Darbo tikslas – įvertinti nuovargio ir pusės metų trukmės sveikatą stiprinančių pratybų įtaką širdies ir kraujagyslių sistemos reakcijai į dozuoto aerobinio krūvio mėginį. Darbo uždaviniai: 1 – Nustatyti ištvermės lavinimo pratybų įtaką elektrokardiogramos rodiklių kaitai. 2 – Palyginti EKG rodiklių kaitą prieš pratybas ir po jų, atliekant tris dozuoto intensyvumo fizinius krūvius. 3 – Nustatyti pusės metų trukmės sveikatą stiprinančių pratybų įtaką širdies ir kraujagyslių sistemos funkcinės būklės rodikliams. ŠKS funkcinių rodiklių registravimui atliekant krūvį ir atsigavimo metu naudojome kompiuterinę EKG analizės sistemą „Kaunas – Krūvis“, kuri apskaičiuodavo ir pateikdavo visų 12–koje EKG atvadų RR ir JT intervalo reikšmių vidurkius. Arterinį kraujo spaudimą (AKS) matavome Korotkovo metodu kairės rankos žasto srityje: sistolinį (S) ir diastolinį (D). Buvo registruojama prieš mėginį, iš karto po jo, baigiantis pirmajai ir antrajai atsigavimo minutėms. Miokardo depoliarizacijos ir repoliarizacijos procesų sąsajos kaitą vertinime pagal EKG QRS ir JTC intervalų kaitą, pasinaudodami matricinės analizės metodika. Pirmajame tyrime dalyvavo 12 vidutinių nuotolių bėgikų. Buvo vertinama tolygaus kroso įtaka širdies ir kraujagyslių sistemos (ŠKS) funkcinei būklei. Antrajame tyrime dalyvavo 16 tiriamųjų. Visi tiriamieji yra sveiki asmenys, nesiskundžiantys širdies ir kraujagyslių sistemos funkcija. Tiriamieji dalyvavo reguliariose sveikatos stiprinimo pratybose tris kartus... [toliau žr. visą tekstą] / The aim of this study was to evaluate the influence of tiredness and health-strengthening exercises on the reaction of cardiovascular system to the repeated measured aerobic loads. The next task was formulated: 1 – to assess the influence of endurance training session to indices of ECG. 2 – to compare the Dynamics OFM ECG indices before ant after exercise training session while performing 3 dosed exercise tests. 3 – To assess the influence of half-year health promotion training on functional indices of cardiovascular system. The computerized system „Kaunas- load“ was used for registration and analysis of 12-leads ECG: RR, JT intervals and their ratio, ST-segment depression. Arterial blood pressure (systolic and diastolic) was measured by Korotkov method. The concatenation between the depolarization and repolarization processes in myocardium by using the ECG indices QRS and JTC was assessed by method matrix analysis. Twelve middle distance runners participated in the first research. The effect of the even cross-country run on the functional state of cardiovascular system (CVS) was assessed. 16 surveyed persons in the second survey. All surveyed are conditionally healthy persons, not having any complains regarding function of cardiovascular system. The participant of this study take part in the regular health promotion groups by exercising three times per week, with the duration of an hour and a half at the gym, including frequent application of northern walking with sticks in... [to full text]

Atliekant fizinius krūvius pirmiausia aktyvėja širdies ir kraujagyslių sistemos funkcija, tačiau visuomet yra funkcinių galimybių ribos, o tai yra fizinį darbingumą limituojantis veiksnys. Darbo tikslas – Nustatyti širdies funkcinių išeminių reiškinių kaitos ypatybes atliekant pakopomis didėjantį krūvį veloergometru, įvertinti širdies funkcinių rodiklių kaitą dėl intervaliniu treniruotės metodu atliktų pratybų. Uždaviniai: 1 – palyginti nesportuojančiųjų ir ištvermę lavinančių sportininkų širdies susitraukimo dažnio kaitą atliekant pakopomis didėjantį krūvį veloergometru; 2 – nustatyti funkcinių išeminių reiškinių miokarde kaitos ypatybes nesportuojančiųjų ir ištvermę lavinančių sportininkų grupėse; 3 – nustatyti širdies funkcinių rodiklių kaitą dėl intervaliniu treniruotės metodu atliktų pratybų. Metodika. Buvo tirti 7 ištvermės rungčių atstovai lengvaatlečiai ir 16 nesportuojančių asmenų. Buvo taikytas provokacinio kas minutę didėjančio krūvio protokolas didinant krūvį po 50W. Fizinio krūvio ir atsigavimo metu buvo registruojama 12 standartinių derivacijų EKG. EKG registruoti naudota Kauno medicinos universitete Kardiologijos institute sukurta kompiuterinė EKG registravimo ir analizės sistema „Kaunas-krūvis“. EKG buvo registruojama prieš krūvį, kas minutę – kiekvienos krūvio pakopos pabaigoje ir pirmąsias tris atsigavimo minutes. Vertinimui buvo pasirinkti patys reikšmingiausi laikiniai EKG parametrai: ŠSD, JT intervalas, JT/RR, ST- segmento depresija ir QRS komplekso... [toliau žr. visą tekstą] / At onset of exercising cardiovascular system activates a lot of mechanism, bet there exist a limit to what any body function could be activated. The factors limiting cardiovascular performance was objective in this study. The aim of the study was to define the peculiarities in changes of functional ischemic episodes while performing incremental exercise stress and to assess cardiac functional parameters change on the interval training method to carry out the exercise. Objectives: 1 – to compare the Dynamics of heart rate changes while performing in steps increasing workload by bicycle ergometer; 2 – to determine the peculiarities in occuring of functional ischemic episodes in myocardium in endurance trained athletes and non-sportsman cohorts; 3 – to determine the dynamics of cardiovascular functional indices under influence of interval training session. Methods. The seven endurance athletes and 16 endurance trained persons take part in the study. Was applied every minute provocative increasing in workload by 50W every one minute. The 12-lead standard leads of ECG was recordered by use the computerised system "Kaunas-load" developed in University of Medicine, Institute of Cardiology. ECG was recorded before the charge, at the end of every minute of the workload step and at the end of the first three minutes of recovery. The most significant parameters of ECG were taken for analysis: heart rate, JT interval, JT/RR, ST-segment depression and QRS complex duration. Results. The... [to full text]

In 1981, no representative study of the medical and social conditions among elderly persons in northern Scandinavia was performed. Nor was there such a study in a smaller Swedish town than Gothenburg. This study was initiated to fill that knowledge gap. The aim of the study was to evaluate gender and age differences in medical and social conditions among elderly people, including the reference intervals of clinical chemistry parameters and characteristic features of the 24-hour electrocardiogram (ECG) in healthy elderly. By way of longitudinal design with birth cohorts stratified by gender, it was assumed that the effects could be demonstrated. Also, the death risk of various social and medical variables was to be assessed. During the study period 1981 to 1990, the subjects were between 70 and 88 years of age. The proportion of persons living in private housing decreased from almost all at the age of 70 to slightly more than half at 88 years of age. The number of socially active persons decreased considerably during the period. The need of help increased from almost none to 60 % of the persons. The proportions of persons with normal sight and hearing decreased from two thirds to around one tenth The most frequent symptoms were general tiredness, pains, dyspnoea, constipation and dryness of the mouth. Cardiovascular diseases were the most frequent. Hypertensive disease became less, and congestive heart failure more frequent with age. The frequency of dementia increased steeply among the oldest persons; at 88 years of age, 40 % were demented. Drug consumption increased; the oldest persons in both age cohorts used 5 different drugs or more per person regularly. The consumption increase was mainly due to the increasing morbidity accompanying age. The most common drugs taken were cardiovascular preparations, psychoactive agents, drugs to alleviate gastrointestinal symptoms, and analgesics. Drug intake and symptom prevalence were generally higher in women, despite the fact that there was no gender difference in the number of diseases. The reference intervals of many blood components in healthy elderly were shown to be broader than those of younger persons. The intervals of P(lasma)-folate and P- potassium were on a lower and those of the erythrocyte sedimentation rate, P-creati- nine and, in women, S(erum)-cholesterol, were on a higher level than among younger persons. Several features of the 24-hour ECG, e.g. the number of episodes of supraventricular tachycardia as well as supraventricular and ventricular premature beats in healthy elderly were more frequent than among younger persons. Between 80 and 88 years of age, many functions crucial to the chances of living a rich and vital life were found deteriorating in the elderly persons. High age, male sex, dementia, congestive heart failure, and low values of S-creatinine were shown to be independent factors connected with an increased death risk. / <p>S. 1-112: sammanfattning, s. 115-177: 5 uppsatser</p> / digitalisering@umu.se

A insuficiência cardíaca é a doença crônica com maior impacto na sobrevida e qualidade de vida dos pacientes. Apesar do constante desenvolvimento de novas estratégias de tratamento, esta doença continua atingindo altos índices de mortalidade. O coração adulto tem capacidade de regeneração limitada e há grande evidência experimental de que os transplantes de células-tronco poderiam ser uma abordagem eficiente na recuperação do miocárdio lesado. Contudo, a maioria dos estudos são realizados em cardiomiopatias isquêmicas, existindo poucos estudos na cardiomiopatia dilatada (CMD). Em função disto, este trabalho foi realizado com o objetivo de avaliar a regeneração do miocárdio em coelhos com CMD induzida pela doxorrubicina, por meio do uso de células-tronco mesenquimais (MSC) obtidas de tecido adiposo, associadas ou não com plasma rico em plaquetas (PRP). Foram utilizadas 40 coelhas, Nova Zelândia, e um coelho macho doador das MSCs derivadas do tecido adiposo. As coelhas foram divididas em dois grupos: CMD induzida pela doxorrubicina e o grupo saudável. Cada grupo foi subdividido conforme o tratamento recebido: solução fisiológica, MCSs, PRP e MSCs associadas ao PRP. Os subgrupos receberam o tratamento por injeção diretamente no miocárdio no ventrículo esquerdo mediante toracoscopia vídeo assistida. Os coelhos foram avaliados por exames de ecocardiograma, eletrocardiograma, troponina I, no dia da chegada, após a indução da CMD e 15 dias após o recebimento das terapias. Nesta última avaliação, foi realizada a eutanásia e coletado o coração para análise histológica. Foi observado que após a indução, a troponina I se elevou, o segmento QRS visto no eletrocardiograma, aumentou e, no ecocardiograma, as frações de ejeção (FE) e encurtamento (FS) diminuíram e o diâmetro sistólico do ventrículo esquerdo (VEs) aumentou, em todos os animais avaliados. Após os tratamentos, o subgrupo MSCs obtiveram os melhores resultados em todas as análises citadas. Houve menor elevação da troponina I, o segmento QRS diminuiu, as FS e FE aumentaram e o VEs diminuiu. No exame histopatógico, analisado pela coloração de hematoxicilina-eosina, constatou-se que o subgrupo MSCs apresentou menos lesões, e nos subgrupos MSCs associadas com PRP, solução fisiológica e PRP as lesões aumentaram gradualmente, respectivamente. Os resultados sugerem que o uso das MSCs melhoraram a função cardíaca em coelhos com cardiomiopatia dilatada e que há necessidade de mais estudos no uso de PRP no miocárdio. / Heart failure is a chronic disease with major impact on survival and quality of patient’s life. Despite the constant development of new treatment strategies, this disease still affects high mortality rates. The adult heart has limited ability to regenerate and there is experimental evidence that large transplants of stem cells could be an effective approach in the recovery of injured myocardium. However, most studies are performed in ischemic cardiomyopathy, there are few studies in dilated cardiomyopathy. Because of this, this study aimed at evaluating the regeneration of the myocardium in rabbits with dilated cardiomyopathy induced by doxorubicin through the use of mesenchymal stem cell (MSC) derived from adipose tissue, associated or not with platelet-rich plasma (PRP). 40 New Zealand rabbits were utilized and a male rabbit donor MSCs derived from adipose tissue. The rabbits were divided into two groups: dilated cardiomyopathy doxorubicin-induced and the healthy group. Each group was divided according to treatment received: saline, MSCs, PRP and MSCs associated with PRP. The subgroups receiving treatment through an injection directly into the myocardium of the left ventricle through video-assisted thoracoscopy. The rabbits were evaluated by echocardiogram, electrocardiogram, troponin I, on the day of arrival, after induction of dilated cardiomyopathy and 15 days after receipt of therapies. This last evaluation, euthanasia was performed and the hearts collected for histological analysis. It was observed that after induction the troponin I increased, the QRS segment, seen on the electrocardiogram, increased, and, in echocardiography, the ejection and shortening fractions decreased, and left ventricular systolic diameter increased in all animals evaluated. After treatments, the subgroup MSCs have the best results in all tests cited. There was a lower elevation of troponin I, decreased QRS segment, the ejection and shortening fractions increased and left ventricular systolic diameter decreased. On examination histologic, analyzed by hematoxylin-eosin staining, the subgroup found that MSCs had fewer injuries, and in the subgroups MSCs associated with PRP, PRP and saline lesions gradually increased, respectively. The results suggest that the use of MSCs improved cardiac function in rabbits with dilated cardiomyopathy and that there is need for more studies on the use of PRP in the myocardium.

Orientador: Simone Biagio Chiacchio / Resumo: Atualmente, observa-se uma maior necessidade de uma assistência adequada tanto no período pré-natal, quanto neonatal, com a finalidade de redução da mortalidade de recém-nascidos, principalmente de animais com elevado valor genético e zootécnico, como os jumentos da raça Pêga. Desta forma, o presente estudo teve por objetivo, descrever os parâmetros clínicos, eletrocardiográficos (ECG) e índices de variabilidade da frequência cardíaca (VFC) em jumentas (no período pré e pós-parto), fetos (35 dias antes do parto) e na fase neonatal, até os 35 dias de idade. Para tal, utilizou-se 10 jumentas clinicamente saudáveis, no terço final de gestação e pós parto, 10 fetos e 10 neonatos pertencentes à raça Pêga, cujo os exames foram realizados ao 35º, 28º, 21º, 14º, 7º e 1º dia antes do parto (jumentas prenhes e fetos) e ao 1º, 7º, 14º, 21º, 28º e 35º dia após o parto para jumentas no período pós-parto e neonatos. Os índices da VFC em jumentas no período pós parto, diferiram significativamente (p<0,05) dentre os momentos de análise, onde o SDNN (ms) variou no primeiro dia após o parto, a RMSSD (ms) no primeiro e 14º dia após o parto, e BF (nu) e a relação BF/AF (nu) no primeiro dia após o parto. As jumentas apresentaram FC constante nos momentos analisados, enquanto que no período pós-parto, apresentaram redução, ambos não significativos. No traçado eletrocardiográfico das jumentas, observou-se significância (p<0,05) na FC (bpm), PR (ms), QT (ms), QTc (ms), T (ms) e R (mV) na derivação b... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Currently, there is a greater need for adequate prenatal and neonatal care in order to reduce the mortality of newborns, especially animals with high genetic and zootechnical value, such as Pêga donkeys. The aim of the present study was to describe the clinical parameters, electrocardiographic (ECG) and heart rate variability (HRV) indices in donkeys (pre and postpartum), fetuses (35 days before delivery) and in the neonatal phase, up to 35 days of age. For this, 10 clinically healthy donkeys were used, in the final third of gestation and postpartum, 10 fetuses and 10 neonates belonging to the Pêga breed, whose examinations were performed at 35º, 28º, 21º, 14º, 7º and 1º day before (pregnant donkeys and fetuses) and at the 1st, 7th, 14th, 21st, 28th and 35th days after delivery for postpartum donkeys and neonates. The HRV indices in donkeys in the postpartum period differed significantly (p <0.05) between the moments of analysis, where the SDNN (ms) ranged on the first day after delivery, the SDSS (ms) on the first and 14th day after delivery, and BF (nude) and the BF / AF ratio (nude) on the first day postpartum. The asses presented constant HR at the analyzed moments, while in the postpartum period, they presented reduction, both of which were not significant. In the electrocardiographic tracing of donkeys, significance was found (p <0.05) for HR (bpm), PR (ms), QT (ms), QTc (ms), T (ms) and R (mV) apex. And in the frontal plane the variables FC (bpm), PR (ms), QT (ms) and ... (Complete abstract click electronic access below) / Doutor

A insuficiência cardíaca é a doença crônica com maior impacto na sobrevida e qualidade de vida dos pacientes. Apesar do constante desenvolvimento de novas estratégias de tratamento, esta doença continua atingindo altos índices de mortalidade. O coração adulto tem capacidade de regeneração limitada e há grande evidência experimental de que os transplantes de células-tronco poderiam ser uma abordagem eficiente na recuperação do miocárdio lesado. Contudo, a maioria dos estudos são realizados em cardiomiopatias isquêmicas, existindo poucos estudos na cardiomiopatia dilatada (CMD). Em função disto, este trabalho foi realizado com o objetivo de avaliar a regeneração do miocárdio em coelhos com CMD induzida pela doxorrubicina, por meio do uso de células-tronco mesenquimais (MSC) obtidas de tecido adiposo, associadas ou não com plasma rico em plaquetas (PRP). Foram utilizadas 40 coelhas, Nova Zelândia, e um coelho macho doador das MSCs derivadas do tecido adiposo. As coelhas foram divididas em dois grupos: CMD induzida pela doxorrubicina e o grupo saudável. Cada grupo foi subdividido conforme o tratamento recebido: solução fisiológica, MCSs, PRP e MSCs associadas ao PRP. Os subgrupos receberam o tratamento por injeção diretamente no miocárdio no ventrículo esquerdo mediante toracoscopia vídeo assistida. Os coelhos foram avaliados por exames de ecocardiograma, eletrocardiograma, troponina I, no dia da chegada, após a indução da CMD e 15 dias após o recebimento das terapias. Nesta última avaliação, foi realizada a eutanásia e coletado o coração para análise histológica. Foi observado que após a indução, a troponina I se elevou, o segmento QRS visto no eletrocardiograma, aumentou e, no ecocardiograma, as frações de ejeção (FE) e encurtamento (FS) diminuíram e o diâmetro sistólico do ventrículo esquerdo (VEs) aumentou, em todos os animais avaliados. Após os tratamentos, o subgrupo MSCs obtiveram os melhores resultados em todas as análises citadas. Houve menor elevação da troponina I, o segmento QRS diminuiu, as FS e FE aumentaram e o VEs diminuiu. No exame histopatógico, analisado pela coloração de hematoxicilina-eosina, constatou-se que o subgrupo MSCs apresentou menos lesões, e nos subgrupos MSCs associadas com PRP, solução fisiológica e PRP as lesões aumentaram gradualmente, respectivamente. Os resultados sugerem que o uso das MSCs melhoraram a função cardíaca em coelhos com cardiomiopatia dilatada e que há necessidade de mais estudos no uso de PRP no miocárdio. / Heart failure is a chronic disease with major impact on survival and quality of patient’s life. Despite the constant development of new treatment strategies, this disease still affects high mortality rates. The adult heart has limited ability to regenerate and there is experimental evidence that large transplants of stem cells could be an effective approach in the recovery of injured myocardium. However, most studies are performed in ischemic cardiomyopathy, there are few studies in dilated cardiomyopathy. Because of this, this study aimed at evaluating the regeneration of the myocardium in rabbits with dilated cardiomyopathy induced by doxorubicin through the use of mesenchymal stem cell (MSC) derived from adipose tissue, associated or not with platelet-rich plasma (PRP). 40 New Zealand rabbits were utilized and a male rabbit donor MSCs derived from adipose tissue. The rabbits were divided into two groups: dilated cardiomyopathy doxorubicin-induced and the healthy group. Each group was divided according to treatment received: saline, MSCs, PRP and MSCs associated with PRP. The subgroups receiving treatment through an injection directly into the myocardium of the left ventricle through video-assisted thoracoscopy. The rabbits were evaluated by echocardiogram, electrocardiogram, troponin I, on the day of arrival, after induction of dilated cardiomyopathy and 15 days after receipt of therapies. This last evaluation, euthanasia was performed and the hearts collected for histological analysis. It was observed that after induction the troponin I increased, the QRS segment, seen on the electrocardiogram, increased, and, in echocardiography, the ejection and shortening fractions decreased, and left ventricular systolic diameter increased in all animals evaluated. After treatments, the subgroup MSCs have the best results in all tests cited. There was a lower elevation of troponin I, decreased QRS segment, the ejection and shortening fractions increased and left ventricular systolic diameter decreased. On examination histologic, analyzed by hematoxylin-eosin staining, the subgroup found that MSCs had fewer injuries, and in the subgroups MSCs associated with PRP, PRP and saline lesions gradually increased, respectively. The results suggest that the use of MSCs improved cardiac function in rabbits with dilated cardiomyopathy and that there is need for more studies on the use of PRP in the myocardium.

abstract: Adaptive processing and classification of electrocardiogram (ECG) signals are important in eliminating the strenuous process of manually annotating ECG recordings for clinical use. Such algorithms require robust models whose parameters can adequately describe the ECG signals. Although different dynamic statistical models describing ECG signals currently exist, they depend considerably on a priori information and user-specified model parameters. Also, ECG beat morphologies, which vary greatly across patients and disease states, cannot be uniquely characterized by a single model. In this work, sequential Bayesian based methods are used to appropriately model and adaptively select the corresponding model parameters of ECG signals. An adaptive framework based on a sequential Bayesian tracking method is proposed to adaptively select the cardiac parameters that minimize the estimation error, thus precluding the need for pre-processing. Simulations using real ECG data from the online Physionet database demonstrate the improvement in performance of the proposed algorithm in accurately estimating critical heart disease parameters. In addition, two new approaches to ECG modeling are presented using the interacting multiple model and the sequential Markov chain Monte Carlo technique with adaptive model selection. Both these methods can adaptively choose between different models for various ECG beat morphologies without requiring prior ECG information, as demonstrated by using real ECG signals. A supervised Bayesian maximum-likelihood (ML) based classifier uses the estimated model parameters to classify different types of cardiac arrhythmias. However, the non-availability of sufficient amounts of representative training data and the large inter-patient variability pose a challenge to the existing supervised learning algorithms, resulting in a poor classification performance. In addition, recently developed unsupervised learning methods require a priori knowledge on the number of diseases to cluster the ECG data, which often evolves over time. In order to address these issues, an adaptive learning ECG classification method that uses Dirichlet process Gaussian mixture models is proposed. This approach does not place any restriction on the number of disease classes, nor does it require any training data. This algorithm is adapted to be patient-specific by labeling or identifying the generated mixtures using the Bayesian ML method, assuming the availability of labeled training data. / Dissertation/Thesis / Ph.D. Electrical Engineering 2012

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2017-04-06T14:46:22Z No. of bitstreams: 1 PDF - Yang Medeiros Cardoso.pdf: 13425632 bytes, checksum: 72b354ab3844ba38f7747c1b7a2f9948 (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2017-07-20T11:33:31Z (GMT) No. of bitstreams: 1 PDF - Yang Medeiros Cardoso.pdf: 13425632 bytes, checksum: 72b354ab3844ba38f7747c1b7a2f9948 (MD5) / Made available in DSpace on 2017-07-20T11:33:31Z (GMT). No. of bitstreams: 1 PDF - Yang Medeiros Cardoso.pdf: 13425632 bytes, checksum: 72b354ab3844ba38f7747c1b7a2f9948 (MD5) Previous issue date: 2016-12-19 / Cardiac arrest is one of the most common causes of death in the world. Among the people who can be saved from this condition, most are in Ventricular Fibrillation or Pulseless Ventricular Tachycardia. Electrical defibrillation is the simplest and most important therapy in the treatment of these patients. The Automatic External Defibrillator is the device that can be used by laypersons with a minimum of training to perform defibrillation, reducing the waiting time of the first pulse application, which directly influenciate the success rate of this therapy. This work describes a way of using the Extended Kalman Filter (FKE) to correct ECG signals used by an Automatic External Defibrillator in the decision making of the defibrillatory pulse application in patients, as well as a proposed Defibrillator model describing the aspects of its operation. / A parada cardíaca é uma das causas mais comuns de morte no mundo. Dentre as pessoas que podem ser salvas dessa condição, a maioria encontra-se em Fibrilação Ventricular ou Taquicardia Ventricular sem pulso. A Desfibrilação Elétrica é a terapia mais simples e importante no tratamento desses pacientes. O Desfibrilador Externo Automático é o aparelho que pode ser utilizado por leigos com um mínimo de treinamento para efetuar a Desfibrilação, diminuindo o tempo de espera da aplicação do primeiro pulso, o que influencia diretamente na taxa de sucesso dessa terapia. Neste trabalho descreve-se uma forma de utilização do Filtro de Kalman Estendido (FKE) para corrigir sinais de ECG utilizados por um Desfibrilador Externo Automático na tomada de decisão da aplicação do pulso desfibrilatório em pacientes, bem como uma proposta modelo de Desfibrilador que descreve os aspectos principais do seu funcionamento.

nÃo hà / A tarefa mais importante em processamento de sinais de eletrocardiograma (ECG) à a determinaÃÃo exata do complexo de QRS, em particular, a detecÃÃo dos picos de onda R atravÃs de sistemas e anÃlises computadorizadas. à essencial, especialmente, para uma medida correta da variabilidade do ritmo cardÃaco (HRV). Um grande obstÃculo a ser superado para uma detecÃÃo confiÃvel à a sensibilidade do eletrocardiograma a diversas fontes de distÃrbio, tais como, a interferÃncia à rede elÃtrica, os artefatos do movimento, flutuaÃÃo da linha base e o ruÃdo dos mÃsculos. Este trabalho utiliza as propriedades matemÃticas da transformaÃÃo de Hilbert sobre wavelets para desenvolver um novo algoritmo capaz de diferenciar as ondas R das demais (P, Q, S, T e U) e facilitar a detecÃÃo dos complexos QRS. Uma taxa de detecÃÃo do complexo QRS de 99,92% à alcanÃada para a base de dados de arritmias do MIT-BIH. A tolerÃncia a ruÃdo do mÃtodo proposto foi tambÃm testada usando os registros padrÃo da base de dados MIT-BIH Noise Stress Test. A taxa da detecÃÃo do detector ficou aproximadamente 99,35% mesmo para as relaÃÃes sinal-ruÃdo (SNR) tÃo baixo quanto 6dB. / The most important task in the ECG signal processing is the accurate determina-tion of QRS complex, in particular, accurate detection of the R wave peaks, is essential in computer-based ECG analysis especially for a correct measurement of Heart Rate Variability (HRV). A great hurdle to be overcome in reliable detection is the sensibility of the electrocar-diogram to several disturbance sources such as powering source interference, movement arti-facts, baseline wandering and muscle noise. This study uses the Hilbert Transform pairs of wavelet bases for QRS detection. From the properties of these mathematical tools it was pos-sible to develop an algorithm which is able to differentiate the R waves from the others (P, Q, S, T and U waves).The performance of the algorithm was verified using the records MIT-BIH arrhythmia and normal databases. A QRS detection rate of 99.92% was achieved against MIT-BIH arrhythmia database. The noise tolerance of the proposed method was also tested using standard records from the MIT-BIH Noise Stress Test Database. The detection rate of the detector remains about 99.35% even for signal-to-noise ratios (SNR) as low as 6dB.

A insuficiência cardíaca é a doença crônica com maior impacto na sobrevida e qualidade de vida dos pacientes. Apesar do constante desenvolvimento de novas estratégias de tratamento, esta doença continua atingindo altos índices de mortalidade. O coração adulto tem capacidade de regeneração limitada e há grande evidência experimental de que os transplantes de células-tronco poderiam ser uma abordagem eficiente na recuperação do miocárdio lesado. Contudo, a maioria dos estudos são realizados em cardiomiopatias isquêmicas, existindo poucos estudos na cardiomiopatia dilatada (CMD). Em função disto, este trabalho foi realizado com o objetivo de avaliar a regeneração do miocárdio em coelhos com CMD induzida pela doxorrubicina, por meio do uso de células-tronco mesenquimais (MSC) obtidas de tecido adiposo, associadas ou não com plasma rico em plaquetas (PRP). Foram utilizadas 40 coelhas, Nova Zelândia, e um coelho macho doador das MSCs derivadas do tecido adiposo. As coelhas foram divididas em dois grupos: CMD induzida pela doxorrubicina e o grupo saudável. Cada grupo foi subdividido conforme o tratamento recebido: solução fisiológica, MCSs, PRP e MSCs associadas ao PRP. Os subgrupos receberam o tratamento por injeção diretamente no miocárdio no ventrículo esquerdo mediante toracoscopia vídeo assistida. Os coelhos foram avaliados por exames de ecocardiograma, eletrocardiograma, troponina I, no dia da chegada, após a indução da CMD e 15 dias após o recebimento das terapias. Nesta última avaliação, foi realizada a eutanásia e coletado o coração para análise histológica. Foi observado que após a indução, a troponina I se elevou, o segmento QRS visto no eletrocardiograma, aumentou e, no ecocardiograma, as frações de ejeção (FE) e encurtamento (FS) diminuíram e o diâmetro sistólico do ventrículo esquerdo (VEs) aumentou, em todos os animais avaliados. Após os tratamentos, o subgrupo MSCs obtiveram os melhores resultados em todas as análises citadas. Houve menor elevação da troponina I, o segmento QRS diminuiu, as FS e FE aumentaram e o VEs diminuiu. No exame histopatógico, analisado pela coloração de hematoxicilina-eosina, constatou-se que o subgrupo MSCs apresentou menos lesões, e nos subgrupos MSCs associadas com PRP, solução fisiológica e PRP as lesões aumentaram gradualmente, respectivamente. Os resultados sugerem que o uso das MSCs melhoraram a função cardíaca em coelhos com cardiomiopatia dilatada e que há necessidade de mais estudos no uso de PRP no miocárdio. / Heart failure is a chronic disease with major impact on survival and quality of patient’s life. Despite the constant development of new treatment strategies, this disease still affects high mortality rates. The adult heart has limited ability to regenerate and there is experimental evidence that large transplants of stem cells could be an effective approach in the recovery of injured myocardium. However, most studies are performed in ischemic cardiomyopathy, there are few studies in dilated cardiomyopathy. Because of this, this study aimed at evaluating the regeneration of the myocardium in rabbits with dilated cardiomyopathy induced by doxorubicin through the use of mesenchymal stem cell (MSC) derived from adipose tissue, associated or not with platelet-rich plasma (PRP). 40 New Zealand rabbits were utilized and a male rabbit donor MSCs derived from adipose tissue. The rabbits were divided into two groups: dilated cardiomyopathy doxorubicin-induced and the healthy group. Each group was divided according to treatment received: saline, MSCs, PRP and MSCs associated with PRP. The subgroups receiving treatment through an injection directly into the myocardium of the left ventricle through video-assisted thoracoscopy. The rabbits were evaluated by echocardiogram, electrocardiogram, troponin I, on the day of arrival, after induction of dilated cardiomyopathy and 15 days after receipt of therapies. This last evaluation, euthanasia was performed and the hearts collected for histological analysis. It was observed that after induction the troponin I increased, the QRS segment, seen on the electrocardiogram, increased, and, in echocardiography, the ejection and shortening fractions decreased, and left ventricular systolic diameter increased in all animals evaluated. After treatments, the subgroup MSCs have the best results in all tests cited. There was a lower elevation of troponin I, decreased QRS segment, the ejection and shortening fractions increased and left ventricular systolic diameter decreased. On examination histologic, analyzed by hematoxylin-eosin staining, the subgroup found that MSCs had fewer injuries, and in the subgroups MSCs associated with PRP, PRP and saline lesions gradually increased, respectively. The results suggest that the use of MSCs improved cardiac function in rabbits with dilated cardiomyopathy and that there is need for more studies on the use of PRP in the myocardium.