Physical exercise improves the functional capacity and quality of life in patients with heart failure

OBJECTIVE: The purpose of this study was to investigate the effects of physical exercise on the functional capacity and quality of life in heart failure patients. METHODS: Forty-two patients of both sexes with heart failure of NYHA class II and III with different etiologies were randomly divided into untrained or trained groups. The six-month exercise program consisted of aerobic training, muscle strength training, agility and joint flexibility activities. Physical fitness was evaluated by testing the performance on these trained components. Quality of life was evaluated by scored answers to a standardized questionnaire involving multiple domains. RESULTS: Baseline values did not differ between groups. Improvement in the trained group was identified in all components of functional capacity when compared to the untrained group (p < 0.001). Quality of life improved in the trained patients concerning physical, psychological, social and environmental domains (p < 0.001), whereas no significant change was found in the untrained patients. CONCLUSIONS: Guided and monitored physical exercise is safe and has the potential to improve functional capacity and quality of life in heart failure patients with multiple etiologies.Federal University of São Paulo Department of Medicine Division of Internal MedicineFederal University of São Paulo Department of Medicine Cardiology DivisionUNIFESP, Department of Medicine Division of Internal MedicineUNIFESP, Department of Medicine Cardiology DivisionSciEL

Repercussions of training and detraining by water-based exercise on functional fitness and quality of life: a short-term follow-up in healthy older women

OBJECTIVE: To evaluate the effects of short-term exercise detraining on the functional fitness of older women after a 12-week water-based exercise (WE) program. METHODS: Healthy older women (trained (TR) group) were submitted to 12 weeks WE (three 45 min sessions per week) followed by a 6-week detraining period. A group of aged-matched women without any exercise training (UN group) were evaluated during the same period. The aerobic power, measured by VO2max and 800 meters performance, and the neuromuscular fitness and quality of life were evaluated. All assessments were made at baseline, after 12 weeks of training and after 4 and 6 weeks of detraining. RESULTS: No changes were found for the UN group during the follow-up study, but WE induced significant improvement in aerobic capacity, neuromuscular fitness and quality of life score. However, the upper and lower body strength, agility, flexibility, and body balance returned to UN levels (p>0.05) after 6 weeks of detraining. CONCLUSIONS: The results confirmed that 12 weeks of WE improves the functional fitness parameters and quality of life of older women. However, after a short detraining period of 4-6 weeks, the neuromuscular parameters and the quality of life score returns to baseline or untrained subject levels.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)Nove de Julho UniversityArbos CollegeFederal University of Espírito SantoUNIFESP, EPMSciEL

Efeitos hemodinâmicos e termorregulatórios da mistura cetamina-xilasina persistem mesmo após o período anestésico em ratos

The xylazine-ketamine mixture (KX) is an anesthetic approach commonly administered to assess cardiovascular function in rodents. This study aimed to examine if the cardiovascular and thermoregulatory effects of KX could persist after the anesthetic state ceased in rats. Male Wistar rats were anesthetized with K (50mg/kg) X (10mg/kg) through the intra-peritoneal route. Hemodynamic and thermoregulatory repercussions were evaluated in animals in awake state, during an anesthetic depth and after complete recovery of anesthetized state. KX was efficient to significantly induce deep anesthesia in all rats after 10min. A complete recovery of anesthetized state was observed only after 210min. Compared with preanesthetic state and control animals that received no drug, KX induced a significant reduction of systolic and diastolic blood pressure at 10min. Hypotension was more prominent at 150min. The heart rate was also significantly reduced after 10 min of KX and the highest magnitude of bradycardia was observed at 30min. In addition, rectal temperature was markedly decreased at 30min of KX and the higher reduction occurred at 150min. The hemodynamic and thermoregulatory effects of KX were maintained even after complete anesthetic recovery.Objetivou-se com este estudo avaliar a persistência dos efeitos cardiovasculares e termorregulatórios da associação cetamina e xilasina (CX) mesmo após o período anestésico em ratos. Ratos Wistar machos foram anestesiados com cetamina 50mg/kg e xilasina 10mg/kg, por via intra-peritoneal. As repercussões hemodinâmica e termorregulatória foram avaliadas com os animais acordados, durante o período anestésico e após recuperação completa da anestesia. A CX foi eficiente em induzir significante regime anestésico em todos os ratos após 10min. A recuperação completa do estado de anestesia foi observada somente após 210min. Comparado com o estado pré-anestésico e com animais controles, que não receberam anestesia, a CX induziu significativa redução das pressões sistólica e diastólica aos 10min. A hipotensão foi mais evidente aos 150min após CX. A frequência cardíaca também foi significativamente reduzida com 10min de CX e a bradicardia foi mais acentuada aos 30min. A temperatura retal foi reduzida aos 30min, sendo mais acentuada após 150min de anestesia. Os efeitos hemodinâmicos e termorregulatórios da CX persistem mesmo após completa recuperação anestésica.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP)Universidade Nove de JulhoUniversidade Federal do Espírito SantoUNIFESPSciEL

Exercise Training Can Prevent Cardiac Hypertrophy Induced by Sympathetic Hyperactivity with Modulation of Kallikrein-Kinin Pathway and Angiogenesis

Sympathetic hyperactivity induces adverse effects in myocardial. Recent studies have shown that exercise training induces cardioprotection against sympathetic overload; however, relevant mechanisms of this issue remain unclear. We analyzed whether exercise can prevent pathological hypertrophy induced by sympathetic hyperactivity with modulation of the kallikrein-kinin and angiogenesis pathways. Male Wistar rats were assigned to non-trained group that received vehicle; non-trained isoproterenol treated group (Iso, 0.3 mg kg(-1) day(-1)); and trained group (Iso+Exe) which was subjected to sympathetic hyperactivity with isoproterenol. the Iso rats showed hypertrophy and myocardial dysfunction with reduced force development and relaxation of muscle. the isoproterenol induced severe fibrosis, apoptosis and reduced myocardial capillary. Interestingly, exercise blunted hypertrophy, myocardial dysfunction, fibrosis, apoptosis and capillary decreases. the sympathetic hyperactivity was associated with high abundance of ANF mRNA and beta-MHC mRNA, which was significantly attenuated by exercise. the tissue kallikrein was augmented in the Iso+Exe group, and kinin B-1 receptor mRNA was increased in the Iso group. Moreover, exercise induced an increase of kinin B-2 receptor mRNA in myocardial. the myocardial content of eNOS, VEGF, VEGF receptor 2, pAkt and Bcl-2 were increased in the Iso+Exe group. Likewise, increased expression of pro-apoptotic Bad in the Iso rats was prevented by prior exercise. Our results represent the first demonstration that exercise can modulate kallikrein-kinin and angiogenesis pathways in the myocardial on sympathetic hyperactivity. These findings suggest that kallikrein-kinin and angiogenesis may have a key role in protecting the heart.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)National Council for Scientific and TechnologicalUniv Nove Julho Uninove, Programa Posgrad Ciencias Reabilitacao, São Paulo, BrazilUniversidade Federal de São Paulo Unifesp, São Paulo, BrazilUniv São Paulo, São Paulo, BrazilUniv Nove Julho Uninove, Programa Posgrad Med, São Paulo, BrazilUniversidade Federal de São Paulo Unifesp, São Paulo, BrazilFAPESP: 2009/54225-8National Council for Scientific and Technological: 477458/2009-2National Council for Scientific and Technological: 479395/2012-8Web of Scienc

Effects and parameters of the photobiomodulation in experimental models of third-degree burn: systematic reviewanalysis / Efeitos e parâmetros da fotobiomodulação em modelos experimentais de queimadura de terceiro grau: revisão sistemática

This systematic review was performed to identify the role of photobiomodulation therapy in experimental models of third-degree burns used to induce oxidative stress. EMBASE, PubMed, and CINAHL databases were searched for studies published between January 2003 and January 2018 on the topics of photobiomodulation therapy and third-degree burns. Any study that assessed the effects of photobiomodulation therapy in animal models of third-degree burns was included in the analysis. A total of 17 studies were selected from 1182 original articles targeted on photobiomodulation therapy and third-degree burns. Two independent raters with a structured tool for rating the research quality critically assessed the articles. Although the small number of studies limits the conclusions, the current literature research indicates that photobiomodulation therapy can be an effective short-term approach to accelerate the healing process of third-degree burns, to increase and modulate the inflammatory process, to accelerate the proliferation of fibroblasts, and to enhance the quality of the collagen network. However, differences still exist in the terminology used to describe the parameters and the dose of photobiomodulation therapy

Amelioration of Cardiac Function and Activation of Anti-Inflammatory Vasoactive Peptides Expression in the Rat Myocardium by Low Level Laser Therapy

Low-level laser therapy (LLLT) has been used as an anti-inflammatory treatment in several disease conditions, even when inflammation is a secondary consequence, such as in myocardial infarction (MI). However, the mechanism by which LLLT is able to protect the remaining myocardium remains unclear. the present study tested the hypothesis that LLLT reduces inflammation after acute MI in female rats and ameliorates cardiac function. the potential participation of the Renin-Angiotensin System (RAS) and Kallikrein-Kinin System (KKS) vasoactive peptides was also evaluated. LLLT treatment effectively reduced MI size, attenuated the systolic dysfunction after MI, and decreased the myocardial mRNA expression of interleukin-1 beta and interleukin-6 in comparison to the non-irradiated rat tissue. in addition, LLLT treatment increased protein and mRNA levels of the Mas receptor, the mRNA expression of kinin B2 receptors and the circulating levels of plasma kallikrein compared to non-treated post-MI rats. On the other hand, the kinin B1 receptor mRNA expression decreased after LLLT. No significant changes were found in the expression of vascular endothelial growth factor (VEGF) in the myocardial remote area between laser-irradiated and non-irradiated post-MI rats. Capillaries density also remained similar between these two experimental groups. the mRNA expression of the inducible nitric oxide synthase (iNOS) was increased three days after MI, however, this effect was blunted by LLLT. Moreover, endothelial NOS mRNA content increased after LLLT. Plasma nitric oxide metabolites (NOx) concentration was increased three days after MI in non-treated rats and increased even further by LLLT treatment. Our data suggest that LLLT diminishes the acute inflammation in the myocardium, reduces infarct size and attenuates left ventricle dysfunction post-MI and increases vasoactive peptides expression and nitric oxide (NO) generation.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Univ Nove Julho, UNINOVE, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, São Paulo, BrazilUniv São Paulo, Heart Inst InCor, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, São Paulo, BrazilCNPq: 477458/2009-2CNPq: 309715/2011-3CNPq: 479395/2012-8: 2009/54225-8Web of Scienc

Does stroke volume increase during an incremental exercise? A systematic review

Introduction: Cardiac output increases during incremental-load exercise to meet metabolic skeletal muscle demand. This response requires a fast adjustment in heart rate and stroke volume. The heart rate is well known to increase linearly with exercise loadhowever, data for stroke volume during incremental-load exercise are unclear. Our objectives were to (a) review studies that have investigated stroke volume on incremental load exercise and (b) summarize the findings for stroke volume, primarily at maximal-exercise load. Methods: A comprehensive review of the Cochrane Library's, Embase, Medline, SportDiscus, PubMed, and Web of Sci-ence databases was carried out for the years 1985 to the present. The search was performed between February and June 2014 to find studies evaluating changes in stroke volume during incremental-load exercise. Controlled and uncontrolled trials were evaluated for a quality score. Results: The stroke volume data in maximal-exercise load are inconsistent. There is evidence to hypothesis that stroke volume increases during maximal-exercise load, but other lines of evidence indicate that stroke volume reaches a plateau under these circumstances, or even decreases. Conclusion: The stroke volume are unclear, include contradictory evidence. Additional studies with standardized reporting for subjects (e.g., age, gender, physical fitness, and body position), exercise test protocols, and left ventricular function are required to clarify the characteristics of stroke volume during incremental maximal-exercise load.National Council for Scientific [479395/2012-8]Universidade Federal de São Paulo, Laboratório de Fisiologia e Fisiopatologia Cardíaca, São Paulo, SP, BrazilUniversidade Nove de Julho, Programa de Pós-Graduação em Biofotônica Aplicada a Ciências da Saúde, São Paulo, SP, BrazilLaboratorio de Fisiologia Transacional dos Programas de Pos Graduacao em Educacao Fisica e Ciências do En-velhecimento, São Paulo, SP, BrasilUniversidade Nove de Julho, Programa de Pós-Graduação em Medicina, São Paulo, SP, BrazilUniversidade Federal do Mato Grosso, Programa de Mestrado em Educação Física, Cuiabá, MT, BrazilUniversidade Federal de São Paulo, Laboratório de Fisiologia e Fisiopatologia Cardíaca, São Paulo, SP, BrazilNational Council for Scientific: 479395/2012-8Web of Scienc

Prior exercise training and experimental myocardial infarction: A systematic review and meta-analysis

Exercising prior to experimental infarction may have beneficial effects on the heart. The objective of this study was to analyze studies on animals that had exercised prior to myocardial infarction and to examine any benefits through a systematic review and meta-analysis. The databases MEDLINE, Google Scholar, and Cochrane were consulted. We analyzed articles published between January 1978 and November 2018. From a total of 858 articles, 13 manuscripts were selected in this review. When animals exercised before experimental infarction, there was a reduction in mortality, a reduction in infarct size, improvements in cardiac function, and a better molecular balance between genes and proteins that exhibit cardiac protective effects. Analyzing heart weight/body weight, we observed the following results - Mean difference 95% CI - -0.02 [-0.61,0.57]. Metaanalysis of the infarct size (% of the left ventricle) revealed a statistically significant decrease in the size of the infarction in animals that exercised before myocardial infarction, in comparison with the sedentary animals -5.05 [-7.68, -2.40]. Analysis of the ejection fraction, measured by echo (%), revealed that animals that exercised before myocardial infarction exhibited higher and statistically significant measures, compared with sedentary animals 8.77 [3.87,13.66]. We conclude that exercise performed prior to experimental myocardial infarction confers cardiac benefits to animals

Nível de atividade física em professores da rede estadual de ensino

OBJECTIVE: To assess the level of physical activity in public school teachers. METHODS: Cross-sectional study conducted with 1,681 teachers from the city of São Paulo, southeastern Brazil, in 2009. The International Physical Activity Questionnaire short version was applied and the level of physical activity was categorized as low, moderate or high. The study sample was stratified by age, gender and area of the city (south and east). The chi-square test was used for comparisons at a 5% level of significance. RESULTS: The prevalence of low, moderate and high levels of physical activity was 46.3%, 42.7% and 11%, respectively. Low physical activity was more prevalent among those aged 31 to 42 years (19.5%) and less prevalent among those aged 55 to 66 (5.7%). Moderate and high levels of physical activity were less prevalent among older teachers. A greater proportion of teachers showed low and high levels of physical activity in the east compared to the south of the city (50.5% vs. 48.6%; 11.4% vs. 8.1%, respectively). The proportion of teachers reporting moderate physical activity was significantly lower in the east (38.1%) compared to the south of the city (43.3%). Low and high levels of physical activity were significantly higher in men than women (53% vs. 42.9%; 14.1% vs. 9.4%, respectively). The prevalence of moderate level of physical activity was significantly lower in men (32.9%) than women (47.7%). CONCLUSIONS: The prevalence of low physical activity was strikingly high. Variables such as age, gender and city area should be taken into account while planning and targeting campaigns aimed at promoting increased physical activity in this population.OBJETIVO: Evaluar el nivel de actividad física en profesores de la red pública estatal de educación. MÉTODOS: Estudio transversal conducido con 1.681 profesores de Sao Paulo, sureste de Brasil, en 2009. La versión corta del Cuestionario Internacional de Actividad Física fue aplicada y el nivel de actividad física de los profesores fue categorizado en bajo, moderado o alto. La muestra fue estratificada por edad, región de la ciudad y sexo. La prueba de chi-cuadrado fue aplicada en las comparaciones y el nivel de significancia adoptado fue de pOBJETIVO: Avaliar o nível de atividade física em professores da rede pública estadual de ensino. MÉTODOS: Estudo transversal conduzido com 1.681 professores de São Paulo, SP, em 2009. A versão curta do Questionário Internacional de Atividade Física foi aplicada e o nível de atividade física dos professores foi categorizado em baixo, moderado ou alto. A amostra foi estratificada por idade, região da cidade e sexo. O teste de qui-quadrado foi aplicado nas comparações e o nível de significância adotado foi de p < 0,05. RESULTADOS: A prevalência de nível baixo de atividade física foi de 46,3%, e os níveis moderado e alto representaram 42,7% e 11%, respectivamente. Níveis baixos de atividade física foram mais prevalentes em indivíduos de 31 a 42 anos (19,5%) e menor prevalência foi observada de 55 a 66 anos (5,7%). Níveis moderados e altos foram menos prevalentes em idade mais avançada. Mais professores apresentaram nível baixo (50,5%) e alto (11,4%) de atividade física na região leste em relação à sul (baixo: 48,6%; alto: 8.1%). O número de professores com nível moderado foi significativamente menor na região leste (38,1%) comparada à sul (43,3%). O número de homens com nível baixo (53%) e alto (14,1%) de atividade física foi significantemente maior que em mulheres (baixo: 42,9%; alto: 9,4%). A prevalência de homens com nível moderado (32,9%) foi significativamente menor em comparação às mulheres (47,7%). CONCLUSÕES: A prevalência de nível baixo de atividade física foi marcadamente elevada. Diferenças nas idades, regiões e sexos devem ser consideradas no planejamento e direcionamento de campanhas que visem promover aumento dos níveis de atividade física nessa população