Novel therapies for hypertension and associated cardiovascular risk
2018-08
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Novel therapies for hypertension and associated cardiovascular risk
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2018-08
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This thesis is comprised of two parts. The first part investigates a novel therapy, vagus nerve stimulation, for hypertension and hypertension-induced heart disease. Hypertension impacts over 1 billion people worldwide, and clinical management is challenging. Left uncontrolled, high blood pressure can significantly increase the risk of cardiovascular events. The majority of hypertensive patients are treated with anti-hypertensive drugs to control blood pressure, but many limitations exist including resistant hypertension, inability to tolerate therapy, and non-compliance with the medication regime. For these patients, an alternative approach is needed to control blood pressure. Recently, the imbalance in the autonomic nervous system, evident in hypertension, has been the target of novel device-based therapies such as vagus nerve stimulation. The main goal of this research is to evaluate the efficacy of vagus nerve stimulation to treat hypertension and hypertension-induced heart disease. This thesis investigates the impact of vagus nerve stimulation on disease progression, survival, and cardiovascular remodeling in Dahl salt-sensitive hypertensive rats. Overall, the results of this work provide evidence for the beneficial therapeutic effects of vagus nerve stimulation in hypertension and motivate future studies to optimize therapy parameters and further understand therapeutic mechanisms. The second part of this thesis focuses on atrial fibrillation and the evaluation of new mapping techniques for improving rotor localization for ablation procedures. Currently, success rates for ablation procedures for non-paroxysmal atrial fibrillation are low and require repeat procedures or a lifetime of pharmacological agents to reduce the risk of stroke. Improved signal processing techniques for mapping electrical activity in the atrium can help further our understanding of the generation and maintenance of atrial fibrillation and ultimately improve ablation procedure success rates and terminate the arrhythmia. The main goal of this work was to validate new signal processing techniques – multiscale frequency, kurtosis, Shannon entropy, and multiscale entropy – to identify regions of abnormal electrical activity. The results of this work demonstrate improved accuracy of these novel techniques in mapping rotors in cardiac arrhythmias and motivates further studies evaluating more complex arrhythmias and human intracardiac electrograms.
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University of Minnesota Ph.D. dissertation. August 2018. Major: Biomedical Engineering. Advisor: Alena Talkachova. 1 computer file (PDF); xvii, 134 pages.
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Annoni, Elizabeth. (2018). Novel therapies for hypertension and associated cardiovascular risk. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/206342.
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