{"id":95474,"date":"2018-03-11T10:15:28","date_gmt":"2018-03-11T10:15:28","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/deteccion-anticipada-y-mecanismos-del-sa%c2%adncope-vasovagal-en-la-prueba-de-basculacion-mediante-tratamiento-digital-de-senales\/"},"modified":"2018-03-11T10:15:28","modified_gmt":"2018-03-11T10:15:28","slug":"deteccion-anticipada-y-mecanismos-del-sa%c2%adncope-vasovagal-en-la-prueba-de-basculacion-mediante-tratamiento-digital-de-senales","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/cardiologia\/deteccion-anticipada-y-mecanismos-del-sa%c2%adncope-vasovagal-en-la-prueba-de-basculacion-mediante-tratamiento-digital-de-senales\/","title":{"rendered":"Detecci\u00f3n anticipada y mecanismos del s\u00edncope vasovagal en la prueba de basculaci\u00f3n mediante tratamiento digital de se\u00f1ales"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Francisco Javier Gimeno Blanes <\/strong><\/h2>\n<p>El s\u00edncope es una patolog\u00eda frecuente, y constituye entre un 3-5% de las urgencias atendidas en los centros hospitalarios y entre un 1-3% de los ingresos. Se estima que aproximadamente un 20% de la poblaci\u00f3n adulta ha sufrido un episodio sincopal al menos una vez en su vida. La elevada duraci\u00f3n de la prueba diagn\u00f3stica, la incomodidad de tener que someter al paciente a un episodio sincopal o pre-sincopal durante la misma, junto con el elevado coste que supone para los servicios sanitarios la aplicaci\u00f3n generalizada de este m\u00e9todo, han motivado a numerosos investigadores a estudiar y proponer formas de predecir el resultado de la prueba. El objetivo principal de esta tesis doctoral es valorar y en su caso proponer la utilizaci\u00f3n de m\u00e9todos efectivos para la predicci\u00f3n temprana del resultado de la prueba de basculaci\u00f3n (pb). Para ello, se desarroll\u00f3 una base de datos suficiente, estructurada y representativa, con 727 casos consecutivos del hospital universitario virgen de la arritxaca de murcia, con la informaci\u00f3n de las se\u00f1ales card\u00edacas procedentes de la pb. Haciendo uso de dicha base de datos se reprodujeron y compararon sobre una base com\u00fan, los diversos m\u00e9todos propuestos en la literatura para la predicci\u00f3n del s\u00edncope vasovagal, y se desarrollaron nuevos m\u00e9todos, variables e \u00edndices con el objetivo de valorar la capacidad de detecci\u00f3n temprana de esta patolog\u00eda, con m\u00e9todos temporales, espectrales y no lineales. Como primera conclusi\u00f3n destaca que el an\u00e1lisis multivariante no lineal mediante m\u00e1quinas de vectores soporte (svm), mejora de forma general la predicci\u00f3n temprana de la prueba de basculaci\u00f3n con agente inductor, en todos los m\u00e9todos estudiados y en particular en el caso de los m\u00e9todos precedentes. En segundo lugar, la predicci\u00f3n en base a indicadores estad\u00edsticos no lineales como son la entrop\u00eda muestral y el \u00edndice fractal, no aporta mejoras significativas frente al uso los m\u00e9todos precedentes con svm. Para finalizar, la moderada capacidad predictora de todos los m\u00e9todos estudiados hasta la fecha, incluidas las mejoras propuestas en esta tesis, y los nuevos m\u00e9todos presentados, hacen necesario plantear otros enfoques que permitan incorporar sobre estos estudios nuevos conocimientos sobre los mecanismos que desencadenan el s\u00edncope.   english: syncope is a common pathology, counting for 3-5% of all emergency cases treated at hospitals and between 1-3% of hospital admissions. It is estimated that approximately 20% of adult population has experienced the syncope at least once in his life. The high duration of the diagnostic test, the discomfort of patient having a syncope or pre-syncope, together with the high cost of this medical test, have motivated many researchers to study and propose ways to predict the outcome of the test. The main objective of this phd thesis is to evaluate and suggest the use of effective methods for early prediction of the outcome of the tilt test (tt). For this purpose, we have developed a structured and large database, with 727 consecutive patients of the hospital universitario virgen de la arritxaca of murcia, containing tt cardiac signals. Using this database, all existing and new proposed methods were replicated and compared on a common basis, to asses the early detection of the tt outcome, by using temporal, spectral, and non-linear indices. A first conclusion to be highlighted is that multivariable non linear analysis using support vector machines (svm), generally improves the outcome of the early prediction of the tt with induction agent in all the methods studied, and particularly in the case of the preceding methods. Second, prediction methods based on nonlinear statistical indicators, such as the sample entropy and the fractal index, do not provide significant improvement with respect to the use the preceding methods together with svm. Finally, the moderate predicting power of all the methods studied to date, including the improvements suggested in this thesis, and of the new methods here presented, make it necessary a different approach incorporating new physiological knowledge from the mechanisms that trigger the syncope.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Detecci\u00f3n anticipada y mecanismos del s\u00edncope vasovagal en la prueba de basculaci\u00f3n mediante tratamiento digital de se\u00f1ales<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Detecci\u00f3n anticipada y mecanismos del s\u00edncope vasovagal en la prueba de basculaci\u00f3n mediante tratamiento digital de se\u00f1ales <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Francisco Javier Gimeno Blanes <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Miguel hern\u00e1ndez de elche<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 21\/07\/2009<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Jos\u00e9 Luis Rojo Alvarez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: salvador Viniegra bover <\/li>\n<li>alfredo Rosado mu\u00f1oz (vocal)<\/li>\n<li>inmaculada Mora jimenez (vocal)<\/li>\n<li>eduardo Pinar bermudez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Francisco Javier Gimeno Blanes El s\u00edncope es una patolog\u00eda frecuente, y constituye entre un 3-5% de las [&hellip;]<\/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 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