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Ferreira RM, Ferron FVF, Borges VTM, Peraçoli JC, Ferron AJT, Roscani MG, Hueb JC, Bazan R, Martin LC, Bazan SGZ. Association of cardiovascular risk factors and myocardial hypertrophy in women with preeclampsia history. Life Sci 2024; 346:122646. [PMID: 38614304 DOI: 10.1016/j.lfs.2024.122646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/31/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Abstract
AIMS A historic of preeclampsia (PE) has been associated with cardiovascular disease (CVD) in women. There are substantial evidences that cardiovascular changes resulting from PE can persist even after pregnancy end. Therefore, the aims was to evaluate the prevalence of myocardial hypertrophy in young women 12 months after PE event as well as try to identify risk factors for these changes. MATERIALS AND METHODS Single-center observational prospective cross-sectional study that included 118 consecutive patients after 12 months of PE. Clinical and laboratory evaluations, echocardiogram were performed. Myocardial hypertrophy (LVH) was defined as an index myocardial mass ≥ 45 g/m2.7, for women. Classical risk factors for CVD were considered. Analysis included linear or logistic regression and Spearman's correlation coefficient. Significance level of 5 %. KEY FINDINGS Systemic arterial hypertension (SAH) was identified in 52 patients (44 %), overweight/obesity (OOB) in 82 (69 %), dyslipidemia in 68 (57 %) and metabolic syndrome in 47 patients (40 %). LVH was present in 35 cases (29 %) and associated with OOB (OR = 4.51; CI95%:1.18-17.17, p < 0.001), in a model corrected for age and SAH diagnosis. When only the metabolic syndrome components were analyzed, in the multiple logistic regression model, the abdominal circumference was the only clinical variable associated with LVH (OR = 17.65; CI95%:3.70-84.17; p < 0.001). SIGNIFICANCE It was observed a high prevalence of ventricular hypertrophy in young women with a history of pre-eclampsia. This condition was associated with the presence of obesity.
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Affiliation(s)
- Ricardo Mattos Ferreira
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil
| | | | | | - José Carlos Peraçoli
- Department of Gynecology and Obstetrics, Botucatu Medical School - UNESP, São Paulo State University, Botucatu, Brazil
| | - Artur Junio Togneri Ferron
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Federal University of Sao Carlos-UFSCar, São Carlos, Brazil
| | - João Carlos Hueb
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil
| | - Rodrigo Bazan
- Department of Neurology, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil
| | - Luis Cuadrado Martin
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil
| | - Silméia Garcia Zanati Bazan
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil.
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Goulart CDL, Agostoni P, Salvioni E, Silva RN, Bassi-Dibai D, Roscani MG, Arena R, Myers J, Borghi-Silva A. Phenotyping cardiopulmonary exercise testing measures in heart failure with reduced ejection fraction: A comparison between Italy and Brazil. Heart Lung 2024; 65:54-58. [PMID: 38402757 DOI: 10.1016/j.hrtlng.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 02/09/2024] [Accepted: 02/11/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND While patients with heart failure (HF) with reduced left ventricular ejection fraction (HFrEF) constitutes a global health crisis the incidence, prevalence and prognosis of the disease may differ depending on the continent and country. OBJECTIVE To profile, analyze and compare cardiopulmonary exercise testing (CPET) data of patients with HFrEF between Italian and Brazilian cohorts. METHODS In this observational study, a total of 630 patients with clinical and functional diagnosis of HFrEF (315 patients from Brazil and 315 patients from Italy) performed CPET. RESULTS Although Brazilian patients were slightly younger (Brazil 60±10 vs Italy 64±11 p<0.001) with a better peak oxygen consumption (V̇O2), circulatory power and left ventricular ejection fraction (LVEF) (p<0.01), ventilatory inefficiency and oscillation ventilation was higher when compared to the Italian cohort. When stratifying patients with LVEF≤30 % and age≥60 years, Brazilian patients presented worse ventilatory efficiency, and lower peak V̇O2 compared to the Italian cohort. CONCLUSION Patients with HFrEF from Brazil exhibited higher ventilatory inefficiency and a greater prevalence of oscillatory ventilation during CPET compared to patients with the same diagnosis from Italy.
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Affiliation(s)
- Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP 13565-905, Brazil
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Via Parea 4, Milan 20138, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milano, Italy
| | | | - Rebeca Nunes Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP 13565-905, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Management in Health Programs and Services, Universidade CEUMA, São Luís, MA, Brazil
| | - Meliza Goi Roscani
- Cardiology and Exercise Research Center Laboratory, Department of Medicine, Federal University of São Carlos, SP, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, United States
| | - Jonathan Myers
- Veterans Affairs Palo Alto Health Care System and Stanford University, Palo Alto CA, United States
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP 13565-905, Brazil.
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Tais Leonardi N, da Silva Rocha Tomaz C, Zavaglia Kabbach E, Domingues Heubel A, Souza Schafauser N, Mayumi de Oliveira Kawakami D, Borghi-Silva A, Goi Roscani M, Castello-Simões V, Gonçalves Mendes R. Left ventricular concentric remodeling in COPD patients: A cross-sectional observational study. Med Clin (Barc) 2024:S0025-7753(24)00146-5. [PMID: 38614905 DOI: 10.1016/j.medcli.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE To investigate the association between left ventricular structure and disease severity in COPD patients. METHODS Twenty-eight COPD patients were stratified according to the disease severity, using the BODE index, into Lower (n=17) and Higher (n=11) groups, composed of patients with lower severity (BODE <5) and higher severity (BODE ≥5), respectively. Left ventricle (LV) was assessed by 2D-echocardiography. BODE index was calculated using body mass index (BMI); forced expiratory volume in the first second (FEV1, %); modified Medical Research Council (mMRC) and distance walked during 6-minute walk test (6MWD). RESULTS Patients in the Higher group showed lower oxygen arterial saturation (p=0.02), FEV1 (p<0.01) and 6MWD (p=0.02) and higher value of relative posterior wall thickness (RWT) compared to Lower group (p=0.02). There were significant associations between LV end-systolic diameter (LVESD) and BODE index (r=-0.38, p=0.04), LV end-diastolic diameter (LVEDD) and FEV1 (r=0.44, p=0.02), LVEDD and BMI (r=0.45, p=0.02), LVESD and BMI (r=0.54, p=0.003) and interventricular septal thickness and 6MWD (r=-0.39, p=0.04). CONCLUSIONS More severe COPD patients, BODE score ≥5, may have higher RWT, featuring a possible higher concentric remodeling of LV in this group. Besides that, a greater disease severity may be related to LV chamber size reduction.
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Affiliation(s)
- Naiara Tais Leonardi
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Camila da Silva Rocha Tomaz
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Erika Zavaglia Kabbach
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Alessandro Domingues Heubel
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Nathany Souza Schafauser
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Débora Mayumi de Oliveira Kawakami
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Audrey Borghi-Silva
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Federal University of Sao Carlos (UFSCar), Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Viviane Castello-Simões
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Renata Gonçalves Mendes
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil.
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Santos-de-Araújo AD, da Luz Goulart C, Marinho RS, Dourado IM, Mendes RG, Roscani MG, Bassi-Dibai D, Phillips SA, Arena R, Borghi-Silva A. The six-minute step test can predict COPD exacerbations: a 36-month follow-up study. Sci Rep 2024; 14:3649. [PMID: 38351306 PMCID: PMC10864352 DOI: 10.1038/s41598-024-54338-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/12/2024] [Indexed: 02/16/2024] Open
Abstract
The six-minute step test (6MST) has been shown to be effective in assessing exercise capacity in individuals with COPD regardless of severity and, despite its easy execution, accessibility and validity, information on the prognostic power of this test remains uncertain. The aim of this study is to investigate whether the 6MST can predict the occurrence of exacerbations in patients with COPD. This is a prospective cohort study with a 36-month follow-up in patients with COPD. All patients completed a clinical assessment, followed by pulmonary function testing and a 6MST. The 6MST was performed on a 20 cm high step; heart rate, blood pressure, oxygen saturation, BORG dyspnea and fatigue were collected. Sixty-four patients were included in the study, the majority being elderly men. Performance on the 6MST demonstrated lower performance compared to normative values proposed in the literature, indicating a reduced functional capacity. Kaplan Meier analysis revealed that ≤ 59 steps climbed during the 6MST was a strong predictor of COPD exacerbation over a 36-month follow-up. We have identified a minimal threshold number of steps (≤ 59) obtained through the 6MST may be able predict the risk of exacerbations in patients with COPD.
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Affiliation(s)
| | - Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Renan Shida Marinho
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Izadora Moraes Dourado
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Universidade Federal de São Carlos (UFSCar), Sao Carlos, SP, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Management in Health Programs and Services, Universidade CEUMA, São Luís, MA, Brazil
| | - Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil.
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da Silva EMF, Loureiro RM, Marinho RS, Marioti J, Sá S, Castilho GPG, Casale G, Silva AB, Lima CHDF, Roscani MG. Mitral Annular Early Diastolic Velocity Has Good Accuracy in the Detection of Low Exercise Tolerance in Patients With Heart Failure. Am J Cardiol 2024; 211:172-174. [PMID: 37884113 DOI: 10.1016/j.amjcard.2023.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/05/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023]
Affiliation(s)
| | | | - Renan Shida Marinho
- Medical Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Júlia Marioti
- Botucatu Medical School, São Paulo State University, Botucatu, SP, Brazil
| | - Samuel Sá
- Botucatu Medical School, São Paulo State University, Botucatu, SP, Brazil
| | | | | | - Audrey Borghi Silva
- Medical Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Meliza Goi Roscani
- Medical Department, Federal University of São Carlos, São Carlos, SP, Brazil.
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Firmino SM, Goulart CDL, Gregorio JP, Wende KW, Yuamoto FY, Kummer L, Curcelli EM, Heubel AD, Kabbach EZ, Santos PB, Borghi-Silva A, Mendes RG, Leal ÂMDO, Roscani MG. Discriminative value of pulse wave velocity for arterial stiffness and cardiac injury in prediabetic patients. J Vasc Bras 2023; 22:e20230076. [PMID: 38162982 PMCID: PMC10755886 DOI: 10.1590/1677-5449.202300762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/12/2023] [Indexed: 01/03/2024] Open
Abstract
Background Prediabetes (PD) is defined as impaired fasting glucose and/or impaired glucose tolerance (IGT) and may be associated with high risk of cardiovascular injury. It is recommended that PD patients be screened for signs of arterial stiffness and cardiovascular injury to reinforce therapeutic strategies. Objectives To identify pulse wave velocity values discriminative for arterial stiffness and cardiovascular injury in PD patients. Methods A cross-sectional study was conducted with PD (N=43) and normoglycemic (N=37) patients who underwent clinical evaluation, arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor, laboratory blood analysis, investigation of morphological and functional cardiac variables by transthoracic echocardiogram, and assessment of carotid intima-media-thickness (CIMT) by carotid ultrasonography. A statistical analysis was performed using SPSS software and values of p<0.05 were considered significant. Results A cfPWV cut-off value of 6.9 m/s was identified for IGT (Sensitivity [SE]: 74% and Specificity [SP]: 51%). Comparison of general data and risk factors between subsets with values above and below this cutoff value revealed higher rates of fasting glucose (p=0.02), obesity (p=0.03), dyslipidemia (p=0.004), early signs of left ventricle (p=0.017) and right ventricle (p=0.03) impaired diastolic function, and elevated CIMT in subjects with cfPWV ≥ 6.9m/s (p=0.04). Conclusions In PD patients, a cfPWV cutoff of 6.9 m/s was considered a discriminative value for arterial stiffness. These findings highlight the value of early investigation of cardiovascular injury and aggressive therapy strategies with good control of risk factors in PD.
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Affiliation(s)
| | | | | | | | | | - Lana Kummer
- Universidade Federal de São Carlos – UFSCar, São Carlos, SP, Brasil.
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Antonelli Rossi DA, De Araujo Junior JA, Luvizutto GJ, Bazan R, Salmazo PS, Modolo GP, Hueb JC, Nunes HRDC, Hokama NK, Minicucci MF, Roscani MG, Zanati Bazan SG. Effect of a Physical Exercise Program on the Inflammatory Response, Cardiac Functions, Functional Capacity, and Quality of Life in Patients with Sickle Cell Disease. J Clin Med 2023; 12:3952. [PMID: 37373647 DOI: 10.3390/jcm12123952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/13/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The beneficial effects of physical exercise on functional capacity and inflammatory response are well-known in cardiovascular diseases; however, studies on sickle cell disease (SCD) are limited. It was hypothesized that physical exercise may exert a favorable effect on the inflammatory response of SCD patients, contributing to an improved quality of life. This study aimed to evaluate the effect of a regular physical exercise program on the anti-inflammatory responses in SCD patients. METHODS A non-randomized clinical trial was conducted in adult SCD patients. The patients were divided into two groups: 1-Exercise Group, which received a physical exercise program three times a week for 8 weeks, and; 2-Control Group, with routine physical activities. All patients underwent the following procedures initially and after eight weeks of protocol: clinical evaluation, physical evaluation, laboratory evaluation, quality of life evaluation, and echocardiographic evaluation. STATISTICAL ANALYSIS Comparisons between groups were made using Student's t-test, Mann-Whitney test, chi-square test, or Fisher's exact test. Spearman's correlation coefficient was calculated. The significance level was set at p < 0.05. RESULTS There was no significant difference in inflammatory response between the Control and Exercise Groups. The Exercise Group showed an improvement in peak VO2 values (p < 0.001), an increase in the distance walked (p < 0.001), an improvement in the limitation domain due to the physical aspects of the 36-Item Short Form Health Survey (SF-36) quality of life questionnaire (p = 0.022), and an increase in physical activity related to leisure (p < 0.001) and walking (p = 0.024) in the International Physical Activity Questionnaire (IPAQ). There was a negative correlation between IL-6 values and distance walked on the treadmill (correlation coefficient -0.444, p = 0.020) and the estimated peak VO2 values (correlation coefficient -0.480; p = 0.013) in SCD patients in both groups. CONCLUSIONS The aerobic exercise program did not change the inflammatory response profile of SCD patients, nor did it show unfavorable effects on the parameters evaluated, and patients with lower functional capacity were those with the highest levels of IL-6.
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Affiliation(s)
| | - Jonas Alves De Araujo Junior
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
| | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Federal University of Triângulo Mineiro, Uberaba 38065-430, Brazil
| | - Rodrigo Bazan
- Department of Neurology, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-970, Brazil
| | - Péricles Sidnei Salmazo
- Department of Medicine, Faculty of Medical and Health Sciences, Pontifical Catholic University of São Paulo, Sorocaba 18052-490, Brazil
| | - Gabriel Pinheiro Modolo
- Department of Neurology, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-970, Brazil
| | - João Carlos Hueb
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
| | | | - Newton Key Hokama
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
| | - Marcos Ferreira Minicucci
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Federal University of Sao Carlos-UFSCar, São Carlos 13565-251, Brazil
| | - Silméia Garcia Zanati Bazan
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
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Petronilho A, Gois MDO, Sakaguchi C, Frade MCM, Roscani MG, Catai AM. Effects of Physical Exercise on Left Ventricular Function in Type 2 Diabetes Mellitus: A Systematic Review. International Journal of Cardiovascular Sciences 2023. [DOI: 10.36660/ijcs.20220020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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9
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Faria RA, Goulart CDL, Dos Santos PB, Marinho RS, Firmino SM, Rizzatti FPG, Mendes RG, Borghi-Silva A, Roscani MG. Right ventricle diastolic diameter as a predictor of adverse outcome of patients with chronic pulmonary obstructive disease: One-year follow-up. Am J Med Sci 2023; 365:212-214. [PMID: 36273624 DOI: 10.1016/j.amjms.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/11/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Ricardo Alexandre Faria
- Cardiology and Exercise Research Center Laboratory, Department of Medicine, Federal University of São Carlos, SP, Brazil
| | - Cassia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos, SP, Brazil
| | | | - Renan Shida Marinho
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos, SP, Brazil
| | | | - Fabiola P G Rizzatti
- Pulmonary Division, Department of Medicine, São Paulo Federal University, São Paulo, Brazil
| | - Renata G Mendes
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos, SP, Brazil
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos, SP, Brazil
| | - Meliza Goi Roscani
- Cardiology and Exercise Research Center Laboratory, Department of Medicine, Federal University of São Carlos, SP, Brazil.
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Langelli TDCO, de Andrade LP, Roscani MG, Cezar NODC, Gomes WDL, Barreiros BA, de Oliveira MPB, Takahashi ACDM. Life-space mobility in older adults with Alzheimer's-type dementia. Braz J Phys Ther 2023; 27:100480. [PMID: 36738662 PMCID: PMC9932364 DOI: 10.1016/j.bjpt.2023.100480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 10/21/2022] [Accepted: 12/21/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Mobility is an important component of functioning. Motor and cognitive impairment in older people with Alzheimer's disease can exert a negative impact on life-space mobility. OBJECTIVE To compare life-space mobility in older adults with mild and moderate Alzheimer-type dementia and those without dementia and determine associations with health factors. METHODS Life-space mobility was assessed using the Life Space Assessment (LSA) in 33 older adults with Alzheimer-type dementia (AD group) and 24 older adults without dementia (WD group). The World Health Organization Disability Assessment Schedule (WHODAS 2.0), Addenbrooke's Cognitive Examination (ACE-R), Geriatric Depression Scale (GDS), Modified Baecke Questionnaire for Older Adults (MBQOA), and Short Physical Performance Battery (SPPB) were completed. Statistical analysis was performed with unpaired t-test or Mann-Whitney tests for comparisons between groups and Spearman's correlation test. RESULTS The AD group had a lower total LSA score compared to the WD group (44 vs 65, mean difference = -20.7 [95% CI: -28.6, -12.9]), 21% of the AD group were restricted to their homes when no assistance was available. In both groups, moderate correlations were found between LSA and both functioning and physical activity level. Symptoms of depression presented moderate correlation only in the WD group. CONCLUSIONS Older adults with AD have lower life-space mobility and require assistance to achieve higher levels of mobility. CLINICAL IMPLICATIONS LSA can help assess life-space mobility. Encouraging and enabling assistance is fundamental to a greater life-space for older adults with dementia.
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Affiliation(s)
| | | | - Meliza Goi Roscani
- Department of Medicine, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | | | - Wildja de Lima Gomes
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
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11
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Camargo PF, Ditomaso-Luporini L, de Carvalho LCS, Goulart CDL, Batista Dos Santos P, Sebold R, Roscani MG, Mendes RG, Borghi-Silva A. Obstructive sleep apnea reduces functional capacity and impairs cardiac autonomic modulation during submaximal exercise in patients with chronic obstructive pulmonary disease: A follow-up study. Heart Lung 2023; 57:257-264. [PMID: 36332349 DOI: 10.1016/j.hrtlng.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Functional capacity and heart rate variability (HRV) are important prognostic markers in chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSA). However, the impact of the overlap of these diseases and the one-year clinical follow-up has not yet been evaluated. OBJECTIVES To assess whether the presence of OSA can impair functional performance and cardiac autonomic control during exercise in patients with COPD; and to verify whether the overlap of these diseases could lead to worse clinical outcomes during the one-year follow-up. METHODS Thirty-four patients underwent pulmonary function tests, echocardiography and polysomnography for diagnostic confirmation, disease staging, exclusion of any cardiac changes, and allocation between groups. The patients underwent the six-minute walk test (6MWT) to assess functional capacity and HRV during exercise. Subsequently, patients were followed up for 12 months to record outcomes such as exacerbation, hospitalization, and deaths. At the end of this period, the patients were revaluated to verify the hypotheses of the study. RESULTS The OSA-COPD group showed greater functional impairment when compared to the COPD group (p=0.003) and showed worse cardiac autonomic responses during the 6MWT with greater parasympathetic activation (p=0.03) and less complexity of the autonomic nervous system, in addition to being more likely to exacerbate (p=0.03) during one year of follow-up. CONCLUSION OSA-COPD produces deleterious effects on functional performance and a greater autonomic imbalance that impairs clinical outcomes.
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Affiliation(s)
- Patrícia Faria Camargo
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Luciana Ditomaso-Luporini
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Luiz Carlos Soares de Carvalho
- Center for Science and Technology in Energy and Sustainability of Federal University of Reconcavo da Bahia, Feira de Santana, Bahia, Brazil
| | - Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Polliana Batista Dos Santos
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Rayane Sebold
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Meliza Goi Roscani
- Medicine Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil.
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Pereira MBDCM, Castello-Simões V, Heubel AD, Kabbach EZ, Schafauser NS, Roscani MG, Borghi-Silva A, Mendes RG. Comparing cardiac function and structure and their relationship with exercise capacity between patients with stable COPD and recent acute exacerbation: a cross-sectional study. J Bras Pneumol 2022; 48:e20220098. [PMID: 36383779 PMCID: PMC9747170 DOI: 10.36416/1806-3756/e20220098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/21/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Patients with COPD are prone to cardiac remodeling; however, little is known about cardiac function in patients recovering from an acute exacerbation of COPD (AECOPD) and its association with exercise capacity. The aim of this study was to evaluate the cardiac function and structure and to compare their relationship with exercise capacity in patients with a recent AECOPD and patients with clinically stable COPD. METHODS This was a cross-sectional study including 40 COPD patients equally divided into two groups: recent AECOPD group (AEG) and clinically stable COPD group (STG). Echocardiography was performed to assess cardiac function and chamber structure. The six-minute walk distance (6MWD) and the Duke Activity Status Index (estimated Vo2) were used in order to assess exercise capacity. RESULTS No significant differences in cardiac function and structure were found between the groups. The 6MWD was associated with early/late diastolic mitral filling velocity ratio (r = 0.50; p < 0.01), left ventricular posterior wall thickness (r = -0.33; p = 0.03), and right atrium volume index (r = -0.34; p = 0.04), whereas Vo2 was associated with right atrium volume index (r = -0.40; p = 0.02). CONCLUSIONS Regardless of the clinical condition (recent AECOPD vs. stable COPD), the cardiac function and structure were similar between the groups, and exercise capacity (determined by the 6MWD and Vo2) was associated with cardiac features.
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Affiliation(s)
| | - Viviane Castello-Simões
- . Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP) Brasil
| | - Alessandro Domingues Heubel
- . Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP) Brasil
| | - Erika Zavaglia Kabbach
- . Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP) Brasil
| | - Nathany Souza Schafauser
- . Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP) Brasil
| | - Meliza Goi Roscani
- . Departamento de Medicina, Universidade Federal de São Carlos - UFSCar - São Carlos (SP) Brasil
| | - Audrey Borghi-Silva
- . Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP) Brasil
| | - Renata Gonçalves Mendes
- . Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP) Brasil
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13
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Heubel AD, Kabbach EZ, Migliato GR, Russo MIS, Brandão GMS, Roscani MG, Borghi-Silva A, Mendes RG. Role of arterial stiffness and endothelial dysfunction on lower limb performance in older adults with type 2 diabetes: A cross-sectional study. J Diabetes Complications 2022; 36:108260. [PMID: 35842303 DOI: 10.1016/j.jdiacomp.2022.108260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/06/2022] [Indexed: 11/24/2022]
Abstract
AIM To verify whether arterial stiffness and endothelial dysfunction influence lower limb muscle strength and gait speed in older adults with type 2 diabetes mellitus (T2DM). METHODS Cross-sectional study including seventy-eight older adults with T2DM (aged 67 ± 6 years and 42 % male). Arterial stiffness was assessed using pulse wave velocity (PWV), while endothelial function was measured by flow-mediated dilation (FMD). Lower limb muscle strength and gait speed were assessed using the 30-second chair stand test (30s-CST) and 10-Meter Walk Test, respectively. RESULTS Both PWV (m/s) and FMD (%) were univariately associated with number of repetitions in 30s-CST and gait speed (P < 0.05). After control for age, sex and body mass index, PWV remained associated with repetitions in 30s-CST (95 % CI: -0.494 to -0.054; P = 0.015) and gait speed (95 % CI: -0.039 to -0.002; P = 0.031). After adjustments for control variables, T2DM duration and glycemic control, FMD was associated with repetitions in 30s-CST (95 % CI: 0.008 to 0.324; P = 0.039) and gait speed (95 % CI: 0.011 to 0.038; P = 0.001). CONCLUSION In older adults with T2DM, both arterial stiffness and endothelial dysfunction are associated with decreased leg muscle strength and slower gait speed.
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Affiliation(s)
- Alessandro Domingues Heubel
- Federal University of São Carlos (UFSCar), Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory (LACAP), São Carlos, Brazil
| | - Erika Zavaglia Kabbach
- Federal University of São Carlos (UFSCar), Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory (LACAP), São Carlos, Brazil
| | - Guilherme Romano Migliato
- Federal University of São Carlos (UFSCar), Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory (LACAP), São Carlos, Brazil
| | - Maria Isabella Santos Russo
- Federal University of São Carlos (UFSCar), Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory (LACAP), São Carlos, Brazil
| | | | - Meliza Goi Roscani
- Federal University of São Carlos (UFSCar), Department of Medicine, São Carlos, Brazil
| | - Audrey Borghi-Silva
- Federal University of São Carlos (UFSCar), Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory (LACAP), São Carlos, Brazil
| | - Renata Gonçalves Mendes
- Federal University of São Carlos (UFSCar), Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory (LACAP), São Carlos, Brazil.
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14
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Pott-Junior H, Paoliello MMB, Miguel ADQC, da Cunha AF, de Melo Freire CC, Neves FF, da Silva de Avó LR, Roscani MG, dos Santos SDS, Chach´ SGF. Retraction notice to "Use of ivermectin in the treatment of Covid-19: A pilot trial" [Toxicol. Rep. 8 (2021) 505-510]. Toxicol Rep 2022; 9:1023. [PMID: 35528725 PMCID: PMC9060540 DOI: 10.1016/j.toxrep.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Henrique Pott-Junior
- Department of Medicine, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
- Corresponding author.
| | | | | | - Anderson Ferreira da Cunha
- Department of Genetics and Evolution, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Caio Cesar de Melo Freire
- Department of Genetics and Evolution, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Fábio Fernandes Neves
- Department of Medicine, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | | | - Meliza Goi Roscani
- Department of Medicine, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Sigrid De Sousa dos Santos
- Department of Medicine, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
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Mazzu-Nascimento T, Evangelista DN, Abubakar O, Roscani MG, Aguilar RS, Chachá SGF, Rosa PRD, Silva DF. Smartphone-Based Screening for Cardiovascular Diseases: A Trend? International Journal of Cardiovascular Sciences 2021. [DOI: 10.36660/ijcs.20210096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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16
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de Carvalho HT, Chiquillo MPL, Tanaka SN, de Castro ACAV, Kummer L, Roscani MG. Accuracy of obstetric ultrasonography compared to fetal echocardiography in diagnosis of congenital heart disease at a secondary level hospital in Brazil: A pilot study. Progress in Pediatric Cardiology 2021. [DOI: 10.1016/j.ppedcard.2021.101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Marinho RS, Jürgensen SP, Arcuri JF, Goulart CL, Santos PBD, Roscani MG, Mendes RG, Oliveira CRD, Caruso FR, Borghi-Silva A. Reliability and validity of six-minute step test in patients with heart failure. Braz J Med Biol Res 2021; 54:e10514. [PMID: 34287574 PMCID: PMC8289340 DOI: 10.1590/1414-431x2020e10514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 06/02/2021] [Indexed: 01/28/2023] Open
Abstract
Exercise intolerance is the hallmark consequence of advanced chronic heart failure (HF). The six-minute step test (6MST) has been considered an option for the six-minute walk test because it is safe, inexpensive, and can be applied in small places. However, its reliability and concurrent validity has still not been investigated in participants with HF with reduced ejection fraction (HFrEF). Clinically stable HFrEF participants were included. Reliability and error measurement were calculated by comparing the first with the second 6MST result. Forty-eight hours after participants underwent the 6MST, they were invited to perform a cardiopulmonary exercise test (CPET) on a cycle ergometer. Concurrent validity was assessed by correlation between number of steps and peak oxygen uptake (V̇O2 peak) at CPET. Twenty-seven participants with HFrEF (60±8 years old and left ventricle ejection fraction of 41±6%) undertook a mean of 94±30 steps in the 6MST. Intra-rater reliability was excellent for 6MST (ICC=0.9), with mean error of 4.85 steps and superior and inferior limits of agreement of 30.6 and -20.9 steps, respectively. In addition, strong correlations between number of steps and CPET workload (r=0.76, P<0.01) and peak V̇O2 (r=0.71, P<0.01) were observed. From simple linear regression the following predictive equations were obtained with 6MST results: V̇O2 peak (mL/min) = 350.22 + (7.333 × number of steps), with R2=0.51, and peak workload (W) = 4.044 + (0.772 × number of steps), with R2=0.58. The 6MST was a reliable and valid tool to assess functional capacity in HFrEF participants and may moderately predict peak workload and oxygen uptake of a CPET.
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Affiliation(s)
- R S Marinho
- Programa de Pós-Graduação Interunidades de Bioengenharia, Universidade de São Paulo, São Carlos, SP, Brasil
| | - S P Jürgensen
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - J F Arcuri
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C L Goulart
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - P B Dos Santos
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - M G Roscani
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - R G Mendes
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C R de Oliveira
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - F R Caruso
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - A Borghi-Silva
- Programa de Pós-Graduação Interunidades de Bioengenharia, Universidade de São Paulo, São Carlos, SP, Brasil.,Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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18
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de Araujo Junior JA, Antonelli Rossi DA, Carneiro Valadão TF, Milan-Mattos JC, Catai AM, Sato TDO, Hueb JC, Zanati Bazan SG, Hokama POM, Hokama NK, Roscani MG. Cardiovascular benefits of a home-based exercise program in patients with sickle cell disease. PLoS One 2021; 16:e0250128. [PMID: 33979369 PMCID: PMC8115779 DOI: 10.1371/journal.pone.0250128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/30/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Physical inactivity is an important risk factor for cardiovascular disease. The benefits of exercise in patients with chronic diseases, including cardiovascular diseases, are well established. For patients with sickle cell disease, medical recommendation was to avoid physical exercise for fear of triggering painful crises or increasing the impairment of the cardiopulmonary function. Only recently, studies have shown safety in exercise programs for this population. Despite that, there is no report that assess the effects of physical exercise on cardiac parameters in patients with sickle cell disease. OBJECTIVE This study aimed to evaluate the impact of regular physical exercise (a home-based program) on cardiovascular function in patients with sickle cell disease. DESIGN A quasi-randomized prospective controlled trial. SETTING During the years 2015 and 2016, we started recruiting among adult patients treated at a Brazilian Center for Patients with Sickle Cell Disease to participate in a study involving a home exercise program. The experimental (exercise) and control groups were submitted to clinical evaluation and cardiovascular tests before and after the intervention. Analysis of variance was applied to compare groups, considering time and group factors. PARTICIPANTS Twenty-seven adult outpatients with a sickle cell disease diagnosis. INTERVENTIONS Exercise group (N = 14): a regular home-based aerobic exercise program, three to five times per week not exceeding give times per week, for eight weeks; no prescription for the control group (N = 13). MAIN OUTCOME MEASURES Echocardiographic and treadmill test parameters. RESULTS The exercise group showed significant improvement in cardiovascular tests, demonstrated by increased distance traveled on a treadmill (p<0.01), increased ejection fraction (p < 0.01) and improvement of diastolic function assessed by mitral tissue Doppler E' wave on echocardiography (p = 0.04). None of the patients presented a sickle cell crisis or worsening of symptoms during the exercise program. CONCLUSION The selected home-based exercise program is safe, feasible, and promotes a favorable impact on functional capacity and cardiovascular function in sickle cell disease patients.
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Affiliation(s)
- Jonas Alves de Araujo Junior
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | | | - Taina Fabri Carneiro Valadão
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | | | - Aparecida Maria Catai
- Department of Physiotherapy, Federal University of Sao Carlos–UFSCar, São Carlos, Brazil
| | | | - Joao Carlos Hueb
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | - Silmeia Garcia Zanati Bazan
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | | | - Newton Key Hokama
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
| | - Meliza Goi Roscani
- Department of Internal Medicine, Sao Paulo State University Julio de Mesquita Filho–Unesp, Botucatu, Sao Paulo, Brazil
- Department of Medicine, Federal University of Sao Carlos–UFSCar, São Carlos, Brazil
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19
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Camargo PF, Ditomaso-Luporini L, de Carvalho LCS, Goulart CDL, Sebold R, Dos Santos PB, Roscani MG, Borghi-Silva A. Association Between the Predictors of Functional Capacity and Heart Rate Off-Kinetics in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:1977-1986. [PMID: 32884254 PMCID: PMC7438181 DOI: 10.2147/copd.s260284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/21/2020] [Indexed: 01/10/2023] Open
Abstract
Background The heart rate (HR) kinetics as well as other predictors of functional capacity such as the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT), the Duke Activity Status Index (DASI) and the handgrip strength (HGS) represent important tools in assessing the impact of COPD on exercise performance and health status of individuals with COPD. Purpose To verify the relationship between functional capacity, measured using the six-minute walking test (6MWT), with the HR off-kinetics, HGS and the DASI and CAT scores. Methods For this cross-sectional study, 29 subjects with COPD underwent body composition, pulmonary function and cardiac function tests. Subsequently, the DASI and CAT questionnaires and HGS test were performed. The beat-to-beat R-R intervals (IRR) were collected in rest, during the test and in recovery after the 6MWT. The HR off-kinetics was obtained during a 360-second period in post-exercise recovery through the HR mono-exponential decay. Results Moderate correlations were observed between: 1) walked distance (WD) in the 6MWT and the CAT and DASI scores (r= −0.58, p=0.001 and r= 0.58, p=0.001, respectively); 2) WD and HGS (r=0.37, p=0.05); 3) and WD and HR off-kinetics (τ; r= −0.54, p=0.002 and MRT; r= −0.55, p=0.002, respectively). Conclusion The 6MWT performance is a direct measurement to evaluate functional capacity. Additionally, it is related to other direct and indirect markers for functional evaluation in patients with COPD. These results suggest the application of these tools in clinical practice, based on the accessibility, non-invasive character and easy applicability of these methods.
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Affiliation(s)
- Patrícia Faria Camargo
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Paulo, Brazil
| | - Luciana Ditomaso-Luporini
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Paulo, Brazil
| | - Luiz Carlos Soares de Carvalho
- Center for Science and Technology in Energy and Sustainability of Federal University of Reconcavo da Bahia, Feira de Santana, Bahia, Brazil
| | - Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Paulo, Brazil
| | - Rayane Sebold
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Paulo, Brazil.,Course of Physiotherapy, Central Paulista University Center, Sao Carlos, Sao Paulo, Brazil
| | - Polliana Batista Dos Santos
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Paulo, Brazil
| | - Meliza Goi Roscani
- Medicine Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Paulo, Brazil
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20
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Goulart CDL, Arêas GPT, Caruso FR, Araújo ASG, de Moura SCG, Catai AM, Beltrame T, Junior LCDC, Dos Santos PB, Roscani MG, Mendes RG, Arena R, Borghi-Silva A. Effect of high-intensity exercise on cerebral, respiratory and peripheral muscle oxygenation of HF and COPD-HF patients. Heart Lung 2020; 50:113-120. [PMID: 32709499 DOI: 10.1016/j.hrtlng.2020.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 05/15/2020] [Accepted: 06/29/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate cerebral oxygenation (Cox) responses as well as respiratory (Res) and active peripheral muscle (Pm) O2 delivery during high-intensity cycling exercise and contrast responses between patients with coexistent chronic obstructive pulmonary disease (COPD)-heart failure (HF) and HF alone. METHODS Cross-sectional study involving 11 COPD-HF and 11 HF patients. On two different days, patients performed maximal incremental cardiopulmonary exercise testing (CPET) and constant load exercise on a cycle ergometer until the limit of tolerance (Tlim). The high-intensity exercise session was 80% of the peak CPET work rate. Relative blood concentrations of oxyhemoglobin ([O2Hb]), deoxyhemoglobin ([HHb]) of Res, Pm (right vastus lateralis) and Cox (pre-frontal) were measured using near infrared spectroscopy. RESULTS We observed a greater decrease in [O2Hb] at a lower Tlim in COPD-HF when compared to HF (P < 0.05). [HHb] of Res was higher (P < 0.05) and Tlim was lower in COPD-HF vs. HF. Pm and Cox were lower and Tlim was higher in (P < 0.05) HF vs. COPD-HF. In HF, there was a lower ∆[O2Hb] and higher ∆ [HHb] of Pm when contrasted to Cox observed during exercise, as well as a lower ∆ [O2Hb] and higher ∆ [HHb] of Res when contrasted with Cox (P < 0.05). However, COPD-HF patients presented with a higher ∆ [HHb] of Res and Pm when contrasted with Cox (P < 0.05). CONCLUSION The coexistence of COPD in patients with HF produces negative effects on Cox, greater deoxygenation of the respiratory and peripheral muscles and higher exertional dyspnea, which may help to explain an even lower exercise tolerance in this multimorbidity phenotype.
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Affiliation(s)
- Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Guilherme Peixoto Tinoco Arêas
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil; Human Physiology Laboratory, Physiology Department, Federal University of Amazonas, UFAM, v. General Rodrigo Octávio, 6200, Coroado I, CEP: 69080-900, Manaus, AM, Brazil
| | - Flávia Rossi Caruso
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Adriana S Garcia Araújo
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Sílvia Cristina Garcia de Moura
- Cardiovascular Physical Therapy Laboratory, Physiotherapy Department, Federal University of São Carlos, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Aparecida Maria Catai
- Cardiovascular Physical Therapy Laboratory, Physiotherapy Department, Federal University of São Carlos, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Thomas Beltrame
- Cardiovascular Physical Therapy Laboratory, Physiotherapy Department, Federal University of São Carlos, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Luiz Carlos de Carvalho Junior
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Polliana Batista Dos Santos
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | | | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil.
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21
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da Luz Goulart C, Dos Santos PB, Caruso FR, Arêas GPT, Marinho RS, de Faria Camargo P, da Silva Alexandre T, Oliveira CR, da Silva ALG, Mendes RG, Roscani MG, Borghi-Silva A. Publisher Correction: The Value of Cardiopulmonary Exercise Testing in Determining Severity in Patients with both Systolic Heart Failure and COPD. Sci Rep 2020; 10:7398. [PMID: 32366922 PMCID: PMC7198566 DOI: 10.1038/s41598-020-64446-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Polliana Batista Dos Santos
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Flávia Rossi Caruso
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Guilherme Peixoto Tinoco Arêas
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Renan Shida Marinho
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | - Patricia de Faria Camargo
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | | | - Claudio R Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | | | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil
| | | | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565-905, Sao Carlos, SP, Brazil.
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Rehder-Santos P, Minatel V, Ribeiro BA, Ducatti R, de Moura-Tonello SCG, Roscani MG, da Silva Reis M, Silva E, Catai AM. Age is the main factor related to expiratory flow limitation during constant load exercise. Clinics (Sao Paulo) 2018; 73:e439. [PMID: 30379226 PMCID: PMC6201139 DOI: 10.6061/clinics/2018/e439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 07/06/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate the interaction among the determinants of expiratory flow limitation (EFL), peak oxygen uptake (VO2peak), dysanapsis ratio (DR) and age during cycling at different intensities in young and middle-aged men. METHODS Twenty-two (11 young and 11 middle-aged) men were assessed. Pulmonary function tests (DR), cardiopulmonary exercise tests (VO2peak) and two constant load tests (CLTs) at 75% (moderate intensity) and 125% (high intensity) of the gas exchange threshold were performed to assess EFL. EFL was classified using the percentage of EFL determined from both CLTs (mild: 5%-30%, moderate: 30%-50%, severe: >50%). RESULTS Only the middle-aged group displayed EFL at both exercise intensities (p<0.05). However, the number of participants with EFL and the percentage of EFL were only associated with age during high-intensity exercise. CONCLUSIONS There was no interaction between the determinants. However, age was the only factor that was related to the presence of EFL during exercise in the age groups studied.
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Affiliation(s)
- Patricia Rehder-Santos
- Laboratorio de Fisioterapia Cardiovascular, Nucleo de Pesquisas em Exercicio Fisico, Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
| | - Vinicius Minatel
- Laboratorio de Fisioterapia Cardiovascular, Nucleo de Pesquisas em Exercicio Fisico, Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
| | - Bruno Araújo Ribeiro
- Laboratorio de Fisioterapia Cardiovascular, Nucleo de Pesquisas em Exercicio Fisico, Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
| | - Richard Ducatti
- Laboratorio de Fisioterapia Cardiovascular, Nucleo de Pesquisas em Exercicio Fisico, Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
| | - Silvia Cristina Garcia de Moura-Tonello
- Laboratorio de Fisioterapia Cardiovascular, Nucleo de Pesquisas em Exercicio Fisico, Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
| | - Meliza Goi Roscani
- Departamento de Medicina, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
| | - Michel da Silva Reis
- Grupo de Pesquisa em Avaliacao e Reabilitacao Cardiorrespiratoria (GECARE), Departamento Fisioterapia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Ester Silva
- Laboratorio de Fisioterapia Cardiovascular, Nucleo de Pesquisas em Exercicio Fisico, Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
| | - Aparecida Maria Catai
- Laboratorio de Fisioterapia Cardiovascular, Nucleo de Pesquisas em Exercicio Fisico, Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
- *Corresponding author. E-mail:
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Zangrando KTL, Trimer R, de Carvalho LCS, Arêas GPT, Caruso FCR, Cabiddu R, Roscani MG, Rizzatti FPG, Borghi-Silva A. Chronic obstructive pulmonary disease severity and its association with obstructive sleep apnea syndrome: impact on cardiac autonomic modulation and functional capacity. Int J Chron Obstruct Pulmon Dis 2018; 13:1343-1351. [PMID: 29731622 PMCID: PMC5927062 DOI: 10.2147/copd.s156168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background The study was conducted to determine the impact of chronic obstructive pulmonary disease (COPD) in association with obstructive sleep apnea syndrome (OSAS) on cardiac autonomic control and functional capacity. Subjects and methods The study was a cross-sectional prospective controlled clinical study. Heart rate variability indices of 24 COPD (n = 12) and COPD+OSAS (n = 12) patients were evaluated and compared by electrocardiographic recordings acquired during rest, active postural maneuver (APM), respiratory sinus arrhythmia maneuver (RSA-m), and the 6-minute walk test (6MWT). Results The COPD group presented higher parasympathetic modulation during APM when compared to the COPD+OSAS group (P = 0.02). The COPD+OSAS group presented higher sympathetic modulation during RSA-m when compared to the COPD group (P = 0.00). The performance during 6MWT was similarly impaired in both groups, despite the greater severity of the COPD group. Conclusion Subjects with COPD+OSAS present marked sympathetic modulation, and the presence of OSAS in COPD subjects has a negative impact on functional capacity regardless of the severity of lung disease.
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Affiliation(s)
- Katiany Thays Lopes Zangrando
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Renata Trimer
- Physical Education and Health Department, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Luiz Carlos Soares de Carvalho
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Guilherme Peixoto Tinoco Arêas
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Flávia Cristina Rossi Caruso
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ramona Cabiddu
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Meliza Goi Roscani
- Medicine Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Roscani MG, Duarte JDC, Augusto GN, Salgueiro TRDM, Meireles MN, Gobbi JIF, Okoshi K, Hueb JC. Association Between Left Ventricle Diastolic Dysfunction and Unfavorable Prognostic Markers in Patients with Aortic Insufficiency. J Clin Diagn Res 2017; 11:OC09-OC11. [PMID: 28764216 DOI: 10.7860/jcdr/2017/23463.9974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/19/2016] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The presence of symptoms, systolic dysfunction and Left Ventricle (LV) dilation are considered unfavourable prognostic markers in Aortic Valve Insufficiency (AVI). The role of diastolic dysfunction, which is considered unfavourable outcome marker in cardiac pathologies, is not well established in AVI. AIM To evaluate if the presence of diastolic dysfunction may be associated with unfavourable prognostic markers in AVI patients. MATERIALS AND METHODS A cross-sectional prospective study was performed on 22 patients with moderate or severe AVI. They underwent clinical evaluation and transthoracic echocardiography. Associations between clinical, epidemiological and echocardiographic were evaluated by Student t-test for normally distributed variables or Mann-Whitney test for non-normal distribution. Comparison between proportions was performed by Chi-square test. RESULTS There was an association between increased LV filling pressure, assessed by E' and E/E' of Mitral Tissue Doppler, and impaired LV systolic function, respectively: R = 0.563, R2 = 0.281; p = 0.008 and R = 0.639, R2 = 0.378; p = 0.002. The LV indexed mass also was inversely associated with the LV ejection fraction (R = 0.62, R2 = 0.35 and p = 0.003). CONCLUSION There was an association of LV diastolic dysfunction and ventricular hypertrophy with impaired left ventricle systolic function. Increased LV filling pressure and LV indexed mass should be considered in the management of AVI patients.
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Affiliation(s)
- Meliza Goi Roscani
- Consultant, Department of Medical Medicine, São Carlos Federal University, São Carlos, São Paulo, Brazil
| | - Juliana da Cunha Duarte
- Consultant, Department of Internal Medicine, Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - Gustavo Nicolodi Augusto
- Consultant, Department of Internal Medicine, Botucatu Medical School, Botucatu, São Paulo, Brazil
| | | | - Mariana N Meireles
- Consultant, Department of Internal Medicine, Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - Juliana I F Gobbi
- Professor, Department of Biosciences Institute, São Paulo State University, Botucatu, São Paulo, Brazil
| | - Katashi Okoshi
- Consultant, Department of Internal Medicine, Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - João Carlos Hueb
- Professor, Department of Internal Medicine, Botucatu Medical School, Botucatu, São Paulo, Brazil
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Carvalho PBD, Gonçalves ADF, Alegre PHC, Azevedo PS, Roscani MG, Bergamasco CM, Modesto PN, Fernandes AA, Minicucci MF, Paiva SAR, Antonio L, Zornoff M, Polegato BF. Pamidronate Attenuates Oxidative Stress and Energetic Metabolism Changes but Worsens Functional Outcomes in Acute Doxorubicin-Induced Cardiotoxicity in Rats. Cell Physiol Biochem 2016; 40:431-442. [PMID: 27889760 DOI: 10.1159/000452558] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cardiotoxicity is the major side effect of doxorubicin. As mechanisms that are involved in cardiotoxicity are ambiguous, new methods for attenuating cardiotoxicity are needed. Recent studies have shown that bisphosphonates can decrease oxidative stress. Therefore, the objective of this study was to evaluate the effect of pamidronate on preventing acute doxorubicin-induced cardiotoxicity. METHODS Sixty-four male Wistar rats were allocated into four groups: the control group (C), the pamidronate group (P), the doxorubicin group (D) and the doxorubicin/pamidronate group (DP). The rats in the P and DP groups received pamidronate injections (3 mg/kg, IP). After 24 hours, the rats in the D and DP groups received doxorubicin injections (20 mg/kg, IP). Forty-eight hours after doxorubicin injection, the rats were killed. Echocardiography, isolated heart study and biochemical analysis were performed. RESULTS Doxorubicin-induced acute cardiotoxicity showed increased matrix metalloproteinases (MMP)-2 activation, oxidative damage and induced alterations in myocardial energetic metabolism. Pamidronate did not inhibit MMP-2 activation but attenuated oxidative stress and improved myocardial energetic metabolism. Regarding cardiac function, the DP group exhibited a decrease in the left ventricular ejection fraction in the echocardiography and a decrease in +dP/dt in the isolated heart study compared with other groups. The same DP group presented serum hypocalcaemia. CONCLUSIONS Despite its ability to reduce oxidative stress and improve energy metabolism in the heart, pamidronate worsened systolic function in rats treated with doxorubicin, and therefore we cannot recommend its use in conjunction with anthracycline chemotherapy.
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Fidelix MP, Tanni SE, Roscani MG, Mesquita CB, Schelini KNDM, Polegato BF, Gaiolla PSA, Minicucci MF, Zornoff LAM, Papini SJ, de Godoy I, de Paiva SAR. Vitamin D role in smoking women and cardiac remodeling. ACTA ACUST UNITED AC 2016. [DOI: 10.1186/s41110-016-0012-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Roscani MG, Augusto GN, Valadão TF, Araújo JA, Duarte JC, Gobbi JI, Silveira LV, Coneglian RC, Rossi DA, Zanati SG, Matsubara BB, Hueb JC. Strain Pattern on Electrocardiogram Is Associated with Increased Carotid Intima-Media Thickness in Patients with Aortic Valve Stenosis. Ann Vasc Surg 2016; 35:197-202. [DOI: 10.1016/j.avsg.2016.01.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 01/18/2016] [Accepted: 01/20/2016] [Indexed: 10/21/2022]
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Ganan CS, Moreira DA, Bazan R, Hueb JC, Bragante ALSES, Magalhães CG, Roscani MG, Peraçoli JC, Reis GS, Borges VTM, Bazan SGZ. 98 Evolution of cardiac remodeling associated with pregnancy in hypertensive women six months postpartum. Pregnancy Hypertens 2016. [DOI: 10.1016/j.preghy.2016.08.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ferreira RM, Borges V, Hueb JC, Bazan R, da Silva Ferreira S, Roscani MG, Peraçoli JC, Martin LC, Zanati Bazan SG. 1 Cardiovascular risk factors in women with preeclampsia history and their association with myocardial hypertrophy and intima-media thickening of the carotids. Pregnancy Hypertens 2016. [DOI: 10.1016/j.preghy.2016.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Roscani MG, Zanati SG, Salmazo PS, Carvalho FC, Magalhães CG, Borges VTM, Matsubara BB, Hueb JC. Invasive tests in pregnancy. Clinics (Sao Paulo) 2014; 69:504. [PMID: 25029585 PMCID: PMC4081885 DOI: 10.6061/clinics/2014(07)12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Meliza Goi Roscani
- Internal Medicine, Department of Medicine, São Carlos Federal University (UFSCar), São Carlos, SP, Brazil
| | - Silmeia G Zanati
- Internal Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP, Brazil
| | - Pericles S Salmazo
- Internal Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP, Brazil
| | - Fabio C Carvalho
- Internal Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP, Brazil
| | - Claudia G Magalhães
- Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP, Brazil
| | - Vera Therezinha M Borges
- Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP, Brazil
| | - Beatriz B Matsubara
- Internal Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP, Brazil
| | - João C Hueb
- Internal Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP, Brazil
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dos Santos PP, Rafacho BPM, Gonçalves ADF, Jaldin RG, do Nascimento TB, Silva MAB, Cau SBA, Roscani MG, Azevedo PS, Minicucci MF, Tostes RDC, Zornoff LAM, de Paiva SAR. Vitamin D induces increased systolic arterial pressure via vascular reactivity and mechanical properties. PLoS One 2014; 9:e98895. [PMID: 24921930 PMCID: PMC4055656 DOI: 10.1371/journal.pone.0098895] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/08/2014] [Indexed: 11/18/2022] Open
Abstract
Background/Aims The aim of this study was to evaluate whether supplementation of high doses of cholecalciferol for two months in normotensive rats results in increased systolic arterial pressure and which are the mechanisms involved. Specifically, this study assesses the potential effect on cardiac output as well as the changes in aortic structure and functional properties. Methods Male Wistar rats were divided into three groups: 1) Control group (C, n = 20), with no supplementation of vitamin D, 2) VD3 (n = 19), supplemented with 3,000 IU vitamin D/kg of chow; 3) VD10 (n = 21), supplemented with 10,000 IU vitamin D/kg of chow. After two months, echocardiographic analyses, measurements of systolic arterial pressure (SAP), vascular reactivity, reactive oxygen species (ROS) generation, mechanical properties, histological analysis and metalloproteinase-2 and -9 activity were performed. Results SAP was higher in VD3 and VD10 than in C rats (p = 0.001). Echocardiographic variables were not different among groups. Responses to phenylephrine in endothelium-denuded aortas was higher in VD3 compared to the C group (p = 0.041). Vascular relaxation induced by acetylcholine (p = 0.023) and sodium nitroprusside (p = 0.005) was impaired in both supplemented groups compared to the C group and apocynin treatment reversed impaired vasodilation. Collagen volume fraction (<0.001) and MMP-2 activity (p = 0.025) was higher in VD10 group compared to the VD3 group. Elastin volume fraction was lower in VD10 than in C and yield point was lower in VD3 than in C. Conclusion Our findings support the view that vitamin D supplementation increases arterial pressure in normotensive rats and this is associated with structural and functional vascular changes, modulated by NADPH oxidase, nitric oxide, and extracellular matrix components.
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Affiliation(s)
- Priscila Portugal dos Santos
- Department of Internal Medicine, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Bruna Paola Murino Rafacho
- Department of Internal Medicine, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Andréa de Freitas Gonçalves
- Department of Internal Medicine, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Rodrigo Gibin Jaldin
- Department of Surgery and Orthopaedics, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Thiago Bruder do Nascimento
- Department of Pharmacology, School of Medicine at Ribeirao Preto - USP, University of São Paulo, São Paulo, Brazil
| | | | - Stêfany Bruno Assis Cau
- Department of Pharmacology, School of Medicine at Ribeirao Preto - USP, University of São Paulo, São Paulo, Brazil
| | - Meliza Goi Roscani
- Department of Internal Medicine, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Paula Schimdt Azevedo
- Department of Internal Medicine, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Marcos Ferreira Minicucci
- Department of Internal Medicine, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Rita de Cássia Tostes
- Department of Pharmacology, School of Medicine at Ribeirao Preto - USP, University of São Paulo, São Paulo, Brazil
| | - Leonardo Antonio Memede Zornoff
- Department of Internal Medicine, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Sergio Alberto Rupp de Paiva
- Department of Internal Medicine, Botucatu Medical School, UNESP - Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
- * E-mail:
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Roscani MG, Polegato BF, Minamoto SET, Lousada APM, Minicucci M, Azevedo P, Matsubara LS, Matsubara BB. Left ventricular sphericity index predicts systolic dysfunction in rats with experimental aortic regurgitation. J Appl Physiol (1985) 2014; 116:1259-62. [DOI: 10.1152/japplphysiol.00840.2013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Although an increased left ventricular (LV) diastolic diameter (DD) and a decreased ejection fraction have been used as markers for the surgical replacement of an insufficient aortic valve, these signals may be observed when irreversible myocardium damage has already occurred. The aim of this study was to determine whether change in LV geometry predicts systolic dysfunction in experimental aortic regurgitation. Male Wistar rats underwent surgical acute aorta regurgitation (aorta regurgitation group; n = 23) or a sham operation (sham group; n = 12). After the procedure, serial transthoracic echocardiograms were performed at 1, 4, 8, and 16 wk. At the end of protocol, the LV, lungs, and liver were dissected and weighed. During the follow-up, no animal developed overt heart failure. There was a correlation between the LV sphericity index and reduced fractional shortening ( P < 0.001) over time. A multiple regression model showed that the LVDD-sphericity index association at 8 wk was a better predictor of decreased fractional shortening at week 16 ( R2 = 0.50; P < 0.001) than was the LVDD alone ( R2 = 0.39; P = 0.001). LV geometry associated with increased LVDD improved the prediction of systolic dysfunction in experimental aortic regurgitation.
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Affiliation(s)
- Meliza Goi Roscani
- Department of Internal Medicine, Botucatu Medical School, University of Estadual Paulista (Universidade Estadual Paulista “Júlio de Mesquita Filho”), São Paulo, Brazil
| | - Bertha Fulan Polegato
- Department of Internal Medicine, Botucatu Medical School, University of Estadual Paulista (Universidade Estadual Paulista “Júlio de Mesquita Filho”), São Paulo, Brazil
| | - Suzana Erico Tanni Minamoto
- Department of Internal Medicine, Botucatu Medical School, University of Estadual Paulista (Universidade Estadual Paulista “Júlio de Mesquita Filho”), São Paulo, Brazil
| | - Ana Paula Mena Lousada
- Department of Internal Medicine, Botucatu Medical School, University of Estadual Paulista (Universidade Estadual Paulista “Júlio de Mesquita Filho”), São Paulo, Brazil
| | - Marcos Minicucci
- Department of Internal Medicine, Botucatu Medical School, University of Estadual Paulista (Universidade Estadual Paulista “Júlio de Mesquita Filho”), São Paulo, Brazil
| | - Paula Azevedo
- Department of Internal Medicine, Botucatu Medical School, University of Estadual Paulista (Universidade Estadual Paulista “Júlio de Mesquita Filho”), São Paulo, Brazil
| | - Luiz Shiguero Matsubara
- Department of Internal Medicine, Botucatu Medical School, University of Estadual Paulista (Universidade Estadual Paulista “Júlio de Mesquita Filho”), São Paulo, Brazil
| | - Beatriz Bojikian Matsubara
- Department of Internal Medicine, Botucatu Medical School, University of Estadual Paulista (Universidade Estadual Paulista “Júlio de Mesquita Filho”), São Paulo, Brazil
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Bussoni MF, Guirado GN, Matsubara LS, Roscani MG, Polegato BF, Minamoto ST, Bazan SGZ, Matsubara BB. Diastolic function and functional capacity after a single session of continuous positive airway pressure in patients with compensated heart failure. Clinics (Sao Paulo) 2014; 69:354-9. [PMID: 24838902 PMCID: PMC4012238 DOI: 10.6061/clinics/2014(05)010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 10/11/2013] [Accepted: 11/07/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The effects of acute continuous positive airway pressure therapy on left ventricular diastolic function and functional capacity in patients with compensated systolic heart failure remain unclear. METHODS This randomized, double-blind, placebo-controlled clinical trial included 43 patients with heart failure and a left ventricular ejection fraction <0.50 who were in functional classes I-III according to the New York Heart Association criteria. Twenty-three patients were assigned to continuous positive airway pressure therapy (10 cmH2O), while 20 patients received placebo with null pressure for 30 minutes. All patients underwent a 6-minute walk test (6MWT) and Doppler echocardiography before and immediately after intervention. Clinicaltrials.gov: NCT01088854. RESULTS The groups had similar clinical and echocardiographic baseline variables. Variation in the diastolic function index (e') after intervention was associated with differences in the distance walked in both groups. However, in the continuous positive airway pressure group, this difference was greater (continuous positive airway pressure group: Δ6MWT = 9.44+16.05×Δe', p = 0.002; sham group: Δ6MWT = 7.49+5.38×Δe'; p = 0.015). There was a statistically significant interaction between e' index variation and continuous positive airway pressure for the improvement of functional capacity (p = 0.020). CONCLUSIONS Continuous positive airway pressure does not acurately change the echocardiographic indexes of left ventricle systolic or diastolic function in patients with compensated systolic heart failure. However, 30-minute continuous positive airway pressure therapy appears to have an effect on left ventricular diastolic function by increasing functional capacity.
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Affiliation(s)
| | | | - Luiz Shiguero Matsubara
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP, Brazil
| | - Meliza Goi Roscani
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP, Brazil
| | - Bertha Furlan Polegato
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP, Brazil
| | - Suzana Tanni Minamoto
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP, Brazil
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Bussoni MF, Guirado GN, Roscani MG, Polegato BF, Matsubara LS, Bazan SGZ, Matsubara BB. Diastolic function is associated with quality of life and exercise capacity in stable heart failure patients with reduced ejection fraction. Braz J Med Biol Res 2013; 46:803-8. [PMID: 24036912 PMCID: PMC3854427 DOI: 10.1590/1414-431x20132902] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 06/21/2013] [Indexed: 11/22/2022] Open
Abstract
Exercise capacity and quality of life (QOL) are important outcome predictors in
patients with systolic heart failure (HF), independent of left ventricular (LV)
ejection fraction (LVEF). LV diastolic function has been shown to be a better
predictor of aerobic exercise capacity in patients with systolic dysfunction and
a New York Heart Association (NYHA) classification ≥II. We hypothesized that the
currently used index of diastolic function E/e' is associated with exercise
capacity and QOL, even in optimally treated HF patients with reduced LVEF. This
prospective study included 44 consecutive patients aged 55±11 years (27 men and
17 women), with LVEF<0.50 and NYHA functional class I-III, receiving optimal
pharmacological treatment and in a stable clinical condition, as shown by the
absence of dyspnea exacerbation for at least 3 months. All patients had
conventional transthoracic echocardiography and answered the Minnesota Living
with HF Questionnaire, followed by the 6-min walk test (6MWT). In a
multivariable model with 6MWT as the dependent variable, age and E/e' explained
27% of the walked distance in 6MWT (P=0.002; multivariate regression analysis).
No association was found between walk distance and LVEF or mitral annulus
systolic velocity. Only normalized left atrium volume, a sensitive index of
diastolic function, was associated with decreased QOL. Despite the small number
of patients included, this study offers evidence that diastolic function is
associated with physical capacity and QOL and should be considered along with
ejection fraction in patients with compensated systolic HF.
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Affiliation(s)
- M F Bussoni
- Universidade Estadual Paulista, Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, BotucatuSP, Brasil
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Pereira CA, Roscani MG, Zanati SG, Matsubara BB. Anemia, heart failure and evidence-based clinical management. Arq Bras Cardiol 2013; 101:87-92. [PMID: 23917508 PMCID: PMC3998166 DOI: 10.5935/abc.20130126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 12/05/2012] [Indexed: 12/21/2022] Open
Abstract
Anemia is a prevalent comorbidity and marker of a poorer prognosis in patients with
heart failure (HF). Its clinical relevance, as well as its pathophysiology and the
clinical management of these patients are important subjects in the specialized
literature. In the present review, we describe the current concepts on the
pathophysiology of anemia in HF, its diagnostic criteria, and the recommendations for
iron supplementation. Also, we make a critical analysis of the major studies showing
evidences on the benefits of this supplementation. The four main components of anemia
are addressed: chronic disease, dilutional, "renal" and malabsorption. In patients
with HF, the diagnostic criteria are the same as those used in the general
population: serum ferritin levels lower than 30 mcg/L in patients without kidney
diseases and lower than 100 mcg/L or serum ferritin levels between 100-299 mcg/L with
transferring saturation lower than 20% in patients with chronic kidney diseases.
Finally, the therapeutic possibilities for anemia in this specific patient population
are discussed.
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Assalin HB, Rafacho BP, dos Santos PP, Ardisson LP, Roscani MG, Chiuso-Minicucci F, Barbisan LF, Fernandes AAH, Azevedo PS, Minicucci MF, Zornoff LA, de Paiva SAR. Impact of the length of vitamin D deficiency on cardiac remodeling. Circ Heart Fail 2013; 6:809-16. [PMID: 23709660 DOI: 10.1161/circheartfailure.112.000298] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND This study was aimed to evaluate the influence of vitamin D (VD) deficiency on cardiac metabolism, morphology, and function. Thus, we investigated the relationship of these changes with the length of the nutrient restriction. METHODS AND RESULTS Male weanling Wistar rats were allocated into 4 groups: C2 (n=24), animals were fed an AIN-93G diet with 1000 IU VD/kg of chow and were kept under fluorescent light for 2 months; D2 (n=22), animals were fed a VD-deficient AIN-93G diet and were kept under incandescent light for 2 months; C4 (n=21) animals were kept in the same conditions of C2 for 4 months; and D4 (n=23) animals were kept in the same conditions of D2 for 4 months. Biochemical analyses showed lower β-hydroxyacyl coenzyme-A dehydrogenase activity and higher lactate dehydrogenase activity in VD-deficient animals. Furthermore, VD deficiency was related to increased cytokines release, oxidative stress, apoptosis, and fibrosis. Echocardiographic data showed left ventricular hypertrophy and lower fractional shortening and ejection fraction in VD-deficient animals. Difference became evident in the lactate dehydrogenase activity, left ventricular weight, right ventricle weight, and left ventricular mass after 4 months of VD deficiency. CONCLUSIONS Our data indicate that VD deficiency is associated with energetic metabolic changes, cardiac inflammation, oxidative stress, fibrosis and apoptosis, cardiac hypertrophy, left chambers alterations, and systolic dysfunction. Furthermore, length of the restriction influenced these cardiac changes.
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Affiliation(s)
- Heloisa Balan Assalin
- Internal Medicine Department, Botucatu Medical School, UNESP, São Paulo State University, Botucatu, Brazil
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Roscani MG, Zanati SG, Salmazo PS, Carvalho FC, Magalhães CG, Borges VTM, Bregagnollo EA, Matsubara BB, Hueb JC. Congenital aneurysmal circumflex coronary artery fistula in a pregnant woman. Clinics (Sao Paulo) 2012; 67:1523-5. [PMID: 23295614 PMCID: PMC3521823 DOI: 10.6061/clinics/2012(12)30] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Meliza Goi Roscani
- Universidade Estado de São Paulo, Botucatu Medical School, Department of Internal Medicine, Botucatu/SP, Brazil.
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Rafacho BPM, Santos P, Assalin HB, Ardisson LP, Roscani MG, Polegato BF, Chiuso-Minicucci F, Fernandes AAH, Azevedo PS, Minicucci MF, Zornoff LAM, Paiva S. Role of vitamin D in the cardiac remodeling induced by tobacco smoke exposure. Int J Cardiol 2012; 155:472-3. [PMID: 22257686 DOI: 10.1016/j.ijcard.2011.12.078] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 12/21/2011] [Indexed: 12/25/2022]
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Moriel G, Roscani MG, Matsubara LS, Cerqueira ATDAR, Matsubara BB. Quality of life in patients with severe and stable coronary atherosclerotic disease. Arq Bras Cardiol 2011; 95:691-7. [PMID: 21271189 DOI: 10.1590/s0066-782x2010005000151] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Accepted: 07/15/2010] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There are few data on the factors decreasing quality of life (QoL) in patients with coronary artery disease (CAD) before a percutaneous coronary intervention (PCI). OBJECTIVE To associate clinical variables with QoL scores in patients with stable CAD before the PCI and with unfavorable outcomes, 12 months after the procedure. METHODS The present is a longitudinal study of 78 patients (43 men and 35 women), before an elective PCI. The associations between the QoL scores (SF-36 questionnaire) and age, sex, weight, body mass index, diabetes mellitus (DM), arterial hypertension, dyslipidemia, current smoking, previous cardiovascular event or PCI, glycemia control and blood pressure (BP) were analyzed by multivariate logistic regression. We also analyzed the associations between the clinical features and the unfavorable outcomes (death due to any cause, heart failure or nonfatal infarction). The level of significance was set at p < 0.05. RESULTS The medians of the QoL scores were < 70 percentage in all domains. Female sex, age < 60 years, previous cardiovascular event or PCI, BMI ≥ 25 kg/m², DM and high BP were associated with a higher degree of impairment of at least one QoL score. Female sex (OR: 7.19; 95%CI: 1.55 - 33.36; p = 0.012), previous cardiovascular event (OR: 3.97; 95%CI: 1.01 - 15.66; p = 0.049) and PCI failure (OR: 10.60; 95%CI: 1.83 - 61.46; p = 0.008) were associated with increased risk of combined outcome. CONCLUSION In the presence of CAD, women and patients with comorbidities present a higher degree of QoL impairment. The unfavorable outcomes 12 months after the PCI are associated with the female sex, previous event or procedure failure.
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Hueb JC, Vicentini JTR, Roscani MG, Fusco D, Mattos R, Zanatti SG, Okoshi K, Matsubara BB. Impact of hypertension on ventricular remodeling in patients with aortic stenosis. Arq Bras Cardiol 2011; 97:254-9. [PMID: 21808850 DOI: 10.1590/s0066-782x2011005000081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 01/26/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Left ventricular hypertrophy (LVH) is a marker of increased cardiovascular risk and is frequently associated with both arterial hypertension (AH) and aortic stenosis (AoS). Also, these two maladies may co-exit in a same patient. However, in these cases, it is not clear the impact of each one in LVH. OBJECTIVE To evaluate LVH and ventricular geometry in patients with AS associated or not with arterial hypertension. METHODS This was a retrospective, observational and transversal study, including 298 consecutive patients with echocardiographic diagnosis of AoS. LVH was defined as myocardial mass > 224 g for men and > 162 g for women. Patients were classified as having mild (peak gradient < 30 mmHg), moderate (between 30 and 50 mmHg) or severe (> 50 mmHg) AoS and separated into two subgroups: with and without hypertension. RESULTS AH was associated with increased ventricular mass in all three levels of aortic stenosis (mild AS: 172 ± 45 g vs 223 ± 73 g, p < 0.0001 moderate AoS: 189 ± 77 g vs 245 ± 81 g, p = 0.0313 severe AoS: 200 ± 62 g vs 252 ± 88 g, p = 0.0372), and increased risk of LVH (OR = 2.1 CI95%:1.2-3.6 p = 0.012). Regarding to geometric remodeling, hypertensive patients with severe AS presented a significant increase in frequency of concentric hypertrophy, when compared with those without hypertension (p = 0.013). CONCLUSION Hypertension is an additional factor of increased left ventricular mass in patients with AS. Also, hypertension was influential in ventricular geometry.
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Affiliation(s)
- João Carlos Hueb
- Hospital das Clínicas, Faculdade de Medicina de Botucatu-Unesp, Botucatu, SP, Brasil.
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Polegato BF, Roscani MG, Minicucci MF, Azevedo P, Campana Á, Pereira E, Ferreira A, Matsubara B, Matsubara L. Early ventricular dysfunction in acute doxorubicin‐induced cardiotoxicity in rats. FASEB J 2011. [DOI: 10.1096/fasebj.25.1_supplement.1000.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Roscani MG, Matsubara LS, Matsubara BB. Heart failure with normal ejection fraction. Arq Bras Cardiol 2010; 94:652-60, 694-702. [PMID: 20549032 DOI: 10.1590/s0066-782x2010000500019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 09/21/2009] [Indexed: 11/22/2022] Open
Abstract
Heart failure with normal ejection fraction (HFNEF) is a complex syndrome that has been broadly studied since the last decade. It is caused by diastolic ventricular dysfunction demonstrated by complementary methods, such as hemodynamic study or echocardiogram, in the presence of a normal ejection fraction (EF). It affects primarily elderly individuals with comorbidities, such as systemic arterial hypertension, coronary failure and obesity. The physiopathological mechanisms are complex and multifactorial, involving the myocardial passive stiffness, the ventricular geometry, the pericardial restraint and the interaction between the ventricles. The main objectives of the treatment were to decrease the pulmonary venous congestion and the heart rate and control the comorbidities. There is no strong evidence that the use of specific medications, such as the angiotensin-converting enzyme inhibitors or beta-blockers can influence mortality. The poorer prognostic factors include advanced age, presence of kidney dysfunction, diabetes, functional class III and IV (NYHA) and advanced-stage diastolic dysfunction, with a restrictive pattern of ventricular filling. Another aspect that has been increasingly cited in the literature is the analysis of the role of the systolic function in HFNEF cases. All these aspects are analyzed in detail in the present review.
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