LIGIA DE MORAES ANTUNES CORREA
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conferenceObject Exercise Training Restores Muscle Mechano and Metaboreflex Sensitivity in Heart Failure Patients(2013) ANTUNES-CORREA, Ligia M.; NOBRE, Thais S.; GROEHS, Raphaela V.; ALVES, Maria Janieire N. N.; RONDON, Maria Urbana P. B.; MADY, Charles; ALMEIDA, Dirceu R.; OLIVEIRA, Patricia; LIMA, Marta F.; MATHIAS, Wilson; BRUM, Patricia C.; ROSSONI, Luciana V.; OLIVEIRA, Edilamar M.; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos EduardoIncreased sympathetic muscle mechanoreflex sensitivity and attenuated sympathetic muscle metaboreflex sensitivity have been described in heart failure (HF) patients. We tested the hypothesis that exercise training (ET) would improve sympathetic mechano and metaboreflex sensitivity in HF patients. 24 consecutive, randomized, HF patients, Functional Class II-III NYHA, EF≤40% were divided into two groups: Exercise-trained (n=12, 55±2 years) and untrained (n=12, 54±2 years). 10 normal controls (NC) were also studied. Muscle sympathetic nerve activity (MSNA) was directly recorded from the peroneal nerve. Mechanoreceptors were activated by passive exercise. Metaboreceptors were activated by post-exercise circulatory arrest. ET consisted of three 60-minutes exercise sessions per week for 4 months. ET significantly reduced MSNA in HF patients (34 vs. 40 bursts/min, P<0.05). ET significantly reduced MSNA responses to passive exercise ({Delta} = 2 vs. 5 bursts/min, P<0.05) and increased MNSA responses during post-exercise circulatory arrest ({Delta} = 5 vs. –1 bursts/min, P<0.0 5). These changes were so dramatic that the difference between HF patients and NC were no longer observed. No changes in untrained HF patients were found. In conclusion, ET restores sympathetic muscle mechano and metaboreflex sensitivity in HF patients, which may contribute to the reduction in MSNA and clinical outcomes in these patients.- High levels of C-reactive protein are associated with reduced vagal modulation and low physical activity in young adults(2012) SOARES-MIRANDA, L.; NEGRAO, C. E.; ANTUNES-CORREA, L. M.; NOBRE, T. S.; SILVA, P.; SANTOS, R.; VALE, S.; MOTA, J.The purpose of this study was to examine the relationship between cardiac autonomic control derived from heart rate variability (HRV), high-sensitivity C-reactive protein (hs-CRP) and physical activity (PA) levels measured using accelerometers. A total of 80 healthy university students volunteered to participate in this study (20.56 +/- 0.82 years, 1.36 +/- 1.5 mg/L of hs-CRP). The participants were divided into groups based on tertiles of hs-CRP. Analysis of covariance adjusted to PA was used to assess group differences in HRV. Associations between hs-CRP, HRV indices and PA were analyzed using Pearson's correlation. The participants at the highest tertile of hs-CRP (tertile 3) had lower cardiac vagal modulation (SDNN, tertile 1=78.05 +/- 5.9,tertile 2=82.43 +/- 5.9,tertile 3=56.03 +/- 6.1; SD1, tertile 1=61.27 +/- 5.3, tertile 2=62.93 +/- 5.4, tertile 3=40.03 +/- 5.5). In addition, vagal indices were inversely correlated with hs-CRP but positively correlated with PA (SDNN r=-0.320, SD1 r=-0.377; SDNN r=0.304, SD1 r=0.299; P<0.05). Furthermore, the most physically active subjects had lower levels of hs-CRP and the highest levels of vagal modulation.
- Effects of exercise training on neurovascular responses during handgrip exercise in heart failure patients(2011) SOARES-MIRANDA, Luisa; FRANCO, Fabio G. M.; ROVEDA, Fabiana; MARTINEZ, Daniel G.; RONDON, Maria U. P. B.; MOTA, Jorge; BRUM, Patricia C.; ANTUNES-CORREA, Ligia M.; NOBRE, Thais S.; BARRETTO, Antonio C. P.; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos E.
- Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age(2012) ANTUNES-CORREA, Ligia M.; KANAMURA, Bianca Y.; MELO, Ruth C.; NOBRE, Thais S.; UENO, Linda M.; FRANCO, Fabio G. M.; ROVEDA, Fabiana; BRAGA, Ana Maria; RONDON, Maria U. P. B.; BRUM, Patricia C.; BARRETTO, Antonio C. P.; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos E.Background: Exercise training is a non-pharmacological strategy for treatment of heart failure. Exercise training improves functional capacity and quality of life in patients. Moreover, exercise training reduces muscle sympathetic nerve activity (MSNA) and peripheral vasoconstriction. However, most of these studies have been conducted in middle-aged patients. Thus, the effects of exercise training in older patients are much less understood. The present study was undertaken to investigate whether exercise training improves functional capacity, muscular sympathetic activation and muscular blood flow in older heart failure patients, as it does in middle-aged heart failure patients. Design: Fifty-two consecutive outpatients with heart failure from the database of the Unit of Cardiovascular Rehabilitation and Physiology Exercise were divided by age (middle-aged, defined as 45-59 years, and older, defined as 60-75 years) and exercise status (trained and untrained). Methods: MSNA was recorded directly from the peroneal nerve using the microneurography technique. Forearm Blood Flow (FBF) was measured by venous occlusion plethysmography. Functional capacity was evaluated by cardiopulmonary exercise test. Results: Exercise training significantly and similarly increased FBF and peak VO2 in middle-aged and older heart failure patients. In addition, exercise training significantly and similarly reduced MSNA and forearm vascular resistance in these patients. No significant changes were found in untrained patients. Conclusion: Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age.
conferenceObject Exercise Training Associated With Cardiac Resynchronization Therapy Improves Peripheral Vasoconstriction and Functional Capacity in Heart Failure Patients(2013) NOBRE, Thais S.; ANTUNES-CORREA, Ligia M.; GROEHS, Raphaela V.; ALVES, Maria J.; RONDON, Maria U.; MARTINELLI FILHO, Martino; OLIVEIRA, Patricia A.; LIMA, Marta F.; SARMENTO, Adriana O.; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos E.- Molecular basis for the improvement in muscle metaboreflex and mechanoreflex control in exercise-trained humans with chronic heart failure(2014) ANTUNES-CORREA, Ligia M.; NOBRE, Thais S.; GROEHS, Raphaela V.; ALVES, Maria Janieire N. N.; FERNANDES, Tiago; COUTO, Gisele K.; RONDON, Maria Urbana P. B.; OLIVEIRA, Patricia; LIMA, Marta; MATHIAS, Wilson; BRUM, Patricia C.; MADY, Charles; ALMEIDA, Dirceu R.; ROSSONI, Luciana V.; OLIVEIRA, Edilamar M.; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos E.Previous studies have demonstrated that muscle mechanoreflex and metaboreflex controls are altered in heart failure (HF), which seems to be due to changes in cyclooxygenase (COX) pathway and changes in receptors on afferent neurons, including transient receptor potential vanilloid type-1 (TRPV1) and cannabinoid receptor type-1 (CB1). The purpose of the present study was to test the hypotheses: 1) exercise training (ET) alters the muscle metaboreflex and mechanoreflex control of muscle sympathetic nerve activity (MSNA) in HF patients. 2) The alteration in metaboreflex control is accompanied by increased expression of TRPV1 and CB1 receptors in skeletal muscle. 3) The alteration in mechanoreflex control is accompanied by COX-2 pathway in skeletal muscle. Thirty-four consecutive HF patients with ejection fractions <40% were randomized to untrained (n = 17; 54 +/- 2 yr) or exercise-trained (n = 17; 56 +/- 2 yr) groups. MSNA was recorded by microneurography. Mechanoreceptors were activated by passive exercise and metaboreceptors by postexercise circulatory arrest (PECA). COX-2 pathway, TRPV1, and CB1 receptors were measured in muscle biopsies. Following ET, resting MSNA was decreased compared with untrained group. During PECA (metaboreflex), MSNA responses were increased, which was accompanied by the expression of TRPV1 and CB1 receptors. During passive exercise (mechanoreflex), MSNA responses were decreased, which was accompanied by decreased expression of COX-2, prostaglandin-E-2 receptor-4, and thromboxane-A(2) receptor and by decreased in muscle inflammation, as indicated by increased miRNA-146 levels and the stable NF-kappa B/I kappa B-alpha ratio. In conclusion, ET alters muscle metaboreflex and mechanoreflex control of MSNA in HF patients. This alteration with ET is accompanied by alteration in TRPV1 and CB1 expression and COX-2 pathway and inflammation in skeletal muscle.
conferenceObject Exercise Training Improves Muscle Mechano and Metaboreflex Sensitivity in Heart Failure Patients(2013) ANTUNES-CORREA, Ligia M.; NOBRE, Thais S.; GROEHS, Raphaela V.; FERNANDES, Tiago; ALVES, Maria Janieire N.; RONDON, Maria Urbana; OLIVEIRA, Patricia; MADY, Charles; ALMEIDA, Dirceu; LIMA, Marta; MATHIAS, Wilson; BRUM, Patricia C.; ROSSONI, Luciana V.; OLIVEIRA, Edilamar M.; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos E.