Marcio Clementino de S. Santos

Influência do uso de contraceptivos orais nos níveis lipídicos e nas respostas cardiorrespiratórias de mulheres saudáveis e sedentárias

OBJECTIVE: To evaluate the influence of oral contraceptive use on lipid levels, heart rate (HR) variability and aerobic capacity among sedentary young women. METHODS: The subjects were 20 healthy women (23.55±1.88 years): ten used oral contraceptives (TG) and ten did not (CG). Ergospirometric test on a cycle ergometer was used to determine the aerobic capacity at the anaerobic threshold and at the exercise peak. In addition, recordings of HR and R-R (iRR) intervals in the supine and seated positions, for 15 minutes, and biochemical blood analysis were performed. The iRR (ms) indices were analyzed in the time domain (TD) for RMSSD, RMSM and pNN50 (%), and in the frequency domain (FD) using fast Fourier transforms from low (LF) and high (HF) frequency bands in normalized units, obtaining the LF/HF ratio. Mann-Whitney and Kruskal-Wallis, with α=5%, were used for statistical analyses. RESULTS: The triglyceride and cholesterol levels in the TG were greater than those in the CG (p<0.05). At the anaerobic threshold and at the exercise peak, the power (W), oxygen uptake (VO2), carbon dioxide production (VCO2), (VO2/VCO2) ratio, pulmonary ventilation and HR were not significantly different between the groups. The indices for HR variability in the TD and FD for the two groups in the supine and seated positions were also not different. CONCLUSIONS: The use of oral contraceptives did not influence the aerobic capacity or the autonomic modulation of the HR. However, it influenced the total cholesterol and triglyceride levels. These assessments are important for determining protocols for physical training for cardiovascular disease prevention.

Heart rate variability in multibacillar leprosy: Linear and nonlinear analysis

Objective To evaluate the heart rate variability (HRV) in patients with multibacillary leprosy using dynamic linear and nonlinear analysis. Material and methods Twenty-one leprosy patients (mean age: 39.14 ±10.58 years) and 21 healthy subjects (mean age: 36.24 ± 12.64 years) completed the sample. Heart rate variability recording was performed by a Polar RS800 CX heart monitor during a period of 15 min in the supine position and 15 min in a sitting position. Analysis of HRV was performed by frequency domain from high frequency (HF) and low frequency (LF) spectral indexes in absolute and normalized units. The nonlinear analysis of HRV was calculated using symbolic analysis (0V%, 1V%, 2LV% and 2UV% indexes), Shannon entropy (SE) and normalized complexity index (NCI). Results Linear analysis: both groups showed higher HF values (p < 0.05) and smaller LF values (p < 0.05) in supine than in sitting position. The leprosy patients showed higher LF values (p < 0.05) and smaller HF values (p < 0.05) compared to the controls on supine position. Symbolic analysis: leprosy patients had higher 0V% values (p < 0.05), smaller 2LV% values (p < 0.05) and 2UV % values compared to healthy subjects on both positions. The 1V % had higher values (p < 0.05) for leprosy patients than for controls in the sitting position. The control subjects had smaller 0V % values (p < 0.05), and higher 2UV % values (p < 0.05) in the supine position compared to the sitting position. Leprosy patients had higher 2UV index values (p < 0.05) in the supine position compared to the sitting position. In the complexity analysis, leprosy patients had smaller SE and NCI values (p < 0.05) than the control in the supine position. There was no difference between the SE and NCI values of leprosy and the control subjects in the sitting position. The control subjects had higher SE and NCI values (p < 0.05) in the supine position than in the sitting position. Conclusion Leprosy patients had higher sympathetic modulation and smaller vagal modulation than controls, indicating less HRV and cardiac modulation with lower complexity. The control group displayed significant HRV differences in response to position changes while leprosy patients had fewer HRV differences after the same postural change. An analysis of HRV with linear and non-linear dynamics proved to be a reliable method and promising for the investigation of autonomic dysfunction in patients with multibacillary leprosy.

Spectral Analysis of Heart Rate Variability in Women

Heart activity is largely modulated by the autonomic nervous system (ANS), which promotes rapid adjustments in the cardiovascular system during different stimuli (i.e., physical exercise, mental stress and postural change) (Hainsworth, 1998). HRV is a noninvasive measure used to analyze the influence of the autonomic nervous system on the heart, providing information about both sympathetic and parasympathetic contributions to consecutive heart rate (HR) oscillations. It has been proposed that a decrease in HRV is a powerful predictor of morbidity and mortality resulting from arrhythmic complications. HRV decreases with age (Catai et al., 2002; Melo et al., 2005) as a consequence of parasympathetic reduction and predominance of sympathetic modulation (Lipsitz et al., 1990; Longo & Correia, 1995; Akselrod, 1995).