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Kent, Marjorie Anne. "Coping with angina pectoris following diagnosis." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24415.
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The purpose of this study was to determine how angina pectoris patients experience and cope with their chronic illness following diagnosis.
Qualitative methodology, using phenomenological theory, was used to guide the study. The study was conducted with a convenience sample of six male angina patients, ranging in age from 42 to 72 years, with recency of diagnosis from two to thirty-four months. None of these subjects were known to have had a myocardial infarction (MI). Using a semi-structured interview guide with open-ended questions, the investigator interviewed each subject at home, on two occasions. Data coding and analysis were approached using the constant comparative method developed by Glaser and Strauss (1967).
The findings of the study revealed angina patients progressing through four phases of coping experience as they adjusted to their illness and its concomitant need for risk modification. These phases were identified as: (1) Initial Coping Response; (2) Managing Specific Adjustment Areas; (3) Secondary Coping Response; and (4) Awareness of Resulting Changes.
The findings supported the use of a chronic illness framework adapted from Strauss et al. (1984) for identifying some of the adjustment areas encountered and coping strategies utilized by the angina patients investigated. Nurses and other health professionals are angina patients investigated. Nurses and other health professionals are in a critical position to assist angina patients in coping with their illness. The phases of coping experience identified in this study may serve as a useful guide to help these health professionals assess the nature of problems and concerns related to coping with angina so that better adjustment in daily life will ensue.Applied Science, Faculty of
Nursing, School of
Graduate
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Würbel, Helga. "Lokaler Kälteexpositionstest der Nagelfalzkapillaren bei Patienten mit vasospastischer Angina pectoris (Prinzmetal) und bei Patienten mit stabiler Angina pectoris /." [S.l : s.n.], 1988. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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Jerrewing, Magdalena Sohlin Madeleine. "Patienters kunskap och upplevelser av angina pectoris." Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-13461.
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Welsh, Colin John Percy. "Oestrogen replacement in postmenopausal women with angina pectoris." Thesis, University of Glasgow, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.421120.
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Borge, Fredrik, and Lena Winberg. "Patienters erfarenheter av att leva med angina pectoris." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-28211.
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Ett stort antal personer insjuknar varje år i kranskärlssjukdom, vilket inkluderar angina pectoris. Sjuksköterskan behöver ha goda kunskaper om hur patienter med angina pectoris erfar olika symptom relaterat till sjukdomsbilden, samt hur patienter anterar och lever med sin sjukdom. Detta för att kunna ge bästa stöd och arbeta på ett personcentrerat sätt. Syftet var att beskriva patienters erfarenheter av att leva med angina pectoris. Metoden som användes var litteraturstudie vilken grundades på tolv vetenskapliga artiklar vilka analyserades och sammanställdes. Resultatet visade att patienter med angina pectoris har olika erfarenheter av sjukdomen. Tre teman framkom i resultatet; Patienters erfarenheter av smärta och obehag, Patienters erfarenheter av stress och oro samt Patienters erfarenheter av stöd. Då befintlig forskning mer generellt inriktas på patienter med kranskärlssjukdomar, behövs mer specifik forskning där situationen för patienter med angina pectoris belyses.
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Forslund, Lennart. "Prognostic implications of exercise induced and ambulatory ischemia in patients with stable angina pectoris /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3894-6/.
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Rück, Andreas. "Myocardial gene therapy and gene expression in angina pectoris /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-648-4/.
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Chen, Fei. "Studies on vascular remodeling in acute coronary artery disease /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-467-8/.
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Silva, Silvia Sidnéia da. ""Angina pectoris instável: perfil de clientes de uma instituição privada"." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-27082004-093303/.
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Trata-se de estudo descritivo com abordagem de análise quantitativa que tem por objetivo identificar o perfil de clientes portadores de angina pectoris instável atendidos numa instituição privada, de um município do interior paulista. O referencial teórico utilizado foi o modelo de Campo de Saúde de Lalonde que analisa elementos como a biologia humana, meio ambiente, estilo de vida e organização dos serviços de saúde diante da ocorrência de patologias. A amostra constituiu-se de 58 clientes, com idade entre 34 e 88 anos, de ambos os sexos, a maioria aposentados, que reinternaram na Unidade Coronariana da referida instituição, no período de 01 de setembro de 2002 a 31 de março de 2003. A coleta de dados se deu no domicílio dos clientes, através de entrevista semi-estruturada; aplicada pela pesquisadora. Quanto à biologia humana 32,7% clientes apresentaram obesidade; os pais destes tiveram como causa mortis o infarto agudo do miocárdio e angina pectoris com índices de 24,1% e 20,7%, respectivamente; os antecedentes familiares mais freqüentes quanto às patologias foram a ocorrência de infarto agudo do miocárdio em 22,4% dos pais e hipertensão arterial sistêmica em 41,3% dos parentes próximos; 84,4% clientes possuíam hipertensão arterial sistêmica; 46,5% eram hipercolesterolêmicos; 27,5% tiveram doença vascular periférica e 17,2% apresentaram quadro de acidente vascular cerebral; valores de PAS≥140 mmHg e PAD≥90 mmHg, identificados em 71,1% e 55,7% dos clientes, respectivamente; além de valores de glicemia de jejum >110 mg/dl apresentados por 34,5% da amostra. Com relação ao meio ambiente, 55,1% dos clientes possuíam 1º grau incompleto e 8,6% eram analfabetos; 82,7% dos clientes eram casados, 65,5% não exerciam atividade remunerada e tinham renda familiar entre 03 e 06 salários mínimos. No que concerne ao estilo de vida, 100% dos clientes relacionaram a doença com fatores de risco como a hipertensão arterial sistêmica, o estresse, história familiar, dieta inadequada, tabagismo e falta de atividade física; 24,1% referiram o consumo de bebida alcoólica; 55,2% eram ex-fumantes; 37,9% dos clientes realizavam atividade física; 48,3% referiram fatos ocorridos antes da dor anginosa; 55,2% dos clientes relataram alterações de sono; inatividade sexual em 43,1% dos clientes sendo que 88,0% das clientes já estavam na menopausa e apenas 13,6% faziam terapia de reposição hormonal. No tocante ao atendimento de saúde, todos os clientes eram conveniados mas apenas 13,8% dos clientes utilizavam o serviço de medicina preventiva disponibilizado pelo convênio para prevenir doenças; o serviço de saúde pública é referência para a amostra no tocante à aquisição de medicamentos. Os achados confirmaram a interferência dos elementos referenciados pelo modelo de Campo de Saúde na ocorrência das patologias e identificaram a necessidade de trabalhar a mudança no estilo de vida dos clientes, através da prevenção dos fatores de risco para as doenças cardiovasculares e promoção da saúde, em geral.Descriptive study which was carried out in order to identify customers profiles with unstable pectoris angina attended in a Sao Paulos states town. The theoretical model used was the Lalondes Health Field Model, which analyses elements like human biology, environment, lifestyle, and health services organization ahead diseases occurrences. The sample was composed by 58 customers, aged between 34 and 88 year old, masculine and feminine, most of them retired, which were readmitted in a the mentioned Coronary Unitys institution. The data were collected at the customers residences and a semi- structured interview was used. Concerning about human biology, 32.7% male customers presented obesity; the parents died under acute infarct and pectoris angina and the percentual was 24,1% and 20,7%, respectively. The most common relatives diseases were related to the parents acute infarct (22,4%) and systemic arterial hypertension for the near relatives; 84.4% of the costumers suffered by systemic arterial hypertension; 46.5% had high cholesterol; 27.5% had peripheral vascular diseases and 17.2% demonstrated cerebral vascular accidents. Values like PAS≥140mmHg and PAD≥90 mmHg, identified in 71,1% and 55,7% among the customers, respectively; beyond glycemias values over 110mg/d, presented by 34,4% among the costumers. According to the environment, 55,1% customers didnt study high school and 8,6% were illiterate; 82,7% were married and among them 65.5% didnt have remunerate activity and their familiar remuneration was between 03 and 06 Brazils minimum salary. Related to the life style, 100% customers related the disease with risk factorsdiseases as systemic arterial hypertension, stress, family history, inadequate diet, smoking and physical activitys lack; 24,1% referred alcoholics drinks consume; 55,2% were ex-smokers; 37,9% practiced physical activity; 55.2% related sleeping problems; 43,1% related sexual inactivity and among them 88,0% female costumers already had menopause and only 13.6% were doing hormonal replacement therapy. About health services, all the costumers were had health policies but only 13.8% customers had used preventive medicine. The public health service is a reference in medicines acquisition. The data confirm the mentioned health field model elements in the happening of diseases and identify the need of working on changes in the costumers life style, through risk factors prevention for the cardiovascular diseases and health promotion.
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Mohammad, Razhan, and Peyam Eizuldeen. "Radiologiska undersökningsmetoder vid diagnostisering av Stabil Angina Pectoris : En litteraturstudie." Thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-50532.
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Wilcox, Ian. "Predictors of adverse prognosis in unstable angina." Thesis, The University of Sydney, 1991. https://hdl.handle.net/2123/26398.
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The prognostic significance of a clinical diagnosis of unstable angina was examined in a prospective study of 530 consecutive patients admitted with suspected unstable coronary disease. The 296 patients with a clinical diagnosis of unstable angina were shown to be at high risk of cardiac death, myocardial infarction or recurrent unstable angina in the year after presentation. This adverse outcome was no different to that of 64 patients with the diagnosis of a small myocardial infarction based on serial cardiac enzymes. In contrast, the outcome of 170 patients who presented with suspected unstable coronary disease, which was not confirmed clinically (’suspected unstable angina"), was excellent and most of these low risk patients could be identified clinically early after admission to hospital.
Factors which identified patients with unstable angina at relatively increased risk of adverse events, were examined using multivariate analysis. This showed that clinical (diabetes, prior coronary bypass surgery) and ECG descriptors (deep T wave inversion on admission) were independent adverse prognostic factors in unstable angina. Evidence of left ventricular dysfunction was also an important determinant of risk of death or nonfatal infarction. In contrast, transient ECG changes during rest pain, documented in only 21% of patients, were only important in the subgroup of 202 patients with unstable angina who had coronary angiography. Among patients who had angiography. the number of diseased vessels was an independent prognostic factor but inferior to non-invasive predictors such as rest pain after admission and transient ECG changes during pain.
The clinical significance of transient myocardial ischaemia detected by early continuous ECG recordings, performed within 24 hours of admission to hospital, was examined in 66 patients. In these patients, who had a low prevalence of transient ECG changes on 12—lead ECGs recorded during chest pain, episodes of transient ischaemia occurred in only 11% of patients but when present indicated adverse prognosis. However, transient ischaemia during the continuous ECG recordings was a much less sensitive prognostic factor than symptoms of rest pain after admission.
The prognostic importance a pre-discharge exercise test was assessed in 107 patients discharged on medical therapy. Low rate x pressure product and ischaemic ECG changes during the exercise test were shown to be independent predictors of adverse outcome. However, in contrast to previous studies, these exercise test descriptors were shown to add independent adverse prognostic information to standard clincial and serial ECG descriptors.
Pre-discharge exercise testing was compared with real-time ambulatory ECG monitoring to detect myocardial ischaemia in 40 patients with unstable coronary disease, either unstable angina (32 patients) or a small myocardial infarction (8 patients). The exercise test detected ischaemia in more patients than ambulatory ECG monitoring. There was a close relationship between the magnitude of ST segment depresssion during the exercise ECG and the probability of detecting ischaemic episodes during ambulatory monitoring. Patients with negative exercise ECGs were unlikely to have ischaemia during ambulatory monitoring whereas patients with a strongly positive exercise ECG were likely to have ischaemia during ambulatory monitoring. Since patients with stable angina who have frequent episodes of ishcaemia during daily life are at increased risk of adverse events, this technique may be useful in patients with recent unstable coronary disease, particularly those with positive exercise ECGs.
The prevalence of anticardiolipin antibodies was examined in a subgroup of 67 patients with unstable angina. Although 33% of patients had elevated antibody levels, there was an apparently inverse relationship between a prior history of unstable coronary disease or bypass surgery and normal antibody levels which was unexpected and not explained. There was no relationship between anticardiolipin antibody levels and subsequent clinical events.
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Azadan, Niaz. "Den diagnostiska säkerheten i arbetsprov på kvinnor med angina pectoris : Slutversion." Thesis, Hälsohögskolan, Jönköping University, HHJ, Avd. för naturvetenskap och biomedicin, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-49238.
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Angina pectoris är bröstsmärta orsakat av myokardischemi, till följd av kranskärlsjukdom med eller utan stenoser eller icke kranskärlsjukdom. Arbetsprov är den vanligaste undersökningen för angina pectoris. Diffusa symtom och angina pectoris varianter utan stenoser med låg sensitivitet för elektrokardiografi (EKG) sänker den diagnostiska säkerheten i arbetsprov på kvinnor. Litteraturstudiens syfte var att utreda om hemodynamiska parametrar och riskbedömning med Pre-test sannolikhet (PTP) samt Dukes Löpbands Index (DTS, Dukes Treadmill Score) kan öka den diagnostiska säkerheten i arbetsprov på kvinnor. Inklusionskriterierna var vetenskapligt granskade kliniska studier på engelska, med information om etiskt godkännande eller samtycke. Snowballing metoden, PUBMED, MEDLINE och CINAHL användes. Studier som inkluderades i resultatet granskades återigen och jämfördes med varandra. Hemodynamiska parametrar, PTP och DTS ökar den diagnostiska säkerheten i arbetsprov på kvinnor. Denna diagnostiska säkerhet beror dock också på PTP metod, PTP riskgrupp, etnicitet och angina pectoris variant. Vidare forskning behövs om etnicitetspecifika PTP metoder, mekanismen bakom blodtrycksreaktionen, DTS på icke kranskärlsjukdomar samt metoder som kan skilja mellan olika icke kranskärlsjukdomar. Utan studier om Systematic COronary Risk Evaluation (SCORE) och Diamond Forrester Score (DFS) samt deras påverkan på arbetsprov, kan inte resultatet i litteraturstudien generaliseras till arbetsprov i Sverige.Angina pectoris is chest pain and myocardial ischemia due to Coronary Artery Disease (CAD) or Non-Coronary Artery Disease (non-CAD). Exercise stress test (EST) is the most common diagnostic procedure for angina pectoris. Non-CAD, low sensitivity for exercise electrocardiography (ex-ECG) and diffuse symptoms lower the diagnostic accuracy for females. This review’s aim was to study whether haemodynamic parameters and risk stratifications with Pre-test probability (PTP) or Duke Treadmill Score (DTS) improves the diagnostic accuracy of EST for females. Inclusion criterions were English peer reviewed, clinical studies with mentioned ethical approval or consent. Snowballing, PUBMED, MEDLINE and CINAHL were used. Articles that were included in the results, were reviewed once again, and compared to one another. Hemodynamic parameters, PTP and DTS increase the diagnostic accuracy of EST in women. This diagnostic accuracy depends on PTP method, risk group, ethnicity, and angina pectoris variant. Further research regarding ethnic specific PTP methods, mechanism behind the blood pressure reaction, DTS for diagnosis of non-CAD and methods for differentiation of subtypes of non-CAD, would be valuable. Without studies about the Systematic Coronary Risk Evaluation (SCORE), Diamond Forrester Score (DFS), and their impact on ex-ECG, the result of this review cannot be generalized to ex-ECG in Sweden.
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Beckman, Jeannette, and Maria Nilsson. "Symtom och hälsorelaterad livskvalitet med angina pectoris kopplat till kropp-själ." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25853.
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Beckman, J & Nilsson, M. Symtom och hälsorelaterad livskvalitet med anginapectoris kopplat till kropp-själ, ur ett genusperspektiv. En litteraturstudie.Examensarbete i Omvårdnad. 15 högskolepoäng .Malmö högskola: Hälsa ochSamhälle, Utbildningsområde omvårdnad, 2009.Syftet med denna litteraturstudie är att beskriva symtom och hälsorelateradlivskvalitet med angina pectoris ur ett genusperspektiv kopplat tillmänniskodimensionerna, kropp-själ. Metoden som används är sökning av relevantlitteratur databas Pubmed och Cinahl, vilket resuterar i ett urval av kvantitativaartiklar som granskas enligt Polit & Beck (2001). Resultatet i litteraturstudienvisar att män och kvinnor lokaliserar smärta vid angina pectoris oftast på centraltbröstparti men också att det finns skillnader i beskrivningarna av smärtan.Kvinnor beskriver smärtan med känslor så som varm-brännande, orolig mage elleråtstramning i hals nacke. Män beskriver sin smärta som värk ellergenomträngande. Kvinnor upplever att de har mer smärta än männen. När kvinnoroch män får självskatta sin livskvalitet så visar det sig att kvinnor har sämrelivskvalitet jämfört med männen. Resultatet tas upp för diskussion och jämförelsemed sjuksköterskans omvårdnadsarbete, omvårdnadsteorier om lidande ochgenus.Beckman, J & Nilsson, M. Symtom and health related quality of life with anginapectoris related to body-spirit, from a gender perspective. A litteratur review.Degree Project, 15 Credit Points. Nursing Programme, Malmö University: Healthand Society, Department of Nursing, 2009.The aim of this study is to describe symptoms and health related quality of life ofangina pectoris from a gender perspective - related to the dimensions of human,body-spirit. The applied methodology is search for relevant articles in databasesPubmed and Cinahl. The search gives a selection of quantitative articles that arereviewed according to Polit & Beck (2001). The result of this study shows thatmen and women locate pain from angina often in the central abdominal but alsothat there is a gender oriented difference. Women describe pain with feelings suchas hot-burning, upset stomach or tightness in neck/throat. Men describe their painas ache or throbbing. Women experience that they have more pain than men.When women and men have to estimate their quality of life the study shows thatwomen had lower quality of life compared to men. The results are finallycompared and discussed with nurse caring, theories of care and suffering andgender differences.
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Willoughby, Scott R. "Inhibition of human platelet aggregation by perhexiline maleate : mechanisms and therapeutic implications /." Title page, contents and summary only, 1999. http://web4.library.adelaide.edu.au/theses/09PH/09phw739.pdf.
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Glover, Jessica Colleen. "Coronary Vasospasm signs, symptoms, risk factors and management /." Montana State University, 2009. http://etd.lib.montana.edu/etd/2009/glover/GloverJ0509.pdf.
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Storti, Fernanda Coutinho. "Avaliação prognóstica da doença coronária estável através de um escore composto com dados clínicos e o resultado do teste de esforço." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-11012012-151652/.
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Introdução. A necessidade de melhorar a acurácia do teste de esforço determinou o desenvolvimento de escores, cuja aplicabilidade já foi amplamente reconhecida. Objetivo. Avaliação prognóstica do coronariopata estável por meio de um novo escore simplificado ao ser comparado com o escore de Hubbard. Métodos. Um novo escore foi aplicado em 372 coronariopatas bi ou triarteriais, 71,8% homens com idade média de 59,5+9,07 anos, randomizados para angioplastia, revascularização cirúrgica e tratamento clínico, com seguimento de cinco anos. O óbito cardiovascular foi o desfecho primário. O infarto do miocárdio não-fatal, e o óbito e re-intervenção formaram o desfecho combinado secundário. O escore baseou-se em uma equação previamente validada, resultante da soma de um ponto para: gênero masculino, história de infarto, angina, diabetes, uso de insulina e ainda um ponto para cada década de vida a partir dos 40 anos. Para o teste positivo foi adicionado um ponto. Resultados. Ocorreram 36 óbitos (10 no grupo angioplastia, 15 no grupo revascularização e 11 no grupo clínico), p=0,61. Observou-se 93 eventos combinados: 37 no grupo angioplastia, 23 no grupo revascularização e 33 no grupo clínico (p=0,058). Duzentos e quarenta e sete pacientes apresentaram escore clínico 5 pontos e 216 pacientes 6 pontos. O valor de corte >5 ou >6 pontos identificou maior risco, com p=0,015 e p=0,012, respectivamente. A curva de sobrevida mostrou uma incidência de óbito após a randomização diferente daquela com escore 6 pontos (p=0,07), e uma incidência de eventos combinados diferente entre pacientes com escore <6 e 6 pontos (p=0,02). Conclusão. O novo escore demonstrou consistência na avaliação prognóstica do coronariopata estável multiarterialIntroduction. The need to improve the exercise testing accuracy, lead the development of scores, which applicability were already widely recognized. Objective. Prognostic evaluation of stable coronary disease throughout a new simplified score. Methods. A new score was applied in 372 bi or triarterial coronary patients, 71,8% men mean age 59,5+9,07 years, randomized for percutaneous coronary intervention (PCI), coronary artery bypass graft surgery (CABG) and clinical treatment, with 5 years follow-up. Cardiovascular death was considered the primary outcome. Non-fatal myocardial infarction, death and re-intervention were considered the combined secondary outcome. The score was based on a previously validated equation, resulting from a sum of one point score for: male gender, infarction history, angina, diabetes, use of insulin and one point score for each decade of life after the age of 40 years. Positive exercise testing summed one additional point score. Results. There were 36 deaths (10 in the PCI group, 15 in the CABG group and 11 in the clinical group), p=0.61. There were 93 combined events: 37 in the PCI group, 23 in CABG group and 33 in the clinical group (p=0.058). Two hundred and forty-seven patients presented a clinical score 5 points and 216 patients 6 points. The cut-off point 5 or 6 identified an increased risk, p=0.015 and p=0.012, respectively. The survival curve showed a different death incidence after the randomization when the score reached 6 points or more (p=0.07), and a distinct incidence of combined events between the patients with points score <6 and 6 (p=0.02). Conclusion. The new score showed to be consistent in the prognostic evaluation of stable multivessel coronary artery disease
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Eriksson, Björn E. "Angina pectoris: neurophysiological mechanisms : with special references to adenosine and Syndrome X /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3809-1/.
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Souza, Alinne Alice Dias de Araujo. "Doen?a periodontal e angina pectoris est?vel: um estudo caso-controle." Universidade Federal do Rio Grande do Norte, 2009. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17050.
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Previous issue date: 2009-04-20The search which it aim was to analyze the Periodontal Disease as a risk factor for the development of the Stable Angina Pectoris. For that, 120 patients (52 blokes and 68 wenches ), ages ranging from 40 to 65 years old, and attended to the Hemodinamic?s Sector of the Natal Hospital Center, showing the historic of Angina Pectoris to accomplishment of cinecoronariografhy. Before the accomplishment of this exam, the patients were submitted to interview, to investigate the possible risk factors for the Cardiovascular diseases , and it was followed of clinical periodontal examination to evaluate the presence of Periodontal Disease. After the cinecoronariography, the patients who presented diagnosis of important arterial obstruction (above 70%) were enrolled to the case grup. However the individuals with arteries free of obstruction, or obstrution below 30%, were considered without historic of Cardiovascular disease and therefore enrolled for the control grup. The groups were paired by the variables age and gender. From the analysis of the results, a did not observed statisticment the significant association between the presence of the Periodontal Disease, probing depth, periodontal attachment level, severity and extension index of the Periodontal Disease, besides the visible plaque index (VPI) an gingival bleeding index (GBI) regarding to the existence of Stable Angina Pectoris. Nevertheless , it was identified statisticment the significant association between the sistemic arterial hypertension , seric level of total cholesterol, LDL, HDL and triglycerides, showing all of them, classic risk factors appointed by the literature. Therefore, it was conclued that Periodontal Disease did not represent association with the StableAngina Pectoris at least among the studied population
Este trabalho teve como objetivo avaliar a doen?a periodontal como fator de risco para o desencadeamento da angina pectoris est?vel. Para tanto, foram examinados 120 pacientes (52 homens e 68 mulheres), com idade entre 40 e 65 anos, que compareceram ao Setor de Hemodin?mica do Natal Hospital Center, com hist?rico de Angina Pectoris e que foram submetidos ? cinecoronariografia. Antes da realiza??o de tal exame, os pacientes foram entrevistados para investiga??o de poss?veis fatores de risco ?s doen?as cardiovasculares, seguida de exame cl?nico periodontal para avalia??o dos par?metros relacionados ? doen?a periodontal. Ap?s a realiza??o da cinecoronariografia, os pacientes que apresentaram diagn?stico de obstru??o arterial importante, acima de 70%, foram arrolados para o grupo caso. J? os indiv?duos com art?rias isentas de obstru??es ou obstru??es inferiores a 30%, foram considerados sem hist?rico de doen?a cardiovascular e, portanto, arrolados para o grupo controle. Os grupos foram emparelhados pelas vari?veis idade e g?nero. A partir da an?lise dos resultados, n?o observouse associa??o estatisticamente significativa entre a presen?a da doen?a periodontal, da profundidade de sondagem, do n?vel de inser??o periodontal, dos ?ndices de extens?o e severidade da doen?a periodontal, al?m do ?ndice de de sangramento gengival, em rela??o ? exist?ncia de angina pectoris est?vel. No entanto, identificou-se associa??o estatisticamente significativa entre a hipertens?o arterial sist?mica, o n?vel s?rico de colesterol total, de LDL, de HDL e de triglicer?deos, compreendendo estes os fatores de risco cl?ssicos para a doen?a cardiovascular apontados pela literatura. Portanto, conclui-se que a doen?a periodontal n?o constitui fator de risco para o desencadeamento da angina pectoris est?vel nesta popula??o estudada
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Andersson, Jessica, and Caroline Hemberg. "Livsstilsförändringar hos patienter med angina pectoris efter sekundärpreventivt behandlingsprogram : en kvalitativ intervjustudie." Thesis, Sophiahemmet Högskola, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3021.
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Kranskärlssjukdom anses vara en av de vanligaste dödsorsakerna i världens höginkomstländer och kan idag även benämnas som en folksjukdom som drabbar personer i alla åldrar. Sjukdomen är komplex och delas oftast in i stabil angina pectoris och akut koronart syndrom [AKS]. Riskfaktorer som t.ex. högt blodtryck, höga blodfetter och rökning ökar risken avsevärt för att drabbas av kranskärlssjukdom eller att återinsjukna. Fokus på att reducera dessa riskfaktorer kan förbättra överlevnad, minskar risken för nya kardiovaskulära händelser samt kan förbättra livskvalitén. Det grundar sig bl.a. i sjukvårdens sekundärpreventiva arbete där information och kunskap om riskfaktorer kan leda till livsstilsförändringar. Hjärtrehabiliteringssjuksköterskans roll innebär bl.a. att utbilda och vägleda patienten till livsstilsförändringar utifrån ett personcentrerat förhållningssätt och ett individuellt stöd som kan generera hälsofrämjande fördelar. Syftet var att undersöka om patienter med angina pectoris genomfört livsstilsförändringar efter att ha medverkat i ett sekundärpreventivt behandlingsprogram samt beskriva deras upplevelse av den givna informationen. En empirisk intervjustudie med kvalitativ ansats användes, där intervjuer av sju informanter utfördes med hjälp av en semistrukturerad intervjuguide. Alla informanter hade nydiagnostiserats med angina pectoris, deltagit i hjärtskola och haft uppföljningssamtal hos hjärtrehabiliteringssjuksköterskan. Det insamlade intervjumaterialet analyserades med en kvalitativ innehållsanalys på en manifest nivå. I resultatet framträdde fyra kategorier; beteendeförändring, önskan om personcentrerad vård, kunskap om att tillämpa egenvård och livsstilsförändringar kan ge hälsorelaterad livskvalitet. Första kategorin ”Beteendeförändring” beskrev önskan om förändringar, dels av redan invanda vanor men även skapandet av nya hälsosamma vanor. Det framkom en ökad medvetenhet kring hälsofrämjande vanor men de upplevdes vara svåra att bibehålla och därför fanns en önskan om mer uppföljning från hjärtrehabiliteringspersonal. Nästa kategori var ”Önskan om personcentrerad vård”. Det var önskvärt att den information och utbildning som tillämpades skulle vara personcentrerad och individanpassad då förutsättningarna och behoven hos informanterna var olika. Det kunde då ge trygghet och möjlighet att hantera sin sjukdom men det grundade sig i att det skedde återkoppling från bl.a. hjärtrehabiliteringssjuksköterskan. Nästa kategori, ”Kunskap att tillämpa egenvård” beskrev vikten av information. En välinformerad patient med sjukdomsinsikt gjorde mer livsstilsförändringar och bibehöll dom. Det gav även en motivation till delaktighet i sin egenvård men där kunskap saknades eller informationen inte nått fram gav det motsatt resultat. Den sista kategorin som framträdde var ”Livsstilsförändringar kan ge hälsorelaterad livskvalitet” där betydande faktorer var ett ökat välmående till följd av god psykosocial hälsa. Att stärka känslan av god livskvalitet genom ett helhetsperspektiv. Denna studie visar på att sekundärprevention kräver en personcentrerad vård som utgår från den enskildes behov och förutsättningar. Det grundar sig i en individuell behandlingsplan med en anpassad information som skapar förutsättningar för delaktighet och kunskap och som sin tur kan leda till livsstilsförändringar. Men det kräver även kvalitetsutveckling med tydligare riktlinjer och rutiner kring uppföljning och återkoppling.
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MUROHARA, TOYOAKI, MUTSUHARU HAYASHI, SOICHIRO KUMAGAI, MIHO TANAKA, SEIICHI HAYAKAWA, HIDEKI ISHII, DAIJI YOSHIKAWA, and MASAYA MATSUMOTO. "MORPHOLOGIC CHARACTERIZATION AND QUANTIFICATION OF SUPERFICIAL CALCIFICATIONS OF THE CORONARY ARTERY : IN VIVO ASSESSMENT USING OPTICAL COHERENCE TOMOGRAPHY." Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16736.
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Palelogou, A. "Inquiry into changes in the psychological profile of new angina pectoris male patients." Thesis, University of Manchester, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.582621.
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Dewes, Patricia [Verfasser]. "Inkrementelle prognostische Relevanz der Stress-Perfusions-Magnetresonanztomographie bei stabiler Angina pectoris / Patricia Dewes." Ulm : Universität Ulm. Medizinische Fakultät, 2013. http://d-nb.info/1044023341/34.
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Lockowandt, Ulf. "Endothelial function and dysfunction in coronary artery bypass grafting /." Stockholm : [Karolinska institutets bibl.], 2002. http://diss.kib.ki.se/2002/91-7349-111-x/.
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Duda, Norberto Toazza. "Ensaio clínico randomizado comparando implante de próteses intracoronárias com e sem revestimento de carbeto de silício amorfo." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2001. http://hdl.handle.net/10183/16857.
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Горбунова, А. Ю., and В. І. Смирнова. "Івабрадин у комплексному лікуванні хворих на стабільну стенокардію." Thesis, Сумський державний університет, 2017. http://essuir.sumdu.edu.ua/handle/123456789/54842.
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Alan, Mustafa. "Der Effekt von Abciximab auf Proliferation, Migration und ICAM-1 Expression in humanen koronaren Gefäßwandzellen." [S.l. : s.n.], 2006. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-55874.
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Todd, Iain Charles. "A study of the mechanisms underlying the cardiac effects of exercise training in angina pectoris." Thesis, University of Edinburgh, 1989. http://hdl.handle.net/1842/27008.
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This thesis investigates the use of exercise training as a therapy in the management of angina pectoris. The hypothesis underlying this work is that in the presence of ischaemia the myocardium will, if possible, respond in such a way as to minimise the effects of ischaemia. Improved collateral function was felt to be the most likely mechanism. A series of non-invasive investigations was developed in such a way as to make them useful for the detection of any possible improvement in myocardial ischaemia. These investigations included treadmill exercise tolerance testing, Thallium scintigraphy, Technetium ventriculography, exercise echocardiography and 24 hour ambulatory ECG monitoring. These techniques were refined for use in this study by the development of computerised analysis where appropriate. Forty male patients under 60 years of age with angina pectoris and no prior myocardial damage were recruited and randomised into exercise and control groups. Both groups were followed up over a one year period, the exercise group carrying out a brief daily home-based exercise programme, using the Canadian Airforce PBX Program for Physical Fitness. The techniques developed proved to be effective follow up tools in this group. Using them significant improvements in treadmill performance were demonstrated in the exercise group. These improvements were found to be partly due to changes in the peripheral control of exercise induced heart rate increases but also due to myocardial improvements. The peripheral effects were compared to and contrasted with betablockade. Within the myocardium significant reductions in ischaemic area were demonstrated, particularly in the territory of the left anterior descending coronary artery. These improvements in perfusion were accompanied by improvements in left ventricular function and regional wall motion. The improvements demonstrated in the laboratory were also evident during ambulatory ECG monitoring. The results demonstrated support the hypothesis outlined that controlled myocardial ischaemia can induce improvements in myocardial perfusion due to collateral enhancement and furthermore support the use of these techniques in such follow up studies.
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Widdershoven, J. W. M. G. Vreede-Swagemakers J. J. M. de. "Acute Coronary Syndromes in the Maastricht area acute myocardial infarction, unstable angina pectoris, sudden cardiac arrest /." Maastricht : Maastricht : Universiteiet Maastricht ; University Library, Maastricht University [Host], 1997. http://arno.unimaas.nl/show.cgi?fid=5911.
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Davies, H. J. A. "Angina and oesophageal disease : a study of 1, the relationship between angina pectoris and oesphageal disease, and 2, the medical treatment of oesophageal spasm." Thesis, University of Oxford, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.370253.
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Laubner, Katerina [Verfasser], Julinda [Akademischer Betreuer] Mehilli, and Herbert [Akademischer Betreuer] Deppe. "Der prognostische Nutzen von sensitivem Troponin T bei Patienten mit stabiler oder instabiler Angina pectoris, nicht nachweisbarem konventionellen Troponinspiegel und Revaskularisation : Sensitives Troponin bei Patienten mit Angina pectoris / Katerina Laubner. Gutachter: Herbert Deppe. Betreuer: Julinda Mehilli." München : Universitätsbibliothek der TU München, 2012. http://d-nb.info/1022683853/34.
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Finsterer, Stefan. "Nichtinvasive Bypass-Angiographie mit dem Cardio-CT zur Erkennung eines Bypassverschlusses bei Patienten ohne Angina pectoris." Diss., lmu, 2005. http://nbn-resolving.de/urn:nbn:de:bvb:19-46634.
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Zare, Jaber [Verfasser]. "Freisetzungskinetik von hochsensitiv gemessenem Troponin T bei stabiler Angina pectoris und induzierter myokardialer Ischämie / Jaber Zare." Gießen : Universitätsbibliothek, 2019. http://d-nb.info/1182224776/34.
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Ylöstalo, P. (Pekka). "Dental health, lifestyle and cardiovascular risk factors—a study among a cohort of young adult population in northern Finland." Doctoral thesis, University of Oulu, 2008. http://urn.fi/urn:isbn:9789514287213.
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Abstract
To date, most epidemiological studies have shown a weak or moderate association between dental diseases such as periodontal infections, dental caries and tooth loss, and atherosclerotic vascular diseases. However, the nature of this association is not known; it may be due to the biological effect of oral infections on initiation or progress of atherosclerosis or it may be non-causal due to determinants in common, either biological or behavioural. Methodological shortcomings, inconsistent results and a lack of definite proof from intervention studies have led to the conclusion that causality between dental diseases and atherosclerotic vascular diseases has not been established. The aim of this study was to produce evidence on the nature of the association between dental diseases and atherosclerotic vascular diseases.
The study uses data from the 1966 Birth Cohort of Northern Finland (N = 11,637). The data were collected in 1997–1998, when the cohort members had reached 31 years of age. The respondents were asked through a postal questionnaire about their oral health. In addition, respondents were asked about their general health and oral and general health habits. The response rate was 75.3%. Those who lived in Northern Finland or the capital city region were invited to clinical health examination (N = 8,463). Altogether 5,696 subjects supplied the data, representing 67.3% of those who were invited to the clinical examination.
While the study showed an association of self-reported gingivitis, dental caries and tooth loss with the prevalent angina pectoris, it also showed that these self-reported dental diseases were not important determinants for elevated C-reactive protein levels. This suggests that the associations that were found between dental conditions and prevalent angina pectoris are mainly caused by factors other than biological mechanisms related to infection or inflammation. The lack of a biological explanation related to infections or inflammatory processes suggests that other biological mechanisms or biases, including confounding, should be considered as an alternative explanation. However, it must be noted that the possibility that oral infections also contribute to the development of atherosclerosis should not be rejected either.
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Schiessl, Stephan. "Einsatz der Koronarkalkbestimmung und der nicht invasiven Angiographie mittels Mehrzeilen-Computertomographie bei Patienten mit instabiler Angina pectoris." Diss., lmu, 2010. http://nbn-resolving.de/urn:nbn:de:bvb:19-123389.
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Müller, Erik. "Einfluss der perkutanen koronaren Intervention (PCI) auf das Ergebnis der elektiven chirurgischen Koronarrevaskularisation bei stabiler Angina pectoris." Doctoral thesis, Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-165781.
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Erkrankungen der Herzkranzgefäße sind die häufigste Todesursache in den Industrieländern. Chirurgische und interventionelle Verfahren spielen eine wichtige Rolle in ihrer Behandlung. Die Anzahl perkutaner koronarer Interventionen (PCI) nimmt seit ihrer Einführung stetig zu. Bislang ist unklar, welchen Einfluss diese Entwicklung auf das Ergebnis einer späteren chirurgischen Revaskularisierung hat.
Für die vorliegende Arbeit wurden 815 Patienten untersucht, die sich im Jahr 2008 am Herzzentrum Leipzig einer koronaren Bypassoperation unterzogen. Davon wiesen 181 Patienten präoperativ eine oder mehrere PCI auf. Die retrospektiv erhobenen Daten wurden mithilfe von χ²-Test, t-Test und Mann-Whitney-U-Test ausgewertet. Die gewonnenen Follow-up Daten wurden mittels logistischer Regressionsanalyse, Cox-Regressionsanalyse und dem Kaplan-Meier-Überlebensmodell ausgewertet. Es wurde untersucht, inwieweit präoperativ durchgeführte PCIs das Ergebnis der chirurgischen Revaskularisierung beeinflussten.
Eine vorausgegangene PCI konnte nicht als negativer Prädiktor für die Krankenhausmortalität (OR 0,87; CI 0,24–3,13; p = 0,836) oder für das Auftreten von MACCE (OR 0,55; CI 0,26–1,19; p = 0,129) nachgewiesen werden. Das Risiko für MACCE im Follow-up erhöhte sich abhängig von der Anzahl der präoperativ stattgehabten PCIs (HR 1,07; CI 1,01–1,14; p = 0,017) und der Anzahl implantierter Stents (HR 1,14; CI 1,05–1,22; p = 0,001). Dies zeigte sich speziell bei der Verwendung von bare-metal stents (HR 1,18; CI 1,08–1,29; p ≤ 0,001). Die genannten Variablen konnten jedoch nicht als unabhängige Einflussgrößen bestätigt werden. Die Patienten der PCI-Gruppe litten im Langzeitverlauf signifikant häufiger an Dyspnoe (p = 0,023) und an pectanginösen Ruhebeschwerden (p = 0,009).
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Skrockienė, Kristina. "Pacientų sergančių stabiliąja krūtinės angina gyvenimo kokybės vertinimas." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2005. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2005~D_20050615_111445-72562.
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SUMMARY
Aim: To evaluate the quality of life of patients with stable angina pectoris, the decrease of physical load tolerance by them and influence of prevention measures for their quality of life.
Methods of the study: The following research methods were used for the study: questioning of patients, interview method, method of document analysis, statistical data processing. The study sample consisted of 93 investigated persons. All investigated persons were divided into two groups: the first group included patients with stable angina pectoris of functional classes III-IV; the second group comprised the investigated with stable angina pectoris of funktional classes I-II (according to the classification of the Canadian Heart Association).
Findings: Very limited physical activity was found in 14,6 % of patients of the investigated group, moderately limited in 29,2 %, partially limited in 39,5 %, litlle limited in 12,5 % and unlimited in 4,2% of patients of the investigated group. After receiving findings of the study we could state that physical activity was more or less limited in more than 95 % of patients with AP (of functional slasses III-IV). The number of patients of the compared group distributed in the following way by the abovementioned ranges: very limited physical activity was in case of 11,1% of patients, moderately limited in 40 %, partially limited in 31,1 %, little limited in 11,1 %, unlimited in 6,7 % of patients of the compared groups.
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Гордіна, Марина Андріївна, Марина Андреевна Гордина, Maryna Andriivna Hordina, Альбiна Володимирiвна Жаркова, Альбина Владимировна Жаркова, Albina Volodymyrivna Zharkova, and Г. О. Логвинюк. "Вплив застосування L-аргініну на толерантність до фізичного навантаження у хворих на стабільну стенокардію напруги." Thesis, Сумський державний універсистет, 2015. http://essuir.sumdu.edu.ua/handle/123456789/41783.
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Незважаючи на визначеність факторів ризику ішемічної хвороби серця (ІХС), використання
базисних схем лікування, захворюваність та смертність від даної патології займає перше місце
серед населення України. Визначення додаткових факторів ризику розвитку серцево-
судинних захворювань та використання нових схем лікування є актуальною проблемою.
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Geovanini, Glaucylara Reis. "Associação entre apneia obstrutiva do sono e lesão miocárdica em pacientes com angina refratária." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5150/tde-24082015-114849/.
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Introdução: A doença arterial coronária (DAC) é a principal causa de mortalidade nos países industrializados e representa cerca de 10% de todos os óbitos no Brasil.1 Num espectro de maior gravidade dos pacientes com DAC crônica, encontram-se aqueles classificados como angina refratária, uma vez que apresentam sintomas aos esforços habituais e mesmo ao repouso, a despeito de otimização da terapêutica clínica e do controle de fatores de risco. No conhecimento e combate aos fatores de risco da DAC, a apneia obstrutiva do sono (AOS) é comum nesta população,2 no entanto, ainda sub diagnosticada e seus potenciais efeitos deletérios no sistema cardiovascular precisam ser esclarecidos. A AOS é caracterizada por episódios recorrentes de obstrução parcial (hipopneias) ou total (apneias) das vias aéreas superiores durante o sono. Estes eventos recorrentes geram hipoxemia intermitente e aumento da estimulação simpática, com consequente aumento da demanda de oxigênio pelo miocárdio durante o sono. No entanto, o papel da AOS em pacientes com angina refratária é desconhecido. Objetivos: Estudo 1: comparar a prevalência de AOS em duas populações de DAC crônica, a de angina refratária, com sintomas limitantes e recorrentes, com a de pacientes com DAC estável. Estudo 2: avaliar a associação entre lesão miocárdica e AOS em pacientes com angina refratária. Material e Métodos: Estudo 1: pacientes consecutivos, com diagnóstico estabelecido de angina refratária, que faziam parte do NEPAR (Núcleo de Ensino e Pesquisa em Angina Refratária) do InCor, foram avaliados para presença de AOS, através do exame de polissonografia (PSG) noturna, que é padrão-ouro para diagnóstico de AOS. Eles foram comparados ao grupo de pacientes com DAC estável (pacientes com DAC crônica, em pré-operatório para cirurgia de revascularização miocárdica (RM), que faziam parte do ambulatório de DAC crônica do InCor), sendo que a frequência de AOS nestes pacientes com DAC estável já foi descrita previamente.3 Todos os pacientes foram avaliados quanto a condições clínicas preexistentes, uso de medicamentos, medidas antropométricas, aferição de pressão arterial (PA) e Resumo frequência cardíaca (FC) ao repouso e responderam questionários para avaliação da qualidade do sono. Estudo 2: os pacientes com diagnóstico de angina refratária, do NEPAR, foram encaminhados ao laboratório do sono do InCor e submetidos a: avaliação clínica detalhada, medidas antropométricas, questionários de qualidade do sono e exame de PSG noturna. Eles também foram avaliados quanto a presença de isquemia miocárdica por exames de imagem: ressonância magnética cardíaca (RMC) e/ou cintilografia de perfusão miocárdica (CPM). A dosagem da troponina T ultra-sensível (TnT-us) também foi realizada, sendo que a determinação deste biomarcador foi feita em três coletas (às 14, 22 e 07h). Sendo as duas primeiras coletas (14 e 22h) pré exame de PSG noturna e a coleta das 07h foi realizada na manhã seguinte após exame de PSG. Resultados Estudo 1: foram avaliados 79 pacientes com angina refratária, no entanto, 9 foram excluídos por não preencheram os critérios de inclusão. Portanto, 70 pacientes com angina refratária foram comparados a 70 pacientes com DAC estável. Os pacientes com angina refratária eram em média mais velhos que os com DAC estável (61 ±10 x 57±7 anos, p=0,013, respectivamente), no entanto, semelhantes quanto a porcentagem de sexo masculino (61,5% x 75,5%, p=0,07, respectivamente) e índice de massa corpórea (IMC) (29,5 ±4 x 28,5± 4 kg/m2, p= 0,06, respectivamente). O grupo de angina refratária era mais depressivo, com maior escore no inventário de depressão de Beck (19 ±8 x 10±8, p< 0001, respectivamente). A AOS foi mais frequente no grupo com angina refratária em relação ao de DAC estável (73% x 54%, p=0,022, respectivamente) e também a AOS grave (48% x 27%, p=0,009, respectivamente). A AOS e depressão permaneceram independentemente associadas a angina refratária, na análise multivariada, após ajuste para fatores de confusão como sexo masculino, idade e IMC (AOS com OR:7,91; p=0,017 e Depressão com OR:15,71; p< 0,001). Estudo já publicado4 e se encontra anexado a esta tese. Estudo 2: foram avaliados 89 pacientes com diagnóstico de angina refratária, mas 9 foram excluídos, portanto amostra final de 80 pacientes. 66% eram do sexo masculino, no geral esta população não era obesa (IMC: 29,5±4 kg/m2) e idade média de (62 ±10 anos). 75% tinham AOS e 50% apresentaram AOS grave. Diante da elevada frequência de AOS Resumo nesta população, nós dividimos a população através de quartis de AOS e assumimos o 1° quartil como sem AOS (IAH <=15 eventos/h). Assim, o 2° quartil (IAH: 16 a 30 eventos/h), 3°quartil (IAH: 31 a 50 eventos/h) e 4°quartil (>= 51 eventos/h). No geral, os participantes estavam bem medicados, com controle da PA e da FC ao repouso, além do controle laboratorial adequado e cessação do tabagismo. A grande maioria (94%) já havia apresentado pelo menos uma intervenção de revascularização como RM ou intervenção coronária percutânea (ICP) e a avaliação de isquemia, pelos métodos de imagem (RMC e/ou CPM) foi presente em 92% dos pacientes. No entanto, os pacientes com AOS mais grave, quanto aos quartis, apresentavam maior proporção de isquemia naqueles dos últimos quartis, com diferença estatística significativa (p=0,005). Quanto a TnT-us coletada na manhã seguinte ao exame de PSG (às 07h), 88% apresentaram valores detectáveis e 36% com valores acima do percentil 99 do ensaio utilizado. Os pacientes do 4° quartil de AOS apresentaram valores de TnT-us cerca de 2 vezes maiores do que os pacientes dos outros três quartis. Além disso, os pacientes do 4°quartil de AOS apresentaram uma variação circadiana dos valores de TnT-us, com pico matinal e este comportamento não foi demonstrado na população dos outros três quartis de AOS. Conclusões: A AOS é extremamente frequente na população de DAC, sendo mais frequente nos pacientes com angina refratária do que naqueles com DAC estável e encontra-se independentemente associada a angina refratária, mesmo após ajuste para fatores de confusão clássicos como idade, sexo masculino e IMC. No estudo 2 observamos que existe associação da gravidade da AOS com lesão miocárdica demonstrada por: elevados valores detectáveis de troponina na manhã seguinte ao exame de PSG, mais de um terço apresentou valores de TnT-us acima do percentil 99 e pela ocorrência de variação circadiana da TnT-us nos pacientes do 4°quartil de AOSBackground (Paper 1): Refractory angina is a severe form of coronary artery disease (CAD) characterized by persistent angina despite optimal medical therapy. Obstructive sleep apnea (OSA) and depression are common in patients with stable CAD and may contribute to a poor prognosis. Objectives: We hypothesized that OSA and depression are more common and more severe in patients with refractory angina than in patients with stable CAD. Methods: We used standardized questionnaires and full polysomnography to compare consecutive patients with well-established refractory angina versus consecutive patients with stable CAD evaluated for coronary artery bypass graft surgery. Results: Patients with refractory angina (n=70) compared with patients with stable CAD (n=70) were similar in respect to sex distribution (male: 61.5% vs 75.5%; p=0.07), body mass index (29.5+- 4 kg/m2 vs 28.5 +- 4 kg/m2; p=0.06) and were older (61 +- 10 yr vs 57 +- 7 yr; p=0.013), respectively. Patients with refractory angina had significantly more symptoms of daytime sleepiness (Epworth: 12±6 vs 8±5; p<0.001), had higher depression symptom scores (Beck: 19 +- 8 vs 10 +- 8; p < 0.001) despite greater use of antidepressants, had higher apnea-hypopnea index (AHI: 37±30 events/h vs 23±20 events/h, p=0.001), higher proportion of oxygen saturation <90% during sleep (8%±13 vs 4%±9, p=0.04) and a higher proportion of severe OSA (AHI >=30 events/h: 48% vs 27%; p=0.009) than patients with stable CAD. OSA (p=0.017), depression (p < 0.001), higher Epworth (p=0.007) and lower sleep efficiency (p=0.016) were independently associated with refractory angina in multivariate analysis. Conclusions: OSA and depression are independently associated with refractory angina and may contribute to poor cardiovascular outcome. Background (Paper 2): Obstructive Sleep Apnea (OSA) is common and may contribute to poor cardiovascular outcomes. OSA is extremely common among patients with refractory angina. Objectives: Investigate the association between severe OSA with markers of overnight myocardial injury in patients with refractory angina. Methods: All patients were characterized clinically, underwent ischemia imaging stress tests as single-photon emission computed tomography (SPECT) and/or cardiac magnetic resonance imaging (MRI), and submitted to sleep evaluation by full polysomnography (PSG).The patients were admitted to the hospital, remained under resting conditions for blood determination of high-sensitivity cardiac troponin T (hs-cTnT) at 2 P.M., 10 P.M., and on the following morning after PSG at 7 A.M. Results: We studied 80 consecutive patients (age: 62±10ys; male: 66%; body mass index (BMI): 29.5±4 kg/m2) with a well-established diagnosis of refractory angina. The mean apnea-hypopnea index (AHI) was 37±29 events/h and OSA (AHI > 15 events/h) was present in 75% of the population. Morning detectable hs-cTnT and above 99th percentile was present in 88% and 36%, respectively. Patients in the first to third quartiles of OSA severity did not have circadian variation of hs-cTnT. In contrast, patients in the fourth quartile had a circadian variation of hs-cTnT with a morning peak of hs-cTnT that was two times higher than that in the remaining population (p=.02). The highest quartile of OSA severity remained associated with the highest quartile of hscTnT (p=.028) in multivariate analysis. Conclusions: Severe OSA is common and independently associated with overnight myocardial injury in patients with refracto
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NOUCHI, CAROLE. "Le registre lyonnais de l'etude europeenne e. C. A. T. -a. P. (european concerted action on thrombosis : angina pectoris)." Lyon 1, 1991. http://www.theses.fr/1991LYO1M033.
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Lemos, Karine Franke. "Qualidade de vida relacionada à saúde e adesão ao tratamento de pacientes com angina estável em retirada de nitrato : evidências de ensaio clínico randomizado." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/143487.
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Introdução: O tratamento com nitrato fixo em pacientes com angina estável é comum na prática clínica. Contudo, os eventos adversos podem interferir na qualidade de vida relacionada à saúde (QVRS) e adesão ao tratamento medicamentoso. O objetivo do estudo foi comparar a QVRS e adesão ao tratamento em grupos de pacientes com angina estável em retirada e manutenção de nitrato. Métodos: Ensaio clínico randomizado conduzido com pacientes com angina estável em dois grupos: intervenção com retirada de nitrato e introdução de placebo e controle com manutenção de nitrato. Ambos os grupos receberam três avaliações: basal, 30 dias e 120 dias no período de quatro meses. A QVRS foi mensurada pelo Short Form Health Survey (SF-36) e Seattle Angina Questionnaire (SAQ), e a adesão foi aferida pela escala de Morisky e contagem de comprimidos. Resultados: 105 pacientes foram randomizados (51: placebo e 54: nitrato). Após quatro meses, observou-se maiores escores nos domínios de dor (63+19; 67+23; 72+24; P=0,004) e aspecto social (87+19; 91+21; 91+19; P=0,002) do SF-36 e no escore de limitação física (74+11; 78+10; 78+8; P=0,006) do SAQ no grupo nitrato, e redução do escore de estabilidade da angina (81+19; 72+20; 72+24; P=0,031) no grupo placebo. Contudo, o tamanho de efeito foi igual ou inferior a 0,42 nesses domínios. A adesão aferida no final entre os grupos foi significativamente maior no grupo intervenção (94% vs 80%; P=0,041) com a escala de Morisky, mas não houve diferença entre os grupos na contagem da medicação. Conclusão: Pacientes com angina estável em uso de nitrato em comparação aos pacientes com uso de placebo não tiveram comprometimento clinicamente relevante da QVRS, porém demonstraram pior adesão ao tratamento na escala de Morisky.Background: Long-term nitrate treatment of stable angina is associated with adverse events and can interfere with health-related quality of life (HRQoL) and medication adherence. The aim of the present study was to compare HRQoL and adherence to treatment in patients with stable angina undergoing nitrate withdrawal and maintenance. Methods: Randomized clinical trial. Patients were allocated into an intervention group (nitrate withdrawal followed by introduction of placebo) or a control group (nitrate maintenance). The assessments were performed at baseline, 30 days, and 120 days with the Short Form Health Survey (SF-36) and the Seattle Angina Questionnaire (SAQ). Treatment adherence was measured by the Morisky scale and pill count. Results: 51 participants were randomized for replacement of nitrate with placebo and 54 for maintenance of treatment with nitrate. After four months, SF-36 scores increased for the bodily pain (P=0.004) and social functioning (P=0.002) in the nitrate maintenance group. Increased SAQ scores were also noted for physical limitations (P=0.006) in the nitrate maintenance group. SAQ score for angina stability (P=0.031) decreased in the placebo group. However, the effect size was small ! 0.42 in those domains. At the end of the study, adherence was significantly higher in the placebo group (P=0.041), but no difference was detected between the groups with the pill count method. Conclusion: HRQoL was similar in patients with stable angina using nitrate regularly as compared to patients undergoing nitrate withdrawal. However, adherence to treatment was lower in nitrate users according to the Morisky scale.
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Weber, Ariana [Verfasser]. "Rolle der Cardiogoniometrie (CGM) unter Belastungsbedingungen in der nicht-invasiven Diagnostik bei Patienten mit stabiler Angina pectoris-Symptomatik / Ariana Weber." Magdeburg : Universitätsbibliothek, 2018. http://d-nb.info/1160593663/34.
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Heptinstall, Stephen. "The 'hidden' and the 'invisible' : the lived experiences of farming dyads with stable angina pectoris : a longitudinal, hermeneutic phenomenological study." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683545.
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Stable Angina Pectoris (SAP) pain is caused by decreased blood flow to the heart muscle. It is exacerbated by exertion and eased with rest. Research indicates the need to improve support given to sufferers (NACR, 2008) that considers ethno-cultural factors (King et al., 2006) and close relational influences (Dalteg et al., 2011). However, delivery of appropriate care in isolated rural communities remains challenging. Despite agriculture being recognised as one of the most dangerous occupations, with above average incidence of chronic conditions and mental health issues, the profession remains medically under-served, due to geographic and attitudinal restraints (Anderson et al., 2012). The impact SAP has on male farmers, who rely on a physically active body, and their female partners who sometimes, though not always, work on the farm, is poorly understood. Hence, this study sought to investigate the lived experiences of eight Herefordshire male-female farming couples where the man had SAP, to help inform future care. Using a longitudinal, hermeneutic phenomenological research design, data were obtained through semi-structured interviews, on three occasions, over twelve months. Lifeworld existential dimensions, corporeality, spatiality, temporality, relationality were used to categorise findings and draw analytic interpretations, alongside the embodied reflections of the researcher. This study found that couples practised bodily subterfuge, in order to manage vulnerabilities inconsistent with their worldview. The men with SAP attempted to hide body disruption, to maintain their sense of self and social standing. The women became body invisible, to conform to dutiful care-giving, supplement their partner’s farm-work, and distance themselves, inter-corporeally. Disharmony between body, self and world, during illness, also eroded the participants’ sense of existential trust. This research demonstrates the importance of acknowledging the existential lifeworld of both the individual farming male with SAP and their female partner. It also offers a threshold whereby more targeted, humanised healthcare may proceed.
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MIRBAZEL, SEYEDEH HOURIEH. "Jämförelse mellan kvinnor och mäns överlevnad baserad på resultat från arbetsprov och myokardscintigrafi." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26493.
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Mirbazel SH. Jämförelse mellan kvinnor och mäns överlevnad baserad på resultat från arbetsprov och myokardscintigrafi. Examensarbete i Biomedicinsk Laboratorievetenskap, 15 högskolepoäng. Malmö högskola: Hälsa och Samhälle, utbildningsområde för Biomedicinsk Laboratorievetenskap, 2011.En av de vanligaste orsakerna till död både i utvecklingsländerna och i västvärlden är hjärtinfarkt som drabbar vanligtvis individer över 65 år. Hjärtischemi är den vanligaste orsaken till hjärtinfarkt/ plötsligt hjärtstopp. För diagnostik av hjärtischemi används oftast arbetsprov som förstahandsval, eftersom metoden är billig, icke-invasiv och relativt ofarlig. Myokardscintigrafi utförs ofta efter arbetsprovet, om detta varit inkonklusivt. Syftet i denna retrospektiva studie var att ta reda på om prognosen och överlevnaden skiljer sig åt mellan kvinnor och män beroende på undersökningsresultat från arbetsprov och myokardscintigrafi. I denna studie analyserades 2045 patienter som var registrerade att utföra arbetsprov för misstänkt eller tidigare känd koronarkärlssjukdom under 2006 & 2007. Patienternas resultat delades i tre grupper: normalt, patologiskt och intermediärt enligt bestämda kriterier. Intermediärgruppen analyserades också om de hade utfört ett myokardscintigrafi inom 6 månader. Intermediärgruppen delades därefter in i tre grupper: de med normal myokardscintigrafi, de med patologisk och de som inte hade utfört någon. Patienter med normalt arbetsprov var 1110, med intermediärt arbetsprov 540 och med patologiskt arbetsprov 254 personer. Det finns statistiskt signifikanta skillnader av antal levande och avlidna mellan män och kvinnor i intermediärt arbetsprov (p < 0,001) och i undergruppen, intermediär utan utförd myokardscintigrafi (p < 0,001). Det finns också en statistiskt signifikant skillnad i överlevnad i huvudgruppen med intermediärt arbetsprov(p < 0,01). Inga analyser av överlevad utfördes för undergrupperna. Sammanfattningsvis har denna studie visat att det inte finns några statistiskt säkerställda skillnader i överlevnad mellan män och kvinnor med normalt och patologiskt arbetsprov däremot finns det en signifikant skillnad i intermediärgruppen.Mirbazel SH. Comparison between men and women’s survival based on the results from the exercise tests and myocardial perfusion imaging. Degree Project in Biomedical Laboratory Science, 15 points. Malmö University: Health and Society, Department of Biomedical Laboratory Science, 2011.One of the most common causes of death in both developing countries and in the Western world is heart attack that hits usually individuals over 65 years. Cardiac ischemia is the most common cause of myocardial infarction/sudden cardiac arrest. For the diagnosis of cardiac ischemia, exercise test is the first choice, because the method is inexpensive, non-invasive and relatively harmless. Myocardial perfusion imaging is often performed after an inconclusive exercise test. The purpose of this retrospective study was to determine if the prognosis and survival differ between women and men depending on the outcome of the investigation from the exercise test, and the myocardial perfusion imaging. In this study 2045 patients were analyzed who were registered to perform the exercise tests for a suspected or previously known coronary artery disease in 2006/2007. Patient’s results were divided into three groups: normal, pathological and intermediate findings. The intermediary group was further divided according to results of myocardial perfusion imaging within 6 months of the exercise test: those with normal, those with pathologic and those who had not carried out any myocardial perfusion imaging. Patients with normal exercise test were 1110, with intermediate exercise test 540 and with pathologic exercise test were 254 people. There are statistically significant differences in the number of living and deceased between men and women in intermediate exercise tests (p < 0, 001) and in the subgroup, intermediary without myocardial perfusion imaging (p < 0,001). There is also a statistically significant difference in survival in the main group with the intermediate exercise tests (p < 0.01). No analysis was performed for sub-groups. In conclusion, this study has shown that there are no statistically significant differences in survival between men and women with normal and pathological exercise test. However there is a significant difference in intermediary group.
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Kurashova, Elena. "Utvärdering av en ny metod för utredning av stabil kranskärlssjukdom baserad på akustisk fonokardiografi." Thesis, Högskolan Kristianstad, Fakulteten för naturvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-18807.
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Kranskärlssjukdom (CAD) är en av de vanligast förekommande kardiovaskulära sjukdomarna och en av de dominerande dödsorsakerna hos äldre människor världen över. För att bekräfta diagnos och bedöma sjukdomens svårighetsgrad används idag flera diagnostiska strategier. Ökade hälsokostnader och lång kö för undersökningar väcker oro hos både patienter, läkare och myndigheter. Behovet av en enkel, säker och kostnadseffektiv metod som kan hjälpa till i utredning av CAD är stor. Det danska företaget Acarix utarbetade en ny apparat, CADScor®-system, som använder en icke-invasiv och strålningsfri metod för att utesluta stabil CAD baserad på akustisk fonokardiografi. Apparaten spelar in koronarblåsljud, vilket uppstår vid stenos i kranskärl, och beräknar patientens risk för CAD. Syftet med den här studien var att utvärdera metoden, testa CADScor® och beräkna apparatens sensitivitet, specificiteten samt positivt och negativt prediktivt värde (PPV och NPV). Tjugo patienter med misstänkt stabil CAD undersöktes med CADScor®-system och deras CAD-resultat jämfördes med resultatet efter myokardscintigrafi. Beräkningar visade att apparatens sensitivitet är 80 %, specificitet 60 %, PPV 40 % och NPV 90 %. Resultatet innebär att sannolikheten är 90 % för att en patient som fick CAD-score ≤ 20 är frisk. Det är tillräckligt högt för att använda CADScor® i klinisk praxis för patienter med låg risk för CAD.Coronary artery disease (CAD) is one of the most common cardiovascular diseases and one of the dominant causes of death in older people worldwide. In order to confirm diagnosis and assess the severity of the disease, several diagnostic strategies are being used today. Increased health costs and long queues for investigations raise concerns among patients, medical doctors and authorities. A simple, safe and cost-effective method that can assist in the investigation of CAD is of major importance. The Danish company Acarix developed a new device, CADScor® system, which uses a non-invasive and radiation-free method to exclude stable CAD based on acoustic phonocardiography. The device records intracoronary murmurs, resulting from coronary stenosis, and calculates the patient's risk of CAD. The purpose of this study was to evaluate the method, test CADScor® and calculate the device's sensitivity, specificity and positive and negative predictive value (PPV and NPV). Twenty patients with suspected stable CAD were examined with CADScor® systems, and their CAD results were compared to the result after myocardial perfusion scan. Calculations showed that the device's sensitivity is 80 %, specificity 60 %, PPV 40 % and NPV 90 %. The result means that the probability is 90 % that a patient who has a CAD score ≤ 20 is healthy. It is high enough to use CADScor® in clinical practice for patients with low risk for CAD.
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Müller, Erik [Verfasser], Ardawan J. [Akademischer Betreuer] Rastan, Gerhard [Gutachter] Schuler, and Friedrich W. [Gutachter] Mohr. "Einfluss der perkutanen koronaren Intervention (PCI) auf das Ergebnis der elektiven chirurgischen Koronarrevaskularisation bei stabiler Angina pectoris : Einfluss der perkutanen koronaren Intervention (PCI)auf das Ergebnis der elektiven chirurgischen Koronarrevaskularisation bei stabiler Angina pectoris / Erik Müller ; Gutachter: Gerhard Schuler, Friedrich W. Mohr ; Betreuer: Ardawan J. Rastan." Leipzig : Universitätsbibliothek Leipzig, 2015. http://d-nb.info/1239565488/34.
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Weiss, Thomas. "Schlafbezogene Atmungsstörungen in einem Kollektiv von Patienten, die zur Angina-Pectoris-Abklärung zugewiesen wurden pathophysiologische Zusammenhänge und Assoziation mit linksventrikulärer Dysfunktion /." [S.l.] : [s.n.], 2002. http://deposit.ddb.de/cgi-bin/dokserv?idn=968834418.
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Voss, Karl Moritz Hendrik [Verfasser]. "Effekt von Humortraining auf die Beschwerdesymptomatik und die Lebensqualität von Patienten mit therapierefraktärer Angina pectoris ohne Revaskularisationsmöglichkeit / Karl Moritz Hendrik Voss." Tübingen : Universitätsbibliothek Tübingen, 2020. http://d-nb.info/1224882466/34.
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Voss, Moritz [Verfasser]. "Effekt von Humortraining auf die Beschwerdesymptomatik und die Lebensqualität von Patienten mit therapierefraktärer Angina pectoris ohne Revaskularisationsmöglichkeit / Karl Moritz Hendrik Voss." Tübingen : Universitätsbibliothek Tübingen, 2020. http://d-nb.info/1224882466/34.
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Bastos, Maria do Socorro Castelo Branco de Oliveira. "Validação do questionário de angina da OMS na sua versão curta utilizando como padrão ouro o teste de esforço e o ecocardiograma sob estresse farmacológico." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5169/tde-03092010-142019/.
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OBJETIVO: Avaliar a validade da versão curta do questionário de angina da OMS/Rose em português, em adultos de 40 a 74 anos, moradores do Butantã, área de referência do Hospital Universitário da Universidade de São Paulo, Brasil usando como padrão-ouro o teste ergométrico e o ecocardiograma sob estresse farmacológico. Analisar ainda se a associação do questionário de dispnéia da American Thoracic Society ao questionário de angina da OMS/Rose altera a sensibilidade, especificidade, valor preditivo positivo (VPP) e negativo (VPN), a razão de verossimilhança positiva (RVP) e negativa (RVN). MÉTODOS: A versão curta do questionário de angina, traduzida e adaptada para o português, consiste das três primeiras perguntas que caracterizam dor no peito aos esforços e foi aplicada a 116 pessoas classificadas como de baixo e alto risco, de acordo com o escore de Framingham, utilizando como padrão-ouro o teste ergométrico Em um subgrupo de 74 participantes foi utilizado o ecocardiograma sob estresse farmacológico como padrão-ouro. Foram calculados a sensibilidade, especificidade, acurácia, VPP, VPN, RVP, RVN.. O PRIME-MD foi usado para diagnóstico de ansiedade e depressão. Utilizou-se o questionário de dispnéia da American Thoracic Society (ATS) traduzido RESULTADOS: A frequência de angina foi de 8,7%, similar a outros estudos e, de isquemia 4,8% semelhante à população geral do município de São Paulo. Dentre 126 participantes, 116 pessoas apresentaram um teste de esforço conclusivo, sendo 44 do grupo de alto risco, escore de Framingham médio 9,3 (2,5) com idade média 53,6 (7,0) anos, mais altos quando comparados aos 72 do grupo de baixo risco com escore de 3,3 (3,0) (p=0,000) e idade 49,2 (7,3) anos (p=0,002). No grupo de baixo risco ocorreu a maioria dos casos de isquemia. Dos 126 participantes, 88 foram submetidos ao ecocardiograma sob estresse e ele foi conclusivo em 74, 29 pessoas no grupo de alto risco apresentaram um escore médio de Framingham de 9.4 (2.7) e 45 do grupo de baixo risco com escore de 3.4 (3.4) (p=0.000).O questionário de angina comparado ao teste ergométrico apresentou sensibilidade de 25,0%, especificidade de 92,0%, acurácia de 89,7%, VPP de 10,0%, VPN de 97,2%, RVP de 3,1 e RVN de 0,82. Não houve nenhum caso de isquemia ao ecocardiograma sob estresse associado ao questionário de angina positivo. A freqüência de ansiedade foi 18,3% e de depressão 13,5% mas, houve associação entre presença de depressão ou ansiedade definida pelo questionário com presença de angina avaliada pelo questionário de angina da OMS/Rose (p=0,076). Nenhum participante com dispnéia apresentou sinais de isquemia aos exames. CONCLUSÃO: A versão curta do questionário de angina traduzida para o português tem parâmetros de qualidade de teste similar aos encontrados em outros estudos em amostras maiores, ou seja, baixa sensibilidade e alta especificidade, e sua utilização depende dos objetivos do estudo. Os transtornos mentais estudados se associaram com a positividade ao questionário de angina. Dispnéia não foi um sintoma equivalente de isquemia miocárdica na amostra estudadaOBJECTIVE: To assess the validity of the short version of the WHO/Rose angina questionnaire in Portuguese, applied to adults aged 40-74 years, living at Butantã, reference area of the Hospital Universitário - Universidade de São Paulo, in Brazil using exercise treadmill test and pharmacological stress echocardiography as gold standard. To analyze if the association of the American Thoracic Society (ATS) dyspnea questionnaire to the WHO/Rose angina questionnaire modifies de sensitivity, specificity, accuracy, positive (PPV) and negative (NPV) predictive values, positive (PLR) and negative (NLR) likelihood ratios. METHODS: The short version of the angina questionnaire adapted and translated into Portuguese has three first questions to characterize exertional chest pain. It was applied to 116 individuals classified into low- and high-risks groups according to the Framingham score, using the exercise treadmill test as the gold standard. Pharmacological stress echocardiography was used as the gold standard in a group of 74 participants. Sensibility, specificity, accuracy, PPV, NPV, PLR and NLR were calculated. The PRIME-MD was used to diagnose anxiety and depression. The translated version of the dyspnea questionnaire of the American Thoracic Society (ATS) was also employed. RESULTS: The frequency of angina was 8.7%, similar to that found in other studies, and of 4.8% for ischemia, which is similar to the general population of the city of Sao Paulo. Among 126 participants, 116 individuals had a conclusive exercise treadmill test; 44 subjects in the high-risk group had a mean Framingham score of 9.3 (2.5) and mean age of 53.6 (7.0) years these figures are higher as compared to 72 individuals of the low-risk group, with a score of 3.3 (3.0) (p=0.000) and mean age of 49.2 (7.3) years (p=0.002). Most cases of ischemia were in the low-risk group. Out of 126 participants, 88 were submitted to the stress echocardiography and it was conclusive in 74, 29 subjects in the high-risk group had a mean Framingham score of 9.4 (2.7) and 45 of the low-risk group had a score of 3.4 (3.4) (p=0.000). The angina questionnaire was compared to the exercise treadmill test and presented sensibility of 25.0%, specificity of 92.0%, accuracy of 89.7%, PPV of 10.0%, NPV of 97.2%, PLR of 3.1 and NLR of 0.82. There was no case of ischemia on stress echocardiography associated to a positive angina questionnaire. The frequency of anxiety was 18.3% and of depression was 13.5%, there was association among presence of the depression and anxiety as questionnaire defined with angina presence the assessed by the OMS/Rose angina questionnaire (p=0.076). No participant with dyspnea presented signs of ischemia on exams. CONCLUSION: The short version of the angina questionnaire translated into Portuguese has quality parameters of test that are similar to those of other studies with larger samples, that is, low sensibility and high specificity and its utilization depends on the study objectives. The mental disorders assessed were associated with positive angina questionnaire. Dyspnea was not a myocardial ischemia equivalent symptom in studied sample
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Devi, R. "Evaluating the feasibility and effectiveness of a web based cardiac rehabilitation programme for those with angina in primary care." Thesis, Coventry University, 2013. http://curve.coventry.ac.uk/open/items/71ffe44a-6f6a-47e0-9dd1-572fe005bf2b/1.
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In the UK angina affects 2 million people (BHF, 2010b) and unfortunately secondary prevention interventions such as Cardiac Rehabilitation (CR) are not widely available for this population (NACR, 2011). This doctoral research project examined the effectiveness and feasibility of an alternative intervention for this population; CR delivered via the internet. The programme was interactive and comprised personalised goal setting orientated around exercise, diet, emotions, and smoking with support available through an online email link or synchronised chat room. A randomised controlled trial (RCT) and semi-structured interviews were used to evaluate the intervention. Primary care patients with angina were randomised to either an intervention group (n=48) or to a control group that did not receive any intervention other than treatment as usual (n=47). Outcome measures were taken at baseline, 6 week and 6 month follow ups. The primary outcome measure was daily steps (measured objectively using Sensewear Pro 3® accelerometer technology). Secondary outcome measures included daily energy expenditure (EE), daily duration of sedentary activity (DDSA), daily duration of moderate activity (DDMA), daily duration of vigorous activity (DDVA), weight, diastolic blood pressure (DBP), systolic blood pressure (SBP), body fat %, fat intake, fibre intake, anxiety, depression, self-efficacy, and health related quality of life (HRQOL). At the 6 week follow up the intervention group had greater improvements than the control group in daily steps, daily EE, DDSA, DDMA, weight, self-efficacy, emotional quality of life and frequency of angina symptoms. In addition, at the 6 month follow up there were significantly greater improvements in anxiety, and frequency of angina symptoms among the intervention group compared to the control group. Semi-structured interviews were also conducted with a subsample of intervention group participants at the 6 week follow up (n=16). Themes resulting from these interviews indicated a high level of programme acceptability and feasibility; ‘self reported improvements’ and ‘programme facilitators’. However, the theme labelled ‘programme barriers’ illustrated intervention related challenges which should be taken into account when delivering the programme. Overall the study demonstrated that a new web based CR programme was effective at improving lifestyle related cardiac risk factors for a primary care angina population in both the short-term (significantly improved daily steps, DDSA, DDMA, weight, self-efficacy, emotional QOL and frequency of angina) and medium-term (significantly improved anxiety, and frequency of angina). These findings on the whole suggest that the programme could be offered to a primary care angina population who are not routinely included within conventional CR. However, there is a need to consider the factors described to affect engagement of the programme; family and work commitments, bad weather, older age, receiving the programme late in angina diagnosis and levels of self-motivation.