<p>Background: Stem cell therapy can facilitate cardiac repair after healed myocardial infarction but the optimal cell type remains uncertain. <p>Aims: To investigate the pathophysiology of heart failure in a canine model of healed myocardial infarction and to compare the efficacy and the safety of autologous bone marrow mononuclear cell (BMNC) transfer and mesenchymal stem cell (MSC) transfer in this model. It was a blind, randomized and placebo control study.<p>Methods: Eleven weeks after coronary ligation, 24 dogs received intramyocardial injections of BMNC, MSC or Placebo (n = 8 per groups). Echocardiography, conductance method, magnetic resonance imaging, serum neurohormones, holter monitoring, macromorphometry, histology and real time quantitative polymerase chain reaction were used to assess cardiac performance, safety and remodelling in healthy animals, before cell transplantation and up to 16 weeks’ follow-up. <p>Results: The model was characterized by decreased left ventricular end-systolic elastance and ventricular-arterial uncoupling without alteration of compliance. <p>Four months after BMNC transfer, the regional systolic function measured at echocardiographic showed a sustained improvement. This improvement was associated with an improved left ventricular end-systolic elastance and a decreased infarct size. Although the left ventricular ejection fraction stayed unchanged, the serum level of N-terminal B-type natriuretic propeptide level decreased. Mononuclear cell transfer was also associated with increased left ventricular relative wall area, increased vascular density, intramyocardial vascular remodelling and upregulation of angiogenic factors gene expression. Mesenchymal stem cell transfer only improved lately and moderately the regional systolic function, without improvement of cardiac contractility or decreased infarct size. <p>Conclusions: In a canine model of chronic myocardial infarction, BMNC transfer is superior to MSC transfer in improvement of cardiac contractility and regional systolic function, and to reduce the infarct size and plasma N-terminal B-type natriuretic propeptide level. Functional improvement is associated with a favourable angiogenic environment and neovascularization. <p> / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

This Master's thesis deals with the influence of breathe to baroreceptor reflex. The first chapter is focused on measuring of blood pressure, in reference to later used method. In the second part is detailed analysis and explanation of term baroreflex, relationship between frequency spectra of systolic blood pressure, heart rate and breathing, mechanisms of regulation of blood pressure and heart rate variability. Third chapter deals with possible ways, how to analyze data, which are needed for estimation of baroreflex sensitivity, analyze of heart rate variability and estimation of power spectral density. Next parts of this thesis is paid attention to technical equipment and methods of acqusition of data, using this equipmnent. Part of this work is also software application, which makes possible from the recorded data estimate baroreflex sensitivity.

Doctor Pharmaceuticae - DPharm / An aqueous extract prepared from the leaves and smaller stems of Leonotis leonurus was used to investigate the potential effects on certain cardiovascular parameters, such as left ventricular systolic pressure, end-diastolic pressure, developed pressure, heart rate, cardiac work and coronary perfusion pressure in isolated rat hearts. Hearts were perfused at constant flow for 3min using the modified Langendorf! perfused model of the heart. Effects of adrenaline and digoxin solutions on the isolated heart were compared to that of the plant extract. Adrenaline produced both positive inotropic and chronotropic effects. Adrenaline increased (p<O.Ol) the left ventricular systolic pressure and hence the left ventricular developed pressure by 40.6% and 43.9% at peak, and 24.3% and 31.9%, after 3min, respectively. Simultaneously, the heart rate and the cardiac work were increased (p<0.01) by 22.5% and 89.4% at peak, and 24.6% and 63%, after 3rnin, respectively. There were no significant effects on the left ventricular diastolic pressure and the coronary perfusion pressure. Digoxin solution (2.5ng/ml) significantly (p<O.Ol) increased the left ventricular systolic pressure by 5.1% after 3min and the left ventricular diastolic pressure by 9.7% at peak and 5.3% after 3min. The heart rate was significantly (p<O.OI) decreased by 3.7% at peak. The cardiac work was increased by 4.5% after 3rnin. Digoxin did not significantly affect the left end diastolic pressure and the coronary perfusion pressure. The extract of Leonons leonurus at O.lmg/ml increased (p<O.OI) the left ventricular systolic pressure and hence the left ventricular diastolic pressure by 9.7% and 10.7% at peak, and 5.4% and 5.5% after 3rnin, respectively. The cardiac work was increased (p<O.Ol) by 10.1% at peak. Leonotis leonurus (0.1mg/ml) did not significantly affect the left ventricular end diastolic pressure, the heart rate and the coronary perfusion pressure. At 0.5mg/ml, the left ventricular systolic pressure and hence the left ventricular diastolic pressure were increased (p<0.01) by 14.8% and 15.4% at peak and 7.4% and 7.8% after 3rnin, respectively with a corresponding decrease (p<O.OI) in the coronary perfusion pressure of 8.5% at peak and 4.4% after 3rnin. The cardiac work was increased (p<O.OI) by 13.6% at peak and 5.2% after 3rnin. The extract at 1.0mg/ml increased (p<O.Ol) the left ventricular systolic pressure and hence the left ventricular diastolic pressure by 25.4% and 29.4% at Peak, and 23.1% and 26.3% after 3rnin, respectively. The heart rate was reduced (p<O.OI) by 34.7% at peak and 28.3% after 3min. The cardiac work and the coronary perfusion pressure were decreased (p<O.OI) by 15.9% and 12.1% at Peak and 3.3% and 11.4% after 3rnin. However, at 2.0mg/ml, the left ventricular systolic pressure and the left ventricular diastolic pressure were increased (p<O.OI) by 14.9% at peak. The left ventricular diastolic pressure was decreased (p<O.OI)by 9.8% over the 3rnin. The heart rate was drastically decreased (p<O.OI) by 42.7% after 3rnin. The cardiac work was reduced (p<O.Ol) by 48.8% over the 3min period. Also, the coronary perfusion pressure was decreased (p<0.01) by 16.9% at peak. Thus, Leonatis leonurus produced both positive inotropic and negative chronotropic effects after 3min perfusion, accompanied by a decreased coronary perfusion pressure. Thus, it appears that the extract seemed to contain certain constituents associated with positive inotropic and negative chronotropic agents as wel! as constituents associated with coronary vasodilation. However, at the higher concentration, it seemed to contain some constituents associated with toxic effects on the isolated heart. Therefore, further studies are needed to isolate the various constituents and examine their possible pharmacological effects on the heart individually before it could be considered safe to recommend this plant for its use in the treatment of cardiovascular disease.

L’hyperthyroïdie représente la maladie endocrinienne la plus commune chez les chats gériatriques. Ses répercussions systémiques sont similaires chez l’espèce féline et l’humain. L’hypertension pulmonaire se développe chez plus du deux tiers des humains hyperthyroïdiens. L’objectif de cette étude est d’évaluer si l’hyperthyroïdie féline affecte les paramètres hémodynamiques pulmonaires mesurés à l’échocardiographie (volet rétrospectif) ainsi que leur évolution dans le temps (volet prospectif). L’étude rétrospective a été réalisée à partir des examens échocardiographiques révisés de 26 chats hyperthyroïdiens non traités. Pour l’étude prospective, 7 chats hyperthyroïdiens non traités ont été recrutés et des échocardiographies ont été réalisées au moment du diagnostic, puis un mois et six mois suivant le retour à l’état euthyroïdien. Les groupes hyperthyroïdiens de chacun des volets ont été comparés à un groupe de chats sains (n = 15). Les chats hyperthyroïdiens présentent 1) une hyperdynamie ventriculaire droite, 2) un ratio du temps d’accélération sur le temps d’éjection du flux pulmonaire et une vitesse pulmonaire maximale augmentés et 3) un débit ou une fréquence cardiaque augmentés. L’évolution de ces changements dans le temps n’a montré aucune différence significative. Cette étude montre pour la première fois la présence d’altérations hémodynamiques pulmonaires à l’échocardiographie chez les chats hyperthyroïdiens. Les changements observés sont en partie différents de ceux décrits chez les humains hyperthyroïdiens, suggérant des mécanismes d’adaptation particuliers à l’espèce féline. Une importante variation à même la population féline dans la réponse métabolique aux hormones thyroïdiennes est soupçonnée. Des études supplémentaires sont nécessaires pour corréler les changements échocardiographiques observés au développement d’hypertension pulmonaire chez les chats hyperthyroïdiens. / Hyperthyroidism represents the most common endocrine disease in cats >10-years-old. Several of its multisystemic repercussions are similar between feline species and humans, including an increased basal metabolic rate and an activation of the sympathetic nervous system. Pulmonary hypertension has been reported in more than two third of humans with hyperthyroidism. This study aims to determine whether feline hyperthyroidism affects pulmonary arterial hemodynamics (retrospective study) and their progression in time (prospective study) with echocardiography. A bi-center retrospective study was realized from reviewed echocardiographic examinations of 26 untreated hyperthyroid cats. For the prospective study, 7 untreated hyperthyroid cats were recruited, and echocardiographic examinations were performed initially, followed by one and six months after treatment of hyperthyroidism. Hyperthyroid groups of each study were compared to a group of healthy cats (n = 15). Hyperthyroid cats presented 1) an hyperdynamic right ventricle, 2) elevated acceleration to ejection time ratio of the pulmonary flow and maximal pulmonary velocity and 3) a higher cardiac output or heart rate than healthy cats. The magnitude of these changes did not vary significantly over time. This study shows for the first time the presence of pulmonary hemodynamic alterations in hyperthyroid cats using echocardiography. These changes are partially different from those described in hyperthyroid humans, suggesting adaptation mechanisms specific to the feline species. Significant variation within the feline population in the metabolic response to thyroid hormones is suspected. Further studies are needed to correlate echocardiographic changes with the development of pulmonary hypertension in hyperthyroid cats.

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No description available.

No description available.

In many occupations, exposure to hand-transmitted vibration (HTV) over a prolonged period causes various disorders involving the vascular, neural and musculoskeletal systems, collectively known as the hand-arm vibration syndrome (HAVS). It is a complex and potentially disabling chronic disorder of the upper extremities, especially of the hands. Numbness, tingling, reduced tactile discrimination, and impaired manipulative dexterity are often reported by workers exposed to HTV. The precise pathophysiological mechanism responsible for vascular injuries in HAVS has not yet been fully clarified; it seems to be multifactorial and highly complex. Interaction of neural signals, hormones, mediators and changes in the blood vessel itself appear to contribute to the development of such vascular injuries. This study aims to assess the risk of the hand-transmitted vibration exposure during pneumatic impact wrench operation in a rock drill repair and maintenance workshop at a South African platinum mine. A total of 8 workers working on a day to day basis with impact wrenches were available for this study. For each of the workers a control (not exposed to vibration) was selected on the basis of gender, ethnic group, smoking habits, age and body mass index (BMI). Grip force, dexterity and hand-eye co-ordination were tested on the workers and control group before and after work. Finger systolic blood pressure (FSBP) was also measured after cold provocation of the worker and control groups. Results have shown astatistically significant difference between the two groups with respect coordination, dexterity and FSBP after cold provocation. Vibration measurements shows three workers had values above the suggested ELV of 5 m/s² for an eight hour A (8) workday. With regards to dexterity, workers were capable to manipulate small objects better with their dominant right (vibration exposed) hand after work than before work. In contrast, it seems that the number of pegs correctly inserted by the controls is not uniformly affected by their 8 hour workday. The worker group showed a greater grip force than that of the control group, both before and after work.There was a statistically significant difference between the control and worker group with respect to the number of mistakes during the mirror trace and the time to complete this test only for the right hand. The difference in FSBP after cold provocation between the control and worker group observed is of medium importance when compared with effect sizes, however, there was no statistical significant difference. In this study, it was very difficult to make valid conclusions due to the limitations of a small sample size. A longitudinal study should be conducted preferably using newly appointed workers with no prior exposure to vibration and a sufficient control group to eliminate the effect other confounding variables such as general working conditions. / Thesis (MSc (Occupational Hygiene))--North-West University, Potchefstroom Campus, 2013.

In many occupations, exposure to hand-transmitted vibration (HTV) over a prolonged period causes various disorders involving the vascular, neural and musculoskeletal systems, collectively known as the hand-arm vibration syndrome (HAVS). It is a complex and potentially disabling chronic disorder of the upper extremities, especially of the hands. Numbness, tingling, reduced tactile discrimination, and impaired manipulative dexterity are often reported by workers exposed to HTV. The precise pathophysiological mechanism responsible for vascular injuries in HAVS has not yet been fully clarified; it seems to be multifactorial and highly complex. Interaction of neural signals, hormones, mediators and changes in the blood vessel itself appear to contribute to the development of such vascular injuries. This study aims to assess the risk of the hand-transmitted vibration exposure during pneumatic impact wrench operation in a rock drill repair and maintenance workshop at a South African platinum mine. A total of 8 workers working on a day to day basis with impact wrenches were available for this study. For each of the workers a control (not exposed to vibration) was selected on the basis of gender, ethnic group, smoking habits, age and body mass index (BMI). Grip force, dexterity and hand-eye co-ordination were tested on the workers and control group before and after work. Finger systolic blood pressure (FSBP) was also measured after cold provocation of the worker and control groups. Results have shown astatistically significant difference between the two groups with respect coordination, dexterity and FSBP after cold provocation. Vibration measurements shows three workers had values above the suggested ELV of 5 m/s² for an eight hour A (8) workday. With regards to dexterity, workers were capable to manipulate small objects better with their dominant right (vibration exposed) hand after work than before work. In contrast, it seems that the number of pegs correctly inserted by the controls is not uniformly affected by their 8 hour workday. The worker group showed a greater grip force than that of the control group, both before and after work.There was a statistically significant difference between the control and worker group with respect to the number of mistakes during the mirror trace and the time to complete this test only for the right hand. The difference in FSBP after cold provocation between the control and worker group observed is of medium importance when compared with effect sizes, however, there was no statistical significant difference. In this study, it was very difficult to make valid conclusions due to the limitations of a small sample size. A longitudinal study should be conducted preferably using newly appointed workers with no prior exposure to vibration and a sufficient control group to eliminate the effect other confounding variables such as general working conditions. / Thesis (MSc (Occupational Hygiene))--North-West University, Potchefstroom Campus, 2013.

Introdução: Prever a capacidade de resposta a fluidos continua sendo um desafio para os médicos que lidam com pacientes instáveis hemodinamicamente. A utilização de parâmetros estáticos, como pressão venosa central (PVC) tem sido usada por décadas, mas não é confiável, evidências robustas sugerem que seu uso deve ser abandonado. Ao longo dos últimos 15 anos, foram desenvolvidos vários testes dinâmicos, baseados no princípio de alteração da pré-carga cardíaca, usando as interações coração-pulmão, e, consequentemente do débito cardíaco. A elevação passiva das pernas (EPP), a infusão de pequenos volumes de fluidos, a variação da pressão de pulso (ΔPP), as variações nos diâmetros de grandes veias tem sido muito utilizados para avaliação de fluidoresponsividade (FR), neste contexto. Objetivo: Analisar e comparar medidas estáticas e dinâmicas antes, após EPP e após infusão de SF, verificando qual delas apresentam melhor FR. Métodos: Trinta e um pacientes instáveis hemodinamicamente e sob ventilação mecânica (VM) foram incluídos no estudo. Foram avaliados VTIFAO, VTIFMi, IDVCI, ΔPP, PVC, PAM antes de qualquer intervenção, após EPP e após infusão de 500ml SF. As variações dos parâmetros foram calculados para todos os pacientes. Resultados: Após EPP e infusão de SF o VTIFAO aumentou em 10% ou mais em 14 (45%) e 18 (58%) pacientes respectivamente, definidos como FR. A EPP previu a capacidade de resposta a fluidos com uma sensibilidade de 77,7%, especificidade de 100%, valor preditivo positivo de 100% e probabilidade de falso positivo de 0%. O parâmetro utilizado como padrão para FR foi o VTIFAO após SF. A PVC, o IDVCI, o ΔPP, PAM e avaliação médica não se mostraram capazes de avaliar adequadamente FR. Conclusão: Em pacientes instáveis hemodinamicamente e sob VM, a EPP foi capaz de avaliar FR com adequada sensibilidade e especificidade, podendo ser usada com segurança, antes da administração de fluidos. / Introduction: Predictig fluid responsiveness remains a constant challenge for physicians dealing with hemodynamically unstable patients. The use of static parameters, such as central venous pressure (CVP), although used for decades is not a trustworthy source, and the suggestion derived from more robust evidence suggests that the use of such should be abandoned. Over the last 15 years, various dynamic tests have been developed based on the principle of altering the cardiac preload, by using the heart-lung interactions and consequently cardiac output. Hence, Passive Leg Raising (PLR), the intake of small amounts of fluid, the variation of pulse pressure, variations in the diameter of large veins have all been widely used for evaluating fluid responsiveness (FR), within this context. Objective: The underlying objective behind this study was to test, if the non-invasive evaluation with transthoracic echocardiography, the Subaortic velocity time integral (VTI), the Distensibility Index of the Inferior Vena Cava (dIVC), the mitral velocity time integral (MTI), the (CVP) and the change in pulse pressure (ΔPP) after (PLR) and fluid infusion (500ml of saline solution) are able to predict the responsiveness of fluid therapy. Methods: Thirty one hemodynamically unstable patients, under mechanical ventilation (MV) were included in the study. Evaluations were made of VTI, MTI, DIVC), ΔPP and CVP before any intervention, after PLR and after infusion of 500ml saline solution. The variations of the parameters were calculated for all patients. Results: After PLR and infusion of saline solution, the VTI increased by 10% or more in 14 (45%) and 18 (58%) patients, respectively, defined as fluid responders. The PLR predicted a response capacity to fluids with a sensibility of 77,7%, specificity of 100%, a positive predictive value of 100% and a false positive probability of 0%. The CVP, dIVC, ΔPP, PAM and the medical evaluation were not capable of providing an adequate FR evaluation. Conclusion: In hemodynamically unstable patients under MV, PLR were capable of precisely predicting the capacity of FR. / Dissertação (Mestrado)