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Dubin A, Mugno M. The Effects of Dobutamine in Septic Shock: An Updated Narrative Review of Clinical and Experimental Studies. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:751. [PMID: 38792934 PMCID: PMC11123338 DOI: 10.3390/medicina60050751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024]
Abstract
The key objective in the hemodynamic treatment of septic shock is the optimization of tissue perfusion and oxygenation. This is usually achieved by the utilization of fluids, vasopressors, and inotropes. Dobutamine is the inotrope most commonly recommended and used for this purpose. Despite the fact that dobutamine was introduced almost half a century ago in the treatment of septic shock, and there is widespread use of the drug, several aspects of its pharmacodynamics remain poorly understood. In normal subjects, dobutamine increases contractility and lacks a direct effect on vascular tone. This results in augmented cardiac output and blood pressure, with reflex reduction in systemic vascular resistance. In septic shock, some experimental and clinical research suggest beneficial effects on systemic and regional perfusion. Nevertheless, other studies found heterogeneous and unpredictable effects with frequent side effects. In this narrative review, we discuss the pharmacodynamic characteristics of dobutamine and its physiologic actions in different settings, with special reference to septic shock. We discuss studies showing that dobutamine frequently induces tachycardia and vasodilation, without positive actions on contractility. Since untoward effects are often found and therapeutic benefits are occasional, its profile of efficacy and safety seems low. Therefore, we recommend that the use of dobutamine in septic shock should be cautious. Before a final decision about its prescription, efficacy, and tolerance should be evaluated throughout a short period with narrow monitoring of its wanted and side effects.
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Affiliation(s)
- Arnaldo Dubin
- Cátedras de Terapia Intensiva y Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, La Plata B1902AGW, Argentina
- Sanatorio Otamendi, Azcuénaga 870, Ciudad Autónoma de Buenos Aires C1115AAB, Argentina;
| | - Matías Mugno
- Sanatorio Otamendi, Azcuénaga 870, Ciudad Autónoma de Buenos Aires C1115AAB, Argentina;
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Sánchez-Delgado JC, Jácome-Hortúa AM, Uribe-Sarmiento OM, Philbois SV, Pereira AC, Rodrigues KP, Souza HCD. Combined effect of physical exercise and hormone replacement therapy on cardiovascular and metabolic health in postmenopausal women: A systematic review and meta-analysis. Braz J Med Biol Res 2023; 56:e12241. [PMID: 37194832 DOI: 10.1590/1414-431x2023e12241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/31/2023] [Indexed: 05/18/2023] Open
Abstract
The cardioprotective effect of postmenopausal hormone replacement therapy (HRT) has been demonstrated in several studies. Similarly, physical exercise has yielded positive results. However, the effects of their combination remain inconclusive. This review describes the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We searched the Scopus, Web of Science, PubMed, and Embase databases and included randomized controlled trials published up to December 2021 on the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We identified 148 articles, of which only seven met the inclusion criteria (386 participants; 91 [23%] HRT + exercise; 104 [27%] HRT; 103 [27%] exercise; 88 [23%] placebo). The combined treatment further decreased systolic blood pressure (SBP) compared to the isolated effect of aerobic training (AT) (mean difference [MD]=-1.69; 95% confidence interval [CI]=-2.65 to -0.72, n=73). Nevertheless, it attenuated the decrease in diastolic blood pressure (DBP) (MD=0.78; 95%CI: 0.22-1.35, n=73), and the increase in peak oxygen consumption (VO2 peak) promoted by exercise (AT + HRT=2.8±1.4 vs AT + placebo=5.8±3.4, P=0.02). The combination of AT and oral HRT improved SBP. However, AT alone seemed to have a better effect on physical fitness and DBP in postmenopausal women.
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Affiliation(s)
- J C Sánchez-Delgado
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga, Colombia
| | - A M Jácome-Hortúa
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga, Colombia
| | - O M Uribe-Sarmiento
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga, Colombia
| | - S V Philbois
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A C Pereira
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - K P Rodrigues
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - H C D Souza
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Salin S, Savukoski S, Tulppo M, Pesonen P, Auvinen J, Suvanto E, Puukka K, Niinimäki M. Does climacteric status impact regulation of the autonomic nervous system at the age of 46 years? Climacteric 2022; 25:586-594. [PMID: 35383514 DOI: 10.1080/13697137.2022.2052842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate whether an earlier-onset climacteric phase is associated with autonomic imbalance at the age of 46 years. METHODS This cross-sectional birth cohort study included 2661 women aged 46 years. Participants were divided into climacteric (n = 359) and preclimacteric (n = 2302) groups based on menstrual history and follicle stimulating hormone values. The mean heart rate (HR), low-frequency (LF) power, high-frequency (HF) power and LF/HF ratio were analyzed from heart rate variability recordings. The variables were compared between the groups using multivariable linear regression models, including body mass index, smoking and physical activity. The effects of hormone therapy and hot flashes on autonomic function were evaluated in sub-analyses. RESULTS Climacteric women had a lower mean HR in seated (71.9 ± 10.5 vs. 72.6 ± 10.4 bpm, p = 0.015) and standing (81.2 ± 12.8 vs. 83.6 ± 12.1 bpm, p = 0.002) positions compared to preclimacteric women, and the differences remained significant after the adjustments. In the sub-analyses, more frequent hot flashes were associated with a lower LF power and LF/HF ratio in the sitting position. CONCLUSIONS The present study suggested an association between greater parasympathetic activation in women with more advanced climacteric status at the age of 46 years.
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Affiliation(s)
- S Salin
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, OYS, Oulu, Finland.,Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - S Savukoski
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, OYS, Oulu, Finland.,Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M Tulppo
- Research Unit of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - P Pesonen
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - J Auvinen
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Centre for Life Course Health Research, University of Oulu, Oulu, Finland
| | - E Suvanto
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, OYS, Oulu, Finland.,Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - K Puukka
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,NordLab Oulu, Oulu University Hospital, Oulu, Finland.,Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - M Niinimäki
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, OYS, Oulu, Finland.,Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Philbois SV, Facioli TP, Gastaldi AC, Rodrigues JAL, Tank J, Fares TH, Rodrigues KP, Souza HCD. Important differences between hypertensive middle-aged women and men in cardiovascular autonomic control-a critical appraisal. Biol Sex Differ 2021; 12:11. [PMID: 33430973 PMCID: PMC7802327 DOI: 10.1186/s13293-020-00355-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Normotensive premenopausal women show a vagal predominance of cardiac autonomic modulation, whereas age-matched men show a predominance of sympathetic modulation. However, some women develop systemic arterial hypertension (SAH) even with preserved ovarian function. Our hypothesis is that these women may have cardiovascular autonomic parameters similar to those of hypertensive men, even when subjected to pharmacological treatment. We aimed to investigate cardiovascular autonomic control and baroreflex sensitivity (BRS) in hypertensive premenopausal women and age-matched men. Methods One hundred volunteers between 18 and 45 years of age were assigned to two groups (50 participants each): a hypertensive group including patients with a history of SAH for at least 6 months (25 men and 25 women), who were under treatment with monotherapy (losartan, 25–50 mg/kg); and a normotensive group (25 men and 25 women). Anthropometric, hemodynamic, metabolic, and autonomic cardiovascular assessments were performed focusing on BRS, autonomic modulation of heart rate variability (HRV), and blood pressure variability (BPV). Results On HRV analysis, women showed higher values of high-frequency (HF) oscillations in absolute and normalized units, lower values of low-frequency (LF) in normalized units, and lower LF/HF ratio, as compared with men. When the normotensive and hypertensive groups were compared, hypertensive groups showed lower values of total variance and of LF and HF bands in absolute units. On BRS, hypertensive groups showed lower values than the normotensive group. Conclusion Regardless of blood pressure control through pharmacological treatment, hypertensive patients continued to have reduced HRV compared to normotensive, and hypertensive men had more autonomic impairment than hypertensive premenopausal women.
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Affiliation(s)
- Stella V Philbois
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Tábata P Facioli
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Ada C Gastaldi
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Jhennyfer A L Rodrigues
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Jens Tank
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Thauane H Fares
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Karine P Rodrigues
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Hugo C D Souza
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
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The blood pressure variability and baroreflex sensitivity in healthy participants are not determined by sex or cardiorespiratory fitness. Blood Press Monit 2019; 23:260-270. [PMID: 29994926 DOI: 10.1097/mbp.0000000000000338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Heart rate (HR) and blood pressure (BP) autonomic modulation and baroreflex sensitivity (BRS) are important indexes of cardiovascular homeostasis. However, methodological errors are often observed, such as joint analysis of men and women. Another important aspect is that we still do not know whether cardiorespiratory fitness influences these autonomic parameters in healthy individuals. OBJECTIVES This study aimed to investigate whether sex can affect BRS, autonomic modulation of HR and BP variabilities (HRV and BPV, respectively), as well as the influence of cardiorespiratory fitness on these autonomic parameters. METHODS Healthy men and women (N=120) were assigned to groups according to the peak oxygen consumption (VO2 peak) obtained in the cardiorespiratory test: low cardiorespiratory fitness (VO2 peak: 22-38 ml/kg/min), moderate cardiorespiratory fitness (VO2 peak: 38-48 ml/kg/min), and high cardiorespiratory fitness (VO2 peak>48 ml/kg/min). HRV and BPV evaluations were performed for all groups in the frequency domain by spectral analysis. Spontaneous BRS was assessed using the sequence method. RESULTS Women presented lower BP values compared with men. HR did not differ between sexes, but showed an inverse relationship with cardiorespiratory performance. The HRV analysis showed greater sympathetic modulation for men and greater vagal modulation for women. Men and women presented similar results for systolic BPV and BRS, and cardiorespiratory performance did not influence any of the autonomic parameters evaluated. CONCLUSION Cardiorespiratory fitness does not interfere with HRV and BPV autonomic modulation or BRS. However, the cardiac modulatory balance differs between sexes, with a greater influence of the autonomic vagal component in women and the sympathetic component in men.
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Felix ACS, Gastaldi AC, Dutra SG, de Freitas ACS, Philbois SV, de Paula Facioli T, Da Silva VJ, Fares TH, de Souza HCD. Early ovarian hormone deprivation increases cardiac contractility in old female rats—Role of physical training. Auton Neurosci 2019; 218:1-9. [DOI: 10.1016/j.autneu.2019.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/08/2019] [Accepted: 02/10/2019] [Indexed: 12/29/2022]
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Abnormalities of heart rate turbulence and heart rate variability as indicators of increased cardiovascular risk in patients with systemic sclerosis. Postepy Dermatol Alergol 2019; 36:707-713. [PMID: 31997999 PMCID: PMC6986290 DOI: 10.5114/ada.2019.83134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/15/2018] [Indexed: 01/16/2023] Open
Abstract
Introduction Systemic sclerosis (SSc) is a connective tissue disease manifested by progressive fibrosis of many internal organs including the cardiovascular system and development of autonomic disorders with sympathetic predominance. These abnormalities can increase cardiovascular mortality. Aim To evaluate heart rate turbulence (HRT) and variability (HRV) parameters (indicator of autonomic imbalance) obtained from 24-hour ECG Holter monitoring, as predictors of the increased cardiovascular risk in patients with scleroderma. Material and methods Thirty-twoscleroderma patients and 30 healthy people were included. After clinical examination, ECG, routine laboratory tests and echocardiography, participants performed 24-hour Holter-ECG at home. For HRT assessment, turbulence onset (To) and turbulence slope (Ts) parameters were used. Both time and frequency domain analysis of HRV was used. The HRV circadian rhythm was also evaluated. Results Time domain: SDNN, SDNN-ix, SDANN and frequency domain: LF, VLF, ULF, NHF, NLF, parameters were lower, while p50NN was higher in SSc as compared to the control group. There was also a loss of the circadian rhythm for r-MSSD and p50NN present in the control group. Abnormal HRT parameters To and/or Ts occurred in the SSc group only. The median value of To = –1.24% and Ts = 11.13 ms/RR did not differ significantly as compared to the control group. Conclusions The study confirmed the presence of HRV disturbances, including HRV circadian rhythm, as it may seem at an early stage of SSc. The HRT disorders may be characterized by the increasing changes with advancing disease. This indicates the presence of autonomic imbalance and an increased cardiovascular risk.
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Hardy RN, Simsek ZD, Curry B, Core SL, Beltz T, Xue B, Johnson AK, Thunhorst RL, Curtis KS. Aging affects isoproterenol-induced water drinking, astrocyte density, and central neuronal activation in female Brown Norway rats. Physiol Behav 2018; 192:90-97. [PMID: 29518407 PMCID: PMC6019141 DOI: 10.1016/j.physbeh.2018.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/26/2018] [Accepted: 03/03/2018] [Indexed: 01/22/2023]
Abstract
Age-dependent impairments in the central control of compensatory responses to body fluid challenges have received scant experimental attention, especially in females. In the present study, we found that water drinking in response to β-adrenergic activation with isoproterenol (30 μg/kg, s.c.) was reduced by more than half in aged (25 mo) vs. young (5 mo) ovariectomized female Brown Norway rats. To determine whether this age-related decrease in water intake was accompanied by changes in central nervous system areas associated with fluid balance, we assessed astrocyte density and neuronal activation in the SFO, OVLT, SON, AP and NTS of these rats using immunohistochemical labeling for GFAP and c-fos, respectively. GFAP labeling intensity was increased in the SFO, AP, and NTS of aged females independent of treatment, and was increased in the OVLT of isoproterenol-treated rats independent of age. Fos immunolabeling in response to isoproterenol was reduced in both the SFO and the OVLT of aged females compared to young females, but was increased in the SON of female rats of both ages. Finally, fos labeling in the AP and caudal NTS of aged rats was elevated after vehicle control treatment and did not increase in response to isoproterenol as it did in young females. Thus, age-related declines in water drinking are accompanied by site-specific, age-related changes in astrocyte density and neuronal activation. We suggest that astrocyte density may alter the detection and/or processing of signals related to isoproterenol treatment, and thereby alter neuronal activation in areas associated with fluid balance.
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Affiliation(s)
- Rachel N Hardy
- Oklahoma State University - Center of Health Sciences, Tulsa, OK 74107, United States
| | - Zinar D Simsek
- Oklahoma State University - Center of Health Sciences, Tulsa, OK 74107, United States
| | - Brandon Curry
- Oklahoma State University - Center of Health Sciences, Tulsa, OK 74107, United States
| | - Sheri L Core
- Oklahoma State University - Center of Health Sciences, Tulsa, OK 74107, United States
| | - Terry Beltz
- University of Iowa, Iowa City, IA, United States
| | - Baojian Xue
- University of Iowa, Iowa City, IA, United States
| | | | | | - Kathleen S Curtis
- Oklahoma State University - Center of Health Sciences, Tulsa, OK 74107, United States.
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Chronic treatment with angiotensin-converting enzyme inhibitor increases cardiac fibrosis in young rats submitted to early ovarian failure. Auton Neurosci 2017; 206:28-34. [PMID: 28712539 DOI: 10.1016/j.autneu.2017.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/06/2017] [Accepted: 07/06/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND We investigated whether the treatment with enalapril maleate, combined with aerobic physical training, promotes positive effects on the autonomic balance, the morphology and the cardiac function in female rats submitted to early ovarian failure. METHODS Thirty-five female Wistar rats, ovariectomized at 10weeks of age, were assigned into Ovariectomized rats (OVX) and Ovariectomized rats treated with enalapril maleate (OVX-EM, 10mg-1·kg-1·d-1) Each group was subdivided into sedentary and trained (aerobic swimming training for 10weeks). All animals were submitted to a) double pharmacological autonomic blockade, b) study of morphology and cardiac function by echocardiography, and c) analysis of cardiac fibrosis. RESULTS The OVX-EM sedentary group showed a significant increase in cardiac fibrosis, relative heart weight, interventricular septum thickness and increased sympathetic participation and reduced participation of the vagal tone in the determination of the basal heart rate when compared to the OVX sedentary group. Physical training reduced cardiac fibrosis in both groups, however, with less intensity in the OVX-EM group. It also increased the absolute and relative heart weight and the end-systolic volume. Finally, the OVX-EM trained group showed higher values for left ventricular end-systolic volume and lower values for ejection fraction and shortening fraction than the sedentary OVX-EM group. CONCLUSION Enalapril maleate exacerbated cardiac fibrosis and increased sympathetic participation in the basal heart rate determination, without significantly affecting the cardiac function. Aerobic physical training did not change the cardiac autonomic control, but reduced cardiac fibrosis and had little effect on the cardiac function.
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Felix ACS, Dutra SGV, Gastaldi AC, Bonfim PC, Vieira S, de Souza HCD. Physical training promotes similar effects to the blockade of angiotensin-converting enzyme on the cardiac morphology and function in old female rats subjected to premature ovarian failure. Exp Gerontol 2017; 109:90-98. [PMID: 28408160 DOI: 10.1016/j.exger.2017.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/05/2017] [Accepted: 04/08/2017] [Indexed: 02/07/2023]
Abstract
We investigated the effects of angiotensin-converting enzyme (ACE) inhibition and aerobic physical training on the heart of old female rats (82-wk-old) submitted to premature ovarian failure (10-wk.-old). We used different approaches: morphology and function by echocardiography, reactivity of the coronary bed and left ventricular contractibility (Langendorff Technique). Female Wistar ovariectomized (OVX) rats (n=42) were assigned to one of four groups: OVX, vehicle treated only; OVX-EM, Enalapril Maleate only (EM, 10mg·kg-1·d-1); OVX-T, aerobic trained only; and OVX-EMT, treated with Enalapril Maleate and aerobic trained. Both Enalapril Maleate treatment and aerobic training were done in the last 20weeks of the experimental protocol. When compared to the OVX group, the OVX-EM group showed lower values of wall thickness and left ventricular (LV) mass, lower values of coronary bed reactivity and reduced maximum response of LV contractility to dobutamine, while the OVX-T group showed lower values of LV wall thickness, increase in end-systolic volume, reduced maximum response of LV contractility to dobutamine, and left intraventricular pressure due to increased flow. The combination of treatments (EM and aerobic physical training) did not promote additional important effects on the parameters evaluated. Our results suggest similar beneficial effects of physical training and EM treatment on the morphology and cardiac function in old female rats submitted to premature ovarian failure. Although the causes of these benefits are still unknown, both treatments have promoted a decrease in cardiac contractility, and the reduced β1-adrenergic sensitivity suggests that both treatments may attenuate the sympathetic effect on the heart.
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Affiliation(s)
- Ana Carolina S Felix
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sabrina G V Dutra
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ada C Gastaldi
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Pâmela C Bonfim
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Suenimeire Vieira
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Hugo Celso Dutra de Souza
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Machi JF, Dias DDS, Freitas SC, de Moraes OA, da Silva MB, Cruz PL, Mostarda C, Salemi VMC, Morris M, De Angelis K, Irigoyen MC. Impact of aging on cardiac function in a female rat model of menopause: role of autonomic control, inflammation, and oxidative stress. Clin Interv Aging 2016; 11:341-50. [PMID: 27042032 PMCID: PMC4809309 DOI: 10.2147/cia.s88441] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective The aim of this study was to evaluate the effects of aging on metabolic, cardiovascular, autonomic, inflammatory, and oxidative stress parameters after ovarian hormone deprivation (OVX). Methods Female Wistar rats (3 or 22 months old) were divided into: young controls, young ovariectomized, old controls, and old ovariectomized (bilateral ovaries removal). After a 9-week follow-up, physical capacity, metabolic parameters, and morphometric and cardiac functions were assessed. Subsequently, arterial pressure was recorded and cardiac autonomic control was evaluated. Oxidative stress was measured on the cardiac tissue, while inflammatory profile was assessed in the plasma. Results Aging or OVX caused an increase in body and fat weight and triglyceride concentration and a decrease in both insulin sensitivity and aerobic exercise capacity. Left ventricular diastolic dysfunction and increased cardiac overload (myocardial performance index) were reported in old groups when compared with young groups. Aging and OVX led to an increased sympathetic tonus, and vagal tonus was lower only for the old groups. Tumor necrosis factor-α and interleukin-6 were increased in old groups when compared with young groups. Glutathione redox balance (GSH/GSSG) was reduced in young ovariectomized, old controls, and old ovariectomized groups when compared with young controls, indicating an increased oxidative stress. A negative correlation was found between GSH/GSSG and tumor necrosis factor-α (r=−0.6, P<0.003). Correlations were found between interleukin-6 with adipose tissue (r=0.5, P<0.009) and vagal tonus (r=−0.7, P<0.0002); and among myocardial performance index with interleukin-6 (r=0.65, P<0.0002), sympathetic tonus (r=0.55, P<0.006), and physical capacity (r=−0.55, P<0.003). The findings in this trial showed that ovariectomy aggravated the impairment of cardiac and functional effects of aging in female rats, probably associated with exacerbated autonomic dysfunction, inflammation, and oxidative stress.
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Affiliation(s)
- Jacqueline Freire Machi
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of Sao Paulo, São Paulo, Brazil; Institute of Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Danielle da Silva Dias
- Laboratory of Translational Physiology, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Sarah Cristina Freitas
- Laboratory of Translational Physiology, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Maikon Barbosa da Silva
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | - Paula Lázara Cruz
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | - Cristiano Mostarda
- Health Adult and Child, Federal University of Maranhao (UFMA), São Luiz, Maranhão, Brazil
| | - Vera M C Salemi
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | - Mariana Morris
- Institute of Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Kátia De Angelis
- Laboratory of Translational Physiology, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Maria-Cláudia Irigoyen
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of Sao Paulo, São Paulo, Brazil
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12
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Lindenfeld J, Cleveland JC, Kao DP, White M, Wichman S, Bristow JC, Peterson V, Rodegheri-Brito J, Korst A, Blain-Nelson P, Sederberg J, Hunt SA, Gilbert EM, Ambardekar AV, Minobe W, Port JD, Bristow MR. Sex-related differences in age-associated downregulation of human ventricular myocardial β1-adrenergic receptors. J Heart Lung Transplant 2016; 35:352-361. [PMID: 26970472 DOI: 10.1016/j.healun.2015.10.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 09/24/2015] [Accepted: 10/14/2015] [Indexed: 12/12/2022] Open
Affiliation(s)
| | | | - David P Kao
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michel White
- The Montreal Heart Institute, Montreal, Quebec, Canada
| | - Scott Wichman
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | | | | | - Armin Korst
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - James Sederberg
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | | | | | - Wayne Minobe
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jonathan D Port
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
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13
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Neufeld IW, Kiselev AR, Karavaev AS, Prokhorov MD, Gridnev VI, Ponomarenko VI, Bezruchko BP. Autonomic control of cardiovascular system in pre- and postmenopausal women: a cross-sectional study. J Turk Ger Gynecol Assoc 2015; 16:11-20. [PMID: 25788843 DOI: 10.5152/jtgga.2015.15201] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 11/08/2014] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The aim of this cross-sectional study was to assess the features of autonomic control of the cardiovascular system in pre- and postmenopausal women. MATERIAL AND METHODS We studied 185 postmenopausal women aged 59.3±8.5 years (mean±SD) and 104 premenopausal women aged 45.1±5.8 years. Standard indices of heart rate variability (HRV) (mean heart rate, coefficient of variation, standard deviation of the NN interval (the time elapsing between two consecutive R waves in the electrocardiogram with normal sinus rhythm) (SDNN), square root of the mean squared differences of successive NN intervals (RMSSD), proportion derived by dividing RR50, the number of interval differences of successive NN intervals greater than 50 ms, by the total number of NN intervals (PNN50), and power of low frequency (LF) and high frequency (HF) bands in absolute values and percentages of total spectral power) and index S of synchronization between the 0.1-Hz rhythms in heart rate and photoplethysmogram were compared between these two groups at rest. We assessed the following sex hormones: estradiol, follicle stimulating hormone, dehydroepiandrosterone sulfate, and testosterone. RESULTS Mean heart rate and power of LF and HF bands were significantly different (p<0.05) in pre- and postmenopausal women. The autonomic indices were similar in women with natural and surgical menopause. Some indices (coefficient of variation, SDNN, RMSSD, PNN50, and power of LF and HF bands) showed weak correlation with menopause time in women with natural menopause. In women with surgical menopause, a moderate statistically significant correlation was observed only between menopause time and S index (r=-0.41, p=0.039). In premenopausal women, only testosterone correlated weakly with coefficient of variation, SDNN, PNN50, RMSSD, and power of HF band. In postmenopausal women, no correlations were found. We did not find any significant relationship between autonomic indices and hot flashes, assessed by hot flash diary. CONCLUSION We did not find a clinically important relationship between cardiovascular autonomic control and menopausal status in women.
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Affiliation(s)
- Irina W Neufeld
- Department of Obstetrics and Gynecology, Saratov State Medical University, Saratov, Russia
| | - Anton R Kiselev
- Centre of New Cardiological Informational Technologies, Research Institute of Cardiology, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russia ; Department of Nano- and Biomedical Technologies, Saratov State University, Saratov, Russia
| | - Antoly S Karavaev
- Department of Nano- and Biomedical Technologies, Saratov State University, Saratov, Russia
| | - Mikhail D Prokhorov
- Saratov Branch of the Institute of Radio Engineering and Electronics, Saratov, Russia
| | - Vladimir I Gridnev
- Centre of New Cardiological Informational Technologies, Research Institute of Cardiology, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russia ; Department of Nano- and Biomedical Technologies, Saratov State University, Saratov, Russia
| | - Vladimir I Ponomarenko
- Department of Nano- and Biomedical Technologies, Saratov State University, Saratov, Russia
| | - Boris P Bezruchko
- Department of Nano- and Biomedical Technologies, Saratov State University, Saratov, Russia
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14
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Efficacy of female rat models in translational cardiovascular aging research. J Aging Res 2014; 2014:153127. [PMID: 25610649 PMCID: PMC4294461 DOI: 10.1155/2014/153127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 12/05/2014] [Accepted: 12/05/2014] [Indexed: 01/11/2023] Open
Abstract
Cardiovascular disease is the leading cause of death in women in the United States. Aging is a primary risk factor for the development of cardiovascular disease as well as cardiovascular-related morbidity and mortality. Aging is a universal process that all humans undergo; however, research in aging is limited by cost and time constraints. Therefore, most research in aging has been done in primates and rodents; however it is unknown how well the effects of aging in rat models translate into humans. To compound the complication of aging gender has also been indicated as a risk factor for various cardiovascular diseases. This review addresses the systemic pathophysiology of the cardiovascular system associated with aging and gender for aging research with regard to the applicability of rat derived data for translational application to human aging.
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