Assuntos
Fumantes , Fumar , Sistema Nervoso Autônomo , Exercício Físico , Humanos , Sono , Fumar/efeitos adversosAssuntos
Humanos , Fumar/efeitos adversos , Fumantes , Sono , Sistema Nervoso Autônomo , Exercício FísicoAssuntos
Serviços Médicos de Emergência/métodos , Infarto do Miocárdio/terapia , Biomarcadores/sangue , Brasil , Cardiologia , Eletrocardiografia , Humanos , Infarto do Miocárdio/sangue , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/prevenção & controle , Medição de Risco , Fatores de Risco , Prevenção Secundária , Sociedades Médicas , Terapia Trombolítica/métodosAssuntos
Doenças Cardiovasculares/prevenção & controle , Morte Súbita , Exercício Físico/fisiologia , Esportes/fisiologia , Adolescente , Adulto , Atletas , Brasil , Cardiologia/normas , Criança , Morte Súbita/etiologia , Morte Súbita/prevenção & controle , Pessoas com Deficiência , Medicina Baseada em Evidências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sociedades Médicas , Medicina Esportiva/normas , Adulto JovemRESUMO
BACKGROUND: Parasympathetic dysfunction is an independent risk factor for mortality in heart failure for which there is no specific pharmacologic treatment. This article aims to determine the effect of pyridostigmine, an anticholinesterase agent, on the integrated physiologic responses to dynamic exercise in heart failure. METHODS AND RESULTS: Patients with chronic heart failure (n = 23; 9 female; age = 48 +/- 12 years) were submitted to 3 maximal cardiopulmonary exercise tests on treadmill in different days. The first test was used for adaptation and to determine exercise tolerance. The other tests were performed after oral administration of pyridostigmine (45 mg, 3 times/day, for 24 hours) or placebo, in random order. All patients were taking their usual medication. Pyridostigmine reduced cholinesterase activity by 30%, inhibited the chronotropic response throughout exercise, up to 60% of maximal effort (pyridostigmine = 108 +/- 3 beats/min vs. placebo = 113 +/- 3 beats/min; P = .040), and improved heart rate reserve (pyridostigmine = 73 +/- 5 beats/min vs. placebo = 69 +/- 5 beats/min; P = 0.035) and heart rate recovery in the first minute after exercise (pyridostigmine = 25 +/- 2 beats/min vs. placebo = 22 +/- 2 beats/min; P = .005), whereas peak heart rate was similar to placebo. Oxygen pulse, an indirect indicator of stroke volume, was higher under pyridostigmine during submaximal exercise. CONCLUSIONS: Pyridostigmine was well tolerated by heart failure patients, leading to improved hemodynamic profile during dynamic exercise.
Assuntos
Acetilcolinesterase/efeitos dos fármacos , Sistema Nervoso Autônomo/fisiopatologia , Inibidores da Colinesterase/uso terapêutico , Insuficiência Cardíaca/fisiopatologia , Hemodinâmica , Brometo de Piridostigmina/uso terapêutico , Receptores Colinérgicos/metabolismo , Adaptação Fisiológica , Análise de Variância , Estudos Cross-Over , Método Duplo-Cego , Teste de Esforço , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Volume SistólicoRESUMO
Dados clínicos: criança de 12 anos, sexo feminino, peso de 40Kg, altura de 150cm, assintomática, foi encaminhada ao Serviço de Ergometria para a realização de teste ergometrico, objetivando acompanhamento clínico. Eletrocardiograma: O traçado eletrocardiográfico em repouso, com a...
Assuntos
Humanos , Feminino , Criança , Teste de Esforço/métodos , EletrocardiografiaRESUMO
As alterações eletrocardiográficas observadas no segmento ST compatíveis com isquemia miocárdica induzida pelo exercício, durante o teste ergométrico, apresentam maior acurácia diagnóstica e prognóstica quando correlacionadas com variáveis hemodinâmicas e outros parâmetros eletrocardiográficos.
Assuntos
Humanos , Feminino , Eletrocardiografia/métodos , Isquemia Miocárdica/diagnóstico , Teste de EsforçoRESUMO
OBJECTIVE: To assess the influence of skeletal muscle mass on ventilatory and hemodynamic variables during exercise in patients with chronic heart failure (CHF). METHODS: Twenty-five male patients underwent maximum cardiopulmonary exercise testing on a treadmill with a ramp protocol and measurement of the skeletal muscle mass of their thighs by using magnetic resonance imaging. The clinically stable, noncachectic patients were assessed and compared with 14 healthy individuals (S) paired by age and body mass index, who underwent the same examinations. RESULTS: Similar values of skeletal muscle mass were found in both groups (CHF group: 3863 ± 874 g; S group: 3743 ± 540 g; p = 0.32). Significant correlations of oxygen consumption in the anaerobic threshold (CHF: r = 0.39; P= 0.02 and S: r = 0.14; P = 0.31) and of oxygen pulse also in the anaerobic threshold (CHF: r = 0.49; P = 0.01 and S: r =0.12; P = 0.36) were found only in the group of patients with chronic heart failure. CONCLUSION: The results obtained indicate that skeletal muscle mass may influence the capacity of patients with CHF to withstand submaximal effort, due to limitations in their physical condition, even maintaining a value similar to that of healthy individuals. This suggests qualitative changes in the musculature
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Índice de Massa Corporal , Baixo Débito Cardíaco , Exercício Físico , Teste de Esforço , Hemodinâmica , Músculo Esquelético , Ventilação Pulmonar , Limiar Anaeróbio , Modelos Lineares , Espectroscopia de Ressonância Magnética , Músculo Esquelético , Coxa da PernaRESUMO
OBJECTIVE: To assess the influence of skeletal muscle mass on ventilatory and hemodynamic variables during exercise in patients with chronic heart failure (CHF). METHODS: Twenty-five male patients underwent maximum cardiopulmonary exercise testing on a treadmill with a ramp protocol and measurement of the skeletal muscle mass of their thighs by using magnetic resonance imaging. The clinically stable, noncachectic patients were assessed and compared with 14 healthy individuals (S) paired by age and body mass index, who underwent the same examinations. RESULTS: Similar values of skeletal muscle mass were found in both groups (CHF group: 3863 874 g; S group: 3743 540 g; p = 0.32). Significant correlations of oxygen consumption in the anaerobic threshold (CHF: r = 0.39; P= 0.02 and S: r = 0.14; P = 0.31) and of oxygen pulse also in the anaerobic threshold (CHF: r = 0.49; P = 0.01 and S: r =0.12; P = 0.36) were found only in the group of patients with chronic heart failure. CONCLUSION: The results obtained indicate that skeletal muscle mass may influence the capacity of patients with CHF to withstand submaximal effort, due to limitations in their physical condition, even maintaining a value similar to that of healthy individuals. This suggests qualitative changes in the musculature.
Assuntos
Baixo Débito Cardíaco/fisiopatologia , Exercício Físico/fisiologia , Músculo Esquelético/fisiologia , Ventilação Pulmonar/fisiologia , Limiar Anaeróbio/fisiologia , Índice de Massa Corporal , Hemodinâmica , Humanos , Modelos Lineares , Espectroscopia de Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologiaRESUMO
Apresenta uma análise de testes ergométricos aplicados em indivíduos maiores de 65 anos com vistas a identificar as adaptações clínicas, hemodinâmicas, metabólicas e eletrocardiográficas decorrentes do trabalho físico efetuado. Apresenta os métodos utilizados, os resultados do estudo e a bibliografia consultada. Documento em formato pdf; requer o Acrobat Reader.
Assuntos
Idoso , Saúde do Idoso , Teste de EsforçoRESUMO
OBJETIVE: The evaluation, by exercise stress testing, of the cardiorespiratory effects of pyridostigmine (PYR), a reversible acetylcholinesterase inhibitor. METHODS: A double-blind, randomized, cross-over, placebo-controlled comparison of hemodynamic and ventilation variables of 10 healthy subjects who underwent three exercise stress tests (the first for adaptation and determination of tolerance to exercise, the other two after administration of placebo or 45mg of PYR). RESULTS: Heart rate at rest was: 68 + or - 3 vs 68 + or - 3bpm before and after placebo, respectively (P=0.38); 70 + or - 2 vs 59 + or - 2bpm, before and after pyridostigmine, respectively (P<0.01). During exercise, relative to placebo: a significantly lower heart rate after PYR at, respectively, 20 per cent (P=0.02), 40 per cent (P=0.03), 80 per cent (P=0.05) and 100 per cent (P=0.02) of peak effort was observed. No significant differences were observed in arterial blood pressure, oxygen consumption at submaximal and maximal effort, exercise duration, respiratory ratio, CO2 production, ventilation threshold, minute ventilation, and oxygen pulse. CONCLUSION: Pyridostigmine, at a dose of 45mg, decreases heart rate at rest and during exercise, with minimal side effects and without interfering with exercise tolerance and ventilation variables.
