Introduction: Coronary artery bypass surgery (CABG) patients with postoperative decreased cardiac autonomic modulation (CAM) have a higher mortality rate and although cardiovascular rehabilitation and exercises have substantial benefits... more
Introduction: Coronary artery bypass surgery (CABG) patients with postoperative decreased cardiac autonomic modulation (CAM) have a higher mortality rate and although cardiovascular rehabilitation and exercises have substantial benefits in CAM, there is a paucity of information about its effects considering a possible "dose-dependent” autonomic adaptation in a hospital-based exercise program. The aim was to evaluate the impact of once daily versus twice daily dosing regimens of hospital-based exercise training on CAM in post CABG patients. Hypothesis: We hypothesized that there is a dose-dependent exercise adaptation on CAM and greater benefit to twice daily exercise group. Methods: Thirty-seven patients post-CABG were divided into: GEX1 (n = 12) and GEX2 (n = 11), composed of patients who underwent exercises one and two daily sessions, respectively; and of a control group (CG, n = 14) who received usual care (respiratory therapy). GEX patients initiated the exercises on post-o...
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Severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with significant poor outcomes including an increased risk of cardiovascular (CV) events and exercise intolerance. Endothelial dysfunction might... more
Severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with significant poor outcomes including an increased risk of cardiovascular (CV) events and exercise intolerance. Endothelial dysfunction might contribute to an impaired vascular homeostasis and consequently to CV events and exercise capacity. This study aimed to evaluate the association between exercise capacity and endothelial function in patients with severe AECOPD. Forty-five COPD patients diagnosed with severe AECOPD and admitted to the University Hospital of São Carlos from 2017 to 2019 were enrolled in this observational clinical study. Endothelial Function was assessed by brachial artery ultrasonography (M-Turbo, Sonosite, Bottle, WA, USA) and Flow Mediated Dilatation (FMD) technique in absolute (mm) and percentage values (%). Walking distance (6MWD) obtained by six-minute walk test was considered to characterize the exercise capacity. Pearson’s correlation analysis and linear regres...
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RESUMO Na unidade de terapia intensiva (UTI) pediátrica, a falha de extubação pode aumentar o risco de mortalidade. Este estudo objetivou: (1) verificar a taxa de falha de extubação na UTI pediátrica de um hospital público do município de... more
RESUMO Na unidade de terapia intensiva (UTI) pediátrica, a falha de extubação pode aumentar o risco de mortalidade. Este estudo objetivou: (1) verificar a taxa de falha de extubação na UTI pediátrica de um hospital público do município de Bauru (São Paulo, Brasil); (2) identificar a principal causa atribuída à falha de extubação; (3) avaliar se características como a idade e o tempo de ventilação mecânica invasiva (VMI) estão associadas à falha de extubação; (4) avaliar se o tempo de permanência na UTI e hospital é maior entre os pacientes que apresentaram falha de extubação. Foi realizado estudo de coorte retrospectivo com 89 pacientes internados de maio de 2017 até julho de 2018. Os resultados mostraram taxa de falha de extubação correspondente a 16%. A principal causa atribuída à falha de extubação foi o estridor laríngeo, totalizando 57% dos casos. A comparação intergrupos (sucesso vs. falha de extubação) não mostrou diferenças em relação à idade (p=0,294) e ao tempo de VMI (p=0...
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Aim was to identify critical load (CL) in young and elderly apparently healthy male cohorts. To contrastthe metabolic, cardiovascular and perceptual responses on CL according to age. We evaluated 12 young(23 ± 3 years) and 10 elderly (70... more
Aim was to identify critical load (CL) in young and elderly apparently healthy male cohorts. To contrastthe metabolic, cardiovascular and perceptual responses on CL according to age. We evaluated 12 young(23 ± 3 years) and 10 elderly (70 ± 2 years) apparently healthy active males, who underwent: (1) 1repetition maximum (1RM) test on a 45° Leg Press; (2) on different days, three high-intensity resistanceexercise constant load tests (60%, 75% and 90% 1RM) until fatigue (Tlim). Absolute values of both theCL asymptote and curvature constant (kg) were significantly lower in elderly subjects (P< 0.05). Incontrast, elderly subjects demonstrated a significantly higher number of repetitions at CL whencompared with young subjects (P< 0.05). As expected, oxygen uptake (VO2) and heart rate (HR) duringmaximal aerobic exercise testing were significantly reduced in older subjects. However, percent-predicted aerobic capacity were higher in older subjects (P< 0.05). In addition, blood lactate ([La−])corrected to Tlim and rating of perceived exertion values were greater in younger subjects at allintensities (P< 0.05). These findings, despite reduced force production in older subjects, endurance-related parameters are well preserved according to age-adjusted percent-predicted values in apparentlyhealthy males.
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Chronic obstructive pulmonary disease (COPD) manifests itself in complex ways, with local and systemic effects; because of this, a multifactorial approach is needed for disease evaluation, in order to understand its severity and impact on... more
Chronic obstructive pulmonary disease (COPD) manifests itself in complex ways, with local and systemic effects; because of this, a multifactorial approach is needed for disease evaluation, in order to understand its severity and impact on each individual. Thus, our objective was to study the correlation between easily accessible variables, usually available in clinical practice, and maximum aerobic capacity, and to determine models for peak oxygen uptake (VOpeak) estimation in COPD patients. Individuals with COPD were selected for the study. At the first visit, clinical evaluation was performed. During the second visit, the volunteers were subjected to the cardiopulmonary exercise test. To determine the correlation coefficient of VOpeak with forced expiratory volume in 1 second (FEV) (% pred.) and the COPD Assessment Test score (CATs), Pearson or Spearman tests were performed. VO at the peak of the exercise was estimated from the clinical variables by simple and multiple linear regr...
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Type 2 diabetes Mellitus (T2DM) is associated with cardiac autonomic dysfunction, which is an independent predictor of mortality in chronic diseases. However, whether the coexistence of systemic arterial hypertension (HTN) with DMT2... more
Type 2 diabetes Mellitus (T2DM) is associated with cardiac autonomic dysfunction, which is an independent predictor of mortality in chronic diseases. However, whether the coexistence of systemic arterial hypertension (HTN) with DMT2 alters cardiac autonomic modulation remains unknown. To evaluate the influence of HTN on cardiac autonomic modulation and cardiorespiratory fitness in subjects with DMT2. 60 patients of both genders were evaluated and allocated to two groups: DMT2 patients (n = 32; 51 ± 7.5 years old) and DMT2 + HTN patients (n = 28; 51 ± 6.9 years old). RR intervals were obtained during rest in supine position. Linear and nonlinear indices of heart rate variability (HRV) were computed using Kubios HRV software. Pulmonary gas exchange was measured breath-by-breath, using a portable telemetric system during maximal incremental exercise testing on a cycle ergometer. Statistical analysis included Shapiro-Wilk test followed by Student's t Test, Pearson correlation and li...
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The primary objective of this study was to investigate whether noninvasive ventilation (NIV) can positively affect exercise capacity, maximum oxygen uptake ( ), and symptoms after a 6-week physical training program for subjects with... more
The primary objective of this study was to investigate whether noninvasive ventilation (NIV) can positively affect exercise capacity, maximum oxygen uptake ( ), and symptoms after a 6-week physical training program for subjects with moderate to very severe COPD. 47 subjects with COPD who were enrolled in a physical training program were randomized to either physical training alone or NIV + physical training (NIV-Physical training). Physical training consisted of dynamic aerobic exercises on a treadmill 3 times/week for 6 weeks, for a total of 18 sessions. NIV was titrated according to the subject's tolerance at rest and during exercise. Assessments included physiological responses and symptoms at the incremental cardiopulmonary exercise test peak and during submaximal exercise on a treadmill, 6-min walk distance, maximum inspiratory (P) and expiratory pressure (P), BODE index, and health-related quality of life. 43 subjects completed the 6-week physical training program. Both gr...
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Obesity is often associated with metabolic disorders. However, some obese people can present a metabolically healthy phenotype, despite having excessive body fat. Obesity-related cytokines, such as myostatin (MSTN), leptin (LP) and... more
Obesity is often associated with metabolic disorders. However, some obese people can present a metabolically healthy phenotype, despite having excessive body fat. Obesity-related cytokines, such as myostatin (MSTN), leptin (LP) and adiponectin (ADP) appear to be key factors for the regulation of muscle and energy metabolism. Our aim was to compare lipid, glucose-insulin and inflammatory (tumor necrosis factor alpha; TNF-α) profiles, muscle function, energy expenditure and aerobic capacity between healthy normal-weight (NW) adults, metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) adults; to study the associations between these outcomes and the cytokines MSTN, ADP, LP; and to establish cutoffs for MSTN and LP/ADP to identify the MUHO phenotype. Sixty-one young adults (NW, n = 24; MHO, n = 16; MUHO, n = 21) underwent body composition (body fat -BF and muscle mass - MM), energy expenditure at rest (RER) and aerobic capacity (VO2peak) evaluation, muscle strength...
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The endothelium plays an important role in maintaining vascular homeostasis and regulating blood vessel function. Endothelial function is considered an independent predictor for risk of future cardiovascular events in cardiovascular and... more
The endothelium plays an important role in maintaining vascular homeostasis and regulating blood vessel function. Endothelial function is considered an independent predictor for risk of future cardiovascular events in cardiovascular and non-cardiovascular patients, as well as a predictor for postoperative complications in cardiovascular surgery patients. Brachial artery flow-mediated dilation by high-resolution ultrasound is widely used to evaluate endothelium-dependent vasodilation, which is mainly mediated by nitric oxide release. Physical exercise exerts beneficial effects on endothelial function and can be used in both primary and secondary prevention of cardiac and peripheral artery diseases, even in the postoperative period of cardiovascular surgery.
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The aim of this study was to investigate whether it is possible to identify the first turn point of blood lactate (BL) concentration (1(st) lactate threshold - LT1) during a discontinuous resistance exercise protocol in coronary artery... more
The aim of this study was to investigate whether it is possible to identify the first turn point of blood lactate (BL) concentration (1(st) lactate threshold - LT1) during a discontinuous resistance exercise protocol in coronary artery disease (CAD) patients and verify if heart rate variability (HRV) responses are consistent with BL responses. A total of 22 elderly men, 12 with CAD and 10 apparently healthy (control group = CG), underwent one-repetition maximum (1RM) testing on an inclined leg press. Discontinuous resistance exercise testing (DRET) was initiated at 10% of the 1RM with subsequent increases of 10% until 30% and after this percentage, 5% increments of 1RM was carried out. The load corresponding to LT1 was approximately 30% 1RM in both groups; and the LT1 estimate by HRV was associated with BL responses. HRV indices representing parasympathetic modulation decreased with increasing loads until LT1 and stabilized thereafter in both groups, and HRV indices representing sym...
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Concurrent aerobic and resistance training (CART) programs have been widely recommended as an important strategy to improve physiologic and functional performance in patients with chronic diseases. However, the impact of a personalized... more
Concurrent aerobic and resistance training (CART) programs have been widely recommended as an important strategy to improve physiologic and functional performance in patients with chronic diseases. However, the impact of a personalized CART program in patients with type 2 diabetes (T2D) requires investigation. Therefore, the primary aim of the current study is to investigate the impact of CART programs on metabolic profile, glycemic control, and exercise capacity in patients with diabetes. We evaluated 41 subjects with T2D (15 females and 19 males, 50.8 ± 7 years); subjects were randomized into two groups; sedentary (SG) and CART (CART-G). CART was performed over 1.10-h sessions (30-min aerobic and 30-min resistance exercises) three times/week for 12 weeks. Body composition, biochemical analyses, peripheral muscular strength, and cardiopulmonary exercise testing were primary measurements. The glycated hemoglobin HbA1c (65.4 ± 17.9 to 55.9 ± 12.7 mmol/mol), cholesterol (198.38.1 ± 50...
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Recent studies have shown that the magnitude of the metabolic and autonomic responses during progressive resistance exercise (PRE) is associated with the determination of the anaerobic threshold (AT). AT is an important parameter to... more
Recent studies have shown that the magnitude of the metabolic and autonomic responses during progressive resistance exercise (PRE) is associated with the determination of the anaerobic threshold (AT). AT is an important parameter to determine intensity in dynamic exercise. To investigate the metabolic and cardiac autonomic responses during dynamic resistance exercise in patients with Coronary Artery Disease (CAD). Twenty men (age = 63±7 years) with CAD [Left Ventricular Ejection Fraction (LVEF) = 60±10%] underwent a PRE protocol on a leg press until maximal exertion. The protocol began at 10% of One Repetition Maximum Test (1-RM), with subsequent increases of 10% until maximal exhaustion. Heart Rate Variability (HRV) indices from Poincaré plots (SD1, SD2, SD1/SD2) and time domain (rMSSD and RMSM), and blood lactate were determined at rest and during PRE. Significant alterations in HRV and blood lactate were observed starting at 30% of 1-RM (p<0.05). Bland-Altman plots revealed a ...
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Page 1. / Thematic Poster Session / C72 CARDIOPULMONARY STRESSORS: EXERCISE, HYPOXIA AND ALTITUDE: NEW INSIGHTS Tuesday, May 17/8:15 AM-4:30 PM / Area G, Hall B (Upper Level), Colorado Convention Center ...
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Resistance (RE) and aerobic exercise (AE) can promote hemodynamic, physiologic and clinical modifications in coronary artery disease (CAD) patients. The aim of the study is to assess key physiologic and clinical responses during RE at 30%... more
Resistance (RE) and aerobic exercise (AE) can promote hemodynamic, physiologic and clinical modifications in coronary artery disease (CAD) patients. The aim of the study is to assess key physiologic and clinical responses during RE at 30% and 60% of 1-RM on a 45° leg press and to compare responses during AE. We evaluated fifteen male subjects with coronary artery disease (60.8±4.7 years) that performed the following tests: (1) incremental AE test on cycle ergometer; (2) 1-RM test on a leg press at 45°; (3) and RE at 30% and 60% of 1-RM for 24 repetitions. Peak cardiac output (CO), heart rate (HR), oxygen consumption (VO2), carbon dioxide production (VCO2) and the minute ventilation (VE, L/min)/VCO2 ration were measured. We found that both AE and RE at 60% of aerobic and resistance capacity elicited similar hemodynamic and ventilatory responses (p>0.05). However, RE at 30% 1-RM showed more attenuated responses of VO2, VE/VCO2, HR and CO when compared with 60% of aerobic and resist...
Research Interests: Nonparametric Statistics, Quality of life, Treatment Outcome, Exercise therapy, Muscle strength, and 12 moreHumans, Female, Male, Clinical Sciences, Aged, Questionnaires, Respiratory, Chronic obstructive pulmonary disease, Physical Exercise, Exercise Test, Respiratory Care, and Cardiovascular medicine and haematology
Portable respiratory inductive plethysmography (RIP) systems have been validated for ventilatory assessment during resting conditions and during incremental treadmill exercise. However, in clinical settings and during field-based... more
Portable respiratory inductive plethysmography (RIP) systems have been validated for ventilatory assessment during resting conditions and during incremental treadmill exercise. However, in clinical settings and during field-based exercise, intensity is usually constant and submaximal. A demonstration of the ability of RIP to detect respiratory measurements accurately during constant intensity conditions would promote and validate the routine use of portable RIP devices as an alternative to ergospirometry (ES), the current gold standard technique for ventilatory measures. To investigate the agreement between respiratory variables recorded by a portable RIP device and by ES during rest and constant intensity exercise. Tidal volume (VT), respiratory rate (RR) and minute ventilation (VE) were concurrently acquired by portable RIP and ES in seven healthy male volunteers during standing rest position and constant intensity treadmill exercise. Significant agreement was found between RIP an...
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... Quando comparado com os valores previstos, foi verificado que as mulheres obesas apresentaram menores valores para PImax (76% do predito) e para a PEmax (67 ... Viviane Castello, Rodrigo Polaquini Simões, Daniela Bassi, Renata... more
... Quando comparado com os valores previstos, foi verificado que as mulheres obesas apresentaram menores valores para PImax (76% do predito) e para a PEmax (67 ... Viviane Castello, Rodrigo Polaquini Simões, Daniela Bassi, Renata Gonçalves Mendes, Audrey Borghi-Silva ...
A hyperbolic function as well as a linear relationship between power output and time to exhaustion (Tlim) has been consistently observed during dynamic non-resistive exercises. However, little is known about its concept to resistance... more
A hyperbolic function as well as a linear relationship between power output and time to exhaustion (Tlim) has been consistently observed during dynamic non-resistive exercises. However, little is known about its concept to resistance exercises (RE), which could be defined as critical load (CL). This study aimed to verify the existence of CL during dynamic RE and to verify the number of workbouts necessary to determine the optimal modeling to achieve it. Fifteen healthy men (23±2.5 ys) completed 1 repetition maximum test (1RM) on a Leg press and 3 (60, 75 and 90% of 1RM) or 4 (+ 30% of 1RM) workbouts protocols to obtain the CL by hyperbolic and linear regression models between Tlim and load performed. Blood lactate and leg fatigue were also measured. CL was obtained during RE and 3 workbouts protocol estimate it at 53% while 4 tests at 38% of 1 RM. However, based on coefficients of determination, 3 protocols provided a better fit than the 4- parameter model, respectively (R2>.95 v...
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Impaired cardiorespiratory fitness (CRF) is a hallmark characteristic in obese and lean sedentary young women. Peak oxygen consumption (VO2peak) prediction from the six-minute step test (6MST) has not been established for sedentary... more
Impaired cardiorespiratory fitness (CRF) is a hallmark characteristic in obese and lean sedentary young women. Peak oxygen consumption (VO2peak) prediction from the six-minute step test (6MST) has not been established for sedentary females. It is recognized that lower-limb muscle strength and power play a key role during functional activities. The aim of this study was to investigate cardiorespiratory responses during the 6MST and CPX and to develop a predictive equation to estimate VO2peak in both lean and obese subjects. Additionally we aim to investigate how muscle function impacts functional performance. Lean (LN = 13) and obese (OB = 18) women, aged 20-45, underwent a CPX, two 6MSTs, and isokinetic and isometric knee extensor strength and power evaluations. Regression analysis assessed the ability to predict VO2peak from the 6MST, age and body mass index (BMI). CPX and 6MST main outcomes were compared between LN and OB and correlated with strength and power variables. CRF, func...
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INTRODUCTION: It is well known that type 2 diabetes mellitus (T2DM) produces cardiovascular autonomic neuropathy (CAN), which may affect the cardiac autonomic modulation. However, it is unclear whether the lack of glycemic control in T2DM... more
INTRODUCTION: It is well known that type 2 diabetes mellitus (T2DM) produces cardiovascular autonomic neuropathy (CAN), which may affect the cardiac autonomic modulation. However, it is unclear whether the lack of glycemic control in T2DM without CAN could impact negatively on cardiac autonomic modulation. Objective: To evaluate the relationship between glycemic control and cardiac autonomic modulation in individuals with T2DM without CAN. Descriptive, prospective and cross sectional study.METHODS: Forty-nine patients with T2DM (51±7 years) were divided into two groups according to glycosylated hemoglobin (HbA1c): G1≤7% and G2>7.0%. Resting heart rate (HR) and RR interval (RRi) were obtained and calculated by linear (Mean iRR; Mean HR; rMSSD; STD RR; LF; HF; LF/HF, TINN and RR Tri,) and non-linear (SD1; SD2; DFα1; DFα2, Shannon entropy; ApEn; SampEn and CD) methods of heart rate variability (HRV). Insulin, HOMA-IR, fasting glucose and HbA1c were obtained by blood tests.RESULTS: G...
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Obesity is associated with cardiovascular mortality. Linear methods, including time domain and frequency domain analysis, are normally applied on the heart rate variability (HRV) signal to investigate autonomic cardiovascular control,... more
Obesity is associated with cardiovascular mortality. Linear methods, including time domain and frequency domain analysis, are normally applied on the heart rate variability (HRV) signal to investigate autonomic cardiovascular control, whose imbalance might promote cardiovascular disease in these patients. However, given the cardiac activity non-linearities, non-linear methods might provide better insight. HRV complexity was hereby analyzed during wakefulness and different sleep stages in healthy and obese subjects. Given the short duration of each sleep stage, complexity measures, normally extracted from long-period signals, needed be calculated on short-term signals. Sample entropy, Lempel-Ziv complexity and detrended fluctuation analysis were evaluated and results showed no significant differences among the values calculated over ten-minute signals and longer durations, confirming the reliability of such analysis when performed on short-term signals. Complexity parameters were ext...
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Background: Exercise is an important part of COPD treatment. However, it is not know about the minimum effective time of physical training that could beneficially modify the cardiac autonomic modulation (CAM) and exercise capacity in... more
Background: Exercise is an important part of COPD treatment. However, it is not know about the minimum effective time of physical training that could beneficially modify the cardiac autonomic modulation (CAM) and exercise capacity in these patients. Aim: To contrast the potential effects of a physical training program (PTP), for 6 versus 12 weeks, on CAM by linear and nonlinear heart rate variability (HRV) indices and exercise capacity in COPD patients. Design: Prospective randomized controlled trial. Setting: Outpatient pulmonary rehabilitation. Population: Twenty moderatetosevere COPD patients were assigned randomly to either a training group (n=10) or a control group (n=10). Methods: HRV at rest and during submaximal test was determined by linear (rMSSD and SDNN) and nonlinear indices [SD1, SD2 and sample entropy (SE)]. In addition, key responses were obtained during cardiopulmonary exercise testing (CPET), the walking distance (WD) during the six minute walking test and submaxim...
The purpose of this study was to investigate the behavior of heart rate (HR) and HR variability (HRV) during different loads of resistance exercise (incline bench press) in patients with coronary artery disease (CAD) and healthy sedentary... more
The purpose of this study was to investigate the behavior of heart rate (HR) and HR variability (HRV) during different loads of resistance exercise (incline bench press) in patients with coronary artery disease (CAD) and healthy sedentary controls. Ten healthy men (65 ± 1.2 years, control group, CG) and 10 men with clinically stable CAD (66 ± 2.4 years, CADG) were recruited. A discontinuous progressive protocol was applied with an initial load of 10% of the maximum load achieved in the 1RM (1 repetition maximum) with increases of 10% until 30% 1RM was reached, which was followed by subsequent increases of 5% 1RM until exhaustion. HRV was analyzed by linear and non-linear methods. There was a significant reduction in rMSSD (CG: 20 ± 2 to 11 ± 3 ms; CADG: 19 ± 3 to 9 ± 1 ms) and SD1 indexes (CG: 14 ± 2 to 8 ± 1 ms; CADG: 14 ± 2 to 7 ± 1 ms). An increase in HR (CG: 69 ± 5 to 90 ± 5 bpm; CADG: 62 ± 4 to 75 ± 4 bpm) and in systolic blood pressure (CG: 124 ± 3 to 138 ± 3 mmHg; CADG: 122 ±...