Influência da obesidade no desempenho cognitivo e na resposta hemodinâmica ao teste de estresse mental / Influence of obesity on cognitive performance and hemodynamic response to mental stress test

O estudo da interação entre fatores sócio-ambientais com obesidade, tem sido uma estratégia para determinar os mecanismos dos fatores de risco para doenças cardiovasculares. Acreditamos que o aumento exacerbado da pressão arterial e da atividade simpática durante o estresse mental em adultos podem ser um mecanismo precoce importante. No entanto, a influência da presença de obesidade não está clara em resposta a esse estresse. Desta forma, o objetivo foi avaliar o impacto da obesidade na performance funcional cognitiva e no perfil hemodinâmico em resposta ao teste de estresse mental. Foi realizado um estudo clínico transversal com 80 sujeitos do sexo masculino e feminino divididos em 3 grupos: grupo eutrófico com idade de 18 a 33 anos (GE, n=37), grupo obeso com idade de 18 a 35 anos (GO1, n=29), e grupo obeso com idade de 36 a 55 anos (GO2, n=14). Todos os sujeitos assinaram o termo de consentimento livre esclarecido, sob parecer do CEP 2.696.993/18. A análise da composição corporal foi realizada através do índice de massa corporal (IMC), índice da relação circunferência cintura-quadril (RCQ), porcentagem da massa gorda (MG), massa magra (MM) e taxa metabólica basal (TMB) através da bioimpedância elétrica, e o nível de atividade física pelo questionário internacional de atividade física (IPAQ). O desempenho cognitivo foi avaliado pelo Stroop Color and Word Test e o perfil hemodinâmico através da aferição da pressão arterial (PA) pelo método auscultatório e a frequência cardíaca (FC) a partir de um oxímetro de pulso. Para análise dos dados foi utilizado o teste de Student Newman Keuls, teste de Correlação de Pearson com nível de significância de 5%. Como resultados, os grupos obesos apresentaram maior peso corporal, IMC, RCQ e massa gorda do que o grupo eutrófico, com aumento adicional no grupo GO2 em relação ao GO1. GO1 e GO2 apresentaram maior tempo para execução do teste de estresse mental (GO1: 27,88±7,66 seg.; GO2: 45,97±14,68 seg.) e prejuízo na função executiva específica (GO1: 1,58±0,67 seg- /desvio ; GO2: 2,63±1,62 seg- /desvio ) em relação ao grupo eutrófico (GE: 19,16±6,80 s seg- /desvio ; 1,14±0,46 seg- /desvio ). Nos parâmetros hemodinâmicos, os grupos obesos apresentaram maiores valores de PAS (GO1: 119±11,3 mmHg; GO2: 132±16,0 mmHg) e PAD (GO1: 75±9,3 mmHg; GO2: 85±7,6 mmHg) em relação ao grupo eutrófico (GE PAS: 105±12,4 mmHg; PAD: 66±9,9 mmHg). Os resultados evidenciam que o Stroop Color and Word Test é um instrumento eficaz de indução à reatividade cardiovascular e da avaliação de função executiva específica em indivíduos eutróficos e obesos sedentários.

Role of Training and Detraining on Inflammatory and Metabolic Profile in Infarcted Rats: Influences of Cardiovascular Autonomic Nervous System

The aim of this study was to evaluate the effects of exercise training (ET, 50-70% of VO2max, 5 days/week) and detraining (DT) on inflammatory and metabolic profile after myocardial infarction (MI) in rats. Male Wistar rats were divided into control (C, n = 8), sedentary infarcted (SI, n = 9), trained infarcted (TI, n = 10; 3 months of ET), and detrained infarcted (DI, n = 11; 2 months of ET + 1 month of DT). After ET and DT protocols, ventricular function and inflammation, cardiovascular autonomic modulation (spectral analysis), and adipose tissue inflammation and lipolytic pathway were evaluated. ET after MI improved cardiac and vascular autonomic modulation, and these benefits were correlated with reduced inflammatory cytokines on the heart and adipose tissue. These positive changes were sustained even after 1 month of detraining. No expressive changes were observed in oxidative stress and lipolytic pathway in experimental groups. in conclusion, our results strongly suggest that the autonomic improvement promoted by ET, and maintained even after the detraining period, was associated with reduced inflammatory profile in the left ventricle and adipose tissue of rats subjected to MI. These data encourage enhancing cardiovascular autonomic function as a therapeutic strategy for the treatment of inflammatory process triggered by MI.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)Sao Judas Tadeu Univ USJT, Human Movement Lab, BR-03166000 São Paulo, BrazilFed Univ São Paulo UNIFESP, Nutr Physiol Discipline, Dept Physiol, BR-04021001 São Paulo, BrazilUniv Extremo Catarinense UNESC, Lab Exercise Physiol & Biochem, BR-88806000 Criciuma, SC, BrazilUniv São Paulo, Sch Med, Heart Inst InCor, Hypertens Unit, BR-05403900 São Paulo, BrazilUniv São Paulo State UNESP, Dept Phys Educ, Immunometab Res Grp, BR-19060900 Presidente Prudente, SP, BrazilFed Univ São Paulo UNIFESP, Nutr Physiol Discipline, Dept Physiol, BR-04021001 São Paulo, BrazilFAPESP: 2013/14788-9FAPESP: 07/58942-0CNPq: CNPq: 563961/2010-4CNPq: 479076/2012-0CNPq: 457581/2013-1CAPES: CAPES: 074/2012CAPES: 095/2010Web of Scienc

Obesity as an additional factor for autonomic imbalance and poor sleep behavior in chronic obstructive pulmonary disease: a case-control study

OBJECTIVES: We compared the autonomic modulation and sleep behavior of eutrophic and overweight patients with chronic obstructive pulmonary disease (COPD). METHODS: COPD participants were divided into the overweight and eutrophic groups. Pulmonary function, blood pressure, body composition, autonomic modulation, and the Pittsburgh Sleep Quality Index score were assessed. Participants performed the six-minute walk test for functional assessment. RESULTS: Spirometric variables obtained in eutrophic and overweight individuals with COPD showed no statistically different results. We observed that the SDNN index indicated lower overall variability (p=0.003), and root mean square of successive differences between normal heart beats (RMSSD) (p=0.04) indicated lower parasympathetic modulation in the overweight group than observed in the eutrophic group. The indexes of the frequency domain presented lower values of total variability (po0.01), low frequency bands (po0.01), and high frequency (p=0.02), suggesting a higher sympathetic modulation and reduced parasympathetic modulation of the overweight group compared to eutrophic group. The overweight group also showed reduced sleep quality than the eutrophic group. CONCLUSION: Overweight COPD patients showed lower autonomic modulation and impaired sleep quality, latency, and efficiency as compared eutrophic subjects. These results reinforce the importance of weight control and the acquisition of healthy habits in this population

Combined Aerobic and Resistance Exercises Evokes Longer Reductions on Ambulatory Blood Pressure in Resistant Hypertension: A Randomized Crossover Trial

Aim. The present study compared the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure (BP) levels in people with resistant hypertension (RH) and nonresistant hypertension (NON-RH). Methods. Twenty patients (10 RH and 10 NON-RH) were recruited and randomly performed three exercise sessions and a control session. Ambulatory BP was monitored over 24 hours after each experimental session. Results. Significant reductions on ambulatory BP were found in people with RH after AER, RES, and COM sessions. Notably, ambulatory BP was reduced during awake-time and night-time periods after COM. On the other hand, the effects of AER were more prominent during awake periods, while RES caused greater reductions during the night-time period. In NON-RH, only RES acutely reduced systolic BP, while diastolic BP was reduced after all exercise sessions. However, the longest postexercise ambulatory hypotension was observed after AER (~11 h) in comparison to RES (~8 h) and COM (~4 h) exercises. Conclusion. Findings of the present study indicate that AER, RES, and COM exercises elicit systolic and diastolic postexercise ambulatory hypotension in RH patients. Notably, longer hypotension periods were observed after COM exercise. In addition, NON-RH and RH people showed different changes on BP after exercise sessions, suggesting that postexercise hypotension is influenced by the pathophysiological bases of hypertension

Diabetic hyperglycemia attenuates sympathetic dysfunction and oxidative stress after myocardial infarction in rats

Background: Previous research has demonstrated that hyperglycemia may protect the heart against ischemic injury. The aim of the present study was to investigate the association between hyperglycemia and myocardial infarction on cardiovascular autonomic modulation and cardiac oxidative stress profile in rats. Male Wistar rats were divided into: control (C), diabetic (D), myocardial infarcted (MI) and diabetic infarcted rats (DMI). Methods: Diabetes was induced by streptozotocin (STZ, 50 mg/Kg) at the beginning of the protocol and MI was induced by left coronary occlusion 15 days after STZ. Thirty days after streptozocin-induced diabetes, cardiovascular autonomic modulation was evaluated by spectral analysis, and oxidative stress profile was determined by antioxidant enzyme activities and superoxide anion, together with protein carbonylation and redox balance of glutathione (GSH/GSSG). Results: The diabetic and infarcted groups showed decreased heart rate variability and vagal modulation (p < 0.05); however, sympathetic modulation decreased only in diabetic groups (p < 0.05). Sympatho/vagal balance and vascular sympathetic modulation were increased only in the MI group (p < 0.05). Diabetes promoted an increase in catalase concentration (p < 0.05). Glutathione peroxidase activity was increased only in DMI when compared to the other groups (p < 0.05). Superoxide anion and protein carbonylation were increased only in MI group (p < 0.05). Cardiac redox balance, as evaluated by GSH/GSSG, was lower in the MI group (p < 0.05). Conclusions: These data suggest that hyperglycemia promotes compensatory mechanisms that may offer protection against ischemia, as demonstrated by increased antioxidants, decreased pro-oxidants and protein damage, possibly related to the improvements in both redox balance and sympathetic modulation to the heart