Janieire Alves - Academia.edu (original) (raw)

Papers by Janieire Alves

The FASEB Journal, Mar 31, 2017

<p>Hemodynamic and neurovascular characteristics at baseline and during handgrip exercise i... more <p>Hemodynamic and neurovascular characteristics at baseline and during handgrip exercise in patients with polymorphisms Gln27Gln and Gln27Glu+Glu27Glu before and after the exercise training period.</p

<p>Physical and clinical characteristics in patients with polymorphisms Gln27Gln and Gln27G... more <p>Physical and clinical characteristics in patients with polymorphisms Gln27Gln and Gln27Glu+Glu27Glu one month after the ischemic event.</p

<p>Individual data for MSNA in burst frequency (bursts/min) at baseline and during the hand... more <p>Individual data for MSNA in burst frequency (bursts/min) at baseline and during the handgrip exercise and the MSNA response (Delta) in patients with polymorphism Gln27Gln (<i>n</i> = 17, 2A and 2C, respectively) and Gln27Glu+Glu27Glu (<i>n</i> = 08, 2B and 2D, respectively), pre- and postexercise training period. Note that the MSNA significantly decreased after the exercise training period at baseline and during exercise in the Gln27Gln group. *<i>P</i><0.05, vs. baseline; ^†<i>P</i><0.05, vs. preintervention.</p

<p>MSNA response (delta) in bursts/min in the postexercise training period in patients with... more <p>MSNA response (delta) in bursts/min in the postexercise training period in patients with the polymorphism Gln27Gln (<i>n</i> = 17) and in the Gln27Glu+Glu27Glu group (<i>n</i> = 08). Note that MSNA response was similar in both groups after the exercise training period.</p

Rev. Soc. Cardiol. …, 1991

Resumo: Considerando-se o usual emprego de fármacos depressores do cronotropismo em portadores de... more Resumo: Considerando-se o usual emprego de fármacos depressores do cronotropismo em portadores de fibrilaçäo atrial crônica (FAC), objetivou-se avaliar os reais efeitos da digoxina e do verapamil sobre a capacidade física de idosis portadores desta arritmia, ...

Atherosclerosis, 2011

Objective: To evaluate the effects of resistance training (RT) on the metabolism of an LDL-like n... more Objective: To evaluate the effects of resistance training (RT) on the metabolism of an LDL-like nanoemulsion and on lipid transfer to HDL, an important step of HDL metabolism. Methods: LDL-like nanoemulsion plasma kinetics was studied in 15 healthy men under regular RT for 1-4 years (age = 25 ± 5 years, VO 2 peak = 50 ± 6 mL/kg/min) and in 15 healthy sedentary men (28 ± 7 years, VO 2 peak = 35 ± 9 mL/kg/min). LDL-like nanoemulsion labeled with 14 C-cholesteryl-ester and 3 H-freecholesterol was injected intravenously, plasma samples were collected over 24-h to determine decay curves and fractional clearance rates (FCR). Lipid transfer to HDL was determined in vitro by incubating of plasma samples with nanoemulsions (lipid donors) labeled with radioactive free-cholesterol, cholesterylester, triacylglycerols and phospholipids. HDL size, paraoxonase-1 activity and oxidized LDL levels were also determined. Results: The two groups showed similar LDL and HDL-cholesterol and triacylglycerols, but oxidized LDL was lower in RT (30 ± 9 vs. 61 ± 19 U/L, p = 0.0005). In RT, the nanoemulsion 14 C-cholesteryl-ester was removed twice as fast than in sedentary individuals (FCR: 0.068 ± 0.023 vs. 0.037 ± 0.028, p = 0.002), as well as 3 H-free-cholesterol (0.041 ± 0.025 vs. 0.022 ± 0.023, p = 0.04). While both nanoemulsion labels were removed at the same rate in sedentary individuals, RT 3 H-free-cholesterol was removed slower than 14 C-cholesteryl-ester (p = 0.005). HDL size, paraoxonase 1 and the transfer rates to HDL of the four lipids were the same in both groups. Conclusions: RT accelerated the clearance of LDL-like nanoemulsion, which probably accounts for the oxidized LDL levels reduction in RT. RT also changed the balance of free and esterified cholesterol FCR's. However, RT had no effect on HDL metabolism related parameters.

American Journal of Respiratory and Critical Care Medicine, 2002

Epidemiological studies have implicated obstructive sleep apnea (OSA) as an independent comorbid ... more Epidemiological studies have implicated obstructive sleep apnea (OSA) as an independent comorbid factor in cardiovascular and cerebrovascular diseases. It is postulated that recurrent episodes of occlusion of upper airways during sleep result in pathophysiological changes that may predispose to vascular diseases. Insulin resistance is a known risk factor for atherosclerosis, and we postulate that OSA represents a stress that promotes insulin resistance, hence atherogenesis. This study investigated the relationship between sleep-disordered breathing and insulin resistance, indicated by fasting serum insulin level and insulin resistance index based on the homeostasis model assessment method (HOMA-IR). A total of 270 consecutive subjects (197 male) who were referred for polysomnography and who did not have known diabetes mellitus were included, and 185 were documented to have OSA defined as an apnea-hypopnea index (AHI) у 5. OSA subjects were more insulin resistant, as indicated by higher levels of fasting serum insulin (p ϭ 0.001) and HOMA-IR (p Ͻ 0.001); they were also older and more obese. Stepwise multiple linear regression analysis showed that obesity was the major determinant of insulin resistance but sleepdisordered breathing parameters (AHI and minimum oxygen saturation) were also independent determinants of insulin resistance (fasting insulin: AHI, p ϭ 0.02, minimum O 2 , p ϭ 0.041; HOMA-IR: AHI, p ϭ 0.044, minimum O 2 , p ϭ 0.022); this association between OSA and insulin resistance was seen in both obese and nonobese subjects. Each additional apnea or hypopnea per sleep hour increased the fasting insulin level and HOMA-IR by about 0.5%. Further analysis of the relationship of insulin resistance and hypertension confirmed that insulin resistance was a significant factor for hypertension in this cohort. Our findings suggest that OSA is independently associated with insulin resistance, and its role in the atherogenic potential of sleep disordered breathing is worthy of further exploration.

Frontiers in Neuroscience, 2020

Exercise training is a cornerstone in reducing blood pressure (BP) and muscle sympathetic nerve a... more Exercise training is a cornerstone in reducing blood pressure (BP) and muscle sympathetic nerve activity (MSNA) in individuals with essential hypertension. Highintensity interval training (HIIT) has been shown to be a time efficient alternative to classical continuous training in lowering BP in essential hypertension, but the effect of HIIT on MSNA levels has never been investigated. Leg MSNA responsiveness to 6 weeks of HIIT was examined in 14 hypertensive men (HYP; age: 62 ± 7 years, night time BP: 136 ± 12/83 ± 8 mmHg, BMI: 28 ± 3 kg/m 2), and 10 age-matched normotensive controls (NORM; age: 60 ± 8 years, night time BP: 116 ± 2/68 ± 4 mmHg and BMI: 27 ± 3 kg/m 2). Before training, MSNA levels were not different between HYP and NORM (burst frequency (BF): 41.0 ± 10.3 vs. 33.6 ± 10.6 bursts/min and burst incidence (BI): 67.5 ± 19.7 vs. 64.2 ± 17.0 bursts/100 heart beats, respectively). BF decreased (P < 0.05) with training by 13 and 5% in HYP and NORM, respectively, whereas BI decreased by 7% in NORM only, with no difference between groups. Training lowered (P < 0.05) night-time mean arterial-and diastolic BP in HYP only (100 ± 8 vs. 97 ± 5, and 82 ± 6 vs. 79 ± 5 mmHg, respectively). The change in HYP was greater (P < 0.05) compared to NORM. Training reduced (P < 0.05) body mass, visceral fat mass, and fat percentage similarly within-and between groups, with no change in fat free mass. Training increased (P < 0.05)VO 2-max in NORM only. Six weeks of HIIT lowered resting MSNA levels in age-matched hyper-and normotensive men, which was paralleled by a significant reduction in BP in the hypertensive men.

The FASEB Journal, Mar 31, 2017

Obstructive sleep apnea (OSA) is a risk factor frequently present in patients with metabolic synd... more Obstructive sleep apnea (OSA) is a risk factor frequently present in patients with metabolic syndrome (MetS). Despite of MetS, moderate and severe OSA has been associated with cardiovascular diseas...

The FASEB Journal

Obstructive sleep apnea (OSA) impairs insulin‐glucose metabolism and muscle sympathetic nervous a... more Obstructive sleep apnea (OSA) impairs insulin‐glucose metabolism and muscle sympathetic nervous activity (MSNA). Metabolic syndrome (MetS) frequently is common in OSA patients, exacerbating these alterations. In this context, the effect of hypocaloric diet and exercise training (D+ET) in patients with OSA+MetS is not clear. We tested the hypotheses that: 1) D+ET would improve insulin‐glucose metabolism and MSNA; and 2) The reduction in MSNA is associated with the improvement insulin‐glucose metabolism. Never treated OSA patients (apnea‐hypopnea index‐AHI>15 events/h by polysomnography, PSG) and MetS (ATP‐III), were divided into: Control (C, n=10, 46±2y) and D+ET (n=11, 55±3y). D (−500kcal/day) and ET (40min, 3times/week of cycle exercise for 4‐months). We evaluated MSNA (microneurography) and HOMA‐IR and QUICK by fasting insulin/glucose. Both groups were similar in MetS risk factors, PSG parameters, MSNA and fasting insulin/glucose at pre‐intervention. Compared with C, D+ET impro...

The FASEB Journal

Increased sympathetic muscle mechanoreflex sensitivity and attenuated sympathetic muscle metabore... more Increased sympathetic muscle mechanoreflex sensitivity and attenuated sympathetic muscle metaboreflex sensitivity have been described in heart failure (HF) patients. We tested the hypothesis that exercise training (ET) would improve sympathetic mechano and metaboreflex sensitivity in HF patients. 24 consecutive, randomized, HF patients, Functional Class II‐III NYHA, EF≤40% were divided into two groups: Exercise‐trained (n=12, 55±2 years) and untrained (n=12, 54±2 years). 10 normal controls (NC) were also studied. Muscle sympathetic nerve activity (MSNA) was directly recorded from the peroneal nerve. Mechanoreceptors were activated by passive exercise. Metaboreceptors were activated by post‐exercise circulatory arrest. ET consisted of three 60‐minutes exercise sessions per week for 4 months. ET significantly reduced MSNA in HF patients (34 vs. 40 bursts/min, P<0.05). ET significantly reduced MSNA responses to passive exercise (Δ = 2 vs. 5 bursts/min, P<0.05) and increased MNSA ...

International Journal of Cardiology

Circulation, 2021

Introduction: Coronavirus disease 2019 (COVID-19) has become one of the more dramatic health prob... more Introduction: Coronavirus disease 2019 (COVID-19) has become one of the more dramatic health problems in the century. This disease has enormous consequence for the health care worldwide. In addition to high mortality rate, patients recovered from COVID-19 present short and long-term cardiovascular sequelae including chest pain, myocardial dysfunction, arrhythmia, dyspnea, breathlessness, postural tachycardia syndrome, and thrombotic complications. The explanations for these clinical manifestations are still uncertain but can involve a constellation of physiological alterations. Hypothesis: To test if COVID-19 survivors have augmented sympathetic outflow, diminished endothelial function, elevated aortic stiffness, and reduced physical capacity compared to healthy individuals. Methods: Nineteen COVID-19 survivors [age: 47.0±2.3 years, BMI: 30.1±1.2 Kg/m 2 ] and eighteen well-matched healthy controls (age: 44.0±2.0 years, BMI: 28.4 ±1.2 Kg.m 2 ] were included in study. COVID-19 survivo...

Circulation, Oct 28, 2008

<jats:p>Obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) independently increase... more <jats:p>Obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) independently increases muscular sympathetic nervous activity (MSNA). Unknown is whether OSA has an additive effect on MSNA in patients with MetS. We tested the hypothesis that: OSA would have an additive effect on MSNA in patients with MetS. In addition, we studied whether the increase in MSNA in patients with MetS is associated with alteration in arterial baroreflex sensitivity (BRS). Twenty four patients with MetS diagnosed according ATP-III were divided in two groups:</jats:p> <jats:p> <jats:list list-type="order"> <jats:list-item> <jats:p>MetS+OSA (n=14) and</jats:p> </jats:list-item> <jats:list-item> <jats:p>MetS (n=10).</jats:p> </jats:list-item> </jats:list> </jats:p> <jats:p> They were matched for age, body mass index, waist circumference, and metabolic profile: OSA was defined by an apnoea/hypopnoea index (AHI)&gt;15 events/hour by polysonography. MSNA was recorded directly from the peroneal nerve using the technique of microneurography. Blood pressure (BP) was monitored on a beat-by-beat basis (Finapress) and heart rate by ECG. BRS was analyzed by spontaneous BP and heart rate fluctuations. AHI was higher (42±9 vs. 7±1 events/h, <jats:italic>P</jats:italic> =0.0001) and minimum oxygen saturation lower (77±2 vs. 87±1 %, <jats:italic>P</jats:italic> =0.001) in MetS+OSA patients. Patients MetS+OSA had higher MSNA (55±3 vs. 43±2 bursts/100 beats, <jats:italic>P</jats:italic> =0.01) and systolic BP (158±4 vs.144±3 mmHg, <jats:italic>P</jats:italic> =0.01) when compared with patients with MetS without OSA. Further analysis showed that AHI and minimum oxygen saturation have significant correlation with MSNA (r=0.65; <jats:italic>P</jats:italic> =0.001 and r=−0.48; <jats:italic>P</jats:italic> =0.017, respectively). Patients with MetS+OSA had lower BRS for increases (7.8±0.9 <jats:italic>vs.</jats:italic> 13.4 ± 1.4 msec/mmHg, <jats:italic>P</jats:italic> =0.01) and decreases (7.2±0.9 <jats:italic>vs.</jats:italic> 13.2 ± 2.0 msec/mmHg, <jats:italic>P</jats:italic> =0.03) in blood pressure than patients with MetS without OSA. MSNA significantly correlated with BRS during spontaneous increases in blood pressure (r=−0.56, <jats:italic>P</jats:italic> =0.01). OSA exacerbates MSNA in patients with MetS. In addition, the augmented MSNA in patients with MetS+OSA is associated with reduced BRS. These findings suggest that OSA increases the risk for cardiovascular disease in patients with MetS. </jats:p>

Circulation, 2015

Background: Sympathetic activation and arterial baroreflex (ABR) dysfunction typify chronic heart... more Background: Sympathetic activation and arterial baroreflex (ABR) dysfunction typify chronic heart failure (CHF). In addition, decreased oscillatory pattern of muscle sympathetic nerve activity (MSNA, LF MSNA /HF MSNA ) seems to contribute to sympathetic exacerbation in patients with CHF. Unknown is whether the LF MSNA /HF MSNA is associated with ABR dysfunction in CHF patients. To answer this question, we investigated the association between gain, latency and coupling of ABR function and LF MSNA /HF MSNA in CHF patients. Methods and Results: Forty-three CHF patients, Functional Class II to III, NYHA, ejection fraction ≤40% were allocated into two groups according to the level of LF MSNA /HF MSNA index: 1) Higher LF MSNA /HF MSNA (n=21, 52±2 years) and 2) Lower LF MSNA /HF MSNA (n=22, 54±1 years). Blood pressure (BP, oscillometric beat-to-beat basis) and MSNA (microneurography technique) were recorded during 10 min at rest. Spectral and cross-spectral analyses of BP and MSNA variabil...

The FASEB Journal, Mar 31, 2017

<p>Hemodynamic and neurovascular characteristics at baseline and during handgrip exercise i... more <p>Hemodynamic and neurovascular characteristics at baseline and during handgrip exercise in patients with polymorphisms Gln27Gln and Gln27Glu+Glu27Glu before and after the exercise training period.</p

<p>Physical and clinical characteristics in patients with polymorphisms Gln27Gln and Gln27G... more <p>Physical and clinical characteristics in patients with polymorphisms Gln27Gln and Gln27Glu+Glu27Glu one month after the ischemic event.</p

<p>Individual data for MSNA in burst frequency (bursts/min) at baseline and during the hand... more <p>Individual data for MSNA in burst frequency (bursts/min) at baseline and during the handgrip exercise and the MSNA response (Delta) in patients with polymorphism Gln27Gln (<i>n</i> = 17, 2A and 2C, respectively) and Gln27Glu+Glu27Glu (<i>n</i> = 08, 2B and 2D, respectively), pre- and postexercise training period. Note that the MSNA significantly decreased after the exercise training period at baseline and during exercise in the Gln27Gln group. *<i>P</i><0.05, vs. baseline; ^†<i>P</i><0.05, vs. preintervention.</p

<p>MSNA response (delta) in bursts/min in the postexercise training period in patients with... more <p>MSNA response (delta) in bursts/min in the postexercise training period in patients with the polymorphism Gln27Gln (<i>n</i> = 17) and in the Gln27Glu+Glu27Glu group (<i>n</i> = 08). Note that MSNA response was similar in both groups after the exercise training period.</p

Rev. Soc. Cardiol. …, 1991

Resumo: Considerando-se o usual emprego de fármacos depressores do cronotropismo em portadores de... more Resumo: Considerando-se o usual emprego de fármacos depressores do cronotropismo em portadores de fibrilaçäo atrial crônica (FAC), objetivou-se avaliar os reais efeitos da digoxina e do verapamil sobre a capacidade física de idosis portadores desta arritmia, ...

Atherosclerosis, 2011

Objective: To evaluate the effects of resistance training (RT) on the metabolism of an LDL-like n... more Objective: To evaluate the effects of resistance training (RT) on the metabolism of an LDL-like nanoemulsion and on lipid transfer to HDL, an important step of HDL metabolism. Methods: LDL-like nanoemulsion plasma kinetics was studied in 15 healthy men under regular RT for 1-4 years (age = 25 ± 5 years, VO 2 peak = 50 ± 6 mL/kg/min) and in 15 healthy sedentary men (28 ± 7 years, VO 2 peak = 35 ± 9 mL/kg/min). LDL-like nanoemulsion labeled with 14 C-cholesteryl-ester and 3 H-freecholesterol was injected intravenously, plasma samples were collected over 24-h to determine decay curves and fractional clearance rates (FCR). Lipid transfer to HDL was determined in vitro by incubating of plasma samples with nanoemulsions (lipid donors) labeled with radioactive free-cholesterol, cholesterylester, triacylglycerols and phospholipids. HDL size, paraoxonase-1 activity and oxidized LDL levels were also determined. Results: The two groups showed similar LDL and HDL-cholesterol and triacylglycerols, but oxidized LDL was lower in RT (30 ± 9 vs. 61 ± 19 U/L, p = 0.0005). In RT, the nanoemulsion 14 C-cholesteryl-ester was removed twice as fast than in sedentary individuals (FCR: 0.068 ± 0.023 vs. 0.037 ± 0.028, p = 0.002), as well as 3 H-free-cholesterol (0.041 ± 0.025 vs. 0.022 ± 0.023, p = 0.04). While both nanoemulsion labels were removed at the same rate in sedentary individuals, RT 3 H-free-cholesterol was removed slower than 14 C-cholesteryl-ester (p = 0.005). HDL size, paraoxonase 1 and the transfer rates to HDL of the four lipids were the same in both groups. Conclusions: RT accelerated the clearance of LDL-like nanoemulsion, which probably accounts for the oxidized LDL levels reduction in RT. RT also changed the balance of free and esterified cholesterol FCR's. However, RT had no effect on HDL metabolism related parameters.

American Journal of Respiratory and Critical Care Medicine, 2002

Epidemiological studies have implicated obstructive sleep apnea (OSA) as an independent comorbid ... more Epidemiological studies have implicated obstructive sleep apnea (OSA) as an independent comorbid factor in cardiovascular and cerebrovascular diseases. It is postulated that recurrent episodes of occlusion of upper airways during sleep result in pathophysiological changes that may predispose to vascular diseases. Insulin resistance is a known risk factor for atherosclerosis, and we postulate that OSA represents a stress that promotes insulin resistance, hence atherogenesis. This study investigated the relationship between sleep-disordered breathing and insulin resistance, indicated by fasting serum insulin level and insulin resistance index based on the homeostasis model assessment method (HOMA-IR). A total of 270 consecutive subjects (197 male) who were referred for polysomnography and who did not have known diabetes mellitus were included, and 185 were documented to have OSA defined as an apnea-hypopnea index (AHI) у 5. OSA subjects were more insulin resistant, as indicated by higher levels of fasting serum insulin (p ϭ 0.001) and HOMA-IR (p Ͻ 0.001); they were also older and more obese. Stepwise multiple linear regression analysis showed that obesity was the major determinant of insulin resistance but sleepdisordered breathing parameters (AHI and minimum oxygen saturation) were also independent determinants of insulin resistance (fasting insulin: AHI, p ϭ 0.02, minimum O 2 , p ϭ 0.041; HOMA-IR: AHI, p ϭ 0.044, minimum O 2 , p ϭ 0.022); this association between OSA and insulin resistance was seen in both obese and nonobese subjects. Each additional apnea or hypopnea per sleep hour increased the fasting insulin level and HOMA-IR by about 0.5%. Further analysis of the relationship of insulin resistance and hypertension confirmed that insulin resistance was a significant factor for hypertension in this cohort. Our findings suggest that OSA is independently associated with insulin resistance, and its role in the atherogenic potential of sleep disordered breathing is worthy of further exploration.

Frontiers in Neuroscience, 2020

Exercise training is a cornerstone in reducing blood pressure (BP) and muscle sympathetic nerve a... more Exercise training is a cornerstone in reducing blood pressure (BP) and muscle sympathetic nerve activity (MSNA) in individuals with essential hypertension. Highintensity interval training (HIIT) has been shown to be a time efficient alternative to classical continuous training in lowering BP in essential hypertension, but the effect of HIIT on MSNA levels has never been investigated. Leg MSNA responsiveness to 6 weeks of HIIT was examined in 14 hypertensive men (HYP; age: 62 ± 7 years, night time BP: 136 ± 12/83 ± 8 mmHg, BMI: 28 ± 3 kg/m 2), and 10 age-matched normotensive controls (NORM; age: 60 ± 8 years, night time BP: 116 ± 2/68 ± 4 mmHg and BMI: 27 ± 3 kg/m 2). Before training, MSNA levels were not different between HYP and NORM (burst frequency (BF): 41.0 ± 10.3 vs. 33.6 ± 10.6 bursts/min and burst incidence (BI): 67.5 ± 19.7 vs. 64.2 ± 17.0 bursts/100 heart beats, respectively). BF decreased (P < 0.05) with training by 13 and 5% in HYP and NORM, respectively, whereas BI decreased by 7% in NORM only, with no difference between groups. Training lowered (P < 0.05) night-time mean arterial-and diastolic BP in HYP only (100 ± 8 vs. 97 ± 5, and 82 ± 6 vs. 79 ± 5 mmHg, respectively). The change in HYP was greater (P < 0.05) compared to NORM. Training reduced (P < 0.05) body mass, visceral fat mass, and fat percentage similarly within-and between groups, with no change in fat free mass. Training increased (P < 0.05)VO 2-max in NORM only. Six weeks of HIIT lowered resting MSNA levels in age-matched hyper-and normotensive men, which was paralleled by a significant reduction in BP in the hypertensive men.

The FASEB Journal, Mar 31, 2017

Obstructive sleep apnea (OSA) is a risk factor frequently present in patients with metabolic synd... more Obstructive sleep apnea (OSA) is a risk factor frequently present in patients with metabolic syndrome (MetS). Despite of MetS, moderate and severe OSA has been associated with cardiovascular diseas...

The FASEB Journal

Obstructive sleep apnea (OSA) impairs insulin‐glucose metabolism and muscle sympathetic nervous a... more Obstructive sleep apnea (OSA) impairs insulin‐glucose metabolism and muscle sympathetic nervous activity (MSNA). Metabolic syndrome (MetS) frequently is common in OSA patients, exacerbating these alterations. In this context, the effect of hypocaloric diet and exercise training (D+ET) in patients with OSA+MetS is not clear. We tested the hypotheses that: 1) D+ET would improve insulin‐glucose metabolism and MSNA; and 2) The reduction in MSNA is associated with the improvement insulin‐glucose metabolism. Never treated OSA patients (apnea‐hypopnea index‐AHI>15 events/h by polysomnography, PSG) and MetS (ATP‐III), were divided into: Control (C, n=10, 46±2y) and D+ET (n=11, 55±3y). D (−500kcal/day) and ET (40min, 3times/week of cycle exercise for 4‐months). We evaluated MSNA (microneurography) and HOMA‐IR and QUICK by fasting insulin/glucose. Both groups were similar in MetS risk factors, PSG parameters, MSNA and fasting insulin/glucose at pre‐intervention. Compared with C, D+ET impro...

The FASEB Journal

Increased sympathetic muscle mechanoreflex sensitivity and attenuated sympathetic muscle metabore... more Increased sympathetic muscle mechanoreflex sensitivity and attenuated sympathetic muscle metaboreflex sensitivity have been described in heart failure (HF) patients. We tested the hypothesis that exercise training (ET) would improve sympathetic mechano and metaboreflex sensitivity in HF patients. 24 consecutive, randomized, HF patients, Functional Class II‐III NYHA, EF≤40% were divided into two groups: Exercise‐trained (n=12, 55±2 years) and untrained (n=12, 54±2 years). 10 normal controls (NC) were also studied. Muscle sympathetic nerve activity (MSNA) was directly recorded from the peroneal nerve. Mechanoreceptors were activated by passive exercise. Metaboreceptors were activated by post‐exercise circulatory arrest. ET consisted of three 60‐minutes exercise sessions per week for 4 months. ET significantly reduced MSNA in HF patients (34 vs. 40 bursts/min, P<0.05). ET significantly reduced MSNA responses to passive exercise (Δ = 2 vs. 5 bursts/min, P<0.05) and increased MNSA ...

International Journal of Cardiology

Circulation, 2021

Introduction: Coronavirus disease 2019 (COVID-19) has become one of the more dramatic health prob... more Introduction: Coronavirus disease 2019 (COVID-19) has become one of the more dramatic health problems in the century. This disease has enormous consequence for the health care worldwide. In addition to high mortality rate, patients recovered from COVID-19 present short and long-term cardiovascular sequelae including chest pain, myocardial dysfunction, arrhythmia, dyspnea, breathlessness, postural tachycardia syndrome, and thrombotic complications. The explanations for these clinical manifestations are still uncertain but can involve a constellation of physiological alterations. Hypothesis: To test if COVID-19 survivors have augmented sympathetic outflow, diminished endothelial function, elevated aortic stiffness, and reduced physical capacity compared to healthy individuals. Methods: Nineteen COVID-19 survivors [age: 47.0±2.3 years, BMI: 30.1±1.2 Kg/m 2 ] and eighteen well-matched healthy controls (age: 44.0±2.0 years, BMI: 28.4 ±1.2 Kg.m 2 ] were included in study. COVID-19 survivo...

Circulation, Oct 28, 2008

<jats:p>Obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) independently increase... more <jats:p>Obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) independently increases muscular sympathetic nervous activity (MSNA). Unknown is whether OSA has an additive effect on MSNA in patients with MetS. We tested the hypothesis that: OSA would have an additive effect on MSNA in patients with MetS. In addition, we studied whether the increase in MSNA in patients with MetS is associated with alteration in arterial baroreflex sensitivity (BRS). Twenty four patients with MetS diagnosed according ATP-III were divided in two groups:</jats:p> <jats:p> <jats:list list-type="order"> <jats:list-item> <jats:p>MetS+OSA (n=14) and</jats:p> </jats:list-item> <jats:list-item> <jats:p>MetS (n=10).</jats:p> </jats:list-item> </jats:list> </jats:p> <jats:p> They were matched for age, body mass index, waist circumference, and metabolic profile: OSA was defined by an apnoea/hypopnoea index (AHI)&gt;15 events/hour by polysonography. MSNA was recorded directly from the peroneal nerve using the technique of microneurography. Blood pressure (BP) was monitored on a beat-by-beat basis (Finapress) and heart rate by ECG. BRS was analyzed by spontaneous BP and heart rate fluctuations. AHI was higher (42±9 vs. 7±1 events/h, <jats:italic>P</jats:italic> =0.0001) and minimum oxygen saturation lower (77±2 vs. 87±1 %, <jats:italic>P</jats:italic> =0.001) in MetS+OSA patients. Patients MetS+OSA had higher MSNA (55±3 vs. 43±2 bursts/100 beats, <jats:italic>P</jats:italic> =0.01) and systolic BP (158±4 vs.144±3 mmHg, <jats:italic>P</jats:italic> =0.01) when compared with patients with MetS without OSA. Further analysis showed that AHI and minimum oxygen saturation have significant correlation with MSNA (r=0.65; <jats:italic>P</jats:italic> =0.001 and r=−0.48; <jats:italic>P</jats:italic> =0.017, respectively). Patients with MetS+OSA had lower BRS for increases (7.8±0.9 <jats:italic>vs.</jats:italic> 13.4 ± 1.4 msec/mmHg, <jats:italic>P</jats:italic> =0.01) and decreases (7.2±0.9 <jats:italic>vs.</jats:italic> 13.2 ± 2.0 msec/mmHg, <jats:italic>P</jats:italic> =0.03) in blood pressure than patients with MetS without OSA. MSNA significantly correlated with BRS during spontaneous increases in blood pressure (r=−0.56, <jats:italic>P</jats:italic> =0.01). OSA exacerbates MSNA in patients with MetS. In addition, the augmented MSNA in patients with MetS+OSA is associated with reduced BRS. These findings suggest that OSA increases the risk for cardiovascular disease in patients with MetS. </jats:p>

Circulation, 2015

Background: Sympathetic activation and arterial baroreflex (ABR) dysfunction typify chronic heart... more Background: Sympathetic activation and arterial baroreflex (ABR) dysfunction typify chronic heart failure (CHF). In addition, decreased oscillatory pattern of muscle sympathetic nerve activity (MSNA, LF MSNA /HF MSNA ) seems to contribute to sympathetic exacerbation in patients with CHF. Unknown is whether the LF MSNA /HF MSNA is associated with ABR dysfunction in CHF patients. To answer this question, we investigated the association between gain, latency and coupling of ABR function and LF MSNA /HF MSNA in CHF patients. Methods and Results: Forty-three CHF patients, Functional Class II to III, NYHA, ejection fraction ≤40% were allocated into two groups according to the level of LF MSNA /HF MSNA index: 1) Higher LF MSNA /HF MSNA (n=21, 52±2 years) and 2) Lower LF MSNA /HF MSNA (n=22, 54±1 years). Blood pressure (BP, oscillometric beat-to-beat basis) and MSNA (microneurography technique) were recorded during 10 min at rest. Spectral and cross-spectral analyses of BP and MSNA variabil...