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Paim LR, da Silva LM, Antunes-Correa LM, Ribeiro VC, Schreiber R, Minin EO, Bueno LC, Lopes EC, Yamaguti R, Coy-Canguçu A, Dertkigil SSJ, Sposito A, Matos-Souza JR, Quinaglia T, Neilan TG, Velloso LA, Nadruz W, Jerosch-Herold M, Coelho-Filho OR. Profile of serum microRNAs in heart failure with reduced and preserved ejection fraction: Correlation with myocardial remodeling. Heliyon 2024; 10:e27206. [PMID: 38515724 PMCID: PMC10955197 DOI: 10.1016/j.heliyon.2024.e27206] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Background and aims Cardiomyocyte hypertrophy and interstitial fibrosis are key components of myocardial remodeling in Heart Failure (HF) with preserved (HFpEF) or reduced ejection fraction (HFrEF). MicroRNAs (miRNAs) are non-coding, evolutionarily conserved RNA molecules that may offer novel insights into myocardial remodeling. This study aimed to characterize miRNA expression in HFpEF (LVEF ≥ 45%) and HFrEF (LVEF < 45%) and its association with myocardial remodeling. Methods Prospectively enrolled symptomatic HF patients (HFpEF:n = 36; HFrEF:n = 31) and controls (n = 23) underwent cardiac magnetic resonance imaging with T1-mapping and circulating miRNA expression (OpenArray system). Results 13 of 188 miRNAs were differentially expressed between HF groups (11 downregulated in HFpEF). Myocardial extracellular volume (ECV) was increased in both HF groups (HFpEF 30 ± 5%; HFrEF 30 ± 3%; controls 26 ± 2%, p < 0.001). miR-128a-3p, linked to cardiac hypertrophy, fibrosis, and dysfunction, correlated positively with ECV in HFpEF (r = 0.60, p = 0.01) and negatively in HFrEF (r = - 0.51, p = 0.04). miR-423-5p overexpression, previously associated HF mortality, was inversely associated with LVEF (r = - 0.29, p = 0.04) and intracellular water lifetime (τ ic) (r = - 0.45, p < 0.05) in both HF groups, and with NT-proBNP in HFpEF (r = - 0.63, p < 0.01). Conclusions miRNA expression profiles differed between HF phenotypes. The differential expression and association of miR-128a-3p with ECV may reflect the distinct vascular, interstitial, and cellular etiologies of HF phenotypes.
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Affiliation(s)
- Layde Rosane Paim
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Luis Miguel da Silva
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | | | | | - Roberto Schreiber
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Eduarda O.Z. Minin
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Larissa C.M. Bueno
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Elisangela C.P. Lopes
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Renan Yamaguti
- Faculdade de Engenharia Elétrica e de Computação – Universidade Estadual de Campinas, São Paulo, Brazil
| | - Andréa Coy-Canguçu
- Faculdade de Medicina – Pontifícia Universidade Católica de Campinas, São Paulo, Brazil
| | | | - Andrei Sposito
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | | | - Thiago Quinaglia
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
- Cardiovascular Imaging Research Center, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tomas G. Neilan
- Cardiovascular Imaging Research Center, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Licio A. Velloso
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Wilson Nadruz
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Michael Jerosch-Herold
- Non-Invasive Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Coy-Canguçu A, Antunes-Correa LM, Mazzali M, Abrão P, Ronco F, Teixeira CM, Viana KP, Cordeiro G, Longato M, Coelho OR, Matos-Souza JR, Nadruz W, Sposito AC, Petersen SE, Jerosch-Herold M, Coelho-Filho OR. Prognostic role of renal replacement therapy among hospitalized patients with heart failure in the Brazilian national public health system. Front Cardiovasc Med 2023; 10:1226481. [PMID: 37680567 PMCID: PMC10482263 DOI: 10.3389/fcvm.2023.1226481] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023] Open
Abstract
Introduction Data on patients hospitalized with acute heart failure in Brazil scarce. Methods We performed a cross-sectional, retrospective, records-based study using data retrieved from a large public database of heart failure admissions to any hospital from the Brazilian National Public Health System (SUS) (SUS Hospital Information System [SIHSUS] registry) to determine the in-hospital all-cause mortality rate, in-hospital renal replacement therapy rate and its association with outcome. Results In total, 910,128 hospitalizations due to heart failure were identified in the SIHSUS registry between April 2017 and August 2021, of which 106,383 (11.7%) resulted in in-hospital death. Renal replacement therapy (required by 8,179 non-survivors [7.7%] and 11,496 survivors [1.4%, p < 0.001]) was associated with a 56% increase in the risk of death in the univariate regression model (HR 1.56, 95% CI 1.52 -1.59), a more than threefold increase of the duration of hospitalization, and a 45% or greater increase of cost per day. All forms of renal replacement therapy remained independently associated with in-hospital mortality in multivariable analysis (intermittent hemodialysis: HR 1.64, 95% CI 1.60 -1.69; continuous hemodialysis: HR 1.52, 95% CI 1.42 -1.63; peritoneal dialysis: HR 1.47, 95% CI 1.20 -1.88). Discussion The in-hospital mortality rate of 11.7% observed among patients with acute heart failure admitted to Brazilian public hospitals was alarmingly high, exceeding that of patients admitted to North American and European institutions. This is the first report to quantify the rate of renal replacement therapy in patients hospitalized with acute heart failure in Brazil.
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Affiliation(s)
- Andréa Coy-Canguçu
- Catholic Pontifical University of Campinas Medical School, Campinas, Brazil
- Department of Medicine, State University of Campinas School of Medical Sciences, Campinas, Brazil
| | - Lígia M. Antunes-Correa
- Department of Medicine, State University of Campinas School of Medical Sciences, Campinas, Brazil
| | - Marilda Mazzali
- Department of Medicine, State University of Campinas School of Medical Sciences, Campinas, Brazil
| | | | | | | | | | | | | | - Otávio Rizzi Coelho
- Department of Medicine, State University of Campinas School of Medical Sciences, Campinas, Brazil
| | - José Roberto Matos-Souza
- Department of Medicine, State University of Campinas School of Medical Sciences, Campinas, Brazil
| | - Wilson Nadruz
- Department of Medicine, State University of Campinas School of Medical Sciences, Campinas, Brazil
| | - Andrei C. Sposito
- Department of Medicine, State University of Campinas School of Medical Sciences, Campinas, Brazil
| | - Steffen E. Petersen
- William Harvey Research Institute NIHR Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Michael Jerosch-Herold
- Non-Invasive Cardiovascular Imaging Program, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
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Toledo CC, Vellosa Schwartzmann P, Miguel Silva L, da Silva Ferreira G, Bianchini Cardoso F, Citelli Ribeiro V, Paim LR, Antunes-Correa LM, Carvalho Sposito A, Matos Souza JR, Modolo R, Nadruz W, Fernandes de Carvalho LS, Coelho-Filho OR. Serum potassium levels provide prognostic information in symptomatic heart failure beyond traditional clinical variables. ESC Heart Fail 2021; 8:2133-2143. [PMID: 33734611 PMCID: PMC8120348 DOI: 10.1002/ehf2.13295] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/27/2021] [Accepted: 02/20/2021] [Indexed: 11/13/2022] Open
Abstract
Aims Despite of recent advances in the pharmacological treatment, heart failure (HF) maintains significant morbidity and mortality rates. While serum potassium disorders are common and associated with adverse outcomes, the exact recommended potassium level for patients with HF are not entirely established. We aimed to investigate the prognostic role of potassium levels on a cohort of patients with symptomatic chronic HF. Methods and results Patients with symptomatic chronic HF were identified at the referral to 6 min walking test (6MWT) and were prospectively followed up for cardiovascular events. Clinical and laboratorial data were retrospectively obtained. The primary endpoint was the composite of cardiovascular death, hospitalization due to HF, and heart transplantation. The cohort included 178 patients with HF with the mean age of 51 ± 12.76 years, 39% were female, 85% of non‐ischaemic cardiomyopathy, and 38% had New York Heart Association Class III with a relatively high Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) score (12.91 ± 6.6). The mean left ventricular ejection fraction was 39.98 ± 15.79%, and the mean 6MWT distance was 353 ± 136 m. After a median follow‐up of 516 days, there were 22 major cardiovascular events (4 cardiovascular deaths, 13 HF admissions, and 5 heart transplants). Patients were stratified according to cut‐point level of serum potassium of 4.7 mmol/L to predict combined cardiac events based on receiver operating characteristic analysis. Individuals with higher potassium levels had worse renal function (glomerular filtration rate, K ≤ 4.7: 102.8 ± 32.2 mL/min/1.73 m2 vs. K > 4.7: 85.42 ± 36.2 mL/min/1.73 m2, P = 0.004), higher proportion of New York Heart Association Class III patients (K ≤ 4.7: 28% vs. K > 4.7: 48%, P = 0.0029), and also higher MAGGIC score (K ≤ 4.7: 12.08 ± 5.7 vs. K > 4.7: 14.9 ± 7.9, P = 0.0089), without significant differences on the baseline pharmacological HF treatment. Both potassium levels [hazard ratio (HR) 4.26, 95% confidence interval (CI) 1.59–11.421, P = 0.003] and 6MWT distance (HR 0.99, 95% CI 0.993–0.999, P = 0.01) were independently associated with the primary outcome. After adjustments for MAGGIC score and 6MWT distance, potassium levels > 4.7 mmol/L maintained a significant association with outcomes (HR 3.57, 95% CI 1.305–9.807, P = 0.013). Patients with K > 4.7 mmol/L were more likely to present clinical events during the follow‐up (log rank = 0.005). Adding potassium levels to the model including 6MWT and MAGGIC significantly improved the prediction of events over 2 years (integrated discrimination index 0.105, 95% CI 0.018–0.281, P = 0.012 and net reclassification index 0.447, 95% CI 0.077–0.703, P = 0.028). Conclusions Potassium levels were independently associated with worse outcomes in patients with chronic symptomatic HF, also improving the accuracy model for prognostic prediction when added to MAGGIC score and 6MWT distance. The potassium levels above 4.7 mmol/L might identify those patients at an increased risk of cardiovascular events.
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Affiliation(s)
| | | | - Luis Miguel Silva
- Faculty of Medical Science, University of Campinas, São Paulo, Brazil
| | | | | | | | - Layde Rosane Paim
- Faculty of Medical Science, University of Campinas, São Paulo, Brazil
| | - Lígia M Antunes-Correa
- Faculty of Medical Science, University of Campinas, São Paulo, Brazil.,School of Physical Education, University of Campinas, São Paulo, Brazil
| | | | | | - Rodrigo Modolo
- Faculty of Medical Science, University of Campinas, São Paulo, Brazil
| | - Wilson Nadruz
- Faculty of Medical Science, University of Campinas, São Paulo, Brazil
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Spaggiari CV, Kuniyoshi RR, Antunes-Correa LM, Groehs RV, de Siqueira SF, Martinelli Filho M. Cardiac resynchronization therapy restores muscular metaboreflex control. J Cardiovasc Electrophysiol 2019; 30:2591-2598. [PMID: 31544272 DOI: 10.1111/jce.14195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The muscular metaboreflex, whose activation regulates blood flow during isometric and aerobic exercise, is blunted in patients with heart failure (HF), and cardiac resynchronization therapy (CRT) may restore this regulatory reflex. OBJECTIVE To evaluate metaboreflex responses after CRT. METHODS Thirteen HF patients and 12 age-matched healthy control subjects underwent the following evaluations (pre- and post-CRT implantation in the patient group): (a) heart rate, blood pressure, and forearm blood flow measurements; (b) muscle sympathetic nerve activity (MSNA) evaluation; and (c) peak oxygen consumption (VO2peak ). Examinations were performed at rest, during moderate isometric exercise (IE), and during forearm ischemia (metaboreflex activation). The primary outcome was the increment in MSNA during limb ischemia compared to the rest moment (ΔMSNA rest to metaboreflex activation). RESULTS After CRT, rest MSNA decreased in the HF participants: 50.4 ± 9.2 bursts/min pre-CRT vs 34.0 ± 14.4 bursts/min post-CRT, P = .001, accompanied by an improvement in systolic blood pressure and in rate-pressure product. MSNA during limb ischemia decreased: 56.6 ± 11.5 bursts/min pre-CRT vs 43.6 ± 12.7 bursts/min post-CRT, P = .001, and the ΔMSNA rest to metaboreflex activation increased: 0% (interquartile range [IQR)], -7 to 9) vs 13% (IQR, 5-30), P = .03. An augmentation of mean blood pressure during limb ischemia post-CRT was noticed: 94 mmHg (IQR, 81-104) vs 110 mmHg (IQR, 100-117), P = .04. CRT improved VO2peak , and this improvement was correlated with diminution in ΔMSNA pre- to post-CRT at rest moment (rs = -0.74, P = .006). CONCLUSION CRT provides metaboreflex sensitization and MSNA enhancement. The restoration of sympathetic responsiveness correlates with the improvement in functional capacity.
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Affiliation(s)
- Caio V Spaggiari
- Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Lígia M Antunes-Correa
- Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Raphaela V Groehs
- Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sérgio F de Siqueira
- Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Martino Martinelli Filho
- Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Cardoso FB, Antunes-Correa LM, Silva TQAC, Silva LM, Toledo C, Ribeiro VC, Paim LR, Neilan TG, Velloso L, Nadruz W, Ramos CD, Dertkigil SS, Schreiber R, Sposito A, Matos-Souza JR, Berwanger O, Jerosch-Herold M, Coelho-Filho OR. Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale. Ther Adv Chronic Dis 2019; 10:2040622319868376. [PMID: 31489153 PMCID: PMC6709440 DOI: 10.1177/2040622319868376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/19/2019] [Accepted: 07/12/2019] [Indexed: 12/28/2022] Open
Abstract
Background: Studies have shown significant benefits of exercise therapy in heart failure
(HF) with a reduced ejection fraction (HFrEF) and HF with a preserved
ejection fraction (HFpEF). The mechanisms responsible for the beneficial
effect of exercise in HFrEF and HFpEF are still unclear. We hypothesized
that the effect of exercise on myocardial remodeling may explain its
beneficial effect. Methods: IMAGING-REHAB-HF is a single-center, randomized, controlled clinical trial
using cardiac magnetic resonance imaging, vasomotor endothelial function,
cardiac sympathetic activity imaging and serum biomarkers to compare the
effect of exercise therapy in HFpEF (LVEF ≥ 45%) and HFrEF (LVEF < 45%).
Subjects will be assessed at baseline and after 4 months. The exercise
program will consist of three 60-min exercise sessions/week. The primary
endpoints are the effect of exercise on myocardial extracellular volume
(ECV), left ventricular (LV) systolic function, LV mass, LV mass-to-volume
and LV cardiomyocyte volume. Secondary endpoints include the effect of
exercise on vasomotor endothelial function, cardiac sympathetic activity and
plasmatic biomarkers. Patients will be allocated in a 2:1 fashion to
supervised exercise program or usual care. A total sample size of 90
patients, divided into two groups according to LVEF:HFpEF group (45
patients:30 in the intervention arm and 15 in the control arm) and HFrEF
group (45 patients:30 in the intervention arm and 15 in the control arm) –
will be necessary to achieve adequate power. Conclusion: This will be the first study to evaluate the benefits of a rehabilitation
program on cardiac remodeling in HF patients. The unique design of our study
may provide unique data to further elucidate the mechanisms involved in
reverse cardiac remodeling after exercise in HFpEF and HFrEF patients.
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Affiliation(s)
| | | | | | - Luis Miguel Silva
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Camilla Toledo
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | | | - Layde R Paim
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Tomas G Neilan
- Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lício Velloso
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Wilson Nadruz
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Celso Darío Ramos
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Sergio S Dertkigil
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Roberto Schreiber
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | - Andrei Sposito
- Faculdade de Ciências Médicas - Universidade Estadual de Campinas, São Paulo, Brazil
| | | | - Otávio Berwanger
- Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Michael Jerosch-Herold
- Noninvasive Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Otávio Rizzi Coelho-Filho
- Discipline of Cardiology, Department of Internal Medicine, Hospital de Clínicas, State University of Campinas, UNICAMP, Rua Vital Brasil,251- Cidade Universitária 'Zeferino Vaz', Campinas, SP, CEP:13083-888, Brazil
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Antunes-Correa LM. Non-traditional exercises in rehabilitation programmes for symptomatic patients with peripheral artery disease. Eur J Prev Cardiol 2019; 26:1623-1624. [PMID: 31216869 DOI: 10.1177/2047487319856130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Sarmento ASO, Antunes-Correa LM, Alves MJNN, Bacurau AVN, Fonseca KCB, Pessoa FG, Trombetta IC, Rondon MUPB, Ramires FJA, Brasileiro-Santos MS, Brum PC, Mady C, Negrao CE, Thomas S, Ianni BM. P5681Effects of exercise training on cardiovascular autonomic modulation and skeletal muscle tissue in chagasic cardiopathy patients and preserved systolic function. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5681] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A S O Sarmento
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - L M Antunes-Correa
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - M J N N Alves
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - A V N Bacurau
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - K C B Fonseca
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - F G Pessoa
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - I C Trombetta
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - M U P B Rondon
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - F J A Ramires
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - M S Brasileiro-Santos
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - P C Brum
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - C Mady
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - C E Negrao
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - S Thomas
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
| | - B M Ianni
- University of Sao Paulo, Researcher at the Institute of the Heart, Sao Paulo, Brazil
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Castro RRT, Antunes-Correa LM, Ueno LM, Rondon MUPB, Negrão CE, Nóbrega ACL. Reversal of periodic breathing after aerobic training in heart failure. Eur Respir J 2010; 35:1409-11. [PMID: 20513913 DOI: 10.1183/09031936.00177209] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Soares-Miranda L, Negrao CE, Antunes-Correa LM, Nobre TS, Silva P, Santos R, Vale S, Mota J. High levels of C-reactive protein are associated with reduced vagal modulation and low physical activity in young adults. Scand J Med Sci Sports 2010; 22:278-84. [PMID: 20626701 DOI: 10.1111/j.1600-0838.2010.01163.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The purpose of this study was to examine the relationship between cardiac autonomic control derived from heart rate variability (HRV), high-sensitivity C-reactive protein (hs-CRP) and physical activity (PA) levels measured using accelerometers. A total of 80 healthy university students volunteered to participate in this study (20.56 ± 0.82 years, 1.36 ± 1.5 mg/L of hs-CRP). The participants were divided into groups based on tertiles of hs-CRP. Analysis of covariance adjusted to PA was used to assess group differences in HRV. Associations between hs-CRP, HRV indices and PA were analyzed using Pearson's correlation. The participants at the highest tertile of hs-CRP (tertile 3) had lower cardiac vagal modulation (SDNN, tertile 1=78.05 ± 5.9,tertile 2=82.43 ± 5.9,tertile 3=56.03 ± 6.1; SD1, tertile 1=61.27 ± 5.3, tertile 2=62.93 ± 5.4, tertile 3=40.03 ± 5.5). In addition, vagal indices were inversely correlated with hs-CRP but positively correlated with PA (SDNN r=-0.320, SD1 r=-0.377; SDNN r=0.304, SD1 r=0.299; P<0.05). Furthermore, the most physically active subjects had lower levels of hs-CRP and the highest levels of vagal modulation.
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Affiliation(s)
- L Soares-Miranda
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.
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