Effect of Sex on Vascular Adaptations to Isometric Handgrip Training in Elderly Patients with Peripheral Artery Disease: A Randomized Controlled Trial.

BACKGROUND: Isometric handgrip training (IHT) promotes vascular adaptations in different populations. AIMS: We assessed the sex differences in vascular adaptations of IHT in a sample of older adults with symptomatic peripheral artery disease (PAD). METHODS: Fifty-three older patients with symptomatic PAD (6 women and 13 men in IHT and 13 women and 21 men in the control group) participated in this study. The IHT group performed 3 sessions per week, for 8 weeks, consisting of 4 sets of isometric contractions for 2 min at 30% of maximum voluntary contraction and a 4-min interval between sets. The control group received a compression ball in order to minimize the placebo effects, representing sham training. Blood flow and brachial flow-mediated dilation were analyzed at before and after 8 weeks of intervention. We compared the responses (Δ = post-pre values) of each group (women control, women IHT, men control, and men IHT) with a Kruskal-Wallis test. RESULTS: There were no differences in all groups after 8 weeks of IHT in Δ brachial diameter (p = 0.850), Δ flow-mediated dilation (p = 0.241), Δ time to peak diameter (p = 0.528), and Δ FMD/AUC (p = 0.397). CONCLUSIONS: There are no effects of sex on vascular adaptation after 8 weeks of IHT in older adults with symptomatic PAD.

Functional and Cardiovascular Parameters in Peripheral Artery Disease Patients with Interarm Blood Pressure Difference.

BACKGROUND: To analyze the impact of interarm blood pressure difference (IAD) on functional and cardiovascular parameters in patients with peripheral artery disease (PAD). METHODS: Ninety-eight patients with PAD were recruited in this cross-sectional study. Patients with differences between the right and left arms of systolic and/or diastolic blood pressure ≥10 mm Hg were classified as IAD, whereas the remaining patients were classified as PAD control subjects. Functional parameters included were the 6-min walk test, short physical performance battery, walking impairment questionnaire (WIQ), and the walking estimated-limitation calculated by history. Systemic cardiovascular parameters included were arterial stiffness and heart rate variability. Local cardiovascular parameters assessed in both arms were brachial blood pressure and flow-mediated dilation. RESULTS: Patients with IAD presented higher systolic blood pressure and pulse pressure compared with control patients (P < 0.01). The carotid femoral pulse wave velocity tended to be higher and flow-mediated dilation tended to be lower in PAD patients with IAD compared with control subjects (P < 0.09). Patients with IAD presented lower scores in short physical performance battery (P = 0.012), WIQ distance (P = 0.003), WIQ speed (P = 0.008), WIQ stair climbing (P = 0.034), and walking estimated-limitation calculated by history (P = 0.026) when compared with PAD control patients. CONCLUSIONS: In patients with PAD, IAD is associated with lower physical function and impairments in cardiovascular parameters compared with PAD patients without IAD.

Effects of Isometric Handgrip Training in Patients With Peripheral Artery Disease: A Randomized Controlled Trial.

Background Meta-analyses have shown that isometric handgrip training (IHT) can reduce brachial systolic and diastolic blood pressure (BP) by >6/4 mm Hg, respectively. However, whether IHT promotes these effects among patients with peripheral artery disease, who exhibit severe impairment in cardiovascular function, is currently unknown. This study aimed to evaluate the effects of IHT on the cardiovascular function of patients with peripheral artery disease. Methods and Results A randomized controlled trial with peripheral artery disease patients assigned to either the IHT or control group was conducted. The IHT group performed 3 sessions per week, for 8 weeks, of unilateral handgrip exercises, consisting of 4 sets of isometric contractions for 2 minutes at 30% of maximum voluntary contraction and a 4-minute interval between sets. The control group received a compression ball in order to minimize the placebo effects, representing sham training. The primary outcome was brachial BP. The secondary outcomes were central BP, arterial stiffness parameters, cardiac autonomic modulation, and vascular function. The IHT program reduced diastolic BP (75 [10] mm Hg preintervention versus 72 [11] mm Hg postintervention), with no change in the control group (74 [11] mm Hg preintervention versus 74 [11] mm Hg postintervention), with this between-group difference being significant (P=0.04). Flow-mediated dilation improved in the IHT group (6.0% [5.7] preintervention versus 9.7% [5.5] postintervention), with no change in the control group (7.6% [5.5] preintervention versus 7.4% [5.1] postintervention), with this between-group difference being significant (P=0.04). There was no change in other measured variables over the intervention period. Conclusions IHT reduced brachial diastolic BP and improved local vascular function in patients with peripheral artery disease. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02742220.

SEM observations on seeds of some herbaceous Phyllanthus L. species (Phyllanthaceae) / Observações de sementes de algumas espécies herbáceas de Phyllanthus L. (Phyllanthaceae) em MEV

Six medicinal herbaceous Phyllanthus L. (Phyllanthaceae) species, P. tenellus Roxb., P. niruri L., P. stipulatus (Raf.) Webster, P. urinaria L., P. caroliniensis Walt., and P. amarus Schum. & Thonn. are difficult to distinguish. In order to solve this problem, the ornamentation of the seed surfaces was analyzed by SEM (scanning electron microscopy). Differences between lateral, dorsal and ventral surfaces were observed. The seeds were cut into sections at different angles, exposing testa sculptures. Three types of surface ornamentation patterns were observed and they showed to be avaluable diagnostic.

Seis espécies herbáceas de Phyllanthus L. (P. tenellus Roxb., P. niruri L., P. stipulatus (Raf.) Webster, P. urinaria L., P. caroliniensis Walt. e P. amarus Schum. & Thonn.) mencionadas como medicinais apresentam dificuldades na identificação. Com o objetivo de auxiliar neste problema e determinar diferenças entre as espécies, o padrão de ornamentação das sementes foi estudado utilizando técnicas de microscopia eletrônica de varredura (MEV). As sementes apresentaram ornamentação distinta, sendo observadas as superfícies laterais, dorsais e ventrais. As espécies puderam ser separadas em três tipos de ornamentação, que demonstraram importância como caractere diagnóstico para a sua separação.