ANTONIO CASELLA FILHO
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conferenceObject RELATIONSHIPS BETWEEN HDL FUNCTIONAL CHARACTERISTICS AND ENDOTHELIAL VASCULAR FUNCTION AFTER SHORT-TERM EXERCISE TRAINING IN PATIENTS WITH THE METABOLIC SYNDROME(2013) CASELLA-FILHO, Antonio; TROMBETTA, Ivani C.; DOURADO, Paulo; LEITE-JUNIOR, Antonio C.; JONKE, Vivian; SEGRE, Alexandre; SANTOS, Raul; NEGRAO, Carlos E.; MARANHAO, Raul C.; CHAGAS, AntonioIntroduction: Endothelial dysfunction, leading to vasodilation impairment and atherosclerosis, frequently affects patients with metabolic syndrome (MS). A recent study showed that HDL estimulates endothelial nitric oxide synthase (eNOS: a key regulator of vascular nitric oxide production) by activation of Akt and MAP kinases in cultured endothelial cells. Objectives: To investigate the relationships between HDL characteristics (concentration, composition, functionality) on the eNOS availability and endothelial vascular function in patients with MS after a short-term exercise training (T). Methods: Forty sedentary persons (30 MS and 10 controls) were studied. Twenty with MS were subjected to a 3 times/week of a training load (45min/d) for 3 months on a bicycle. Cyclic guanosine monophosphate (cGMP), blood nitrite concentrations (biomarkers of eNOS availability) and HDL subfractions obtained by plasma ultracentrifugation were analyzed. A control LDL was incubated with HDL subfractions from the patients with MS (before-after T) and the in vitro resistance to oxidation was verified. An artificial radio-labeled lipoprotein emulsion was incubated with plasma from the participants. After precipitation of VLDL and LDL, the HDL containing supernatant was counted for radioactivity, to verify the HDL ability to accept lipids. Endothelial vascular function was assessed from forearm blood flow-mediated responses to vasodilation tests (FMD). Results: T did not change HDL-C concentration but changed the molecular composition and improved the functional characteristics of the HDL-particles subfractions: protecting LDL against oxidation (+21%) and increasing the HDL-particles ability to accept lipids (+23%). T increased cGMP and blood nitrite concentrations. The best HDL functional results were associated with the highest cGMP and blood nitrite concentrations and with the best FMD improvement results in the MS group. Conclusions: T early changes functional characteristics of HDL-particles, rather than HDL-C concentration, associated with eNOS biomarkers and with endothelial vascular function improvement in patients with MS, highlighting the early vascular benefits of exercisingconferenceObject SHORT-TERM EXERCISE TRAINING CHANGES TRIGLYCERIDES MOLECULAR CONTENT OF THE LDL AND HDL PARTICLES AFFECTING THEIR FUNCTIONAL CHARACTERISTICS IN METABOLIC SYNDROME(2013) CASELLA-FILHO, Antonio; TROMBETTA, Ivani; DOURADO, Paulo Magno; LEITE-JUNIOR, Antonio Carlos; SPRANDEL, Marilia C. O.; SEGRE, Alexandre; SANTOS, Raul; NEGRAO, Carlos Eduardo; MARANHAO, Raul C.; CHAGAS, AntonioBackground: Long–term exercise training associated with diet changes lipoproteins plasma levels. Objectives: We sought to investigate the effects of short–term exercise training without any specific diet (T) on the concentration, composition and functional characteristics of LDL and HDL particles in patients with metabolic syndrome (MS). Methods: Forty sedentary persons (30 MS and 10 controls) were studied. Twenty of those with MS were subjected to a 3 times/week controlled training load (45 min/day) for 3 months on a bicycle ergometer. LDL and HDL subfractions were obtained by plasma ultracentrifugation and their compositions were analyzed. The in vitro resistance to oxidation of the LDL from the patients with MS (before and after T) was verified. A control LDL was incubated with HDL2a and HDL3b from the patients with MS (before – after T) and the in vitro resistance to oxidation was verified. An artificial lipoprotein emulsion (LDE) labeled with 14C–phospholipid, 3H–triglycerides, 14C–cholesterol and 3H–cholesteryl ester was incubated with plasma from the participants. After precipitation of VLDL, LDL and LDE, the HDL–containing supernatant was counted for radioactivity, to verify the HDL ability to accept lipids. Results: T decreased triglycerides (TG) but did not change LDL–C and HDL–C plasma levels. The LDL resistance to oxidation of the MS group increased (+91%) after T, associated with a significant decrease in the LDL–particles content of TG (−14%) and apoB (−16%), and with a 27% reduction of the small and dense LDL–particles plasma levels. The oxidizability of the control LDL decreased when mixed with HDL2a or HDL3b from patients with MS, before vs. after T (−23% for HDL2a and −18% for HDL3b) associated with a significant decrease in the content of TG in HDL3b (−12%) and HDL3c (−15%). The transference of TG to HDL normalized after T in the MS group. Conclusions: In patients with MS, T early reduces TG concentration influencing the LDL and HDL functionality by changing their molecular composition rather than their concentration, emphasizing the early benefits of exercise and highlighting the importance of evaluating lipoproteins composition and functional aspects besides their plasma levels.conferenceObject Lipid Transfer to HDL in Patients With Coronary Artery Disease(2013) SPRANDEL, Marilia C.; HUEB, Whady; CASELLA-FILHO, Antonio; SEGRE, Carlos A.; CARVALHO, Ana Luiza O.; REZENDE, Paulo C.; CESAR, Luiz A.; RAMIRES, Jose A.; KALIL FILHO, Roberto; MARANHAO, Raul C.conferenceObject LIPID TRANSFER TO HIGH DENSITY LIPOPROTEINS IN TYPE 2 DIABETIC PATIENTS WITH AND WITHOUT CORONARY ARTERY DISEASE(2012) SPRANDEL, Marilia C. O.; HUEB, Whady; CASELLA-FILHO, Antonio; SEGRE, Alexandre; REZENDE, Paulo Cury; CARVALHO, Ana L. O.; FAVARATO, Desiderio; MARANHAO, Raul C.; RAMIRES, Jose; KALIL-FILHO, RobertoBackground In type 2 diabetes mellitus (DM2), HDL-cholesterol is diminished and it is important to understand the functional and metabolic changes existing in HDL in DM2 patients that may predispose to coronary artery disease (CAD). Lipid transfers between HDL and the other lipoproteins, mediated by cholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP), are crucial steps in HDL formation and role in reverse cholesterol transfer. Objective Investigate whether development of CAD in DM2 patients are associated with alterations in lipid transfers to HDL and in content of free cholesterol in the plasma. Methods 78 patients with DM2 and CAD (DM2-CAD) and 78 with DM2 without CAD, as diagnosed by cineangiography, were studied. They were of both genders, aged 40-80 yrs. Plasma was incubated for 1h at 37oC with a donor nanoemulsion labeled with 3H -cholesteryl-esters and14C -phospholipids or with 14C-free-cholesterol and 3H -triglycerides. Radioactive lipids transferred from the donor nanoemulsion to HDL were measured in the supernatant after chemical precipitation of non-HDL fractions and the nanoemulsion. Results are % of the total radioactivity of each lipid in HDL. Results In DM2-CAD, LDL-cholesterol and triglycerides were higher than in DM2; HDL-cholesterol was lower. Compared to DM2, DM2-CAD showed diminished transfer to HDL of free-cholesterol (DM2-CAD=4.23±0.24; DM2= 5.66±0.14, p<0.0001) and of triglycerides (1.65±0.13 vs 3.08±0.11, p<0.0001), whereas cholesteryl-ester transfer was increased (3.67±0.16 vs 2.25±0.13, p<0.0001); phospholipid transfer was equal (15.37±0.60 vs15.18±0.20, p=0.76). CETP concentration was equal, while plasma free-cholesterol was higher in DM2-CAD (DM2-CAD=36.9±0.9; DM2=33.1±0.7, p=0.003).HDL particle diameter was equal in both groups. Conclusion The reduction of free-cholesterol transfer to HDL may hinder cholesterol esterification and reverse cholesterol transport. Alterations in triglyceride and cholesteryl-ester transfer may affect lipoprotein stability. Those disturbances in HDL metabolism may facilitate CAD development in DM2. ACC Oral Contributions McCormick Place South, S100c Sunday, March 25, 2012, 9:04 a.m.-9:17 a.m. Session Title: Prevention: Focus on Lipids Abstract Category: 9. Prevention: Clinical Presentation Number: 911-8conferenceObject Lipid Transfer to Hdl in Type 2 Diabetic Patients With and Without Coronary Artery Disease(2013) SPRANDEL, Marilia C.; HUEB, Whady; CASELLA-FILHO, Antonio; SEGRE, Carlos A.; CARVALHO, Ana Luiza O.; REZENDE, Paulo C.; CESAR, Luiz A.; RAMIRES, Jose A.; KALIL FILHO, Roberto; MARANHAO, Raul C.- Effect of Exercise Training on Plasma Levels and Functional Properties of High-Density Lipoprotein Cholesterol in the Metabolic Syndrome(2011) CASELLA-FILHO, Antonio; CHAGAS, Antonio Carlos P.; MARANHAO, Raul C.; TROMBETTA, Ivani C.; CESENA, Fernando H. Y.; SILVA, Vanessa M.; TANUS-SANTOS, Jose Eduardo; NEGRAO, Carlos E.; LUZ, Protasio L. daIntense lifestyle modifications can change the high-density lipoprotein (HDL) cholesterol concentration. The aim of the present study was to analyze the early effects of short-term exercise training, without any specific diet, on the HDL cholesterol plasma levels and HDL functional characteristics in patients with the metabolic syndrome (MS). We studied 30 sedentary subjects, 20 with and 10 without the MS. The patients with the MS underwent moderate intensity exercise training for 3 months on bicycle ergometers. Blood was sampled before and after training for biochemical analysis, paraoxonase-1 activity, and HDL subfraction composition and antioxidative capacity. Lipid transfer to HDL was assayed in vitro using a labeled nanoemulsion as the lipid donor. At baseline, the MS group had greater triglyceride levels and a lower HDL cholesterol concentration and lower paraoxonase-1 activity than did the controls. Training decreased the plasma triglycerides but did not change the low-density lipoprotein or HDL cholesterol levels. Nonetheless, exercise training increased the HDL subfractions' antioxidative capacity and paraoxonase-1 activity. After training, the MS group had compositional changes in the smallest HDL subfractions associated with increased free cholesterol and cholesterol ester transfers to HDL, reaching normal values. In conclusion, the present investigation has added relevant information about the dissociation between the quantitative and qualitative aspects of HDL after short-term exercise training without any specific diet in those with the MS, highlighting the importance of evaluating the functional aspects of the lipoproteins, in addition to their plasma levels.
conferenceObject HIGH SENSITIVITY CARDIAC TROPONIN I AS A DIAGNOSTIC TOOL FOR THE PRESENCE OF CORONARY ARTERY DISEASE IN STABLE DIABETIC PATIENTS(2014) SEGRE, Alexandre; HUEB, Whady; SPRANDEL, Marilia O.; CASELLA-FILHO, Antonio; FAVARATO, Desiderio; STRUNZ, Celia; VENTURA, Laura; CARVALHO, Ana; MARANHAO, Raul C.; RAMIRES, Jose; KALIL-FILHO, Roberto