Actualización en el diagnóstico y terapéutica en hipertensión pulmonar arterial

Indexación: ScieloResumen: Pulmonary Arterial Hypertension includes a heterogeneous group of disorders with a common genetic, pathological and hemodinamyc origin. It is characterized by a high pulmonary artery pressure due to a primary vascular disease, as a consequence of genetic and environmental factors. The common pathway is a vascular imbalance towards vasoconstriction and proliferation inside the small vessels. According to the World Health Organization, 2003, Pulmonary Arterial Hypertension is classified as idiopathic, familiar or associated to connective tissue diseases, HIV, drugs, porto-pulmonary hypertension, congenital intracardiac shunts and others. The diagnosis is based in hemodynamics. Echocardiogram is a non invasive and right ventricular catheterization is an invasive diagnostic tool. Follow up is based on a clinical and functional assessment through functional class classification, dyspnea scores and 6-minute walking test. The prognosis is historically devastating but new therapies are changing the natural history of the disease. New treatments have demonstrated improvement in symptoms, hemodynamic profiles and survival. Intravenous, subcutaneous or inhaled prostanoids such as Epoprostenol, Treprostinil or Iloprost respectively have been approved for Pulmonary Arterial Hypertension treatment as well as oral endothelial receptor blockers. They are all considered first line treatments for arterial pulmonary hypertensive patients with even better benefits than lung transplantation. Phosphodiesterase inhibitors (Sildenafil), have been recently approved for the treatment of pulmonary arterial hypertension.http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000700015&nrm=is

Data analysis strategies for the detection of gravitational waves in non-Gaussian noise

In order to analyze data produced by the kilometer-scale gravitational wave detectors that will begin operation early next century, one needs to develop robust statistical tools capable of extracting weak signals from the detector noise. This noise will likely have non-stationary and non-Gaussian components. To facilitate the construction of robust detection techniques, I present a simple two-component noise model that consists of a background of Gaussian noise as well as stochastic noise bursts. The optimal detection statistic obtained for such a noise model incorporates a natural veto which suppresses spurious events that would be caused by the noise bursts. When two detectors are present, I show that the optimal statistic for the non-Gaussian noise model can be approximated by a simple coincidence detection strategy. For simulated detector noise containing noise bursts, I compare the operating characteristics of (i) a locally optimal detection statistic (which has nearly-optimal behavior for small signal amplitudes) for the non-Gaussian noise model, (ii) a standard coincidence-style detection strategy, and (iii) the optimal statistic for Gaussian noise.Comment: 5 pages RevTeX, 4 figure

Parametrized tests of post-Newtonian theory using Advanced LIGO and Einstein Telescope

General relativity has very specific predictions for the gravitational waveforms from inspiralling compact binaries obtained using the post-Newtonian (PN) approximation. We investigate the extent to which the measurement of the PN coefficients, possible with the second generation gravitationalwave detectors such as the Advanced Laser Interferometer Gravitational-Wave Observatory (LIGO) and the third generation gravitational-wave detectors such as the Einstein Telescope (ET), could be used to test post-Newtonian theory and to put bounds on a subclass of parametrized-post-Einstein theories which differ from general relativity in a parametrized sense. We demonstrate this possibility by employing the best inspiralling waveform model for nonspinning compact binaries which is 3.5PN accurate in phase and 3PN in amplitude. Within the class of theories considered, Advanced LIGO can test the theory at 1.5PN and thus the leading tail term. Future observations of stellar mass black hole binaries by ET can test the consistency between the various PN coefficients in the gravitational-wave phasing over the mass range of 11-44 Msun. The choice of the lower frequency cut off is important for testing post-Newtonian theory using the ET. The bias in the test arising from the assumption of nonspinning binaries is indicated.Comment: 18 pages, 11 figures, Matches with the published versio

Caracterización clínica, funcional y hemodinámica de la población con hipertensión pulmonar arterial evaluada en el Instituto Nacional del Tórax

Pulmonary Arterial Hypertension is a rare, progressive and devastating disease with severe consequences in quality of life and survival. Aim: A clinical, functional and hemodynamic assessment of patients with pulmonary arterial hypertension and categorization according to severity. Material and methods: Prospective registry of patients with arterial pulmonary hypertension, hemodynamically defined. Clinical evaluation was performed using World Health Organization functional score (I to IV) and Borg dyspnea scale. Six minute walking test, echocardiography and right heart catheterization were used for functional and hemodynamic assessment. Intravenous Adenosine was used to assess vascular reactivity during the hemodynamic evaluation. Results: Twenty nine patients were included (25 women, age range 16-72 years). Pulmonary hypertension was idiopathic in 11, associated to connective tissue disease in seven, associated to congenital heart disease in nine and associated to chronic thromboembolism in two. The mean lapse of symptoms before assessment was 2.9 years and 100% had dyspnea (Borg 5.1). Functional class I, II, III and IV was observed in 0, 5, 21 and 3 patients respectively. Six minutes walking test was 378±113 m. Mean pulmonary pressure was 59.4±12.2 mmHg, cardiac index was 2.57±0.88 and pulmonary vascular resistance index: 1798.4±855 (dyne.sec)/cm5. Nine patients had a mean pulmonary arterial pressure >55 mmHg and a cardiac index <2.1, considered as bad prognosis criteria. Adenosine test was positive in 17%. Conclusions: This group of patients with Pulmonary Arterial Hypertension was mainly conformed by young females, with a moderate to severe disease.http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000500007&nrm=is

Template banks to search for compact binaries with spinning components in gravitational wave data

Gravitational waves from coalescing compact binaries are one of the most promising sources for detectors such as LIGO, Virgo and GEO600. If the components of the binary posess significant angular momentum (spin), as is likely to be the case if one component is a black hole, spin-induced precession of a binary's orbital plane causes modulation of the gravitational-wave amplitude and phase. If the templates used in a matched-filter search do not accurately model these effects then the sensitivity, and hence the detection rate, will be reduced. We investigate the ability of several search pipelines to detect gravitational waves from compact binaries with spin. We use the post-Newtonian approximation to model the inspiral phase of the signal and construct two new template banks using the phenomenological waveforms of Buonanno, Chen and Vallisneri. We compare the performance of these template banks to that of banks constructed using the stationary phase approximation to the non-spinning post-Newtonian inspiral waveform currently used by LIGO and Virgo in the search for compact binary coalescence. We find that, at the same false alarm rate, a search pipeline using phenomenological templates is no more effective than a pipeline which uses non-spinning templates. We recommend the continued use of the non-spinning stationary phase template bank until the false alarm rate associated with templates which include spin effects can be substantially reduced.Comment: 11 pages, 3 figure

Black-hole hair loss: learning about binary progenitors from ringdown signals

Perturbed Kerr black holes emit gravitational radiation, which (for the practical purposes of gravitational-wave astronomy) consists of a superposition of damped sinusoids termed quasi-normal modes. The frequencies and time-constants of the modes depend only on the mass and spin of the black hole - a consequence of the no-hair theorem. It has been proposed that a measurement of two or more quasi-normal modes could be used to confirm that the source is a black hole and to test if general relativity continues to hold in ultra-strong gravitational fields. In this paper we propose a practical approach to testing general relativity with quasi-normal modes. We will also argue that the relative amplitudes of the various quasi-normal modes encode important information about the origin of the perturbation that caused them. This helps in inferring the nature of the perturbation from an observation of the emitted quasi-normal modes. In particular, we will show that the relative amplitudes of the different quasi-normal modes emitted in the process of the merger of a pair of nonspinning black holes can be used to measure the component masses of the progenitor binary.Comment: 24 pages, 9 figures, 4 tables, accepted for publication in Physical Review

A coherent triggered search for single spin compact binary coalescences in gravitational wave data

In this paper we present a method for conducting a coherent search for single spin compact binary coalescences in gravitational wave data and compare this search to the existing coincidence method for single spin searches. We propose a method to characterize the regions of the parameter space where the single spin search, both coincident and coherent, will increase detection efficiency over the existing non-precessing search. We also show example results of the coherent search on a stretch of data from LIGO's fourth science run but note that a set of signal based vetoes will be needed before this search can be run to try to make detections.Comment: 14 pages, 4 figure

Angular Resolution of the LISA Gravitational Wave Detector

We calculate the angular resolution of the planned LISA detector, a space-based laser interferometer for measuring low-frequency gravitational waves from galactic and extragalactic sources. LISA is not a pointed instrument; it is an all-sky monitor with a quadrupolar beam pattern. LISA will measure simultaneously both polarization components of incoming gravitational waves, so the data will consist of two time series. All physical properties of the source, including its position, must be extracted from these time series. LISA's angular resolution is therefore not a fixed quantity, but rather depends on the type of signal and on how much other information must be extracted. Information about the source position will be encoded in the measured signal in three ways: 1) through the relative amplitudes and phases of the two polarization components, 2) through the periodic Doppler shift imposed on the signal by the detector's motion around the Sun, and 3) through the further modulation of the signal caused by the detector's time-varying orientation. We derive the basic formulae required to calculate the LISA's angular resolution $\Delta \Omega_S$ for a given source. We then evaluate $\Delta \Omega_S$ for two sources of particular interest: monchromatic sources and mergers of supermassive black holes. For these two types of sources, we calculate (in the high signal-to-noise approximation) the full variance-covariance matrix, which gives the accuracy to which all source parameters can be measured. Since our results on LISA's angular resolution depend mainly on gross features of the detector geometry, orbit, and noise curve, we expect these results to be fairly insensitive to modest changes in detector design that may occur between now and launch. We also expect that our calculations could be easily modified to apply to a modified design.Comment: 15 pages, 5 figures, RevTex 3.0 fil

LISA Data Analysis using MCMC methods

The Laser Interferometer Space Antenna (LISA) is expected to simultaneously detect many thousands of low frequency gravitational wave signals. This presents a data analysis challenge that is very different to the one encountered in ground based gravitational wave astronomy. LISA data analysis requires the identification of individual signals from a data stream containing an unknown number of overlapping signals. Because of the signal overlaps, a global fit to all the signals has to be performed in order to avoid biasing the solution. However, performing such a global fit requires the exploration of an enormous parameter space with a dimension upwards of 50,000. Markov Chain Monte Carlo (MCMC) methods offer a very promising solution to the LISA data analysis problem. MCMC algorithms are able to efficiently explore large parameter spaces, simultaneously providing parameter estimates, error analyses and even model selection. Here we present the first application of MCMC methods to simulated LISA data and demonstrate the great potential of the MCMC approach. Our implementation uses a generalized F-statistic to evaluate the likelihoods, and simulated annealing to speed convergence of the Markov chains. As a final step we super-cool the chains to extract maximum likelihood estimates, and estimates of the Bayes factors for competing models. We find that the MCMC approach is able to correctly identify the number of signals present, extract the source parameters, and return error estimates consistent with Fisher information matrix predictions.Comment: 14 pages, 7 figure

Gravitational waves from inspiraling compact binaries: Validity of the stationary-phase approximation to the Fourier transform

We prove that the oft-used stationary-phase method gives a very accurate expression for the Fourier transform of the gravitational-wave signal produced by an inspiraling compact binary. We give three arguments. First, we analytically calculate the next-order correction to the stationary-phase approximation, and show that it is small. This calculation is essentially an application of the steepest-descent method to evaluate integrals. Second, we numerically compare the stationary-phase expression to the results obtained by Fast Fourier Transform. We show that the differences can be fully attributed to the windowing of the time series, and that they have nothing to do with an intrinsic failure of the stationary-phase method. And third, we show that these differences are negligible for the practical application of matched filtering.Comment: 8 pages, ReVTeX, 4 figure