Cougars (Puma concolor) are a growing concern for managers of Pacific Rim National Park Reserve and Clayoquot Sound UNESCO Biosphere Reserve on the west coast of Vancouver Island, British Columbia. Since the mid-1990s, the frequency and intensity of human-cougar interactions have dramatically increased. Concurrently, these areas have become increasingly popular for human activities. The primary goal of my study was to recommend ways to reduce the potential risk of human-cougar interactions to ensure long-term conservation of cougars while minimizing risks to visitor safety. To achieve this goal, I examined the use of two noninvasive approaches. First, during 2005-2006, I compared the rate of detection, cost and time required for a detector dog, sign surveys, scented rub pads and remotely triggered cameras to detect cougars in coastal temperate rainforests. Sign surveys were the most effective method due to the availability of good tracking substrate throughout the study areas. Cameras were also practical because they could be used by less skilled personnel and had the capacity to detect several species of wildlife. Second, I demonstrated the utility of pre-existing data by analysing the spatiotemporal trends of human-cougar interactions on the West Coast Trail from 1993-2006. My results showed a moderate increase of reported human-cougar interactions (n = 157) despite a steady decline in hiker numbers across these years. I identified four areas where activities of people and cougars repeatedly overlapped (hotspots). In general, interaction locations were primarily associated with high human activity: near campsites and landscape characteristics that were associated with campsites (i.e., beaches and freshwater drainages >20 m wide). However, the distribution of hotspots suggests that the co-occurrence of human-use areas (e.g., campsites) and important travel routes (e.g., freshwater drainages and logging roads) used by cougars may increase the likelihood of interactions. These findings will allow protected area managers to proactively mitigate human-cougar conflict through visitor education and protocols that reduce people and cougars from intersecting in space and time.

Durante as últimas duas décadas, as técnicas de análise de esteroides fecais têm sido utilizadas para pesquisa em endocrinologia reprodutiva em diversas espécies animais silvestres de vida livre, ou cativeiro. O presente estudo propõe a validação da técnica do ensaio imunoenzimático antiprogestinas CL425 e antiandrógenos R156/7 fecais em papagaio-de-peito-roxo (Amazona vinacea). Objetiva-se descrever os perfis endócrinos anuais dos esteroides sexuais urofecais em Amazona vinacea com potencial aplicação para o aprimoramento do manejo reprodutivo da espécie. Foram utilizados 10 casais adultos da espécie Amazona vinacea mantidos em viveiros suspensos, em Lomba Grande, Rio Grande do Sul, Brasil. As excretas foram coletadas duas vezes por semana, entre maio de 2012 e maio de 2013. O monitoramento da atividade gonadal foi feito por mensuração de metabólitos de andrógenos nas excretas dos machos e progestágenos, nas de fêmeas. Foram coletadas amostras frescas de excretas, consistentemente, entre 12h00min e 16h00min e mantidas congeladas até o processamento. O perfil anual de andrógenos nas excretas de machos de A. vinacea apresentou médias mensais variáveis de 25,9 ng/g, em janeiro até 125,7 ng/g, em setembro. O perfil anual de progestinas nas excretas de fêmeas A. vinacea, as médias mensais variaram de 2,76 ng/g, em dezembro até 45,7 ng/g, em setembro. Os perfis reprodutivos apresentaram variação na atividade hormonal, durante a fase reprodutiva. Porém, comparando-se casais reprodutores com não-reprodutores, observa-se que os níveis de progestágenos não diferiram significativamente entre fêmeas que fizeram postura e aquelas que não fizeram. Entretanto, os níveis de andrógenos diferiram significativamente entre reprodutores e não-reprodutores. Diferenças hormonais foram observadas nas diferentes estações anuais, tanto nos machos, quanto nas fêmeas. Dados metereológicos de temperatura e insolação demostraram correlação negativa com os perfís anuais de progestágenos. A utilização da metodologia aqui mencionada demonstrou aplicabilidade, praticidade e segurança como ferramenta para o estudo da fisiologia e do manejo reprodutivos de Amazona vinacea. / During the last two decades, the techniques of analysis of fecal steroids have been applied for studying reproductive profiles in many species of captive wild and free living wild animals. The advantages of this methodology are widely understood. This study aimed to validate the anti- CL425 progestin and anti-R156/7 androgen enzyme immunoassay in fecal samples from parrot-breasted-purple (Amazon vinacea). This communication describes the annual endocrine profiles of urofecal sex steroids in Amazona vinacea with potential application for improving the species reproductive management. In total, 10 adult A. vinacea pairs kept in suspended aviaries in southern Brazil were studied. Excreta samples were collected twice weekly between May 2012 and May 2013. Gonadal activity was monitored by measurement of androgen and progestin metabolites in excreta of birds. Fresh excreta samples were collected always between 12:00 and 16:00 hs, and kept frozen until processing. The samples were dried at 57oC, hormones crushed and extracted using 80% methanol. The hormone dosage was performed at the Laboratory of Endocrinology, NUPECCE (Center for Research and Conservation of Deer, Jaboticabal, SP) using enzyme immunoassay with antibody to androgen and progestin. Feces from 5 A. vinacea pairs were used in two distinct periods for assay validation, within and outside the breeding season. Tests included Parallelism, Dose-Response, and Physiological Validation. It was concluded that the enzyme immunoassay for determining progestin and androgen profiles in urofecal samples from A. vinacea is accurate, precise and reliable. The annual profile of androgen in excreta of A. vinacea resulted the following monthly averages: January 25.9 ± 3.7 ng/g (n = 90); February 28.7 ± 3.2 ng/g (n = 60); March 31 7 ± 17.7 ng/g (n = 80); April 27.9 ± 5.5 ng/g (n = 90); May 43.3 ± 7.9 ng/g (n = 90); June 49.1 ± 15.9 ng/g (n = 80); July 36.5 ± 7.5 ng/g (n = 90); August 86.9 ± 46.2 ng/g (n = 90); September 42 125.7 ± 1 ng/g (n = 80); October 110.3 ± 63.2 ng/g (n = 90); November 74.2 ± 57.7 ng/g (n = 90) and December 43.3 ± 13 4 ng/g (n = 80). The monthly averages in the annual profile of progestin in excreta of A. vinacea were as follows: January 7.2 ± 0.9 ng/g (n = 90); February 9.26 ± 1.3 ng/g (n = 60); March 15 8 ± 2.9 ng/g (n = 80); April 14.15 ± 1.85 ng/g (n = 90); May 16.05 ± 3.16 ng/g (n = 90); June 11.85 ± 2.54 ng/g (n = 80); July 11.89 ± 2.17 ng/g (n = 90); August 13.52 ± 3.48 ng/g (n = 90); September 55 ± 45.7 ng/g (n = 80); October 15.44 ± 24.91 ng/g (n = 90); November 4.27 ± 6.42 ng/g (n = 90) and December 2.76 ± 0.42 ng/g (n = 80). Reproductive profiles showed variation in hormonal activity during the reproductive phase. When comparing breeding to non-breeding pairs, it was observed that the progestin levels did not differ significantly between laying and not-laying birds. However, the androgen levels differed significantly between breeding and non-breeding birds. In addition, hormonal differences were observed in both male and female birds in accordance with different annual seasons. Meteorological temperature and insolation data showed a negative correlation with the annual progestin profiles. Measurement of androgen and progestin metabolites in A. vinacea feces proved to be a practical and safe tool for studying reproductive physiology and management of the species.

Made available in DSpace on 2014-06-11T19:29:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-26Bitstream added on 2014-06-13T19:59:06Z : No. of bitstreams: 1 christofoletti_md_me_jabo.pdf: 728449 bytes, checksum: c3e0031c932c62484c010871b451c29b (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A constante ameaça às populações de veado-campeiro (Ozotoceros bezoarticus) faz deste cervídeo uma espécie ameaçada de extinção, trazendo à tona uma necessidade eminente de mais estudos, principalmente relacionado à biologia e fisiologia reprodutiva. Sendo assim, os objetivos deste trabalho foram: definir o padrão de excreção de progestágenos fecais durante a gestação do veado-campeiro e validar possível método não-invasivo para diagnóstico de gestação da espécie, com uso de análises endócrinas. Para isso, onze fêmeas da espécie foram capturadas, marcadas e receberam colares radiotransmissores no Pantanal, região da Nhecolândia. Elas foram acompanhadas mensalmente e tiveram sua fezes colhidas para caracterização hormonal da gestação, entre o período de agosto de 2008 a novembro de 2009. Foi observada a ocorrência de parto em apenas sete fêmeas, as quais foram utilizadas na caracterização endócrina da gestação. As dosagens das progestinas fecais foram feitas por ensaio imunoenzimático. Os nascimentos observados ocorreram entre agosto e outubro, com pico entre agosto e setembro. Os níveis das progestinas fecais durante o início da gestação foram semelhantes aos períodos não-gestantes, com aumento progressivo a partir do segundo terço da gestação até o momento do parto, decaindo após esse período aos níveis não-gestantes. Os níveis de progestinas fecais acima de 6000 ng/g de fezes são sugestivos de gestação. / The constant risk of pampas deer populations (Ozotoceros bezoarticus) makes these threatened specie, bringing an eminent necessity of more studies, mainly related to biology and reproductive physiology. Being thus, the objectives of this work were: obtain the profile of fecal progestins excretion during the pampas deer gestation and to validate a possible noninvasive diagnosis method of gestation for the species, using endocrine analysis. For this, eleven females had been captured, marked and received necklaces radiotransmitters in Pantanal, region of Nhecolândia. They had been followed and their excrements were collected monthly for hormonal characterization between August, 2008 - November, 2009. Was observed the occurrence of birth in only seven females, which had been used in the endocrine characterization of gestation. The levels of fecal progestins during the beginning of gestation had been similar to those at nogestational periods, with gradual increase from the second part of gestation until the moment of birth, decaying after this period to no-gestation levels. The levels of fecal progestins above 6000 ng/g of excrements are suggestive of gestation.

Durante as últimas duas décadas, as técnicas de análise de esteroides fecais têm sido utilizadas para pesquisa em endocrinologia reprodutiva em diversas espécies animais silvestres de vida livre, ou cativeiro. O presente estudo propõe a validação da técnica do ensaio imunoenzimático antiprogestinas CL425 e antiandrógenos R156/7 fecais em papagaio-de-peito-roxo (Amazona vinacea). Objetiva-se descrever os perfis endócrinos anuais dos esteroides sexuais urofecais em Amazona vinacea com potencial aplicação para o aprimoramento do manejo reprodutivo da espécie. Foram utilizados 10 casais adultos da espécie Amazona vinacea mantidos em viveiros suspensos, em Lomba Grande, Rio Grande do Sul, Brasil. As excretas foram coletadas duas vezes por semana, entre maio de 2012 e maio de 2013. O monitoramento da atividade gonadal foi feito por mensuração de metabólitos de andrógenos nas excretas dos machos e progestágenos, nas de fêmeas. Foram coletadas amostras frescas de excretas, consistentemente, entre 12h00min e 16h00min e mantidas congeladas até o processamento. O perfil anual de andrógenos nas excretas de machos de A. vinacea apresentou médias mensais variáveis de 25,9 ng/g, em janeiro até 125,7 ng/g, em setembro. O perfil anual de progestinas nas excretas de fêmeas A. vinacea, as médias mensais variaram de 2,76 ng/g, em dezembro até 45,7 ng/g, em setembro. Os perfis reprodutivos apresentaram variação na atividade hormonal, durante a fase reprodutiva. Porém, comparando-se casais reprodutores com não-reprodutores, observa-se que os níveis de progestágenos não diferiram significativamente entre fêmeas que fizeram postura e aquelas que não fizeram. Entretanto, os níveis de andrógenos diferiram significativamente entre reprodutores e não-reprodutores. Diferenças hormonais foram observadas nas diferentes estações anuais, tanto nos machos, quanto nas fêmeas. Dados metereológicos de temperatura e insolação demostraram correlação negativa com os perfís anuais de progestágenos. A utilização da metodologia aqui mencionada demonstrou aplicabilidade, praticidade e segurança como ferramenta para o estudo da fisiologia e do manejo reprodutivos de Amazona vinacea. / During the last two decades, the techniques of analysis of fecal steroids have been applied for studying reproductive profiles in many species of captive wild and free living wild animals. The advantages of this methodology are widely understood. This study aimed to validate the anti- CL425 progestin and anti-R156/7 androgen enzyme immunoassay in fecal samples from parrot-breasted-purple (Amazon vinacea). This communication describes the annual endocrine profiles of urofecal sex steroids in Amazona vinacea with potential application for improving the species reproductive management. In total, 10 adult A. vinacea pairs kept in suspended aviaries in southern Brazil were studied. Excreta samples were collected twice weekly between May 2012 and May 2013. Gonadal activity was monitored by measurement of androgen and progestin metabolites in excreta of birds. Fresh excreta samples were collected always between 12:00 and 16:00 hs, and kept frozen until processing. The samples were dried at 57oC, hormones crushed and extracted using 80% methanol. The hormone dosage was performed at the Laboratory of Endocrinology, NUPECCE (Center for Research and Conservation of Deer, Jaboticabal, SP) using enzyme immunoassay with antibody to androgen and progestin. Feces from 5 A. vinacea pairs were used in two distinct periods for assay validation, within and outside the breeding season. Tests included Parallelism, Dose-Response, and Physiological Validation. It was concluded that the enzyme immunoassay for determining progestin and androgen profiles in urofecal samples from A. vinacea is accurate, precise and reliable. The annual profile of androgen in excreta of A. vinacea resulted the following monthly averages: January 25.9 ± 3.7 ng/g (n = 90); February 28.7 ± 3.2 ng/g (n = 60); March 31 7 ± 17.7 ng/g (n = 80); April 27.9 ± 5.5 ng/g (n = 90); May 43.3 ± 7.9 ng/g (n = 90); June 49.1 ± 15.9 ng/g (n = 80); July 36.5 ± 7.5 ng/g (n = 90); August 86.9 ± 46.2 ng/g (n = 90); September 42 125.7 ± 1 ng/g (n = 80); October 110.3 ± 63.2 ng/g (n = 90); November 74.2 ± 57.7 ng/g (n = 90) and December 43.3 ± 13 4 ng/g (n = 80). The monthly averages in the annual profile of progestin in excreta of A. vinacea were as follows: January 7.2 ± 0.9 ng/g (n = 90); February 9.26 ± 1.3 ng/g (n = 60); March 15 8 ± 2.9 ng/g (n = 80); April 14.15 ± 1.85 ng/g (n = 90); May 16.05 ± 3.16 ng/g (n = 90); June 11.85 ± 2.54 ng/g (n = 80); July 11.89 ± 2.17 ng/g (n = 90); August 13.52 ± 3.48 ng/g (n = 90); September 55 ± 45.7 ng/g (n = 80); October 15.44 ± 24.91 ng/g (n = 90); November 4.27 ± 6.42 ng/g (n = 90) and December 2.76 ± 0.42 ng/g (n = 80). Reproductive profiles showed variation in hormonal activity during the reproductive phase. When comparing breeding to non-breeding pairs, it was observed that the progestin levels did not differ significantly between laying and not-laying birds. However, the androgen levels differed significantly between breeding and non-breeding birds. In addition, hormonal differences were observed in both male and female birds in accordance with different annual seasons. Meteorological temperature and insolation data showed a negative correlation with the annual progestin profiles. Measurement of androgen and progestin metabolites in A. vinacea feces proved to be a practical and safe tool for studying reproductive physiology and management of the species.

Durante as últimas duas décadas, as técnicas de análise de esteroides fecais têm sido utilizadas para pesquisa em endocrinologia reprodutiva em diversas espécies animais silvestres de vida livre, ou cativeiro. O presente estudo propõe a validação da técnica do ensaio imunoenzimático antiprogestinas CL425 e antiandrógenos R156/7 fecais em papagaio-de-peito-roxo (Amazona vinacea). Objetiva-se descrever os perfis endócrinos anuais dos esteroides sexuais urofecais em Amazona vinacea com potencial aplicação para o aprimoramento do manejo reprodutivo da espécie. Foram utilizados 10 casais adultos da espécie Amazona vinacea mantidos em viveiros suspensos, em Lomba Grande, Rio Grande do Sul, Brasil. As excretas foram coletadas duas vezes por semana, entre maio de 2012 e maio de 2013. O monitoramento da atividade gonadal foi feito por mensuração de metabólitos de andrógenos nas excretas dos machos e progestágenos, nas de fêmeas. Foram coletadas amostras frescas de excretas, consistentemente, entre 12h00min e 16h00min e mantidas congeladas até o processamento. O perfil anual de andrógenos nas excretas de machos de A. vinacea apresentou médias mensais variáveis de 25,9 ng/g, em janeiro até 125,7 ng/g, em setembro. O perfil anual de progestinas nas excretas de fêmeas A. vinacea, as médias mensais variaram de 2,76 ng/g, em dezembro até 45,7 ng/g, em setembro. Os perfis reprodutivos apresentaram variação na atividade hormonal, durante a fase reprodutiva. Porém, comparando-se casais reprodutores com não-reprodutores, observa-se que os níveis de progestágenos não diferiram significativamente entre fêmeas que fizeram postura e aquelas que não fizeram. Entretanto, os níveis de andrógenos diferiram significativamente entre reprodutores e não-reprodutores. Diferenças hormonais foram observadas nas diferentes estações anuais, tanto nos machos, quanto nas fêmeas. Dados metereológicos de temperatura e insolação demostraram correlação negativa com os perfís anuais de progestágenos. A utilização da metodologia aqui mencionada demonstrou aplicabilidade, praticidade e segurança como ferramenta para o estudo da fisiologia e do manejo reprodutivos de Amazona vinacea. / During the last two decades, the techniques of analysis of fecal steroids have been applied for studying reproductive profiles in many species of captive wild and free living wild animals. The advantages of this methodology are widely understood. This study aimed to validate the anti- CL425 progestin and anti-R156/7 androgen enzyme immunoassay in fecal samples from parrot-breasted-purple (Amazon vinacea). This communication describes the annual endocrine profiles of urofecal sex steroids in Amazona vinacea with potential application for improving the species reproductive management. In total, 10 adult A. vinacea pairs kept in suspended aviaries in southern Brazil were studied. Excreta samples were collected twice weekly between May 2012 and May 2013. Gonadal activity was monitored by measurement of androgen and progestin metabolites in excreta of birds. Fresh excreta samples were collected always between 12:00 and 16:00 hs, and kept frozen until processing. The samples were dried at 57oC, hormones crushed and extracted using 80% methanol. The hormone dosage was performed at the Laboratory of Endocrinology, NUPECCE (Center for Research and Conservation of Deer, Jaboticabal, SP) using enzyme immunoassay with antibody to androgen and progestin. Feces from 5 A. vinacea pairs were used in two distinct periods for assay validation, within and outside the breeding season. Tests included Parallelism, Dose-Response, and Physiological Validation. It was concluded that the enzyme immunoassay for determining progestin and androgen profiles in urofecal samples from A. vinacea is accurate, precise and reliable. The annual profile of androgen in excreta of A. vinacea resulted the following monthly averages: January 25.9 ± 3.7 ng/g (n = 90); February 28.7 ± 3.2 ng/g (n = 60); March 31 7 ± 17.7 ng/g (n = 80); April 27.9 ± 5.5 ng/g (n = 90); May 43.3 ± 7.9 ng/g (n = 90); June 49.1 ± 15.9 ng/g (n = 80); July 36.5 ± 7.5 ng/g (n = 90); August 86.9 ± 46.2 ng/g (n = 90); September 42 125.7 ± 1 ng/g (n = 80); October 110.3 ± 63.2 ng/g (n = 90); November 74.2 ± 57.7 ng/g (n = 90) and December 43.3 ± 13 4 ng/g (n = 80). The monthly averages in the annual profile of progestin in excreta of A. vinacea were as follows: January 7.2 ± 0.9 ng/g (n = 90); February 9.26 ± 1.3 ng/g (n = 60); March 15 8 ± 2.9 ng/g (n = 80); April 14.15 ± 1.85 ng/g (n = 90); May 16.05 ± 3.16 ng/g (n = 90); June 11.85 ± 2.54 ng/g (n = 80); July 11.89 ± 2.17 ng/g (n = 90); August 13.52 ± 3.48 ng/g (n = 90); September 55 ± 45.7 ng/g (n = 80); October 15.44 ± 24.91 ng/g (n = 90); November 4.27 ± 6.42 ng/g (n = 90) and December 2.76 ± 0.42 ng/g (n = 80). Reproductive profiles showed variation in hormonal activity during the reproductive phase. When comparing breeding to non-breeding pairs, it was observed that the progestin levels did not differ significantly between laying and not-laying birds. However, the androgen levels differed significantly between breeding and non-breeding birds. In addition, hormonal differences were observed in both male and female birds in accordance with different annual seasons. Meteorological temperature and insolation data showed a negative correlation with the annual progestin profiles. Measurement of androgen and progestin metabolites in A. vinacea feces proved to be a practical and safe tool for studying reproductive physiology and management of the species.

Deficits in executive functions, specifically in response inhibition (RI), have been reported in antisocial behavior, conduct disorder, attention-deficit/hyperactivity disorder (ADHD), etc. Individuals with deficits in RI have a high probability to show non-adapted social behavior that can lead to crime. Many studies have shown that transcranial direct current stimulation (tDCS), a noninvasive brain stimulation (NIBS) technique, modulate the activity of the prefrontal cortex and the functions involved in executive control and RI. This article aims to review the literature on the effect of tDCS on RI and executive control and to highlight research avenues to develop therapeutic alternatives to prevent onset and recidivism of crime. A systematic review of the literature was performed in the Libsearch database following PRISMA method. Ten studies were selected showing tDCS modulation of RI measured with the Stop Signal and the Go-NoGo task. Eight of the studies showed gains on RI with tDCS versus sham. The data led to consideration of tDCS as a new therapeutic alternative to improve RI and hence prevention of onset and recidivism on crime. Individual differences, targeted brain areas, the polarity of electrodes and long-term learning effects are further discussed as crucial considerations for future studies.

Despite the advantages of using NIV, healthcare professionals are not in agreement about precisely when to commence NIV (Elliott, Confalonieri& Nava 2002:1159; Lightowler, Wedzicha, Elliott&Ram 2003: [4]; Garpestad &Hill 2006:147), which adds to the underutilisation of NIV. The aim of this study was to collaboratively develop a clinical pathway for NIV. Two main objectives were identified, namely (i) to identify the components of a clinical pathway for NIV, and (ii) to develop a clinical pathway for NIV that can be implemented in the CCU. The research design utilised for this study was qualitative, contextual, explorative and descriptive in nature. The study consisted of three phases, namely Phase 1: Components of the clinical pathway, Phase 2: Literature control, and Phase 3: Development of the clinical pathway. The objectives of the study were met, and a clinical pathway for NIV was developed. / Dissertation (MCur)--University of Pretoria, 2011. / Nursing Science / unrestricted

Recent improvements in genetic analyses have paved the way in using molecular data to answer questions regarding evolutionary history, genetic structure, and demography. Key deer are a federally endangered subspecies assumed to be genetically unique (based on one allozyme study), homogeneous, and have a female-biased population of approximately 900 deer. I used 985bp of the mitochondrial cytochrome b gene and 12 microsatellite loci to test two hypotheses: 1) if the Moser Channel is a barrier to gene flow, I should expect that Key deer are differentiated and have reduced diversity compared to mainland deer and (2) if isolation on islands leads to a higher probability of extinction, I should expect that Key deer exhibit a small population size and a high risk of extinction. My results indicate that Key deer are genetically isolated from mainland white-tailed deer and that there is a lack of genetic substructure between islands. While Key deer exhibit reduced levels of genetic diversity compared to their mainland counterparts, they contain enough diversity of which to uniquely identify individual deer. Based on genetic identification, I estimated a census size of around 1,000 individuals with a heavily skewed female-biased adult sex ratio. Furthermore, I combined genetic and contemporary demographic data to generate a species persistence model of the Key deer. Sensitivity tests within the population viability analysis brought to light the importance of fetal sex ratio and female survival as the primary factors at risk of driving the subspecies to extinction.

INTRODUÇÃO: A ecocardiografia tridimensional em tempo real (E3DTR) vem provando sua acurácia para quantificar os volumes do ventrículo esquerdo (VE), fração de ejeção (FEVE) e massa em pacientes com cardiomiopatia. Na cardiomiopatia hipertrófica (CMH), onde a morfologia ventricular pode estar muito alterada, a análise das estruturas cardíacas é fundamental para indicação da terapêutica ideal. A ressonância magnética cardiovascular (RMC) é um método superior na análise segmentar do VE em comparação a ecocardiografia bidimensional (E2D), mas com alta complexidade e existente em poucos centros diagnósticos, com contraindicações e limitações para a sua realização. MÉTODOS: Estudo transversal, comparativo, duplo cego, em 20 portadores de CMH, com E2D, E3DTR e RMC realizados com intervalo máximo de 06 meses e armazenados em formato digital. A espessura das paredes, volumes, função sistólica e massa ventricular esquerda foram analisados pelos métodos ecocardiográficos e pela RMC, assim como o movimento anterior sistólico da valva mitral, o índice geométrico do VE e o índice sistólico de dissincronia do VE. ANÁLISE ESTATÍSTICA: Análise estatística pelo coeficiente de concordância de Lin, correlação linear de Pearson e modelo de Bland-Altman. RESULTADOS: Foi obtida exeqüibilidade elevada acima de 94%, dependente do parâmetro avaliado. Concordância satisfatória e forte correlação linear evidenciada para a análise segmentar (Rc>0.84 e r>0.85; p<0.0001) observada para os métodos ecocardiográficos comparados à RMC, com concordância excelente entre os métodos ecocardiográficos (Rc=0,92 e r=0,92, p<0,0001). Concordância satisfatória e forte correlação linear para a fração de ejeção do VE (Rc=0.83 e r=0.93; p<0.0001) pela E3DTR comparada à RMC. Concordância excelente e forte correlação linear para o VDFVE e VSFVE pela E3DTR comparada à RMC e pela E2D comparada à E3DTR (Rc>0.90 and r>0.95; p<0.0001), assim como para a massa do VE, para os métodos E3DTR e RMC (Rc=0.96 e r=0.97; p<0.0001). Evidenciada maior exeqüibilidade da análise do MAS pela E3DTR. O índice geométrico do VE foi >0,15mmxm²xml-1 para todos os métodos. Observada correlação negativa entre o índice de dissincronia do VE e o percentual de fibrose miocárdica, sem significância estatística. CONCLUSÕES: A E3DTR é precisa e superior à E2D na avaliação da distribuição da hipertrofia miocárdica, quantificação dos volumes, função e massa ventricular esquerda em pacientes com CMH quando comparada à RMC, e parece ser superior na análise do MAS, pela melhor visão espacial da valva mitral.Todas as medidas do índice geométrico do ventrículo esquerdo estavam acima de 0,15mmxm²xml-1, compatível com CMH. Não foi identificada correlação entre o índice sistólico de dissincronia ventricular esquerda e a fibrose miocárdica. / INTRODUCTION: Real-time three-dimensional echocardiography (RT3D) has been demonstrated an accurate technique for the quantification of left ventricular (LV) volumes, ejection fraction (LVEF), and mass. In patients with hypertrophic cardiomyopathy (HCM), in which alterations of ventricular morphology are common, cardiac structural analysis is of utmost importance for guiding adequate therapy. Although magnetic resonance imaging (MRI) seems to have better definition for segmental analysis than two-dimensional echocardiography, (2D-E), it is considered a complex test with low availability and some limitations for use. METHODS: Comparative and double-blinded study in 20 patients with HCM. All patients underwent 2DE, RT3D and MRI within maximal interval of 6 months. Parameters analyzed by echocardiography and MRI included: wall thickness, LV volumes, systolic function, LV mass, systolic anterior motion of mitral valve, LV geometric index and LV dyssynchrony index. Statistical analysis was performed by Lin agreement coefficient, Pearson linear correlation and Bland-Altman model. RESULTS: Feasibility for measurements by MRI and echocardiography was 94%. There was good agreement and linear correlation between segmental analysis by echocardiography and MRI (Rc>0.84 and r>0.85; p<0.0001) and excellent correlation between 2DE and RT3DE (Rc=0.92 and r=0.92; p<0.0001). We also observed good agreement and linear correlation between RT3DE and MRI for ejection fraction (Rc=0.83 and r=0.93; p<0.0001) and excellent agreement and linear correlation between RT3DE and MRI for LV end diastolic volume and LV end systolic volume determinations (Rc>0.90 and r>0.95; p<0.0001) and mass (Rc=0.96 and r=0.97; p<0.0001). The feasibility for systolic anterior motion of mitral valve was higher by RT3DE (91%) than 2DE (64%). LV geometric index was >0.15 mmxm²xml-1 for all techniques. There was no correlation between LV dyssynchrony index and the percentage of myocardial fibrosis. CONCLUSIONS: RT3D is an accurate technique with superior performance than 2DE for the evaluation of myocardial hypertrophy localization, LV volume and functional determination as well as for LV mass assessment in patients with HCM in comparison with MRI. In addition, it seems to be superior for the analysis of systolic anterior motion due to its better spatial view of mitral valve. All measurements of LV geometric index were above the value of 0.15 mmxm²xml-1, and such findings are compatible with HCM. No correlation between LV dyssynchrony index by RT3D and the percentage of myocardial fibrosis determined by MRI was identified.

Die im Rahmen dieser Arbeit vorgestellten Studien führen zu einer Erweiterung der Indikationen der kardiovaskulären Magnetresonanztomographie bei der Diagnostik der koronaren Herzerkrankung. Die Methoden zur schnellen Erfassung der Myokardbewegung bis hin zu Echtzeittechniken, zur Bestimmung der Myokardperfusion, zur Quantifizierung von hibernating Myokard und zur Unterdrückung von Atemartefakten bei der Koronararteriendarstellung oder Koronarflussmessung wurden optimiert und in klinischen Studien evaluiert. Die Magnetresonanztomographie ist der Echokardiographie bei Dobutamin-Stress-Untersuchungen zur Erkennung einer koronaren Herzerkrankung signifikant überlegen, was sich insbesondere durch die bessere Bildqualität erklärt. Dabei kann zur Überwachung der Patienten während der Stressuntersuchung auf Echtzeitverfahren zurückgegriffen werden, die sowohl für eine quantitative Analyse der linksventrikulären Funktion, als auch für die Erkennung von stressinduzierten Wandbewegungsstörungen geeignet ist. Für die Beurteilung der Myokardperfusion ist die Magnetresonanztomographie mit herkömmlichen Techniken wie SPECT oder PET vergleichbar. Dabei ist insbesondere die Analyse der Einwaschgeschwindigkeit eines Kontrastmittelbolus in Ruhe und unter Vasodilatation geeignet, ischämische und normal perfundierte Myokardabschnitten zu differenzieren. Für die Abbildung der Koronararterien haben sich insbesondere Navigatortechniken als sinnvoll erwiesen. Dabei kann die Anwendung optimierter Korrekturverfahren der Zwerchfellposition zu einer Verringerung von ateminduzierten Bewegungsartefakten führen. Mit Hilfe diese Navigatortechnik können auch Koronarflussmessungen optimiert und ihre Genauigkeit im Vergleich zur intravaskulären Doppler-Sonographie durch Verbesserung der räumlichen und zeitlichen Auflösung gesteigert werden. Damit steht die kardiovaskuläre Magnetresonanztomographie an der Schwelle zum breiten Einsatz in der klinischen Routine. Das derzeitige Indikationsspektrum ist für eine integrative und genaue Untersuchung geeignet und kann in den nächsten Jahren durch weitere Aspekte (z.B. Darstellung von Gefäßplaques, Anwendung spezifischer Kontrastmittel) noch erweitert werden. / The studies compiled in the following manuscript lead to a broadening of indications for cardiovascular magnetic resonance imaging for the diagnosis of coronary artery disease Methods for rapid assessment of myocardial motion including real-time techniques, for the determination of myocardial perfusion, for the quantification of hibernating myocardium, and for the reduction of artefacts from breathing motion for the visualization of the coronary arteries and coronary flow measurements were optimised and evaluated in clinical studies. Dobutamin stress magnetic resonance imaging is superior to dobutamine stress echocardiography for the detection of coronary artery disease, which is mainly due to the superior image quality. For patient monitoring real-time techniques can be used which allow quantitative assessment of left ventricular function and detection of stressinduced wall motion abnormalities. The accuracy of perfusion measurements with magnetic resonance imaging is comparable to conventional techniques such as SPECT of PET. Especially the analysis of the wash-in of a contrast agent bolus at rest and during vasodilation allows a differentiation of ischemic and normal myocardium. For coronary artery imaging especially navigator techniques have been shown to be useful. The application of optimised correction techniques for the position of the diaphragm can lead to a reduction of breathing induced artefacts. Thus, cardiovascular magnetic resonance is on its way towards broad clinical application. The current spectrum of indications allows an integrative and accurate examination and can be expanded with additional aspects (e.g. plaque imaging, use of specific contrast agents) in the next years