Vivian Arakelian | Universidade Federal de São Paulo (UNIFESP) (original) (raw)

Papers by Vivian Arakelian

European Respiratory Journal, 2012

BACKGROUND: Coronary angioplasty (PTCA) is a common treatment method in patients with coronary he... more BACKGROUND: Coronary angioplasty (PTCA) is a common treatment method in patients with coronary heart disease, but its effects on deep-breathing heart rate variability (HRV) has not been well established. OBJECTIVE: The aim of the study was to analyse deep breathing heart rate variability, which reflect the sympathovagal control of heart rate in patients before, after 1 and 30 days of elective PTCA. METHODS: The study consisted of 10 consecutive patients (7 men, 3 women) with age of 62.4±11.6 years, single-vessel coronary artery disease (CAD) who underwent elective coronary angioplasty with stent implant. Heart-rate variability (HRV) was obtained at rest (spontaneous breathing) and during respiratory sinus arrhythmia maneuver (RSA-M) by cardiofrequencimeter (Polar S810i) before, after 1 and 30 days of PTCA. RSA-M consisted of deep-breathing in 6 respiratory cycles per minute. HRV analyses were obtained by the time, frequency-domain (high frequency- HF; and low frequency-LF) and non-l...

Resistance (RE) and aerobic exercise (AE) can promote hemodynamic, physiologic and clinical modif... more Resistance (RE) and aerobic exercise (AE) can promote hemodynamic, physiologic and clinical modifications in coronary artery disease (CAD) patients. The aim of the study is to assess key physiologic and clinical responses during RE at 30% and 60% of 1-RM on a 45° leg press and to compare responses during AE. We evaluated fifteen male subjects with coronary artery disease (60.8±4.7 years) that performed the following tests: (1) incremental AE test on cycle ergometer; (2) 1-RM test on a leg press at 45°; (3) and RE at 30% and 60% of 1-RM for 24 repetitions. Peak cardiac output (CO), heart rate (HR), oxygen consumption (VO 2), carbon dioxide production (VCO 2) and the minute ventilation (V E , L/min)/VCO 2 ration were measured. We found that both AE and RE at 60% of aerobic and resistance capacity elicited similar hemodynamic and ventilatory responses (p>0.05). However, RE at 30% 1-RM showed more attenuated responses of VO 2 , V E /VCO 2 , HR and CO when compared with 60% of aerobic...

The aim was to compare the behavior of lactacidemia and gasometric parameters in resistance exerc... more The aim was to compare the behavior of lactacidemia and gasometric parameters in resistance exercises using a minimally invasive technique Abbott i-STAT Portable Clinical Analyzer. 10 men, 20.3 ± 4.2 years, 74 ± 10.2Kg, 177 ± 4.6cm and 23.8 ± 3.2Kg/m2 underwent one session each of leg press (LP) and bench press (BP) (4 x 10 in 70% 1RM x 3’). Values rose from a grade to post-exercise in Borg and Omni and rest to post-exercise in lactate and paO2. And reduced rest to post-exercise in pH, paCO2, HCO3_ and BE (P<0,05) in both tests. We conclude that both exercises promoted unbalance in the acid-base system which can be related to the intensity. And minimally invasive technique that is excellent tool for studying the behavior these variables by means of a reduced volume of blood sample allows a wide variety of gas exchange variables accurately and immediately.

printing supported by . Visit Chiesi at Stand D.30 SUNDAY, SEPTEMBER 25TH 2011 and psychological ... more printing supported by . Visit Chiesi at Stand D.30 SUNDAY, SEPTEMBER 25TH 2011 and psychological function between analgesic intolerant and tolerant asthmatic (AIA and ATA, respectively) patients. Methods: Twenty-seven AIA and 29 ATA patients participated in this study. Respiratory and quadriceps muscle strength (QMS) were measured. Asthma Control Questionnaire and Asthma Knowledge Test were applied. Six-minute walk test was performed, and physical activity level was determined using International Physical Activity Questionnaire (IPAQ). Dyspnea and fatigue perception was evaluated using modified Medical Research Council dyspnea scale and Fatigue Severity Scale, respectively. Psychological function was evaluated using Beck Depression Inventory and State Trait Anxiety Inventory. General and disease specific quality of life were determined using Nottingham Health Profile and Asthma Quality of Life Questionnaire, respectively. Results: The FEV1, QMS, IPAQ walking score, and Asthma Knowle...

European Journal of Physical and Rehabilitation Medicine, 2021

BACKGROUND The prognosis of Pulmonary Hypertension (PH) is directly correlated with the functiona... more BACKGROUND The prognosis of Pulmonary Hypertension (PH) is directly correlated with the functional capacity (FC). The most common FC test is the 6-Minute Walk Test (6MWT), however, there is evidence to suggest that the 6MWT does not reflect the real FC in PH patients. OBJECTIVE To compare physiological responses among three field walk tests and cardiopulmonary exercise testing (CPET) in patients with pulmonary hypertension (PH), and to determine the determinants of distance walked in the field walk tests. DESIGN Cross sectional. SETTING Outpatient clinic. PARTICIPANTS 26 volunteers (49.8 ± 14.6 years), WHO functional class II-III and a mean pulmonary artery pressure of 45 mmHg. INTERVENTIONS Patients underwent three field walk test: 6MWT, incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT) and CPET on different, nonconsecutive days. MAIN OUTCOME MEASURES Heart rate and perception of effort at the peak of exercise. RESULTS The ISWT achieved maximum levels of effort without significant difference in any physiologic response compared to CPET. The physiological responses during ISWT were significantly higher than 6MWT and ESWT responses. CONCLUSIONS The ISWT produced the greatest physiologic response of the field tests safely for which reason it appears to be the most effective test to assess FC of PH patients.

Pulmonary Circulation and Pulmonary Vascular Disease, 2017

To investigate the effectiveness of combined aerobic and resistance training (CT), we conducted t... more To investigate the effectiveness of combined aerobic and resistance training (CT), we conducted this metaanalysis to directly compare the effect of CT with that of aerobic training (AT) alone on type 2 diabetic patients. We searched PUBMED, EMBASE, Cochrane Controlled Trials Register, and SPORT DISCUS (from the earliest date available to June 2013) for randomized controlled trials (RCTs) examining effects of CT versus AT in type 2 diabetic patients. Two reviewers selected studies independently. Seven studies met the study criteria (192 male patients, 240 female patients). We found that compared with AT, CT decreased HbA1c, abdominal adipose tissue, total cholesterol, and triglycerides. CT had similar effect on HDL cholesterol, LDL cholesterol, and blood pressure to AT alone. Study withdrawals were similar for AT and CT. No serious adverse events were reported. CT is more effective than AT and does not compromise study completion or safety when compared to AT.

Journal of Sports Sciences, 2018

ABSTRACT Aim was to identify critical load (CL) in young and elderly apparently healthy male coho... more ABSTRACT Aim was to identify critical load (CL) in young and elderly apparently healthy male cohorts. To contrast the metabolic, cardiovascular and perceptual responses on CL according to age. We evaluated 12 young (23 ± 3 years) and 10 elderly (70 ± 2 years) apparently healthy active males, who underwent: (1) 1 repetition maximum (1RM) test on a 45° Leg Press; (2) on different days, three high-intensity resistance exercise constant load tests (60%, 75% and 90% 1RM) until fatigue (Tlim). Absolute values of both the CL asymptote and curvature constant (kg) were significantly lower in elderly subjects (P < 0.05). In contrast, elderly subjects demonstrated a significantly higher number of repetitions at CL when compared with young subjects (P < 0.05). As expected, oxygen uptake (VO2) and heart rate (HR) during maximal aerobic exercise testing were significantly reduced in older subjects. However, percent-predicted aerobic capacity were higher in older subjects (P < 0.05). In addition, blood lactate ([La−]) corrected to Tlim and rating of perceived exertion values were greater in younger subjects at all intensities (P < 0.05). These findings, despite reduced force production in older subjects, endurance-related parameters are well preserved according to age-adjusted percent-predicted values in apparently healthy males.

Motriz: Revista de Educação Física, 2018

The present study investigated the behavior of glycemia in subjects with type 2 diabetes (T2DM) d... more The present study investigated the behavior of glycemia in subjects with type 2 diabetes (T2DM) during 36 sessions of a combined training program. Methods: This is a single arm clinical study with 20 patients with T2DM submitted to combined exercise training (strength and aerobic exercise). The sessions occurred on alternate days, 3x/week, lasting ~ 80 minutes, totaling ~ 240 minutes/week, for 12 weeks, over a total of 36 sessions. Capillary glycemia was measured before and 10 to 15 minutes after the end of each combined exercise session. Results: There was a significant reduction (p<0.05) in glycemia after application of the combined training program in 27 (75%) of the 36 sessions. Regarding the maintenance of this reduction after about 48 hours, no significant differences were identified (p>0.05). When investigating the cumulative effect of the 36 sessions of combined training program on capillary glycemia, no significant differences were observed (p>0.05). Conclusion: Glycemia exhibits a behavior of reduction immediately after concurrent strength and aerobic training programs in patients with T2DM. However, the immediate reduction of glycemia is not maintained until 48 hours, nor is there a cumulative effect of the 36 training sessions on baseline glycemia.

Brazilian Journal of Medical and Biological Research, 2018

The objective of this study was to assess cardiovascular, respiratory, and metabolic responses du... more The objective of this study was to assess cardiovascular, respiratory, and metabolic responses during a commonly used dynamic leg press resistance exercise until exhaustion (T Ex) at different intensities and compare with critical load (CL). This was a prospective, cross-sectional, controlled, and crossover study. Twelve healthy young men (23±2.5 years old) participated. The subjects carried out three bouts of resistance exercise in different percentages of 1 repetition maximum (60, 75, and 90% 1RM) until T Ex. CL was obtained by means of hyperbolic model and linearization of the load-duration function. During all bout intensities, oxygen uptake (VO 2), carbon dioxide production (VCO 2), ventilation (V E), and respiratory exchange ratio (RER) were obtained. Variations (peak-rest=D) were corrected by T Ex. In addition, systolic and diastolic blood pressure (SBP and DBP), blood lactate concentration [La-] and Borg scores were obtained at the peak and corrected to T Ex. CL induced greater T Ex as well as number of repetitions when compared to all intensities (Po0.001). During CL, Borg/T Ex , DSBP/T Ex , DDBP/T Ex , and [La-] were significantly lower compared with 90% load (Po0.0001). In addition, VO 2, VCO 2, V E , and RER were higher during CL when compared to 90 or 75%. T Ex was significantly correlated with VO 2 on CL (r=0.73, Po0.05). These findings support the theory that CL constitutes the intensity that can be maintained for a very long time, provoking greater metabolic and ventilatory demand and lower cardiovascular and fatigue symptoms during resistance exercise.

Arquivos brasileiros de cardiologia, 2018

Type 2 diabetes Mellitus (T2DM) is associated with cardiac autonomic dysfunction, which is an ind... more Type 2 diabetes Mellitus (T2DM) is associated with cardiac autonomic dysfunction, which is an independent predictor of mortality in chronic diseases. However, whether the coexistence of systemic arterial hypertension (HTN) with DMT2 alters cardiac autonomic modulation remains unknown. To evaluate the influence of HTN on cardiac autonomic modulation and cardiorespiratory fitness in subjects with DMT2. 60 patients of both genders were evaluated and allocated to two groups: DMT2 patients (n = 32; 51 ± 7.5 years old) and DMT2 + HTN patients (n = 28; 51 ± 6.9 years old). RR intervals were obtained during rest in supine position. Linear and nonlinear indices of heart rate variability (HRV) were computed using Kubios HRV software. Pulmonary gas exchange was measured breath-by-breath, using a portable telemetric system during maximal incremental exercise testing on a cycle ergometer. Statistical analysis included Shapiro-Wilk test followed by Student's t Test, Pearson correlation and li...

Medicine & Science in Sports & Exercise, 2014

American journal of physical medicine & rehabilitation, Jan 21, 2017

To the Editor Several interesting concerns about methods and results were raised in the Letter to... more To the Editor Several interesting concerns about methods and results were raised in the Letter to the Editor regarding the study by Ferraresi et al., 1 which also suggest possible bias in the discussion. Although at first view, all concerns seem to be pertinent, most of them were based on different studies compared with the study by Ferraresi et al. 1 Therefore, these concerns require a detailed response to avoid a biased interpretation.

Circulation, 2015

Background: The prevalence of diabetes have increased globally to epidemic proportions; glycemic ... more Background: The prevalence of diabetes have increased globally to epidemic proportions; glycemic control and treatment remains a challenge. Concurrent aerobic and resistance training programs (CART) have been widely recommended as an important strategy to improve physiologic and functional performance. Objective: The impact of CART programs on metabolic profile, glycemic control and exercise capacity status in patients with diabetes requires additional study, which is the primary aim of the current study. Materials and Methods: We evaluated 41 patients (15 female and 19 male, 50.8±7 years) with a confirmed diagnosis of diabetes. The subjects were randomized in two groups: sedentary group (SG) and CART group (CART-G). CART was performed 12 weeks, 3 times a week for approximately 1 hour per session (30 minutes aerobic and 30 minutes resistance). Body habitus was assessed by body mass index, waist circumference, and skinfolds. Peripheral muscular strength was evaluated by an isokinetic...

European Respiratory Journal, 2016

Background: New indices such as cardiopulmonary (CP) and ventilator power (VP) have been proposed... more Background: New indices such as cardiopulmonary (CP) and ventilator power (VP) have been proposed as important markers of exercise limitation (1). Concurrent aerobic and resistance training (CART) have been widely recommended in diabetic patients (2). However, no study has evaluated if these indices can be beneficially modulated by CART programs in patients with type 2 diabetes mellitus (T2DM). Objective: To evaluate the effects of CART on CP and VP in maximal exercise in T2DM. Materials and Methods: We evaluated 41 patients (50.8±7 years) with T2DM randomized in sedentary group (SG) and CART group (CART-G). The CART consisted of ∼210 min/week, 3 three times per week on individually supervised sessions, in alternate days, for 12 weeks, 30 minutes aerobic and 30 minutes resistance. Pulmonary gas exchange was measured using a portable telemetric system during maximal incremental exercise testing on a cycle ergometer. Shapiro-Wilk test follow by ANOVA two way repeated measures were performed. Results: Only CART group was able to increase CP in 24% (from 4275.1±1746±2 to 5340.2±1448.2 mmHg/mlO 2 /Kg/min) as well as peak oxygen uptake, in 18.8% (from 22.9±6.1 to 27.2±4.7 ml.kg −1. min −1 ) after training. Also, improvement of CP were contrasted between CART-G vs SG (41.2%, p Conclusion: Our study introduced and evaluated the beneficial effects of CART program on ventilatory and cardiocirculatory efficiency in T2DM. Our results can potentially recommend the indicate of CART as an important tool to beneficially impact on clinical prognostic of these patients.

À Deus por me guiar para sempre seguir em frente; por me dar sabedoria, força e saúde para supera... more À Deus por me guiar para sempre seguir em frente; por me dar sabedoria, força e saúde para superar os obstáculos e pela oportunidade de concluir mais uma etapa de minha vida. Aos meus pais por estarem sempre presentes e por motivarem todos os meus passos. À minha orientadora Profª Drª Audrey Borghi Silva, por ter me recebido de braços abertos no laboratório, possibilitando um grande crescimento profissional para minha carreira. Agradeço pela dedicação, pelos ensinamentos e incentivos fornecidos, paciência e confiança depositada. Meus sinceros agradecimentos. Ao Prof. Dr. Vilmar Baldissera, por ter me acolhido no laboratório desde 2005, ainda em minha graduação. Obrigado por me fazer amar a fisiologia, mostrando o quanto ela é interessante, motivante, cativante e inesquecível. Agradeço pelo carinho, dedicação e por todos os ensinamentos e incentivos e principalmente por me fazer entender o que significa ser mestre. Ao Prof. Dr. Fábio Serrão, por ter me emprestado o eletromiografo, sem o qual esse trabalho não seria realizado. Ao meu amigo Nuno Frade, pela amizade, companheirismo, confiança e pela ajuda para a realização desse trabalho. Às minhas amigas Vanessa, Camila, Daniela e Renata pela amizade, paciência, confiança e ajuda para a realização e conclusão desse trabalho. À Ramona pela ajuda constante nas rotinas do Matlab, não sei o que teria feito sem você! Aos amigos do Laboratório de Fisiologia do Exercício pela amizade, aprendizado e por todos os momentos de alegria que passamos juntos. Aos amigos do Laboratório de Fisioterapia Cardiopulmonar pela ajuda, atenção e companheirismo. Ao Jonas meu namorado, por compreender a importância dessa conquista; pelo carinho, amor, companheirismo e apoio em todos os momentos desta importante etapa em minha vida. Aos meus voluntários pela paciência, compreensão, aprendizagem, por sempre serem solícitos aos nossos chamados e realizarem os testes sempre de bom humor. Sem o auxilio de vocês o trabalho não teria sido possível. A todos os meus familiares, que são parte importante na minha vida e que torceram por essa conquista. Aos meus amigos que longe ou perto sempre me ajudam de alguma maneira, ou com uma palavra de apoio ou simplesmente com sua amizade. Aos professores e funcionários do Programa de Pós-Graduação Interunidades em Bioengenharia da USP e do Programa de Pós-Graduação em Fisioterapia na UFSCar. Aos órgãos de pesquisa CAPES e FAPESP, pelo auxílio financeiro. A todos aqueles que direta ou indiretamente contribuíram de alguma forma para a realização desse trabalho. Muito Obrigada! Resumo ARAKELIAN, V. M. Comparação do Limiar Anaeróbio e da Carga Crítica com Relação aos parâmetros cardiorrespiratórios, metabólicos e eletromiográficos no exercício resistido de Leg Press 45° em jovens e idosos. 2015. 90f.

Summary Objective To evaluate acid-base status during constant-load resistance exercise at the la... more Summary Objective To evaluate acid-base status during constant-load resistance exercise at the lactate threshold (LT) intensity. Methods Seven healthy men underwent two protocols on a leg press machine. One maximal incremental test to determine LT intensity and a constant-load resistance protocol executed at this intensity. The participants performed 15 sets of 20 repetitions lasting 1 min with 1 min rest intervals during the constant-load exercise. Capillary blood samples were collected during the tests in order to evaluate blood lactate concentration, pH, bicarbonate, base excess, peripheral blood gas levels and oxygen saturation. Results Blood lactate concentration increased significantly (P ≤ 0.017; significant level with Bonferroni correction) between rest (0.65 ± 0.21 mmol.L−1) and set 15 (4.58 ± 1.96 mmol.L−1). Blood lactate concentration remained stable during the constant-load resistance exercise (P > 0.017). Bicarbonate, base excess and partial pressure of carbon dioxide had a significant decrease (26.4 ± 2.1 mmol.L−1, 2.7 ± 2.4 and 36.0 ± 2.7 mmHg at rest, respectively, to 19.6 ± 4.3 mmol.L−1, −5.0 ± 3.4, 30.2 ± 4.0 mmHg at set 15, respectively; P ≤ 0.017). Oxygen saturation and pH also remained constant during the exercise (97.2 ± 1.8% and 7.47 ± 0.03 at rest to 97.0 ± 1.4 and 7.41 ± 0.05 at set 15, respectively; P > 0.017). Conclusion During a constant-load resistance exercise at LT intensity pH remained constant and this intensity seems to correspond to a metabolic steady state.