Birth Weight and Its Relationship with the Cardiac Autonomic Balance in Healthy Children

Several studies indicate that the fetal environment plays a significant role in the development of cardiometabolic disease later in life. However, a few studies present conflicting data about the correlation between birth weight and the impairment of cardiac autonomic modulation. The purpose of the present study was to provide further knowledge to elucidate this contradictory relationship. One hundred children aged 5 and 14 years had anthropometric parameters, body composition and blood pressure levels determined. Heart rate variability (HRV) was evaluated by heart rate monitoring, including measurements of both the time and frequency domains. The results showed inverse correlation between the HRV parameters with BMI (RMSSD: P = 0.047; PNN50: P = 0.021; HF: P = 0.041), systolic (RMSSD: P = 0.023; PNN50: P = 0.032) and diastolic (PNN50: P = 0.030) blood pressure levels. On the other hand, there were consistent positive correlations between the HRV parameters and birth weight (RMSSD: P = 0.001; PNN50: P = 0.001; HF: P = 0.002). To determine the effect of birth weight on HRV parameters, we perform multivariate linear regression analysis adjusted for potentially confounding factors (prematurity, gender, age, BMI, physical activity index and SBP levels). These findings were preserved even after adjusting for these confounders. Our results suggested that impaired cardiac autonomic modulation characterized by a reduction in the parasympathetic activity occurs in children with low birth weight. One possible interpretation for these data is that a vagal withdrawal, rather than a sympathetic overactivity, could precede the development of hypertension and other cardiometabolic diseases in children with low birth weight. However, long-term studies should be performed to investigate this possibility.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Fed Sao Paulo, Div Nephrol, Sao Paulo, BrazilUniv Fed Alagoas, Dept Nutr, Alagoas, BrazilUniv Fed Sao Paulo, Dept Pediat, Sao Paulo, BrazilUniv Fed Sao Paulo, Div Nephrol, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Pediat, Sao Paulo, BrazilFAPESP: 2013/03139-0Web of Scienc

Serum endocan levels associated with hypertension and loss of renal function in pediatric patients after two years from renal transplant

Endocan is an important biomarker of inflammation and endothelial dysfunction that increases in association with several chronic diseases. Few published data have described the role of endocan in pediatric renal transplant (RT) patients. We evaluated the endocan concentrations in 62 children who underwent renal transplantation and assessed their relationships with the patients' blood pressure and loss of renal function. The endocan levels were significantly elevated in the pediatric RT patients who had hypertension and a loss of renal function. We determined positive correlations between the endocan concentrations and the hemodynamic variables (systolic blood pressure: r = 0.416P = 0.001pulse pressure: r = 0.412P = 0.003). The endocan levels were inversely correlated with the estimated glomerular filtration rate (r = -0.388P = 0.003). An endocan cutoff concentration of 7.0 ng/mL identified pediatric RT patients who had hypertension and a loss of renal function with 100% sensitivity and 75% specificity. In conclusion, the endocan concentrations were significantly elevated in pediatric RT patients who had both hypertension and a loss of renal function. The correlations between the endocan levels and the hemodynamic variables and the markers of renal function strengthen the hypothesis that it is an important marker of cardiorenal risk.FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo, Brazil) [2013/03139-0]CNPq (Conselho-Nacional de Desenvolvimento Cientifico e Tecnologico) [443248/2014-1]Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, SP, BrazilPediatrics Department, School of Medicine, Federal University of São Paulo, São Paulo, SP, BrazilNephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, SP, BrazilPediatrics Department, School of Medicine, Federal University of São Paulo, São Paulo, SP, BrazilFAPESP: 2013/03139-0CNPq: 443248/2014-1Web of Scienc

Disfunçâo vasodilatadora durante o exercício físico em indivíduos saudáveis com histórico familiar de doença renal crônica

INTRODUCTION: Individuals with positive family history of chronic kidney disease (CKD+FH) present hemodynamic changes that directly influence the emergence and development of this disease. However it is unclear whether there is impairment of vasodilatation in CKD+FH individuals during the exercise. OBJECTIVES: To test the hypothesis that healthy subjects with CKD+FH have diminished muscle vasodilatation during exercise. METHODS: We study nine healthy subjects with CKD+FH and 17 healthy individuals without family history of chronic disease (CKD-FH) matched for age (27±2 vs. 26±1 years, p=0,67, respective). Blood pressure (oscilometric - DIXTAL® 2023) heart rate (DIXTAL® 2023) and forearm blood flow (venous occlusion pletysmography - Hokanson®) were measured for 3 minutesbaseline followed by 3 minutes isometric handgrip exercise 30% of maximum voluntary contration. Vasodilatation muscle was calculated by dividing the forearm blood flow by the blood pressure mean multiplied by 100. Serum creatinina was measure to estimate glomerular filtration rate. Was applied ANOVA two-way followed by post hoc Tukey, adopting p<0,05. The results are expressed as mean ± SE. RESULTS: Serum creatinina (p=0,74), the estimate glomerular filtration rate (p=0,90), systolic blood pressure (p=0,11), diastolic blood pressure (p=0,82), mean blood pressure (p=0,44) and heart rate (p=0,86) were similar between groups. And all the volunteers showed no proteinuria and hematuria. At baselina forearm blood flow was similar between the groups CKD+FH and CKD-FH (2,51±0,37 vs. 2,85±0,18 mL/min/100mL, p=0,06), but increased significantly during exercise only in CKD-FH group (p=0,03). At baseline, muscle vasodilatation was similar between groups (2,85±0,37 vs. 3,41±0,21 units, respectively, p=0,78). During exercise the CKD+FH group showed no significant changes during the first, second and third minute of exercise in relation to baseline (3,19±0,54, 2,91±0,30 e 2,45±0,24 units, respectively). However we observed a significant increased in muscle vasodilatation in relation to physical exercise in CKF-FH group (4,06±0,36, 4,30±0,34 e 4,55±0,48 units, respectively). CONCLUSION: In healthy subjects with positive family history of chronic kidney disease have vasodilator dysfunction during exercise.INTRODUÇÃO: Indivíduos com histórico familiar positivo para doença renal crônica (HF+DRC) apresentam alterações hemodinâmicas que influenciam diretamente no surgimento e desenvolvimento dessa doença. Porém, ainda não está claro se há prejuízo na vasodilatação em indivíduos HF+DRC, durante o exercício físico. OBJETIVOS: Testar a hipótese de que indivíduos saudáveis com HF+DRC apresentam vasodilatação muscular diminuída durante o exercício físico. MÉTODOS: Foram avaliados 9 indivíduos saudáveis com HF+DRC e 17 indivíduos saudáveis sem histórico familiar para doença renal crônica (Grupo HF-DRC), pareados por idade (27±2 vs. 26±1 anos, p=0,67, respectivamente). A pressão arterial (oscilométrico - DIXTAL® 2023), a frequência cardíaca (DIXTAL® 2023) e o fluxo sanguíneo do antebraço (pletismografia de oclusão venosa - Hokanson®) foram aferidos durante 3 minutos basais seguidos de 3 minutos de exercício físico isométrico de preensão de mão a 30% da contração voluntária máxima. A vasodilatação muscular foi calculada pela divisão do fluxo sanguíneo do antebraço pela pressão arterial média, multiplicada por 100. A creatinina sérica foi medida para estimativa da taxa de filtração glomerular. Foi aplicada ANOVA two-way seguida pelo post hoc de Tukey, adotando significativo p<0,05. Os resultados são expressos como média±EP. RESULTADOS: A Creatinina sérica (p=0,74), a taxa de filtração glomerular estimada (p=0,90), a pressão arterial sistólica (p=0,11), diastólica (p=0,82), média (p=0,44) e a frequência cardíaca (p=0,86) foram semelhantes entre os grupos. E, todos os voluntários apresentaram ausência de proteinúria e hematúria. No basal, o fluxo sanguíneo do antebraço foi semelhante entre os grupos HF+DRC e HF-DRC (2,51±0,37 vs. 2,85±0,18 mL/min/100mL, p=0,06), porém aumentou significativamente durante o exercício físico apenas no grupo HF-DRC (p=0,03). No basal, a vasodilatação muscular foi semelhante entre os grupos (2,85±0,37 vs. 3,41±0,21 unidades, respectivamente, p=0,78). Durante o exercício físico o grupo HF+DRC não apresentou mudanças significativas durante o primeiro, segundo e terceiro minutos de exercício físico em relação ao basal (3,19±0,54, 2,91±0,30 e 2,45±0,24 unidades, respectivamente). Porém, foi observado aumento significativo da vasodilatação muscular em relação ao exercício físico no grupo HF-DRC (4,06±0,36, 4,30±0,34 e 4,55±0,48 unidades, respectivamente). CONCLUSÃO: Indivíduos saudáveis com histórico familiar positivo para DRC apresentam disfunção vasodilatadora durante o exercício físico.FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerai

Efeitos Cardiovasculares Do Exercício Físico Na Infância: O Estabelecimento Do Papel Das Células Progenitoras Endoteliais

Cardiovascular diseases (CVD) are the leading causes of death in the world. Characterized by morphofunctional changes in the arteries defined by changes in the stiffness, thickness and decrease of the lumen of the vessel, as well as the atherosclerotic process and the formation of the atheroma plaque that give rise to adverse cardiac events. In addition, it is clear in the literature that the atherosclerotic process is a result of natural aging. What's more, the key to these cardiovascular changes that occur from birth to death of the individual is endothelial function. In this sense, some recent studies in the literature have shown that the development of cardiovascular diseases begins in the childhood period as a result of the natural development of the individual associated with endogenous and exogenous factors. It is therefore important to develop strategies to prevent CVD during childhood. Considering that it is important that physical exercise is a playful and functional practice for children, it is important to evaluate whether recreational physical exercise is capable of promoting the benefits observed in response to physical training. Thus, the present study evaluated the effects of 10 weeks of recreational physical exercise in healthy children on the number of circulating endothelial progenitor cells. For that, 74 children were evaluated. Anthropometric assessments of physical abilities and biomarkers of endothelial function (VEGF-A, NO, MMP-9 and MMP-2) were performed. In addition, we evaluated endothelial progenitor cells (EPCs) by flow cytometry (triple labeling, CD34 / CD133 / CD309 and CD34 / CD133 / CD45) and cell culture (colony forming units). After 10 weeks of recreational physical exercise, there was a significant reduction of body weight, increase of lean mass, muscle strength and flexibility. Endothelial biomarkers VEGF-A, NO, MMP-9 showed a significant increase. Regarding CPEs, a significant increase in number and efficiency was observed. Therefore, with the data obtained in the present study we can conclude that recreational physical exercise was able to increase the number of CPEs, in addition to improving metabolic, anthropometric and physical fitness parameters and, consequently, to reduce cardiovascular risks in healthy children.As doenças cardiovasculares (DCV) são as maiores causas de morte no mundo. Caracterizadas por alterações morfofuncionais nas artérias definidas por alterações na rigidez, espessura e diminuição do lúmen do vaso, bem como o processo aterosclerótico e a formação da placa de ateroma que dão origem aos eventos cardíacos adversos. Além disso, está claro na literatura que o processo aterosclerótico é resultado do envelhecimento natural. E mais, a chave para a essas alterações cardiovasculares que ocorrem desde o nascimento até a morte do indivíduo é a função endotelial. Nesse sentido, alguns estudos recentes na literatura têm mostrado que o desenvolvimento das doenças cardiovasculares se inicia no período da infância como resultado do desenvolvimento natural do indivíduo associado a fatores endógenos e exógenos. Portanto, torna-se importante elaborar estratégias de prevenção das DCV durante a infância. Considerando que é importante que o exercício físico seja uma prática lúdica e funcional para as crianças, é importante avaliar se o exercício físico recreativo é capaz de promover os benefícios observados em resposta ao treinamento físico. Dessa forma, o presente estudo avaliou os efeitos de 10 semanas de exercícios físico recreativo em crianças saudáveis sobre o número de células progenitoras endoteliais circulantes. Para tanto, foram avaliadas 74 crianças. Foram realizadas avaliações antropométricas, das capacidades físicas e avaliações de biomarcadores de função endotelial (VEGF-A, NO, MMP-9 e MMP-2). Além disso, avaliamos as células progenitoras endoteliais (CPEs) por meio de citometria de fluxo (triplas marcações, CD34/CD133/CD309 e CD34/CD133/CD45) e cultura de células (unidades formadoras de colônias). Após 10 semanas de exercício físico recreativo, houve redução significativa do peso corporal, aumento da massa magra, da força muscular e da flexibilidade. Os biomarcadores endoteliais VEGF-A, NO, MMP-9 apresentaram aumento significativo. Em relação às CPEs foi observado aumento significativo no número e eficiência. Portanto, com os dados obtidos no presente estudo podemos concluir que o exercício físico recreativo foi capaz de aumentar o número de CPEs, além de melhorar, os parâmetros metabólicos, antropométricos e de aptidão física e, consequentemente reduzir os riscos cardiovasculares em crianças saudáveis.Dados abertos - Sucupira - Teses e dissertações (2017

Scatter plots showing the correlation between birth weight with parameters of the time domain: (A) RMSSD and (B) PNN50.

<p>The lines represent the weighted regression with its 95% confidence interval.</p

General Characteristics and Linear Index Values of Heart Rate Variability (Time and Frequency Domain) in the Study Population (n = 100).

<p>General Characteristics and Linear Index Values of Heart Rate Variability (Time and Frequency Domain) in the Study Population (n = 100).</p

Scatter plots showing the correlation between birth weight with systolic (A) and diastolic (B) blood pressure levels.

<p>The lines represent the weighted regression with its 95% confidence interval.</p