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1.
Braz J Med Biol Res ; 52(9): e8402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482976

RESUMO

Cardiopulmonary fitness assessment is a valuable resource to obtain quantitative indicators of an individual's physical performance. The cardiopulmonary exercise test (CPX), considered the gold standard test for this evaluation, is costly and difficult to be accessed by the general population. In order to make this evaluation more accessible, and to better reflect the performance of daily life activities, alternative tests were proposed. Morbidly obese patients present limitations that impair physical performance assessment and could benefit from a test of shorter duration, provided it is validated. This observational study aimed to validate the two-minute step test (2MST) as a tool to evaluate functional capacity (FC) in obese with comorbidities and morbidly obese patients, compared the 2MST with CPX as a measure of physical performance, and developed a predictive equation to estimate peak oxygen uptake (VO2) in the 2MST. The CPX and the 2MST were performed and metabolic and ventilatory parameters were recorded in 31 obese individuals (BMI>35 kg/m2). Pearson correlation and multiple linear regression analyses were performed to evaluate the peak VO2 best predictors. Bland-Altman analysis was performed to assess the agreement between the two methods. Peak VO2 measured by CPX and 2MST showed a strong correlation (r=0.70, P<0.001) and there was a moderate correlation between peak VO2 of the 2MST and the number of up-and-down step cycles (UDS) (r=0.55; P=0.01). The reference equation obtained was: VO2 (mL·kg-1·min-1) = 13.341 + 0.138 × total UDS - (0.183 × BMI), with an estimated standard error of 1.3 mL·kg-1·min-1. The 2MST is a viable, practical, and easily accessible test for FC. UDS and BMI can predict peak VO2 satisfactorily.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Tolerância ao Exercício/fisiologia , Frequência Cardíaca/fisiologia , Obesidade/fisiopatologia , Consumo de Oxigênio/fisiologia , Teste de Caminhada/métodos , Adolescente , Adulto , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/fisiopatologia , Fatores de Tempo , Adulto Jovem
2.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 396-407, July-Aug. 2019. graf, ilus
Artigo em Inglês | LILACS | ID: biblio-1012340

RESUMO

The use of technology has increased tremendously, by means of more reliable, smaller, more accessible and specially more user-friendly devices, which provide a wider range of features, and promote significant benefits for the population and health professionals. It is in this context that monitors and apps for heart rate (HR) measurement have emerged. HR is a clinical vital sign of diagnostic and prognostic importance. In response to body movement, HR tends to increase, in a direct relationship with the intensity of exercise. HR was primarily measured by the count of arterial pulse, and recently, HR can be precisely measured by monitors, bracelets and smartphone apps capable to perform real-time measurements and storage of data. This paper aimed to make a brief and updated review on the theme, providing a broader view of advantages and limitations of these resources for HR measurement in exercise. HR monitors and apps use basically two types of technology, optical sensor (photoplethysmography) and electrical signal from the heart. In general, these devices have shown good accuracy in measuring HR and HR variability at rest, but there are differences between brands and models considering the type, mode and intensity of exercise. HR measurements by monitors and smartphone apps are simple, accessible and may help cardiologists in the monitoring of the intensity of aerobic exercise, focusing on health promotion and on primary and secondary prevention of cardiovascular diseases


Assuntos
Humanos , Masculino , Feminino , Palpação/métodos , Exercício , Monitores de Aptidão Física , Frequência Cardíaca , Arritmias Cardíacas , Prognóstico , Esportes , Débito Cardíaco , Doenças Cardiovasculares/diagnóstico , Tecnologia Biomédica , Teste de Esforço/métodos
3.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 368-373, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1012344

RESUMO

Cardiopulmonary exercise testing is widely used in the evaluation of patients with left ventricular dysfunction, and some of these patients have an implantable cardioverter-defibrillator (ICD). However, this test presents specific challenges because of the susceptibility to ventricular arrhythmias during maximal levels of exercise. Objective: To evaluate the safety of cardiopulmonary exercise testing in patients with ICD. Methods: The study included patients with ICD who underwent cardiopulmonary exercise testing between 2007 and 2015. The tests were completed once the electronic devices were programmed. The maximum allowed heart rate reached during exercise was 10 beats below the first therapy zone programmed. Results: The study included 69 patients with mean age 53.7 ± 10.8 years, including 68% men. Exercise time was 8.7±2.3 minutes, with peak oxygen consumption of 13.3 ± 4.3 ml.kg-1.min-1. Peak heart rate was 62.9 ± 13.4% of the maximum rate predicted, with all patients taking specific medication. Ventricular arrhythmia was observed in 29% of the patients, and paired ventricular extrasystoles, ventricular bigeminism or non-sustained ventricular tachycardia were observed in only 14.5% of the patients. There was no sustained ventricular arrhythmia resulting in ICD therapy or other complications, such as inappropriate therapies. The frequency of severe events was 0%, 95% CI (0 - 5.2%). Conclusion: In the sample of patients evaluated, the cardiopulmonary exercise testing was shown to be safe during its performance in a hospital setting, following the safety standards


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Desfibriladores Implantáveis , Teste de Esforço/métodos , Consumo de Oxigênio , Arritmias Cardíacas , Doenças Cardiovasculares , Índice de Massa Corporal , Morte Súbita Cardíaca , Eletrocardiografia/métodos , Frequência Cardíaca
4.
Medicine (Baltimore) ; 98(35): e16998, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464952

RESUMO

RATIONALE: Syncope caused by head and neck cancer (HNC) is rare. However, syncope caused by tongue cancer (TC) is even rarer. In TC, syncope is caused by tumor-mediated compression of the carotid sinus and stimulation of the glossopharyngeal nerve. PATIENT CONCERNS: In this study, we report the case of a 48-year-old male patient who was diagnosed with advanced TC and bilateral cervical lymph node metastasis. On the third day of admission, the patient experienced recurrent syncope with hypotension and bradycardia. DIAGNOSES: The patient was diagnosed with a well-differentiated squamous cell carcinoma of the tongue along with massive cervical lymph node metastasis and carotid sinus syndrome. INTERVENTIONS: Initially, symptomatic treatment of syncope boosted the blood pressure and increased the heart rate. Thereafter, a temporary pacemaker was implanted. Finally, chemotherapy was used to control the tumor and relieve syncope. OUTCOMES: After chemotherapy, the tongue ulcers and cervical lymph node reduced in size; syncope did not recur. LESSONS: This case shows that chemotherapy may be a valid treatment option in patients with cancer-related syncope; however, the choice of chemotherapeutic drugs is critical. Intensive care provides life support to patients and creates opportunities for further treatment.


Assuntos
Cuidados Paliativos , Síncope/complicações , Neoplasias da Língua/complicações , Antineoplásicos/uso terapêutico , Pressão Sanguínea , Seio Carotídeo/patologia , Nervo Glossofaríngeo/patologia , Frequência Cardíaca , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial , Síncope/cirurgia , Neoplasias da Língua/tratamento farmacológico , Neoplasias da Língua/patologia
5.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(4): 742-747, 2019 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-31420633

RESUMO

OBJECTIVE: To compare the effects of thoracic epidural administration of lidocaine on hemodynamic and arousal responses of double lumen tracheal intubation during induction of anesthesia. METHODS: In the study, 40 patients with American Society of Anesthesiologists (ASA) physical statuses I-II, aged 19-66 years, scheduled for elective thoracic surgeries under general anesthesia requiring orotracheal intubation were allocated to either the double-lumen endobronchial intubation (T group) or double-lumen endobronchial intubation after epidural administration of lidocaine (E group). After an intravenous anesthetic induction, the orotracheal double-lumen intubation was performed using a Macintosh direct laryngoscopy (MDLS), respectively. Invasive blood pressure (BP), heart rate (HR) and bispectral index (BIS) were recorded before and after anesthetic induction, immediately after intubation and 5 minutes after intubation with 1-minute interval and the intubation time also noted. The rate pressure product (RPP) was calculated. RESULTS: After anesthetic induction, BP and RPP in the two groups decreased significantly compared with their preinduction values. In comparison with their postinduction values, the orotracheal intubation in the two groups caused significant increases in BPs, HRs and RPP. In comparison with their preinduction values, BPs decreased significantly in E group, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) increased significantly and lasted for 1 min in T group. The HRs of both groups after intubation were significantly higher than their baseline values , and increased in HR and lasted for 1 min and 4 min in E group and T group, respectively. SBP, DBP, MAP, HR and RPP after intubation in T group were significantly higher than those of E group during the observation period. The values of BIS were similar between both the groups. In T group, the incidences of SBP percent increased>30% of the baseline value and RPP more than 22 000 were significantly higher than in E group. None of the patients in group E had SBP more than 130% of the baseline value and RPP more than 22 000. CONCLUSION: During double-lumen endobronchial intubation, epidural administration of lidocaine can provide less hemodynamic response and similar arousal response.


Assuntos
Intubação Intratraqueal , Laringoscópios , Adulto , Idoso , Nível de Alerta , Pressão Sanguínea , Frequência Cardíaca , Hemodinâmica , Humanos , Lidocaína , Pessoa de Meia-Idade , Adulto Jovem
6.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 374-383, July-Aug. 2019. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1012347

RESUMO

Maximal oxygen uptake (VO2max) and both first (VT1) and second (VT2) thresholds have been used as reference points for exercise prescription in different populations. Objective: We aimed to test the hypothesis that exercise prescription, based on VTs determined by treadmill cardiopulmonary exercise testing (CPET), is influenced by the rate of increase in treadmill workload. Methods: Nine healthy individuals underwent two CPETs, followed by two sessions of submaximal exercise, both in randomized order. For the "speed" protocol, there was an increment of 0.1 to 0.3 km.h-1 every 15s. The "grade" incremental protocol increased 1% every 30s and 0.1 km.h-1 every 45s. This was followed by submaximal exercise sessions lasting 40min at an intensity corresponding to heart rate (HR) between the VT1 and VT2. Results: The "speed" protocol resulted in higher VT1 (p = 0.01) and VT2 (p = 0.02) when compared to the "grade" incremental protocol, but there was no effect on VO2max. The target HR for the submaximal exercise sessions was higher in the "speed" protocol compared to the "grade" incremental protocol (p < 0.01) and remained stable during the two steady-state exercise sessions. Blood lactate remained stable during the submaximal exercise sessions, with higher values observed during the "speed" protocol than those "grade" incremental protocol (p < 0.01). Conclusions: Compared to a grade-based protocol, a speed-based protocol resulted in higher VT1 and VT2, which significantly affected cardiorespiratory and metabolic responses to prescribed exercise intensity in healthy young adults


Assuntos
Humanos , Masculino , Feminino , Adulto , Tolerância ao Exercício , Teste de Esforço/métodos , Consumo de Oxigênio , Prognóstico , Doenças Cardiovasculares/diagnóstico , Exercício , Protocolos/métodos , Eletrocardiografia/métodos , /métodos , Frequência Cardíaca
7.
High Blood Press Cardiovasc Prev ; 26(4): 339-344, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31385256

RESUMO

INTRODUCTION: Opportunistic screening of atrial fibrillation is a valuable approach to the identification of subjects with unknown or non-symptomatic atrial fibrillation (AF) with the potential of reducing the burden of ischemic stroke in the population. AIM: To evaluate the feasibility of a large-scale screening for atrial fibrillation using a blood pressure monitor (MicrolifeAFIB) endowed with a validated algorithm able to detect AF calculating the irregularity of interval times between heartbeats. METHODS: In this cross-sectional study conducted in 74 pharmacies in Verona participated 3071 people aged 50 years or more. In 6 months, information about drugs, previous diagnoses of cardiovascular diseases, anthropometric and demographic data was recorded, together with the measurement of blood pressure and cardiac rhythm by using the MicrolifeAFIB device. Pharmacists also collected anthropometric and demographic data of the participants, along with information concerning their personal history of cardiovascular disease and the use of antihypertensive and antithrombotic agents. All those who were positive at the screening for atrial fibrillation were referred to their family doctor. RESULTS: The screening revealed 98 subjects (3.2%) positive for AF; 44 of these reported a previous diagnosis of AF and were treated with anticoagulants (77%) or with antiplatelet agents (7%). By logistic regression analysis, age, male sex and heart failure were independently associated with positivity for AF. Association between positive test and previous stroke/TIA was found in the 54 subjects without a previous diagnosis of AF (9% had a previous stroke/TIA). CONCLUSIONS: Opportunistic screening for atrial fibrillation in the pharmacies is feasible and allows to identify a number of subjects with silent, non-previously diagnosed AF, therefore is potentially useful in large-scale projects aimed at the prevention of cardiovascular morbidity and mortality.


Assuntos
Fibrilação Atrial/diagnóstico , Determinação da Pressão Arterial/instrumentação , Serviços Comunitários de Farmácia , Frequência Cardíaca , Programas de Rastreamento/instrumentação , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/fisiopatologia , Pressão Sanguínea , Estudos Transversais , Eletrocardiografia , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico
8.
Braz J Med Biol Res ; 52(8): e8088, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31389489

RESUMO

There is currently a lack of information adjacent on the influence of sex and age in heart rate variability (HRV), adjusted according to accelerometer-based physical activity (PADL). We hypothesized that the effect of sex and age on the HRV should be reduced or absent in individuals with a suitable PADL level. We aim to evaluate the influence of sex and age on HRV, adjusted for the confounding effects of the PADL level. A total of 485 age-stratified subjects (18-39, 40-59, and ≥60 years) underwent HRV analyses at rest and 7-day assessments of accelerometer-based PADL. Multivariate analyses of covariance were done using log-transformed HRV indices as outcomes, age and sex as fixed factors, and PADL, cardiovascular risk, fat body mass, and heart rate (HR) at rest as covariates. Despite the adjustment for directly measured PADL, women had better indices of vagal tone, whereas men had higher sympathetic influence. Also, compared to middle-aged and older adults, younger individuals (ages 18-39 years) presented better HRV. Multiple regression analyses confirmed that age and sex were the main predictors of HRV indices, even after adjusting for PADL directly assessed by triaxial accelerometer and HR. We also observed that the correlation between some HRV indexes and the different indexes of physical activity directly evaluated was significant, but not very consistent. Thus, HRV indices are influenced by age and sex, regardless of accelerometer-based physical activity. Interventions with physical activity and exercise aimed at improving the autonomic modulation of asymptomatic adults should take such differences into account.


Assuntos
Fatores Etários , Doenças Cardiovasculares/fisiopatologia , Exercício/fisiologia , Frequência Cardíaca/fisiologia , Fatores Sexuais , Acelerometria , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
9.
Medicine (Baltimore) ; 98(33): e16863, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415420

RESUMO

Heart rate variability (HRV) is an objective measure of emotional regulation. This study aimed to estimate the accuracy with which an artificial neural network (ANN) algorithm could classify emotions using HRV data that were obtained using wristband heart rate monitors.Four emotions were evoked during gameplay: pleasure, happiness, fear, and anger. Seven normalized HRV features (i.e., 3 time-domain features, 3 frequency-domain features, and heart rate), which yielded 29,727 segments during gameplay, were collected and analyzed first by statistics and then classified by the trained ANN model.General linear model adjusted for individual differences in HRV showed that all HRV features significantly differed across emotions, despite disparities in their magnitudes and associations. When compared to neutral status (i.e., no emotion evoked), the mean of R-R interval was significantly higher for pleasure and fear but lower for happiness and anger. In addition, pleasure evidenced the HRV features that suggested a superior parasympathetic to sympathetic activation. Happiness was associated with a prominent sympathetic activation. These statistical findings suggest that HRV features significantly differ across emotions evoked by gameplay. When further utilizing ANN-based emotion classification, the accuracy rates for prediction were above 75.0% across the 4 emotions with accuracy rates for classification of paired emotions ranging from 82.0% to 93.4%.For classifying emotion in an individual person, the trained ANN model utilizing HRV features yielded a high accuracy rate in our study. ANN is a time-efficient and accurate means to classify emotions using HRV data obtained from wristband heart rate monitors. Thus, this integrated platform can help monitor and quantify human emotions and physiological biometrics.


Assuntos
Ira/fisiologia , Medo/fisiologia , Felicidade , Frequência Cardíaca/fisiologia , Redes Neurais (Computação) , Prazer/fisiologia , Adulto , Algoritmos , Humanos , Masculino , Smartphone , Jogos de Vídeo/psicologia , Dispositivos Eletrônicos Vestíveis , Adulto Jovem
10.
Adv Exp Med Biol ; 1155: 415-427, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31468419

RESUMO

Maternal dyslipidemia induces metabolic and cardiovascular disorders in adult offspring. This study tests the hypothesis that perinatal taurine supplementation prevents the adverse effects of maternal dyslipidemia on growth and cardiovascular function in adult rat offspring. Female Wistar rats were fed normal rat chow and water with (Dyslipidemia) or without dyslipidemia induction (Control) by intraperitoneal Triton WR-1339 injection, three times a week for 4 weeks. The female Control and Dyslipidemia rats were supplemented with (Control+T, Dyslipidemia+T) or without 3% taurine in water from conception to weaning. After weaning, male and female offspring were fed normal rat chow and water throughout the experiment. At 16 weeks of age, body weights significantly increased in male but not female Dyslipidemia compared to other groups, while visceral fat content significantly increased in both male and female Dyslipidemia groups. Further, both sexes displayed similar high fasting blood sugar and normal plasma leptin levels among the groups. While plasma total cholesterol and triglycerides significantly increased only in female Dyslipidemia, low-density lipoprotein cholesterol increased in both male and female Dyslipidemia groups. Mean arterial pressures and heart rates significantly increased, while baroreflex sensitivity decreased in male and female Dyslipidemia compared to all other groups. High-density lipoprotein cholesterol did not significantly different among male or female groups. These changes of the male and female Dyslipidemia group were ameliorated by perinatal taurine supplementation. The present study indicates that perinatal taurine supplementation prevents the adverse effects of maternal dyslipidemia on growth and cardiovascular function in both male and female, adult offspring.


Assuntos
Suplementos Nutricionais , Dislipidemias/fisiopatologia , Fenômenos Fisiológicos da Nutrição Materna , Taurina/farmacologia , Animais , Barorreflexo , Pressão Sanguínea , LDL-Colesterol/sangue , Feminino , Frequência Cardíaca , Lipídeos/sangue , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Ratos , Ratos Wistar
12.
J Sports Med Phys Fitness ; 59(8): 1281-1284, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31373188

RESUMO

BACKGROUND: The use of smartphone applications to monitor heart rate has become increasingly popular. However, there is limited research available on the validity of these applications. The purpose of this study was to examine the accuracy of a free heart rate monitoring application on two smartphone platforms while at rest and during moderate intensity exercise. One heart rate monitor application was chosen for two different technological platforms. METHODS: Twenty-four adults aged 18 and older (six males, 18 females) were randomly assigned a platform. Two groups were formed based on the platform being utilized. Both groups were monitored using an electrocardiograph (ECG) and the smart phone application. Heart rate for each participant was recorded while seated before exercise, and during moderate intensity exercise on an elliptical machine. Measurements were recorded in one-minute intervals. RESULTS: Data was analyzed using correlations and t-tests between platforms. All data was analyzed for both resting and exercise heart rate averages. There was no significant difference in heart rate while seated, t-test (-1.33; P=0.197) nor exercise heart rate, t-test (-1.54; P=0.142) when comparing means of the two platforms to an ECG. CONCLUSIONS: The applications chosen for both platforms to monitor heart rate were found to be fairly accurate, especially at rest. There are small user adaptations for monitoring heart rate, but heart rate applications provide a low-cost and efficient method for non-medical heart rate tracking. Future research should investigate the difference in accuracy for skin tone, ethnicity, race, hand size, and callosity of fingertips.


Assuntos
Frequência Cardíaca/fisiologia , Aplicativos Móveis/normas , Monitorização Fisiológica/instrumentação , Smartphone , Adulto , Eletrocardiografia , Exercício/fisiologia , Feminino , Humanos , Masculino , Adulto Jovem
13.
Stud Health Technol Inform ; 264: 55-59, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31437884

RESUMO

When dealing with electrocardiography (ECG) the main focus relies on the classification of the heart's electric activity and deep learning has been proving its value over the years classifying the heartbeats, exhibiting great performance when doing so. Following these assumptions, we propose a deep learning model based on a ResNet architecture with convolutional 1D layers to classify the beats into one of the 4 classes: normal, atrial premature contraction, premature ventricular contraction and others. Experimental results with MIT-BIH Arrhythmia Database confirmed that the model is able to perform well, obtaining an accuracy of 96% when using stochastic gradient descent (SGD) and 83% when using adaptive moment estimation (Adam), SGD also obtained F1-scores over 90% for the four classes proposed. A larger dataset was created and tested as unforeseen data for the trained model, proving that new tests should be done to improve the accuracy of it.


Assuntos
Eletrocardiografia , Processamento de Sinais Assistido por Computador , Algoritmos , Arritmias Cardíacas , Bases de Dados Factuais , Frequência Cardíaca , Humanos
14.
Stud Health Technol Inform ; 264: 1648-1649, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438274

RESUMO

The project SCARAB2 (Scalable, Robust and Adaptive on Board Ballistocardiography) aims to use Ballistocardiography (BCG) to monitor flight passengers. In order to show that recorded BCG data from flights give evaluable information even in the noisy environment of an airplane, we monitored a heart-healthy passenger using BCG. Furthermore, we show that there can be a conclusion to heart activities from the recorded ballistocardiogram by comparing the data to a concurrently recorded electrocardiogram (ECG).


Assuntos
Balistocardiografia , Aviação , Eletrocardiografia , Estudos de Viabilidade , Coração , Frequência Cardíaca
15.
Sheng Li Xue Bao ; 71(4): 505-513, 2019 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-31440747

RESUMO

Activation of peripheral respiratory chemoreceptors provokes respiratory and cardiovascular reflexes, providing a novel understanding of pathogenic mechanism of hypertension. Here we hypothesize that activation of peripheral respiratory chemoreceptors by hypoxia causes enhanced cardiorespiratory activity in conscious spontaneously hypertensive rats (SHRs). Using whole body plethysmography in combination with radio telemetry, pulmonary ventilation, arterial blood pressure and heart rate were examined in SHRs and Wistar-Kyoto (WKY) rats. We found that exposure to hypoxia induced greater increases in tidal volume and minute ventilation volume in SHRs compared to WKY rats. In addition, hypoxia caused a robust increase in arterial blood pressure and heart rate in SHRs relative to WKY counterparts. After carotid body denervation, the hypoxic ventilatory response was significantly decreased in both SHRs and WKY rats, but without significant difference between the two strains; moreover, the differences of arterial blood pressure and heart rate changes during hypoxic exposure were statistically insignificant between SHRs and WKY rats. It is concluded that hypoxia remarkably potentiates cardiorespiratory activity in the SHRs, suggesting an enhanced sensitivity of carotid bodies to hypoxia.


Assuntos
Pressão Sanguínea , Frequência Cardíaca , Hipertensão/fisiopatologia , Hipóxia/fisiopatologia , Animais , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY
16.
J Int Soc Sports Nutr ; 16(1): 33, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375128

RESUMO

BACKGROUND: Affective responses experienced during exercise are a significant determinant on exercise adherence. We have previously demonstrated that consumption of New Zealand (NZ) blackcurrants preserves cognition by attenuating the feeling of fatigue. This positive affective response correlated with the ability of blackcurrant polyphenols to support monoamine neurotransmission via inhibition of monoamine oxidase-B (MAO-B) activity. Here we explore how the consumption of a NZ blackcurrant juice (BJ) influenced affective responses and potential ergogenic action on the motivation to adhere to a low impact walking exercise. METHODS: In a parallel randomized controlled study (Trial registration #: ACTRN12617000319370p, registered 28th February 2017, http://www.anzctr.org.au/ ), 40 healthy sedentary male and female participants drank a BJ or matched placebo (PLA) (n = 20 per group), 1 h prior to a self-motivated treadmill walk, where heart rate and affective responses (exertion [ES] or feeling / mood [FS]) scores) were recorded at 3 or 5 min intervals. Blood glucose, lactate, malondialdehyde (MDA) and platelet MAO-B activity were measured pre- and post-exercise and comparisons were conducted using with Student's t-tests. Subjective data were analysed using 2-way ANOVA with appropriate post hoc tests. RESULTS: Consuming a BJ 1 h prior to exercise caused a 90% decline in platelet MAO-B activity. The exercise had no significant (p > 0.05) effect on blood lactate, glucose or plasma MDA levels. Assessment of affective responses over the first 60 mins (adjusting for participant drop-out) revealed a time-dependent ES increase in both groups, with ES reported by participants in the BJ group consistently lower than those in the PLA group (p < 0.05). FS declined in PLA and BJ groups over 60 mins, but an inverse relationship with ES was only observed within the PLA group (r2 = 0.99, p = 0.001). Whilst the average time walked by participants in the BJ group was 11 mins longer than the PLA group (p = 0.3), and 30% of the BJ group achieving > 10 km compared to only 10% for the PLA group (p = 0.28), statistical significance was not achieved. CONCLUSION: Our findings demonstrate that drinking a polyphenolic-rich NZ blackcurrant juice 1 h prior to exercise supports positive affective responses during a self-motivated exercise.


Assuntos
Afeto , Sucos de Frutas e Vegetais , Motivação , Caminhada , Adulto , Glicemia/análise , Plaquetas/enzimologia , Feminino , Frequência Cardíaca , Humanos , Ácido Láctico/sangue , Masculino , Malondialdeído/sangue , Monoaminoxidase/metabolismo , Nova Zelândia , Polifenóis/administração & dosagem , Ribes , Fenômenos Fisiológicos da Nutrição Esportiva , Fatores de Tempo
17.
Medicine (Baltimore) ; 98(32): e16642, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393361

RESUMO

RATIONALE: Tachycardia-induced cardiomyopathy (TIC) is defined as systolic and/or diastolic dysfunction of the left ventricle resulting from prolonged elevated heart rates, completely reversible upon control of the arrhythmia. Atrioventricular reentrant tachycardia (AVRT) is one of the most frequent causes of TIC. In its incessant form, it is unlikely to be controlled by pharmacological treatment, catheter ablation being the principal therapeutic option. The coexistence of left bundle branch block (LBBB) in patients with AVRT may cause difficulties in the early diagnosis and management of tachycardia because of the wide complex morphology, making it harder to localize the accessory pathway (AP). PATIENT CONCERNS: A 60-year-old woman, presented incessant episodes of palpitations and shortness of breath due to a LBBB tachycardia leading to hemodynamic instability. DIAGNOSIS: The patient had a wide QRS tachycardia, with LBBB morphology and a heart rate of 160/minute. Echocardiography showed global hypokinesia with 25% left ventricular ejection fraction (LVEF). Considering the patient's clinical picture, TIC was suspected. INTERVENTIONS: The electrophysiological study revealed a left lateral accessory pathway. Catheter ablation was successfully performed at the level of the lateral mitral ring. OUTCOMES: One week after the ablation the patient had no signs of heart failure and the LVEF normalized to 55%. During 6-months follow-up the patient presented no more episodes of tachycardia or heart failure and the LVEF remained normal. LESSONS: AVRT is rarely associated with intrinsic LBBB, being a potential cause of TIC. In these patients, it is unlikely to control the arrhythmia pharmacologically, catheter ablation being the best therapeutic option. The variation of QRS complex duration between LBBB pattern in SR and AVRT could be useful for early diagnosis of an ipsilateral AP on surface ECG.


Assuntos
Bloqueio de Ramo/cirurgia , Ablação por Cateter/métodos , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Bloqueio de Ramo/complicações , Bloqueio de Ramo/diagnóstico , Cardiomiopatias/diagnóstico , Cardiomiopatias/etiologia , Ecocardiografia , Eletrocardiografia , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Volume Sistólico , Taquicardia por Reentrada no Nó Atrioventricular/complicações
18.
Medicine (Baltimore) ; 98(34): e16938, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441885

RESUMO

We aimed to investigate heart rate recovery (HRR) in patients with transient ischemic attack (TIA) and the relationship between HRR and health-related quality of life (HRQOL).All available patients were enrolled during the enrollment period. A total of 120 patients with TIA and 120 healthy controls were included in this study. A treadmill stress test was performed to calculate the HRR. The HRR were calculated as follows: HRR 1, 2, 3, and 5 minutes = heart rate at peak during exercise - heart rate at 1, 2, 3, and 5 minutes at rest. All patients enrolled were asked to fill in the Short Form 36 Health Survey to calculate HRQOL.We found that the maximum heart rate of TIA patients was significantly higher than that of healthy controls (166 ±â€Š11 vs. 162 ±â€Š14 beats/min, P = .015). Similarly, maximum systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in TIA group compared with healthy control group (SBP: 172 ±â€Š15 vs. 165 ±â€Š14 mm Hg, P < .001; DBP: 102 ±â€Š12 vs. 93 ±â€Š16 mm Hg, P < .001). The HRR were significantly lower in TIA group compared with control group (TIA vs. controls, HRR1: 17 ±â€Š7 vs. 30 ±â€Š8 beats/min, HRR2: 32 ±â€Š11 vs. 49 ±â€Š9 beats/min, HRR3: 43 ±â€Š13 vs. 63 ±â€Š12 beats/min, HRR5: 54 ±â€Š16 vs. 73 ±â€Š15 beats/min, all P < .001). Multivariate analysis showed that older age (P = .03) and high BMI (P = .04) were risk factors associated with abnormal HRR in patients with TIA. With regard to HRQOL, we found that role limitations due to physical problems, general health, vitality, and role limitations due to emotional problems were significantly lower in patients with abnormal HRR compared with patients with normal HRR. Multivariate analysis showed that older age (P = .04) and abnormal HRR (P = .03) were predictors for poor HRQOL in TIA patients.HRR was impaired in patients with TIA. In addition, TIA patients with abnormal HRR suffered from a significantly poorer HRQOL. Hence, given the prognostic value of HRR, patients with TIA should be monitored to prevent cardiovascular events and to improve HRQOL.


Assuntos
Frequência Cardíaca/fisiologia , Ataque Isquêmico Transitório/fisiopatologia , Qualidade de Vida , Adulto , Fatores Etários , Pressão Sanguínea , Índice de Massa Corporal , Estudos de Casos e Controles , Eletrocardiografia , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica/fisiologia , Inquéritos e Questionários
19.
Heliyon ; 5(7): 1-8, Jul 2019.
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1006879

RESUMO

Objectives: Our aims were to evaluate HRV in pulmonary hypertension (WHO Group 1 and 4) compared to control subjects, and to assess whether the presence of sleep apnea in those with pulmonary hypertension would be deleterious and cause greater impairment in HRV. Methods: This retrospective case-control study analyzed electrocardiogram segments obtained from diagnostic polysomnography. Results: Forty-one pulmonary hypertension patients were compared to 41 age, sex and apnea-hypopnea index matched healthy controls. The pulmonary hypertension group had decreased high frequency, very low frequency, low frequency, and percentage of normal R-R intervals that differ by > 50 ms compared to control subjects. Moderate to severe right ventricle dysfunction on echocardiography was a predictor of lower high frequency in pulmonary hypertension patients. Conclusions: There were no differences in any HRV measures in pulmonary hypertension patients with or without sleep apnea. Impaired HRV was demonstrated in pulmonary hypertension patients however, the presence of sleep apnea did not appear to further reduce vagal modulation.


Assuntos
Síndromes da Apneia do Sono , Frequência Cardíaca , Hipertensão Pulmonar
20.
Zhonghua Shao Shang Za Zhi ; 35(6): 434-440, 2019 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-31280536

RESUMO

Objective: To explore the guiding significance of pulse contour cardiac output (PiCCO) monitoring technology in the treatment of fluid replacement during shock stage of extensive burn in clinic. Methods: Sixty-five patients with extensive burn hospitalized in our unit from January 2014 to December 2018, conforming to the inclusion criteria, were recruited to conduct a prospective controlled research. According to the order of admission, 35 odd-numbered patients and 30 even-numbered patients were enrolled in routine rehydration group (25 males and 10 females) and PiCCO monitoring rehydration group (21 males and 9 females) respectively, with the age of (48±9) and (44±8) years respectively. All patients of the two groups were rehydrated according to the rehydration formula of the Third Military Medical University during shock stage. The rehydration speed was adjusted in routine rehydration group according to the general indexes of shock such as central venous pressure, mean arterial pressure, heart rate, respiratory rate, urine volume, and clinical symptoms of patients. PiCCO monitoring was performed in patients of PiCCO monitoring rehydration group, and the global end-diastolic volume index combined with the other relevant indicators of PiCCO were used to guide rehydration on the basis of the monitoring indicators of routine rehydration group. The heart rates and positive fluid balance volumes at post injury hour (PIH) 8, 16, 24, 32, 40, 48, 56, 64, and 72, the diuretic dosage at PIH 48 and 72, the total fluid replacement volumes, urine volumes, blood lactic acid, platelet count, and hematocrit at PIH 24, 48, and 72, the length of intensive care unit (ICU) stay, and the incidence of complications and death within 28 days after injury were compared between patients in the two groups. Data were processed with analysis of variance for repeated measurement, t test, Bonferroni correction, Mann-Whitney U test, chi-square test, and Fisher's exact probability test. Results: The heart rates of patients in the two groups were similar at PIH 8, 16, 24, 32, 40, 48, and 56 (t=0.775, 1.388, 2.511, 2.203, 1.654, 2.303, 1.808, P>0.05), and the heart rates of patients in PiCCO monitoring rehydration group at PIH 64 and 72 were obviously lower than those of routine rehydration group (t=3.229, 3.357, P<0.05 or P<0.01). The positive fluid balance volumes of patients in the two groups were similar at PIH 8, 16, 40, and 56 (t=0.768, 1.670, 2.134, 2.791, P>0.05), and the positive fluid balance volumes of patients in PiCCO monitoring rehydration group at PIH 24, 32, 48, 64, and 72 were obviously less than those of routine rehydration group (t=3.364, 4.047, 2.930, 2.950, 2.976, P<0.05 or P<0.01). The amount of diuretics used by patients in the two groups was similar at PIH 48 and 72 (Z=-0.697, -1.239, P>0.05). The total fluid replacement volumes of patients in PiCCO monitoring rehydration group at PIH 24, 48, and 72 were (13 864±4 241), (9 532±2 272), and (8 480±2 180) mL, respectively, obviously more than those in routine rehydration group [(10 388±2 445), (8 095±1 720), and (7 059±1 297) mL, respectively, t=-3.970, -2.848, -3.137, P<0.05 or P<0.01]. The urine volumes of patients in the two groups at PIH 24 were close (t=-1.027, P>0.05). The urine volumes of patients in PiCCO monitoring rehydration group at PIH 48 and 72 were (3 051±702) and (3 202±624) mL respectively, obviously more than those in routine rehydration group [(2 401±588) and (2 582±624) mL respectively, t=-4.062, -4.001, P<0.01]. The levels of blood lactate acid of patients in PiCCO monitoring rehydration group at PIH 24, 48, and 72 were obviously lower than those in routine rehydration group (t=4.758, 6.101, 3.938, P<0.01). At PIH 24 and 48, the values of the platelet count of patients in PiCCO monitoring rehydration group were obviously higher than those in routine rehydration group (t=-2.853, -2.499, P<0.05), and the values of hematocrit of patients in PiCCO monitoring rehydration group were obviously lower than those in routine rehydration group (t=2.698, 4.167, P<0.05 or P<0.01). Both the platelet count and hematocrit of patients in the two groups were similar at PIH 72 (t=-1.363, 0.476, P>0.05). The length of ICU stay of patients in PiCCO monitoring rehydration group was obviously shorter than that of routine rehydration group (t=2.184, P<0.05). Within 28 days after injury, the incidence of complications of patients in routine rehydration group was obviously higher than that in PiCCO monitoring rehydration group (P<0.05), while the mortality rate of patients in routine rehydration group was similar to that in PiCCO monitoring rehydration group (P>0.05). Conclusions: The application of PiCCO monitoring technology in monitoring fluid replacement in patients with extensive burn can quickly correct shock, reduce the occurrence of organ complications caused by improper fluid replacement, and shorten the length of ICU stay, which is of great significance in guiding the treatment of burn shock.


Assuntos
Queimaduras/terapia , Débito Cardíaco/fisiologia , Hidratação , Frequência Cardíaca/fisiologia , Monitorização Fisiológica/métodos , Choque/terapia , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Estudos Prospectivos , Resultado do Tratamento
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