EDUARDO MOACYR KRIEGER
Projetos de Pesquisa
Unidades Organizacionais
30 resultados
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- Lack of Circadian Variation of Pulse Wave Velocity Measurements in Healthy Volunteers(2011) DRAGER, Luciano F.; DIEGUES-SILVA, Luzia; DINIZ, Patricia M.; LORENZI-FILHO, Geraldo; KRIEGER, Eduardo M.; BORTOLOTTO, Luiz A.Arterial stiffness is an independent marker of cardiovascular events. Pulse wave velocity (PWV) is a validated method to detect arterial stiffness that can be influenced by several factors including age and blood pressure. However, it is not clear whether PWV could be influenced by circadian variations. In the present study, the authors measured blood pressure and carotid-femoral PWV measurements in 15 young healthy volunteers in 4 distinct periods: 8 am, noon, 4 pm, and 8 pm. No significant variations of systolic (P=.92), mean (P=.77), and diastolic (P=.66) blood pressure among 8 am (113 +/- 15, 84 +/- 8, 69 +/- 6 mm Hg), noon (114 +/- 13, 83 +/- 8, 68 +/- 6 mm Hg), 4 pm (114 +/- 13, 85 +/- 8, 70 +/- 7 mm Hg), and 8 pm (113 +/- 7, 83 +/- 10, 68 +/- 7 mm Hg), respectively, were observed. Similarly, carotid-femoral PWV did not change among the periods (8 am: 7.6 +/- 1.4 m/s, noon: 7.4 +/- 1.1 m/s, 4 pm: 7.6 +/- 1.0 m/s, 8 pm, 7.6 +/- 1.3 m/s; P=.85). Considering all measurements, mean blood pressure significantly correlated with PWV (r=.31; P=.016). In young healthy volunteers, there is no significant circadian variation of carotid-femoral PWV. These findings support the concept that it does not appear mandatory to perform PWV measurements at exactly the same period of the day. J Clin Hypertens (Greenwich). 2011;13:19-22. (c) 2010 Wiley Periodicals, Inc.
- Academic health centers: integration of clinical research with healthcare and education. Comments on a workshop(2018) ARAI, Roberto Jun; NORONHA, Irene de Lourdes; NICOLAU, Jose Carlos; SCHMIDT, Charles; ALBUQUERQUE, Gustavo Moreira de; MAHAFFEY, Kenneth W.; KRIEGER, Eduardo Moacyr; AULER JUNIOR, Jose Otavio Costa
- 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.
- PBMCs express a transcriptome signature predictor of oxygen uptake responsiveness to endurance exercise training in men(2015) DIAS, Rodrigo Goncalves; SILVA, Michelle Sabrina Moreira; DUARTE, Nubia Esteban; BOLANI, Wladimir; ALVES, Cleber Rene; LEMOS JUNIOR, Jose Ribeiro; SILVA, Jeferson Luis da; OLIVEIRA, Patricia Alves de; ALVES, Guilherme Barreto; OLIVEIRA, Edilamar Menezes de; ROCHA, Cristiane Souza; MARSIGLIA, Julia Daher Carneiro; NEGRAO, Carlos Eduardo; KRIEGER, Eduardo Moacyr; KRIEGER, Jose Eduardo; PEREIRA, Alexandre CostaPeripheral blood cells are an accessible environment in which to visualize exercise-induced alterations in global gene expression patterns. We aimed to identify a peripheral blood mononuclear cell (PBMC) signature represented by alterations in gene expression, in response to a standardized endurance exercise training protocol. In addition, we searched for molecular classifiers of the variability in oxygen uptake ((V) over dotO(2)). Healthy untrained policemen recruits (n = 13, 25 +/- 3 yr) were selected. Peak (V) over dotO(2) (measured by cardiopulmonary exercise testing) and total RNA from PBMCs were obtained before and after 18 wk of running endurance training (3 times/wk, 60 min). Total RNA was used for whole genome expression analysis using Affymetrix GeneChip Human Gene 1.0 ST. Data were normalized by the robust multiarray average algorithm. Principal component analysis was used to perform correlations between baseline gene expression and (V) over dotO(2peak). A set of 211 transcripts was differentially expressed (ANOVA, P < 0.05 and fold change > 1.3). Functional enrichment analysis revealed that transcripts were mainly related to immune function, cell cycle processes, development, and growth. Baseline expression of 98 and 53 transcripts was associated with the absolute and relative (V) over dotO(2)peak response, respectively, with a strong correlation (r > 0.75, P < 0.01), and this panel was able to classify the 13 individuals according to their potential to improve oxygen uptake. A subset of 10 transcripts represented these signatures to a similar extent. PBMCs reveal a transcriptional signature responsive to endurance training. Additionally, a baseline transcriptional signature was associated with changes in (V) over dotO(2peak). Results might illustrate the possibility of obtaining molecular classifiers of endurance capacity changes through a minimally invasive blood sampling procedure.
- Baroreflex Sensitivity Impairment Is Associated With Cardiac Diastolic Dysfunction in Rats(2011) MOSTARDA, Cristiano; MORAES-SILVA, Ivana Cinthya; MOREIRA, Edson Dias; MEDEIROS, Alessandra; PIRATELLO, Aline Cristina; CONSOLIM-COLOMBO, Fernanda Marciano; CALDINI, Elia Garcia; BRUM, Patricia Chakur; KRIEGER, Eduardo Moacyr; IRIGOYEN, Maria ClaudiaBackground: Studies have shown that the autonomic dysfunction accompanied by impaired baroreflex sensitivity was associated with higher mortality. However, the influence of decreased baroreflex sensitivity on cardiac function, especially in diastolic function, is not well understood. This study evaluated the morpho-functional changes associated with baroreflex impairment induced by chronic sinoaortic denervation (SAD). Methods and Results: Animals were divided into sinoaortic denervation (SAD) and control (C) groups. Baroreflex sensitivity was evaluated by tachycardic and bradycardic responses, induced by vasoactive drugs. Cardiac function was studied by echocardiography and by left ventricle (LV) catheterization. LV collagen content and the expression of regulatory proteins involved in intracellular Ca(2+) homeostasis were quantified. Results showed higher LV mass in SAD versus C animals. Furthermore, an increase in deceleration time of E-wave in the SAD versus the C group (2.14 +/- 0.07 ms vs 1.78 +/- 0.03 ms) was observed. LV end-diastolic pressure was increased and the minimum dP/dt was decreased in the SAD versus the C group (12 +/- 1.5 mm Hg vs 5.3 +/- 0.2 mm Hg and 7,422 +/- 201 vs 4,999 +/- 345 mm Hg/s, respectively). SERCA/NCX ratio was lower in SAD than in control rats. The same was verified in SERCA/PLB ratio. Conclusions: The results suggest that baroreflex dysfunction is associated with cardiac diastolic dysfunction independently of the presence of other risk factors. (J Cardiac Fail 2011;17:519-525)
- Resistant Hypertension Optimal Treatment Trial: A Randomized Controlled Trial(2014) KRIEGER, Eduardo M.; DRAGER, Luciano F.; GIORGI, Dante Marcelo Artigas; KRIEGER, Jose Eduardo; PEREIRA, Alexandre Costa; BARRETO-FILHO, Jose Augusto Soares; NOGUEIRA, Armando da Rocha; MILL, Jose GeraldoThe prevalence of resistant hypertension (ReHy) is not well established. Furthermore, diuretics, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and calcium channel blockers are largely used as the first 3-drug combinations for treating ReHy. However, the fourth drug to be added to the triple regimen is still controversial and guided by empirical choices. We sought (1) to determine the prevalence of ReHy in patients with stage II hypertension; (2) to compare the effects of spironolactone vs clonidine, when added to the triple regimen; and (3) to evaluate the role of measuring sympathetic and renin-angiotensin-aldosterone activities in predicting blood pressure response to spironolactone or clonidine. The Resistant Hypertension Optimal Treatment (ReHOT) study (ClinicalTrials.gov NCT01643434) is a prospective, multicenter, randomized trial comprising 26 sites in Brazil. In step 1, 2000 patients will be treated according to hypertension guidelines for 12 weeks, to detect the prevalence of ReHy. Medical therapy adherence will be checked by pill count monitoring. In step 2, patients with confirmed ReHy will be randomized to an open label 3-month treatment with spironolactone (titrating dose, 12.5-50 mg once daily) or clonidine (titrating dose, 0.1-0.3 mg twice daily). The primary endpoint is the effective control of blood pressure after a 12-week randomized period of treatment. The ReHOT study will disseminate results about the prevalence of ReHy in stage II hypertension and the comparison of spironolactone vs clonidine for blood pressure control in patients with ReHy under 3-drug standard regimen.
conferenceObject Temporal Evaluation of Baroreflex Dysfunction: Role in Target Organ Damage(2013) AGUIAR, Janaina Paulini; JORGE, Luciana; PIRES, Romulo; KRIEGER, Eduardo Moacir; IRIGOYEN, Maria ClaudiaWistar rats were divided into 5 groups: control, D1(24h), D2(28 days), D3 (90 days) and D4 (6 months). Sinoaortic denervation (D) was used as a model of arterial baroreflex deficit. BP, HR were analysed using a data acquisition system. Cardiac output (CO) and tissues blood flow were evaluated using microspheres. BP and the HR was incresed in D after 24h (C:106 ± 0.6 vs. D1: 142 ± 2 mmHg; C: 355 ± 7 vs. D1: 453 ± 10 bpm), but it were normalizaed in chronic D. Moreover, it was observed a gradual reduction over time in CO (C: 111 ± 7, D1:81±5, D2:85 ± 6, D3:69±5 D4:35±2 mL/min) accompanied by an increase in total peripheral resistance (C:0.97±0.07, D1:1.74±0.05, D2:1.23±0.07, D3:1.60±0.09, D4:3.00±0.05 mL/min/mmHg) in D groups. Those alterations resulted in a decreased renal blood flow (C:3.47±0.21, D1:1.37±0.19, D2:1.49±0.18, D3:1.12±0.13, D4:0.42±0.16 mL/min/g), coronary flow (C:2.91±0.71, D1:2.07±0.19, D2:1.58±0.28, D3:0.92±0.13, D4:0.34±0.16 mL/min/g) and muscle flow (C:0.24±0.02, D1:0.08±0.005, D2:0.10±0.02, D3:0.05±0.01, D4:0.05±0.007 mL/min/g) in D groups. The acute total baroreflex dysfuntion incresed BP and HR and reduced blood flow and cardiac output, these changes are associated with the body’s attempt to maintain homeostasis. However, was observed a progressive reduction in CO and regional flow associated with an increase in RPT. These adjustements may play an important role in target organ-damage.conferenceObject Prevalence, Predictors and Comparison of Spironolactone versus Clonidine as a Fourth Drug for Resistant Hypertension: the Resistant Hypertension Optimal Treatment (ReHOT) study(2016) KRIEGER, Eduardo M.; DRAGER, Luciano F.; GIORGI, Dante M.; PEREIRA, Alexandre C.; BARRETO-FILHO, Jose A.; NOGUEIRA, Armando R.; MILL, Jose G.; KRIEGER, Jose E.conferenceObject Blood Pressure Variability: An Independent Marker to Morbimortality(2013) PAULINI, Janaina; NISHI, Fernanda; JORGE, Luciana; PIRES, Romulo; KRIEGER, Eduardo Moacir; IRIGOYEN, Maria Claudia- 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.
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