrien actuar com a factors de risc independents als haplogrups. En aquest cas, també es van observar diferències significatives entre casos i controls, mostrant que les variants m.16.145G>A i m.16.311T>C podien comportar-se com possibles factors de risc en el desenvolupament de l’accident cerebrovascular, mentre que les variants m.72T>C, m.73A>G i m.16.356T>C podien actuar com possibles factors genètics de protecció front a l’infart de miocardi. Tenint en compte els resultats obtinguts, es va realitzar una darrera anàlisi (capítol 4) per tal d’avaluar la magnitud de la informació genètica mitocondrial en la millora de la capacitat de discriminació de les malalties cardiovasculars. Es va crear una puntuació de risc segons el model additiu que suma els al·lels de susceptibilitat de 11 SNPs nuclears i les 5 posicions mitocondrials descrites anteriorment. L'addició de les variants mitocondrials millora la capacitat de discriminació de les malalties cardiovasculars més enllà de la del conjunt dels factors de risc clàssic i els SNPs nuclears en aquesta població. En resum, els resultats presentats en aquesta tesi posen de manifest la influència de les variants mitocondrials en les malalties cardiovasculars. Aquest és el primer treball en avaluar l’ús d’una puntuació de risc que incorpora el genoma mitocondrial i que aconsegueix millorar significativament la capacitat de discriminació dels esdeveniments cardiovasculars.
In recent years, several studies have focused on understanding the role of nuclear and, to a lesser extent, mitochondrial genetic determinants, in cardiovascular diseases to prevent clinical events. Although most studies have tried to predict cardiovascular risk using a genetic risk scores based on nuclear variants, so far no risk score was developed using the mitochondrial genome. The main goals of this thesis are summarized in the following three points: 1) to analyse the state of mortality and hospital morbidity from the most relevant cardiovascular diseases in Spain; 2) to determine the possible association of control region variants of the mitochondrial genome with the susceptibility to develop a myocardial infarction and stroke; and 3) to assess whether the incorporation of mitochondrial variants in a genetic risk score, based in nuclear SNPs, improves the ability to discriminate and predict cardiovascular risk. The methods as well as the presentation of the results and the discussion were organized in 4 chapters aimed to answer the defined objectives. In chapter 1, a descriptive epidemiological study that responds to the need to update the mortality and morbidity data of the main subtypes of cardiovascular disease, by age and sex, in all the Spanish autonomous communities over the last 15 years has been carried out. The results obtained show that cardiovascular diseases continue to be one of the main causes of mortality and morbidity in Spain. However, there is also a decrease in standardized mortality rates by age. Bearing this in mind, mitochondrial DNA has been considered for analysis in individuals residing in in the Spanish autonomous community of Castile and Leon who come from cross-sectional, observational and descriptive study. For this reason, in chapter 2 of this thesis the link between mitochondrial haplogroups and two cardiovascular diseases, myocardial infarction and stroke, and the classic cardiovascular risk factors, was investigated. The data obtained showed suggestive evidence that haplogroup H can act as a genetic risk factor for myocardial infarction. Additionally, in relation to classic risk factors, the results also suggested a beneficial role of haplogroup J against hypertension. In chapter 3, for the same Castile and Leon population, the role of fixed and heteroplasmy mutations of the mitochondrial DNA control region, which act as independent risk factors from haplogroups, was analysed. In this case, significant differences were also observed, reporting that the variants m.16.145G> A and m.16.311T> C could act as possible risk factors in the development of stroke, while variants m.72T>C, m.73A>G and m.16.356T>C could act as possible beneficial genetic factors for myocardial infarction. Taking into account the results obtained, a final analysis (chapter 4) was carried out in order to evaluate the magnitude of the mitochondrial genetic information in improving the ability to discriminate cardiovascular diseases. A risk score was created based on the additive model that adds the susceptibility alleles from the 11 nuclear SNPs and the 5 mitochondrial positions described above. The addition of mitochondrial variants improves, in this population, the ability to discriminate cardiovascular diseases beyond the set of classic risk factors and nuclear SNPs. In summary, the results presented in this thesis show the influence of mitochondrial variants on cardiovascular diseases. This is the first work to evaluate the use of a risk score that incorporates the mitochondrial genome and that significantly improves the ability to discriminate cardiovascular events.
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41

Malas, Tolsá Olga. "Variables psicológicas de riesgo cardiovascular". Doctoral thesis, Universitat de Lleida, 2020. http://hdl.handle.net/10803/669699.

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L'objectiu principal d'aquesta tesi doctoral era el de reexportar les relacions entre algunes variables biomètriques, bioquímiques, de conducta i de personalitat relacionades amb el risc cardiovascular. Per a fer-ho, es va crear un protocol extens de recollida de dades, el qual es va aplicar a un total 1201 persones de raça caucàsica, 647 homes (78.8%) i 554 dones (25.2%), d'entre 18 i 72 anys, amb una mitja d'edat de 44.92 anys (DE: 14.15). La mostra estava composada per 202 pacients que es trobaven hospitalitzats per un infart de miocardi o per una angina inestable i per tres grups de persones sanes de la comunitat. Amb les dades recollides, es van realitzar tres estudis diferents. El primer tenia per objectiu explorar les propietats psicomètriques de la versió espanyola de l'Escala de Personalitat tipus D (DS14), així com la seva validesa i fiabilitat; i explorar les relacions entre aquest constructe i els trets de personalitat del model alternatiu de Zuckerman. El segon estudi tenia com a objectiu estudiar les relacions entre l'alexitímia i les variables de risc cardiovascular en una població amb mínim un episodi de malaltia cardiovascular, i comparar-ho amb població sana. El tercer estudi tenia com a objectiu reexportar les relacions entre la Síndrome Metabòlica i les variables psicològiques de risc utilitzant els criteris IDF i NCEP, i verificar el poder predictiu de les variables psicològiques vers la resta de variables. En línies generals, es troben associacions moderades entre les variables de personalitat analitzades i els factors de risc cardiovascular, assumintse, per tant, que la seva presència pot afectar al risc cardiovascular. Existeixen proves psicomètricament fiables i vàlides que permeten avaluar aquests patrons de personalitat. Aquests resultats van en la línia amb estudis previs realitzats en diferents contextos culturals. Per tant, es defensa que la detecció de subjectes amb determinats trets de personalitat pot ser d'utilitat en els programes de prevenció cardiovascular.
El objetivo principal de esta tesis doctoral era el de reexplorar las relaciones entre variables biométricas, bioquímicas, de conducta y de personalidad relacionadas con el riesgo cardiovascular. Para ello, se creó un protocolo extenso de recogida de datos, el cual se aplicó a un total 1201 personas de raza caucásica, 647 hombres (78.8%) y 554 mujeres (25.2%), de entre 18 y 72 años, con una media de edad de 44.92 años (DE: 14.15). La muestra estaba compuesta por 202 pacientes que se encontraban hospitalizados por un infarto de miocardio o por una angina inestable y tres grupos de sujetos sanos de la comunidad. Con los datos recogidos, se realizaron tres estudios diferentes. El primero tenía como objetivo explorar las propiedades psicométricas de la versión española de la Escala de Personalidad tipo D (DS14), así como su validez y confiabilidad; y explorar las relaciones entre este constructo y los rasgos de personalidad del modelo alternativo de Zuckerman. El segundo estudio tenía como objetivo estudiar las relaciones entre la alexitimia y las variables de riesgo cardiovascular en una población con al menos un episodio de enfermedad cardiovascular, y compararlo con población sana. El tercer estudio tenía como objetivo reexplorar las relaciones entre el Síndrome Metabólico y las variables psicológicas de riesgo utilizando los criterios IDF y NCEP, y verificar el poder predictivo de las variables psicológicas respecto al resto de variables. En líneas generales, se hallan asociaciones moderadas entre las variables de personalidad analizadas y los factores de riesgo cardiovascular, por lo que se asume que su presencia puede afectar al riesgo cardiovascular. Existen pruebas psicométricamente confiables y válidas que permiten evaluar dichos patrones de personalidad. Estos resultados van en la línea con estudios previos realizados en diferentes contextos culturales. Por lo tanto, se defiende que la detección temprana de sujetos con determinados rasgos de personalidad puede ser de utilidad en los programas de prevención cardiovascular.
The main objective of this doctoral thesis was to re-explore the relationships between biometric, biochemical, behavioural and personality variables related to cardiovascular risk. To do this, an extensive data collection protocol was created, which was applied to 1202 Caucasian people, 647 men (78.8%) and 554 women (25.2%), between 18 and 72 years old, with a mean age of 44.92 years (SD: 14.15). The sample was composed of 202 patients who were hospitalized for an acute myocardial infarction or unstable angina and three groups of healthy people of the community. With the data collected, three different studies were conducted. The first one aimed to explore the psychometric properties of the Spanish version of the Type D Personality Scale (DS14), as well as their validity and reliability; and to explore the relationships between this construct and the personality traits of Zuckerman's alternative model. The second study aimed to analyse the relationships between alexithymia and the cardiovascular risk factors in a population with at least one episode of cardiovascular disease, and compare it with a healthy population. The third study aimed to re-explore the relationships between the metabolic syndrome and psychological risk variables using the IDF and NCEP criteria, and to verify the predictive power of psychological variables relative to other factors. In general terms, moderate associations between personality variables and cardiovascular risk factors are found, supporting that psychological variables can affect the probability of developing cardiovascular disorders. There are psychometrically reliable and valid tests to assess these personality patterns. The results are in line with previous studies carried out in different cultural contexts. Therefore, it is argued that early detection of subjects with certain personality traits may be useful in cardiovascular prevention.
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42

Hammett, Christopher John Keith. "Inflammatory markers and cardiovascular disease". Thesis, University of Auckland, 2010. http://hdl.handle.net/2292/14345.

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Background: Inflammation is now recognised to play a central part in the initiation, progression and clinical manifestation of atherosclerotic cardiovascular disease. Correspondingly, on a population level, circulating levels of a wide range of inflammatory markers have been shown to be predictive of future cardiovascular events, regardless of whether they are measured in asymptomatic people, patients with stable angina, or patients with acute coronary syndromes. These include both systemic markers of inflammation such as the white blood cell count (WBC), fibrinogen, and C-reactive protein (CRP), and locally produced mediators of inflammation such as the cellular adhesion molecule soluble intercellular adhesion molecule 1 (sICAM-1), the cell-surface protein soluble CD40 ligand (sCD40L), and the metalloproteinase pregnancy associated plasma protein-A (PAPP-A). Investigation of these inflammatory markers has given many useful insights into the mechanisms that underlie the development of atherosclerosis and atherosclerotic clinical events. However, although the association (on a population level) of raised inflammatory markers with increased atherosclerotic events is widely accepted, the clinical utility of these markers (their ability to provide meaningful additional information that will help individualise treatment strategies and lead to better clinical outcomes) remains a subject of vigorous debate. Consequently, the research presented in this thesis has two broad purposes: to determine the value of inflammatory markers in a particular clinical situation (the prediction of restenosis following percutaneous coronary intervention), and to examine whether vascular inflammation is a modifiable risk factor (whether marker levels can be lowered by health interventions such as drug therapy, exercise, or smoking cessation). Methods and results: a. Inflammatory markers and restenosis To investigate whether inflammatory markers are predictive of restenosis following PCI, inflammatory markers (CRP, sICAM-1, sCD40L and PAPP-A) were measured prior to and 48 hours, 1 week and 1 month after elective PCI, and angiographic follow-up was performed at 6 months, in 133 stable angina patients. PCI led to a significant rise in CRP, sCD40L and PAPP-A levels 48 hours post-procedure, but neither pre-PCI nor post-PCI inflammatory marker levels were predictive of restenosis. This lack of association could not be attributed to concurrent use of medications such as statins, thienopyridines or glycoprotein IIb/IIIa inhibitors, since 50% of patients were not on statins and no patients received thienopyridines or glycoprotein IIb/IIIa inhibitors during the study. b. The effects of lipid lowering agents on inflammatory marker levels The effects of lipid-modifying agents on inflammatory marker levels were tested in 215 participants with stable angina randomised to simvastatin or placebo, and a further 100 participants randomised to simvastatin or bezafibrate, over a treatment period of at least 2 years. In addition, the effect of statins on the inflammatory response to PCI was assessed in a subset of 92 patients by comparing inflammatory marker levels before and 48 hours, 1week, and 1 month after PCI in those randomised to simvastatin versus those randomised to placebo. Although simvastatin led to a reduction in CRP levels with long-term therapy, the effect was modest and variable compared to the predictable effect on cholesterol levels. Average CRP levels fell ~5%, compared to a 40% reduction in LDL cholesterol, and CRP levels increased in nearly a quarter of patients on simvastatin. In addition, simvastatin did not lower levels of any other inflammatory marker, and had no appreciable effect on the inflammatory response to PCI. Similarly, bezafibrate therapy did not lower levels of any inflammatory marker. c. The effect of exercise training on inflammatory marker levels. The effects of exercise training on inflammatory markers were assessed in two separate randomised controlled trials. The first trial involved CRP measurement in 63 healthy elderly participants randomised to either 6 months��� exercise training or to a control group. The second trial involved measurement of several inflammatory markers (WBC, fibrinogen, CRP, sCD40L, sICAM-1) in 152 healthy female smokers randomised to either 12 weeks��� exercise training or to a health education (control) group as part of a smoking cessation program. In both trials, exercise led to a significant improvement in fitness but had no effect on inflammatory marker levels. d. The effect of smoking cessation on inflammatory marker levels The smoking cessation trial also investigated the effect of abstinence from smoking on inflammatory marker levels. Forty-eight individuals (35%) achieved 6 weeks verified abstinence from smoking. Abstinence caused a significant decrease in WBC and fibrinogen levels but had no effect on other inflammatory markers (CRP, sICAM-1, and sCD40L). Conclusions: There are several important findings from this research. Firstly, inflammatory markers are not useful in the prediction of restenosis following PCI in stable angina. Secondly, neither simvastatin nor bezafibrate have major antiinflammatory effects in vivo. This brings into question the mechanism(s) by which statins lower CRP, and has implications for recent proposals in the literature advocating the clinical use of CRP to titrate statin therapy. Thirdly, smoking cessation leads to a reduction in WBC and fibrinogen levels (which may reflect changes in pulmonary inflammation), but neither exercise nor smoking cessation are associated with a broad reduction in inflammatory markers linked to cardiovascular risk. It is therefore unlikely the appreciable cardiovascular benefits of these interventions are due in any substantial part to antiinflammatory effects. It remains to be demonstrated whether there are interventions which can reliably lower inflammatory marker levels, whether this decreases cardiovascular risk, and whether measurement of inflammatory markers improves upon current management of cardiovascular disease and leads to actual clinical benefit.
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43

Saikus, Christina Elena. "Towards mri-guided cardiovascular interventions". Diss., Georgia Institute of Technology, 2011. http://hdl.handle.net/1853/44912.

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Imaging guidance may allow minimally invasive alternatives to open surgical exposure and help reduce procedure risk and morbidity. The inherent vascular and soft-tissue contrast of MRI make it an appealing imaging modality to guide cardiovascular interventional procedures. Advances in real-time MRI have made MRI-guided procedures a realistic possibility. The MR environment, however, introduces additional challenges to the development of compatible, conspicuous and safe devices. The overall goal of this work was to enable selected MRI-guided cardiovascular interventional procedures with clearly visible MR devices. In the first part of this work, we developed actively visualized devices for three distinct MRI-guided interventional procedures and techniques to assess their signal performance. We then investigated factors influencing complex device safety in the MR environment and evaluated a technique to better determine and monitor potential device heating. This input contributed to the development of a system to further improve device safety with continual device monitoring and dynamic scanner feedback control. In the final part of this work, we demonstrated the utility of MRI guidance and actively visualized devices to enable traditional and complex cardiovascular access. Together these provide important elements to bring MRI-guided cardiovascular interventional procedures closer to clinical implementation.
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44

Hermansson, Jonas. "Shift work and cardiovascular disease". Licentiate thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-17466.

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Shift work is a work schedule being the opposite of normal daytime work, often defined as working time outside normal daytime hours (06:00 to 18:00). In recent years, shift work has been associated with an increased risk of numerous chronic conditions including for example cardiovascular disease, some types of cancer, type II diabetes, and the metabolic syndrome. While some studies on the association between shift work and chronic disease have found results supporting it, others have not. Therefore, more research is needed to clarify potential associations.The aim of this thesis was to further study the proposed association between shift work and cardiovascular disease. This was addressed by performing two studies, one analysing if shift workers had an increased risk of ischemic stroke compared to day workers. The other study analysed whether shift workers had an increased risk of short-term mortality (case fatality) after a myocardial infarction compared to day workers. The studies were performed using logistic regression analysis in two different case-control databasesThe findings from the first study indicated that shift workers did not have an increased risk of ischemic stroke. The findings from the second study showed that male shift workers had an increased risk of death within 28 days after a myocardial infarction; the results did not indicate an increased risk for female shift workers. The results from both studies were adjusted for both behavioural and medical risk factors without affecting the results. The findings from this thesis provide new evidence showing that male shift workers have an increased risk of death 28 days after a myocardial infarction, however more research is needed to clarify and characterise any such potential associations.
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45

Achan, Vinod. "Cardiovascular effects of asymmetric dimethylarginine". Thesis, University College London (University of London), 2004. http://discovery.ucl.ac.uk/1446828/.

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Nitric Oxide (NO) is an important mediator of cardiovascular function and its impaired synthesis is a feature of many cardiovascular diseases. Raised concentrations of an endogenous inhibitor of NO synthesis, asymmetric dimethylarginine (ADMA), are associated with renal failure, hypertension, heart failure and impaired angiogenesis. ADMA is generated during protein turnover and metabolized by the enzyme dimethylarginine dimethylaminohydrolase (DDAH). The significance of this pathway in vivo is unknown. This series of studies demonstrates that the metabolism of ADMA by DDAH influences NO synthesis in vitro and in vivo and that this pathway is likely to be important in man. An important regulator of tissue development and remodelling, all-trans-retinoic acid (atRA), has been shown to upregulate an isoform of DDAH, DDAH2, and regulate NO synthesis in vitro. Using a novel transgenic mouse model, it has been shown that the overexpression of DDAH in vivo can increase NOS activity and lower blood pressure. A mouse model of unilateral hindlimb ischaemia has been used to demonstrate that ischaemia can increase ADMA formation and also upregulate DDAH expression in order to restore ADMA levels to baseline and potentiate NO synthesis. Finally, a randomised, double-blind, placebo-controlled study demonstrates that an acute systemic increase in ADMA produces adverse cardiovascular effects in humans, both at rest and during exercise. These results support a causal role relationship between raised ADMA levels and cardiovascular dysfunction. The data also indicates that ADMA is metabolised by DDAHs extensively in humans in vivo; humans generate approximately 300 mol of ADMA per day, of which approximately 250 mol is metabolised by DDAHs.
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46

Neal, David A. J. "Cardiovascular risk after liver transplantation". Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.418005.

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47

Wijnen, Joseph Anna Guillaume. "Exercise and cardiovascular risk reduction". Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1994. http://arno.unimaas.nl/show.cgi?fid=6547.

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48

Soveri, Inga. "Renal Dysfunction and Cardiovascular Disease". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6941.

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49

Hurtig, Wennlöf Anita. "Cardiovascular risk factors in children /". Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-179-2/.

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Rosenlund, Mats. "Environmental factors in cardiovascular disease /". Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-292-6/.

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