Effect of physical activity on the relationship between adiposity and cardiac autonomic modulation in female breast cancer survivors: a longitudinal study.

This longitudinal study aimed to analyze the influence of physical activity (PA) on the relationship between body adiposity and cardiac autonomic modulation (CAM) in women survivors of breast cancer. We collected body adiposity through electrical bioimpedance considering body fat percentage (BFP), CAM through heart rate variability (considering RMSSD, SDNN, PNN50, LF (m2), HF (m2), SD1 indexes and SD1/SD2 ratio) and PA through a questionnaire in 64 participants (58.0 ± 9.6 years), recruited through the local association of support for breast cancer and by direct indications from city mastologists. After insertion of PA into the multivariate statistical model, significant attenuation was observed in the relationship between body adiposity and CAM for the indices: SDNN (ß = -0.94; 95 percent CI: -1.93; 0.04; p = .060) and SD1/SD2 (ß = -0.01;95 percent CI = -0.02; 0.001; p = .065). In conclusion, it was observed that PA was able to mitigate the relationships between BFP and CAM (considering SDNN index and SD1/SD2 ratio) in breast cancer survivors.

Association Between Physical Activity Levels in Different Domains and Cardiac Autonomic Modulation in Breast Cancer Survivors: A Cross-sectional Study.

BACKGROUND: Breast cancer survivors frequently present cardiac autonomic dysfunction. Physical activity (PA) has been associated with better cardiac autonomic modulation (CAM) in breast cancer survivors. OBJECTIVE: This study aimed to analyze the association between CAM and PA levels performed in different domains (work and occupation, sport and exercise, and leisure time and commuting) in breast cancer survivors. METHODS: This is a cross-sectional study with 99 breast cancer survivors (age, 55.3 ± 10.4 years). Cardiac autonomic modulation was assessed by heart rate variability, and PA levels at work and occupation, sport and exercise, and leisure time and commuting were assessed using the Baecke PA questionnaire. The sum of these 3 domains provided the total PA. The Mann-Whitney test was used to compare CAM between active and inactive women in different domains of PA. RESULTS: Cardiac autonomic modulation was similar between active and inactive women in the different domains ( P > .05). However, when considering the total PA, active breast cancer survivors presented higher SDNN (average standard deviation of all normal RR intervals) (20.0 ± 13.4 vs 28.8 ± 14.0; P = .008) and SD2 (standard deviation of the long-term intervals between consecutive heartbeats) indices (29.2 ± 17.3 vs 38.7 ± 19.9; P = .005) compared with their inactive counterparts. CONCLUSION: Breast cancer survivors with higher total PA presented better CAM compared with their less active peers. IMPLICATIONS FOR PRACTICE: The results of this study are promising and show the importance of increasing PA levels in different domains for the maintenance of cardiovascular health among breast cancer survivors.

Association between cardiac autonomic modulation and sedentary behavior in breast cancer survivors: a 12-month cohort study.

PURPOSE: This study aimed to analyze the longitudinal influence of sitting time (ST) on cardiac autonomic modulation (CAM) and resting heart rate (RHR) in a 12-month cohort of 67 breast cancer survivors. METHODS: CAM was assessed by heart rate variability with heart monitor which also assessed RHR, and ST was self-reported. The relationship between the variables was analyzed by the Pearson correlation and its magnitude by linear regression. RESULTS: At baseline, no associations were found between ST and CAM or RHR. In the delta analyses, a decrease in RMSSD, SD1, and HF(ms2) was associated with sitting time. At 12-month follow-up, there was an increase in the ST and a decrease in RHR. ST was negatively related with CAM (RMSSD, PNN50, and SD1), but no association was observed between ST and RHR. CONCLUSION: The increase in ST was associated with worsening of CAM after 12-month follow-up. Promoting reduction in ST will be an important strategy against cardiovascular impairment in breast cancer survivors.

Physical activity domains are differently related with quality of life in breast cancer survivors: a cross-sectional study.

OBJECTIVES: Treatments for breast cancer (BC) can lead to physical and mental impairments which may affect quality of life (QoL). Physical activity (PA) is highly recommended for this population due to its protective effect against BC relapse and its ability to reduce the health impact of treatment. However, it is not clear whether the different domains of PA are associated with better QoL of BC survivors. The current study aimed to verify the relationship between different PA domains with QoL of BC survivors. METHODS: The sample consisted of 128 women BC survivors, with a mean age of 58.2 ±â€Š9.7 years. QoL was assessed using the Short-Form Health Survey questionnaire (SF-36) and PA was verified through the Baecke questionnaire, in domains of occupation, sports practice, and leisure time/commuting. The relationship between QoL and different PA domains was verified by linear regression, adjusted by age, marital status, and socioeconomic condition. RESULTS: Occupational PA was negatively related to physical limitations [ß= -15.36 (-29.04 to -1.68] and body pain [ß=-6.61 (-14.53 to 1.31) marginal association]. Sports practice was positively related to functional capacity [ß= 4.24 (0.60 to 7.88)]. Leisure time/commuting PA was positively related to functional capacity [ß = 7.17 (3.09 to 11.26)], vitality [ß = 4.30 (0.39 to 8.22)], social aspects [ß= 5.47 (0.80 to 10.15)], and mental health [ß = 4.08 (0.40 to 7.75)]. CONCLUSIONS: Sports practice and leisure time/commuting PA were positively related to QoL in BC survivors, while occupational PA was negatively related to QoL, independently of age, marital status, and socioeconomic condition.

Body dissatisfaction and its relationship with overweight, sedentary behavior and physical activity in survivors of breast cancer.

OBJECTIVES: This study aimed to verify the prevalence of body satisfaction in breast cancer survivors and the association of this variable with overweight, sedentary behavior and physical activity in this population. STUDY DESIGN: This is a cross-sectional study realized in Presidente Prudente-Brazil. Breast cancer survivors participated in this study. Questionnaires were used to obtain data on socioeconomic status, body dissatisfaction, sedentary behavior and level of physical activity. The association between body dissatisfaction and the independent variables was verified through binary logistic regression in the unadjusted model and model adjusted by socioeconomic level. RESULTS: A total of 102 breast cancer survivors participated in this study with a mean age of 58.2 (±10.3) years. The prevalence of body dissatisfaction was 75.7%. Body dissatisfaction was higher in women with higher BMI (pvalue = 0.003) and in woman with high sedentary behavior (p-value = 0.049). Women with overweight had 7.87 times more chance of presenting body dissatisfaction. Women who reported hormone therapy were approximately 3 times more likely to be dissatisfacted with their body. CONCLUSION: Body dissatisfaction was associated with lower age, high sedentary behavior and overweight in breast cancer survivors in the unadjusted analysis. When adjusted for socioeconomic status, only the variables of overweight and hormone therapy were associated with body dissatisfaction.

Association between hypertension in adolescents and the health risk factors of their parents: an epidemiological family study.

Hypertension in adolescence may be a predictor of cardiovascular problems in adulthood. Therefore, verification of the factors associated with this condition in adolescence is important. The aim of this study was to analyze the relationship between hypertension in adolescents with hypertension and the sociodemographic characteristics and lifestyle of their parents. This study was conducted on 1231 adolescents, 1202 mothers, and 871 fathers. The blood pressure of the adolescents was measured with an oscillometric device. Details of parental hypertension, sociodemographic characteristics, and lifestyle were obtained by self-report. The prevalence of hypertension was higher among adolescents with older fathers and older mothers, with both parents reporting hypertension and with mothers who were overweight. In multivariable analysis, adolescents with older mothers (OR = 2.36; 95% confidence interval [CI] = 1.12-4.98), hypertensive mothers (OR = 2.22 [95% CI = 1.26-3.89]), and hypertensive fathers (OR = 1.70 [95% CI = 1.03-2.81]) were more likely to have hypertension. In the analysis that considered clusters of health risk factors, higher risks of hypertension were observed in adolescents whose mothers had four or more aggregated risk factors (OR = 2.53 [95% CI = 1.11-5.74]). In conclusion, there was a relationship between hypertension in adolescents and hypertension in their parents. However, an association between hypertension in adolescents and parental age and clusters of health risk factors was only observed for their mothers.

Agreement analysis of oscillometric devices in the measure of resting heart rate in breast cancer survivors.

OBJECTIVE: The aim of this study was to verify the reproducibility of an oscillometric device in the measurement of resting heart rate (RHR) in breast cancer survivors. METHODS: This study included 85 breast cancer survivors with a mean age of 58.87±10.03 years. For the RHR evaluation, the equipment used was the Omron HEM 742, electronic and digital arm device, for measurement of blood pressure and heart rate (HR), with automatic cuff inflation and deflation. At the same time as the oscillometric measurement, HR was measured by the HR monitor Polar RS800 CX, which has been validated previously for HR uptake. The HR value obtained by the cardiofrequency meter was registered at the same time that the Omron device measured blood pressure and HR values. RESULTS: It was observed that the RHR values were very close in both devices and that the correlation values and intraclass correlation coefficient were high. These results were replicated when the female breast cancer survivors were stratified by age group. The agreement values presented by the Bland-Altman analysis showed good values; both for the entire sample and stratified by age, few cases were outside beyond 95% confidence interval range. CONCLUSION: The present study showed that the oscillometric device used presented good values of reproducibility in the detection of RHR values in breast cancer survivors compared with a cardiac monitor.

Relationship between amputation and risk factors in individuals with diabetes mellitus: A study with Brazilian patients.

Individuals with diabetes develop lower extremity amputation for several reasons. Investigations into pathways to the development of complications are important both for treatment and prevention. AIM: To evaluate the relationship between amputation and risk factors in people with diabetes mellitus. MATERIALS AND METHOD: All participants included in this study (n=165) were recruited from the Diabetic Foot Program, developed in a Brazilian University, over seven years (2007-2014) and all information for this study was extracted from their clinical records. RESULTS: The prevalence of amputation in patients with diabetes with four risk factors was up to 20% higher when compared to those with only one risk factor. The main predictive risk factors for amputation in this population were the presence of an ulcer and smoking. CONCLUSION: The risk factors for amputation can be predicted for people with diabetes mellitus and, in the present study, the main factors were the presence of an ulcer and the smoking habit.

Comparação dos efeitos da ventilação mecânica não invasiva contínua e intermitente sobre parâmetros cardiorrespiratórios e modulação autonômica de indivíduos saudáveis / Comparison of the effects of continuous and intermittent non invasive mechanical ventilation on cardiorespiratory parameters and autonomic modulation of healthy individuals

Modelo do estudo: Estudo transversal. Objetivo: Avaliar a influência da Ventilação Mecânica não Invasiva (VMNI) de forma contínua e intermitente sobre a modulação autonômica cardíaca e parâmetros cardiorrespiratórios em mulheres saudáveis. Métodos: Vinte voluntárias realizaram duas modalidades de VMNI: contínua por meio do CPAP e intermitente por meio do Reanimador de Muller. Inicialmente permaneceram em repouso em respiração espontânea por 20 minutos. Em seguida foram submetidas a 20 minutos de aplicação de VMNI com a técnica selecionada e por fim permaneceram 20 minutos em repouso em respiração espontânea. Os parâmetros cardiorrespiratórios e variabilidade da frequência cardíaca (VFC) foram mensurados em todos estes momentos. Resultados: Não houve diferenças significantes quando comparadas as duas técnicas. Observaram-se diferenças nos parâmetros cardiorrespiratórios e VFC quando analisadas individualmente. Menores valores de frequência cardíaca e frequência respiratória foram observados na modalidade contínua quando comparado os valores durante a ventilação com respiração espontânea (p<0,005). Em ambas técnicas observaram-se aumentos significantes de SpO2 durante a ventilação em comparação a respiração espontânea. Observou-se aumento da modulação parassimpática (RMSSD, HF ms2 e SD1) e da variabilidade global (SDNN, RR triangular e SD2) em ambas as técnicas quando comparado ventilação e respiração espontânea (p<0,005). Conclusão: Não houve diferença quando comparadas as duas modalidades de VMNI. Contudo, quando analisadas individualmente observam-se comportamento diferentes dos parâmetros cardiorrespiratórios e na modulação autonômica.

Study design: Cross-sectional study. Objective: To evaluate the influence of continuous and intermittent non invasive mechanical ventilation (NIV) on cardiac autonomic modulation and cardiorespiratory parameters in healthy women. Methods: Twenty subjects performed two types of NIV: continuous through CPAP and intermittent through Müller Reanimator. Initially they remained at rest for 20 minutes in spontaneous breathing. Then volunteers were subjected to 20 minutes of NIV application with the selected technique and finally remained at rest for 20 minutes in spontaneous breathing. Cardiorespiratory parameters and heart rate variability (HRV) were measured in all these moments. Results: Therewere no significant differences when comparing the two techniques. Differences were observed in HRVand cardiorespiratory parameters when analyzed individually. Lower values of heart rate and respiratory rate were observed in continuous ventilation when compared to values during ventilation with spontaneous breathing (p <0.005). In both techniques we observed significant increases in SpO2 during ventilation compared to spontaneous breathing. We observed an increase in parasympathetic modulation (RMSSD, HF ms2 and SD1) and overall variability (SDNN, RR triangular and SD2) in both techniques when compared ventilation to spontaneous breathing (p <0.005). Conclusion: There was no difference comparing the two types of NIV. However, when analyzed individually we observe different behavior of cardiorespiratory parameters and autonomic modulation.