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Moll-Bernardes R, Ferreira JR, Sousa AS, Tortelly MB, Pimentel AL, Figueiredo ACBS, Schaustz EB, Secco JCP, Sales ARK, Terzi FVO, Xavier de Brito A, Sarmento RO, Noya-Rabelo MM, Fortier S, Matos E Silva FA, Vera N, Conde L, Cabral-Castro MJ, Albuquerque DC, Rosado de-Castro P, Camargo GC, Pinheiro MVT, Souza OF, Bozza FA, Luiz RR, Medei E. Impact of the immune profiles of hypertensive patients with and without obesity on COVID-19 severity. Int J Obes (Lond) 2024; 48:254-262. [PMID: 37932408 DOI: 10.1038/s41366-023-01407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Comorbidities such as obesity, hypertension, and diabetes are associated with COVID-19 development and severity, probably due to immune dysregulation; however, the mechanisms underlying these associations are not clear. The immune signatures of hypertensive patients with obesity with COVID-19 may provide new insight into the mechanisms of immune dysregulation and progression to severe disease in these patients. METHODS Hypertensive patients were selected prospectively from a multicenter registry of adults hospitalized with COVID-19 and stratified according to obesity (BMI ≥ 30 kg/m²). Clinical data including baseline characteristics, complications, treatment, and 46 immune markers were compared between groups. Logistic regression was performed to identify variables associated with the risk of COVID-19 progression in each group. RESULTS The sample comprised 213 patients (89 with and 124 without obesity). The clinical profiles of patients with and without obesity differed, suggesting potential interactions with COVID-19 severity. Relative to patients without obesity, patients with obesity were younger and fewer had cardiac disease and myocardial injury. Patients with obesity had higher EGF, GCSF, GMCSF, interleukin (IL)-1ra, IL-5, IL-7, IL-8, IL-15, IL-1β, MCP 1, and VEGF levels, total lymphocyte counts, and CD8+ CD38+ mean fluorescence intensity (MFI), and lower NK-NKG2A MFI and percentage of CD8+ CD38+ T cells. Significant correlations between cytokine and immune cell expression were observed in both groups. Five variables best predicted progression to severe COVID-19 in patients with obesity: diabetes, the EGF, IL-10, and IL-13 levels, and the percentage of CD8+ HLA-DR+ CD38+ cells. Three variables were predictive for patients without obesity: myocardial injury and the percentages of B lymphocytes and HLA-DR+ CD38+ cells. CONCLUSION Our findings suggest that clinical and immune variables and obesity interact synergistically to increase the COVID-19 progression risk. The immune signatures of hypertensive patients with and without obesity severe COVID-19 highlight differences in immune dysregulation mechanisms, with potential therapeutic applications.
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Affiliation(s)
| | - Juliana R Ferreira
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Cardiology and Internal Medicine Department, Rede D'Or São Luiz, São Paulo, Brazil
| | - Andréa Silvestre Sousa
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Mariana B Tortelly
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Cardiology and Internal Medicine Department, Rede D'Or São Luiz, São Paulo, Brazil
| | - Adriana L Pimentel
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Cardiology and Internal Medicine Department, Rede D'Or São Luiz, São Paulo, Brazil
| | - Ana Cristina B S Figueiredo
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Cardiology and Internal Medicine Department, Rede D'Or São Luiz, São Paulo, Brazil
| | | | | | | | - Flavia V O Terzi
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Cardiology and Internal Medicine Department, Rede D'Or São Luiz, São Paulo, Brazil
| | | | - Renée O Sarmento
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Internal Medicine Department, Rio de Janeiro Federal State University, Rio de Janeiro, Brazil
| | - Marcia M Noya-Rabelo
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Cardiology and Internal Medicine Department, Rede D'Or São Luiz, São Paulo, Brazil
- Bahia School of Medicine and Public Health, Bahia, Brazil
| | - Sergio Fortier
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | | | - Narendra Vera
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Luciana Conde
- Bahia School of Medicine and Public Health, Bahia, Brazil
| | - Mauro Jorge Cabral-Castro
- Institute of Microbiology Paulo de Góes, UFRJ, Rio de Janeiro, Brazil
- Department of Pathology, Faculty of Medicine, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Denilson C Albuquerque
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Cardiology Department, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | | | | | - Olga F Souza
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Cardiology and Internal Medicine Department, Rede D'Or São Luiz, São Paulo, Brazil
| | - Fernando A Bozza
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ronir R Luiz
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Institute for Studies in Public Health-IESC, UFRJ, Rio de Janeiro, Brazil
| | - Emiliano Medei
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
- National Center for Structural Biology and Bioimaging, UFRJ, Rio de Janeiro, Brazil.
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Peçanha T, Meireles K, Pinto AJ, Rezende DAN, Iraha AY, Mazzolani BC, Smaira FI, Sales ARK, Bonfiglioli K, Sá-Pinto ALD, Lima FR, Irigoyen MC, Gualano B, Roschel H. Increased sympathetic and haemodynamic responses to exercise and muscle metaboreflex activation in post-menopausal women with rheumatoid arthritis. J Physiol 2020; 599:927-941. [PMID: 33180998 DOI: 10.1113/jp280892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 09/30/2020] [Accepted: 11/05/2020] [Indexed: 12/20/2022] Open
Abstract
KEY POINTS Rheumatoid arthritis (RA) patients present exacerbated blood pressure responses to exercise, but little is known regarding the underlying mechanisms involved. This study assessed autonomic and haemodynamic responses to exercise and to the isolated activation of muscle metaboreflex in post-menopausal women with RA. Participants with RA showed augmented pressor and sympathetic responses to exercise and to the activation of muscle metaboreflex. These responses were associated with multiple pro- and anti-inflammatory cytokines and with pain. The results of the present study support the suggestion that an abnormal reflex control of circulation is an important mechanism underlying the exacerbated cardiovascular response to exercise and increased cardiovascular risk in RA. ABSTRACT Studies have reported abnormal cardiovascular responses to exercise in rheumatoid arthritis (RA) patients, but little is known regarding the underlying mechanisms involved. This study assessed haemodynamic and sympathetic responses to exercise and to the isolated activation of muscle metaboreflex in women diagnosed with RA. Thirty-three post-menopausal women diagnosed with RA and 10 matched controls (CON) participated in this study. Mean arterial pressure (MAP), heart rate (HR) and muscle sympathetic nerve activity (MSNA frequency and incidence) were measured during a protocol of isometric knee extension exercise (3 min, 30% of maximal voluntary contraction), followed by post-exercise ischaemia (PEI). Participants with RA showed greater increases in MAP and MSNA during exercise and PEI than CON (ΔMAPexercise = 16 ± 11 vs. 9 ± 6 mmHg, P = 0.03; ΔMAPPEI = 15 ± 10 vs. 5 ± 5 mmHg, P = 0.001; ΔMSNAexercise = 17 ± 14 vs. 7 ± 9 bursts min-1 , P = 0.04; ΔMSNAPEI = 14 ± 10 vs. 6 ± 4 bursts min-1 , P = 0.04). Autonomic responses to exercise showed significant (P < 0.05) association with pro- (i.e. IFN-γ, IL-8, MCP-1 and TNFα) and anti-inflammatory (i.e. IL-1ra and IL-10) cytokines and with pain. In conclusion, post-menopausal women with RA showed augmented pressor and sympathetic responses to exercise and to the activation of muscle metaboreflex. These findings provide mechanistic insights that may explain the abnormal cardiovascular responses to exercise in RA.
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Affiliation(s)
- Tiago Peçanha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Kamila Meireles
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ana Jéssica Pinto
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Diego Augusto Nunes Rezende
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Amanda Yuri Iraha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruna Caruso Mazzolani
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Fabiana Infante Smaira
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Allan Robson Kluser Sales
- Heart Institute, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,D'Or Institute for Research and Education (IDOR), São Paulo, Brazil
| | - Karina Bonfiglioli
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ana Lúcia de Sá-Pinto
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Fernanda Rodrigues Lima
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Maria Cláudia Irigoyen
- Heart Institute, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
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3
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Castro RR, Sales ARK, Nóbrega AC. Lifestyle interventions reduce exercise ventilatory variability in healthy individuals: a randomized intervention study. Future Cardiol 2020; 16:439-446. [PMID: 32323560 DOI: 10.2217/fca-2019-0070] [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] [Indexed: 11/21/2022] Open
Abstract
Aim: Variation of exercise ventilation confers poor prognosis in heart failure. Sedentary men have higher exercise ventilatory variability than athletes. However, the impact of lifestyle intervention on exercise ventilatory variability in sedentary people is unknown and this is the aim of this study. Materials & methods: Prospective controlled single-blinded interventional study that randomly assigned healthy sedentary individuals to diet and exercise (intervention group, n = 12) or no intervention (control group, n = 12) for 12 weeks. Exercise ventilatory variability was accessed before and after intervention. Results: Despite similar values at baseline, there was a 15% reduction in respiratory rate variability (root mean square of the successive differences/n) in intervention group. Conclusion: Diet and exercise training reduced exercise ventilatory variability.
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Affiliation(s)
- Renata Rt Castro
- Medicine School, Iguaçu University, Nova Iguaçu, Brazil.,Hospital Naval Marcílio Dias, Marinha do Brasil, Rio de Janeiro, Brazil
| | - Allan Robson Kluser Sales
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil.,D'Or Institute for Research and Education, São Paulo, Brazil
| | - Antonio Cl Nóbrega
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
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Sales ARK, Negrão MV, Testa L, Ferreira-Santos L, Groehs RVR, Carvalho B, Toschi-Dias E, Rocha NG, Laurindo FRM, Debbas V, Rondon MUPB, Mano MS, Hajjar LA, Hoff PMG, Filho RK, Negrão CE. Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer. Am J Physiol Heart Circ Physiol 2019; 317:H1-H12. [DOI: 10.1152/ajpheart.00756.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/19/2022]
Abstract
The purpose of the present study was to test the hypothesis that doxorubicin (DX) and cyclophosphamide (CY) adjuvant chemotherapy (CHT) acutely impairs neurovascular and hemodynamic responses in women with breast cancer. Sixteen women (age: 47.0 ± 2.0 yr; body mass index: 24.2 ± 1.5 kg/m) with stage II-III breast cancer and indication for adjuvant CHT underwent two experimental sessions, saline (SL) and CHT. In the CHT session, DX (60 mg/m2) and CY (600 mg/m2) were administered over 45 min. In the SL session, a matching SL volume was infused in 45 min. Muscle sympathetic nerve activity (MSNA) from peroneal nerve (microneurography), calf blood flow (CBF; plethysmography) and calf vascular conductance (CVC), heart rate (HR; electrocardiography), and beat-to-beat blood pressure (BP; finger plethysmography) were measured at rest before, during, and after each session. Venous blood samples (5 ml) were collected before and after both sessions for assessment of circulating endothelial microparticles (EMPs; flow cytometry), a surrogate marker for endothelial damage. MSNA and BP responses were increased ( P < 0.001), whereas CBF and CVC responses were decreased ( P < 0.001), during and after CHT session when compared with SL session. Interestingly, the vascular alterations were also observed at the molecular level through an increased EMP response to CHT ( P = 0.03, CHT vs. SL session). No difference in HR response was observed ( P > 0.05). Adjuvant CHT with DX and CY in patients treated for breast cancer increases sympathetic nerve activity and circulating EMP levels and, in addition, reduces muscle vascular conductance and elevates systemic BP. These responses may be early signs of CHT-induced cardiovascular alterations and may represent potential targets for preventive interventions. NEW & NOTEWORTHY It is known that chemotherapy regimens increase the risk of cardiovascular events in patients treated for cancer. Here, we identified that a single cycle of adjuvant chemotherapy with doxorubicin and cyclophosphamide in women treated for breast cancer dramatically increases sympathetic nerve activity and circulating endothelial microparticle levels, reduces the muscle vascular conductance, and elevates systemic blood pressure.
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Affiliation(s)
| | - Marcelo Vailati Negrão
- Cancer Institute of the State of São Paulo, University of São Paulo Medical School, São Paulo, Brazil
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Laura Testa
- Cancer Institute of the State of São Paulo, University of São Paulo Medical School, São Paulo, Brazil
| | | | | | - Bruna Carvalho
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Edgar Toschi-Dias
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Natalia Galito Rocha
- Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Brazil
| | | | - Victor Debbas
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | | | - Max Sena Mano
- Cancer Institute of the State of São Paulo, University of São Paulo Medical School, São Paulo, Brazil
| | - Ludhmila Abrahao Hajjar
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
- Cancer Institute of the State of São Paulo, University of São Paulo Medical School, São Paulo, Brazil
| | - Paulo Marcelo Gehm Hoff
- Cancer Institute of the State of São Paulo, University of São Paulo Medical School, São Paulo, Brazil
| | - Roberto Kalil Filho
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
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Peçanha T, Meireles K, Pinto AJ, Rezende DAN, Iraha AY, Sales ARK, Bonfiglioli KR, Sá‐Pinto AL, Lima FR, Irigoyen MC, Gualano B, Roschel H. Sympathetic Overactivity and Increased Cardiovascular Responses to Muscle Metaboreflex Activation in Post‐menopausal Women with Rheumatoid Arthritis. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.696.13] [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]
Affiliation(s)
- Tiago Peçanha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Kamila Meireles
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Ana Jéssica Pinto
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Diego Augusto Nunes Rezende
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Amanda Yuri Iraha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Allan Robson Kluser Sales
- Heart Institute, Hospital das ClínicasFaculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Karina Rossi Bonfiglioli
- Laboratory of Assessment and Conditioning in Rheumatology; Clinics HospitalFaculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Ana Lúcia Sá‐Pinto
- Laboratory of Assessment and Conditioning in Rheumatology; Clinics HospitalFaculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Fernanda Rodrigues Lima
- Laboratory of Assessment and Conditioning in Rheumatology; Clinics HospitalFaculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Maria Cláudia Irigoyen
- Heart Institute, Hospital das ClínicasFaculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSPUniversity of Sao PauloSao PauloBrazil
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de Souza FR, Sales ARK, Dos Santos MR, Porello RA, Fonseca GWPD, Sayegh ALC, Filho ACB, Pereira RMR, Takayama L, Oliveira TFD, Yonamine M, Negrão CE, Alves MJDNN. Retrograde and oscillatory shear rate in young anabolic androgenic steroid users. Scand J Med Sci Sports 2018; 29:422-429. [PMID: 30387184 DOI: 10.1111/sms.13332] [Citation(s) in RCA: 5] [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: 04/18/2018] [Revised: 10/01/2018] [Accepted: 10/24/2018] [Indexed: 12/16/2022]
Abstract
Disturbed shear rate (SR), characterized by increased retrograde and oscillatory SR in the brachial artery, is associated with inflammation, atherosclerosis, endothelial dysfunction, and sympathetic hyperactivity. Young subjects do not have disturbed SR; however, elderly subjects do, which seems to be associated with sympathetic hyperactivity. Anabolic androgenic steroids (AAS) abuse in young is associated with increased muscle sympathetic nerve activity (MSNA). We hypothesized that AAS users might have disturbed SR. We tested the association between retrograde and oscillatory SR with MSNA. In addition, we measured the high-sensitivity C-reactive protein (hs-CRP). We evaluated 10 male AAS users, age 27 ± 4 years, and 10 age-matched AAS nonusers, age 29 ± 5 years. At rest, retrograde and oscillatory SR were evaluated by Doppler ultrasound, MSNA was measured with microneurography, and hs-CRP was measured in blood sample. Flow-mediated dilation (FMD) was also assessed. AAS users had higher retrograde SR (24.42 ± 17.25 vs 9.15 ± 6.62 s- 1 , P = 0.01), oscillatory SR (0.22 ± 0.13 vs 0.09 ± 0.07 au P = 0.01), and MSNA (42 ± 9 vs 32 ± 4 bursts/100 heart beats, P = 0.018) than nonusers. MSNA (bursts/100 heart beats) was correlated with retrograde SR (r = 0.50, P = 0.050) and oscillatory SR (r = 0.51, P = 0.042). AAS users had higher hs-CRP [1.17 (0.44-3.63) vs 0.29 (0.17-0.70) mg/L, P = 0.015] and decreased FMD (6.42 ± 2.07 vs 8.28% ± 1.53%, P = 0.035) than nonusers. In conclusion, AAS abuse is associated with retrograde and oscillatory SR which were associated with augmented sympathetic outflow. In addition, AAS seems to lead to inflammation characterized by increased hs-CRP. These alterations may have the potential of increasing the early risk of atherosclerotic disease in young AAS users.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Liliam Takayama
- Bone Laboratory Metabolism, Rheumatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Tiago Franco de Oliveira
- Pharmacoscience Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Mauricio Yonamine
- Faculty of Pharmaceutical Sciences, Toxicology, University of São Paulo, São Paulo, Brazil
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Costa-Hong VA, Muela HCS, Macedo TA, Sales ARK, Bortolotto LA. Gender differences of aortic wave reflection and influence of menopause on central blood pressure in patients with arterial hypertension. BMC Cardiovasc Disord 2018; 18:123. [PMID: 29921220 PMCID: PMC6008932 DOI: 10.1186/s12872-018-0855-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 02/04/2018] [Accepted: 06/06/2018] [Indexed: 11/25/2022] Open
Abstract
Background Evidences suggest that central hemodynamics indexes are independent predictors of future cardiovascular events and all-cause mortality. Multiple factors have been pointed to have potential influence on central aortic function: height, heart rate, left ventricular ejection duration and blood pressure level. Data related to the influence of gender and postmenopausal status on aortic waveform reflection is scarce. We aim to evaluate the impact of gender and menopause on central blood pressure of hypertensive patients. Methods In a cross sectional study 122 hypertensive patients (52 men and 70 women) were studied. Hypertension was defined as blood pressure (BP) levels ≥140/90 mmHg or use of antihypertensive drugs. Central arterial pressure, augmentation index (AIx) and augmentation index normalized to 75 bpm (AIx75) were obtained using applanation tonometry. Menopause and postmenopause history were accessed by a direct series of questions. Postmenopause was defined as at least one year since last menstruation. Patients were paired by age, gender and menopausal status, and the data were compared considering gender and menopausal status. Results Height and weight were significantly lower in women than in men at the same age. Conversely, AIx (32.7 ± 9.8% vs. 20.1 ± 11.7%, p < 0.01), AIx75 (29.6 ± 6.7% vs. 18.3 ± 9.4%, p < 0.01) and central systolic blood pressure (136 ± 30 vs. 125 ± 23 mmHg, p = 0.03) were higher in women than men. The menopausal women (mean age of menopause = 48 years) had the worst indexes of aortic wave reflection, compared to men at the same age and younger women. Conclusion Hypertensive women had both higher reflected aortic pressure waveform and central blood pressure indexes than hypertensive men, and these findings were worsened by the menopausal status.
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Affiliation(s)
- Valeria Aparecida Costa-Hong
- Heart Institute (Incor), Hypertension Unit, University of São Paulo Medical School, 2nd floor, Room 8, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 44 - Cerqueira César, 05403-900, Brazil
| | - Henrique Cotchi Simbo Muela
- Heart Institute (Incor), Hypertension Unit, University of São Paulo Medical School, 2nd floor, Room 8, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 44 - Cerqueira César, 05403-900, Brazil. .,Department of Physiology, Faculty of Medicine, Agostinho Neto University, Luanda, Angola.
| | - Thiago Andrade Macedo
- Heart Institute (Incor), Hypertension Unit, University of São Paulo Medical School, 2nd floor, Room 8, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 44 - Cerqueira César, 05403-900, Brazil
| | - Allan Robson Kluser Sales
- Heart Institute (Incor), Cardiovascular Rehabilitation and Exercise Physiology Unit, University of São Paulo Medical School, São Paulo, Brazil
| | - Luiz Aparecido Bortolotto
- Heart Institute (Incor), Hypertension Unit, University of São Paulo Medical School, 2nd floor, Room 8, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 44 - Cerqueira César, 05403-900, Brazil
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8
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Castro RRTD, Lima SP, Sales ARK, Nóbrega ACLD. Minute-Ventilation Variability during Cardiopulmonary Exercise Test is Higher in Sedentary Men Than in Athletes. Arq Bras Cardiol 2017; 109:185-190. [PMID: 28977060 PMCID: PMC5586224 DOI: 10.5935/abc.20170104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 10/12/2016] [Accepted: 03/29/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The occurrence of minute-ventilation oscillations during exercise, named periodic breathing, exhibits important prognostic information in heart failure. Considering that exercise training could influence the fluctuation of ventilatory components during exercise, we hypothesized that ventilatory variability during exercise would be greater in sedentary men than athletes. OBJECTIVE To compare time-domain variability of ventilatory components of sedentary healthy men and athletes during a progressive maximal exercise test, evaluating their relationship to other variables usually obtained during a cardiopulmonary exercise test. METHODS Analysis of time-domain variability (SD/n and RMSSD/n) of minute-ventilation (Ve), respiratory rate (RR) and tidal volume (Vt) during a maximal cardiopulmonary exercise test of 9 athletes and 9 sedentary men was performed. Data was compared by two-tailed Student T test and Pearson´s correlations test. RESULTS Sedentary men exhibited greater Vt (SD/n: 1.6 ± 0.3 vs. 0.9 ± 0.3 mL/breaths; p < 0.001) and Ve (SD/n: 97.5 ± 23.1 vs. 71.6 ± 4.8 mL/min x breaths; p = 0.038) variabilities than athletes. VE/VCO2 correlated to Vt variability (RMSSD/n) in both groups. CONCLUSIONS Time-domain variability of Vt and Ve during exercise is greater in sedentary than athletes, with a positive relationship between VE/VCO2 pointing to a possible influence of ventilation-perfusion ratio on ventilatory variability during exercise in healthy volunteers.
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Affiliation(s)
- Renata Rodrigues Teixeira de Castro
- Laboratório de Ciências do Exercício (LACE) - Universidade Federal Fluminense (UFF), Niterói, RJ.,Hospital Naval Marcílio Dias - Marinha do Brazil, Rio de Janeiro, RJ - Brazil
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Machado ADC, Barbosa TC, Kluser Sales AR, de Souza MN, da Nóbrega ACL, Silva BM. Adults with initial metabolic syndrome have altered muscle deoxygenation during incremental exercise. Obesity (Silver Spring) 2017; 25:424-431. [PMID: 28059464 DOI: 10.1002/oby.21744] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/27/2016] [Accepted: 11/11/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Reduced aerobic power is independently associated with metabolic syndrome (MetS) incidence and prevalence in adults. This study investigated whether muscle deoxygenation (proxy of microvascular O2 extraction) during incremental exercise is altered in MetS and associated with reduced oxygen consumption ( V˙O2peak ). METHODS Twelve men with initial MetS (no overt diseases and medication-naive; mean ± SD, age 38 ± 7 years) and 12 healthy controls (HCs) (34 ± 7 years) completed an incremental cycling test to exhaustion, in which pulmonary ventilation and gas exchange (metabolic analyzer), as well as vastus lateralis deoxygenation (near infrared spectroscopy), were measured. RESULTS Subjects with MetS, in contrast to HCs, showed lower V˙O2peak normalized to total lean mass, similar V˙O2 response to exercise, and earlier break point (BP) in muscle deoxygenation. Consequently, deoxygenation slope from BP to peak exercise was greater. Furthermore, absolute V˙O2peak was positively associated with BP in correlations adjusted for total lean mass. CONCLUSIONS MetS, without overt diseases, altered kinetics of muscle deoxygenation during incremental exercise, particularly at high-intensity exercise. Therefore, the balance between utilization and delivery of O2 within skeletal muscle is impaired early in MetS natural history, which may contribute to the reduction in aerobic power.
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Affiliation(s)
| | - Thales Coelho Barbosa
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Allan Robson Kluser Sales
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Marcio Nogueira de Souza
- Department of Electronics and Computing, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Bruno Moreira Silva
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
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Garcia VP, Rocha HNM, Sales ARK, Rocha NG, da Nóbrega ACL. Sex Differences in High Sensitivity C-Reactive Protein in Subjects with Risk Factors of Metabolic Syndrome. Arq Bras Cardiol 2016; 106:182-7. [PMID: 27027366 PMCID: PMC4811272 DOI: 10.5935/abc.20160027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 09/18/2015] [Accepted: 11/05/2015] [Indexed: 11/20/2022] Open
Abstract
Background Metabolic syndrome (MetS) is associated with a higher risk of all-cause
mortality. High-sensitivity C-reactive protein (hsCRP) is a prototypic
marker of inflammation usually increased in MetS. Women with MetS-related
diseases present higher hsCRP levels than men with MetS-related diseases,
suggesting sex differences in inflammatory markers. However, it is unclear
whether serum hsCRP levels are already increased in men and/or women with
MetS risk factors and without overt diseases or under pharmacological
treatment. Objective To determine the impact of the number of MetS risk factors on serum hsCRP
levels in women and men. Methods One hundred and eighteen subjects (70 men and 48 women; 36 ± 1 years)
were divided into four groups according to the number of MetS risk factors:
healthy group (CT; no risk factors), MetS ≤ 2, MetS = 3, and MetS
≥ 4. Blood was drawn after 12 hours of fasting for measurement of
biochemical variables and hsCRP levels, which were determined by
immunoturbidimetric assay. Results The groups with MetS risk factors presented higher serum hsCRP levels when
compared with the CT group (p < 0.02). There were no differences in hsCRP
levels among groups with MetS risk factors (p > 0.05). The best linear
regression model to explain the association between MetS risk factors and
hsCRP levels included waist circumference and HDL cholesterol (r = 0.40, p
< 0.01). Women with MetS risk factors presented higher hsCRP levels when
compared with men (psex < 0.01). Conclusions Despite the absence of overt diseases and pharmacological treatment, subjects
with MetS risk factors already presented increased hsCRP levels, which were
significantly higher in women than men at similar conditions.
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Affiliation(s)
- Vinicius Pacheco Garcia
- Departamento de Fisiologia e Farmacologia, Laboratório de Ciências do Exercício, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Helena Naly Miguens Rocha
- Departamento de Fisiologia e Farmacologia, Laboratório de Ciências do Exercício, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | - Natália Galito Rocha
- Departamento de Fisiologia e Farmacologia, Laboratório de Ciências do Exercício, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Antonio Claudio Lucas da Nóbrega
- Departamento de Fisiologia e Farmacologia, Laboratório de Ciências do Exercício, Universidade Federal Fluminense, Niterói, RJ, Brazil
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Sales ARK, Fernandes IA, Rocha NG, Garcia VP, Costa LS, Silva BM, Nóbrega ACL. A single bout of aerobic exercise prevents the transient endothelial dysfunction induced by mental stress in men with metabolic syndrome. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.1136.11] [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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Neves FJ, Carvalho ACG, Rocha NG, Silva BM, Sales ARK, de Castro RRT, Rocha JD, Thomaz TG, Nóbrega ACL. Hemodynamic mechanisms of the attenuated blood pressure response to mental stress after a single bout of maximal dynamic exercise in healthy subjects. Braz J Med Biol Res 2012; 45:610-6. [PMID: 22584644 PMCID: PMC3854267 DOI: 10.1590/s0100-879x2012007500083] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 05/03/2012] [Indexed: 11/28/2022] Open
Abstract
To determine the hemodynamic mechanisms responsible for the attenuated blood pressure response to mental stress after exercise, 26 healthy sedentary individuals (age 29 ± 8 years) underwent the Stroop color-word test before and 60 min after a bout of maximal dynamic exercise on a treadmill. A subgroup (N = 11) underwent a time-control experiment without exercise. Blood pressure was continuously and noninvasively recorded by infrared finger photoplethysmography. Stroke volume was derived from pressure signals, and cardiac output and peripheral vascular resistance were calculated. Perceived mental stress scores were comparable between mental stress tests both in the exercise (P = 0.96) and control (P = 0.24) experiments. After exercise, the systolic blood pressure response to mental stress was attenuated (pre: 10 ± 13 vs post: 6 ± 7 mmHg; P < 0.01) along with lower values of systolic blood pressure (pre: 129 ± 3 vs post: 125 ± 3 mmHg; P < 0.05), stroke volume (pre: 89.4 ± 3.5 vs post: 76.8 ± 3.8 mL; P < 0.05), and cardiac output (pre: 7.00 ± 0.30 vs post: 6.51 ± 0.36 L/min; P < 0.05). Except for heart rate, the hemodynamic responses and the mean values during the two mental stress tests in the control experiment were similar (P > 0.05). In conclusion, a single bout of maximal dynamic exercise attenuates the blood pressure response to mental stress in healthy subjects, along with lower stroke volume and cardiac output, denoting an acute modulatory action of exercise on the central hemodynamic response to mental stress.
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Affiliation(s)
- F J Neves
- Programa de Pós-Graduação em Ciências Cardiovasculares, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil
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13
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Vianna LC, Sales ARK, da Nóbrega ACL. Cerebrovascular responses to cold pressor test during static exercise in humans. Clin Physiol Funct Imaging 2011; 32:59-64. [DOI: 10.1111/j.1475-097x.2011.01055.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rocha NG, Neves FJ, Silva BM, Sales ARK, Nóbrega AC. The 894G>T endothelial nitric oxide synthase genetic polymorphism affects hemodynamic responses to mental stress performed before and after exercise. Eur J Appl Physiol 2011; 112:877-86. [DOI: 10.1007/s00421-011-2042-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 06/03/2011] [Indexed: 11/30/2022]
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Rocha NG, Silva BM, Neves FJ, Medeiros RF, Carvalho ACG, Sales ARK, Toste FP, Pereira FS, Barbosa TC, Nóbrega ACL. 894G>T polymorphism of endothelial nitric oxide synthase impairs hemodynamic responses to mental stress. FASEB J 2011. [DOI: 10.1096/fasebj.25.1_supplement.lb553] [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]
Affiliation(s)
- Natália Galito Rocha
- Graduate Program in Cardiovascular Sciences
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
| | - Bruno Moreira Silva
- Graduate Program in Cardiovascular Sciences
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
| | - Fabricia Junqueira Neves
- Graduate Program in Cardiovascular Sciences
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
| | - Renata Frauches Medeiros
- Graduate Program in Cardiovascular Sciences
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
| | | | - Allan Robson Kluser Sales
- Graduate Program in Cardiovascular Sciences
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
| | - Fabiane Pereira Toste
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
| | - Felipe Sá Pereira
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
| | - Thales Coelho Barbosa
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
| | - Antonio Claudio Lucas Nóbrega
- Graduate Program in Cardiovascular Sciences
- Department of Physiology and PharmacologyFluminense Federal UniversityNiteróiRJBrazil
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Medeiros RF, Silva BM, Neves FJ, Rocha NG, Sales ARK, Nobrega AC. Impaired hemodynamic response to mental stress in subjects with prehypertension is improved after a single bout of maximal dynamic exercise. Clinics (Sao Paulo) 2011; 66:1523-9. [PMID: 22179153 PMCID: PMC3164398 DOI: 10.1590/s1807-59322011000900003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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: 02/08/2011] [Accepted: 03/16/2011] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION High blood pressure during mental stress in subjects with prehypertension is associated with blunted vasodilation in skeletal muscles, which might be improved by an acute bout of exercise. OBJECTIVE To investigate the hemodynamic responses to mental stress before and after a bout of exercise in subjects with prehypertension. METHOD Eighteen subjects with prehypertension and 16 with normotension underwent a mental stress test before and after a maximal cardiopulmonary exercise test on a treadmill. Blood pressure was measured by auscultation, and forearm blood flow was measured by venous occlusion plethysmography; from these measurements, the vascular conductance was calculated. RESULTS Subjects with prehypertension had a higher mean blood pressure during mental stress (prehypertension 112 ± 2 vs. normotension 101 ± 3 mm Hg, p<0.05), and their vascular conductance did not increase (baseline 0.025 ± 0.004 vs. mental stress 0.022 ± 0.003 a.u., p.0.05). After the exercise bout, the mean blood pressure during mental stress was lower in subjects with prehypertension (before exercise 112 ± 2 vs. after exercise 107 ± 2 mm Hg, p<0.05), and vascular conductance increased (baseline 0.011 ± 0.001 vs. mental stress 0.024 ± 0.004 a.u., p<0.05). CONCLUSION Subjects with prehypertension had elevated blood pressure and a blunted vasodilator response during mental stress, but their blood pressure was attenuated and their vasodilator response was normalized after a single bout of maximal dynamic exercise.
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Affiliation(s)
- Renata Frauches Medeiros
- Department of Physiology and Pharmacology, Postgraduate Program in Cardiovascular Sciences, Fluminense Federal University, Niteroi, RJ, Brazil
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