FERNANDA MARCIANO CONSOLIM COLOMBO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
15 resultados
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- Acute physical and mental stress resulted in an increase in fatty acids, norepinephrine, and hemodynamic changes in normal individuals: A possible pathophysiological mechanism for hypertension-Pilot study(2021) MOTTA, Jasiane Motta e; SOUZA, Ludmila Neves; VIEIRA, Bianca Bassetto; DELLE, Humberto; CONSOLIM-COLOMBO, Fernanda Marciano; EGAN, Brent M.; LOPES, Heno FerreiraHypertension is often associated with metabolic changes. The sustained increase in sympathetic activity is related to increased blood pressure and metabolic changes. Environmental stimuli may be related to increased sympathetic activity, blood pressure, and metabolic changes, especially in genetically predisposed individuals. The aim of this study was to evaluate the response of fatty acids to physical and mental stress in healthy volunteers and the hemodynamic, hormonal, and metabolic implications of these stimuli. Fifteen healthy individuals with a mean age of 31 +/- 7 years, of both sexes, were evaluated. They were assessed at baseline and after combined physical and mental stress (isometric exercise test, Stroop color test). Blood samples were collected at baseline and after stimulation for glucose, insulin, fatty acid, and catecholamine levels. Blood pressure, heart rate, cardiac output, systemic vascular resistance, and distensibility of the large and small arteries were analyzed. The data obtained at baseline and after stimuli were from the same individual, being the control itself. Compared to baseline, after physical and mental stress there was a statistically significant increase (p < .05) in free fatty acids, norepinephrine, diastolic blood pressure, peripheral vascular resistance, and distensibility of the large and small arteries. In conclusion, the combination of physical and mental stress raised fatty acids, norepinephrine, diastolic blood pressure, and peripheral vascular resistance in healthy individuals.
- Hypertension, Blood Pressure Variability, and Target Organ Lesion(2016) IRIGOYEN, Maria-Claudia; ANGELIS, Katia De; SANTOS, Fernando dos; DARTORA, Daniela R.; RODRIGUES, Bruno; CONSOLIM-COLOMBO, Fernanda MarcianoHypertensive patients have a higher risk of developing health complications, particularly cardiovascular (CV) events, than individuals with normal blood pressure (BP). Severity of complications depends on the magnitude of BP elevation and other CV risk factors associated with the target organ damage. Therefore, BP control and management of organ damage may contribute to reduce this risk. BP variability (BPV) has been considered a physiological marker of autonomic nervous system control and may be implicated in increased CV risk in hypertension. This review will present some evidence relating BPV and target organ damage in hypertension in clinical and experimental settings.
- High Muscle Sympathetic Nerve Activity Is Associated With Left Ventricular Dysfunction in Treated Hypertensive Patients(2013) SOUZA, Silvia Beatriz Cavasin de; ROCHA, Juraci Aparecida; CUOCO, Marco Antonio Romeu; GUERRA, Grazia Maria; FERREIRA-FILHO, Julio Cesar; BORILE, Suellen; KRIEGER, Eduardo Moacyr; BORTOLOTTO, Luiz Aparecido; CONSOLIM-COLOMBO, Fernanda MarcianoThe presence of asymptomatic left ventricular diastolic dysfunction (LVDD) in hypertensive patients can be associated with the development of cardiac events. The increase in sympathetic activity may be 1 of the mechanisms that predisposes to this outcome. In this study, we analyzed 2 hypotheses: (i) whether sympathetic activity is higher in the presence of LVDD, independent of blood pressure control and (ii) whether different classes of LVDD have a different effect on sympathetic activity. After analyzing left ventricular function using echo Doppler cardiography, 45 hypertensive patients receiving treatment were allocated into 3 groups: normal function (LV-NF, n 15), impaired relaxation (LV-IR, n 15), and pseudonormal or restrictive (LV-P/R, n 15). An age-, sex-, and body mass indexmatched control group of normotensive volunteers (N, n 14) was included. Muscle sympathetic nerve activity (MSNA), heart rate, and systolic blood pressure variabilities and baroreflex sensitivity were evaluated while the patient was in a supine position. Blood pressure and antihypertensive drug use were similar among the hypertensive groups. The LV-IR and LV-P/R groups had similar MSNA (331 and 321 bursts/min, respectively), which was significantly higher than that of the LV-NF and N groups (263 and 152 bursts/min, respectively). The LV-IR and LV-P/R groups had significantly higher LF-systolic blood pressure variability and significantly lower baroreflex sensitivity compared with the N group. The presence of asymptomatic LVDD is associated with increased MSNA, independent of blood pressure control. The sympathetic hyperactivity associated with LVDD is similar in the different patterns of LVDD studied.
- High Dialysate Calcium Concentration May Cause More Sympathetic Stimulus During Hemodialysis(2016) JIMENEZ, Zaida N. C.; SILVA, Bruno C.; REIS, Luciene dos; CASTRO, Manuel C. M.; RAMOS, Camila D.; COSTA-HONG, Valeria; BORTOLOTTO, Luiz A.; CONSOLIM-COLOMBO, Fernanda; DOMINGUEZ, Wagner V.; OLIVEIRA, Ivone B.; MOYSES, Rosa M. A.; ELIAS, Rosilene M.Background/Aims: Acute activation of sympathetic activation during hemodialysis is essential to maintain blood pressure (BP), albeit long-term overactivity contributes to higher mortality. Low heart rate variability (HRV), a measure of autonomic nervous system activity, and abnormal ankle-brachial index (ABI) are associated with higher mortality in patients on hemodialysis. In this study, we assessed HRV and ABI pre and post dialysis in incident patients on hemodialysis using high (1.75mmol/l) and low (1.25mmol/l) dialysate calcium concentration (DCa). Methods: HRV was measured as the ratio between low frequency and high frequency power (LF/HF). Thirty patients (age 47 16 years, 67% men) were studied in two consecutive mid-week hemodialysis sessions. Results: Mean BP variation was positive with DCa 1.75 and negative with DCa 1.25 [4.0 (-6.0, 12.2 mmHg) vs. -3.2 (-9.8, 1.3 mmHg); p=0.050]. Reduction of ABI from pre to post HD was related to higher sympathetic activity (p=0.031). The increase in LF/HF ratio was higher with DCa 1.75 (58.3% vs. 41.7% in DCa 1.75 and 1.25, respectively, RR 2.8; p=0.026). Conclusion: Although higher DCa is associated with better hemodynamic tolerability during hemodialysis, this occurs at the expense of increased sympathetic activity. Higher sympathetic activity was associated with a decrease of ABI during hemodialysis. (C) 2016 The Author(s) Published by S. Karger AG, Basel
- Vascular Reactivity Is Impaired and Associated With Walking Ability in Patients With Intermittent Claudication(2015) SILVA, Rita de Cassia Gengo e; WOLOSKER, Nelson; YUGAR-TOLEDO, Juan Carlos; CONSOLIM-COLOMBO, Fernanda MarcianoWe verified whether vascular reactivity is impaired and whether there is any association between vascular reactivity, walking ability, and peripheral artery disease (PAD) severity in patients with intermittent claudication (IC). We studied 63 patients and 17 age- and sex-matched volunteers without PAD. Vascular reactivity was evaluated in the brachial artery during reactive hyperemia (flow-mediated dilation [FMD]) and after a sublingual single dose of nitroglycerin (nitroglycerin-induced vasodilation [NID]). Walking ability was verified by a 6-minute walk test. Vascular reactivity and walking ability were significantly worse in patients with IC compared with control participants. The ankle-brachial index correlated with FMD, NID, as well as total and pain-free distances. The NID and walking ability progressively decreased as PAD severity increased. Walking ability correlated with NID but not with FMD. In patients with IC, vascular reactivity is impaired and is related to the severity of PAD and to walking ability.
- 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.
- 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.conferenceObject Sympathetic Neural Overdrive, Endothelial Dysfunction and Aortic Stiffness in Coronavirus Disease 2019 Survivors: A Short-Term Study of Cardiovascular Sequelae(2021) FARIA, Diego; TESTA, Laura; MOLL-BERNARDES, Renata; MONIZ, Camila; RODRIGUES, Erika; COSTA-NETO, Abel; SOUSA, Andrea; RODRIGUES, Amanda; OLIVEIRA, Patricia; ALVES, Maria Janieire; SANTOS, Gabriel; SALEMI, Vera; PIMENTA, Ruan; PAIXAO, Camila; SANTOS, Beatriz; RONDON, Maria U.; CRAIGHEAD, Daniel; ROSSMAN, Matthew; CONSOLIM-COLOMBO, Fernanda M.; IRIGOYEN, Maria C.; MARTINEZ-LEMUS, Luis A.