1
|
Rampazo ÉP, Rehder-Santos P, Catai AM, Liebano RE. Heart rate variability in adults with chronic musculoskeletal pain: A systematic review. Pain Pract 2024; 24:211-230. [PMID: 37661339 DOI: 10.1111/papr.13294] [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: 05/13/2022] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE The aim of this review was to compare the heart rate variability (HRV) responses at rest of adults with chronic musculoskeletal pain against healthy controls. METHODS The PubMed, Scopus, Web of Science (Science and Social Science Citation Index), and CINAHL databases were searched, with no date restrictions. Two independent reviewers selected observational studies that characterized the HRV responses at rest in adults with chronic musculoskeletal pain compared with those of healthy controls. Methodological quality was assessed using the Downs and Black checklist. RESULTS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. HRV in adults with chronic musculoskeletal pain was evaluated systematically. Of the 4893 studies screened, 20 of poor-to-moderate quality met the inclusion criteria. Most studies used electrocardiography and at least one time and/or frequency domain index. Studies were found that investigated HRV in adults with temporomandibular disorders, neck pain, whiplash, low back pain, and fibromyalgia. The heterogeneity of the studies in relation to painful conditions, parameters or position for HRV analysis precluded a meta-analysis. In general, these studies seem to show increased sympathetic and decreased parasympathetic modulation in adults with musculoskeletal pain when compared to controls. CONCLUSIONS Adults with musculoskeletal pain exhibited a decline in HRV compared to controls. However, definitive conclusions cannot be drawn since the evidence is heterogeneous and of moderate quality. Further high-quality research with standardized measurements is needed.
Collapse
Affiliation(s)
- Érika P Rampazo
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod Washington Luiz, km 235, São Carlos, 13565-905, São Paulo, Brazil
| | - Patrícia Rehder-Santos
- Cardiovascular Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod Washington Luiz, km 235, São Carlos, 13565-905, São Paulo, Brazil
| | - Aparecida M Catai
- Cardiovascular Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod Washington Luiz, km 235, São Carlos, 13565-905, São Paulo, Brazil
| | - Richard E Liebano
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod Washington Luiz, km 235, São Carlos, 13565-905, São Paulo, Brazil
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
| |
Collapse
|
2
|
Castro A, Catai AM, Rehder-Santos P, Signini ÉF, de Abreu RM, Da Silva CD, Dato CC, Oliveira RV, Ferreira AG. Insights into the Serum Metabolic Adaptations in Response to Inspiratory Muscle Training: A Metabolomic Approach Based on 1H NMR and UHPLC-HRMS/MS. Int J Mol Sci 2023; 24:16764. [PMID: 38069087 PMCID: PMC10706640 DOI: 10.3390/ijms242316764] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
Inspiratory muscle training (IMT) is known to promote physiological benefits and improve physical performance in endurance sports activities. However, the metabolic adaptations promoted by different IMT prescribing strategies remain unclear. In this work, a longitudinal, randomized, double-blind, sham-controlled, parallel trial was performed to investigate the effects of 11 weeks (3 days·week-1) of IMT at different exercise intensities on the serum metabolomics profile and its main regulated metabolic pathways. Twenty-eight healthy male recreational cyclists (30.4 ± 6.5 years) were randomized into three groups: sham (6 cm·H2O of inspiratory pressure, n = 7), moderate-intensity (MI group, 60% maximal inspiratory pressure (MIP), n = 11) and high-intensity (HI group, 85-90% MIP, n = 10). Blood serum samples were collected before and after 11 weeks of IMT and analyzed by 1H NMR and UHPLC-HRMS/MS. Data were analyzed using linear mixed models and metabolite set enrichment analysis. The 1H NMR and UHPLC-HRMS/MS techniques resulted in 46 and 200 compounds, respectively. These results showed that ketone body metabolism, fatty acid biosynthesis, and aminoacyl-tRNA biosynthesis were upregulated after IMT, while alpha linolenic acid and linoleic acid metabolism as well as biosynthesis of unsaturated fatty acids were downregulated. The MI group presented higher MIP, Tryptophan, and Valine levels but decreased 2-Hydroxybutyrate levels when compared to the other two studied groups. These results suggest an increase in the oxidative metabolic processes after IMT at different intensities with additional evidence for the upregulation of essential amino acid metabolism in the MI group accompanied by greater improvement in respiratory muscle strength.
Collapse
Affiliation(s)
- Alex Castro
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
- Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas 13083-100, Brazil
| | - Aparecida M. Catai
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Patrícia Rehder-Santos
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Étore F. Signini
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Raphael Martins de Abreu
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Claudio Donisete Da Silva
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Carla Cristina Dato
- Nutrition Course, Central Paulista University Center, Sao Carlos 13563-470, Brazil;
| | - Regina V. Oliveira
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
| | - Antônio G. Ferreira
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
| |
Collapse
|
3
|
De Maria B, Dalla Vecchia LA, Bari V, Cairo B, Gelpi F, Perego F, Takahashi ACM, Milan-Mattos JC, Minatel V, Rehder-Santos P, Esler M, Lambert E, Baumert M, Catai AM, Porta A. The degree of engagement of cardiac and sympathetic arms of the baroreflex does not depend on the absolute value and sign of arterial pressure variations. Physiol Meas 2023; 44:114002. [PMID: 37922536 DOI: 10.1088/1361-6579/ad0976] [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: 06/21/2023] [Accepted: 11/03/2023] [Indexed: 11/07/2023]
Abstract
Objective.The percentages of cardiac and sympathetic baroreflex patterns detected via baroreflex sequence (SEQ) technique from spontaneous variability of heart period (HP) and systolic arterial pressure (SAP) and of muscle nerve sympathetic activity (MSNA) burst rate and diastolic arterial pressure (DAP) are utilized to assess the level of the baroreflex engagement. The cardiac baroreflex patterns can be distinguished in those featuring both HP and SAP increases (cSEQ++) and decreases (cSEQ--), while the sympathetic baroreflex patterns in those featuring a MSNA burst rate decrease and a DAP increase (sSEQ+-) and vice versa (sSEQ-+). The present study aims to assess the modifications of the involvement of the cardiac and sympathetic arms of the baroreflex with age and postural stimulus intensity.Approach.We monitored the percentages of cSEQ++ (%cSEQ++) and cSEQ-- (%cSEQ--) in 100 healthy subjects (age: 21-70 years, 54 males, 46 females), divided into five sex-balanced groups consisting of 20 subjects in each decade at rest in supine position and during active standing (STAND). We evaluated %cSEQ++, %cSEQ--, and the percentages of sSEQ+- (%sSEQ+-) and sSEQ-+ (%sSEQ-+) in 12 young healthy subjects (age 23 ± 2 years, 3 females, 9 males) undergoing incremental head-up tilt.Main results.We found that: (i) %cSEQ++ and %cSEQ-- decreased with age and increased with STAND and postural stimulus intensity; (ii) %sSEQ+- and %sSEQ-+ augmented with postural challenge magnitude; (iii) the level of cardiac and sympathetic baroreflex engagement did not depend on either the absolute value of arterial pressure or the direction of its changes.Significance.This study stresses the limited ability of the cardiac and sympathetic arms of the baroreflex in controlling absolute arterial pressure values and the equivalent ability of both positive and negative arterial pressure changes in soliciting them.
Collapse
Affiliation(s)
| | | | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | | | - Vinicius Minatel
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Murray Esler
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Elisabeth Lambert
- School of Health Science, Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Australia
| | - Mathias Baumert
- Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia
| | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| |
Collapse
|
4
|
Galdino GAM, Rehder-Santos P, Linares SN, Beltrame T, Catai AM. Cerebral oxygenation during cardiopulmonary exercise testing in cardiorespiratory diseases: A systematic review. Heart Lung 2023; 59:23-32. [PMID: 36669443 DOI: 10.1016/j.hrtlng.2023.01.004] [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: 06/14/2022] [Revised: 12/29/2022] [Accepted: 01/08/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Cardiopulmonary exercise testing (CPET) is the gold standard for analyzing cardiorespiratory fitness and integrating physiological responses. However, the presence of chronic diseases may compromise cerebral hemodynamic responses during CPET. In addition, the acute response of cerebral oxygenation during incremental CPET may identify abnormal behavior and ensure greater safety for patients with cardiovascular, respiratory, and metabolic diseases. OBJECTIVE To summarize the cerebral oxygenation acute response during CPET of patients with cardiovascular, metabolic, or respiratory diseases. METHODS From inception to 23rd September 2022, five databases (PubMed, SCOPUS, Web of Science, Embase and CINAHAL) were searched for cross-sectional studies performing incremental CPET and measuring the cerebral oxygenation acute response in cardiovascular, metabolic, or respiratory diseases compared with healthy individuals. The Downs and Black tool assessed the risk of bias of the studies. RESULTS We included seven studies with 428 participants (305 men and 123 women), aged 43 to 70 years. Of these, 101 had heart failure NYHA II and III; 77 idiopathic dilated cardiomyopathy; 33 valvular disease; 25 coronary heart disease; 22 pulmonary arterial hypertension; 15 had severe obstructive sleep apnea (OSA) and 166 were apparently healthy. There was no eligible article with metabolic disease. There was a lower magnitude increase in cerebral oxygenation of cardiovascular patients compared with the healthy individuals during the CPET. Furthermore, pulmonary arterial hypertension patients presented increased cerebral oxygen extraction, differently to those with severe OSA. CONCLUSION Considering the heterogeneity of the included studies, patients with cardiovascular disease may suffer from reduced cerebral oxygen supply, and individuals with OSA presented lower brain oxygen extraction during the CPET. Future studies should aim for strategies to improve cerebral oxygenation to ensure greater safety at CPET of cardiovascular and OSA patients. An acute response pattern for metabolic and other respiratory diseases was not established.
Collapse
Affiliation(s)
- Gabriela Aguiar Mesquita Galdino
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Patrícia Rehder-Santos
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Stephanie Nogueira Linares
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Thomas Beltrame
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Samsung R&D Institute Brazil - SRBR, Campinas, SP, Brazil
| | - Aparecida Maria Catai
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
| |
Collapse
|
5
|
De Favari Signini É, Castro A, Rehder-Santos P, Cristina Millan-Mattos J, Magalhães de Oliveira J, Minatel V, Bianca Falasco Pantoni C, Sobreiro Selistre de Araújo H, Fabrizzi F, Porta A, Gilberto Ferreira A, Vincenzi Oliveira R, Maria Catai A. Integrative perspective of the healthy aging process considering the metabolome, cardiac autonomic modulation and cardiorespiratory fitness evaluated in age groups. Sci Rep 2022; 12:21314. [PMID: 36494472 PMCID: PMC9734749 DOI: 10.1038/s41598-022-25747-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 08/27/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
The aging process causes changes at all organic levels. Although metabolism, cardiac autonomic modulation (CAM), and cardiorespiratory fitness (CRF) are widely studied as a function of age, they are mainly studied in isolation, thus making it difficult to perceive their concomitant variations. This study aimed to investigate the integrated changes that occur in the metabolome, CAM, and CRF throughout aging in apparently healthy individuals. The subjects (n = 118) were divided into five groups according to age (20-29, 30-39, 40-49, 50-59, and 60-70 years old) and underwent blood collection, autonomic assessment, and a cardiopulmonary exercise test for metabolomics analysis using mass spectrometry and nuclear magnetic resonance, cardiac autonomic modulation analysis, and CRF by peak oxygen consumption analysis, respectively. The Tukey's post hoc and effect size with confidence interval were used for variables with a significant one-way ANOVA effect (P < 0.01). The main changes were in the oldest age group, where the CRF, valine, leucine, isoleucine, 3-hydroxyisobutyrate, and CAM reduced and hippuric acid increased. The results suggest significant changes in the metabolome, CAM, and CRF after the age of sixty as a consequence of aging impairments, but with some changes in the metabolic profile that may be favorable to mitigate the aging deleterious effects.
Collapse
Affiliation(s)
- Étore De Favari Signini
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Alex Castro
- grid.411247.50000 0001 2163 588XDepartment of Chemistry, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Patrícia Rehder-Santos
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Juliana Cristina Millan-Mattos
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Juliana Magalhães de Oliveira
- grid.411247.50000 0001 2163 588XDepartment of Chemistry, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Vinicius Minatel
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Camila Bianca Falasco Pantoni
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil ,grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | | | - Fernando Fabrizzi
- Penápolis Educational Foundation (FUNEPE), Penápolis, São Paulo Brazil
| | - Alberto Porta
- grid.4708.b0000 0004 1757 2822Department of Biomedical Sciences for Health, University of Milan, Milan, Italy ,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Policlinico San Donato, San Donato Milanese, Milan Italy
| | - Antônio Gilberto Ferreira
- grid.411247.50000 0001 2163 588XDepartment of Chemistry, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Regina Vincenzi Oliveira
- grid.411247.50000 0001 2163 588XDepartment of Chemistry, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Aparecida Maria Catai
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil ,grid.411247.50000 0001 2163 588XCardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Nucleus of Research in Physical Exercise, Federal University of São Carlos, Via Washington Luiz, Km 235, CP: 676, São Carlos, SP 13565-905 Brazil
| |
Collapse
|
6
|
Castro A, Signini ÉF, De Oliveira JM, Di Medeiros Leal MCB, Rehder-Santos P, Millan-Mattos JC, Minatel V, Pantoni CBF, Oliveira RV, Catai AM, Ferreira AG. The Aging Process: A Metabolomics Perspective. Molecules 2022; 27:molecules27248656. [PMID: 36557788 PMCID: PMC9785117 DOI: 10.3390/molecules27248656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Aging process is characterized by a progressive decline of several organic, physiological, and metabolic functions whose precise mechanism remains unclear. Metabolomics allows the identification of several metabolites and may contribute to clarifying the aging-regulated metabolic pathways. We aimed to investigate aging-related serum metabolic changes using a metabolomics approach. Fasting blood serum samples from 138 apparently healthy individuals (20−70 years old, 56% men) were analyzed by Proton Nuclear Magnetic Resonance spectroscopy (1H NMR) and Liquid Chromatography-High-Resolution Mass Spectrometry (LC-HRMS), and for clinical markers. Associations of the metabolic profile with age were explored via Correlations (r); Metabolite Set Enrichment Analysis; Multiple Linear Regression; and Aging Metabolism Breakpoint. The age increase was positively correlated (0.212 ≤ r ≤ 0.370, p < 0.05) with the clinical markers (total cholesterol, HDL, LDL, VLDL, triacylglyceride, and glucose levels); negatively correlated (−0.285 ≤ r ≤ −0.214, p < 0.05) with tryptophan, 3-hydroxyisobutyrate, asparagine, isoleucine, leucine, and valine levels, but positively (0.237 ≤ r ≤ 0.269, p < 0.05) with aspartate and ornithine levels. These metabolites resulted in three enriched pathways: valine, leucine, and isoleucine degradation, urea cycle, and ammonia recycling. Additionally, serum metabolic levels of 3-hydroxyisobutyrate, isoleucine, aspartate, and ornithine explained 27.3% of the age variation, with the aging metabolism breakpoint occurring after the third decade of life. These results indicate that the aging process is potentially associated with reduced serum branched-chain amino acid levels (especially after the third decade of life) and progressively increased levels of serum metabolites indicative of the urea cycle.
Collapse
Affiliation(s)
- Alex Castro
- Department of Chemistry, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil
- Correspondence: (A.C.); (A.G.F.)
| | - Étore F. Signini
- Department of Physiotherapy, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil
| | | | | | - Patrícia Rehder-Santos
- Department of Physiotherapy, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil
| | | | - Vinicius Minatel
- Department of Physiotherapy, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil
| | - Camila B. F. Pantoni
- Department of Physiotherapy, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil
| | - Regina V. Oliveira
- Department of Chemistry, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil
| | - Aparecida M. Catai
- Department of Physiotherapy, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil
| | - Antônio G. Ferreira
- Department of Chemistry, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil
- Correspondence: (A.C.); (A.G.F.)
| |
Collapse
|
7
|
Aguiar Mesquita Galdino G, Rehder-Santos P, Nogueira Linares S, Beltrame T, Catai AM. Cerebral oxygenation during cardiopulmonary exercise testing of patients with cardiovascular and respiratory diseases: a systematic review. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.204] [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] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): National Council for Scientific and Technological Development - CNPq (310612/2019-5) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES (001)
Background
Cardiopulmonary exercise testing (CPET) has been widely used in clinical practice to determine aerobic capacity and assess the integrity of cardiovascular, respiratory, muscular and neurohumoral adjustments in health and disease. However, little is known about the acute cerebral oxygenation responses during CPET in cardiorespiratory patients, to increase safety for the physical intervention protocols development.
Purpose
To conduct a systematic review to evaluate the cerebral oxygenation acute responses during CPET in patients with cardiovascular, metabolic or respiratory diseases.
Methods
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Five electronic databases PubMed, Scopus, Web of Science, Embase and Cinahal were searched from the inception to November 10th, 2021. The eligibility criteria were determined considering the PICOS format: patients with heart, metabolic or respiratory disease (P); who carried out incremental CPET (I); compared with healthy subjects (C); our results of interest were cerebral oxygenation response through near-infrared spectroscopy (NIRS) (O); in cross-sectional studies (S). The articles were independently selected by two researchers and the disagreements were solved by a third researcher. The ROBINS I scale assessed the risk of bias of the eligible studies.
Results
The initial search identified 3557 articles and 4 additional articles were identified through other sources (references of eligible articles). After screening and deleting the duplicated articles, 7 studies were included. The studies were classified as moderate risk of bias and the most questioned domains were due to outcome measurement and due to selection of reported result. This systematic review analyzed 428 individuals, 305 men and 123 women aged between 43 to 70 years. Of these, 247 had diagnosis of cardiovascular disease (101 with heart failure NYHA II and III; 77 idiopathic dilated cardiomyopathy; 33 valvular disease; 25 coronary artery disease; 22 pulmonary arterial hypertension); 15 with severe obstructive sleep apnea and 166 apparently healthy. No article was found with metabolic disease. The results showed impairment of cerebral oxygenation, evaluated by NIRS, in patients with cardiovascular diseases during the CPET compared with healthy individuals. On the other hand, severe obstructive sleep apnea was not related with a poorer cerebral oxygenation during CPET.
Conclusion
The acute CPET response negatively impacts the cerebral oxygenation in patients with cardiovascular diseases. Taking into account the considered risk of bias of the included studies, more attention is necessary to ensure greater safety for testing maximal exercise in cardiac patients.
Collapse
Affiliation(s)
| | - P Rehder-Santos
- Federal University of Sao Carlos, Department of Physical Therapy, Sao Carlos, Brazil
| | - S Nogueira Linares
- Federal University of Sao Carlos, Department of Physical Therapy, Sao Carlos, Brazil
| | - T Beltrame
- Federal University of Sao Carlos, Department of Physical Therapy, Sao Carlos, Brazil
| | - AM Catai
- Federal University of Sao Carlos, Department of Physical Therapy, Sao Carlos, Brazil
| |
Collapse
|
8
|
Cairo B, de Abreu RM, Bari V, Gelpi F, De Maria B, Rehder-Santos P, Sakaguchi CA, da Silva CD, De Favari Signini É, Catai AM, Porta A. Optimizing phase variability threshold for automated synchrogram analysis of cardiorespiratory interactions in amateur cyclists. Philos Trans A Math Phys Eng Sci 2021; 379:20200251. [PMID: 34689616 DOI: 10.1098/rsta.2020.0251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 06/13/2023]
Abstract
We propose a procedure suitable for automated synchrogram analysis for setting the threshold below which phase variability between two marker event series is of such a negligible amount that the null hypothesis of phase desynchronization can be rejected. The procedure exploits the principle of maximizing the likelihood of detecting phase synchronization epochs and it is grounded on a surrogate data approach testing the null hypothesis of phase uncoupling. The approach was applied to assess cardiorespiratory phase interactions between heartbeat and inspiratory onset in amateur cyclists before and after 11-week inspiratory muscle training (IMT) at different intensities and compared to a more traditional approach to set phase variability threshold. The proposed procedure was able to detect the decrease in cardiorespiratory phase locking strength during vagal withdrawal induced by the modification of posture from supine to standing. IMT had very limited effects on cardiorespiratory phase synchronization strength and this result held regardless of the training intensity. In amateur athletes training, the inspiratory muscles did not limit the decrease in cardiorespiratory phase synchronization observed in the upright position as a likely consequence of the modest impact of this respiratory exercise, regardless of its intensity, on cardiac vagal control. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
Collapse
Affiliation(s)
- Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
| | - Raphael Martins de Abreu
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | | | - Patrícia Rehder-Santos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Camila Akemi Sakaguchi
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Claudio Donisete da Silva
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Étore De Favari Signini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| |
Collapse
|
9
|
da Silva CD, de Abreu RM, Rehder-Santos P, De Noronha M, Catai AM. Can respiratory muscle training change the blood pressure levels in hypertension? A systematic review with meta-analysis. Scand J Med Sci Sports 2021; 31:1384-1394. [PMID: 33630377 DOI: 10.1111/sms.13943] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 08/24/2020] [Accepted: 02/22/2021] [Indexed: 02/07/2023]
Abstract
The aim was to systematically review randomized controlled trials investigating the effects of respiratory training on blood pressure control in hypertensive individuals. Systematic review with meta-analysis was coducted following the guidelines from PRISMA statement. Searches for randomized controlled trials were performed in four electronic databases (PubMed, Cochrane Library, SCOPUS, and PEDro). Studies were included if they were randomized controlled trials that examined the impact of respiratory training on blood pressure of individuals with systemic arterial hypertension and the patients had no other associated disease. Eight studies were included for final analysis (total of 270 participants; 18-85 years) and presented an average score of 6.25 in the PEDro scale, being considered of high methodological quality. The meta-analysis showed a reduction in systolic and diastolic blood pressure for respiratory training when the load was applied [-15.72 (-18.63; -12.81) and -7.08 (-9.03; -5.13) mmHg, respectively]. There was also a reduction in systolic, but not in diastolic blood pressure when the training was performed without load [-5.08 (-7.49; -2.66) and -1.04 (-2.55; +0.46) mmHg, respectively]. The respiratory training has a positive effect in BP in hypertensive patients, however, only when performed with load seems to be able to promote some beneficial effect on diastolic blood pressure reduction.
Collapse
Affiliation(s)
- Claudio D da Silva
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Raphael M de Abreu
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Patrícia Rehder-Santos
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | - Aparecida M Catai
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| |
Collapse
|
10
|
Milan-Mattos JC, Anibal FF, Perseguini NM, Minatel V, Rehder-Santos P, Castro CA, Vasilceac FA, Mattiello SM, Faccioli LH, Catai AM. Effects of natural aging and gender on pro-inflammatory markers. ACTA ACUST UNITED AC 2019; 52:e8392. [PMID: 31411315 PMCID: PMC6694726 DOI: 10.1590/1414-431x20198392] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [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: 01/02/2019] [Accepted: 06/25/2019] [Indexed: 12/21/2022]
Abstract
The term inflammaging is now widely used to designate the inflammatory process of natural aging. During this process, cytokine balance is altered, presumably due to the loss of homeostasis, thus contributing to a greater predisposition to disease and exacerbation of chronic diseases. The aim of the study was to analyze the relationship between pro-inflammatory markers and age in the natural aging process of healthy individuals. One hundred and ten subjects were divided into 5 groups according to age (22 subjects/group). Interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) were quantified using the ELISA method. High-sensitivity C-reactive protein (hsCRP) was analyzed by turbidimetry according to laboratory procedures. The main findings of this study were: a positive correlation between hsCRP and IL-6 as a function of age (110 subjects); women showed stronger correlations; the 51–60 age group had the highest values for hsCRP and IL-6; women presented higher values for hsCRP in the 51–60 age group and higher values for IL-6 in the 61–70 age group; and men showed higher values in the 51–60 age group for hsCRP and IL-6. In conclusion, the natural aging process increased IL-6 and hsCRP levels, which is consistent with the inflammaging theory; however, women presented stronger correlations compared to men (IL-6 and hsCRP) and the 51–60 age range seems to be a key point for these increases. These findings are important because they indicate that early preventive measures may minimize the increase in these inflammatory markers in natural human aging.
Collapse
Affiliation(s)
- J C Milan-Mattos
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil.,Departamento de Morfologia e Patologia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - F F Anibal
- Departamento de Morfologia e Patologia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - N M Perseguini
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - V Minatel
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - P Rehder-Santos
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C A Castro
- Departamento de Morfologia e Patologia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - F A Vasilceac
- Laboratório de Função Articular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - S M Mattiello
- Laboratório de Função Articular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - L H Faccioli
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A M Catai
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| |
Collapse
|
11
|
Abreu RMD, Rehder-Santos P, Simões RP, Catai AM. Can high-intensity interval training change cardiac autonomic control? A systematic review. Braz J Phys Ther 2018; 23:279-289. [PMID: 30293954 DOI: 10.1016/j.bjpt.2018.09.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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] [Received: 03/19/2018] [Revised: 09/13/2018] [Accepted: 09/21/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND High intensity interval training (HIIT) has been used as a cardiovascular exercise strategy to promote greater adherence in cardiovascular rehabilitation. However, little is known about the effect of this training modality on cardiac autonomic control. OBJECTIVE To perform a systematic review to evaluate the effects of HIIT on cardiac autonomic responses in humans. METHODS PEDro, SCOPUS and PubMed were searched from the inception to March 29th, 2018. Moreover, the methodological quality and statistical reporting from all eligible clinical trials were assessed by the PEDro scale. The articles were eligible if: The primary objective was related to the effects of HIIT on the cardiac autonomic nervous system. Outcomes evaluated were indirect measures of cardiac autonomic control, represented by HRV indexes. RESULTS The search strategies resulted in 339 citations and 2 additional citations were identified through other sources. After deleting the duplicate articles and revising the full text, 6 articles were included. Overall, the results showed an improvement in parasympathetic and/or sympathetic modulation after HIIT, when evaluated by linear and non-linear indexes of HRV. CONCLUSIONS HIIT is a promising tool to improve the cardiac autonomic control, with more recommendation in healthy individuals and patients with metabolic syndrome.
Collapse
Affiliation(s)
- Raphael Martins de Abreu
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Patrícia Rehder-Santos
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Rodrigo Polaquini Simões
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Aparecida Maria Catai
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Sao Carlos (UFSCar), São Carlos, SP, Brazil.
| |
Collapse
|
12
|
de Abreu RM, Rehder-Santos P, Minatel V, Dos Santos GL, Catai AM. Effects of inspiratory muscle training on cardiovascular autonomic control: A systematic review. Auton Neurosci 2017; 208:29-35. [PMID: 28916152 DOI: 10.1016/j.autneu.2017.09.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 05/03/2017] [Revised: 08/24/2017] [Accepted: 09/05/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To carry out a systematic review to determine if inspiratory muscle training (IMT) promotes changes in cardiovascular autonomic responses in humans. METHODS The methodology followed the PRISMA statement for reporting systematic review analysis. MEDLINE, PEDro, SCOPUS and PubMed electronic databases were searched from the inception to March 2017. The quality assessment was performed using a PEDro scale. The articles were included if: (1) primary objective was related to the effects of IMT on the cardiovascular autonomic nervous system, and (2) randomized clinical trials and quasi-experimental studies. Exclusion criteria were reviews, short communications, letters, case studies, guidelines, theses, dissertations, qualitative studies, scientific conference abstracts, studies on animals, non-English language articles and articles addressing other breathing techniques. Outcomes evaluated were measures of cardiovascular autonomic control, represented by heart rate variability (HRV) and blood pressure variability (BPV) indexes. RESULTS The search identified 729 citations and a total of 6 studies were included. The results demonstrated that IMT performed at low intensities can chronically promote an increase in the parasympathetic modulation and/or reduction of sympathetic cardiac modulation in patients with diabetes, hypertension, chronic heart failure and gastroesophageal reflux, when assessed by HRV spectral analysis. However, there was no study which evaluated the effects of IMT on cardiovascular autonomic control assessed by BPV. CONCLUSIONS IMT can promote benefits for cardiac autonomic control, however the heterogeneity of populations associated with different protocols, few studies reported in the literature and the lack of randomized controlled trials make the effects of IMT on cardiovascular autonomic control inconclusive.
Collapse
Affiliation(s)
- Raphael Martins de Abreu
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Patrícia Rehder-Santos
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Vinicius Minatel
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Gabriela Lopes Dos Santos
- Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Aparecida Maria Catai
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
| |
Collapse
|
13
|
Perseguini NM, Verlengia R, Milan JC, Minatel V, Rehder-Santos P, Takahashi ACM, Santana-Lemos BA, Calado RT, Ferreira Filho P, Porta A, Catai AM. Cardiac autonomic modulation, C-reactive protein or telomere length: which of these variables has greater importance to aging? Int J Cardiol 2014; 178:79-81. [PMID: 25464224 DOI: 10.1016/j.ijcard.2014.10.123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 09/04/2014] [Accepted: 10/21/2014] [Indexed: 11/18/2022]
Affiliation(s)
- Natália M Perseguini
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Rozangela Verlengia
- College of Health Sciences, Methodist University of Piracicaba, Piracicaba, São Paulo, Brazil
| | - Juliana C Milan
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Vinicius Minatel
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Patrícia Rehder-Santos
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Anielle C M Takahashi
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Bárbara A Santana-Lemos
- Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo T Calado
- Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Pedro Ferreira Filho
- Department of Statistics, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Alberto Porta
- Department of Technologies for Health, Galeazzi Orthopaedic Institute, University of Milan, Milan, Italy
| | - Aparecida M Catai
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
| |
Collapse
|