Made available in DSpace on 2015-05-14T16:53:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-02-28Bitstream added on 2015-05-14T16:59:08Z : No. of bitstreams: 1 000816066.pdf: 8199814 bytes, checksum: 04f16c134dd5ae0397ebe390e2b76778 (MD5) / Uma vez iniciada a diálise, a sobrevida dos pacientes com doença renal crônica está diretamente relacionada às seguintes alterações cardiovasculares: hipertrofia ventricular esquerda) infarto agudo do miocãrdio, acidente vascular encefálico, arritmias cardíacas e hipertensão arterial. Dentre essas alterações encontradas em pacientes renais crônicos) merece destaque a hipertrofia ventricular esquerda. Desta forma) a reversão da hipertrofia ventricular esquerda tem potencial para interferir positivamente na sobrevida dos pacientes renais crônicos) tanto para as causas cardiovasculares como para mortalidade geral. O presente estudo teve como objetivo avaliar a influência da regressão da hipertrofia cardíaca na mortalidade cardiovascular dos pacientes em diálise e analisar a influência de variáveis clínicas sobre a regressão da hipertrofia ventricular esquerda. Foram analisados pacientes renais crônicos com idade superior a 18 anos) em programa de hemodiálise por 2 meses ou mais) antes da avaliação inicial; com dois ecocardiogramas no período de junho de 2000 a dezembro de 2008) seguidos até 2012; acompanhados no serviço de hemodiálise no Hospital das Clínicas de Botucatu-UNESP. Foram Excluídos os pacientes com evidência de discinesias ventriculares em ecocardiograma; doença valvar moderado ou grave; ecocardiografia de qualidade técnica insatisfatória; portadores de miocardiopatias de outras causas que não hipertensivas ou urêmicas; portadores de doenças com baixa expectativa de vida) quais sejam: neoplasias e cirrose hepática; e aqueles submetidos a transplante renal entre a primeira e a segunda avaliação. Os pacientes foram divididos em dois grupos: aqueles que mantiveram ou aumentaram a massa ventricular cardíaca e) aqueles que reduziram a massa ventricular cardíaca durante o seguimento. Observamos) em regressão múltipla de Cox, que a reversão da hipertrofia ventricular esquerda possui impacto na ... / Once started dialysis, the survival of patients with chronic kidney disease is directly related to cardiovascular changes, as following: left ventricular hypertrophy, myocardial infarction, stroke, cardiac arrhythmias and hypertension. Among these changes left ventricular hypertrophy is a common and powerful risk factor. In this way, reversal of left ventricular hypertrophy has potential to interfere positively with the survival of patients with renal disease, both for cardiovascular causes and for overall mortality. The present study aimed to evaluate the influence of regression of cardiac hypertrophy in cardiovascular mortality in dialysis patients and analyze the influence of clinical variables on the regression of left ventricular hypertrophy. Chronic kidney diseases patíents, aged over 18 years were analyzed, on hemodialysis for at least two months before the initial evaluation, from June 2000 to December 2008, and followed until 2012 in the hemodialysis service at the University Hospital of Botucatu-UNESP. The patients must have two echocardiograms. Were excluded patients with evidence of ventricular dyskinesia in echocardiogram, moderate or severe valvular disease, echocardiography with unsatisfactory technical quality; patients with cardiomyopathies due to causes other than hypertension or uremic; patients whose disease has a low life expectancy, which are: neoplasms and liver cirrhosis, and those undergoing kidney transplantation between the ftrst and second assessment. The patients were divided into two groups: those that maintained or increased the cardiac ventricular mass, and those that have reduced cardiac ventricular mass during follow-up. Multiple Cox regression was performed to evaluate the influence of reversal of left ventricular hypertrophy on mortality from cardiovascular causes. Over 6 years of follow-up, the survival curves of the two groups distanced themselves in a statistically signiftcant way. Reversal of left ...

Orientador: Leonardo Antonio Mamede Zornoff / Banca: Leonardo Antonio Mamede Zornoff / Banca: Beatriz Bojikian Matsubara / Banca: Marina Politi Okoshi / Banca: Wilson Nasdruz Junior / Banca: José Luiz Ferrari de Souza / Resumo: O efeito da exposição à fumaça de cigarro (EFC) tem sido extensivamente estudado; entretanto, os efeitos diretos cardíacos da fumaça de cigarro despertam menos atenção. O objetivo deste estudo foi determinar as alterações cardíacas estruturais e funcionais causadas pela EFC, em ratos e, analisar a influência do tempo de EFC na remodelação ventricular. Material e método – Ratos Wistar adultos foram alocados em dois grupos: controle (C, n=43), subdividido em dois grupos, controle dois meses (C2, n=25), controle seis meses (C6, n=18) e grupo fumante (F, n=47), igualmente, subdivididos em dois grupos, fumante dois meses (F2, n=22) e fumante seis meses (F6, n=25), que foram expostos à fumaça de cigarro, respectivamente por períodos de dois e seis meses. Todos os animais foram pesados e tiveram mensurado na cauda a pressão arterial sistólica (PAS). A função cardíaca foi estudada pelo método ecocardiográfico (in vivo) e pelo método do coração isolado (in vitro) contraindo isovolumetricamente. Resultados – Não houve diferença significante no peso do corpo (PC) entre os grupos controle e fumante. Foram observados valores maiores para o átrio esquerdo (AE), com p=0,005, entre os grupos C e o grupo F, para o AE, corrigido pelo peso do corpo (AE/PC), com p=0,001 e índice de massa do ventrículo esquerdo (IMVE), com p=0,048. Foi observada interação estatística significante para o diâmetro diastólico do ventrículo esquerdo (DDVE), corrigido pelo peso do corpo dos animais (DDVE/PC), com diferença (p=0,023) entre o grupo C e o grupo F, também, com diferença (p=0,048) entre o grupo dois meses e o grupo seis meses e valores diferentemente (p=0,010) entre fumantes e o tempo de exposição ao fumo. Para PAS, foi observada diferença significante na análise da PAS caudal nos grupos C2 e C6 (valores menores) em comparação... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The vascular effects of exposure to smoke of cigarettes have been extensively studied; however, the cardiac effects of tobacco smoke deserved less attention. The aim of this study was to determine the cardiac structural and functional alterations caused by cigarette smoke exposure in rats and analyse the influence to time of exposure to smoke of cigarettes in remodeling ventricular. Material and Methods - Adult Wistar rats were allocated into two groups: control (C, n=43), separated into two sub-groups, two months control (C2, n=25), six months control (C6, n=18) and exposed to tobacco smoke (S, n=47), equally, separated in two sub-groups, two months exposed to tobacco smoke (S2, n=22) and six months exposed to tobacco smoke (S6, n=25), repectively per period into two months and six month. All animals were weighed and had the tail cuff systolic arterial pressure (SAP) measured. The cardiac function was studied study by echocardiogram method (in vivo) and by isolated isovolumetrically beating heart method (in vitro). Results - There was no significant difference in body weight (BW) between groups control and exposed to tobacco smoke. Higher values were found for left atrium (LA), with p=0,005, between groups C and grup S, by LA, adjusted for BW, with p=0,001 and left ventricular mass index, with p=0,048. There was statistically significant interaction by left ventricular diastolic diameter (LVDD), adjusted for BW into animals (LVDD/BW), with difference significant (p=0,023) between group C e o group F, also, with difference (p=0,048) between group two months and o grupo six months and, values differently (p=0,010) between smoking and exposure to tobacco load. There was systolic arterial pressure (SAP), to the difference significant the... (Complete abstract click electronic access below) / Doutor

Orientador: Roberto Jorge da Silva Franco / Coorientador: Luís Cuadrado Martin / Banca: José Jayme Galvão de Lima / Banca: João Egidio Romão Junior / Banca: Katashi Okoshi / Banca: Ana Lúcia Gut / Resumo: Uma vez iniciada a diálise, a sobrevida dos pacientes com doença renal crônica está diretamente relacionada às seguintes alterações cardiovasculares: hipertrofia ventricular esquerda) infarto agudo do miocãrdio, acidente vascular encefálico, arritmias cardíacas e hipertensão arterial. Dentre essas alterações encontradas em pacientes renais crônicos) merece destaque a hipertrofia ventricular esquerda. Desta forma) a reversão da hipertrofia ventricular esquerda tem potencial para interferir positivamente na sobrevida dos pacientes renais crônicos) tanto para as causas cardiovasculares como para mortalidade geral. O presente estudo teve como objetivo avaliar a influência da regressão da hipertrofia cardíaca na mortalidade cardiovascular dos pacientes em diálise e analisar a influência de variáveis clínicas sobre a regressão da hipertrofia ventricular esquerda. Foram analisados pacientes renais crônicos com idade superior a 18 anos) em programa de hemodiálise por 2 meses ou mais) antes da avaliação inicial; com dois ecocardiogramas no período de junho de 2000 a dezembro de 2008) seguidos até 2012; acompanhados no serviço de hemodiálise no Hospital das Clínicas de Botucatu-UNESP. Foram Excluídos os pacientes com evidência de discinesias ventriculares em ecocardiograma; doença valvar moderado ou grave; ecocardiografia de qualidade técnica insatisfatória; portadores de miocardiopatias de outras causas que não hipertensivas ou urêmicas; portadores de doenças com baixa expectativa de vida) quais sejam: neoplasias e cirrose hepática; e aqueles submetidos a transplante renal entre a primeira e a segunda avaliação. Os pacientes foram divididos em dois grupos: aqueles que mantiveram ou aumentaram a massa ventricular cardíaca e) aqueles que reduziram a massa ventricular cardíaca durante o seguimento. Observamos) em regressão múltipla de Cox, que a reversão da hipertrofia ventricular esquerda possui impacto na ... / Abstract: Once started dialysis, the survival of patients with chronic kidney disease is directly related to cardiovascular changes, as following: left ventricular hypertrophy, myocardial infarction, stroke, cardiac arrhythmias and hypertension. Among these changes left ventricular hypertrophy is a common and powerful risk factor. In this way, reversal of left ventricular hypertrophy has potential to interfere positively with the survival of patients with renal disease, both for cardiovascular causes and for overall mortality. The present study aimed to evaluate the influence of regression of cardiac hypertrophy in cardiovascular mortality in dialysis patients and analyze the influence of clinical variables on the regression of left ventricular hypertrophy. Chronic kidney diseases patíents, aged over 18 years were analyzed, on hemodialysis for at least two months before the initial evaluation, from June 2000 to December 2008, and followed until 2012 in the hemodialysis service at the University Hospital of Botucatu-UNESP. The patients must have two echocardiograms. Were excluded patients with evidence of ventricular dyskinesia in echocardiogram, moderate or severe valvular disease, echocardiography with unsatisfactory technical quality; patients with cardiomyopathies due to causes other than hypertension or uremic; patients whose disease has a low life expectancy, which are: neoplasms and liver cirrhosis, and those undergoing kidney transplantation between the ftrst and second assessment. The patients were divided into two groups: those that maintained or increased the cardiac ventricular mass, and those that have reduced cardiac ventricular mass during follow-up. Multiple Cox regression was performed to evaluate the influence of reversal of left ventricular hypertrophy on mortality from cardiovascular causes. Over 6 years of follow-up, the survival curves of the two groups distanced themselves in a statistically signiftcant way. Reversal of left ... / Doutor

Abstract Natriuretic peptides have emerged as important candidates for the development of diagnostic tools in cardiovascular disease. Their increased concentrations have been found to be useful for ruling out disease of cardiac origin, as prognostic indicators, and in the follow-up of patients with heart failure. In order for natriuretic peptides to be efficient biomarkers, analytical problems in assay specificity and calibration need to be resolved. The aim of the present study was to elucidate circulating molecular components of N-terminal fragments of A- and B-type natriuretic peptides (NT-proANP and NT-proBNP) in human blood, and to develop reliable and novel assays for their measurement with clinical application. Reliable immunoassays for NT-proANP and NT-proBNP were set up based on recombinant calibrators and antisera against different epitopes. A novel immunoassay for detecting the activation of A- and/or B-type natriuretic peptide systems, referred to as NT-proXNP, was also developed. The chromatographic results of human plasma and serum samples indicated that NT-proANP and especially NT-proBNP are heterogeneous in human circulation. They are truncated at both termini, causing a serious risk of preanalytical errors. Further studies with recombinant peptides confirmed that the central parts of NT-proANP and NT-proBNP are stable in plasma and serum even at harsh storage conditions. Thus the most reliable assays are directed at the central portions of the molecule only. All developed assays were applicable to clinical samples of cardiac patients. NT-proXNP showed a diagnostic efficiency equal to or slightly better compared to individual NT-proANP and NT-proBNP assays. Furthermore, the prognostic value of NT-proANP and NT-proBNP was investigated in a population-based sample of men. Both peptides were strong predictors of mortality and its co-morbidities, adding to the prognostic value of conventional risk factors.

M.Tech. / Cardiovascular disease and its complications accounts for about half of all deaths worldwide. As conventional risk factors do not successfully explain all of these cases, homocysteine (Hey) appears to be a new and promising field to investigate as an accompanying risk factor for the development of cardiovascular disease (Stanger et al., 2004). Hyperhomocysteinaemia, or elevated Hey levels, have been shown to be directly linked to the development of cardiovascular disease (Wald and Morris, 2002). Crataegus oxyaeantha Mother Tincture (0) has been used over centuries for various cardiovascular disease conditions and is considered to have cardio-protective properties (Rose and Treadway, 1999), however its effect on homocysteine levels has not been researched. The atm of this double-blind placebo-controlled study was to determine the effect of homoeopathically prepared Crataegus oxyaeantha (J on Hey levels in males aged 25-35 years of age by measuring Hey levels in the blood over a three week period. Participants attended an initial consultation where the procedure of the research was discussed, a short medical history was taken, and a full cardiovascular examination together with vital signs was assessed. Thereafter a pathology laboratory (Lancet laboratories) measured Hey levels of the participants. Those participants that qualified for the study were divided into two groups of fifteen. The experimental group received a 25mL bottle of Crataegus oxyaeantha 0 and the placebo group received a 25mL bottle of alcohol identical in appearance and taste. Participants were informed not to make any substantial changes to their diet and lifestyle. After three weeks a second Hey test was completed and a follow up consultation was scheduled. Collected data was statistically analyzed and a Chi Square goodness of fit test was utilized to determine if there was any significant decrease in Hey levels in the participating individuals. Preliminary findings suggest that Crataegus oxyaeantha (J was not effective in reducing plasma Hey levels in adult males with Hey levels of 6.3 mmoVL and higher, however more research over an extended period of time is needed to confirm these findings.

The purpose of this study was to examine the relationship between training heart rate (THR) and the HR occurring at the Aerobic Threshold (AerTHR), and to examine the AerT as an index of training intensity in selected coronary artery disease (CAD), post-myocardial infarction (MI), and post-coronary artery bypass surgery (CABS) patients. Twenty male subjects (age=54.9; wt=73.7 kg; %body fat=25.8) were recruited on the basis of regular participation in a cardiac rehabilitation program (CRP) (3/week at 70 - 85% HRmax) for 6 months; no beta-adrenergic medication; and symptom-free during exercise. Field measurements of THR during the aerobic phase at CRP was carried out by computer-assisted portable telemetry with mean THR computed from each 30 minute value per subject. A maximal treadmill test starting at 2.5 mph at 0% grade with speed increasing 0.5 mph each minute was carried out using a Beckman MMC for 30 second determinations of respiratory gas values. The AerT was determined by visual inspection of the first departure from linearity of Ve and excess CO₂. VO₂max was 35.6 ±5.6 ml/kg/min⁻¹, with HRmax 166.2 ±11.8 bpm. Paired t-tests were performed; AerTHR was 124.8 ±15.3 bpm with THR 133.7 ±13.4 bpm (p < .03). Percent HRmaxAerT was 75.1 ±8.05 and %HRmaxTHR was 80.6 ±8.3 (p < .03). Mean %VO₂maxAerT (54.4 ±6.7) is consistent with other reported data showing .lower values in less trained individuals. Stepwise correlations were performed, and a regression equation was produced to predict AerT grom HRmax, height, and weight with a multiple r = .74 (p < .01). These data suggest that in this population, THR, as calculated by the relative percentage of maximum method, produces training intensities above the AerT expressed as absolute or relative percents of HRmax. This finding may have implications for optimal body fat reductions, patient compliance to the exercise program, and safety in CRP's. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

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Yes / Developing new methods to treat heart diseases is always a focus for basic research and clinical applications. Existing drugs have strong side-effects and also require lifetime administration for patients. Recent attempts of using nanoparticles (NPs) in treating atherosclerosis in animals and some heart diseases such as heart failure and endocarditis have provided hopes for better drug delivery and reducing of drug side-effects. In this mini-review, we summarize the present applications of using gold nanoparticles (GNPs) as a new drug delivery system in diseased hearts and of the assessment of toxicity in using GNPs. We suggest that conjugating existing clinical drugs with GNPs is a favorable choice to provide “new and double-enhanced” potentiality to those existing drugs in treating heart diseases. Other applications of using NPs in the treatment of heart diseases including using drugs in nano-form and coating drugs with a surface of relevant NP are also discussed.

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