{"id":111653,"date":"2011-02-11T00:00:00","date_gmt":"2011-02-11T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/valor-pronostico-de-la-resonancia-magnetica-de-estres-en-pacientes-con-dolor-toracico\/"},"modified":"2011-02-11T00:00:00","modified_gmt":"2011-02-11T00:00:00","slug":"valor-pronostico-de-la-resonancia-magnetica-de-estres-en-pacientes-con-dolor-toracico","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/resonancia-magnetica\/valor-pronostico-de-la-resonancia-magnetica-de-estres-en-pacientes-con-dolor-toracico\/","title":{"rendered":"Valor pron\u00f3stico de la resonancia magn\u00e9tica de estr\u00e9s en pacientes con dolor tor\u00e1cico"},"content":{"rendered":"

Tesis doctoral de Mar\u00eda Jos\u00e9 Bosch Campos <\/strong><\/h2>\n

Valor pron\u00f3stico e implicaciones terap\u00e9uticas de la resonancia magn\u00e9tica de estr\u00e9s con dipiridamol en el dolor tor\u00e1cico en base a la cascada isqu\u00e9mica. 1. Objetivos: evaluar el valor pron\u00f3stico de la resonancia magn\u00e9tica (rmc) de estr\u00e9s con dipiridamol en pacientes con dolor tor\u00e1cico de perfil isqu\u00e9mico utilizando como base la cascada isqu\u00e9mica (ci). 2. M\u00e9todos: incluimos en un registro prospectivo multic\u00e9ntrico 1725 pacientes con dolor tor\u00e1cico isqu\u00e9mico sin s\u00edndrome coronario agudo, remitidos para realizaci\u00f3n de una rmc de estr\u00e9s con dipiridamol. Se analiz\u00f3 la extensi\u00f3n (n\u00famero de segmentos) con disfunci\u00f3n sist\u00f3lica basal (ds-b), d\u00e9ficit de perfusi\u00f3n con el estr\u00e9s (dp), disfunci\u00f3n sist\u00f3lica inducida (ds-i) y realce tard\u00edo de gadolinio (rt) (anormal si >1 segmento). En base a la ci se definieron tres grupos de pacientes: c1 (sin evidencia de isquemia, n=1013, 59%), c2 (d\u00e9ficit de perfusi\u00f3n con el estr\u00e9s, n= 520, 30%) y c3 (defectos de perfusi\u00f3n e hipocinesia inducida con el estr\u00e9s, n= 192, 11%). Se censuraron los pacientes que sufrieron una revascularizaci\u00f3n tras la rmc de estr\u00e9s (242 pacientes,14%) y se contabilizaron el n\u00famero de eventos mayores (ev= mortalidad de causa cardiaca e infarto agudo de miocardio no fatal) 3. Resultados: durante una mediana de seguimiento de 448 d\u00edas se detectaron 64 em (4%), incluyendo 39 muertes cardiacas y 25 infartos de miocardio. Los 4 \u00edndices de rmc se asociaron a mayor tasa de eventos mayores: ds-b 7%, dp 6%, ds-i 13%, rt 6% (p <0,001 en todos los casos). Teniendo en cuenta los tres subgrupos realizados en base a la ci, se demostr\u00f3 una tasa superior de eventos mayores en el grupo c3: c1 2%, c2 3,5% y c3 13,5% (c1 vs. C2: p=0,08; c2 vs. C3: p<0,0001). En un primer an\u00e1lisis multivariado en el que se introdujeron las 4 variables de rmc como variables continuas, los predictores independientes de eventos mayores fueron: edad (hr 1,04; p=0,01), sexo masculino (hr 1,81; p=0,05), diabetes mellitus (hr 1,93, p=0,01), infarto de miocardio previo (hr= 1,99, p= 0,01), volumen telesist\u00f3lico ventr\u00edculo izquierdo (por cada 1 ml\/m2) (hr 1,02 , p< 0,0001), dp (por segmento) (hr 1,09, p=0,01) y ds-i (por segmento) (hr 1,17, p<0,0001). En un segundo modelo se incluyeron los tres grupos de la ci y las variables predictoras independientes de ev fueron: edad (hr 1,03; p=0,02), diabetes mellitus (hr 1,75, p=0,04), infarto de miocardio previo (hr= 2,33, p= 0,001), volumen telesist\u00f3lico ventr\u00edculo izquierdo (por cada 1 ml\/m2) (hr 1,02 , p< 0,0001), pertenecer al grupo c3 (hr 9,51, p<0,0001). conclusiones: la rmc de estr\u00e9s con dipiridamol tiene utilidad pron\u00f3stica para predecir em durante el seguimiento en pacientes remitidos para estudio de dolor tor\u00e1cico de perfil isqu\u00e9mico. El subgrupo de pacientes con una isquemia m\u00e1s severa (c3 = d\u00e9ficit de perfusi\u00f3n asociado a hipocinesia inducible con el estr\u00e9s) presentan un riesgo m\u00e1s alto de sufrir un em, en comparaci\u00f3n con el resto de pacientes que se estudiaron por dolor tor\u00e1cico.\n\n\n\n \n\n\n

Datos acad\u00e9micos de la tesis doctoral \u00abValor pron\u00f3stico de la resonancia magn\u00e9tica de estr\u00e9s en pacientes con dolor tor\u00e1cico<\/strong>\u00ab<\/h3>\n
    \n
  • T\u00edtulo de la tesis:<\/strong>\u00a0 Valor pron\u00f3stico de la resonancia magn\u00e9tica de estr\u00e9s en pacientes con dolor tor\u00e1cico <\/li>\n
  • Autor:<\/strong>\u00a0 Mar\u00eda Jos\u00e9 Bosch Campos <\/li>\n
  • Universidad:<\/strong>\u00a0 Universitat de val\u00e9ncia (estudi general)<\/li>\n
  • Fecha de lectura de la tesis:<\/strong>\u00a0 02\/11\/2011<\/li>\n<\/ul>\n

     <\/p>\n

    Direcci\u00f3n y tribunal<\/h3>\n
      \n
    • Director de la tesis<\/strong>\n
        \n
      • Juan Sanchis Fores<\/li>\n<\/ul>\n<\/li>\n
      • Tribunal<\/strong>\n
          \n
        • Presidente del tribunal: Francisco javier Chorro gasc\u00f3 <\/li>\n
        • Juan Cinca cuscullola (vocal)<\/li>\n
        • alfredo Bardaji ruiz (vocal)<\/li>\n
        • arcadio Garcia alberola (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

           <\/p>\n","protected":false},"excerpt":{"rendered":"

          Tesis doctoral de Mar\u00eda Jos\u00e9 Bosch Campos Valor pron\u00f3stico e implicaciones terap\u00e9uticas de la resonancia magn\u00e9tica de estr\u00e9s con dipiridamol […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[28867],"tags":[55007,45162,11531,222395,104022,222394],"class_list":["post-111653","post","type-post","status-publish","format-standard","hentry","category-resonancia-magnetica","tag-alfredo-bardaji-ruiz","tag-arcadio-garcia-alberola","tag-francisco-javier-chorro-gasco","tag-juan-cinca-cuscullola","tag-juan-sanchis-fores","tag-maria-jose-bosch-campos"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/111653","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=111653"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/111653\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=111653"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=111653"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=111653"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}