CARDIOVASCULAR DISEASE

Author: HERRERO CARBONELL JOAQUIN.
Year: 2003.
University: MIGUEL HERNÁNDEZ DE ELCHE.
Place of defense: MEDICINA.

Summary: Objectives To evaluate the effectiveness of prevention activities (cardiovascular in the adult population discipemia of a health center, analyzing the three years following: changes in cardiovascular risk, the variations of monitoring high-risk strategies for the prevention cardiovaxular and the incidence of events (myocardial infarction and death from any cause). CONCLUSIONS 1, non-intervention was effective in modifying the cardiovascular risk is not statistically significant variations occur. 2, Low-impact on lipid values. Interventions on hypertension noted significant reductions, especially in the pressure -- --. 3 - The start --- for the paraquismo -- to be one of the most effective attitudes. 4-Subjects with more risk obtained greater benefit. 5, - Reduction in the number of expected events.

Author: CABRÉ VILA JUAN JOSÉ.
Year: 2003.
University: ROVIRA I VIRGILI.
Place of defense: MEDICINA.
Place of preparation: FACULTAD DE MEDICINA Y CIENCIAS DE LA SALUD.

Summary: INTRODUCTION The metabolic syndrome (SM) is an extremely prevalent disease, which affects a high cardiovascular risk and therefore is a potentially preventable cause of death. ASSUMPTIONS AND OBJECTIVES Probably the incidence of cardiovascular disease is higher in those subjects who met criteria for SM. Each component of the SM will have a certain impact on the likelihood of introducing active cardiovascular disease. As noted goals: to determine the prevalence of SM and consistency among the most universally accepted diagnostic criteria (WHO and NCEP-ATP III), the cardiovascular risk of individuals according to the diagnosis of SM, the occurrence of cardiovascular events as the S; ; impacteo of the features of the SM on the occurrence of cardiovascular complications and the time in which they are presented, and compare different systems for calculating the cardiovascular risk. MATERIALS AND METHODS We conducted a cross-sectional study to ascertain the prevalence of SM, and a prospective study to analyze cardiovascular events. It selccionaron patients older than 14 years of age, belonging to two basic areas of health, representative of the general population of Reus. The study period runs from 01/01/1998 to 31/12/2002. There was institutional ethical approval and informed consent of subjects. RESULTS Discusses 1500 sujetojs (871 women), among whom there were 59 lost to follow-up during the 5 years. The prevalence of hypertension was 37.4%, diabetes mellitus of 15.7%, intermediate metabolic alterations glucídico of 24%, obesity of 32.4%, from 22.9% lipid disorders and smoking assets of 18.7%. Considering the WHO criteria prevalence of HM was 17.4%, and according to the criteria NCEP-ATP III of 20.3%. The similarity between these two diagnostic criteria has been high, with an index Kappa weighted 0,693. The cardiovascular risk measured by the formula of Framingham has been higher in the patients with SM (19.6 + - 11.4) than in those exempt from the same (9.4 +-8.5) (p less 0001). Differences have also been significant considering the tables of Girona (REGICOR) (12.5 + - 15.4 vs. 7.9 + - 13.1, respectively) (p less 0,001). Cardiovascular complications also differ according to the group considered, well, people with SM had a prevalence of complications of 33.1% over the 5 years, while the group without SM suffered only a 7.8% complication (p less 0,001). Analyzing the evolution of groups through survival curves, it is noted that the high-risk group had a relative risk 16.6 times the group of low risk of complications. Just as a relative risk 29.7 times of developing diabetes, in the 5 years of follow-up, the group of high risk versus low risk. The multiple logistic regression of the components of the SM shows that the main factor is hypertension (OR = 8.9), followed by obesity (OR = 7.3), dyslipidaemia (OR = 6.6) and eventually diabetes (OR = 1.5) . CONCLUSIONS These prevalences obtained are similar to those of the countries around us, but the incidence of cardiovascular disease in Catalonia is the lowest in the world. Probably this difference comes given by dietary patterns, physical exercise as well as genetic factors. The SM is a major concern given the high prevalence and cardiovascular prognosis. The criterion NCEP-ATP III seems more suitable for application in primary care due to its greater simplicity and utilization of clinical parameters. The cardiovascular risk measured by the boards of REGICOR is closest to the true incidence of cardiovascular disease observed in this study. A point of great importance is in 8 corporac 20f ion SM as a risk factor in the list of conditions and problems of clinical primary care.

Author: IRACULUS SOTERES EMILI.
Year: 2003.
University: BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAT DE MEDICINA.

Author: ORÚS PUIGVERT JOSEFINA.
Year: 2003.
University: BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD AUTÓNOMA DE BARCELONA.

Summary: The general hypothesis of the study is carried out in this thesis is that in Idiopathic Dilated cardiomyopathy (MCDI) the presence of the inducible nitric oxide synthase (NOS II) level miocito may be conditioned by the presence of cytokines released during a process inflamatorio.El increased nitric oxide (NO) secondary to the NOS II adversely affect contractility miocárdica.Si this hypothesis is cierta.Las cytokine expression and should be high in the initial stages of the enfermedad.Por other hand, the mechanism the action of nitric oxide to produce disfusión myocardial could be the interaction between NO and enzymes of the mitochondrial respiratory chain. Conclusions: The myocardium of patients with MCDI in functional class IV, the NOS II is expressed in maner constante.Este phenomenon rarely occurs in other etiologies dilated hearts and never in the myocardium healthy. - This finding seems to MCDI has some levels nitratos-nitricos (NOx) much higher than normal levels of our laboratory, while those were normales.Este result reinforces the first conclusion and supports the fact that the NOS II expressed in excess is the cause of increased production of NOx. - Levels of serum cytokines in a significant increase in heart failure patients when compared with controls, and their values increase as worsening its functional class of the New York Heart Association (NYHA). Significantly, there is no difference the pattern citoqunas as itiología of Heart Failure (CHF). - In patients with MCDI, pathological levels of Interlenquina-6 (IL-6) were associated with a fraction of ayección lower incidence of more functional class III-IV and worse prognosis. - The levels of IL-6 elevated serum can contribute to the injury miocárdicad chronic (independent of the cativación of the renin-angiotensin system) play an important role in disease progression. - IL-6 serum was identified during monitoring how the most important independent predictor of new episodes of ICC éxitus or need for transplant cardiaco.Es best predictor that neurohormonas plasma or ventricular function izquierda.Por Consequently, the IL - 6 is an important predictor of poor prognosis. - This study also shows that although levels of Necrosis Factor Tumoral-a (TNF), I and II of TNF receptors, Interlenquina-1b and soluble receptor of the interlenquina-2 are associated with greater morbidity during follow-up . These were less important predictors of poor prognosis quela IL-6. - At the same time, the soluble TNF receptors were better predictors of the same incidents that TNF. - We have found a reduction of the activity of complex III of the mitochondrial respiratory chain in patients with MCDI as in patients with cardipatía ischemic phase dilatada.El fact find it in different etiologies CBI supports the hypothesis that this is a fenómno secondary, and not a primary disease of the mitochondria in most patients with MCDI.

Author: SANTAMARÍA ORTIZ M. AMPARO.
Year: 2003.
University: AUTÓNOMA DE BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD AUTONOMA DE BARCELONA.

Summary: The arterial thromboembolic disease is a disease of increased morbidity and mortality in developed countries. The identification of risk factors associated with the increased development of this condition is of great importance, both to the understanding of the pathophysiology and to carry out primary and secondary prevention. Both TAFI as functional polymorphism 46 C / T gene F12 are two factors that have been linked to disease tromboenbólica vein, but not exístia information about its association with arterial thromboembolic disease including ischemic cerebrovascular disease and acute coronary syndrome. We conducted a survey of association, case-control, which included patients with a first episode of acute coronary syndrome and ischemic cerebrovascular disease. And the goals were: 1-Know IAF functional variation according to age, sex and cardiovascular risk factors in conventional Spanish population, and establish correlations of the IAF with different functional factors of hemostasis. 2-Existence of association between functional TAFI levels and the risk of developing ischemic cerebrovascular disease and acute coronary syndromes. 3-To establish the prevalence of the Spanish population polymorphism 46 C / T gene F12 and the association between genotype polymorphism 46 C / T gene F12 with the plasma levels of factor XII. 4-To investigate the association between genotype polymorphism of the 46 C / T gene F12 and levels of factor XII with the risk of developing ischemic cerebrovascular disease and acute coronary syndromes. The results were: 1-functional TAFI levels are lower in Spanish women younger than 30 years, while the men have not been found variations depending on age. We did not notice changes in the functional TAFI depending on the various cardiovascular risk factors. Nor TAFI functional levels showed significant correlation with different factors of hemostasis. 2-TAFI Functional Levels above 126% were associated with a reduced risk 4 times higher of developing acute coronary disease. TAFI functional levels higher than 120% were associated with a reduced risk 6 times to present acute cerebrovascular disease. 3 - The prevalence of genotype C / C in population control acute coronary syndrome and ischemic cerebrovascular disease was 60% and 61%, and was associated with levels of factor XII between 95% and 98%. The prevalence of genotype C / T in population control was 38% and was associated with levels of factor XII between 95% and 98%. The prevalence of genotype T / T in population ranged between 2% and 3% and link it to levels between 58% and 52.5%. 4 - The homozigosis for the T allele of the polymorphism 46 C / T gene F12 is associated with a reduced risk 4 times higher of developing ischemic cerebrovascular disease. The levels of factor XII less than 74% were associated with a reduced risk 3 times to develop ischemic cerebrovascular disease. The homozigosis for the T allele of the polymorphism 46 C / T gene F12 is associated with a reduced risk 6 times higher of developing acute coronary disease. The levels of factor XII less than 68% were associated with almost 5 times higher risk of developing acute coronary disease. Therefore, we can conclude that the increase in the TAFI is associated with an increased risk of arterial disease and can be considered as a new biomarcador disease risk tromboembóilca aterial and that the polymorphism 46 C / T gene F12 can be viewed as a new genetic risk factor for the 8 sarrolla 209 r arterial thromboembolic disease and must be taken into account when included in the studies of thrombophilia.

Author: RIVAS ELENA JUAN VICENTE.
Year: 2004.
University: SALAMANCA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD DE SALAMANCA.

Summary: The endoglin (CD105) is a glycoprotein homodímerica membrane that forms part of the complex receptor growth factor transformante- (TGF. Has high expression in endothelial cells, also has been identified in vascular smooth muscle cells. Gene encodes this protein has been identified as a target vascular alterations known as hereditary haemorrhagic telangiectasia type-1 (HHT-1). HHT-1 is an autosomal dominant vascular dysplasia associated with frequent epistaxis, gastrointestinal bleeding, and telangiectasias malformations arterio- venous in brain, lung and liver. mice haploinsuficientes to express endoglin fewer endoglin their brothers litter control (Eng +/+). The endothelium-dependent vasodilator is diminished in mice Eng + / compared with that of mice Eng + / +, with a sharp decline in the expression of endothelial nitric oxide synthase (eNOS), which could cause the destruction of the capillary network and this will lead to malformations arterio-venosas characteristics of the HHT-1. That reduced expression of eNOS in mice Eng + /, can be regulated by the slightest expression of TGF-1 in these mice. Despite this decrease in the expression of eNOS in mice Eng + /, these mice maintain blood pressure in a normal range because of the sobreregulación in the expression of ciclooxigeanasa-2 (COX-2), which leads to an increase in the production of prostaglandins that vasodilators offset the deficiency in the production of nitric oxide (NO). So the regulation of blood pressure is different in the two strains of mice, varying levels in the regulation of products derived from the eNOS and COX-2.

Author: IGLESIAS BONILLA PABLO.
Year: 2004.
University: SEVILLA.
Place of defense: FACULTAD DE MEDICINA DE LA UNIVERSIDAD DE SEVILLA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: OBJECTIVE Studying the match between automedida blood pressure (AMPA) and ambulatory monitoring of blood pressure (MAP) as methods for measuring pressure Ambulatory during the period of activity in hypertensive patients in primary care. A cross-sectional study design validation of diagnostic tests. SCOPE OF THE STUDY Urban Health Center in Seville. SUBJECT OF STUDY 130 individuals with hypertension between 18 and 77 years. INSTRUMENTALIZACIÓN map 24 hours in AMPA pattern of four days, AMPA intensive one day. RESULTS Fort concordance between patterns of MAP. Concordance between each pattern of poor AMPA and MAP. Low high sensitivities and specificities between patterns of AMPA and MAP in the detection of the effect of white gown. Poor positive predictive values in both. CONCLUSION The AMPA is not a valid and reliable alternative to the MAP.

Author: GALLEGO DELGADO JULIO.
Year: 2005.
University: AUTÓNOMA DE MADRID.
Place of defense: FACULTAD MEDICINA (SALA PAGODA).
Place of preparation: FUNDACION JIMENEZ DIAZ UAM.

Summary: Hypertension is the most common chronic disease in the developed world and one of the public health problems most important of the Western countries. Hypertension is the single most important cause of left ventricular hypertrophy (HVI), a strong indicator of cardiovascular disease and the most reliable predictor of heart failure in the western world. There are a wide range of available drugs for treating hypertension, however, despite its effectiveness by reducing the levels of blood pressure, there is none that provides a profile organo-protector complete. In this thesis, using an experimental model of chronic hypertension and hypertensive different regimes, there has been organ protective effects associated with different blood pressure control and / or the type of drug used. Moreover, using a dual approach genomics and proteomics, we found that the HVI mediated hypertension presents serious alterations at the molecular level in the physiology of cardiomiocito. In addition, we have seen the decline of HVI is not attached to a complete recovery from his transcriptoma or its proteome. Therefore, the heart returned with HVI still own molecular characteristics of hypertrophic heart. These genes and proteins that remain altered play key roles in the process energy, defense and stress in the regulation of hypertrophy. Therefore, these data may offer potential new avenues implicated in heart disease mediated hypertension.

Author: ANGUERA LAMOS IGNASI.
Year: 2005.
University: BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: * Complications perianulares in infectious endocarditis represent the extent of the infection beyond the structures valvulares and represent one of the most important complications in this disease. The formation of lesions perianulares is associated with a poor prognosis, with high mortality. The formation of fistulas aorto-cavitarias in endocarditits only be described from time to time in endocarditis, and therefore are unaware of their clinical features and prognostic factors of mortality. * The objectives of this study are to determine the clinical characteristics and prognosis of patients with abscesses perianulares full and patients with fistulización aorto-cavitaria in endocarditis and determine the impact on the prognosis of the emergence of fistulización aorto-cavitaria in endocarditis with complicated injuries perianulares. * We have published several studies with the goal of multi recruit a large number of patients with complications perianulares and analyze in detail the clinical characteristics of these complications and be able to analyze their prognostic factors of mortality. * As a result of this study, it can be concluded that the fistulización aorto-cavitaria is a rare complication of infectious endocarditis, which is associated with extensive tissue destruction at the aortic ring and the presence of abscess perianulares. Echocardiography transeofágica is the technique of choice for the detection and study of fistula aorto-cavitarias both at edocarditis on native valve on valve prosthesis. The emergence of severe heart failure is common in these patients, and despite aggressive surgical mortality is high. The prosthesis infection, urgent surgery and the development of heart failure are independent prognostic factors for mortality in patients with fistulas aorto-cavitarias in endocarditis. The formation of fistulas aorto-cavitarias is associated with a higher degree of destruction annular aortic and more frequently to develop heart failure compared with abscesses not fistulizados. Both complications frequently require surgical treatment and have a high mortality, but the fistulización not an independent prognostic factor for mortality, in both the short and long term. Training is not an independent prognostic factor for mortality, in both the short and long term. The formation of abscesses perianulares is frequent in the aortic endocarditis location, is often associated with infection is tafilocócica, and has a high morbidity and mortality. Estafilocócica infection is an independent risk factor for mortality in patients who develop abscesses perianulares level aortic.

Author: MORENO AYUSO JUAN MANUEL.
Year: 2005.
University: GRANADA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: In summary, the results of this study indicate that the attenuated renal response to presora Phe in the hypothyroid status is not due to an increase in the activity of endothelial derived relaxing factors, NO and FHDE. This study also shows evidence of abnormalities in the release of FHDE or K + channels in preparations hipotiroiedeas have a low reactivity to the NPS, NO donor, and that the vasodilation NO-independiente is not altered. Anomalies in the release of the mediators of vasodilation endotelio-dependiente play an important role in the pathogenesis of vascular changes that occur in hypertension, reteriosclerosis or diabetes. This study has analyzed the role of endothelial relaxing factors in change of vascular reactivity of hiportioridismo. The data described above provide evidence that the attenuated responsiveness to Phe in the hypothyroid state is not secondary to an increase in production and activity in endothelial derived relaxing factors, NO and FHDE. This study also shows that the response to vasoconstrictors in preparations hipotiroideas is insensitive to the K + channels. This anomaly, along with the low reactivity of NO can be a compensatory response to a system altered contractile vascular smooth muscle of rats hipotiroideas. This study, in our view, is the first to evaluate the actions of hypothyroidism on K + channels vascular and therefore opens up new perspectives for the management of vascular abnormalities of the thyroid abnormalities. These results indicate that hyperthyroidism is associated with a reduction in antioxidant activity of SOD, GPX and GR in the cardiac and renal tissues and is involved in oxidative stress induced hypertension T4. In addition, we also note that the antihypertensive effect of Tempol in rats treated with T4 is not associated with an improvement in renal abnormalities or cardiac hypertrophy. The oxidative stress induced by the radical superoxide and other ERO contributes to the development of cardiovascular disease, diabetes, renal failure and hypertension. This study shows that hyperthyroidism is associated with a reduction in antioxidant enzyme activity of the cardiac and renal tissues, and that Tempol reduced blood pressure in rats treated with thyroxine. However, the mechanism responsible is unknown. Recent evidence suggests that the ERO may be used in the processes of signal transduction and play a role in regulation of cell biology and physiology. In this sense, the ERO may influence the vascular reactivity, either directly or through an intermediate route, as well as participate in renal haemodynamics and sodium excretion. Further studies would be required to establish which of these mechanisms are responsible for the potential increase in blood pressure and other cardiovascular and renal manifestations of hyperthyroidism.

Author: LAZARO FERNÁNDEZ ALBERTO.
Year: 2005.
University: AUTÓNOMA DE MADRID.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FUNDACIÓN JIMÉNEZ DÍAZ FACULTAD DE MEDICINA - UAM.

Summary: Hypertension is the most common chronic disease in the developed world, and is considered the leading cause of cardiovascular morbidity and mortality globally. Among other effects, leads the progression towards chronic kidney disease, and is a major cause of development of left ventricular hypertrophy (HVI), the biggest predictor of heart failure mediated hypertension in an animal experimental model, in order to elucidate the mechanisms the underlying molecular organic damage. Additionally, we analyzed the effect of blood pressure control in the regression of damage, based on two antihypertensive therapies commonly used: an inhibitor of the angiotensin converting enzyme (ACE - I) and an antagonist delos receivers AT1 of angiotensin II (ARA II ). Through a classical approximation, we found that renal damage is associated with increased oxidative stress (due in part to a decrease in enximas antioxidants) and activation of apoptotic pathways and proinflammatory. Moreover, through a dual approach genomics and proteomics have shown that both the gene and the protein profile of hearts with HVI differ substantially from the normal hearts. Treatment with ACE inhibitors and ARA II significantly decreased all the parameters of renal damage and cardiac damage, including returning the HVI to normal levels. However, the regression of the HVI does not correspond to a complete normalization of the patterns of gene expression and protein, staying altered many genes and proteins. Thus, the analysis of therapeutic responses in the molecular footprint in target organs could lead to the identification of key mediators in the process hypertrophic, and open new avenues of study for the development of better therapies Cardioprotective under the hypertension.

Author: RODRÍGUEZ LECOQ RAFAEL.
Year: 2005.
University: AUTÓNOMA DE BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FAC. MEDICINA, H. VALL D'HEBRON, UAB.

Summary: This thesis makes a thorough and critical study of coronary surgery s done in the last two decades for the service of cardiac surgery Vall d'Hebron in Barcelona. It was two distinct groups, the first with 2,501 patients between 1982 and 1999 who make up a database of 150,000 data. The second group with 918 patients between the years 2000 to 2003 is a database containing 172,748 data. It addresses all the variables, in order to elucidate the factors of the patient themselves and pathological, and the postoperative surgical procedure to identify those variables productive morbidity and mortality, thus determining the evolution of patient care for heart disease ischemic in our environment. We analyze multiple factors, including the volume of patients, as well as age, sex, the existence and type of comporbilidad or not cardiac pathology, as well as the type and degree of cardiac involvement. It also analyzes the characteristics of the surgical operation, and the effect of each and every one of them in the results. Within the results, he examines both the total comorbidity, such as specific in terms of global and complications inherent in different organs and vital systems, ultimately responsible for the evolution of the patient, either in the form of disease, such as hospital stay . They also performed an analysis of the surgical technique, specifically coronary surgery without extracorporeal circulation to determine their involvement in the results obtained by the surgical team of Vall d'Hebron. The results are shown predictors of postoperative morbidity in age, recent myocardial infarction, unstable angor, revasuclarización incomplete, the use of ciruclación extracorporeal (CEC), renal failure and surgery urgently. As predictors of mortality highlights age, the use of ECC, the need for intra balloon, urgent surgery and heart attack recently. Finally highlights the results of surgery without coronary CEC which undoubtedly shows that technique as a reasonable therapeutic option in the therapeutic arsenal for the patient with ischemic cardiomyopathy in our midst.

Author: ASSO ABADÍA ANTONIO.
Year: 2005.
University: ZARAGOZA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: HOSPITAL MIGUEL SERVET DE ZARAGOZA.

Summary: We studied 81 consecutive patients undergoing successfully using radiofrequency catheter ablation for tachycardia accessory pathways mediated pro AV only (50 gross and 31 hidden) to determine the characteristics of electrogramas unipolar and bipolar obtained by the catheter explorer who are predictors of a result of success. The study is comparing the characteristics of electrogramas obtained in points with the final success of registered points successful transition points and ineffective. So to be included in the study patients were due to record points with these characteristics prior to ultimate success. The main objectives were: 1-To determine how the derivations unipolar obtained from the distal catheter electrodes explorer supplement information from the bipolar records in the selection of points of radiofrequency ablation for the elimination of routes accessory auriculoventriculares. 2-To assess the records unipolar, the morphological patterns related to the outcome of each application, to analyze separately the pulses in the handset side of the applications carried out in the handset side of the applications performed on the slope ventricular ring válvular. 3-Evaluate the influence of biophysical variables related to the stability of catheter and tissue contact during the application of radiofrequency in the same result, differentiating the side of the ring where the application of pulse. 4, - Knowing the parameters and morphological characteristics of electrogramas associated with a temporary result of successful implementation. 5-Analyzing the findings during the electrophysiological study and the result of ablation for determining the existence of accessory pathways with oblique journeys to valvular ring and assess its implications. The findings were: 1, - electrogramas unipolar provide useful information and complementary to that obtained in bipolar mode for selecting points in the application of radiofrequency ablation of accessory auriculoventriculares both overt ways as hidden. Such information can be decisive in some ways, especially for those with long driving times where conventional criteria obtained through records with bipolar inadequate. 2 - The morphological criteria of the derivations unipolar that theoretically predicted points for the effective implementation of energy-dependent side of the slope of valvular ring where they are earned. 3-A morphology unipolar type PrS or P-QS registered in ritm6sinusal from the handset side, no negative predictive value even par result of successful applications made from that side. 4, the side - headset, so that the criterion of morphology PrS be valid, the start of the wave 'r' should precede the beginning of the wave of ECG in the delta area and have a duration of less than 8 ms. 5, the slope-ventricular pattern PQS in sinus rhythm is associated commonly a final proved effective when there are other factors needed. The interval between the onset of ventriculograma local and deflation intrinsic (Vu-CI in our study) must be less 2 ms. 6, AV-intervals not provide useful information, though, tend to be more prolonged in places where the pulses are ineffective or temporary effectiveness. They have value, in general, for a patient when compared points from the same side valvular and excludes oblique route. 7 - In the records bipolar and in sinus rhythm, obtaining earliness of less than 15 ms it at the beginning of the wave delta in the right parietal pathways are frequently associated with a result of temporary success. The same result is usually transient apparent in the tracks left parietal with preciocidades under 3ms. , 8-tracks accessory hidden earpiece insertion should be sought through the location of points where they get 8 in the 408 records unipolar type morphology QS in tachycardia or ventricular stimulation, or alternatively, type rS conduración of r less than 5 ms and finally nela approximately half of the cases of ablation being left side and septales in which there are applications failed and there may be a transitional journey oblicúo to valvular ring-therapeutic implications.

Author: GARCÍA-FUSTER GONZALEZ-ALEGRE MARIA JOSÉ.
Year: 2006.
University: VALENCIA.
Place of defense: FACULTAD DE MEDICINA DE VALENCIA.
Place of preparation: FACULTAD DE MEDICINA DE VALENCIA Y HOSPITAL CLÍNICO UNIVERSITARIO DE VALENCIA.

Summary: Hypothesis: The formal study of risk factors and clinical features of young patients suffering from venous thromboembolic disease, may help better understand the risk inherent in the various etiologies in the onset and recurrence of the disease. It could thus be a better prophylaxis. Objectives: 1Â fourth-Being aware the various risk factors of VTE and its prevalence 2Â fourth -Valorar the clinical characteristics of patients with VTE 3Âş thought the incidence of thrombotic relapses in the long term. 4 Â º -Analizar factors that influence the risk of relapse. Conclusions: 1Â º 37% of younger patients with venous thromboembolic disease, have congenital thrombophilia, and 19% AAFL. The 44% only presents risk factors adquiridos-transitorios, of whom treatment with anovulatory and immobilization trauma are the most common. 2 Â º 56% of patients with congenital thrombophilia have a family history of VTE. 3 Â º 34% of patients with congenital thrombophilia or AAFL not require other risk factors in causing thrombosis. 4 Â º anomalies of the inferior vena cava are present in 16% of patients with young iliac vein thrombosis. 5 Â - The likelihood of recurrence thrombotic in younger patients is high, 6 / 100 patients per year, so that the 8 years of evolution have relapsed for 34%. 6 Â - The presence of AAFL, congenital disorders of coagulation, male and obesity are significant risk factors for recurrence thrombotic. But only the first three, are manifested as independent prognostic variables and they AAFL are those that pose a higher risk of relapse. 7 Â fourth location proximal or distal thrombosis is not influenced by leaps and bounds in the occurrence of relapses thrombotic.