FERNANDA MARCIANO CONSOLIM COLOMBO
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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
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article 10 Citação(ões) na Scopus Arg16Gly and Gln27Glu beta 2 adrenergic polymorphisms influence cardiac autonomic modulation and baroreflex sensitivity in healthy young Brazilians(2015) ATALA, Magda M.; GOULART, Alessandra; GUERRA, Grazia M.; MOSTARDA, Cristiano; RODRIGUES, Bruno; MELLO, Priscila R.; CASARINE, Dulce E.; IRIGOYEN, Maria-Claudia; PEREIRA, Alexandre C.; CONSOLIM-COLOMBO, Fernanda M.The association between functional beta(2) adrenergic receptor (beta(2)-AR) polymorphisms and cardiac autonomic modulation is still unclear. Thus, two common polymorphisms in the beta(2)-AR gene (Gln27Glu beta(2) and Arg16Gly beta(2)) were studied to determine whether they might affect tonic and reflex cardiac sympathetic activity in healthy young subjects. A total of 213 healthy young white subjects of both genders (53% female), aged 18-30 years (23.5 +/- 3.4 y), had their continuous blood pressure curves noninvasively recorded by Finometer at baseline, and other hemodynamic parameters, as cardiac autonomic modulation, baroreflex sensitivity, and allele, genotype, and diplotype frequencies calculated. Associations were made between Arg16Gly beta(2) and Gln27Glu beta(2) polymorphisms and between beta(2)-AR diplotypes and all variables. The heart rate was significantly lower (P<0.001) in the presence of homozygous Arg/Arg alleles (60.9 +/- 1.5 bpm) than in that of Arg/Gly heterozygotes (65.9 +/- 1.0 bpm) or Gly/Gly homozygotes (66.3 +/- 1.2 bpm). Homozygous carriers of Arg16 allele had an alpha index (19.2 +/- 1.3) significantly higher (P<0.001) than that of the subjects with the Gly allele Gly/Gly ( 14.5 +/- 0.7) or Arg/Gly (14.6 +/- 0.7). Furthermore, the recessive Glu27Glu and the heterozygous Gln27Glu genotypes had a higher percentage of low-frequency components (LF%) than the homozygous Gln27Gln (15.1% vs. 16.0% vs. 8.2%, P=0.03, respectively). In healthy young subjects, the presence of beta(2)-AR Arg16 allele in a recessive model was associated with higher baroreflex sensitivity, and increased parasympathetic modulation in studied individuals.- Impact of exercise training associated to pyridostigmine treatment on autonomic function and inflammatory profile after myocardial infarction in rats(2017) FERIANI, Daniele J.; SOUZA, Gabriel I. H.; CARROZZI, Nicolle M.; MOSTARDA, Cristiano; DOURADO, Paulo M. M.; CONSOLIM-COLOMBO, Fernanda M.; ANGELIS, Katia De; MORENO, Heitor; IRIGOYEN, Maria Claudia; RODRIGUES, BrunoBackground: The effects of exercise training (ET) associated with pyridostigmine bromide (PYR) treatment on cardiac and autonomic function, as well as on inflammatory profile after myocardial infarction (MI), are unclear. Methods: Male Wistar rats were randomly assigned to: control (C); sedentary + infarcted (I); sedentary + infarcted treated with PYR (IP); infarcted submitted to aerobic exercise training (IT); and infarcted submitted to treatment with PYR and aerobic exercise training (ITP). After 12 weeks of ET (50-70% maximal running speed; 1 h a day, 5 days a week) and/or PYR treatment (0.14 mg/mL on drink water), hemodynamic, autonomic and cytokines expression were performed. Results: Weobserved that both aerobic ET, associated or not with PYR treatment in MI animals, were able to: reduced MI area, improved systolic and diastolic function, baroreflex sensitivity, cardiovascular autonomic modulation, and tonic activity of the sympathetic and parasympathetic nervous system. Also, they led to a reduction of inflammatory profile measured at plasma, left ventricle and soleus skeletal muscle. However, additional effects were observed when ET and PYR were associated, such as an increase in vagal tonus and modulation, reduction of MI area, interferon-gamma and tumor necrosis factor-alpha (TNF-alpha), as well as an increase of interleukin-10/TNF-alpha ratio on left ventricle. Conclusion: These data suggest that associating ET and PYR promotes some additional benefits on cardiovascular autonomic modulation and inflammatory profile in infarcted rats.
- Statin restores cardiac autonomic response to acute hypoxia in hypercholesterolaemia(2013) BRASILEIRO-SANTOS, Maria S.; BARRETO-FILHO, Jose A. S.; SANTOS, Raul D.; CHACRA, Ana P. M.; SANGALETI, Carine Teles; ALVEZ, Gisele; BEZERRA, Otavio Coelho; BORTOLOTO, Luiz Aparecido; IRIGOYEN, Maria C.; CONSOLIM-COLOMBO, Fernanda M.BackgroundHypercholesterolaemia may alter cardiovascular autonomic function. We investigated the autonomic cardiovascular regulation during normoxia and hypoxia in familial isolated HC patients with or without statin treatment. Materials and methodsLow (LF-RR) and high (HF-RR) components of spectral analysis of RR interval and systolic arterial pressure (LF-SAP) were obtained during 5min of normoxia and isocapnic hypoxia (10% O-2) in 10 normotensive familial HC patients without medication, in seven HC patients after a 12-week treatment period with 40mg of simvastatin (HC+SVT) and in eight matched normal volunteers (CO). ResultsThe HC patients had significant impairment of cardiac autonomic modulation parameters compared with CO at normoxia, which was maintained or even accentuated during hypoxia; these parameters included lower total variance of RR, increased normalized LF-RR, decreased normalized HF-RR, increased LF-RR/HF-RR ratio, higher LF-SAP component and reduced index. However, the HC+SVT group had a significant improvement in all parameters: the LF-RR and LF-SAP decreased (indicating a decrease in cardiac and vascular sympathetic activity), the HF-RR increased (indicating an increase in parasympathetic activity) and the spontaneous baroreflex sensitivity improved. These changes were detected at normoxia and were maintained during hypoxia. ConclusionsOur data are the first to show that isolated HC is characterized by an increase in cardiac and vasomotor sympathetic drive, a decrease in cardiac vagal modulation and baroreflex impairment during normoxia and hypoxia. In addition, our data suggest that statin treatment has a potential role in restoring the physiological cardiovascular autonomic control at baseline and during cardiovascular challenge.
- Does Obstructive Sleep Apnea Influence Blood Pressure and Arterial Stiffness in Response to Antihypertensive Treatment?(2018) FATURETO-BORGES, Fernanda; JENNER, Raimundo; COSTA-HONG, Valeria; LOPES, Heno F.; TEIXEIRA, Sandra H.; MARUM, Elias; GIORGI, Dante A. M.; CONSOLIM-COLOMBO, Fernanda M.; BORTOLOTTO, Luiz A.; LORENZI-FILHO, Geraldo; KRIEGER, Eduardo M.; DRAGER, Luciano F.Untreated obstructive sleep apnea (OSA) is common in patients with hypertension and may impair blood pressure (BP) and target-organ damage responses to antihypertensive therapy. In this study, we recruited hypertensive patients who underwent treatment with a 30-day regimen of hydrochlorothiazide 25 mg plus enalapril (20 mg BID) or losartan (50 mg BID) and were assessed with a baseline clinical evaluation, polysomnography, 24-hour ambulatory BP monitoring, and carotid-femoral pulse wave velocity. All the examinations except for polysomnography were repeated at 6 and 18 months of follow-up. We studied 94 hypertensive patients (mean age, 55 +/- 9 years). The frequency of OSA was 55%. Compared with baseline, we did not observe significant differences between groups in 24-hour BP, daytime systolic and diastolic BPs, or night-time systolic BP at 6 and 18 months. The BP control rate at 24 hours (<130/80 mmHg) was similar between the groups (baseline, 42.3% versus 45.2%; 6 months, 46.9% versus 57.5%; 18 months, 66.7% versus 61.5%). However, patients with OSA had higher night-time diastolic BP decrease than did the non-OSA group (6 months, -4.9 +/- 11.8 versus -0.3 +/- 10.3 mmHg; 18 months, -6.7 +/- 11.1 versus -1.2 +/- 10.6 mmHg; P=0.027). There were no differences in the number and class of antihypertensive medications prescribed during follow-up. In terms of arterial stiffness, patients with OSA had higher pulse wave velocity than did patients without OSA at baseline (10.3 +/- 1.9 versus 9.2 +/- 1.7 m/s; P=0.024), but both groups had similar decreases in pulse wave velocity during follow-up. In conclusion, with combined antihypertensive treatment aimed at controlling BP, hypertensive patients with OSA had similar 24-hour BP and arterial stiffness to those without OSA.
- Effectiveness of Chlorthalidone Plus Amiloride for the Prevention of Hypertension: The PREVER-Prevention Randomized Clinical Trial(2016) FUCHS, Sandra Costa; POLI-DE-FIGUEIREDO, Carlos E.; FIGUEIREDO NETO, Jose A.; SCALA, Luiz Cesar N.; WHELTON, Paul K.; MOSELE, Francisca; MELLO, Renato Bandeira de; VILELA-MARTIN, Jose F.; MOREIRA, Leila B.; CHAVES, Hilton; GOMES, Marco Mota; SOUSA, Marcos R. de; SILVA, Ricardo Pereira e; CASTRO, Iran; CESARINO, Evandro Jose; JARDIM, Paulo Cesar; ALVES, Joao Guilherme; STEFFENS, Andre Avelino; BRANDAO, Andrea Araujo; CONSOLIM-COLOMBO, Fernanda M.; ALENCASTRO, Paulo Ricardo de; NETO, Abrahao Afiune; NOBREGA, Antonio C.; FRANCO, Roberto Silva; SOBRAL FILHO, Dario C.; BORDIGNON, Alexandro; NOBRE, Fernando; SCHLATTER, Rosane; GUS, Miguel; FUCHS, Felipe C.; BERWANGER, Otavio; FUCHS, Flavio D.Background-Prehypertension is associated with higher cardiovascular risk, target organ damage, and incidence of hypertension. The Prevention of Hypertension in Patients with PreHypertension (PREVER-Prevention) trial aimed to evaluate the efficacy and safety of a low-dose diuretic for the prevention of hypertension and end-organ damage. Methods and Results-This randomized, parallel, double-blind, placebo-controlled trial was conducted in 21 Brazilian academic medical centers. Participants with prehypertension who were aged 30 to 70 years and who did not reach optimal blood pressure after 3 months of lifestyle intervention were randomized to a chlorthalidone/amiloride combination pill or placebo and were evaluated every 3 months during 18 months of treatment. The primary outcome was incidence of hypertension. Development or worsening of microalbuminuria, new-onset diabetes mellitus, and reduction of left ventricular mass were secondary outcomes. Participant characteristics were evenly distributed by trial arms. The incidence of hypertension was significantly lower in 372 study participants allocated to diuretics compared with 358 allocated to placebo (hazard ratio 0.56, 95% CI 0.38-0.82), resulting in a cumulative incidence of 11.7% in the diuretic arm versus 19.5% in the placebo arm(P=0.004). Adverse events; levels of blood glucose, glycosylated hemoglobin, creatinine, and microalbuminuria; and incidence of diabetes mellitus were no different between the 2 arms. Left ventricular mass assessed through Sokolow-Lyon voltage and voltage-duration product decreased to a greater extent in participants allocated to diuretic therapy compared with placebo (P=0.02). Conclusions-A combination of low-dose chlorthalidone and amiloride effectively reduces the risk of incident hypertension and beneficially affects left ventricular mass in patients with prehypertension.
- Galantamine alleviates inflammation and insulin resistance in patients with metabolic syndrome in a randomized trial(2017) CONSOLIM-COLOMBO, Fernanda M.; SANGALETI, Carine T.; COSTA, Fernando O.; MORAIS, Tercio L.; LOPES, Heno F.; MOTTA, Josiane M.; IRIGOYEN, Maria C.; BORTOLOTO, Luiz A.; ROCHITTE, Carlos Eduardo; HARRIS, Yael Tobi; SATAPATHY, Sanjaya K.; OLOFSSON, Peder S.; AKERMAN, Meredith; CHAVAN, Sangeeta S.; MACKAY, Meggan; BARNABY, Douglas P.; LESSER, Martin L.; ROTH, Jesse; TRACEY, Kevin J.; PAVLOV, Valentin A.BACKGROUND. Metabolic syndrome (MetS) is an obesity-driven condition of pandemic proportions that increases the risk of type 2 diabetes and cardiovascular disease. Pathophysiological mechanisms are poorly understood, though inflammation has been implicated in MetS pathogenesis. The aim of this study was to assess the effects of galantamine, a centrally acting acetylcholinesterase inhibitor with antiinflammatory properties, on markers of inflammation implicated in insulin resistance and cardiovascular risk, and other metabolic and cardiovascular indices in subjects with MetS. METHODS. In this randomized, double-blind, placebo-controlled trial, subjects with MetS (30 per group) received oral galantamine 8 mg daily for 4 weeks, followed by 16 mg daily for 8 weeks or placebo. The primary outcome was inflammation assessed through plasma levels of cytokines and adipokines associated with MetS. Secondary endpoints included body weight, fat tissue depots, plasma glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), cholesterol (total, HDL, LDL), triglycerides, BP, heart rate, and heart rate variability (HRV). RESULTS. Galantamine resulted in lower plasma levels of proinflammatory molecules TNF (-2.57 pg/ml [95% CI -4.96 to -0.19]; P = 0.035) and leptin (-12.02 ng/ml [95% CI -17.71 to -6.33]; P < 0.0001), and higher levels of the antiinflammatory molecules adiponectin (2.71 mu g/ml [95% CI 1.93 to 3.49]; P < 0.0001) and IL-10 (1.32 pg/ml, [95% CI 0.29 to 2.38]; P = 0.002) as compared with placebo. Galantamine also significantly lowered plasma insulin and HOMA-IR values, and altered HRV. CONCLUSION. Low-dose galantamine alleviates inflammation and insulin resistance in MetS subjects. These findings support further study of galantamine in MetS therapy.
- Effects of a contraceptive containing drospirenone and ethinylestradiol on blood pressure, metabolic profile and neurohumoral axis in hypertensive women at reproductive age(2014) MORAIS, Tercio Lemos de; GIRIBELA, Cassiana; NISENBAUM, Marcelo Gil; GUERRA, Grazia; MELLO, Nilson; BARACAT, Edmundo; CONSOLIM-COLOMBO, Fernanda M.The use of combined oral contraceptives is widespread among hypertensive women despite being associated with increased cardiovascular risk. Contraceptives containing drospirenone, which has antimineralocorticoid properties, may have a positive or neutral effect on neurohumoral activation and metabolic homeostasis of hypertensive women at reproductive age. Objectives: To evaluate the effect of combined oral contraceptive containing drospirenone + ethinylestradiol on the systemic blood pressure, metabolic variables and neurohumoral axis in hypertensive women in reproductive age. Design: Prospective controlled trial with 56 hypertensive women allocated in two groups: 30 volunteers under oral combined contraceptive use and 26 volunteers using non-hormonal contraceptive methods. Subjects were tested before the introduction of the contraceptive method and 6 months after its use. For data acquisition, we used continuous non-invasive beat-to-beat blood pressure curve recordings and, for the biochemical and hormonal analyses two blood samples were obtained. Student's t test was used to determine differences between groups and moments and p < 0.05 was considered statistically significant. Results: Comparing antropometric and blood pressure measurements, cardiac sympatho-vagal modulation, baroreceptor sensitivity, metabolic and neurohumoral axis variables between baseline and after 6 months, no significant difference was detected in each group or between groups. Except serum triglyceride levels which increased in the group of women using EE + DRSP after 6 months of use. Conclusion: A contraceptive containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone causes no significant changes in clinical and autonomic parameters, metabolic variables and neurohumoral axis of hypertensive women.
- Sympathetic Neural Overdrive, Aortic Stiffening, Endothelial Dysfunction, and Impaired Exercise Capacity in Severe COVID-19 Survivors: A Mid-Term Study of Cardiovascular Sequelae(2023) FARIA, Diego; MOLL-BERNARDES, Renata J.; TESTA, Laura; MONIZ, Camila M. V.; RODRIGUES, Erika C.; RODRIGUES, Amanda G.; ARAUJO, Amanda; ALVES, Maria J. N. N.; ONO, Bruna E.; IZAIAS, Joao E.; SALEMI, Vera M. C.; JORDAO, Camila P.; AMARO-VICENTE, Graziela; RONDON, Maria U. P. B.; LUDWIG, Katelyn R.; CRAIGHEAD, Daniel H.; ROSSMAN, Matthew J.; CONSOLIM-COLOMBO, Fernanda M.; ANGELIS, Katia De; IRIGOYEN, Maria C. C.; SEALS, Douglas R.; NEGRAO, Carlos E.; SALES, Allan R. K.Background:COVID-19 has become a dramatic health problem during this century. In addition to high mortality rate, COVID-19 survivors are at increased risk for cardiovascular diseases 1-year after infection. Explanations for these manifestations are still unclear but can involve a constellation of biological alterations. We hypothesized that COVID-19 survivors compared with controls exhibit sympathetic overdrive, vascular dysfunction, cardiac morpho-functional changes, impaired exercise capacity, and increased oxidative stress. Methods:Nineteen severe COVID-19 survivors and 19 well-matched controls completed the study. Muscle sympathetic nerve activity (microneurography), brachial artery flow-mediated dilation and blood flow (Doppler-Ultrasound), carotid-femoral pulse wave velocity (Complior), cardiac morpho-functional parameters (echocardiography), peak oxygen uptake (cardiopulmonary exercise testing), and oxidative stress were measured similar to 3 months after hospital discharge. Complementary experiments were conducted on human umbilical vein endothelial cells cultured with plasma samples from subjects. Results:Muscle sympathetic nerve activity and carotid-femoral pulse wave velocity were greater and brachial artery flow-mediated dilation, brachial artery blood flow, E/e ' ratio, and peak oxygen uptake were lower in COVID-19 survivors than in controls. COVID-19 survivors had lower circulating antioxidant markers compared with controls, but there were no differences in plasma-treated human umbilical vein endothelial cells nitric oxide production and reactive oxygen species bioactivity. Diminished peak oxygen uptake was associated with sympathetic overdrive, vascular dysfunction, and reduced diastolic function in COVID-19 survivors. Conclusions:Our study revealed that COVID-19 survivors have sympathetic overactivation, vascular dysfunction, cardiac morpho-functional changes, and reduced exercise capacity. These findings indicate the need for further investigation to determine whether these manifestations are persistent longer-term and their impact on the cardiovascular health of COVID-19 survivors.
- Abnormalities of Anthropometric, Hemodynamic, and Autonomic Variables in Offspring of Hypertensive Parents(2016) MOTTA, Josiane M.; LEMOS, Tercio M.; CONSOLIM-COLOMBO, Fernanda M.; MOYSES, Rosa M. A.; GUSMAO, Marcelo A. N.; EGAN, Brent M.; LOPES, Heno F.Young adult offspring of hypertensive parents (pHTN circle plus) are a good model for assessing abnormalities of anthropometric, cardiometabolic, and autonomic variables prior to clinical hypertension. The objectives of this study were to determine whether these variables and autonomic responses to oral carbohydrates were altered in offspring of pHTN circle plus. Two hundred consecutive patients, including 100 pHTN circle plus, were evaluated, with 29 patients, including 14 pHTN circle plus, given a 70-gram carbohydrate load. The pHTN circle plus group had higher blood pressure, pulse pressure, abdominal circumference (AC), weight, body mass index, and basal metabolic rate than offspring of normotensive parents (pHTN empty set). At baseline, the low-frequency (LF, sympathetic) to high-frequency (HF, parasympathetic) ratio, assessed by spectral analysis of heart rate variability, was similar in both groups. After the carbohydrate load, the LF/HF ratio was greater in offspring of pHTN circle plus. pHTN circle plus individuals have abnormalities of anthropometric and hemodynamic variables at baseline and autonomic responses to oral carbohydrates before developing hypertension.
conferenceObject Cerebral Blood Flow Changes During Intermittent Acute Hypoxia in Heart Failure Patients(2013) MANSUR, Antonio P.; ALVARENGA, Glaura S.; KOPEL, Liliane; GUTIERREZ, Marco A.; CONSOLIM-COLOMBO, Fernanda M.; HAJJAR, Ludhmila A.; LAGE, Silvia G.