CRISTIANO TEIXEIRA MOSTARDA
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- 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)
- Effects of a contraceptive containing drospirenone and ethinyl estradiol on blood pressure and autonomic tone: a prospective controlled clinical trial(2014) NISENBAUM, Marcelo Gil; MELO, Nilson Roberto de; GIRIBELA, Cassiana Rosa Galvao; MORAIS, Tercio Lemos de; GUERRA, Grazia Maria; ANGELIS, Katia de; MOSTARDA, Cristiano; BARACAT, Edmund Chada; CONSOLIM-COLOMBO, Fernanda MarcianoBackground: The use of combined oral contraceptives has been associated with an increased risk of adverse cardiovascular events. Whether these drugs alter cardiac autonomic nervous system control is not completely determined. Objective: To evaluate the effect of a contraceptive containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone on the heart rate variability, baroreflex sensitivity and blood pressure of healthy women. Study design: Prospective controlled trial with 69 healthy women allocated in two groups: 36 volunteers under oral combined contraceptive use and 33 volunteers using of non-hormonal contraceptive methods. Subjects were tested before the introduction of the contraceptive method and 6 months after its use. For data acquisition, we used continuous non-invasive beat-to-beat blood pressure curve recordings. Multiple ANOVA was used to determine differences between groups and moments and p < 0.05 was considered statistically significant. Results: At baseline, there were no differences in demographic and autonomic parameters between groups. Comparing cardiac sympatho-vagal modulation, baroreceptor sensitivity and blood pressure measurements between baseline and after 6 months, no significant difference was detected in each group or between groups. Conclusion: A contraceptive containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone causes no significant changes in clinical, hemodynamic and autonomic parameters of normal women.
- Cholinergic stimulation with pyridostigmine improves autonomic function in infarcted rats(2013) FUENTE, Raquel N. de La; RODRIGUES, Bruno; MORAES-SILVA, Ivana C.; SOUZA, Leandro E.; SIRVENTE, Raquel; MOSTARDA, Cristiano; ANGELIS, Katia De; SOARES, Pedro P.; LACCHINI, Silvia; CONSOLIM-COLOMBO, Fernanda; IRIGOYEN, Maria-Claudia1. In the present study we evaluated the effects of shortterm pyridostigmine bromide (0.14 mg/mL) treatment started early after myocardial infarction (MI) on left ventricular (LV) and autonomic functions in rats. 2. Male Wistar rats were divided into control, pyridostigmine, infarcted and infarcted + pyridostigmine-treated groups. Pyridostigmine was administered in the drinking water, starting immediately after MI or sham operation, for 11 days. Left ventricular function was evaluated indirectly by echocardiography and directly by LV catheterization. Cardiovascular autonomic control was evaluated by baroreflex sensitivity (BRS), heart rate variability (HRV) and pharmacological blockade. All evaluations started after 7 days pyridostigmine treatment and were finalized after 11 days treatment. 3. Pyridostigmine prevented the impairment of + dP/dT and reduced the MI area in infarcted + pyridostigmine compared with infarcted rats (7 +/- 3% vs 17 +/- 4%, respectively). Mean blood pressure was restored in infarcted + pyridostigmine compared with infarcted rats (103 +/- 3 vs 94 +/- 3 mmHg, respectively). In addition, compared with the infarcted group, pyridostigmine improved BRS, as evaluated by tachycardic (1.6 +/- 0.2 vs 2.5 +/- 0.2 b. p. m./mmHg, respectively) and bradycardic (-0.42 +/- 0.01 vs -1.9 +/- 0.1 b. p. m./mmHg) responses, and reduced the low frequency/high frequency ratio of HRV (0.81 +/- 0.11 vs 0.24 +/- 0.14, respectively). These improvements are probably associated with increased vagal tone and reduced sympathetic tone in infarcted + pyridostigmine compared with infarcted rats. 4. In conclusion, the data suggest that short-term pyridostigmine treatment started early after MI can improve BRS, HRV and parasympathetic and sympathetic tone in experimental rats. These data may have potential clinical implications because autonomic markers have prognostic significance after MI.
- Inspiratory Muscle Training Reduces Sympathetic Nervous Activity and Improves Inspiratory Muscle Weakness and Quality of Life in Patients With Chronic Heart Failure A CLINICAL TRIAL(2012) MELLO, Priscila R.; GUERRA, Grazi M.; BORILE, Suellen; RONDON, Maria U.; ALVES, Maria J.; NEGRAO, Carlos E.; LAGO, Pedro Dal; MOSTARDA, Cristiano; IRIGOYEN, Maria C.; CONSOLIM-COLOMBO, Fernanda M.PURPOSE: To evaluate the effect of inspiratory muscle training (IMT) on cardiac autonomic modulation and on peripheral nerve sympathetic activity in patients with chronic heart failure (CHF). METHODS: Functional capacity, low-frequency (LF) and high-frequency (HF) components of heart rate variability, muscle sympathetic nerve activity inferred by microneurography, and quality of life were determined in 27 patients with CHF who had been sequentially allocated to 1 of 2 groups: (1) control group (with no intervention) and (2) IMT group. Inspiratory muscle training consisted of respiratory exercises, with inspiratory threshold loading of seven 30-minute sessions per week for a period of 12 weeks, with a monthly increase of 30% in maximal inspiratory pressure (PImax) at rest. Multivariate analysis was applied to detect differences between baseline and followup period. RESULTS: Inspiratory muscle training significantly increased PImax (59.2 +/- 4.9 vs 87.5 +/- 6.5 cmH(2)O, P = .001) and peak oxygen uptake (14.4 +/- 0.7 vs 18.9 +/- 0.8 mL.kg(-1).min(-1), P = .002); decreased the peak ventilation (V. E) +/- carbon dioxide production (V-CO2) ratio (35.8 +/- 0.8 vs 32.5 +/- 0.4, P = .001) and the (V) over dotE +/-(V) over dotCO(2) slope (37.3 +/- 1.1 vs 31.3 +/- 1.1, P = .004); increased the HF component (49.3 +/- 4.1 vs 58.4 +/- 4.2 normalized units, P = .004) and decreased the LF component (50.7 +/- 4.1 vs 41.6 +/- 4.2 normalized units, P = .001) of heart rate variability; decreased muscle sympathetic nerve activity (37.1 +/- 3 vs 29.5 +/- 2.3 bursts per minute, P = .001); and improved quality of life. No significant changes were observed in the control group. CONCLUSION: Home-based IMT represents an important strategy to improve cardiac and peripheral autonomic controls, functional capacity, and quality of life in patients with CHF.
- Cardiovascular effects of partial sleep deprivation in healthy volunteers(2012) DETTONI, Josilene L.; CONSOLIM-COLOMBO, Fernanda Marciano; DRAGER, Luciano F.; RUBIRA, Marcelo C.; SOUZA, Silvia Beatriz P. Cavasin de; IRIGOYEN, Maria Claudia; MOSTARDA, Cristiano; BORILE, Suellen; KRIEGER, Eduardo M.; MORENO JR., Heitor; LORENZI-FILHO, GeraldoCardiovascular effects of partial sleep deprivation in healthy volunteers. J Appl Physiol 113: 232-236, 2012. First published April 26, 2012; doi: 10.1152/japplphysiol.01604.2011.-Sleep deprivation is common in Western societies and is associated with increased cardiovascular morbidity and mortality in epidemiological studies. However, the effects of partial sleep deprivation on the cardiovascular system are poorly understood. In the present study, we evaluated 13 healthy male volunteers (age: 31 +/- 2 yr) monitoring sleep diary and wrist actigraphy during their daily routine for 12 nights. The subjects were randomized and crossover to 5 nights of control sleep (>7 h) or 5 nights of partial sleep deprivation (<5 h), interposed by 2 nights of unrestricted sleep. At the end of control and partial sleep deprivation periods, heart rate variability (HRV), blood pressure variability (BPV), serum norepinephrine, and venous endothelial function (dorsal hand vein technique) were measured at rest in a supine position. The subjects slept 8.0 +/- 0.5 and 4.5 +/- 0.3 h during control and partial sleep deprivation periods, respectively (P < 0.01). Compared with control, sleep deprivation caused significant increase in sympathetic activity as evidenced by increase in percent low-frequency (50 +/- 15 vs. 59 +/- 8) and a decrease in percent high-frequency (50 +/- 10 vs. 41 +/- 8) components of HRV, increase in low-frequency band of BPV, and increase in serum norepinephrine (119 +/- 46 vs. 162 +/- 58 ng/ml), as well as a reduction in maximum endothelial dependent venodilatation (100 +/- 22 vs. 41 +/- 20%; P < 0.05 for all comparisons). In conclusion, 5 nights of partial sleep deprivation is sufficient to cause significant increase in sympathetic activity and venous endothelial dysfunction. These results may help to explain the association between short sleep and increased cardiovascular risk in epidemiological studies.