Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
PLoS One ; 14(10): e0223838, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31603935

RESUMO

BACKGROUND: Heart failure is associated with exercise intolerance and sleep- disordered breathing; however, studies in patients with chronic constrictive pericarditis are scarce. The purpose of our study was to assess exercise capacity and sleep in patients with chronic constrictive pericarditis (CCP) undergoing a pericardiectomy. METHODS: We studied consecutive patients scheduled for pericardiectomy due to symptomatic CCP. Were performed quality of life (Minnesota Living with Heart Failure Questionnaire-MLHFQ) and sleep questionnaires (Epworth, Pittsburgh Sleep Quality Index-PSQI), serum B-type natriuretic peptide (BNP), serum C-reactive protein, transthoracic echocardiography, cardiopulmonary exercise test and overnight polysomnography immediately before and six months after pericardiectomy. RESULTS: Twenty-five patients (76% males, age: 45.5±13.8 years, body mass index: 24.9±3.7 kg/m2, left ventricular ejection fraction: 60±6%) with CCP (76% idiopathic, 12% tuberculosis) were studied. As compared to the preoperative period, pericardiectomy resulted in reduction in BNP (143 (83.5-209.5) vs 76 (40-117.5) pg/mL, p = 0.011), improvement in VO2 peak (18.7±5.6 vs. 25.2±6.3 mL/kg/min, p<0.001), quality of life (MLHFQ score 62 (43,5-77,5) vs. 18 (8,5-22), p<0,001) and sleep (PSQI score 7.8±4.1 vs. 4.7±3.7, p<0.001) and no significant change in sleep disordered breathing (apnea hypopnea index-AHI 15.6 (8.3-31.7) vs. 14.6 (5.75-29.9) events/h, p = 0.253). CONCLUSION: Patients with symptomatic CCP showed reduced exercise capacity and sleep-disordered breathing. After pericardiectomy, there was improvement in exercise capacity and neutral effect on sleep-disordered breathing.

3.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(4 (Supl)): 393-399, out.-dez. 2019. tab
Artigo em Português | LILACS | ID: biblio-1047325

RESUMO

A testosterona, hormônio masculino com efeitos androgênicos e anabólicos, também exerce efeito sobre o leito vascular. Este hormônio promove vasodilatação através da liberação de óxido nítrico e modulação dos canais de cálcio que impacta a função endotelial. Em pacientes com doença arterial coronariana (DAC) e insuficiência cardíaca (IC), reduções nas concentrações de testosterona total (<300 ng/dL) estão relacionadas com maior mortalidade e severidade dessas doenças. Em pacientes com DAC, a reposição de testosterona (RT) tem relação com melhora do tônus vascular coronário e melhora do limiar de isquemia. Em pacientes com IC, os efeitos parecem estar mais relacionados à melhora da capacidade funcional, aumento na distância percorrida em testes funcionais, maior VO2máx, menor razão VE/VCO2, e melhora adicional da sensibilidade barorreflexa. No entanto, embora os efeitos da testosterona sobre o aumento de massa muscular e força muscular estejam bem estabelecidos na literatura, os efeitos dessa substância no sistema cardiovascular precisam ser elucidados. O aumento das concentrações de antígeno prostático específico da próstata tem sido constantemente discutido quando a RT é proposta no tratamento de pacientes com doenças cardiovasculares. Por se tratar de um hormônio com grande potencial anabólico, os efeitos do uso de quantidades suprafisiológicas de testosterona e seus análogos sobre as alterações cardiovasculares em jovens atletas têm sido estudados. Portanto, o objetivo dessa revisão é abordar os efeitos benéficos da RT em homens com hipogonadismo com DAC e IC, e mostrar os riscos relacionados com a prática indiscriminada do uso de anabolizantes em jovens sem deficiência de testosterona


Testosterone, the male hormone with androgenic and anabolic effects, also has an effect on the vascular bed. This hormone promotes vasodilation by releasing nitric oxide and calcium channel modulation that impacts endothelial function. In patients with coronary artery disease (CAD) and heart failure (HF), reductions in total testosterone concentrations (<300 ng/dL) are related to higher mortality and severity of these diseases. In patients with CAD, testosterone replacement (TR) is related to improved coronary vascular tone and improved ischemia threshold. In HF patients, the effects seem be more related to improved functional capacity, increased distance covered in functional tests, higher VO2max, lower LV/VCO2 ratio, and further improvement of baroreflex sensitivity. However, although the effects of testosterone on muscle mass gain and muscle strength are well established in the literature, the effects of testosterone on the cardiovascular system need to be elucidated. Increased prostate-specific prostate antigen concentrations have been constantly discussed when TR is proposed in the treatment of patients with cardiovascular disease. Because it is a hormone with great anabolic potential, the effects of supraphysiological amounts of testosterone and its analogues on cardiovascular disorders in young athletes have been studied. Therefore, the objective of this review is to address the beneficial effects of TR in men with hypogonadism with CAD and HF, and to show the risks related to anabolic steroids abuse in young people without testosterone deficiency


Assuntos
Testosterona , Doenças Cardiovasculares/terapia , Doença da Artéria Coronariana , Sistema Cardiovascular , Exercício , Vasos Coronários , Insuficiência Cardíaca Diastólica , Hormônios , Hipogonadismo
5.
Arq. bras. cardiol ; 112(6): 739-746, Jun. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1011203

RESUMO

Abstract Background: Resting sympathetic hyperactivity and impaired parasympathetic reactivation after exercise have been described in patients with heart failure (HF). However, the association of these autonomic changes in patients with HF and sarcopenia is unknown. Objective: The aim of this study was to evaluate the impact of autonomic modulation on sarcopenia in male patients with HF. Methods: We enrolled 116 male patients with HF and left ventricular ejection fraction < 40%. All patients underwent a maximal cardiopulmonary exercise testing. Maximal heart rate was recorded and delta heart rate recovery (∆HRR) was assessed at 1st and 2nd minutes after exercise. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography. Dual-energy X-ray absorptiometry was used to measure body composition and sarcopenia was defined by the sum of appendicular lean muscle mass (ALM) divided by height in meters squared and handgrip strength. Results: Sarcopenia was identified in 33 patients (28%). Patients with sarcopenia had higher MSNA than those without (47 [41-52] vs. 40 [34-48] bursts/min, p = 0.028). Sarcopenic patients showed lower ∆HRR at 1st (15 [10-21] vs. 22 [16-30] beats/min, p < 0.001) and 2nd min (25 [19-39] vs. 35 [24-48] beats/min, p = 0.017) than non-sarcopenic. There was a positive correlation between ALM and ∆HRR at 1st (r = 0.26, p = 0.008) and 2nd min (r = 0.25, p = 0.012). We observed a negative correlation between ALM and MSNA (r = -0.29, p = 0.003). Conclusion: Sympatho-vagal imbalance seems to be associated with sarcopenia in male patients with HF. These results highlight the importance of a therapeutic approach in patients with muscle wasting and increased peripheral sympathetic outflow.


Resumo Fundamento: Hiperatividade simpática de repouso e uma reativação parassimpática diminuída pós-exercício têm sido descritas em pacientes com insuficiência cardíaca (IC). No entanto, a associação dessas alterações autonômicas em pacientes com IC sarcopênicos ainda não são conhecidas. Objetivo: O objetivo deste estudo foi avaliar o impacto da modulação autonômica sobre sarcopenia em pacientes com IC do sexo masculino. Métodos: Foram estudados 116 pacientes com IC e fração de ejeção ventricular esquerda inferior a 40%. Todos os pacientes foram submetidos ao teste de exercício cardiopulmonar máximo. A frequência cardíaca máxima foi registrada, e o delta de recuperação da frequência cardíaca (∆RFC) foi avaliado no primeiro e no segundo minuto após o exercício. A atividade nervosa simpática muscular (ANSM) foi registrada por microneurografia. A Absorciometria Radiológica de Dupla Energia foi usada para medir composição cpororal, e a sarcopenia definida como a soma da massa muscular apendicular (MMA) dividida pela altura em metros ao quadrado e força da mão. Resultados: A sarcopenia foi identificada em 33 pacientes (28%). Os pacientes com sarcopenia apresentaram maior ANSM que aqueles sem sarcopenia - 47 (41-52) vs. 40 (34-48) impulsos (bursts)/min, p = 0,028). Pacientes sarcopênicos apresentaram ∆RFC mais baixo no primeiro [15 (10-21) vs. 22 (16-30) batimentos/min, p < 0,001) e no segundo [25 (19-39) vs. 35 (24-48) batimentos/min, p = 0,017) minuto que pacientes não sarcopênicos. Observou-se uma correlação positiva entre a MMA e a ANSM (r = -0,29; p = 0,003). Conclusão: Um desequilíbrio simpático-vagal parece estar associado com sarcopenia em pacientes com IC do sexo masculino. Esses resultados destacam a importância de uma abordagem terapêutica em pacientes com perda muscular e fluxo simpático periférico aumentado.

6.
Arq Bras Cardiol ; 112(6): 739-746, 2019 Jun.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30970141

RESUMO

BACKGROUND: Resting sympathetic hyperactivity and impaired parasympathetic reactivation after exercise have been described in patients with heart failure (HF). However, the association of these autonomic changes in patients with HF and sarcopenia is unknown. OBJECTIVE: The aim of this study was to evaluate the impact of autonomic modulation on sarcopenia in male patients with HF. METHODS: We enrolled 116 male patients with HF and left ventricular ejection fraction < 40%. All patients underwent a maximal cardiopulmonary exercise testing. Maximal heart rate was recorded and delta heart rate recovery (∆HRR) was assessed at 1st and 2nd minutes after exercise. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography. Dual-energy X-ray absorptiometry was used to measure body composition and sarcopenia was defined by the sum of appendicular lean muscle mass (ALM) divided by height in meters squared and handgrip strength. RESULTS: Sarcopenia was identified in 33 patients (28%). Patients with sarcopenia had higher MSNA than those without (47 [41-52] vs. 40 [34-48] bursts/min, p = 0.028). Sarcopenic patients showed lower ∆HRR at 1st (15 [10-21] vs. 22 [16-30] beats/min, p < 0.001) and 2nd min (25 [19-39] vs. 35 [24-48] beats/min, p = 0.017) than non-sarcopenic. There was a positive correlation between ALM and ∆HRR at 1st (r = 0.26, p = 0.008) and 2nd min (r = 0.25, p = 0.012). We observed a negative correlation between ALM and MSNA (r = -0.29, p = 0.003). CONCLUSION: Sympatho-vagal imbalance seems to be associated with sarcopenia in male patients with HF. These results highlight the importance of a therapeutic approach in patients with muscle wasting and increased peripheral sympathetic outflow.

7.
Atherosclerosis ; 283: 100-105, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30826541

RESUMO

BACKGROUND AND AIMS: Anabolic androgenic steroids (AAS) have been associated with coronary artery disease (CAD). AAS abuse leads to a remarkable decrease in high-density lipoprotein (HDL) plasma concentration, which could be a key factor in the atherosclerotic process. Moreover, not only the concentration of HDL, but also its functionality, plays a pivotal role in CAD. We tested the functionality of HDL by cholesterol efflux and antioxidant capacity. We also evaluated the prevalence of CAD in AAS users. METHODS: Twenty strength-trained AAS users (AASU) age 29 ±â€¯5 yr, 20 age-matched strength-trained AAS nonusers (AASNU), and 10 sedentary controls (SC) were enrolled in this cross-sectional study. Functionality of HDL was evaluated by 14C-cholesterol efflux and the ability of HDL in inhibiting LDL oxidation. Coronary artery was evaluated with coronary computed tomography angiography. RESULTS: Cholesterol efflux was lower in AASU compared with AASNU and SC (20 vs. 23 vs. 24%, respectively, p < 0.001). However, the lag time for LDL oxidation was higher in AASU compared with AASNU and SC (41 vs 13 vs 11 min, respectively, p < 0.001). We found at least 2 coronary arteries with plaques in 25% of AASU. None of the AASNU and SC had plaques. The time of AAS use was negatively associated with cholesterol efflux. CONCLUSIONS: This study indicates that AAS abuse impairs the cholesterol efflux mediated by HDL. Long-term AAS use seems to be correlated with lower cholesterol efflux and early subclinical CAD in this population.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA