RENAN SEGALLA GUERRA

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  • article 19 Citação(ões) na Scopus
    Muscle Metaboreflex Control of Sympathetic Activity in Obstructive Sleep Apnea
    (2017) UENO-PARDI, Linda M.; GUERRA, Renan S.; GOYA, Thiago T.; SILVA, Rosyvaldo F.; GARA, Elisangela M.; LIMA, Marta F.; NOBRE, Thais S.; ALVES, Maria J. N. N.; TROMBETTA, Ivani C.; LORENZI-FILHO, Geraldo
    Purpose: Previous studies report abnormal muscle metaboreflex control of muscle sympathetic nerve activity (MSNA) in obesity, hypertension, and heart failure. We hypothesized that obstructive sleep apnea (OSA) is associated with augmented metaboreflex control of MSNA. Methods: Thirty-one sedentary individuals with no comorbidities (age = 52 +/- 1 yr, body mass index = 28 +/- 1 kg.m(-2)) without (control, n = 14) and with OSA(n = 17) defined by polysomnography, underwent echocardiography. HR, blood pressure (BP), MSNA (microneurography), and forearm blood flow measured by venous occlusion plethysmography were continuously measured 4 min at baseline, during 3 min of 30% handgrip static exercise, and during 2 min of post-handgrip muscle ischemia (PHMI). Results: Control and OSA groups were similar in age, body mass index, and ejection fraction. Baseline HR, BP, and forearm blood flow increased similarly during handgrip exercise. Blood pressure remained significantly elevated in relation to baseline during PHMI, but HR and forearm blood flow returned toward baseline during PHMI in both groups. Baseline MSNA was significantly higher in the OSA group than in controls (P < 0.05). During peak 30% static handgrip exercise, MSNA increased significantly in both control and OSA groups, but MSNA responses were higher in patients with OSA. During PHMI, MSNA in control subjects remained significantly elevated compared with that at baseline. In contrast, in patients with OSA, MSNA decreased to baseline values. A significant correlation was found between changes in MSNA due to PHMI and apnea-hypopnea index (r = -0.61, P < 0.001), and with minimum O-2 saturation (r = 0.70, P G 0.001). Conclusions: These findings suggest an association between OSA and decreased metaboreflex control of MSNA. Muscle vasodilation during handgrip static exercise is preserved in patients with OSA.
  • article 32 Citação(ões) na Scopus
    Increased Muscle Sympathetic Nerve Activity and Impaired Executive Performance Capacity in Obstructive Sleep Apnea
    (2016) GOYA, Thiago T.; SILVA, Rosyvaldo F.; GUERRA, Renan S.; LIMA, Marta F.; BARBOSA, Eline R. F.; CUNHA, Paulo Jannuzzi; LOBO, Denise M. L.; BUCHPIGUEL, Carlos A.; BUSATTO-FILHO, Geraldo; NEGRAO, Carlos E.; LORENZI-FILHO, Geraldo; UENO-PARDI, Linda M.
    Study Objectives: To investigate muscle sympathetic nerve activity (MSNA) response and executive performance during mental stress in obstructive sleep apnea (OSA). Methods: Individuals with no other comorbidities (age = 52 +/- 1 y, body mass index = 29 +/- 0.4, kg/m(2)) were divided into two groups: (1) control (n = 15) and (2) untreated OSA (n = 20) defined by polysomnography. Mini-Mental State of Examination (MMSE) and Inteligence quocient (IQ) were assessed. Heart rate (HR), blood pressure (BP), and MSNA (microneurography) were measured at baseline and during 3 min of the Stroop Color Word Test (SCWT). Sustained attention and inhibitory control were assessed by the number of correct answers and errors during SCWT. Results: Control and OSA groups (apnea-hypopnea index, AHI = 8 +/- 1 and 47 +/- 1 events/h, respectively) were similar in age, MMSE, and IQ. Baseline HR and BP were similar and increased similarly during SCWT in control and OSA groups. In contrast, baseline MSNA was higher in OSA compared to controls. Moreover, MSNA significantly increased in the third minute of SCWT in OSA, but remained unchanged in controls (P < 0.05). The number of correct answers was lower and the number of errors was significantly higher during the second and third minutes of SCWT in the OSA group (P < 0.05). There was a significant correlation (P < 0.01) between the number of errors in the third minute of SCWT with AHI (r = 0.59), arousal index (r = 0.55), and minimum O-2 saturation (r = -0.57). Conclusions: As compared to controls, MSNA is increased in patients with OSA at rest, and further significant MSNA increments and worse executive performance are seen during mental stress.