AMANDA GONZALES RODRIGUES
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- 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.
- High-intensity interval training decreases muscle sympathetic nerve activity and improves peripheral vascular function in patients with heart failure with reduced ejection fraction(2020) SALES, Allan; AZEVEDO, Luciene; OLIVEIRA, Thiago; ALVES, Maria Nunes; RODRIGUES, Amanda; OLIVEIRA, Patricia; JORDAO, Camila; ANDRADE, Ana; URIAS, Ursula; GUIMARAES, Guilherme; BOCCHI, Edimar; GRUNEWALD, Zachary; MARTINEZ-LEMUS, Luis; PADILLA, Jaume; NEGRAO, Carlos
- High-Intensity Interval Training Decreases Muscle Sympathetic Nerve Activity and Improves Peripheral Vascular Function in Patients With Heart Failure With Reduced Ejection Fraction(2020) SALES, Allan R. K.; AZEVEDO, Luciene F.; SILVA, Thiago O. C.; RODRIGUES, Amanda G.; OLIVEIRA, Patricia A.; JORDAO, Camila P.; ANDRADE, Ana C. M.; URIAS, Ursula; GUIMARAES, Guilherme V.; BOCCHI, Edimar A.; ALVES, Maria Janieire N. N.; HAJJAR, Ludhmila A.; FILHO, Roberto K.; GRUNEWALD, Zachary I.; MARTINEZ-LEMUS, Luis A.; PADILLA, Jaume; NEGRAO, Carlos E.
- Sympathetic neural overdrive and diminished exercise capacity in reduced ejection fraction heart failure related to anthracycline-based chemotherapy(2023) RODRIGUES, Amanda G.; SALES, Allan R. K.; FARIA, Diego; FONSECA, Silvia M. R.; BOND, Marina M. K.; JORDAO, Camila P.; SOUZA, Francis R. de; BITTAR, Cristina S.; SANTOS, Marilia H. H. Dos; SARMENTO, Adriana O.; NEGRAO, Marcelo V.; HAJJAR, Ludhmila A.; NEGRAO, Carlos E.; KALIL FILHO, RobertoCardiotoxicity is the most worrying cardiovascular alteration in patients treated with chemotherapy. To improve the understanding regarding the cardiotoxicity, we studied whether 1) patients with cardiac dysfunction related to anthracycline-based chemotherapy have augmented sympathetic nerve activity and decreased exercise capacity and 2) these responses are similar to those observed in patients with heart failure caused by other etiologies. Sixteen patients with heart failure with reduced ejection fraction related to anthracycline-based chemotherapy with or without chest radiation (HFrEFCA), 10 patients with heart failure with reduced ejection not related to cancer therapy (HFrEF), and 16 age- and body mass index (BMI)-matched healthy control subjects were studied. Left ventricular ejection fraction (LVEF, echocardiography), peak oxygen consumption (peak (V)over dot(O2), cardiopulmonary exercise test), muscle sympathetic nerve activity (MSNA, microneurography), and forearm blood flow (FBF, venous occlusion plethysmography) were measured. We found that peak oxygen consumption peak (V)over dot(O2) and LVEF were significantly reduced in patients with HFrEFCA compared with that of control subjects (P < 0.0001) but similar to those found in patients with HFrEFCA. The sympathetic nerve activity burst frequency and incidence were significantly higher in patients with HFrEFCA than that in control subjects (P < 0.0001). No differences were found between patients with HFrEF and HFrEFCA. Peak (V)over dot(O2) was inversely associated with MSNA burst frequency (r = -0.53, P = 0.002) and burst incidence (r = -0.38, P = 0.01) and directly associated with LVEF (r = 0.71, P < 0.0001). Taken together, we conclude that patients who develop heart failure due to anthracycline-based chemotherapy have sympathetic neural overdrive and reduced exercise capacity. In addition, these physiological changes are similar to those observed in patients with HFrEF.
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.- Effects of Exercise Training on Left Ventricular Diastolic Function Markers in Patients with Obstructive Sleep Apnea: A Randomized Study(2022) DURANTE, Bruno G.; FERREIRA-SILVA, Rosyvaldo; GOYA, Thiago T.; LIMA, Marta F.; RODRIGUES, Ana Clara T.; DRAGER, Luciano F.; JORDÃO, Camila P.; RODRIGUES, Amanda G.; ALVES, Maria Janieire de Nazare N.; LORENZI-FILHO, Geraldo; NEGRÃO, Carlos E.; UENO-PARDI, Linda M.Abstract Background Exercise training (ET) is an adjunctive treatment for obstructive sleep apnea (OSA) and its consequences. However, the effects of exercise on heart remodeling are unknown in the population with OSA. Objective We investigated the effect of ET on markers of diastolic function, sleep parameters, and functional capacity in patients with OSA. Methods Sedentary patients with OSA (apnea-hypopnea index, AHI ≥15 events/hr) were randomly assigned to untrained (n=18) and trained (n=20) strategies. Polysomnography, cardiopulmonary exercise test, and echocardiography were evaluated at the beginning and end of the study. ET consisted of 3 weekly sessions of aerobic exercise, resistance exercises, and flexibility training (72 sessions, completed in 11.65±0.86 months). A two-way analysis of variance (ANOVA) was used, followed by Tukey's post-hoc test. The level of statistical significance was set at p<0.05 for all analyses. Result Thirty-eight patients were included (AHI:45±29 events/hr, age:52±7 y, body mass index: 30±4 kg/m2). They had similar baseline parameters. ET caused a significant change in OSA severity (AHI:4.5±18 versus -5.7±13 events/hr; arousal index:1.5±8 versus -6.1±13 events/hr, in untrained and trained groups respectively, p<0.05). The trained patients had an increase in functional capacity after intervention. ET improved isovolumetric relaxation time (IVRT, untrained=6.5±17.3 versus trained=-5.1±17.1 msec, p<0.05). There was a significant correlation between changes in IVRT and arousal index in the trained group (r =-0.54, p<0.05). No difference occurred in the other diastolic function parameters evaluated. Conclusion ET promotes modest but significant improvement in AHI, functional capacity, and cardiac IVRT, a validated parameter of diastolic function.