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dc.contributor.advisorTorres Dueñas, Diego
dc.contributor.advisorHiguera Cobos, Juan Diego
dc.contributor.advisorOchoa Vera, Miguel Enrique
dc.contributor.authorCorrea Gómez, David Fernando
dc.coverage.spatialFloridablanca (Santander, Colombia)spa
dc.date.accessioned2020-08-22T01:28:30Z
dc.date.available2020-08-22T01:28:30Z
dc.date.issued2020
dc.identifier.urihttp://hdl.handle.net/20.500.12749/7193
dc.description.abstract“Estudio anidado al proyecto de investigación “Valor pronóstico de los polimorfismos de la Metaloproteinasa de Matriz extracelular-9 (MMP-9: SNP-1562C/T), su inhibidor tisular endógeno (TIMP-1: SNP-372T/C), MMP-2 (– 1575 A/G) y de la Acuaporina 5 (AQP5: SNP-1364A/C) en pacientes sépticos.” Introducción: La disfunción cardiovascular asociada a la sepsis tiene un papel fundamental a nivel diagnóstico y pronóstico. Varios biomarcadores se han estudiado para objetivar la disfunción cardiovascular en la sepsis tales como la troponina, péptidos natriuréticos y parámetros ecocardiográficos. Se han encontrado moléculas como las acuaporinas y su polimorfismo AQP-5 SNP- 1364A/C que se han asociado a la fisiopatología de la sepsis y que impactan en la mortalidad. Objetivo: Determinar la asociación entre polimorfismo de la AQP-5 SNP-1364A/C con la disfunción cardiovascular en pacientes adultos con sepsis. Materiales y Métodos: Estudio analítico de corte transversal anidado a la cohorte del estudio “Valor pronóstico de los polimorfismos de la Metaloproteinasa de Matriz extracelular-9 (MMP-9: SNP-1562C/T), su inhibidor tisular endógeno (TIMP-1: SNP- 372T/C), MMP-2 (– 1575 A/G) y de la Acuaporina 5 (AQP5: SNP-1364 A/C) en pacientes sépticos.” Se calculó la asociación del NT pro BNP, troponina I disfunción sistólica /diastólicas medidas por variables ecocardiográficas con el polimorfismo AQP-5 -SNP1364A/C en pacientes con sepsis. Resultados: Se analizó 540 registros. La mediana de edad de los pacientes fue de 59 años con un rango de edad entre 45-74 años. La mediana de NT-pro BNP fue 762 (RIQ: 215.5-3284), de la troponina I 0.1 (RIQ: 0.1- 0.1). El origen más frecuente de la sepsis fue tracto urinario (34.4%). El 14.63% de los pacientes fallecieron. La disfunción sistólica estuvo presente en 29.64 %, la disfunción diastólica 66.1%. El 76.67% fueron manejados en unidad de cuidados intensivo, 22.04% presentaron choque séptico. La asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la disfunción sistólica (RP:0.94; IC 95%= 0.64- 1.3 Valor P: 0.4503), disfunción diastólica, (RP: 0.93; IC 95%= 0 .75- 1.14 Valor P: 0.2909) Troponina I (RP: 1.2; IC 95%= 0 .75- 2.1 Valor P: 0.2006 ) y NT-proBNP (RP: 1.0; IC 95%= 0 .90- 1.15 Valor P: 0.4169). Conclusiones: No se encontró una asociación estadísticamente significativa entre el polimorfismo AQP-5 -SNP1364A/C con los biomarcadores de lesión miocárdica y variables ecocardiográficas en pacientes con sepsis. A partir de los hallazgos, la metodología de análisis y la evidencia es necesario reorientar las estrategias de investigación alrededor, de la relacion polimorfismo de la AQP-5 -SNP1364A/C con la disfunción cardiovascular incluyendo más pacientes para evaluar su asociación.spa
dc.description.tableofcontentsRESUMEN 9 SUMMARY 11 INTRODUCCIÓN 12 PLANTEAMIENTO DEL PROBLEMA Y JUSTIFICACIÓN 15 MARCO TEÓRICO Y ESTADO DEL ARTE 18 Definición y epidemiologia de la Sepsis 18 Fisiopatología de la sepsis: 22 Disfunción cardiaca asociada a la sepsis 29 Disfunción cardiaca asociada a la sepsis, fisiopatología: 31 Alteraciones hemodinámicas en miocardiopatía séptica 34 Definición de cardiomiopatía séptica 35 Métodos diagnósticos de cardiomiopatía séptica: 37 Biomarcadores de origen cardiogénico 38 Manifestaciones ecocardiográficas 40 Acuaporinas conceptos generales 42 Acuaporinas de origen cardiaco: 43 Acuaporinas cardiacas asociada a la sepsis: 45 OBJETIVOS 47 Objetivos específicos 47 METODOLOGÍA PROPUESTA 48 Tipo de estudio: 48 Población 48 Muestra 49 Recolección de la información 50 Procesamiento y control de calidad 52 Procesamiento y análisis estadístico 52 CONSIDERACIONES ÉTICAS 54 RESULTADOS 56 Características de base 56 Desenlaces primarios 57 Asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la disfunción sistólica medida por ecocardiograma. 57 Asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la disfunción diastólica medida por ecocardiograma. 57 Asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la troponina I.................................................................................................................................................. 58 Asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con el NT- pro BNP. .................................................................................................................................................. 58 DISCUSIÓN 59 CONCLUSIONES 66 BIBLIOGRAFÍA 67 TABLAS 78 FIGURAS 82 ANEXOS 83 CRONOGRAMA 85 CARTAS AUTORIZACIÓN 86spa
dc.format.mimetypeapplication/pdf
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.titleAsociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsisspa
dc.title.translatedAssociation between AQP-5 -1364A / C polymorphism with cardiovascular dysfunction in patients with sepsiseng
dc.degree.nameEspecialista en Medicina Internaspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.rights.localAbierto (Texto Completo)spa
dc.publisher.facultyFacultad Ciencias de la Salud
dc.publisher.programEspecialización en Medicina Interna
dc.description.degreelevelEspecializaciónspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.localTesisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_7a1f
dc.subject.keywordsInternal medicine
dc.subject.keywordsMedicine
dc.subject.keywordsMedical sciences
dc.subject.keywordsHealth sciences
dc.subject.keywordsSepsis
dc.subject.keywordsTroponin I
dc.subject.keywordsMortality
dc.subject.keywordsHeart failure systolic
dc.subject.keywordsHeart failure diastolic
dc.subject.keywordsVentricular dysfunction
dc.subject.keywordsSeptic shock
dc.subject.keywordsAquaporin 5
dc.subject.keywordsInfections
dc.subject.keywordsHematology
dc.subject.keywordsHeart
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponamereponame:Repositorio Institucional UNAB
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2
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dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000066885spa
dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001692834spa
dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000898465spa
dc.contributor.orcidhttps://orcid.org/0000-0002-8006-7461
dc.contributor.orcidhttps://orcid.org/0000-0003-2622-9412
dc.contributor.orcidhttps://orcid.org/0000-0002-4552-3388
dc.contributor.scopushttps://www.scopus.com/authid/detail.uri?authorId=24282065800spa
dc.contributor.scopushttps://www.scopus.com/authid/detail.uri?authorId=36987156500spa
dc.contributor.researchgatehttps://www.researchgate.net/scientific-contributions/29124133_David_Fernando_Correa_Gomezspa
dc.contributor.researchgatehttps://www.researchgate.net/profile/Miguel_Ochoa7spa
dc.subject.lembMedicina internaspa
dc.subject.lembMedicinaspa
dc.subject.lembCiencias médicasspa
dc.subject.lembInfeccionesspa
dc.subject.lembHematologíaspa
dc.subject.lembCorazónspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.description.abstractenglishBackground: Cardiovascular dysfunction associated with sepsis plays a fundamental role at a diagnostic and prognostic level. Various cardiac biomarkers have been studied to identify the cardiovascular dysfunction in sepsis such as troponin, natriuretic peptides and echocardiographic parameters. Molecules have been found such as aquaporins and its polymorphism AQP-5 SNP-136A/C that have been associated to the pathophysiology of sepsis that impact mortality. Objective: An association was determined between polymorphism of the AQP-5 SNP-1364A/C molecule with cardiovascular dysfunction in adult patients with sepsis Methods: Analytic study in a transversal cut added to the cohort of study “Prognostic value of polymorphisms of Extracellular Matrix Metalloproteinase-9 (MMP-9: SNP- 1562C / T), its endogenous tissue inhibitor (TIMP-1: SNP-372T / C), MMP-2 (- 1575 A / G ) and Aquaporin 5 (AQP5: SNP-1364 A / C) in septic patients.” An association was calculated of the NT pro BNP, troponin I dysfunction systolic/diastolic measurements through echocardiographic variables with the polymorphism AQP-5-SNP1364A/C in patients with sepsis. Results: 540 charts were reviewed. The average age of the patients was 59 years with a range of age between 45-74 years. The average NT-pro BNP was 762 (RIQ: 215.5-3284), and the average of troponin I was 0.1 (RIQ: 0.1- 0.1). The most frequent origin of sepsis was via the urinary tract (34.4%). 14.63% of patients expired. Systolic dysfunction was present in 29.64% and diastolic dysfunction was 66.1%. 76.67% were managed in the intensive care unit, 22.04% presented with septic shock. The association between polymorphism of AQP-5 SNP-1364A/C with systolic dysfunction (RP:0.94; IC 95%= 0.64- 1.3; P Value: 0.4503), diastolic dysfunction, (RP: 0.93; IC 95%= 0 .75- 1.14; P value: 0.2909), Troponin I (RP: 1.2; IC 95%= 0 .75- 2.1; P Value: 0.2006) and NT-proBNP (RP: 1.0; IC 95%= 0 .90- 1.15;P Value: 0.4169). Conclusions: There was not a stadistically significant association found between polymorphism AQP-5 SNP-136A/C with the biomarkers of myocardial injury and echocardiographic variables in patients with sepsis. As a result of these findings, the methodology of analysis and evidence is necessary to reorient the strategies of research surrounding the relation between AQP-5 -SNP1364A/C with cardiovascular dysfunction including more patients to assess their association.spa
dc.subject.proposalCiencias de la saludspa
dc.subject.proposalSepsisspa
dc.subject.proposalTroponina Ispa
dc.subject.proposalNT pro BNPspa
dc.subject.proposalMortalidadspa
dc.subject.proposalInsuficiencia cardíaca sistólicaspa
dc.subject.proposalInsuficiencia cardiaca diastólicaspa
dc.subject.proposalDisfunción ventricularspa
dc.subject.proposalChoque sépticospa
dc.subject.proposalAcuaporina 5spa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*


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Atribución-NoComercial-SinDerivadas 2.5 Colombia
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