Navegando por Palavras-chave "Autonomic dysfunction"
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- ItemSomente MetadadadosAutonomic dysregulation in ob/ob mice is improved by inhibition of angiotensin-converting enzyme(Springer, 2010-04-01) Hilzendeger, Aline Mourão [UNIFESP]; Costa Goncalves, Andrey C. da; Plehm, Ralph; Diedrich, Andre; Gross, Volkmar; Pesquero, Joao B. [UNIFESP]; Bader, Michael; Max Delbruck Ctr Mol Med; Universidade Federal de São Paulo (UNIFESP); Vanderbilt UnivThe leptin-deficient ob/ob mice are insulin resistant and obese. However, the control of blood pressure in this model is not well defined. the goal of this study was to evaluate the role of leptin and of the renin-angiotensin system in the cardiovascular abnormalities observed in obesity using a model lacking leptin. To this purpose, we measured blood pressure in ob/ob and control animals by radiotelemetry combined with fast Fourier transformation before and after both leptin and enalapril treatment. Autonomic function was assessed pharmacologically. Blood pressure during daytime was slightly higher in the ob/ob compared to control mice, while no difference in heart rate was observed. Blood pressure response to trimetaphane and heart rate response to metoprolol were greater in ob/ob mice than in control littermates indicating an activated sympathetic nervous system. Heart rate response to atropine was attenuated. Baroreflex sensitivity and heart rate variability were blunted in ob/ob mice, while low frequency of systolic blood pressure variability was found increased. Chronic leptin replacement reduced blood pressure and reversed the impaired autonomic function observed in ob/ob mice. Inhibition of angiotensin-converting enzyme by enalapril treatment had similar effects, prior to the loss of weight. These findings suggest that the renin-angiotensin system is involved in the autonomic dysfunction caused by the lack of leptin in ob/ob mice and support a role of this interplay in the pathogenesis of obesity, hypertension, and metabolic syndrome.
- ItemAcesso aberto (Open Access)Disfunção autonômica e incapacidade física em portadores de cirrose hepática: relevância clínica e impacto prognóstico(Universidade Federal de São Paulo (UNIFESP), 2016-01-27) Mota, Carolina Frade Magalhães Girardin Pimentel [UNIFESP]; Kondo, Mario [UNIFESP]; http://lattes.cnpq.br/3029048791689789; http://lattes.cnpq.br/3331384826336719; Universidade Federal de São Paulo (UNIFESP)For several decades, the association between cardiac dysfunction and liver diseases has been known; however, the understanding about clinical impact in disease prognosis in not well described in literature. The high prevalence of autonomic dysfunction and physical impairment in cirrhotic patients may suggest new prognostic factor related to hepatic decompensation and mortality. Aim: We evaluated the prevalence of high risk heart rate variability (HRV) parameters in a cohort of cirrhotic patients and its association with cardiac dysfunction and mortality. Also, we analyzed six-minute-walking test (6MWT) performance in patients with liver cirrhosis to determine if it predicts hospital admission and mortality. Methods: We evaluated 120 patients, 17 healthy controls and 106 cirrhotic outpatients. All patients had electrocardiogram, echocardiogram, 24-hours Holter monitoring and 6MWT. In addition, corrected QT interval (QTc) was computed, and considered prolonged if >440ms. HRV analysis was based on time domain (SDNN, SDANN, rMSSD) and frequency domain (total, high and low frequency power) parameters. The distance in meters was recorded at the end of 6 minutes (6MWD). Results: Mean age was 51 + 13 years, 55% male and 69,7% related to non-alcoholic etiologies of liver cirrhosis; Child stages were distributed as A (21.1.0%), B (66.0%) and C (12.3%). Alcohol consumption was unrelated to any of parameters studied. HRV parameters were statistically lower in cirrhotic patients than in healthy subjects. High risk HRV parameters were prevalent in this cohort, with 64% of the cohort having at least one high-risk parameter. SDNN and SDANN correlated with Child scores, with statistically significantly lower means with increasing Child stages. In regression models, HRV parameters were independent predictors of diastolic dysfunction (LF/HF and SDNN) and mortality (SDNN<104ms). During 10 months follow-up, there were 11 deaths, all in patients with at least one high-risk HRV parameter. Kaplan Meier survival analysis estimates low survival rates in patients with SDNN<104 (log-rank, p=0.021). 6MWT parameters were inversely correlated with Child scores and shorter means were reported in patients with advanced liver disease, hepatic decompensation or who died during follow-up. 6MWD were considered independent predictor of hospital admission and mortality on multivariate logistic regression, irrespectively of Child scores. Kaplan Meier analysis demonstrated that patients who walked shorter than 444m or 387m presented higher hospital admissions and mortality, respectively. Conclusions: Autonomic dysfunction, as measured by reduced HRV is prevalent in liver cirrhosis and related to cardiac dysfunction, severity of liver disease and mortality. 6MWT is a very simple, inexpensive, secure, and noninvasive test whose result is related to Child scores.
- ItemEmbargoEfeitos do tratamento com a galantamina na prole de genitores submetidos a sobrecarga de frutose: papel do reflexo colinérgico anti-inflamatório(Universidade Federal de São Paulo, 2024-06-27) Miranda, Victor Hugo Martins de [Unifesp]; De Angelis, Kátia [Unifesp]; http://lattes.cnpq.br/4299344810509965; http://lattes.cnpq.br/0549849491760079Objetivo: Investigamos os efeitos neuroimunes, cardiometabólicos e autonômicos do tratamento com a galantamina (GAL) na prole de genitores de ratos submetidos ao consumo crônico de frutose, bem como a participação do reflexo colinérgico anti-inflamatório, por meio da desnervação dos nervos esplênico e colinérgicos, nessa condição. Métodos: Foram utilizados ratos Wistar (genitores) que foram submetidos à sobrecarga de frutose na água de beber (10%) ou ao consumo de água por 60 dias. Em seguida, os genitores foram alocados em caixas para propiciar o acasalamento. A sobrecarga de frutose para as fêmeas foi mantida até o final da lactação. Aos 21 dias de vida (final da lactação) a prole dos genitores (n=40), foi separada em 4 grupos (5 machos e 5 fêmeas por grupo): controle (C), frutose (F), frutose tratado com GAL (GAL) e frutose desnervado tratado com a GAL (D+GAL) (5mg/Kg/ v.o.). Tais grupos, receberam ração padrão e água ad libitum, e foram avaliados e comparados após 30 dias (4 semanas) do desmame quanto a parâmetros metabólicos, hemodinâmicos, neuroimunes (autonômicos e inflamatórios) e de estresse oxidativo. Resultados: O grupo F apresentou redução da constante de decaimento da glicose plasmática (KITT) e aumento da pressão arterial média (PAM) e da frequência cardíaca (FC) (vs. C). Já o grupo GAL teve redução do KITT e da PAM (vs. F e D+GAL) e FC (vs. F). O grupo D+GAL apresentou aumento do KITT, PAM e FC (vs. C). Na modulação autonômica, o grupo F teve redução da variância do intervalo de pulso (Var-IP) e da banda de alta frequência normalizado (HF-IP (nu)), e aumento da banda de baixa frequência normalizado (LF-IP (nu)) e do balanço simpato vagal (LF/HF) cardíacos (vs. C). Os grupos GAL e D+GAL apresentaram aumento do RMSSD, da banda de alta frequência normalizada (HF-IP (nu)) e diminuição do LF-IP (nu) e do LF/HF (vs. F). O grupo F teve aumento (vs. C) na variância e na banda de baixa frequência da pressão arterial sistólica (LF-PAS), enquanto o grupo GAL apresentou diminuição nesses índices. Já o grupo D+GAL manteve o aumento da variância da PAS e do LF-PAS (vs. C). Na sensibilidade do barorreflexo o grupo F apresentou diminuição das respostas bradicárdica e taquicárdica (vs. C). O grupo GAL apresentou aumento das respostas bradicárdica (vs. F) e taquicárdica (vs. F e D+ GAL) . No baço somente os grupos F e D+GAL apresentaram aumento de TNF- α (vs.xC). No entanto, no coração o grupo F teve aumento de TNF-α e da NADPH oxidase e redução da FRAP e da atividade da CAT (vs. C), o que não foi observado nos grupos GAL e D+GAL. Não houve diferença entre os grupos para dano oxidativo avaliado por lipoperoxidação e oxidação de proteínas no coração e no baço. Conclusão: A prole de ratos submetidos ao consumo exacerbado de frutose apresentou, antes da maturação sexual, disfunções cardiometabólicas acompanhadas de alterações neuroimunes e desbalanço de marcadores pró e antioxidantes. A tratamento com GAL atenuou essas alterações, demonstrando papel fundamental da disfunção autonômica. A desnervação esplênica, apesar de não alterar os benefícios cardíacos, impediu a modulação da inflamação no baço, da disautonomia vascular e da pressão arterial induzidas pela GAL, sugerindo participação do reflexo colinérgico inflamatório nesta condição.
- ItemSomente MetadadadosExercise training improves hypertension-induced autonomic dysfunction without influencing properties of peripheral cardiac vagus nerve(Elsevier Science Bv, 2017) Neto, Octavio Barbosa; de Sordi, Carla Cristina; da Mota, Gustavo Ribeiro; Marocolo, Moacir; Chriguer, Rosangela Soares [UNIFESP]; Dias da Silva, Valdo JoseWe examined the vagal transfer function of autonomic heart rate (HR) control in anesthetized sedentary and exercise-trained Spontaneously Hypertensive Rats (SHR). To this end, male SHR and Wystar-Kyoto (WKY) rats with 48-50 weeks of age-old were divided into 4 groups: sedentary (SHRS, n = 12) and trained (SHRT, n = 14) hypertensive rats, sedentary (WKYS, n = 13) and trained (WKYT, n = 13) normotensive rats. The trained groups were submitted to swimming protocol for 9 weeks. Blood pressure (BP), HR, HR variability (HRV), BP variability (BPV), baroreflex sensitivity and cardiac tonus were recorded in baseline conditions. Following, electric stimulation of peripheral vagus nerve was performed in anesthetized conditions. Resting bradycardia was observed in SHRT and WKYT when compared to their respective sedentary groups (p < 0.001). The BP was lower in SHRT than in SHRS (p < 0.001). The SHRT and WKYT rats showed higher baroreflex-mediated tachycardia values when compared to their respective sedentary counterparts (p < 0.001). Baroreflex bradycardic response in SHRT was higher than in SHRS (p < 0.005). The SHRT and WKYT rats showed a decreased sympathetic activity in comparison to their respective sedentary groups (p < 0.05). The cardiac vagal tonus was higher in SHRT than in SHRS (p < 0.05). Regarding the dynamic transducer properties of peripheral vagus nerve to the heart no difference was observed among the groups. In conclusion, our results demonstrate that exercise training decreased BP in SHR and improved cardiovascular autonomic balance to the heart without changes in transduction properties of peripheral cardiac vagus nerve.
- ItemSomente MetadadadosExposure to high-fat diet since post-weaning induces cardiometabolic damage in adult rats(Pergamon-Elsevier Science Ltd, 2016) Fiorino, P.; Americo, A. L. V.; Muller, C. R.; Evangelista, F. S.; Santos, F.; Leite, A. P. O. [UNIFESP]; Farah, V. [UNIFESP]Aims: This study sought to investigate the metabolic, hemodynamic and autonomic responses in adult rats exposed to high-fat diet since post-weaning. Main methods: Young male Wistar rats were assigned into groups fed with standard normal diet (3% lipids
- ItemSomente MetadadadosJuvenile fibromyalgia syndrome: Blunted heart rate response and cardiac autonomic dysfunction at diagnosis(W B Saunders Co-Elsevier Inc, 2016) Maia, Magda M.; Gualano, Bruno; Sa-Pinto, Ana L.; Sallum, Adriana M. E.; Pereira, Rosa M. R.; Len, Claudio Arnaldo [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Barbosa, Cassia M.; Roschel, Hamilton; Silva, Clovis A.Objective: To assess aerobic capacity and cardiac autonomic modulation in juvenile fibromyalgia syndrome (JFM) patients at diagnosis in response to graded exercise text. Methods: A multicenter cross-sectional study included 25 JFM patients and 25 healthy controls. Both groups participated only in physical education classes at school. A treadmill graded cardiorespiratory test was performed and the heart-rate (HR) response during exercise was evaluated by the chronotropic reserve (CR). Pain, functional ability, and health-related quality of life (HRQL) were assessed. Results: The median current age was similar in JFM and controls (15 vs. 15 years, p = 0.890), as well as body mass index (p = 0.332), female gender (p = 1.000), and Tanner stages (p = 0.822). The medians of HRQL parameters (total score/physical health/psychosocial health) were significantly lower in JFM vs. controls according to patient and parent self-reports (p < 0.001). The median of peak HR [181 (150-198) vs. 197 (181-202) bpm, p < 0.001], chronotropic reserve [84 (53-98) vs. 99 (84-103)%, p < 0.001], and resting to peal< [96 (65-181) vs. 127 (61-185) bpm, p = 0.010] were significantly lower in JFM compared to controls. The median of Delta EIRR1 [15 (3-39) vs. 35 (9-52) bpm, p < 0.0011, Delta FIRR2 [37 (20-57) vs. 51 (32-94) bpm, p < 0.001], peak VO2 [32.34 (24.24-39.65) vs. 36A (28.56-52.71) ml/kg/min, p = 0.005], peak speed [5 (4-6.3) vs. 5.9 (4.0-6.3) mph, p = 0.001], time to exhaustion [11.5 (8.5-14.5) vs. 14 (11-18) min, p < 0.0011, and working capacity on power [3.37 (2.04-5.6) vs. 3.89 (2.91-6.55) W/kg, p = 0.006] were significantly lower in JFM compared to controls. The frequency of chronotropic incompetence (<= 80%) was significantly higher in JFM vs. controls (p = 0.0006). Conclusions: This study identified chronotropic incompetence and delayed HR recovery in JFM patients, indicating autonomic dysfunction. Aerobic exercise training should be considered in all JFM patients and may improve cardiac autonomic impairment, thus reducing cardiovascular risk. (C) 2016 Elsevier Inc. All rights reserved.