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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Effects of DynaMatrix on Angiogenic Cytokine and Matrix Metalloproteinase Expression from Human Endothelial Cells: An In-vitro Study

Hill, Scott Thomas January 2015 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: Regenerative endodontics (RE) is a treatment alternative for the infected immature tooth to establish an environment in the canal that enables continued root development and the growth of pulp or pulp-like tissue within the canal. A scaffold created in the canal encourages the formation of vital tissue. The porcine sub-intestinal-submucosa (SIS) membrane, Dynamatrix®, has the potential to serve as an endodontic scaffold. Research at Indiana University School of Dentistry (IUSD) has shown that Dynamatrix® can support the growth of human dental pulp stem cells (HDPSC) and human pulp fibroblasts (HPF). Positive angiogenic cytokine profiles were seen after these cells were seeded on Dynamatrix®. Endothelial cells play an important role in the formation of blood vessels and are a source of angiogenic cytokines. Exposure of these cells to DynaMatrix® may result in a positive angiogenic profile for both cytokines and matrix metalloproteinases (MMPs). Objective: The aim of this in-vitro study was to investigate if the exposure of human endothelial cells to the DynaMatrix® membrane would result in differences in the expression of cytokines and MMPs that play roles in angiogenesis. Materials and Methods: Human endothelial cells (HUVECs) were obtained from American Type Culture Collection (ATTC, Manassas, VA) and used in this study. Groups were established as follows: (a) Group 1: HUVECs seeded in culture media only, (b) Group 2: DynaMatrix® membrane incubated alone in the serum-media without any cells, and (c) Group 3: HUVECs seeded on DynaMatrix® membranes. After 72 hours of incubation, the conditioned media were collected and analyzed for the expression of 20 angiogenic cytokines and MMPs utilizing cytokine and MMP protein arrays. The density of each cytokine and MMP expressed was measured, averaged, and statistically analyzed by ANOVA. Results: Exposure of human umbilical vein endothelial cells (HUVECs) to the DynaMatrix® membrane resulted in a positive angiogenic profile for both cytokines and MMPs. Conclusion: This work furthers the evidence for the potential of DynaMatrix® to serve as a more predictable scaffold in RE.
22

Impact of posterior cerebral artery involvement on long-term clinical and social outcome of pediatric moyamoya disease / 小児もやもや病の成人後の臨床・社会的予後に対する後大脳動脈病変の影響

Funaki, Takeshi 23 January 2015 (has links)
京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第12888号 / 論医博第2088号 / 新制||医||1007(附属図書館) / 31642 / (主査)教授 小泉 昭夫, 教授 平家 俊男, 教授 福山 秀直 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM
23

Arteriogenic Revascularization Does Not Induce Vascular Function Impairment

Yocum, Matthew David 01 March 2009 (has links) (PDF)
Functional hyperemia and arteriolar vasodilation are impaired with chronic ischemia. We sought to examine the impact of chronic ischemia on collateral artery function. For this we used two hindlimb ischemia models to dissect the impact of different repair processes on collateral function. Ligation of the femoral artery increases shear stress in the muscular branch and results in outward remodeling and arteriogenesis. In contrast, resection of the femoral artery proximal to the muscular branch induces blood flow divergence and neutral remodeling along with expectedly greater hypoxia and inflammation. On day 14 after each surgery the diameter of the muscular branch was measured using sidestream dark field (SDF) imaging before and after gracilis muscle stimulation. A slight, but not statistically significant, impairment in functional vasodilation was observed in ligated mice (69±10% average diameter increase compared to 74±7% average diameter increase). Resected mice exhibited slightly (not statistically significant) enhanced collateral artery functional vasodilation (104±16% average diameter increase) but were also refractory to the restoration of resting vascular tone following the cessation of stimulation. Outward remodeling did not significantly impair vascular function, whereas neutral remodeling and tissue hypoxia induced impaired vascular tone.
24

Acute Renal Injury After Renal Artery Stenting

Haller, Steven Thomas 20 July 2005 (has links)
No description available.
25

Shortening cardioplegic arrest time in patients undergoing combined valvular and coronary surgery : a multicentre randomized controlled trial (the SCAT trial)

Capoun, Radek January 2014 (has links)
Background: Combined valvular and coronary artery bypass grafting (CAB G) surgery requires a long period of cardioplegic arrest (CA) that predisposes the heart to ischaemiareperfusion injury, low cardiac output syndrome, reperfusion dysrhythmias, inhospital mortality and increased costs. Procedures that can reduce the duration of CA would be expected to reduce intraoperative and postoperative complications. Mehods: Adults undergoing combined valvular and CABG surgery were randomized to either coronary surgery performed on the beating heart with cardiopulmonary bypass (CPB) support followed by CA for the valvular procedure (hybrid group) or surgery with both procedures carried out under CA (conventional group). The primary outcome was a composite of in-hospital death, postoperative myocardial infarction, cardiac dysrhythmias, requirements for cardiac pacing for more than 12 hours and/or inotropic support for more than 12 hours postoperativeiy. Results: One hundred and sixty patients (80 hybrid, 80 conventional) were randomized between March 2008 and July 2012. Mean age was 66.5 years and 74% were male. Valvular procedures included aortic (61.8%) and mitral (33.1%) alone or in combination (5.l %). The primary outcome occurred in 64/80 of the conventional group patients and 67/80 of the hybrid group patients (odds ratio 1.24, 95% Cl 0.54 to 2.86, p=0.61). The CA time was, on average, 16% shorter in the hybrid group (median 98 minutes vs. 89 minutes, geometric mean ration (GMR) 0.84, 95% Cl 0.77 to 0.93 , p=0.0004), but the overall duration of CPB was on average 7% longer in the hybrid group (GMR 1.07, 95% Cl 0.98 to 1.16, p=0.12). Cardiac troponin T plasma concentrations and levels of metabolites measured in heart biopsies were similar between the two treatment groups. Conclusion: The hybrid technique reduced the CA time, but this did not result in a significant reduction in the frequency of the primary outcome. In this trial the clinical outcomes and the extent of the myocardial injury were similar between the two surgical methods.
26

Avaliação de uma coorte de pacientes submetidos à cirurgia de revascularização do miocárdio: avaliação clínica dos hipertensos / Evaluation of a cohort of patients undergoing coronary artery bypass graft surgery: clinical evolution of hypertensive patients

Colósimo, Flávia Cortez 12 May 2015 (has links)
Introdução: A hipertensão arterial tem elevada prevalência em pessoas submetidas à cirurgia de revascularização do miocárdio. Contudo, em nosso meio, pouco se conhece sobre sua influência no resultado pós-operatório. Objetivos: Avaliar associação da hipertensão arterial com desfechos de morbidade e mortalidade após cirurgia de revascularização miocárdica e identificar os preditores de mortalidade nos pacientes hipertensos. Método: Estudo de coorte que utilizou banco de dados institucional de um hospital da cidade de São Paulo-SP incluindo 3010 pacientes submetidos à revascularização miocárdica cirúrgica com acompanhamento dos desfechos aos 30 dias e até um ano após a cirurgia. Os grupos de hipertensos e não hipertensos foram comparados quanto às características pré-operatórias e quanto à morbidade e mortalidade pós-operatórias. Os grupos de hipertensos controlados e hipertensos não controlados foram comparados quanto às características préoperatórias e à ocorrência de morbidade e mortalidade pósoperatória. Para identificação das variáveis preditoras de mortalidade no grupo dos hipertensos procedeu-se a análise multivariada com regressão logística. Resultados: A prevalência de hipertensão arterial foi de 82,8%. A média de idade dos hipertensos foi de 62,4 anos e 67,8% eram do sexo masculino. Os fatores associados, independentemente, à hipertensão foram (OR- Odds Ratio; ICIntervalo de Confiança 95%): idade (1,01; 1,00-1,02); sexo feminino (1,77; 1,39-2,25), raça parda (1,53; 1,07-2,19), obesidade (1,53;1,13- 2,06), diabetes (1,90; 1,52-2,39), dislipidemia (1,51;1,23-1,85) e creatinina>1,3mg/dL (1,37; 1,09-1,72). Não houve diferença estatisticamente significativa nos desfechos de morbidade e mortalidade entre os grupos de hipertensos e não hipertensos. Cerca da metade dos hipertensos (51,1%) apresentava pressão arterial controlada (PA<140/90 mmHg) na admissão hospitalar. O grupo de hipertensos não controlados apresentou risco significativamente maior do que hipertensos controlados de (Risco Relativo; Intervalo de Confiança 95%): acidente vascular encefálico (2,25; 1,13-4,56), insuficiência cardíaca (1,65; 1,04-2,63), parada cardíaca (1,54; 1,03- 2,31) e óbito (1,59; 1,20-2,10). Após regressão logística múltipla, as variáveis associadas ao óbito dos hipertensos em até 30 dias após a cirurgia foram (OR; IC 95%): idade, variável contínua (1,039; 1,012- 1,066), creatinina sérica, variável contínua (1,245; 1,062-1,459); história familiar de doença coronariana (0,491; 0,265-0,912), dislipidemia (0,512; 0,316-0,829), procedimento de revascularização isolado (0,289; 0,176-0,476) e índice de massa corporal, variável contínua, (0,944; 0,892-0,999). As variáveis associadas ao óbito dos hipertensos em até um ano após a cirurgia foram (OR; IC 95%): idade, variável contínua (1,049; 1,028-1,071), pressão arterial não controlada (1,768; 1,245-2,508), antecedentes de doença renal crônica (2,554; 1,481-4,404), acidente vascular encefálico (2,48; 1,403-4,203), insuficiência arterial periférica (1,894; 1,087-3,300), doença carotídea (3,050; 1,367-6,806), insuficiência cardíaca (4,623; 2,455-8,703), arritmia (1,811; 1,038-3,159), creatinina sérica préoperatória, variável contínua (1,201; 1,017-1,418), glicemia capilar pós-operatória, variável contínua (1,007; 1,002-1,012), história familiar de doença coronariana (0,613; 0,401-0,939), dislipidemia (0,658; 0,463-0,936) e cirurgia de revascularização isolada (0,306; 0,203-0,461) Conclusões: A hipertensão arterial apresentou alta prevalência e se associou a fatores modificáveis e não modificáveis. Entre hipertensos, a falta de controle da pressão arterial foi preditora de mortalidade na avaliação em longo prazo após a cirurgia. / Introduction: Hypertension is highly prevalent in people undergoing coronary artery bypass graft (CABG) surgery. However, in our field, little is known about its influence on postoperative results. Objectives: To evaluate the association of hypertension with morbidity and mortality outcomes after the coronary artery bypass graft surgery and identify predictors of mortality in hypertensive patients. Method: A cohort study which used the institutional database of a hospital in the city of São Paulo (state of São Paulo) and included 3010 patients undergoing CABG surgery, with monitoring of outcomes at 30 days and one year after surgery. The groups of hypertensive and nonhypertensive patients were compared regarding the preoperative characteristics and the postoperative morbidity and mortality. The groups of controlled hypertensive and uncontrolled hypertensive patients were compared in relation to preoperative characteristics and the occurrence of postoperative morbidity and mortality. A multivariate analysis with logistic regression was used to identify the predictors of mortality in the hypertensive group. Results: The prevalence of hypertension was 82.8%. The average age of hypertensive patients was 62.4 years and 67.8% were male. The factors independently associated with hypertension were the following (OR- odds ratio; CIconfidence interval 95%): age (1.01; 1.00-1.02); female gender (1.77; 1.39-2.25), multiracial (pardo) (1.53; 1.07-2.19), obesity (1.53; 1.13- 2.06), diabetes (1.90; 1.52-2.39), dyslipidemia (1.51; 1.23-1.85) and creatinine>1.3mg/dL (1.37; 1.09-1.72). There was no statistically significant difference in the outcomes of morbidity and mortality among hypertensive and non-hypertensive groups. About half of the hypertensive patients (51.1%) had controlled blood pressure (Pa<140/90 mmHg) at hospital admission. The group of uncontrolled hypertensive patients showed significantly higher risk than the group of controlled hypertensive of the following (RR-Relative Risk; CI 95%): cerebrovascular accident (2.25; 1.13-4.56), heart failure (1.65; 1.04- 2.63), cardiac arrest (1.54; 1.03-2.31) and death (1.59; 1.20-2.10). Using multiple logistic regression, the variables associated with death of hypertensive patients within 30 days after surgery were the following (OR; CI 95%): age, continuous variable (1.039; 1.012-1.066), serum creatinine, continuous variable (1.245; 1.062-1.459); family history of coronary artery disease (0.491; 0.265-0.912), dyslipidemia (0.512; 0.316-0.829), isolated revascularization procedure (0.289; 0.176- 0.476) and body mass index, continuous variable, (0.944; 0.892- 0.999). The following variables were associated to the death of hypertensive patients in up toan year after surgery (OR; CI 95%): age, continuous variable (1.049; 1.028-1.071), uncontrolled blood pressure (1.768; 1.245-2.508), history of chronic kidney disease (2.554; 1.481- 4404), stroke (2.48; 1.403-4.203), peripheral artery disease (1.894; 1.087-3.300), carotid artery disease (3.050; 1.367-6.806), cardiac failure (4.623; 2.455-8.703), arrhythmia (1,811; 1,038-3,159), preoperative serum creatinine, continuous variable (1.201; 1.017- 1.418), postoperative blood glucose, continuous variable (1.007; 1.002-1.012), family history of coronary disease (0.613; 0.401-0.939), dyslipidemia (0.658; 0.463-0.936) and isolated coronary artery bypass graft surgery (0.306; 0.203-0.461). Conclusions: Hypertension showed high prevalence and was associated to modifiable and nonmodifiable factors. Among hypertensive patients, the lack of blood pressure control was predictive of mortality in the long-term evaluation after surgery.
27

Avaliação farmacocinética e farmacodinâmica do propofol em pacientes submetidos à revascularização do miocárdio, com ou sem utilização de circulação extracorpórea / Evaluation of pharmacokinetics and pharmacodynamics of propofol in patients undergoing coronary artery bypass grafting, with or without cardiopulmonary bypass

Barbosa, Ricardo Antonio Guimarães 14 December 2004 (has links)
A circulação extracorpórea (CEC) pode alterar a concentração plasmática prevista para fármacos administrados durante a anestesia. Os objetivos deste estudo foram avaliar os efeitos da CEC sobre a farmacocinética, farmacodinâmica e as concentrações plasmáticas do propofol em pacientes submetidos à cirurgia de revascularização miocárdica (RM) com ou sem utilização de CEC, correlacionando-se às concentrações plasmáticas obtidas com as previstas por infusão contínua alvo-controlada. Dez pacientes submetidos à RM com CEC (Grupo CEC) e dez sem CEC (Grupo sem CEC) foram comparados em relação à concentração plasmática obtida, utilizando-se cromatografia líquida de alta eficiência e aquela prevista por infusão alvo-controlada, em relação à farmacocinética (t1/2ß, volume de distribuição e clearance plasmático), ao grau de hipnose (índice bispectral) e aos parâmetros hemodinâmicos (pressão arterial média e freqüência cardíaca), avaliados nos períodos intra-operatório e pós-operatório imediato. Os dados foram avaliados pela análise de variância para medidas repetidas, considerando-se significativo p<0,05. A concentração obtida de propofol foi maior no grupo sem CEC nos momentos 120 min (3,32±1,76 no grupo sem CEC e 2,48±1,12 no grupo CEC, p=0,005) e 240 min (3,24±2,71 no grupo sem CEC e 2,23±2,48 no grupo CEC, p=0,0212) após o início da cirurgia. A concentração medida de propofol foi maior que a prevista nos 2 grupos, com valores superiores no grupo sem CEC (p=0,02). O t1/2 ß foi maior no grupo sem CEC (3,67±1,15 grupo sem CEC e 1,82±0,5 no grupo CEC, p=0,0005) e o clearance plasmático maior no grupo CEC (28,36±11,40 no grupo CEC e 18,29±7,67 no grupo sem CEC, p=0,03). O grau de hipnose foi superior no grupo CEC. Os grupos não diferiram quanto à análise hemodinâmica. Conclui-se que a CEC promove alterações na farmacocinética e nas concentrações plasmáticas de propofol, com conseqüente diferença no grau de hipnose em relação aos pacientes submetidos à revascularização do miocárdio sem utilização de CEC / Cardiopulmonary bypass (CPB) can alter predicted plasmatic concentration of drugs administered during anesthesia. The aim of this study was evaluate the effects of cardiopulmonary bypass under pharmacokinetics, pharmacodynamics and plasmatic concentration of propofol in patients undergoing coronary artery bypass grafting surgery (CABG) with or without CPB, comparing measured plasmatic concentration with predicted concentration administered by target-controlled infusion. Ten patients undergoing coronary artery bypass grafting surgery with CPB (CPB Group, n=10) and ten without CPB (off-pump Group, n=10) were compared in relaction to measured plasmatic concentration using high performance liquid chromatography (HPLC) and predicted concentration administered by target-controlled infusion, pharmacokinetics (t1/2 ß, volume of distribution and total clearance), hypnosis degree (bispectral index) and hemodynamics parameters (mean arterial pressure and heart rate) during and after surgery. Statistical analysis was done using analysis of variance for repeated measures (*p<0,05). Measured plasmatic concentration was higher in off-pump group in the moments 120 min (3,32±1,76 in off-pump group and 2,48±1,12 in CPB group, p=0,005) and 240 min (3,24±2,71 in off-pump group and 2,23±2,48 in CPB group, p=0,0212) after the beginning of surgery. Measured plasmatic concentration was higher than predicted in two groups, with superior values in off-pump group (p=0,02). T1/2 ß was greater in off-pump group (3,67±1,15 in off-pump group and 1,82±0,5 in CPB group, p=0,0005) and total clearance was higher in CPB group (28,36±11,40 in CPB group and 18,29±7,67 in off-pump group, p=0,03). Hypnosis degree was greater in CPB group. Hemodynamics parameters did not differ between the groups. In conclusion, CPB causes alterations on pharmacokinetics and under propofol plasmatic concentration with higher hypnosis degree when compared with patients undergoing coronary artery bypass grafting surgery without CPB (off-pump group)
28

Avaliação da função pulmonar em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea / Evaluation of pharmacokinetics and pharmacodynamics of propofol in patients undergoing coronary artery bypass grafting, with or without cardiopulmonary bypass

Barbosa, Ricardo Antonio Guimarães 18 January 2000 (has links)
A circulação extracorpórea (CEC) pode alterar a concentração plasmática prevista para fármacos administrados durante a anestesia. Os objetivos deste estudo foram avaliar os efeitos da CEC sobre a farmacocinética, farmacodinâmica e as concentrações plasmáticas do propofol em pacientes submetidos à cirurgia de revascularização miocárdica (RM) com ou sem utilização de CEC, correlacionando-se às concentrações plasmáticas obtidas com as previstas por infusão contínua alvo-controlada. Dez pacientes submetidos à RM com CEC (Grupo CEC) e dez sem CEC (Grupo sem CEC) foram comparados em relação à concentração plasmática obtida, utilizando-se cromatografia líquida de alta eficiência e aquela prevista por infusão alvo-controlada, em relação à farmacocinética (t1/2ß, volume de distribuição e clearance plasmático), ao grau de hipnose (índice bispectral) e aos parâmetros hemodinâmicos (pressão arterial média e freqüência cardíaca), avaliados nos períodos intra-operatório e pós-operatório imediato. Os dados foram avaliados pela análise de variância para medidas repetidas, considerando-se significativo p < 0,05. A concentração obtida de propofol foi maior no grupo sem CEC nos momentos 120 min (3,32±1,76 no grupo sem CEC e 2,48±1,12 no grupo CEC, p=0,005) e 240 min (3,24±2,71 no grupo sem CEC e 2,23±2,48 no grupo CEC, p=0,0212) após o início da cirurgia. A concentração medida de propofol foi maior que a prevista nos 2 grupos, com valores superiores no grupo sem CEC (p=0,02). O t1/2 ß foi maior no grupo sem CEC (3,67±1,15 grupo sem CEC e 1,82±0,5 no grupo CEC, p=0,0005) e o clearance plasmático maior no grupo CEC (28,36±11,40 no grupo CEC e 18,29±7,67 no grupo sem CEC, p=0,03). O grau de hipnose foi superior no grupo CEC. Os grupos não diferiram quanto à análise hemodinâmica. Conclui-se que a CEC promove alterações na farmacocinética e nas concentrações plasmáticas de propofol, com conseqüente diferença no grau de hipnose em relação aos pacientes submetidos à revascularização do miocárdio sem utilização de CEC / Cardiopulmonary bypass (CPB) can alter predicted plasmatic concentration of drugs administered during anesthesia. The aim of this study was evaluate the effects of cardiopulmonary bypass under pharmacokinetics, pharmacodynamics and plasmatic concentration of propofol in patients undergoing coronary artery bypass grafting surgery (CABG) with or without CPB, comparing measured plasmatic concentration with predicted concentration administered by target-controlled infusion. Ten patients undergoing coronary artery bypass grafting surgery with CPB (CPB Group, n=10) and ten without CPB (off-pump Group, n=10) were compared in relaction to measured plasmatic concentration using high performance liquid chromatography (HPLC) and predicted concentration administered by target-controlled infusion, pharmacokinetics (t1/2 ß, volume of distribution and total clearance), hypnosis degree (bispectral index) and hemodynamics parameters (mean arterial pressure and heart rate) during and after surgery. Statistical analysis was done using analysis of variance for repeated measures (*p < 0,05). Measured plasmatic concentration was higher in off-pump group in the moments 120 min (3,32±1,76 in off-pump group and 2,48±1,12 in CPB group, p=0,005) and 240 min (3,24±2,71 in off-pump group and 2,23±2,48 in CPB group, p=0,0212) after the beginning of surgery. Measured plasmatic concentration was higher than predicted in two groups, with superior values in off-pump group (p=0,02). T1/2 ß was greater in off-pump group (3,67±1,15 in off-pump group and 1,82±0,5 in CPB group, p=0,0005) and total clearance was higher in CPB group (28,36±11,40 in CPB group and 18,29±7,67 in off-pump group, p=0,03). Hypnosis degree was greater in CPB group. Hemodynamics parameters did not differ between the groups. In conclusion, CPB causes alterations on pharmacokinetics and under propofol plasmatic concentration with higher hypnosis degree when compared with patients undergoing coronary artery bypass grafting surgery without CPB (off-pump group)
29

Les microARN : biomarqueurs et cibles thérapeuthiques des maladies cardiovasculaires / MicroRNAs : biomarkers and therapeutic targets of cardiovascular diseases

Goretti, Emeline 01 October 2014 (has links)
Les maladies cardiovasculaires (MCV) sont la première cause de décès dans le monde. Les problèmes majeurs dans la gestion de ces patients sont le diagnostic et la prédiction du pronostic. Les microARN (miARN) sont de petits ARN simple brin non codants qui inhibent l’expression des gènes. Les miARN circulants sont apparus comme biomarqueurs potentiels des MCV. Les miARN pourraient être également utiles pour la réparation cardiaque post infarctus du myocarde (IM). Nous avons émis l’hypothèse que les miARN pourraient être utilisés comme biomarqueurs des MCV et outils thérapeutiques dans la réparation cardiaque post-IM. Nous avons évalué la capacité diagnostique des miARN chez des patients avec douleurs thoraciques. Les miR-208b et miR-499 sont de potentiels biomarqueurs diagnostiques chez les patients avec IM mais n’améliorent pas la valeur diagnostique des biomarqueurs traditionnels. Le miR-423-5p permet de prédire la réhospitalisation des patients atteints d’insuffisance cardiaque aiguë et les miR-21 et miR-122 sont associés aux séquelles neurologiques de patients après arrêt cardiaque. Les miARN circulants seraient de potentiels biomarqueurs diagnostiques/pronostiques des MCV. Nous avons également montré qu’inhiber le miR-16 permet de stimuler la prolifération, la différenciation et les capacités pro-angiogéniques des cellules endothéliales progénitrices et que le miR-150 est impliqué dans l’effet de l’adénosine sur leur recrutement post-IM. Les miARN pourraient être utilisés pour améliorer la revascularisation post-IM. En conclusion, nos études contribuent à la caractérisation de plusieurs miARN dont l’utilité clinique dans le domaine cardiovasculaire reste à confirmer. / Cardiovascular diseases are the leading cause of death in the world. Major issues in the management of these patients lie on the diagnosis and the prediction of the prognosis. MicroRNAs (miRNAs) are small single-stranded non-coding RNAs that inhibit gene expression. Circulating miRNAs appeared as potentials biomarkers of cardiovascular diseases. MicroRNAs could be also useful to stimulate cardiac repair. We hypothesized that miRNAs could be used as biomarkers of cardiovascular diseases, and also as therapeutic tools to improve cardiac repair after myocardial infarction. We evaluated the diagnostic capacity of miRNAs in patients with chest pain. MicroRNA-208b and miR-499 were potential diagnostic biomarkers in patients with myocardial infarction, without improving the diagnostic accuracy of traditional biomarkers. MicroRNA-423-5p predicted the rehospitalization of patients with acute heart failure and miR-21 and miR-122 are associated with neurological damage after cardiac arrest. Overall, our results indicate that circulating miRNAs could be useful diagnostic and prognostic biomarkers of cardiovascular diseases. We also showed that inhibiting miR-16 could stimulate the proliferation, differentiation and pro-angiogenic capacities of endothelial progenitor cells and that miR-150 is involved in the effect of adenosine on the recruitment of these cells after myocardial infarction. These results suggest that miRNAs could be used to improve the revascularization after myocardial infarction. In conclusion, our studies contributed to the characterization of several miRNAs, which clinical utility in the cardiovascular field remains to be confirmed.
30

Impacto na qualidade de vida de pacientes submetidos a revascularização do miocárdio

Boni, Andréia Lima Matos Dal 04 June 2013 (has links)
Made available in DSpace on 2016-04-27T13:10:21Z (GMT). No. of bitstreams: 1 Andreia Lima Matos Dal Boni.pdf: 8257425 bytes, checksum: 2520db47387276a3878fd26a303cc25e (MD5) Previous issue date: 2013-06-04 / The objective of this study is to determine the quality of life in patients undergoing myocardial revascularization; to analyze and compare it before and after the intervention; to compare clinic and sociodemographic variables to aspects of depression and anxiety disturbs at pre and post-operative periods. Seventy-eight patients were interviewed at pre and post-operative time, applying the instruments: The Medical Study 36- item Short- From Health Survey (SF-36), Macnew Heart Disease Health - related Quality of Life Questionnaire MacNew, Depression Inventory Beck e Stait Trait Anxiety inventory (Idate). There was a significant improvement in all aspects of the quality of life, depression and anxiety (p=0,05). The SF-36 physical and social aspects represents the lowest scores (13,46 and 3,03, respectively), as well as the social aspect of Macnew instrument (3,03). The social and global Macnew aspects were positively compared to patients with previous acute myocardial infarction, which demonstrates that the revascularization surgery impacted positively in the patients quality of life / Este estudo teve como objetivo determinar o impacto da cirurgia de revascularização do miocárdio (RM) na qualidade de vida dos pacientes; analisar e comparar as dimensões da qualidade de vida antes e após a intervenção cirúrgica; comparar as variáveis sociodemográficas e clínicas aos aspectos de depressão e ansiedade no pré e pós-operatório revascularização do miocárdio. Foram entrevistados 78 pacientes no pré e pós-operatório, aplicados os instrumentos: The Medical Study 36- item Short- From Health Survey (SF-36), Macnew Heart Disease Health - related Quality of Life Questionnaire MacNew, Inventário Depressão Beck e Stait Trait Anxiety inventory (Idate). Houve melhora significativa em todos os domínios da qualidade de vida, depressão e ansiedade (p=0,05). Os domínios físico e social do SF-36 apresentaram menor pontuação dos escores (13,46 e 3,03, respectivamente), bem como o domínio social do instrumento Macnew (3,03). Os domínios social e global do MacNew compararam positivamente com pacientes com infarto agudo do miocárdio prévio, o que demonstra que a cirurgia de revascularização ocasionou impacto positivo na qualidade de vida desses pacientes

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