MARIA JANIEIRE DE NAZARE NUNES ALVES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
12 resultados
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bookPart Atividade sexual no cardiopata(2016) SANTOS, Marcelo Rodrigues dos; ALVES, Maria Janieire de Nazaré Nunes; BARRETTO, Antônio Carlos Pereira- Muscle electrical stimulation improves neurovascular control and exercise tolerance in hospitalised advanced heart failure patients(2016) GROEHS, Raphaela V.; ANTUNES-CORREA, Ligia M.; NOBRE, Thais S.; ALVES, Maria-Janieire N. N.; RONDON, Maria Urbana P. B.; BARRETO, Antonio Carlos Pereira; NEGRAO, Carlos E.Background We investigated the effects of muscle functional electrical stimulation on muscle sympathetic nerve activity and muscle blood flow, and, in addition, exercise tolerance in hospitalised patients for stabilisation of heart failure. Methods Thirty patients hospitalised for treatment of decompensated heart failure, class IV New York Heart Association and ejection fraction30% were consecutively randomly assigned into two groups: functional electrical stimulation (n=15; 542 years) and control (n=15; 492 years). Muscle sympathetic nerve activity was directly recorded via microneurography and blood flow by venous occlusion plethysmography. Heart rate and blood pressure were evaluated on a beat-to-beat basis (Finometer), exercise tolerance by 6-minute walk test, quadriceps muscle strength by a dynamometer and quality of life by Minnesota questionnaire. Functional electrical stimulation consisted of stimulating the lower limbs at 10Hz frequency, 150ms pulse width and 70 mA intensity for 60minutes/day for 8-10 consecutive days. The control group underwent electrical stimulation at an intensity of<20 mA. Results Baseline characteristics were similar between groups, except age that was higher and C-reactive protein and forearm blood flow that were smaller in the functional electrical stimulation group. Functional electrical stimulation significantly decreased muscle sympathetic nerve activity and increased muscle blood flow and muscle strength. No changes were found in the control group. Walking distance and quality of life increased in both groups. However, these changes were greater in the functional electrical stimulation group. Conclusion Functional electrical stimulation improves muscle sympathetic nerve activity and vasoconstriction and increases exercise tolerance, muscle strength and quality of life in hospitalised heart failure patients. These findings suggest that functional electrical stimulation may be useful to hospitalised patients with decompensated chronic heart failure.
bookPart O atleta e o sistema cardiovascular(2016) OLIVEIRA, Patrícia de; ALVES, Maria Janieire Nunes; AGOSTINHO, Daniela Regina; NEGRãO, Carlos Eduardo; RODRIGUES, Amanda GonzalesconferenceObject Obstructive sleep apnea impairs insulin resistance in metabolic syndrome patients with normal levels of glucose(2016) CEPEDA, Felipe Xerez; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson Cabral; TOSCHI-DIAS, Edgar; JORDAO, Camila Paixao; RONDON, Maria Urbana; ALVES, Maria Janieire N. N.; LORENZI-FILHO, Geraldo; TROMBETTA, Ivani CredidiobookPart Reabilitação cardíaca(2016) ALVES, Maria Janieire Nunes; AGOSTINHO, Daniela Regina; OLIVEIRA, Patrícia Alves; NEGRãO, Carlos Eduardo; RODRIGUES, Amanda GonzalesconferenceObject Oxygen uptake efficiency slope in patients with metabolic syndrome and obstructive sleep apnea(2016) CARVALHO, Jefferson Cabral; CEPEDA, Felipe Xerez; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene Cristhina Brisolla; TOSCHI-DIAS, Edgar; RONDON, Maria Urbana Pinto Brandao; ALVES, Maria-Janieire Nazare Nunes; BRAGA, Ana Maria Fonseca Wanderley; LORENZI-FILHO, Gerald; TROMBETTA, Ivani CredidiobookPart Reabilitação no infarto agudo do miocárdio(2016) SANTOS, Marcelo Rodrigues dos; ALVES, Maria Janieire de Nazaré Nunes; BARRETTO, Antônio Carlos Pereira- Post-Exercise Neurovascular Control in Chronic Heart Failure Patients(2016) NOBRE, T. S.; GROEHS, R. V.; AZEVEDO, L. F.; ANTUNES-CORREA, L. M.; MARTINEZ, D. G.; ALVES, M. J. N. N.; NEGRAO, C. E.It remains unknown whether or not a reduction in muscle sympathetic nerve activity in heart failure patients is associated over time with the effects of long- or short-term repeated exercise. 10 chronic heart failure patients, age 49 +/- 3 years old, functional class I-III NYHA, ejection fraction <40% were randomly submitted to either an acute bout of moderate continuous exercise OR high-intensity interval exercise. Muscle sympathetic nerve activity (microneurography) and forearm blood flow (venous occlusion plethysmography) were evaluated pre- and post-exercise sessions. The moderate exercise consisted of cycle exercise at an intensity corresponding to anaerobic threshold. The interval exercise consisted of a 2-min cycle exercise at intensity corresponding to anaerobic threshold, followed by a 1-min exercise set at respiratory compensation point. Exercise capacity was evaluated by cardiopulmonary exercise test. The caloric expenditure in both sessions was 100kcal. Baseline muscle sympathetic nerve activity and forearm blood flow levels were not different between sessions. Moderate or high-intensity exercise caused no significant changes in muscle sympathetic nerve activity and forearm blood flow. These findings suggest that the reduction in muscle sympathetic nerve activity and the increase in forearm blood flow provoked by exercise training in chronic heart failure patients are due to cumulative effects over time.
- Effect of Exercise Training and Testosterone Replacement on Skeletal Muscle Wasting in Patients With Heart Failure With Testosterone Deficiency(2016) SANTOS, Marcelo R. dos; SAYEGH, Ana L. C.; BACURAU, Aline V. N.; ARAP, Marco A.; BRUM, Patricia C.; PEREIRA, Rosa M. R.; TAKAYAMA, Liliam; BARRETTO, Antonio C. P.; NEGRAO, Carlos E.; ALVES, Maria Janieire de Nazare NunesObjective: To examine whether combined testosterone replacement and exercise training (ET) therapies would potentiate the beneficial effects of isolated therapies on neurovascular control and muscle wasting in patients with heart failure (HF) with testosterone deficiency. Patients and Methods: From January 10, 2010, through July 25, 2013, 39 male patients with HF, New York Heart Association functional class III, total testosterone level less than 249 ng/dL (to convert to nmol/L, multiply by .03467), and free testosterone level less than 131 pmol/L were randomized to training (4-month cycloergometer training), testosterone (intramuscular injection of testosterone undecylate for 4 months), and training + testosterone groups. Muscle sympathetic nerve activity was measured using microneurography, forearm blood flow using plethysmography, body composition using dual X-ray absorptiometry, and functional capacity using cardiopulmonary test. Skeletal muscle biopsy was performed in the vastus lateralis. Results: Muscle sympathetic nerve activity decreased in ET groups (training, P<.01; training + testosterone, P<.01), whereas no changes were observed in the testosterone group (P=.89). Forearm blood flow was similar in all groups. Lean mass increased in ET groups (training, P<.01; training + testosterone, P<.01), whereas lean mass decreased in the testosterone group (P<.01). The response of cross-sectional area of type I (P<.01) and type II (P<.05) fibers increased in the training + testosterone group as compared with the isolated testosterone group. Conclusion: Our findings provide evidence for a superior effect of combined ET and testosterone replacement therapies on muscle sympathetic nerve activity, muscle wasting, and functional capacity in patients with HF with testosterone deficiency. (C) 2016 Mayo Foundation for Medical Education and Research
bookPart Exercício físico e endotélio(2016) NEGRãO, Carlos Eduardo; ALVES, Maria Janieire de Nazaré Nunes; ANDRADE, Ana Cristina; SALES, Allan Robson Kluser