Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-29T12:00:02Z No. of bitstreams: 1 DIS_ANDREA_MABILDE_PETRACCO_PARCIAL.pdf: 937104 bytes, checksum: d94cfd0a6d65b1765ed29fba02873f27 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-29T12:03:01Z (GMT) No. of bitstreams: 1 DIS_ANDREA_MABILDE_PETRACCO_PARCIAL.pdf: 937104 bytes, checksum: d94cfd0a6d65b1765ed29fba02873f27 (MD5) / Made available in DSpace on 2017-06-29T12:03:12Z (GMT). No. of bitstreams: 1 DIS_ANDREA_MABILDE_PETRACCO_PARCIAL.pdf: 937104 bytes, checksum: d94cfd0a6d65b1765ed29fba02873f27 (MD5) Previous issue date: 2017-03-31 / Introduction: Peripheral Artery Disease (PAD) is associated with cardiovascular events and can be diagnosed and estimated through the Ankle-Brachial Index (ABI). It is well established that ABI is an aggravating factor in the stratification of cardiovascular risk, but its contribution to defining the severity of coronary artery disease is not well established. Objective: The study compared the value of ABI with the severity of coronary atherosclerotic disease by the Syntax (ES) Score in patients with Acute Coronary Syndrome (ACS). Methods: A prospective study with the ABI measurement of all patients hospitalized with ACS at the S?o Lucas Hospital of PUCRS, consecutively, from May to September 2016, and the comparison of their value with ES of these patients and the respective forms of presentation of ACS. Results: We studied101 patients, mean age 62.6 ? 12 years, 58 (57.4%) males, 74 (82.2%) hypertensive, 33 (45.8%) diabetics and 46 (45.5%) presented acute myocardial infarction with ST segment depression (STEMI) . The frequency of PAD was 3 times higher than that described in the general population. The severity of PAD was not related to the anatomical severity of the coronary disease. We found a significant association of patients with intermediate ES with non-ST elevation myocardial infarction (STEMI) and low ES with unstable angina (UA) (P = 0.015), who remained even after adjusting for age, smoking, family history of CAD and prior CAD. OR (95% CI-1.02-1.25). Conclusions: Our results demonstrate that patients with ABI lower than 0.9 were not associated with a greater complexity of coronary atherosclerotic disease, as determined by ES in patients with ACS. Patients with NSTEMI were more associated with intermediate ES. / Introdu??o: A Doen?a Arterial Perif?rica (DAP) est? associada a eventos cardiovasculares podendo ser diagnosticada e estimada atrav?s do ?ndice Tornozelo-Braquial (ITB). Est? bem estabelecido que o ITB ? fator agravante na estratifica??o de risco cardiovascular, mas sua contribui??o para definir a gravidade do acometimento arterial coronariano n?o est? bem estabelecida. Objetivo: O estudo comparou o valor do ITB com a gravidade da doen?a ateroscler?tica coronariana pelo Escore de Syntax (ES) em pacientes com S?ndrome Coronariana Aguda (SCA). M?todos: Estudo prospectivo com a medida do ITB de todos pacientes internados com SCA no Hospital S?o Lucas da PUCRS, consecutivamente, de maio a setembro de 2016, e a compara??o de seu valor com o ES destes pacientes e as respectivas formas de apresenta??o da SCA. Resultados: Estudamos 101 pacientes, com m?dia de idade de 62,6?12,0 anos, 58 (57,4% ) masculinos, 74 (82,2% ) hipertensos, 33 (45,8%) diab?ticos e 46 (45,5% ) apresentaram infarto agudo do mioc?rdio com infradesn?vel do segmento ST (IAMCSST). A gravidade da DAP n?o teve rela??o com a gravidade anat?mica da doen?a coronariana. Encontramos uma associa??o significativa dos pacientes com ES intermedi?rio com o infarto agudo do mioc?rdio sem supradesnivel do segmento ST (IAMSSST) e de ES baixo com angina inst?vel (AI) OR (IC95%): 1,11 (1,03-1,20) (P=0,004), que se manteve ap?s an?lise multivariada, ajustada para idade, tabagismo, hist?ria familiar de doen?a arterial coron?ria (DAC) e DAC pr?via OR (IC95%): 1,13 (1,02-1,25) (P=0,019). Conclus?es: A an?lise dos nossos resultados, demonstram que pacientes com ITB menor que 0,9 n?o apresentaram associa??o com maior complexidade de doen?a ateroscler?tica coronariana determinados pelo ES em pacientes com SCA. Os pacientes com IAMSSST estiveram mais associados com ES intermedi?rio.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-26T19:45:44Z No. of bitstreams: 1 AnaGabrielaCamaraBatistaDaSilva_DISSERT.pdf: 1290926 bytes, checksum: 8d945ae20b850326ca6c815c81b574a7 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-29T19:00:33Z (GMT) No. of bitstreams: 1 AnaGabrielaCamaraBatistaDaSilva_DISSERT.pdf: 1290926 bytes, checksum: 8d945ae20b850326ca6c815c81b574a7 (MD5) / Made available in DSpace on 2016-04-29T19:00:33Z (GMT). No. of bitstreams: 1 AnaGabrielaCamaraBatistaDaSilva_DISSERT.pdf: 1290926 bytes, checksum: 8d945ae20b850326ca6c815c81b574a7 (MD5) Previous issue date: 2015-02-27 / A doen?a arterial obstrutiva perif?rica (DAOP) ? uma patologia oclusiva cr?nica da circula??o arterial perif?rica causada principalmente por aterosclerose. Um dos m?todos cl?nicos propostos para avalia??o do endurance e fun??o muscular de membros inferiores ? o Heel Rise Test (HRT) ou teste de eleva??o do calcanhar, por?m sua capacidade de predizer a disfun??o causada pela DAOP e sua rela??o com a composi??o corporal n?o foram elucidados. O objetivo geral do trabalho foi avaliar o endurance da musculatura de membros inferiores, atrav?s do HRT, e a composi??o corporal em mulheres idosas com ?ndice tornozelo-braquial (ITB) compat?vel com a DAOP e mulheres com ITB Normal. Foram avaliadas 60 mulheres idosas, sendo 39 com ITB normal e 21 com ITB DAOP. A composi??o corporal foi quantificada atrav?s da bioimped?ncia el?trica multifrequencial segmentar direta. N?o foram observadas diferen?as marcantes de composi??o corporal entre grupos al?m de tend?ncia de menor valor de massa muscular em membros inferiores no grupo ITB DAOP. O n?mero de repeti??es no HRT apresentou correla??o com a composi??o corporal tanto de massa de gordura e suas porcentagens (Massa de gordura corporal r= -0,461, p<0,001; porcentagem de gordura corporal r= - 0,45, p<0,001; Porcentagem de gordura de tronco r= -0,584, p<0,0001; Massa de gordura de tronco r= -0,450, p<0,001), quanto de massa muscular em membros inferiores normalizada pelo peso (r= 0,434, p<0,001); contudo, n?o houve correla??o com o ITB que apenas correlacionou-se com a velocidade de realiza??o do teste (r= -0,300; p=0,019). Embora apresente correla??o com a composi??o corporal, sobretudo massa muscular de membros inferiores e seja ?til para avalia??o da endurance muscular de membros inferiores, padroniza??es dos par?metros do HRT s?o necess?rias para que o teste tenha sensibilidade no diagn?stico e determina??o da progress?o da DAOP em mulheres. / Peripheral Artery Disease (PAD) is a chronic atherosclerotic pathology caused by occlusion of peripheral arterial circulation. The standing Heel Rise Test (HRT) has been recommended as a relevant clinical instrument to evaluate endurance and muscular performance in the lower limbs; however, its capacity to predict disability resulted from PAD and its relation to body composition has not yet been elucidated. The aim of this study was to evaluate muscular endurance of the lower limbs using the Heel Rise Test, and to compare body composition through ankle-brachial index in elderly women with and without PAD. Sixty women were evaluated, where 39 presented normal ankle-brachial index and 21 with PAD. The body composition was mensured by segmental multi-frequency bioelectrical impedance. There were no significant differences in body composition between groups apart tendency to lower muscular mass in lower limbs on the group of ankle-brachial index with PAD. The number of repetitions on HRT showed correlation with body composition regarding body fat percentages (Fat mass r= -0,461, p<0,001; Percentage body fat r= -0,45, p<0,001; Percentage trunk mass r= -0,584, p<0,0001; Fat trunk mass r= -0,45, p<0,001) and muscular mass in lower limbs normalized by the weight; nevertheless, there was no correlation with ankle-brachial index, that was only associated with the velocity performed on the test (r= -0,3001, p=0,019). While HRT has correlation with body composition, particularly with lower limb muscular mass, and presents effectiveness in evaluating muscular endurance in lower limbs, standardization of the test parameters is necessary in order to have sensitivity in the diagnosis and determinations of PAD progression in women.