Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-06-01T20:25:43Z No. of bitstreams: 1 Morgana Ayala Sevilia Buzin.pdf: 986231 bytes, checksum: 9712816a88b2b630110ce4cfcdb40c20 (MD5) / Made available in DSpace on 2016-06-01T20:25:43Z (GMT). No. of bitstreams: 1 Morgana Ayala Sevilia Buzin.pdf: 986231 bytes, checksum: 9712816a88b2b630110ce4cfcdb40c20 (MD5) Previous issue date: 2015-12-16 / The incidence of cardiovascular diseases and diabetes significantly increases in women after menopause. Among the chronic diabetes complications is cardiomyopathy, which greatly increases the risk of cardiovascular mortality. On the other hand, aerobic exercise training (ET) induces attenuation of cardiometabolic disorders that affect menopausal women and/or diabetic. However, studies involving the cardiac effects of aerobic ET in association with resistance ET (combined ET) are scarce and controversial. Thus, the aim of this study was to evaluate the effect of combined ET on parameters of morphometry and cardiac function, oxidative stress and inflammation in diabetic ovariectomized rats. Female Wistar rats (200-220g) were divided into 4 groups (n=8 per group): sedentary euglycemic (ES), diabetic (streptozotocin, 50 mg / kg, iv) sedentary (DS) and diabetic ovariectomized (bilateral removal of ovaries) sedentary (DOS) or submitted to combined ET (DOTC). Combined ET was performed on a treadmill and ladder adapted to rats (8 weeks, 5 d/week, 1 h/day), alternating days. Echocardiographic measurements were performed at the end of 8 weeks of ET protocol, and followed the recommendations of the M Mode Standardization Committee of the American Society of Echocardiography. The cardiac oxidative stress was evaluated by chemiluminescence initiated by t-BOOH (QL), the dosage of protein carbonyls and the redox ratio of glutathione (GSH/GSSG). Inflammation was measured by a TNF-α and IL-10 in cardiac tissue. Body weight was lower and blood glucose levels were higher in the diabetic group compared to the ES. Reduction of left ventricular mass (LVM), of relative wall thickness (RWT), and circumferential shortening velocity (VEC), and increased LV cavity in diastole and isovolumetric relaxation time were observed in sedentary diabetic animals (DS group). The combined ET attenuated these morphometric and functional disorders. The myocardial performance index (MPI) indicated a loss in diabetic and improved by physical training (ES: 0.25 ± 0.07; SD: 0.32 ± 0.05; DOS: 0.39 ± 0.13; DOTC: 0.18 ± 0.11). There was an increase of oxidative stress, both assessed by QL as the carbonyl in DOS group (vs. DS group), which was attenuated by combined ET (DOTC group). There was a reduction of GSH/GSSG in all diabetic groups (DS, DOS and DOTC) in relation to euglycemic group (ES), and increase in this parameter in the trained group (ES: 10.4 ± 1.64; SD: 5.8 ± 1.23; DOS: 5.8 ± 0.67; DOTC: 8.6 ± 0.94). There was no difference in TNF-α between studied groups, but IL-10 was decreased in sedentary diabetic groups (DS and DOS groups) regarding the euglycemic (ES group), which was not observed in the trained group (ES: 2.67 ± 1.05; SD: 1.08 ± 0 28; OF: 0.76 ± 0.37; DOTC: 1.84 ± 0.36 pg /mg protein). In conclusion, the results of this study show that the combined exercise training induced attenuation of cardiac morphometric and functional disorders associated with the reduction of oxidative stress and inflammation in the heart in an experimental model of diabetes and menopause, suggesting a positive impact of this approach in the management of risk factors in this condition. / A incidência de doenças cardiovasculares e de diabetes aumenta significativamente em mulheres após a menopausa. Dentre as complicações crônicas do diabetes destaca-se a cardiomiopatia, a qual aumenta muito o risco de mortalidade cardiovascular. Por outro lado, o treinamento físico (TF) aeróbio induz atenuação de disfunções cardiometabólicas que acometem mulheres menopausadas e/ou diabéticas. Entretanto, estudos envolvendo os efeitos cardíacos do TF aeróbio em associação com o TF resistido (TF combinado) são escassos e controversos. Dessa forma, o objetivo do presente estudo foi avaliar o efeito do TF combinado em parâmetros de morfometria e função cardíaca, estresse oxidativo e inflamação em ratas ooforectomizadas diabéticas. Ratas Wistar (200-220g) foram divididas em 4 grupos (n=8 em cada): euglicêmico sedentário (ES), diabético (estreptozotocina, 50 mg/kg, iv) sedentário (DS) e diabético ooforectomizado (retirada bilateral dos ovários) sedentário (DOS) ou submetido a treinamento físico combinado (DOTC). O treinamento físico foi realizado em esteira e escada adaptadas para ratos (8 semanas, 5 dias/semana, 1 hora/dia), de forma alternada. As medidas ecocardiográficas foram realizadas ao final das 8 semanas de TF, e seguiram as recomendações do Comitê de Padronização do Modo M da Sociedade Americana de Ecocardiografia. O estresse oxidativo cardíaco foi avaliado por quimiluminescência iniciada por t-BOOH (QL), pela dosagem de proteínas carboniladas e pela razão redox da glutationa (GSH/GSSG). A inflamação foi por medida pelo TNF α e IL-10 em tecido cardíaco. O peso corporal foi menor e a glicemia foi maior nos grupos diabéticos em relação aos animais euglicêmicos (grupo ES). Houve redução na massa do ventrículo esquerdo (MVE), da espessura relativa de parede (ERP), da velocidade de encurtamento circunferencial (VEC), bem como aumento da cavidade do VE na diástole e do tempo de relaxamento isovolumétrico nos animais diabéticos sedentários (grupos DS e DOS). O TF combinado atenuou tais disfunções morfométricas e funcionais no grupo DOTC. Em relação ao índice de desempenho do miocárdio (IDM) houve prejuízo nos grupos sedentários diabéticos e melhora ocasionada pelo treinamento físico (ES: 0,25±0,07; DS: 0,32±0,05; DOS: 0,39±0,13; DOTC: 0,18±0,11). Houve aumento de estresse oxidativo, tanto avaliado pela QL quanto pelas carbonilas, no grupo DOS em relação ao DS, o que foi atenuado pelo treinamento físico (grupo DOTC). Houve redução da GSH/GSSG em todos os grupos diabéticos em relação ao grupo euglicêmico, e aumento desta razão no grupo treinado (ES: 10,4 ±1,64; DS: 5,8 ±1,23; DOS: 5,8 ±0,67; DOTC: 8,6 ±0,94). Não houve diferença no TNF-α entre os grupos estudados, mas o IL-10 foi menor nos grupos diabéticos sedentários em relação ao euglicêmico, o que não foi observado no grupo treinado (ES: 2,67±1,05; DS: 1,08±0,28; DOS: 0,76±0,37; DOTC: 1,84±0,36 pg/mg proteína). Concluindo, os resultados do presente estudo evidenciam que o treinamento físico combinado induziu atenuação das disfunções morfométricas e funcionais cardíacas associado à redução de estresse oxidativo e de inflamação no coração em um modelo experimental de diabetes e menopausa, sugerindo impacto positivo desta abordagem no manejo do risco cardíaco nessa condição.

Introdução O desequilíbrio do sistema nervoso simpático e parassimpático, caracterizado por hiperatividade simpática e redução da atividade parassimpática cardíacas, tem sido associado diretamente com os mecanismos de desenvolvimento de hipertensão arterial sistêmica (HAS). Este desequilíbrio influencia diretamente outros fatores fisiopatogênicos presentes na doença como, por exemplo, disfunção endotelial e remodelamento vascular. O treinamento muscular inspiratório e o treinamento aeróbio demonstram efeitos satisfatórios no tratamento de doenças cardiovasculares, inclusive na HAS. Contudo, não há relatos na literatura sobre a comparação da magnitude dos benefícios de cada uma destas intervenções, tampouco há dados que demonstrem os efeitos da combinação das duas modalidades na HAS. Objetivo Desta forma, com este trabalho, buscamos avaliar os efeitos do treinamento muscular inspiratório e do treinamento aeróbio isoladamente e de maneira combinada sobre: a pressão arterial sistêmica, a capacidade funcional, a função endotelial, o controle autonômico cardiovascular em pacientes com HAS primária. Metodologia Desenvolvemos um ensaio clinico randomizado cego, com a participação de indivíduos com diagnóstico clínico de hipertensão arterial sistêmica primária, a fim de analisar os efeitos de três programas de treinamento, executados por um período de 12 semanas: treinamento muscular inspiratório (TMI: 7 dias por semana, 30 min por dia, com carga de 30%PIMAX), treinamento aeróbio (TA: 2 dias por semana, 1 hora por dia, a 70%FCmáx) e treinamento combinado (TMI+TA: 7 dias por semana divididos em 2 dias de TA e 5 dias de TMI, seguindo as mesmas cargas aplicadas nos grupos isolados). Para avaliação dos objetivos propostos, realizamos, antes e após as intervenções: monitorização ambulatorial da pressão arterial (MAPA) por 24 horas, teste de esforço (ergoespirometria), aquisição dos sinais de pressão arterial (Finometer®) e eletrocardiograma (PowerLab®) de maneira não invasiva, microneuromiografia do nervo peroneo, avaliação da função endotelial através de vasodilatação mediada por fluxo, manovacuometria e aplicação de questionário de qualidade de vida (SF36). Resultados 43 pacientes hipertensos foram randomizados para participação em um dos quatro grupos (TMI, TA, TMI+TA e Controle). 28 pacientes finalizaram o estudo (7 em cada grupo) que teve como principais resultados: redução da pressão sistólica total, de vigília e do sono nos grupos TMI (deltaPAST: -7,85 ± 7,6; deltaPASV: -8,28 ± 9,26; deltaPASS: -5,85 ± 7,1 mmHg) e TMI+TA (?PAST: -6,42 ± 4,42; deltaPASV: -6 ±2 ,76; deltaPASS: -11,42 ± 10,14 mmHg), redução da pressão arterial diastólica total, de vigília e do sono no grupo TMI+TA (deltaPADT: -5,85 ± 3,57; deltaPADV: -5,42 ± 4,72; deltaPADS: -5,85 ± 6,14 mmHg) e redução da pressão diastólica do sono no grupo TMI (deltaPADS: -5,14 ± 5,01 mmHg). Melhora da capacidade funcional, com aumento do VO2MÁX em todos os grupos intervenção (deltaVO2MÁX TMI: 2,11 ± 0,96; TA: 3,31 ± 2,01; TMI+TA: 3.55 ± 2.96 l/min-1) e redução do VE/VCO2slope nos grupos TA (deltaVE/VCO2slope: -1.02 ± 1.31) e TMI+TA (deltaVE/VCO2slope: -2,17 ± 1,49). Além disso, o grupo TMI apresentou redução da modulação simpática cardíaca (BFabs: 241,32 ± 246,74 vs 166.19 ± 178.25) e melhora do balanço simpatovagal (BF/AF: 3.25 ± 2.23 vs 1.33 ± 1.45) após 12 semanas de protocolo. Obervamos ainda, que os três grupos intervenção apresentaram redução da atividade nervosa simpática muscular (deltaANSM TMI: -11,25 ± 13,43; TA: -4,53 ± 2,99; TMI+TA: -6,52 ± 2,05 bursts/min) e melhora da força muscular inspiratória (deltaPIMAX TMI: -35,27 ± 24,06; TA: -17,57 ± 7,25; TMI+TA: -55,28 ± 20,25 cmH2O) e expiratória (deltaPEMAX TMI: 22,04 ± 12,95; TA: 19,28 ± 5,93; TMI+TA: 42,85 ± 15,53 cmH2O) após 12 semanas. Contudo, não observamos alterações na função endotelial ou na qualidade de vida dos participantes após o estudo. Conclusão As três modalidades de treinamento apresentam benefícios no tratamento de pacientes portadores de hipertensão arterial sistêmica. Observamos que os efeitos apresentados através da prática de TMI foram semelhantes àqueles apresentados a partir da prática de TA sobre alguns componentes fisiopatogênicos da HAS e que a prática combinada das duas modalidades agrega em benefícios os efeitos encontrados com a prática isolada. Assim, acreditamos que o TMI é uma alternativa interessante de tratamento ao TA, e que a prática combinada pode ser incentivada nesta população / Introduction Sympathetic and parasympathetic nervous system imbalance, characterized by sympathetic hyperactivity and reduction of cardiac parasympathetic activity, has been directly associated with the mechanisms of systemic arterial hypertension development. This imbalance influences directly other pathophysiological factors of the disease, such as endothelial dysfunction and vascular remodeling. Inspiratory muscle training and aerobic training demonstrate satisfactory effects in the treatment of cardiovascular diseases, including hypertension. However, there are no reports in the literature comparing the magnitude of the benefits of each one of these interventions, nor any data demonstrating the effects of the combination of both modalities. Objective In this work, we aimed to evaluate the effects of inspiratory muscle training and aerobic training separately and combined on: blood pressure, functional capacity, endothelial function, and cardiovascular autonomic control in patients with primary hypertension. Methods: We performed a randomized blinded clinical trial including individuals with clinical diagnosis of primary arterial hypertension in order to analyze the effects of three training programs performed over a 12-week period: inspiratory muscle training (IMT: 7 days 30 minutes per day, with 30% PIMAX load), aerobic training (AT: 2 days per week, 1 hour per day, 70% HRmax) and combined training (IMT + AT: 7 days per week divided into 2 days of AT and 5 days of IMT, following the same load applied in the isolated groups). To evaluate the proposed objectives, we performed the following evaluations, before and after the interventions: 24-hour ambulatory blood pressure monitoring (ABPM), exercise test (ergospirometry), noninvasive acquisition of blood pressure signals (Finometer®) and electrocardiogram (PowerLab®), peroneal nerve microneuromyography, evaluation of endothelial function through flow-mediated vasodilation, manovacuometry and application of quality of life questionnaire (SF36). Results 43 hypertensive patients were randomized to participate in one of four groups (IMT, TA, IMT + TA and Control). 28 patients completed the study (7 in each group), with the following results: reduction of systolic blood pressure during 24 hours (SBPT), awake (SBPW) and sleep (SBPS) periods in IMT(deltaSBPT: -7,85 ± 7,6; deltaSBPW: -8,28 ± 9,26; deltaSBPS: -5,85 ± 7,1 mmHg) and IMT+AT groups (deltaSBPT: -6,42 ± 4,42; deltaSBPW: -6 ± 2,76; deltaSBPS: -11,42 ± 10,14 mmHg); reduction of diastolic blood pressure during total (DBPT), awake (DBTW) and sleep (DBPS) periods in IMT+AT group (deltaDBPT: -5.85 v± 3.57; deltaDBTW: -5.42 ± 4.72; deltaDBPS: -5.85±6.14 mmHg) and reduction of diastolic sleep pressure in IMT group (deltaDBPS: -5.14 ± 5.01 mmHg). It was also observed improvement of functional capacity, with increase of VO2MAX in all intervention groups (deltaVO2MAX IMT: 2.11 ± 0.96, AT: 3.31 ± 2.01, IMT+AT: 3.55 ± 2.96 l / min-1) and reduction of VE/VCO2slope in AT (deltaVE/VCO2slope: -1.02 ± 1.31) and IMT+AT groups (deltaVE/VCO2slope: -2.17 ± 1.49). In addition, the IMT group presented reduction of sympathetic cardiac modulation (LFabs: 241.32 ± 246.74 vs 166.19 ± 178.25) and improvement of the sympathovagal balance (LF/HF: 3.25 ± 2.23 vs 1.33 ± 1.45) after 12 weeks of protocol. We also observed that the three intervention groups presented reduction of muscle sympathetic nerve activity (deltaMSNA: IMT: -11.25 ± 13.43, TA: -4.53 ± 2.99, IMT+AT: -6.52 ± 2,05 bursts/min) and improvement of inspiratory muscle strength (deltaPIMAX IMT: -35.27 ± 24.06, AT: -17.57 ± 7.25, IMT+AT: -55.28 ± 20.25 cmH2O), and (deltaPEMAX IMT: 22.04 ± 12.95, AT: 19.28 ± 5.93, IMT+AT: 42.85 ± 15.53 cmH2O) after 12 weeks. However, we did not observe changes on endothelial function or quality of life of participants after the study. Conclusion The three training modalities present benefits in the treatment of patients with systemic arterial hypertension. We observed that the effects presented through the practice of IMT were similar to those presented from the practice of AT on some physiopathology components of hypertension and the combination of the two modalities adds some benefits in the effects found with the isolated practice. Thus, we believe that IMT is an interesting alternative to AT, and that the combined practice can be encouraged in this population

OBJETIVO: Verificar o impacto da condição física e pulmonar pré-operatória sobre a evolução pós-operatória intra-hospitalar e o desempenho funcional após alta hospitalar, por meio de avaliação de teste de caminhada de seis minutos (TC6M), comportamento de variabilidade de frequência cardíaca (VFC), função pulmonar e força muscular respiratória em crianças e adolescentes submetidos à correção cirúrgica de cardiopatias congênitas. MÉTODO: Foram avaliados 96 pacientes; dos quais 81 entraram no protocolo. Todos os pacientes foram avaliados utilizando TC6M, VFC, analisados nos domínios tempo e frequência em repouso, espirometria e pressões inspiratórias (PImax) e expiratória (PEmax) máximas nos momentos pré, pós-operatório e 90 dias após a alta hospitalar. As variáveis respostas compreenderam dados de pré-operatório, pós-operatório, complicações hemodinâmicas, cirúrgicas, respiratórias, infecciosas e óbito. Consideramos, além disso, tempo de permanência em unidade de terapia intensiva (UTI) e de internação hospitalar. Para análise estatística foi aceito nível mínimo de significância de p < 0,05. RESULTADOS: Observamos impacto positivo 90 dias após a alta hospitalar na distância caminhada no TC6M com o valor de pré-operatório de 521,88±96,94 metros para 579,28±83,36 metros após 90 dias (p<0,001). A queda significativa na SpO2 imediatamente após o TC6M esteve relacionada com o aumento do tempo de internação em UTI e hospitalar (rP = -0,386 e -0,283 e p = 0,006 e 0,014, respectivamente). Na espirometria os pacientes apresentaram padrão restritivo com recuperação de seus valores 90 dias após a alta e a força muscular respiratória indicou correlação positiva na distância caminhada (rP = 0,4, p<0,05). Valores baixos de VFC demonstraram correlação negativa e significativa durante a internação hospitalar (rP = -0,286, p < 0,05). Na análise multivariada, a variável pNN50 da VFC demonstrou associação significante com a presença de morbimortalidade (p = 0,009). Para as variáveis respostas (complicações) foi observado que LF apresentou associação com complicações hemodinâmicas (p = 0,014) e cirúrgicas (p = 0,007); SpO2 em repouso foi a variável associada com complicações respiratórias (p = 0,033) e IMC, com complicações infecciosas (p = 0,026). CONCLUSÕES: Nossos dados sugerem que a magnitude da reserva dos sistemas cardiovascular e respiratório no período pré-operatório, caracterizada pela distância caminhada e SpO2 reduzidas, associou-se com o tempo de internação na UTI e hospitalar. As variáveis pNN50 e LF, representantes da variabilidade da frequência cardíaca, a SpO2 em repouso e o índice de massa corpórea foram os fatores que se associaram à ocorrência de morbimortalidade. A variabilidade da frequência cardíaca esteve reduzida, com diminuição da atividade parassimpática e aumento da atividade simpática, sugerindo a existência da disfunção autonômica em crianças e adolescentes com cardiopatias congênitas / PURPOSE: To evaluate the impact of the preoperative physical and pulmonary condition on the immediate postoperative course and the functional performance after hospital discharge by means of six minute walk test (6MWT), behavior of heart rate variability (HRV), lung function and respiratory muscle strength in children and adolescents who underwent congenital heart diseases surgery. METHOD: Ninety-six patients were evaluated, of whom 81 entered the protocol. All patients were evaluated using the 6MWT, HRV performed at rest in the time and frequency domains, spirometry, maximum inspiratory (MIP) and expiratory (MEP) pressures, during pre, postoperative and 90 days after discharge. Outcome variables included preoperative, postoperative data and hemodynamic, surgical, respiratory infectious complications and mortality. We also considered time of intensive care unit (ICU) and discharge. For statistical analysis was considered a minimum significance level of p < 0.05. RESULTS: We observed a positive impact 90 days after hospital discharge on the 6MWT distance, with the preoperative value 521.88 ± 96.94 meters to 579.28 ± 83.36 meters 90 days after discharge (p <0.001). A significant decrease in SpO2 immediately after 6MWT is related to the increase in the length of ICU and hospital stay (rP = -0.386 and -0.283 and p = 0.006 and 0.014, respectively). Spirometry showed a restrictive pattern with recovery the values 90 days after hospital discharge and respiratory muscle strength was positively correlates with walked distance (rP = 0.4; p < 0.05). Lower values of HRV had a negative correlation during hospital stay (rP = -0.286, p < 0.05). In multivariate analysis, pNN50 value of HRV showed significant association with the presence of morbidity and mortality. To outcome variables (complications) was observed that LF value was associated with hemodynamic (p = 0.014) and surgical complication (p = 0.007), SpO2 at rest was the variable associated with respiratory complications (p = 0.033) and IMC, with infectious complications (p = 0.026). CONCLUSIONS: Our data show that the magnitude of the reserve of the cardiovascular and respiratory systems in the preoperative period characterized by the distance walked and SpO2 was associated with the reduced length of stay in ICU and hospital. The variables pNN50 and LF, representatives of the HRV, SpO2 at rest and body mass index were factors that were associated with the occurrence of morbidity and mortality. The heart rate variability was reduced, with decreased parasympathetic and increased sympathetic activity suggesting the impaired autonomic function in children and adolescents with congenital heart disease

The impact on health, mental state and quality of life in people after spinal cord injury is enormous. Significant impairment occurs not only of sensorimotor functions. The autonomic nervous system is also disturbed to some extent, which is very closely related to the management of cardiovascular functions (and heart rate). The aim of this study is to evaluate the effect of different physical activities on heart rate in people after spinal cord injury. The study included 30 people in the chronic stage after spinal cord injury, which were divided into 3 groups according to the neurological level of the spinal cord lesion in tetraplegics (lesion C1-C8), paraplegics with high thoracic lesion (T1-T6), and paraplegics with lesion from T6 below. Each proband completed 4 exercise tests on sports simulators (rowing, kayaking and cross-country trainer and Rotren) and peak heart rate values (SFpeak) were measured after reaching the subjective maximum load (according to the Borg RPE scale). The values of SFpeak were then statistically processed, evaluated and compared - within groups between sports simulators and between groups. The results of the statistical processing show that the sports simulators are not different in terms of reaching the top SFpeak. Although differences between peak heart rate values...

An autonomic dysfunction caused by spinal cord injury may have a significant impact on quality of life, especially in cases of lesions occuring above the sixth spinal segment. In these cases also cardiovascular system control is damaged in a different extent, which is subsequently presented by e.g. persisting bradycardia, heart frequency inadequate reaction to strain and stress or by huge variations of blood pressure values, which the situation complicate even more. The fact that cardiovascular diseases take now the frontmost place in causes of mortality of people with spinal cord injury is another evidence how important this topic is. The main aim of my thesis was to describe impacts of autonomic injury on cardiovascular functions and to try to objectify them using heart rate and blood pressure variability. Twenty-one patients of Motol University Hospitalv Spinal Unit with spinal cord lesion above Th6 segment and ten healthy people as a control group participated in the study. We created suitable conditions for highlighting disrupted cardiovascular functions of urgent spinal patients by modification of the standardized Head Up Tilt Test (HUTT). The heart rate and blood pressure values were continuously monitored by Finapres device before, during and also after verticalization on a tilt table....

Objective: Previous studies have used acetylcholinesterase (AChE) histochemistry to identify cholinergic nerves in the heart, but this enzyme is not a selective marker for cholinergic neurons. This study maps cholinergic innervation of guinea pig heart using a new antibody to the human high-affinity choline transporter (CHT), which is present only in cholinergic nerves. Methods: Immunohistochemistry was used to localize CHTs in frozen and paraffin sections of heart and whole mount preparations of atrial ganglionated nerve plexus. AChE-positive nerve fibers were identified in sections from separate hearts for comparison. Results: Control experiments established that the antibody to human CHT selectively labeled cholinergic neurons in the guinea pig. CHT-immunoreactive nerve fibers and AChE-positive nerves were very abundant in the sinus and AV nodes, bundle of His, and bundle branches. Both markers also delineated a distinct nerve tract in the posterior wall of the right atrium. AChE-positive nerve fibers were more abundant than CHT-immunoreactive nerves in working atrial and ventricular myocardium. CHT-immunoreactive nerves were rarely observed in left ventricular free wall. Both markers were associated with numerous parasympathetic ganglia that were distributed along the posterior atrial walls and within the interatrial septum, including the region of the AV node. Conclusions: Comparison of labeling patterns for CHT and AChE suggests that AChE histochemistry overestimates the density of cholinergic innervation in the heart. The distribution of CHT-immunoreactive nerve fibers and parasympathetic ganglia in the guinea pig heart suggests that heart rate, conduction velocity, and automaticity are precisely regulated by cholinergic innervation. In contrast, the paucity of CHT-immunoreactive nerve fibers in left ventricular myocardium implies that vagal efferent input has little or no direct influence on ventricular contractile function in the guinea pig.

Orientador: Dionei Ramos / Resumo: Estudos vem investigando a relação do nível da atividade física com a melhora da qualidade do sono de tabagistas, além da utilização do exercício físico para aumentar o sucesso da cessação do tabagismo. No entanto, faz-se necessário investigar a relação da qualidade do sono e sistema nervoso autônomo (SNA) de acordo com o nível de atividade física habitual de tabagistas, para promover a identificação de possíveis mecanismos responsáveis pelos distúrbios do sono desta população, além disso os efeitos do exercício físico no sucesso da cessação do tabagismo ainda é pouco compreendida indicando pequenas taxas de adesão e abstinência ao final do tratamento. Objetivos: Identificar a relação entre a qualidade do sono de tabagistas com o nível de atividade física habitual e modulação do SNA. Além disso, comparar dois tipos de exercícios associados à terapia cognitivo-comportamental (TCC) no sucesso da cessação do tabagismo. Métodos: Trata-se de dois estudos, sendo o primeiro transversal realizado com 42 tabagistas divididos em dois grupos de acordo com o percentil 50% do nível de atividade física de moderada à vigorosa (AFMV) avaliada por meio da acelerometria; onde a qualidade do sono foi avaliada por meio do questionário Mini-Sleep e a modulação do SNA por meio de índices da variabilidade da frequência cardíaca (VFC). Para as análises dos dados foi utilizado análise de covariância (ANCOVA) ajustado para idade, sexo, composição corporal, anosmaço, medicamentos beta-bloqueadores, ans... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Studies has been investigating the relationship of habitual physical activity with improved of sleep quality in smokers, in addition to using exercise to increase the success of smoking cessation. However, it is necessary to investigate the relationship between sleep quality and autonomic nervous system (ANS) according to the level of habitual physical activity of smokers, to promote the identification of possible mechanisms responsible for sleep disorders in this population. The effects of physical exercise on smoking cessation success, it is still poorly understood, indicating low adherence and abstinence rates at the end of treatment. Objectives: To identify changes in the sleep quality of smokers and its relation with habitual physical activity level and ANS modulation. Also, compare two types of exercise associated with cognitive behavior therapy (CBT) in successful smoking cessation. Methods: These are two studies, the first cross-sectional study conducted with 42 smokers divided into two groups according to the 50th percentile of the moderate-to-vigorous physical activity (MVPA) assessed by accelerometry; where the sleep quality was assessed using the Mini-sleep Questionnaire and the ANS modulation was assessed by indices of heart rate variability (HRV). For the analysis of possible mean differences analysis of covariance (ANCOVA) was used adjusting for age, sex, body composition, pack-years, beta-blockers, anxiety, and depression in log base 10. Correlations were made... (Complete abstract click electronic access below) / Doutor

This mixed-media memoir uses a variety of forms from short epigrammatic essays to straightforward stories and graphic narratives to explore the author’s coming-of-age experiences augmented by chronic illness. Trying to succeed in the film industry, romance, and family situations, the young female narrator navigates the often unexpected or disappointing consequences of having an autonomic nervous system disorder. Relationships between conflicting identities emerge—between healthy versus sick self, projected/envisioned versus actual self, and tough versus vulnerable self—as the narrator journeys toward a more complete and accepting self-understanding.

Sphingosine 1-phosphate (S1P) receptor (S1PR) modulators have a complex mechanism of action, which are among the most efficient therapeutic options in multiple sclerosis (MS) and represent a promising approach for other immune-mediated diseases. The S1P signaling pathway involves the activation of five extracellular S1PR subtypes (S1PR1–S1PR5) that are ubiquitous and have a wide range of effects. Besides the immunomodulatory beneficial outcome in MS, S1P signaling regulates the cardiovascular function via S1PR1–S1PR3 subtypes, which reside on cardiac myocytes, endothelial, and vascular smooth muscle cells. In our review, we describe the mechanisms and clinical effects of S1PR modulators on the cardiovascular system. In the past, mostly short-term effects of S1PR modulators on the cardiovascular system have been studied, while data on long-term effects still need to be investigated. Immediate effects detected after treatment initiation are due to parasympathetic overactivation. In contrast, long-term effects may arise from a shift of the autonomic regulation toward sympathetic predominance along with S1PR1 downregulation. A mild increase in blood pressure has been reported in long-term studies, as well as decreased baroreflex sensitivity. In most studies, sustained hypertension was found to represent a significant adverse event related to treatment. The shift in the autonomic control and blood pressure values could not be just a consequence of disease progression but also related to S1PR modulation. Reduced cardiac autonomic activation and decreased heart rate variability during the long-term treatment with S1PR modulators may increase the risk for subsequent cardiac events. For second-generation S1PR modulators, this observation has to be confirmed in further studies with longer follow-ups. The periodic surveillance of cardiovascular function and detection of any cardiac autonomic dysfunction can help predict cardiac outcomes not only after the first dose but also throughout treatment.

<p dir="ltr">The vagus nerve (VN) is the tenth cranial nerve that mediates most of the parasympathetic functions of the autonomic nervous system. The axons of the human VN comprise a mix of unmyelinated and myelinated axons, where ~80% of the axons are unmyelinated C fibers (Havton et al., 2021). Understanding that most VN axons are unmyelinated, there is a need to map the pathways of these axons to and from organs to understand their function(s) and whether C fiber morphology or signaling characteristics yield insights into their functions. Developing a machine learning model that detects and predicts the morphology of VN single fiber action potentials based on select fiber characteristics, e.g., diameter, myelination, and position within the VN, allows us to more readily categorize the nerve fibers with respect to their function(s). Additionally, the features of this machine learning model could help inform peripheral neuromodulation devices that aim to restore, replace, or augment one or more specific functions of the VN that have been lost due to injury, disease, or developmental abnormalities.</p><p dir="ltr">We designed and trained four types of Multi-layer Perceptron Artificial Deep Neural Networks (MLP-ANN) with 10,000 rat abdominal vagal C-fibers simulated via the peripheral neural interface model ViNERS. We analyze the accuracy of each MLP-ANN’s SFAP predictions by conducting normalized cross-correlation and morphology analyses with the ViNERS C-fiber SFAP counterparts. Our results showed that our best MLP predicted over 94% of the C-fiber SFAPs with strong normalized cross-correlation coefficients of 0.7 through 1 with the ViNERS SFAPs. Overall, this novel tool can use a C-fiber’s biophysical characteristics (i.e., fiber diameter size, fiber position on the x/y axis, etc.) to predict C-fiber SFAP morphology.</p>