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- Resumen es exacto "Traditional cardiovascular risk factors (age, sex, hypertension, smoking, among others) directly affect the risk of developing pathologies of the circulatory system. However, people with similar risk factors do not always develop the same pathologies, depending on additional risk factors. Within this group, in recent years the geometry of blood vessels has been shown to be associated with cardiovascular risk, independently of traditional factors. In this thesis we will show the methodology developed to reconstruct in a non-invasive way the geometry of the two fundamental vascular components of the circulation: the coronary vessels that feed the heart, and the aorta, the main conduit of blood to the rest of the organism. Both components are susceptible to the development of specific pathologies of medical importance due to their high risk. To analyze the arboreal shape of the coronary circulation, we developed two tools: the first, for the measurement of the bifurcation angle of the vessels from three-dimensional cylindrical adjustments, and the second to compare two arterial trees without apparent correspondence using allometric models. In both cases, we relate the geometric differences between groups with and without coronary disease, present in the form of atherosclerosis. For the analysis of the aorta we also developed two tools: one for the modeling of the aorta obtained from non-contrast tomography in patients in primary prevention, and another for the modeling of the aorta with structural pathologies (eg dissections and aneurysms), useful to segment the vasculature even after endovascular repair interventions. The large cohort of patients undergoing non-contrast tomography allowed us to study the average aortic shape of patients at intermediate risk, analyze the natural deformation of the aorta over time, in the presence of arterial hypertension and atheromatous disease. The analysis of the cohort of patients with aortic pathologies surgically repaired was used to predict the appearance of the disease, study its evolution and collaborate in more effective treatments.
Globally, the algorithms we developed were able to quickly reconstruct the geometry of the blood vessels under study. These semiautomatic algorithms were validated with phantoms, as well as inter and intra-observer studies, resulting in reliable and repeatable measurements of the vascular geometry. Finally, our results indicated that arterial geometry is related to different cardiovascular pathologies, independently of traditional risk factors."
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