Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-07-09T19:24:27Z No. of bitstreams: 1 CristianeRochadaSilvaDissertacao2018.pdf: 5301288 bytes, checksum: d93f6864fe5fb158fcddd3b560878637 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-07-09T19:24:49Z (GMT) No. of bitstreams: 1 CristianeRochadaSilvaDissertacao2018.pdf: 5301288 bytes, checksum: d93f6864fe5fb158fcddd3b560878637 (MD5) / Made available in DSpace on 2018-07-09T19:24:49Z (GMT). No. of bitstreams: 1 CristianeRochadaSilvaDissertacao2018.pdf: 5301288 bytes, checksum: d93f6864fe5fb158fcddd3b560878637 (MD5) Previous issue date: 2018-05-14 / The aim of the present study was to analyse heart rate recovery (HRR) and chronotropic index (CI) after treadmill Bruce test in obese elderly women classified on the basis of relative manual grip strength. Methods: Eighty-eight obese elderly women who were between the ages of 60 and 87 participated in the study and were categorized and enrolled to one of two groups based on lower (< 1.51 m²) or higher (≥ 1.51 m²) relative handgrip strength, respectively. The heart rate recovery in the first and second minutes following the treadmill exercise test and the chronotropic index were compared between groups. Results: The higher relative handgrip strength group presented a significantly higher peak heart rate (p= 0,019) during exercise and a faster HRR at the first (p = 0.003) and second minutes (p = 0.002) after the ergometric test compared to the low manual grip strength group (p=0,001). Furthermore, there was a tendency (p = 0.059) towards a significantly higher CI, six-minute walk test (p = 0.001) and low time up and go time in the group of high relative manual grip strength compared to the low force group. Conclusion: In conclusion, elderly women with greater relative handgrip strength also demonstrated a better heart rate response during and following exercise and tendency to higher chronotropic index, possibly indicating better autonomic balance. / O objetivo do presente estudo foi analisar a recuperação da frequência cardíaca (RFC) e o índice cronotrópico (IC) após teste de Bruce em esteira em mulheres idosas obesas classificadas com base na força de preensão manual relativa (FPMR). Métodos: Participaram voluntariamente do estudo 88 mulheres idosas obesas entre 60 e 87 anos que foram categorizadas em dois grupos: baixa força de preensão manual relativa (<1,51 m²) e alta força de preensão manual relativa (≥ 1,51 m²). A RFC no primeiro e no segundo minutos e o índice cronotrópico após o teste ergométrico em esteira foram comparados entre os grupos. Resultados: O grupo de alta força de preensão manual relativa apresentou valores de frequência cardíaca máxima significativamente maiores durante o teste ergométrico (p= 0,019), RFC mais rápida no primeiro (p = 0,003) e segundo minutos (p = 0,002) após o teste ergométrico comparado ao grupo de baixa força de preensão manual relativa (p=0,001). Observamos tendência (p = 0,059) em direção a um IC significativamente maior, Teste de caminhada de 6 minutos (p = 0,001) e baixo tempo no time up and go no grupo de alta força de preensão manual relativa comparado ao grupo de baixa força. Conclusão: Mulheres idosas com alta força de preensão manual relativa apresentam uma melhor resposta da frequência cardíaca durante e após o teste ergométrico, tendência a um índice cronotrópico superior possivelmente indicando um melhor equilíbrio autonômico após o esforço físico e maior capacidade funcional.

Abstract Despite advances in treatment of cardiovascular diseases, coronary heart disease (CHD) remains the most common cause of death in the Western countries; and its first manifestation is often sudden cardiac death (SCD). The development of CHD is a lifelong process, the pace of which is governed by the burden of several risk factors. The purpose of this study was to investigate the association of levels of cardiorespiratory fitness (CRF), exercise-induced myocardial ischemia and physical activity with the risk of CHD-related death, including SCD events among men with different risk factor profiles. This study is based on the population of the Kuopio Ischaemic Heart Disease Risk Factor Study, which recruited a sample of 2682 men aged 42–60 years. Their CRF was assessed with a maximal exercise test using respiratory gas analysis. Exercise-induced ST segment depression was defined as a ≥1 mm ST segment depression on the electrocardiogram. Anthropometric measurements, blood sample analyzes and questionnaires regarding leisure-time physical activity (LTPA) and smoking were performed at baseline. Men with both low CRF and exercise-induced ST segment depression were at higher risk of death from CHD and SCD than men with high CRF without ST segment depressions. Men with low CRF and low LTPA were at higher risk of SCD than men with low CRF and high LTPA. The amount of LTPA did not alter the incidence on SCD among men with high CRF. These findings were adjusted for age, type 2 diabetes and CHD, smoking, alcohol consumption, body mass index, systolic blood pressure, serum low density lipoprotein cholesterol, and serum C-reactive protein level. These findings emphasize the importance of physical activity and treatment of other modifiable risk factors, especially among the men with low CRF. / Tiivistelmä Sydän- ja verisuonisairauksien ennaltaehkäisystä ja hoidon edistysaskeleista huolimatta sepelvaltimotauti on edelleen kehittyneiden maiden yleisin kuolinsyy, sydänperäisen äkkikuoleman ollessa usein taudin ensimmäinen ilmentymä. Sepelvaltimotaudin syntyminen on pitkäaikainen prosessi, jossa riskitekijät määrittävät suurelta osin taudin etenemisen nopeuden. Tämän tutkimuksen tavoitteena oli selvittää kliinisessä rasituskokeessa todetun aerobisen suorituskyvyn, sydänlihasiskemian sekä fyysisen aktiivisuuden yhteyttä sepelvaltimotautikuolemiin ja sydänperäisiin äkkikuolemiin eri sydän- ja verisuonisairauksien riskitekijäyhdistelmien omaavien miesten keskuudessa. Tämä tutkimus perustuu Kuopio Ischaemic Heart Disease Risk Factor Study- aineistoon, johon kuuluu 2682 42–60 vuotiasta miestä. Tutkittavien aerobista suorituskykyä arvioitiin kliinisessä rasituskokeessa mittaamalla hapenkulutus suoraan hengityskaasuista. Sydänlihasiskemian merkkinä pidettiin rasituksen provosoimaa ≥1 mm ST-välin laskua tutkittavien EKG:ssa. Tutkittavilta kartoitettiin alussa antropometriset mittaukset, verikokeet sekä kyselylomakkeilla selvitettiin mm. vapaa-ajan liikunnan määrää ja tupakointia. Miehet, joilla todettiin huono suorituskyky sekä samanaikainen rasituksen aiheuttama sydänlihasiskemia olivat suuremmassa vaarassa menehtyä sepelvaltimotautiin ja sydänperäiseen äkkikuolemaan verrattuna miehiin, joilla todettiin hyvä suorituskyky eikä rasituksen aiheuttamaa sydänlihasiskemiaa. Miehet joilla todettiin huono suorituskyky, mutta harrastivat enemmän liikuntaa vapaa-ajalla, olivat pienemmässä vaarassa sydänperäiseen äkkikuolemaan kuin huonokuntoiset miehet, jotka harrastivat vähemmän liikuntaa vapaa-ajallaan. Vapaa-ajan liikunnan määrä ei muuttanut sydänperäisen äkkikuoleman esiintyvyyttä hyväkuntoisten miesten keskuudessa. Nämä tulokset vakioitiin iän, tyypin 2-diabeteksen, todetun sepelvaltimotaudin, tupakoinnin, alkoholin kulutuksen, painoindeksin, systolisen verenpaineen, seerumin LDL-kolesterolin ja C-reaktiivisen proteiinin suhteen. Nämä löydökset korostavat liikunnan harrastamisen tärkeyttä muiden riskitekijöiden hoidon ohessa, erityisesti lähtötasoltaan huonokuntoisilla miehillä.