Luciene Ferreira Azevedo

Validity and reliability of the Baecke questionnaire for the evaluation of habitual physical activity among people living with HIV/AIDS

This study evaluates the validity and reliability of the Baecke questionnaire on habitual physical activity when applied to a population of HIV/AIDS subjects. Validity was determined by comparing measurements for 30 subjects of peak oxygen uptake, peak workload, and energy expenditure with scores for occupational physical activity (OPA), physical exercise in leisure (PEL), leisure and locomotion activities (LLA), and total score (TS). Reliability was determined by testing and retesting 29 subjects at intervals of 15-30 days. Validity was evaluated with the Pearson correlation and reliability analyses were done using the intraclass correlation, paired Student t-test, and Bland-Altman methods. Peak VO2 and peak workload had significant correlation with PEL (r = 0.41; r = 0.43; respectively). Energy expenditure had a significant correlation with OPA (r = 0.64). The intraclass coefficients were 0.70 or more for OPA, PEL and TS. There was no difference in OPA, PEL, LLA and TS between the two evaluations. The Bland-Altman methods showed that there was good agreement between the measurements for all habitual physical activities scores. Results show that the Baecke questionnaire is valid for the evaluation of habitual physical activity among people living with HIV/AIDS.

Cardiac and metabolic characteristics in long distance runners of sport and exercise cardiology outpatient facility of a tertiary hospital

OBJECTIVE To characterize electrocardiographic and functional cardiac parameters and cardiopulmonary responses to exercise in long-distance Brazilian runners monitored at the Sport and Exercise Cardiology Outpatient Facility of a tertiary care hospital. METHODS Of an initial population of 443 male and female athletes of different sport modalities, we assessed 162 (37%) long-distance male runners, aged from 14 to 67. Electrocardiographic (12 leads) and echocardiographic (M-mode and two-dimensional) parameters were recorded at rest. Cardiopulmonary responses were evaluated on a treadmill with a ramp protocol. RESULTS Metabolic alterations and cardiovascular diseases were diagnosed in 17% and 9% of the runners, respectively. Sinus bradycardia and left ventricular hypertrophy were observed in 62% and 33% of the runners, respectively. Structural alterations such as ventricular cavity > or = 55 mm, relative wall thickness > or = 0.44, and ventricular mass index > or = 134 g/m2 were found in 15%, 11% and 7% of the runners, respectively. Ejection fraction < 55% was observed in 4% of the runners. Peak oxygen uptake (VO2peak) decreased as of the age of 41, although the anaerobic threshold relative to the VO2peak remained unchanged with age. CONCLUSION Resting bradycardia and left ventricular hypertrophy are the most frequent cardiovascular adaptations in Brazilian long distance runners monitored by the Sport and Exercise Cardiology Outpatient Facility. Although VO2peak decreases after the age of 41, the relative oxygen uptake at the anaerobic threshold of these runners remained unchanged.

Effects of losartan combined with exercise training in spontaneously hypertensive rats

We investigate whether combined treatment with losartan, an angiotensin II receptor blocker, and exercise training (ET) in spontaneously hypertensive rats (SHR) would have an additive effect in reducing hypertension and improving baroreflex sensitivity when compared with losartan alone. Male SHR (8 weeks old) were assigned to 3 groups: sedentary placebo (SP, N = 16), sedentary under losartan treatment (SL, N = 11; 10 mg kg-1 day-1, by gavage), and ET under losartan treatment (TL, N = 10). ET was performed on a treadmill 5 days/week for 60 min at 50% of peak VO2, for 18 weeks. Blood pressure (BP) was measured with a catheter inserted into the carotid artery, and cardiac output with a microprobe placed around the ascending aorta. The baroreflex control of heart rate was assessed by administering increasing doses of phenylephrine and sodium nitroprusside (iv). Losartan significantly reduced mean BP (178 16 vs 132 12 mmHg) and left ventricular hypertrophy (2.9 0.4 vs 2.5 0.2 mg/g), and significantly increased baroreflex bradycardia and tachycardia sensitivity (1.0 0.3 vs 1.7 0.5 and 2.0 0.7 vs 3.2 1.7 bpm/mmHg, respectively) in SL compared with SP. However, losartan combined with ET had no additional effect on BP, baroreflex sensitivity or left ventricular hypertrophy when compared with losartan alone. In conclusion, losartan attenuates hypertension and improves baroreflex sensitivity in SHR. However, ET has no synergistic effect on BP in established hypertension when combined with losartan, at least at the dosage used in this investigation.

Cardiovascular risk and clinical factors in athletes: 10 years of evaluation.

PURPOSE Preparticipation screening in athletes is a very current but controversial theme. Part of this controversy is due to the cost benefit, especially when the screening is merely used as a prevention of sudden cardiac death caused by rare and hereditary diseases. The purpose of this study was to describe the prevalence of preexisting diseases, cardiovascular risk factor for cardiovascular diseases development, and hematological profile in a population of amateur and professional athletes. METHODS Data of 623 athletes (529 men and 94 women), aged 13-77 yr, were analyzed to detect preexisting diseases. The variables total cholesterol, LDL, HDL, triglycerides, fasting glucose, body mass index, hemoglobin, hematocrit, and ferritin were analyzed in two groups according to age, that is, younger and older 35 yr old, and their prevalence (%) and distribution in quartiles were presented. χ test and Pearson product-moment correlation coefficients between variables were applied, and P < 0.05 was adopted for significance. RESULTS Hypertension was the most prevalent preexisting diseases, although the data showed low prevalence of cardiomyopathy. Cardiovascular risk factors were prevalent in both genders. There were positive correlations between cardiovascular risk factors and age and between body mass index and lipid levels in male athletes. Also, there was a high prevalence of low ferritin levels for women, with positive correlation between the levels of hemoglobin and ferritin. CONCLUSIONS In the present study, hypertension was the most prevalent diagnosed disease, and cardiovascular risk factors showed important prevalence, especially in athletes older than 35 yr. Although physical training represents a cardioprotective factor to the onset of cardiovascular disease, it does not exclude the prevalence of risk factors and diseases in athletes.

Influence of angiotensinogen and angiotensin-converting enzyme polymorphisms on cardiac hypertrophy and improvement on maximal aerobic capacity caused by exercise training.

Background The allele threonine (T) of the angiotensinogen has been associated with ventricular hypertrophy in hypertensive patients and soccer players. However, the long-term effect of physical exercise in healthy athletes carrying the T allele remains unknown. We investigated the influence of methionine (M) or T allele of the angiotensinogen and D or I allele of the angiotensin-converting enzyme on left-ventricular mass index (LVMI) and maximal aerobic capacity in young healthy individuals after long-term physical exercise training. Design Prospective clinical trial. Methods Eighty-three policemen aged between 20 and 35 years (mean ± SD 26 ± 4.5 years) were genotyped for the M235T gene angiotensinogen polymorphism (TT, n = 25; MM/MT, n = 58) and angiotensin-converting enzyme gene insertion/deletion (I/D) polymorphism (II, n = 18; DD/DI, n = 65). Left-ventricular morphology was evaluated by echocardiography and maximal aerobic capacity (VO2peak) by cardiopulmonary exercise test before and after 17 weeks of exercise training (50–80% VO2peak). Results Baseline VO2peak and LVMI were similar between TT and MM/MT groups, and II and DD/DI groups. Exercise training increased significantly and similarly VO2peak in homozygous TT and MM/MT individuals, and homozygous II and DD/DI individuals. In addition, exercise training increased significantly LVMI in TT and MM/MT individuals (76.5 ± 3 vs. 86.7 ± 4, P = 0.00001 and 76.2 ± 2 vs. 81.4 ± 2, P = 0.00001, respectively), and II and DD/DI individuals (77.7 ± 4 vs. 81.5 ± 4, P = 0.0001 and 76 ± 2 vs. 83.5 ± 2, P = 0.0001, respectively). However, LVMI in TT individuals was significantly greater than in MM/MT individuals (P = 0.04). LVMI was not different between II and DD/DI individuals. Conclusion Left-ventricular hypertrophy caused by exercise training is exacerbated in homozygous TT individuals with angiotensinogen polymorphism.

Comportamento cardiorrespiratório em crianças saudáveis durante o exercício progressivo máximo

BACKGROUND Little is known about cardiorespiratory and metabolic response in healthy children during progressive maximal exercise test. OBJECTIVE To test the hypothesis that children show different responses in cardiorespiratory and metabolic parameters during progressive maximal exercise test when compared with adults. METHODS Twenty-five healthy children (gender, 15M/10F; age, 10.2 +/- 0.2) and 20 healthy adults (gender, 11M/9F; age, 27.5 +/- 0.4) underwent a progressive treadmill cardiopulmonary test until exhaustion to determine the maximal aerobic capacity and ventilatory anaerobic threshold (VAT). RESULTS The peak workload (5.9+/-0.1 vs 5.6+/-0.1 mph, respectively; p>0.05), exercise time (9.8+/-0.4 vs 10.2+/-0.4 min, respectively; p>0.05), and relative aerobic fitness (VO(2)peak, 39.4+/-2.1 vs 39.1+/-2.0 ml*kg(-1)*min-1, respectively; p>0.05) were similar in children and adults. At ventilatory anaerobic threshold, the heart rate, VO(2) ml*kg(-1)*min-1, respiratory rate (RR), functional estimate of dead space (VD/VT), ventilatory equivalent for oxygen (VE/VO(2)) and end-tidal pressure for oxygen (PETO2) were higher in children, while tidal volume (VT), O(2) pulse and end-tidal pressure for carbon dioxide (PETCO(2)) were lower. At peak of exercise, children showed higher RR and VD/VT. However, O(2) pulse, VT, pulmonary ventilation, PETCO(2) and respiratory exchange ratio were lower in children than adults. CONCLUSION Cardiorespiratory and metabolic responses during progressive exercise test are different in children as compared to adults. Specifically, these differences suggest that children have lower cardiovascular and ventilatory efficiency. However, children showed higher metabolic efficiency during exercise. In summary, despite the differences observed, children showed similar levels of exercising capacity when compared with adults.FUNDAMENTO: Pouco se sabe sobre a resposta cardiorrespiratoria e metabolica em criancas saudaveis durante teste de esforco progressivo maximo. OBJETIVO: Testar a hipotese de que as criancas apresentam respostas diferentes nos parâmetros cardiorrespiratorios e metabolicos durante teste de esforco progressivo maximo em comparacao aos adultos. METODOS: Vinte e cinco criancas saudaveis (sexo, 15M/10F; idade, 10,2 ± 0,2) e 20 adultos saudaveis (sexo, 11M/9F; idade, 27,5 ± 0,4) foram submetidos a um teste cardiopulmonar progressivo em esteira ergometrica ate a exaustao para determinar a capacidade aerobia maxima e limiar anaerobio ventilatorio (LAV). RESULTADOS: A carga de pico (5,9 ± 0,1 vs 5,6 ± 0,1 mph, respectivamente; p > 0,05), tempo de exercicio (9,8 ± 0,4 vs 10,2 ± 0,4 min, respectivamente, p > 0,05), e aptidao cardiorrespiratoria (VO2pico, 39,4 ± 2,1 vs 39,1 ± 2,0 ml.kg-1.min-1, respectivamente, p > 0,05) foram semelhantes em criancas e adultos. No limiar anaerobio ventilatorio, a frequencia cardiaca, VO2 ml.kg-1.min-1, a frequencia respiratoria (FR), o espaco morto funcional estimado (VD/VT), o equivalente ventilatorio de oxigenio (VE/VO2) e a pressao expiratoria final do oxigenio (PETO2) foram maiores nas criancas, enquanto o volume corrente (VC), pulso de O2 e a pressao expiratoria final do dioxido de carbono (PETCO2) foram menores. No pico do exercicio, as criancas apresentaram FR e VD/VT superiores. No entanto, o pulso de O2, o VC, a ventilacao pulmonar, o PETCO2 e a razao de troca respiratoria foram menores nas criancas do que em adultos. CONCLUSAO: Respostas cardiorrespiratorias e metabolicas durante o teste de esforco progressivo sao diferentes em criancas em comparacao aos adultos. Especificamente, essas diferencas sugerem que as criancas tem menor eficiencia cardiovascular e respiratoria. No entanto, as criancas apresentaram maior eficiencia metabolica durante o teste de esforco. Em resumo, apesar das diferencas observadas, as criancas mostraram niveis semelhantes de capacidade de esforco, quando comparadas aos adultos.

Cardiorespiratory responses during progressive maximal exercise test in healthy children

BACKGROUND Little is known about cardiorespiratory and metabolic response in healthy children during progressive maximal exercise test. OBJECTIVE To test the hypothesis that children show different responses in cardiorespiratory and metabolic parameters during progressive maximal exercise test when compared with adults. METHODS Twenty-five healthy children (gender, 15M/10F; age, 10.2 +/- 0.2) and 20 healthy adults (gender, 11M/9F; age, 27.5 +/- 0.4) underwent a progressive treadmill cardiopulmonary test until exhaustion to determine the maximal aerobic capacity and ventilatory anaerobic threshold (VAT). RESULTS The peak workload (5.9+/-0.1 vs 5.6+/-0.1 mph, respectively; p>0.05), exercise time (9.8+/-0.4 vs 10.2+/-0.4 min, respectively; p>0.05), and relative aerobic fitness (VO(2)peak, 39.4+/-2.1 vs 39.1+/-2.0 ml*kg(-1)*min-1, respectively; p>0.05) were similar in children and adults. At ventilatory anaerobic threshold, the heart rate, VO(2) ml*kg(-1)*min-1, respiratory rate (RR), functional estimate of dead space (VD/VT), ventilatory equivalent for oxygen (VE/VO(2)) and end-tidal pressure for oxygen (PETO2) were higher in children, while tidal volume (VT), O(2) pulse and end-tidal pressure for carbon dioxide (PETCO(2)) were lower. At peak of exercise, children showed higher RR and VD/VT. However, O(2) pulse, VT, pulmonary ventilation, PETCO(2) and respiratory exchange ratio were lower in children than adults. CONCLUSION Cardiorespiratory and metabolic responses during progressive exercise test are different in children as compared to adults. Specifically, these differences suggest that children have lower cardiovascular and ventilatory efficiency. However, children showed higher metabolic efficiency during exercise. In summary, despite the differences observed, children showed similar levels of exercising capacity when compared with adults.FUNDAMENTO: Pouco se sabe sobre a resposta cardiorrespiratoria e metabolica em criancas saudaveis durante teste de esforco progressivo maximo. OBJETIVO: Testar a hipotese de que as criancas apresentam respostas diferentes nos parâmetros cardiorrespiratorios e metabolicos durante teste de esforco progressivo maximo em comparacao aos adultos. METODOS: Vinte e cinco criancas saudaveis (sexo, 15M/10F; idade, 10,2 ± 0,2) e 20 adultos saudaveis (sexo, 11M/9F; idade, 27,5 ± 0,4) foram submetidos a um teste cardiopulmonar progressivo em esteira ergometrica ate a exaustao para determinar a capacidade aerobia maxima e limiar anaerobio ventilatorio (LAV). RESULTADOS: A carga de pico (5,9 ± 0,1 vs 5,6 ± 0,1 mph, respectivamente; p > 0,05), tempo de exercicio (9,8 ± 0,4 vs 10,2 ± 0,4 min, respectivamente, p > 0,05), e aptidao cardiorrespiratoria (VO2pico, 39,4 ± 2,1 vs 39,1 ± 2,0 ml.kg-1.min-1, respectivamente, p > 0,05) foram semelhantes em criancas e adultos. No limiar anaerobio ventilatorio, a frequencia cardiaca, VO2 ml.kg-1.min-1, a frequencia respiratoria (FR), o espaco morto funcional estimado (VD/VT), o equivalente ventilatorio de oxigenio (VE/VO2) e a pressao expiratoria final do oxigenio (PETO2) foram maiores nas criancas, enquanto o volume corrente (VC), pulso de O2 e a pressao expiratoria final do dioxido de carbono (PETCO2) foram menores. No pico do exercicio, as criancas apresentaram FR e VD/VT superiores. No entanto, o pulso de O2, o VC, a ventilacao pulmonar, o PETCO2 e a razao de troca respiratoria foram menores nas criancas do que em adultos. CONCLUSAO: Respostas cardiorrespiratorias e metabolicas durante o teste de esforco progressivo sao diferentes em criancas em comparacao aos adultos. Especificamente, essas diferencas sugerem que as criancas tem menor eficiencia cardiovascular e respiratoria. No entanto, as criancas apresentaram maior eficiencia metabolica durante o teste de esforco. Em resumo, apesar das diferencas observadas, as criancas mostraram niveis semelhantes de capacidade de esforco, quando comparadas aos adultos.

Exercise intensity optimization for men with high cardiorespiratory fitness

Abstract Exercise intensity is a key parameter for exercise prescription but the optimal range for individuals with high cardiorespiratory fitness is unknown. The aims of this study were (1) to determine optimal heart rate ranges for men with high cardiorespiratory fitness based on percentages of maximal oxygen consumption (%VO2max) and reserve oxygen consumption (%VO2reserve) corresponding to the ventilatory threshold and respiratory compensation point, and (2) to verify the effect of advancing age on the exercise intensities. Maximal cardiorespiratory testing was performed on 210 trained men. Linear regression equations were calculated using paired data points between percentage of maximal heart rate (%HRmax) and %VO2max and between percentage of heart rate reserve (%HRR) and %VO2reserve attained at each minute during the test. Values of %VO2max and %VO2reserve at the ventilatory threshold and respiratory compensation point were used to calculate the corresponding values of %HRmax and %HRR, respectively. The ranges of exercise intensity in relation to the ventilatory threshold and respiratory compensation point were achieved at 78–93% of HRmax and 70–93% of HRR, respectively. Although absolute heart rate decreased with advancing age, there were no age-related differences in %HRmax and %HRR at the ventilatory thresholds. Thus, in men with high cardiorespiratory fitness, the ranges of exercise intensity based on %HRmax and %HRR regarding ventilatory threshold were 78–93% and 70–93% respectively, and were not influenced by advancing age.

The use of exogenous iron by professional cyclists pervades abdominal organs but not the heart

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Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities

OBJECTIVES: In athletes, isolated electrocardiogram high voltage criteria are widely used to evaluate left ventricular hypertrophy, but positive findings are thought to represent normal electrocardiogram alterations. However, which electrocardiogram criterion can best detect left ventricular hypertrophy in athletes of various sport modalities remains unknown. METHODS: Five electrocardiogram criteria used to detect left ventricular hypertrophy were tested in 180 male athletes grouped according to their sport modality: 67% low-static and high-dynamic components and 33% high-static and high-dynamic components of exercise. The following echocardiogram parameters are the gold standard for diagnosing left ventricular hypertrophy: left ventricular mass index ≥134 g.m-2, relative wall thickness ≥0.42 mm, left ventricular diastolic diameter index ≥32 mm.m-2, septum wall thickness ≥13 mm, and posterior wall thickness ≥13 mm. Results for the various criteria were compared using the kappa coefficient. Significance was established at p<0.05. RESULTS: Fifty athletes (28%) presented with left ventricular hypertrophy according to electrocardiogram findings, with the following sensitivities and specificities, respectively: 38-53% and 79-83% (Perugia), 22-40% and 89-91% (Cornell), 24-29% and 90% (Romhilt-Estes), 68-87% and 20-23% (Sokolow-Lyon), and 0% and 99% (Gubner). The Perugia and Cornell criteria had higher negative predictive values for the low-static and high-dynamic subgroup. Kappa coefficients were higher for Romhilt-Estes, Cornell and Perugia criteria than for Sokolow-Lyon and Gubner criteria. CONCLUSION: All five evaluated criteria are inadequate for detecting left ventricular hypertrophy, but the Perugia, Cornell and Romhilt-Estes criteria are useful for excluding its presence. The Perugia and Cornell criteria were more effective at excluding left ventricular hypertrophy in athletes involved in a sport modality with low-static and high-dynamic component predominance.