Browsing by Subject "Heart disease"
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Item Assessing the psychosocial risk factors for coronary artery disease: an investigation of predictive validity for the psychosocial inventory for cardiovascular illness(2009-08) Baker, Maria Kathryn; McCarthy, Christopher J.This dissertation investigated the psychometric properties and clinical applications of the Psychosocial Inventory for Cardiovascular Illness (PICI). The PICI is an inventory developed to measure the psychosocial risk factors for heart disease including anxiety, depression, stress, social isolation, and anger. The inventory was developed to measure the ways that each psychosocial risk factor contributes to the coronary artery disease process through the lifestyle behaviors and pathophysiological mechanisms with which they are associated. The primary purpose of the study was to examine predictive validity for the PICI. With support for predictive validity, the inventory may aid in early identification of individuals at increased risk for coronary artery disease (CAD) so that behavioral, psychosocial, and medical interventions can be implemented. Both healthy and cardiac samples were used in the inventory development and validation process. The PICI was administered in conjunction with similar inventories and physiological markers of CAD were collected including percent of coronary artery blockage and history of heart attacks. Item analysis and factor analysis were used to yield a 20-item PICI comprised of three subscales to include Negative Affect, Social Isolation, and Anger. It was hypothesized that the PICI subscales would predict group membership; whether or not a participant carried a diagnosis of CAD, and would be have a strong relationship to the physiological markers of CAD that were measured. Analysis revealed that the PICI was unable to predict diagnostic status and did not have a strong relationship with the physiological markers of CAD. Results suggest that the PICI has acceptable reliability and construct validity as demonstrated in the current sample, yet further investigation must be conducted to gain support for the instrument’s predictive abilities.Item Mathematical modeling of coupled drug and drug-encapsulated nanoparticle transport in patient-specific coronary artery walls(2009-12) Hossain, Shaolie Samira; Hughes, Thomas J. R.A vast majority of heart attacks occur due to rapid progression of plaque buildup in the coronary arteries that supply blood to the heart muscles. The diseased arteries can be treated with drugs delivered locally to vulnerable plaques—ones that may rupture and release emboli, resulting in the formation of thrombus, or blood clot that can cause blockage of the arterial lumen. In designing these local drug delivery devices, important issues regarding drug distribution and targeting need to be addressed to ensure device design optimization as physiological forces can cause the local concentration to be very different from mean drug tissue concentration estimated from in vitro experiments and animal studies. Therefore, the main objective of this work was to develop a computational tool-set to support the design of a catheter-based local drug delivery system that uses nanoparticles as drug carriers by simulating drug transport and quantifying local drug distribution in coronary artery walls. Toward this end, a three dimensional mathematical model of coupled transport of drug and drug-encapsulated nanoparticles was developed and solved numerically by applying finite element based isogeometric analysis that uses NURBS-based techniques to describe the artery wall geometry. To gain insight into the parametric sensitivity of drug distribution, a study of the effect of Damkohler number and Peclet number was carried out. The tool was then applied to a three-dimensional idealized multilayered model of the coronary artery wall under healthy and diseased condition. Preliminary results indicated that use of realistic geometry is essential in creating physiological flow features and transport forces necessary for developing catheter-based drug delivery design procedures. Hence, simulations were run on a patient-specific coronary artery wall segment with a typical atherosclerotic plaque characterized by a lipid pool encased by a thin fibrous cap. Results show that plaque heterogeneity and artery wall inhomogeneity have a considerable effect on drug distribution. The computational tool-set developed was able to successfully capture trends observed in local drug delivery by incorporating a multitude of relevant physiological phenomena, and thus demonstrated its potential utility in optimizing drug design parameters including delivery location, nanoparticle surface properties and drug release rate.Item The effect of beta-blocking drugs on perceived exertion in post MI cardiac patients(Texas Tech University, 1984-12) Gaule, CyndiGunner Borg introduced his perceptual scale to American scientists in 1967. This 'Borg Scale' has gained considerable attention in the cardiac rehabilitation area as a psychological complement to physiological responses to exercise. Also beta-blocking drugs are a widely accepted measure used to control the cardiac oxygen demand in post MI patients. The relationship between beta-blockade and perceived exertion has received a minimal amount of attention in recent years, and it is this relationship in which the purpose of this study is involved. The pharmacological effects of beta-blockers are numerous and will be explained in detail in Chapter Two. The main effect is to decrease the myocardial oxygen demand by decreasing the heart rate and contractility. These drugs are also known to have side effects on some patients such as mental depression and muscle weakness, which are obviously two factors which could alter a patient's perceived exertion rating.