Access to abstract permanently restricted to Ball State community only / Access to thesis permanently restricted to Ball State community only / School of Physical Education, Sport, and Exercise Science

Obesity is a major epidemic and is increasing in prevalence worldwide. The health problems and consequences of obesity include cardiovascular disease (CVD) risk factors, such as hypertension, hyperlipidemia, glucose intolerance and diabetes mellitus. Each of these abnormalities directly promotes atherosclerosis. More recently, visceral obesity has been shown to be independently associated with abnormalities of both the ventricular and vascular structure and function. The mechanisms by which they occur remain incompletely defined. Cardiovascular magnetic resonance imaging (CMR) offers several advantages for evaluation of cardiac structure and function in the obese. The high accuracy and reproducibility of the technique allows for detection of very small changes in ventricular volumes, mass, ejection fraction, and cardiac output with a relatively small sample size, as compared with echocardiography. In this thesis we investigated whether cardiovascular magnetic resonance imaging can better characterize possible cardiac abnormalities associated with obesity, in the absence of other confounding comorbidities. Obesity is associated with myocardial and vascular function, the extent of reversibility of these abnormalities with rapid acute weight loss remains uncertain. Therefore the first aim of the study was to (i) determine the relationship between obesity and left ventricular structure and function using magnetic resonance imaging, and (ii) the acute effects of rapid diet-induced weight loss on cardiac and vascular function in normal obese and obese diabetic men. Erectile dysfunction is related to cardiovascular risk factors such as obesity by an impairment of endothelial function. Therefore, symptoms of erectile dysfunction are probably to precede cardiovascular disease and events. The second aim of this study was to (i) determine the relationship between obesity and erectile function (EF), sexual desire (SD), lower urinary tract symptoms (LUTS) and quality of life (QOL) measures in obese males, and (ii) determine the effects of rapid diet-induced weight loss on EF, SD, LUTS and QOL measures in normal obese and obese diabetic men. In this group of men, obesity was associated with mild/moderate erectile dysfunction, and significant LUTS, which together with sexual desire improved following rapid diet induced weight loss, but was not directly related to the amount of weight loss or changes in measured metabolic state. Pericardial adipose tissue (PAT) covers 80% of the heart and constitutes 20% of its weight. PAT mass is related to the amount of abdominal fat and the risk of coronary atherosclerosis. Epicardial fat mass may be a sensitive indicator of cardiovascular risk. The third aim of this study was to (i) determine the relationship between obesity and PAT volume and (ii) effectively evaluate the impact of caloric restriction and associated weight reduction on epicardical fat volume via cardiac magnetic resonance imaging (CMR). This is the first study to show a reduction in PAT volume is associated with caloric restriction. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1352389 / Thesis (Ph.D.) - University of Adelaide, School of Medicine, 2009

Obesity is a major epidemic and is increasing in prevalence worldwide. The health problems and consequences of obesity include cardiovascular disease (CVD) risk factors, such as hypertension, hyperlipidemia, glucose intolerance and diabetes mellitus. Each of these abnormalities directly promotes atherosclerosis. More recently, visceral obesity has been shown to be independently associated with abnormalities of both the ventricular and vascular structure and function. The mechanisms by which they occur remain incompletely defined. Cardiovascular magnetic resonance imaging (CMR) offers several advantages for evaluation of cardiac structure and function in the obese. The high accuracy and reproducibility of the technique allows for detection of very small changes in ventricular volumes, mass, ejection fraction, and cardiac output with a relatively small sample size, as compared with echocardiography. In this thesis we investigated whether cardiovascular magnetic resonance imaging can better characterize possible cardiac abnormalities associated with obesity, in the absence of other confounding comorbidities. Obesity is associated with myocardial and vascular function, the extent of reversibility of these abnormalities with rapid acute weight loss remains uncertain. Therefore the first aim of the study was to (i) determine the relationship between obesity and left ventricular structure and function using magnetic resonance imaging, and (ii) the acute effects of rapid diet-induced weight loss on cardiac and vascular function in normal obese and obese diabetic men. Erectile dysfunction is related to cardiovascular risk factors such as obesity by an impairment of endothelial function. Therefore, symptoms of erectile dysfunction are probably to precede cardiovascular disease and events. The second aim of this study was to (i) determine the relationship between obesity and erectile function (EF), sexual desire (SD), lower urinary tract symptoms (LUTS) and quality of life (QOL) measures in obese males, and (ii) determine the effects of rapid diet-induced weight loss on EF, SD, LUTS and QOL measures in normal obese and obese diabetic men. In this group of men, obesity was associated with mild/moderate erectile dysfunction, and significant LUTS, which together with sexual desire improved following rapid diet induced weight loss, but was not directly related to the amount of weight loss or changes in measured metabolic state. Pericardial adipose tissue (PAT) covers 80% of the heart and constitutes 20% of its weight. PAT mass is related to the amount of abdominal fat and the risk of coronary atherosclerosis. Epicardial fat mass may be a sensitive indicator of cardiovascular risk. The third aim of this study was to (i) determine the relationship between obesity and PAT volume and (ii) effectively evaluate the impact of caloric restriction and associated weight reduction on epicardical fat volume via cardiac magnetic resonance imaging (CMR). This is the first study to show a reduction in PAT volume is associated with caloric restriction. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1352389 / Thesis (Ph.D.) - University of Adelaide, School of Medicine, 2009

[Formulae and special characters can only be approximated here. Please see the pdf version of the abstract for an accurate reproduction.] Two randomised controlled trials were conducted to explore the relationship between the consumption of alcoholic beverages and cardiovascular disease risk factors. Study 1 was primarily designed to test the hypothesis that the cardio-protective effect of light alcohol could be mediated, in part, via improvements in endothelial function. Study 1 was also designed to explore the effect of alcohol on both traditional risk factors for cardiovascular disease, such as changes in lipid profile, haemostatic factors and blood pressure, and novel risk factors such as homocysteine, markers of inflammation and oxidative stress. The experimental design of this study also allowed us to determine whether reducing alcohol intake in these moderate-to-heavy drinkers could improvement insulin sensitivity, a component of the metabolic syndrome. In this group of sixteen healthy middle-aged men with a history of moderate to heavy alcohol intake of seven standard drinks per day, reducing intake down to approximately one standard drink per day for four weeks had no beneficial effects on conduit vessel endothelial function as assessed by post-ischaemic brachial artery flow-mediated dilatation, nor were there any detectable changes in soluble E-selectin, endothelin-1 and von Willebrand Factor, which are considered biomarkers of endothelial activation. As this study did not investigate the effect of alcohol on endothelial function in resistance vessels, it cannot exclude the possibility that alcohol may affect endothelial cells resident in that vascular bed. This study does show and confirm, however, that the relationship between alcohol and risk factors for cardiovascular disease is an extremely complex one. On the one hand it demonstrated that alcohol was potentially harmful, increasing blood pressure, plasma F2-isoprostane (oxidative stress), and homocysteine. On the other hand it showed that increasing alcohol intake led to significant reductions in two (i.e. fibrinogen and IL-6) of five inflammatory markers, in addition to improving the HDL-cholesterol profile of these subjects. Although the effects of alcohol on blood pressure, fibrinogen and HDL-cholesterol are not in themselves new, they support our choice of study design and strengthen the argument in favour of accepting the more novel findings of this study, specifically, the lack of effect on endothelial function and insulin sensitivity, and the harmful effect of alcohol in increasing oxidative stress and homocysteine. Study 2 was primarily designed to test the hypothesis that the consumption of red wine may confer greater cardio-protection than beer via improvements in endothelial function. Simultaneously, the study was also designed to determine whether drinking red wine for 4-weeks would have different effects than beer on either traditional risk factors for cardiovascular disease (i.e. blood pressure and lipid profile) or the more novel risk factors, homocysteine and oxidative stress. Using a randomised controlled cross-over study design, Study 2 provides evidence that the regular daily consumption of 4 standard drinks of either beer or red wine does not alter endothelial function, as measured by post-ischaemic flow-mediated vasodilatation of the brachial artery in healthy middle-aged men, nor was there evidence of any beneficial effect of de-alcoholised red wine on brachial artery response. As compliance with drinking protocol was confirmed with increased serum γ-GT and HDL during red wine and beer periods, and increased 24-hr urinary excretion of 4OMGA during red wine and de-alcoholised red wine periods, we are confident that there was excellent compliance with the beverage treatments. Study 2 also provides the first evidence from a carefully controlled intervention study that both red wine and beer elevate blood pressure to a similar degree, with no detectable difference in the magnitude of either treatment. As with endothelial function, there was also no evidence of any beneficial effect of de-alcoholised red wine on blood pressure. In addition, although post hoc analysis found evidence that alcohol increased both plasma homocysteine and urinary excretion of F2-isoprostane and endothelin-1, there was no apparent protective effect conferred from either red wine or de-alcoholised red wine on these cardiovascular risk markers. The results from this study cannot disprove the hypothesis that red wine is more beneficial for cardiovascular health; however, they suggest that if red wine has properties beyond those of beer to confer protection, they are not via any interactions with the nitric oxide regulatory function of the endothelium in conduit vessels nor are they via moderation of the vasopressor, homocysteine-raising, and oxidative stress effects of alcohol. The interpretation of the findings from both intervention studies and their place in the context of our current understanding of the role that alcoholic beverages play in the development and/or prevention of cardiovascular disease are explored in this thesis.

Made available in DSpace on 2014-08-13T14:50:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-02-20Bitstream added on 2014-08-13T18:00:45Z : No. of bitstreams: 1 000754110.pdf: 817895 bytes, checksum: 5606c389431935feaf2fd14af3b4ba2c (MD5) / A Doença Renal Crônica (DRC) é um importante problema mundial de saúde pública. A DRC apresenta, dentre os principais sintomas, a fadiga, a fraqueza muscular e a baixa tolerância ao exercício, sintomas que contribuem diretamente para o sedentarismo e a baixa mobilidade, com consequente aumento da morbidade e mortalidade. Pacientes com DRC apresentam pobre qualidade de vida, incidência elevada de doenças cardiovasculares, alta prevalência de inflamação crônica e disfunção endotelial com aumento de rigidez arterial, da massa ventricular esquerda e da concentração sérica de dimetilarginina assimétrica (ADMA). Acredita-se que o condicionamento físico desses pacientes possa atenuar fatores de risco cardiovascular e implicar na melhora da qualidade de vida e da capacidade funcional. Vários trabalhos têm avaliado essa premissa em pacientes em diálise, porém poucos estudos a avaliaram em portadores de DRC em tratamento conservador. Avaliar o impacto do treinamento físico em relação à capacidade funcional, qualidade de vida e fatores de risco cardiovascular não tradicionais em portadores de DRC em tratamento conservador. Ensaio clínico, prospectivo e controlado, não randomizado, composto por 16 portadores de DRC, estágios de II a IV, em tratamento conservador, divididos, de acordo com sua disponibilidade e vontade, em grupo controle (GC) e grupo treinamento (GT). Todos os pacientes foram avaliados inicialmente com a realização de teste ergométrico (protocolo de Bruce) em esteira ergométrica para estratificar a capacidade aeróbica por meio do VO2max estimado. Foi realizado Teste de caminhada de 6 minutos para avaliar aptidão física. Foi avaliada pressão arterial central e parâmetros de rigidez arterial com o aparelho Sphygmocor e realizado Ultrassonografia para a mensuração de diâmetros arteriais e de massa cardíaca. Foram coletados também exames laboratoriais completos para estabelecer o grau de ... / Chronic Kidney Disease (CKD) is a worldwide major public health problem. The CKD has among the main symptoms, fatigue, muscle weakness and poor exercise tolerance, symptoms that directly contribute to physical inactivity and low mobility, with consequent increased morbidity and mortality. CKD patients have poor quality of life, increased incidence of cardiovascular diseases, high prevalence of chronic inflammation and endothelial dysfunction with increased arterial stiffness, left ventricular mass and serum concentration of asymmetric dimethylarginine (ADMA). It is believed that the improvement at physical fitness of these patients may attenuate cardiovascular risk factors and result in improved quality of life and functional capacity. Several studies have evaluated this premise in dialysis patients, but few studies have evaluated in CKD patients on conservative treatment. Evaluate the impact of exercise training at functional capacity, quality of life and non-traditional cardiovascular risk factors in CKD patients on conservative treatment. Clinical trial, prospective, controlled and non-randomized study, comprising 16 patients with CKD stages II to IV, undergoing conservative treatment, divided according to their availability and desire in control group (CG) and training group (GT). All patients were evaluated with the Exercise Test (Bruce protocol) at treadmill to stratify aerobic capacity through VO2max. 6-minute walk test was performed to assess physical fitness. We evaluated central blood pressure and arterial stiffness parameters with the device Sphygmocor and used ultrasound for the measurement of arterial diameters and cardiac mass. Laboratory tests were also collected to establish the full extent of renal inflammation and serum concentration of ADMA. Were applied questionnaires to verify quality of life, the SF-36, and to stratification of inactivity, the IPAQ. Patients of GT were included in an exercise program consisting of ...

Orientador: Jean Leandro dos Santos / Coorientador: Rafael Victorio Carvalho Guido / Banca: Angelica Amorim Amato / Banca: Ivone Carvalho / Banca: Roberto Parise Filho / Banca: Chung Man Chin / Resumo: A dislipidemia causada por hipertrigliceridemia e baixo HDL-C é um marcador de risco para a progressão da aterosclerose e doenças cardiovasculares. Os receptores PPARs são fatores de transcrição que controlam a expressão de genes envolvidos no metabolismo de lipídios e glicose. A ativação de PPAR-α aumenta a expressão gênica de apoA1 e LPL contribuindo para o aumento de HDL-C e redução de TG, respectivamente. Através da hibridação molecular entre fibratos e resveratrol, nós planejamos e sintetizamos novos agonistas de PPAR-α. O novos compostos híbridos ativaram os receptores PPAR-α/γ na faixa de nM, com destaque para o composto (E)-2-metil-2-(4-fenoxiestireno)propanoamida (5b). O composto 5b foi mais eficiente que o bezafibrato (EC50= 18000nM) na ativação de PPARs, com valor de EC50= 28nM para PPAR-α e EC50= 69nM para PPAR-γ. Ainda, 5b ocupou o sítio ativo de PPAR-α mostrando interação polar com His 440 além de ser estabilizado por interações hidrofóbicas. Além disso, 5b aumentou o efluxo de colesterol em macrófagos em 20% e 20,8% mediado por HDL e apoA1 respectivamente. 5b não mostrou valores significativos no na diferenciação de adipócitos, concluindo que não há acúmulo de TG no tecido adiposo, o qual é o principal efeito adverso das tiazolidinedionas. / Abstract: Dyslipidemia caused by hypertriglyceridemia and low HDL-C is a marker of risk for the progression of atherosclerosis and cardiovascular diseases. Receptors PPARs are transcription factors that control the expression genes involved in lipid and glucose metabolism. The PPAR-α activation increases gene expression of apoA1 and LPL contributing to elevation of HDL-C and reduction of TG. Considering, molecular hybridization between fibrates and resveratrol, we designed and synthesized new PPAR-α agonists. The novel compounds were able to activate both PPAR-α/γ in the nM range, highlighting 5b with EC50 value of 28nM for PPAR-α and 69nM for PPAR-γ. Furthermore, 5b occupied the active site of PPAR-α showing polar interaction with His 440 and it was stabilized by hydrophobic interactions. In addition, 5b was able to remove cholesterol from cells around 20% cholesterol efflux led by HDL and 20.8% by apoA1 in macrophages bone marrow line. Compound 5b did not show significant values in the differentiation of adipocytes. Then, there is no accumulation of TG in adipose tissue, which is the main adverse effect of thiazolidinediones. / Doutor

Made available in DSpace on 2014-06-11T19:25:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-08-22Bitstream added on 2014-06-13T19:32:57Z : No. of bitstreams: 1 nunes_gfs_me_botfm.pdf: 1318917 bytes, checksum: a34c3fe0f8fe7a3e6c54514e9f34ed3b (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As doenças cardiovasculares são atualmente responsáveis por 32% do total de óbitos no Brasil e a hipertensão arterial sistêmica (HAS) é considerada um dos principais fatores de risco. A HAS raramente ocorre de forma isolada e geralmente está associada a outros fatores de risco como a diabetes mellitus, obesidade e o sedentarismo, que são potencialmente modificáveis com a atividade física. A associação dos fatores de risco, sedentarismo e baixo nível de atividade física atuam negativamente na qualidade de vida dos pacientes. Avaliar a associação entre o nível de atividade física e fatores de risco cardiovascular, qualidade de vida e comorbidades dos pacientes do Programa Hiperdia em Agudos. Foram avaliados 200 pacientes hipertensos e diabéticos. Os participantes responderam o Questionário Internacional de Atividade Física, que avalia o nível de atividade física e o SF-36, que avalia a qualidade de vida. Os pacientes foram divididos em quatro grupos conforme a classificação do nível de atividade física (G0: sedentários/GI: irregularmente ativos B/GII: irregularmente ativos A/GIII: ativos). Os grupos foram semelhantes quanto à raça, aspectos sociais, exames físicos, antecedentes de hipertensão, dor, tabagismo e etilismo. Apresentaram diferença estatisticamente significante quanto à idade, sexo, profissão, passado de acidente vascular encefálico, internação por insuficiência cardíaca, diabetes mellitus, adesão aos medicamentos e HDL. Em relação às dimensões da qualidade de vida, os grupos se diferenciaram quanto à capacidade funcional, limitações físicas e estado geral de saúde. Houve associação positiva entre o nível de atividade física e qualidade de vida, mesmo ajustando-se para as variáveis de confusão. O maior nível de atividade física associou-se positivamente a melhor qualidade de vida... / Cardiovascular diseases are currently responsible for 32% of total deaths in Brazil and hypertension (HAS) is considered one of the main risk factors. The HAS rarely occurs in isolation and is usually associated with other risk factors such as diabetes mellitus, obesity and physical inactivity, which are potentially modifiable with physical activity. The association of risk factors, physical inactivity and low level of physical activity act negatively on the quality of life of patients. To evaluate the association between physical activity level and cardiovascular risk factors, quality of life and patient’s comorbidities of Hiper-day Program in Agudos. We evaluated 200 diabetic and hypertensive’s patients. Participants responded to the international physical activity questionnaire, which assesses the level of physical activity and the SF-36, which evaluates the quality of life. The patients were divided into four groups according to the classification of the level of physical activity (G0: sedentary/GI: irregularly active B/GII: irregularly active A /GIII active). The groups were similar regarding race, social aspects, physical exam, high blood pressure in the past, pain, smoking and alcoholism. Showed statistically significant difference as to age, sex, profession, history of stroke, hospitalization for heart failure, diabetes mellitus, adherence to medications and HDL. Related to the dimensions of quality of life, the groups were different with regard to functional capacity, physical limitations and general state of health. There was positivity association between the level of physical activity and quality of life, even adjusting for confounding variables. the highest level of physical activity was associated with the best quality of life, even after excluding the patients... (Complete abstract click electronic access below)

Orientador: Roberto da Silva Franco / Coorientador: Luís Cuadrado Martin / Banca: Roberto Jorge da Silva Franco / Resumo: As doenças cardiovasculares são atualmente responsáveis por 32% do total de óbitos no Brasil e a hipertensão arterial sistêmica (HAS) é considerada um dos principais fatores de risco. A HAS raramente ocorre de forma isolada e geralmente está associada a outros fatores de risco como a diabetes mellitus, obesidade e o sedentarismo, que são potencialmente modificáveis com a atividade física. A associação dos fatores de risco, sedentarismo e baixo nível de atividade física atuam negativamente na qualidade de vida dos pacientes. Avaliar a associação entre o nível de atividade física e fatores de risco cardiovascular, qualidade de vida e comorbidades dos pacientes do Programa Hiperdia em Agudos. Foram avaliados 200 pacientes hipertensos e diabéticos. Os participantes responderam o Questionário Internacional de Atividade Física, que avalia o nível de atividade física e o SF-36, que avalia a qualidade de vida. Os pacientes foram divididos em quatro grupos conforme a classificação do nível de atividade física (G0: sedentários/GI: irregularmente ativos B/GII: irregularmente ativos A/GIII: ativos). Os grupos foram semelhantes quanto à raça, aspectos sociais, exames físicos, antecedentes de hipertensão, dor, tabagismo e etilismo. Apresentaram diferença estatisticamente significante quanto à idade, sexo, profissão, passado de acidente vascular encefálico, internação por insuficiência cardíaca, diabetes mellitus, adesão aos medicamentos e HDL. Em relação às dimensões da qualidade de vida, os grupos se diferenciaram quanto à capacidade funcional, limitações físicas e estado geral de saúde. Houve associação positiva entre o nível de atividade física e qualidade de vida, mesmo ajustando-se para as variáveis de confusão. O maior nível de atividade física associou-se positivamente a melhor qualidade de vida... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Cardiovascular diseases are currently responsible for 32% of total deaths in Brazil and hypertension (HAS) is considered one of the main risk factors. The HAS rarely occurs in isolation and is usually associated with other risk factors such as diabetes mellitus, obesity and physical inactivity, which are potentially modifiable with physical activity. The association of risk factors, physical inactivity and low level of physical activity act negatively on the quality of life of patients. To evaluate the association between physical activity level and cardiovascular risk factors, quality of life and patient's comorbidities of Hiper-day Program in Agudos. We evaluated 200 diabetic and hypertensive's patients. Participants responded to the international physical activity questionnaire, which assesses the level of physical activity and the SF-36, which evaluates the quality of life. The patients were divided into four groups according to the classification of the level of physical activity (G0: sedentary/GI: irregularly active B/GII: irregularly active A /GIII active). The groups were similar regarding race, social aspects, physical exam, high blood pressure in the past, pain, smoking and alcoholism. Showed statistically significant difference as to age, sex, profession, history of stroke, hospitalization for heart failure, diabetes mellitus, adherence to medications and HDL. Related to the dimensions of quality of life, the groups were different with regard to functional capacity, physical limitations and general state of health. There was positivity association between the level of physical activity and quality of life, even adjusting for confounding variables. the highest level of physical activity was associated with the best quality of life, even after excluding the patients... (Complete abstract click electronic access below) / Mestre

This study examined the relationship between physical health, social support, and depression in a married, middle-aged/older adult sample in which at least one partner has heart disease. The data was obtained from a national longitudinal study the Health and Retirement Survey (HRS) and is composed of selected respondents and their spouses. The HRS Wave 1 data that was used for these analyses was collected in 1992 and 1993. This study tested a stress buffer model predicting the relationship between physical health, social support, and depression. For study inclusion, participants must have been diagnosed with cardiovascular disease and received treatment in the last year. A heart disease construct was developed by calculating the level of disease by the number of conditions and medical treatments received within the last year. A second health category for other chronic health conditions included diabetes, arthritis, cancer, and chronic pain. These constructs were combined into a total disease construct, which provided a broad measure of health problems typical of an older adult population. Social support was determined by respondents' satisfaction with friends, neighbors, family, their marriage, and enjoyable time spent with their spouse. Social support was subdivided into two constructs separating spousal support from social support sources outside the marriage. The Center for Epidemiological Studies Depression short-form (CES-D) calculated depression scores. Findings support a stress-buffering model among older married adults with chronic diseases. Hierarchical multiple regressions found the following main effects predicted Depression: Total Disease (Beta=. 03, p<. 000), Exercise (Beta=-.11, p<. 000), Smoking (Beta=. 04, p<. 001), General Support (Beta=-.21, p<. 000), Spousal Support (Beta=-.19, p<. 000). The Total Diseases by Spousal Support interaction was a significant predictor of Depression for men and women (Beta= -.04, p<. 000) and Total Disease by Spousal Support was also a significant predictor for men and women (Beta=-.03, plt;. 000). For men with Heart Disease, Total Disease by Spousal Support was a stronger predictor (Beta=-.03) than it was for women with Heart Disease (Beta=-.10). These results may partially explain gender differences in heart disease patients and suggests several psychological interventions that could be beneficial.

Thesis (Ph. D. (Medical Sciences)) -- University of Limpopo, 2016 / Refer to document / The Belgium Development Co-operation through VLIR-UOS, The University of Limpopo,and The Flemish Universities