Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 4 uppsatser.

Thesis (M. Med. Sc.)--University of Hong Kong, 2000. / Includes bibliographical references (leaves 53-61).

Thesis (M.S.)--Rochester Institute of Technology, 1995. / Typescript. Includes bibliographical references (leaves 63-70).

Thesis (M.Med.Sc.)--University of Hong Kong, 2000. / Includes bibliographical references (leaves 53-61). Also available in print.

Thesis (Ph.D.) - University of Queensland, 2005. / Includes bibliography.

Thesis (doctoral)--University of Lund, 1979. / Includes bibliographical references.

Made available in DSpace on 2014-06-11T19:35:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-08-27Bitstream added on 2014-06-13T19:25:00Z : No. of bitstreams: 1 silva_eg_dr_botfm.pdf: 959345 bytes, checksum: 6ef2475219297629c565247c6d4f26c2 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Financiadora de Estudos e Projetos (FINEP) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Avaliar o sistema cardiorrespiratório e sua influência na capacidade funcional de exercício em gestantes com pré-eclâmpsia. Estudo transversal com 50 gestantes portadoras de pré-eclâmpsia e 50 gestantes normotensas, estimado pelo tamanho amostral. Foi realizado espirometria, dopplerecocardiografia e teste de caminhada de seis minutos. Na análise estatística foi usado o teste t e Mann-Whitney para as variáveis com distribuição simétrica e assimétrica, respectivamente, e regressão múltipla linear. As variáveis espirométricas mostraram redução significativa da capacidade vital forçada (L) [3,35 (2,95; 3,74) ν 3,62 (3,31; 3,88) p=0,012], do volume expirado forçado no primeiro segundo (L) [2,85 (2,58; 3,16) ν 3,06 (2,83; 3,27) p=0,034] e da capacidade vital lenta (L) [3,34 (2,87; 3,91) ν 3,65 (3,32; 4,07) p=0,039], no grupo pré-eclâmpsia comparado com o grupo controle, respectivamente. Os valores do diâmetro sistólico (cm) [2,90 (2,7; 3) ν 2,7(2,65; 2,9) p=0,048] e diastólico do ventrículo esquerdo (cm) [4,8 (4,7; 5) ν 4,7 (4,55; 4,8) p=0,016], índice de massa do ventrículo esquerdo (g/m2,7) [48,65 (45,27; 52,12) ν 34,34 (31,57; 38,05) p<0,001], espessura relativa da parede ventricular esquerda (cm) [0,40 (0,38; 0,45) ν 0,34 (0,34; 0,35) p<0,001], volume sistólico (mL) [62,4 (58,57; 67,66) ν 58,19 (55,24; 63,18) p=0,014], tempo de relaxamento isovolumétrico do ventrículo esquerdo (ms) [88 (80; 92) ν 80 (76;84) p<0,001], tempo de desaceleração da onda E (ms) [196 (192;208) ν 192 (188;196) p=0,002] e onda A (cm/s) [64 (54;75) ν 49 (54;54) p<0,001] foram estatisticamente maiores no grupo préeclâmpsia que no controle. Enquanto que a razão E/A foi significativamente menor no grupo pré-eclâmpsia [1,40 (1,21; 1,63) ν 1,72 (1,55; 1,94) p<0,001]. A distância percorrida (m) no teste de caminhada de seis minutos foi significativamente menor... / To evaluate the cardio respiratory system and its influence on the functional exercise capacity of pregnant women with preeclampsia. Cross-sectional trial on 50 pregnant women with preeclampsia and 50 normotensive pregnant women, estimated by sample size. Spirometry, Doppler echocardiography and the six-minute walk test were performed. In statistical analysis, the t test and the Mann-Whitney test were respectively used for variables with symmetrical and asymmetrical distribution, in addition to multiple linear regression. Results: The spirometric variables showed significant reduction in forced vital capacity (L) 3.35 (2.95; 3.74) 3.62 (3.31; 3.88) p=0.012 , in forced expired volume in the first second (L) 2.85 (2.58; 3.16) 3.06 (2.83; 3.27) p=0.034 and in slow vital capacity (L) 3.34 (2.87; 3.91) 3.65 (3.32; 4.07) p=0.039 as compared to the control group, respectively. The values for systolic (cm) 2.90 (2.7; 3) 2.7(2.65; 2.9) p=0.048 and diastolic diameter of the left ventricle (cm) 4.8 (4.7; 5) 4.7 (4.55; 4.8) p=0.016 , mass index of the left ventricle (g/m2,7) 48.65 (45.27; 52.12) 34.34 (31.57; 38.05) p<0.001 , relative thickness of the left ventricular wall (cm) 0.40 (0.38; 0.45) 0.34 (0.34; 0.35) p<0.001 , systolic volume (mL) 62.4 (58.57; 67.66) 58.19 (55.24; 63.18) p=0.014 , isovolumetric relaxation time of the left ventricle (ms) 88 (80;92) 80 (76;84) p<0.001 , deceleration time of the E wave (ms) 196 (192;208) 192 (188;196) p=0.002 and the A wave (cm/s) 64 (54;75) 49 (54;54) p<0.001 were statistically larger in the preeclampsia group than in control while the E/A ratio was significantly smaller in the preeclampsia group 1.40 (1.21; 1.63) 1.72 (1.55; 1.94) p<0.001 . The distance walked (m) in the six-minute walk test was significantly smaller in the preeclampsia group (465± 61) than in the control group (534± 44) p<0.001. Linear multiple regression showed that, in the presence... (Complete abstract click electronic access below)

A SÃndrome MielodisplÃsica à uma hemopatia clonal de alta prevalÃncia em idosos Anemia à uma caracterÃstica marcante dessa doenÃa Pacientes com dependÃncia de suporte transfusional tem pior prognÃstico Depois das complicaÃÃes relacionadas à prÃpria doenÃa as complicaÃÃes cardiovasculares sÃo a principal causa de morte Novas tÃcnicas ecocardiogrÃficas como o Doppler tecidual e speckle-tracking podem ser Ãteis na anÃlise da funÃÃo cardÃaca nesse grupo Neste estudo foi avaliado um grupo de 34 pacientes e 14 controles saudÃveis emparelhados por sexo e idade sendo submetido à ecocardiograma convencional Doppler tecidual e avaliaÃÃo da deformaÃÃo miocÃrdica (strain) Os pacientes foram subdivididos entre dependentes (13) ou nÃo de suporte transfusional (21) e comparados aos controles Dentre os 13 pacientes do grupo dependentes havia 10 com sobrecarga de ferro (ferritina >1.000 ng/mL) Os pacientes dependentes de suporte transfusional apresentaram maiores volumes diastÃlico e sistÃlico do ventrÃculo esquerdo em relaÃÃo aos controles (p = 0,047 e 0,039) O volume do Ãtrio esquerdo indexado foi maior no grupo de dependentes em relaÃÃo ao grupo controle (p = 0,003) A funÃÃo diastÃlica do ventrÃculo esquerdo (VE) por Doppler convencional e tecidual (razÃo E/A e razÃo E/Eâ) foi normal no grupo de pacientes e nÃo apresentou diferenÃa significante entre os grupos (p = 0,15 e 0,90) Na avaliaÃÃo da funÃÃo sistÃlica do VE por fraÃÃo de ejeÃÃo e por deformaÃÃo miocÃrdica (strain longitudinal global) nÃo houve desvio da normalidade nem diferenÃas entre os grupos (p = 0,71 e 0,097) A espessura do septo interventricular foi maior nos pacientes com ferritina > 1.000 ng/mL (p = 0,012) O nÃvel de hemoglobina mas nÃo o de ferritina apresentou correlaÃÃo com os volumes esquerdos (Ãtrio: r = -0,53 e p = 0,013 / ventrÃculo: r = -0,4 e p = 0,019) Nossa amostra nÃo apresentou disfunÃÃo global nem sistÃlica nem diastÃlica mesmo à anÃlise por novas tÃcnicas de ecocardiograma como Doppler tecidual e deformaÃÃo miocÃrdica (strain) O nÃvel de hemoglobina menor que 8 g/dL foi marcador precoce de pior funÃÃo ventricular nos nossos pacientes com SÃndrome MielodisplÃsica / Myelodysplastic syndrome is a clonal disorder of hematopoietic tissue highly prevalent on elderly Anemia is one of most striking feature of this disorder Patients with transfusional dependence have a poor prognosis Following complications related to the own illness cardiovascular complications are the leading cause of death New echocardiographic techniques such as Tissue Doppler and speckle-tracking may be useful on assessment of the myocardial function in these patients A group with 34 patients and 14 healthy controls matched by sex and age was subjected to conventional echocardiography Tissue Doppler and assessment of myocardial deformation (strain) Patients were divided between those with (13) or without (21) transfusional dependence and compared to controls In the group of transfusional dependence there were 10 subjects with iron overload (serum ferritin levels > 1.000 ng/mL) Those with transfusion dependence had bigger left systolic and diastolic ventricular volumes than controls (p = 0,047 and 0,039) The indexed left atrium volume was larger on those with transfusion dependence compared to controls (p = 0,003) The left ventricular diastolic function assessed by tissue and conventional Doppler (E/A and E/Eâ ratios) was normal in the patient group and has not difference between them (p = 0,15 and 0,9) On the assessment of the systolic left ventricular function by ejection fraction and myocardial deformation (global longitudinal strain) there was no difference between groups or from reference values (p = 0,71 and 0,097) The interventricular septum thickness was larger in the group with serum ferritin > 1.000 ng/mL than patients with ferritin < 1.000 ng/mL (p = 0,012) The hemoglobin level but not ferritin showed linear correlation with the left volumes (atrium: r = -0,53 with p =0,013 / ventricle: r = -0,4 with p = 0,019) Our sample doesnât show diastolic nor systolic global dysfunctions yet with new techniques of tissue Doppler and myocardial deformation (strain). Hemoglobin below 8 g/dL was an early marker of worst ventricular function in our patients with myelodysplastic syndrome

Background: Cardiac resynchronisation therapy (CRT) is a pacemaker-based therapy for patients with heart failure and dyssynchrony manifest as prolonged QRS duration. Approximately 30% fail to respond either symptomatically or echocardiographically. The role of several echocardiographic parameters to select patients and improve response rate has been studied. The utility of these parameters remains unclear. In particular recent advances in echocardiography with speckle tracking technology may provide more accurate assessment of dyssynchrony. This study aims to explore the role of echocardiography in prediction of CRT response and investigate mechanisms involved in response.Methods:Patients undergoing CRT according to national guidance were recruited. Baseline assessment included clinical examination, quality of life questionnaire, six minute walk test, electrocardiogram and detailed echocardiography. Follow-up assessment was performed six months after CRT. Response was defined as ≥15% reduction in left ventricular end-systolic volume. Baseline parameters of echocardiographic dyssynchrony were compared between responders and non-responders. Individual baseline and follow-up echocardiograms also were examined to assess mechanism of response.Results:51 patients were recruited and 40 patients completed six months follow-up. Echocardiographic response rate was 67.5%. Baseline parameters of dyssynchrony were not significantly different between responders and non-responders, and receiver operating characteristic (ROC) curve analysis suggested echocardiographic parameters have no role in prediction of response beyond QRS duration. Study of individual echocardiograms demonstrated several mechanisms of CRT response the relative importance of which vary between patients.Conclusion:Single echocardiographic dyssynchrony parameters appear to have no role in the prediction of CRT response. However, several mechanisms of response to CRT are identified, each of which may be identified echocardiographically, and echocardiography therefore continues to have an important role in pre-assessment of patients undergoing CRT.