Vitor Giatte Angarten

Capacidade funcional como preditor de qualidade de vida na insuficiência cardíaca

Abstract Introduction : Heart failure (HF) affects the quality of life (QoL), while metabolic and cardiopulmonary rehabilitation program (MCRP) of patients with the syndrome provides improved functional capacity (FC) and QoL. Objectives : To determine the relationship of the QoL domains with CF in patients with HF and propose cutoff points of the QoL domains by CF. Materials and methods : We evaluated 57 patients with HF functional, class II and III, with 37 beginners (GI) in MCRP and 20 participants (GP) with more than three-month program. QoL was evaluated by the Minnesota through the physical, emotional, and general dimension domains. The CF was determined by testing the six-minute walk (6MWT), with cutoffs defined as proposed in the literature. We used the Student t test, Pearson correlation and ROC curve analysis to an-swer the research objectives, considering a 5% significance. Results : Participants of RCPM showed better QoL scores when compared to beginners. Significant correlations were observed between the Emotional Domain and 6MWT for both groups. There were significant cutoffs of domains of QoL arising from CF, highlighting the emotional domain (sensitivity/ specificity) for both groups.

Influence of exercise on oxidative stress in patients with heart failure

Reactive oxygen species play an important role in the pathophysiology of heart failure (HF). In contrast, regular physical exercise can promote adaptations to reactive oxygen species that are beneficial for patients with HF. We completed a systematic review of randomized controlled trials that evaluate the influence of exercise on oxidative stress in patients with HF. Articles were searched in the PubMed, Cochrane, SciELO, and LILACS databases. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed using the Physiotherapy Evidence Database scale. We selected 12 studies with a total of 353 participants. The included patients had a left ventricle ejection fraction of < 52% and New York Heart Association functional class II or III disease. A significant increase was observed in peak oxygen consumption (between 10 and 46%) in the group that underwent training (TG). There was an improvement in the oxidative capacity of skeletal muscles in the TG, related to the positive activity of mitochondrial cytochrome c oxidase (between 27 and 41%). An increase in the expression of the enzymes glutathione peroxidase (41%), catalase (between 14 and 42%), and superoxide dismutase (74.5%), and a decrease in lipid peroxidation (between 28.8 and 58.5%) were observed in the TG. Physical training positively influenced the cardiorespiratory capacity and enhanced the benefits of oxidant and antioxidant biomarkers in patients with HF. High-intensity training promoted a 15% increase in the plasma total antioxidant capacity, whereas moderate training had no effect.

Omega-3 Fatty Acids Improve Lipid Metabolism and Inflammatory Markers in Patients with Heart Failure Undergoing Exercise Training

We hypothesize whether omega-3 (n-3) polyunsaturated fatty acids (PUFA) supplementation may improve the lipid metabolism and inflammatory biomarkers in heart failure (HF) patients undergoing exercise training. Sixteen male patients, who were participating in a physical cardiac rehabilitation program, ingested 4.8 g of fish oil daily (2.51 g of eicosapentaenoic and docosahexaenoic acids) for 60 days. Blood samples were collected at baseline and after 60 days of n-3 PUFA supplementation for analysis. The paired Student t-test was applied to detect differences (p < 0.05). The n-3 PUFA significantly reduced the levels of triglyceride (28.9%), small dense LDLcholesterol (16.2%), non-HDL-cholesterol (9.0%), and TNF-α (17.8%) after 60 days (p < 0.05). Furthermore, the transfer of cholesteryl-ester to HDL increased by 23.1% (p < 0.05). In summary, the n-3 PUFA supplementation improved the lipid metabolism and low-grade systemic inflammation in HF patients submitted to exercise training, which may lower the risk of cardiovascular events. Corresponding author: da Silva, E. L, Department of Clinical Analysis, Health Sciences Center, Federal University of Santa Catarina, Campus, s/n, Trinity, 88.040-370, Florianópolis, SC, Brazil. Telephone: +55-48-3721-97.12; Fax: +55-48-3721-5072; E-mails: edson.silva@ufsc.br ; dasilvael@hotmail.com Received Date: Feb 19, 2015 Accepted Date: April 17, 2015 Published Date: April 24, 2015 Citation: da Silva, E. L. et al. Omega-3 Fatty Acids Improve Lipid Metabolism and Inflammatory Markers in Patients with Heart Failure Undergoing Exercise Training. (2015) J Food Nutr Sci 2(2): 1-6. Int J Food Nutr Sci | Volume 2: Issue 2 www.ommegaonline.com

Exercício intenso e suplementação de testosterona em portadores de insuficiência cardíaca

^aINTRODUCAO: O sono e um estado natural e recorrente, no qual acontecem processos neurobiologicos importantes. A ma qualidade do sono esta diretamente A insuficiencia cardiaca (IC) e uma sindrome com alteracoes neuroendocrinas, limitacoes funcionais associadas a baixa qualidade de vida. Ha pouco conhecimento dos efeitos do exercicio fisico de alta intensidade e terapia de suplementacao de testosterona (TST) em portadores de IC e hipotestosteronemia.OBJETIVO: Avaliar os efeitos do exercicio de alta intensidade associado a TST na qualidade de vida e potencia aerobia destes pacientes.METODOS: Dezenove pacientes portadores de IC (idade media, 58 ± 10 anos; fracao de ejecao, 34 ± 8%) foram randomizados para o grupo exercicio de alta intensidade (controle; n=9) e exercicio de alta intensidade com suplementacao hormonal (intervencao; n=10). Os Pacientes exercitaram-se (40 minutos, 90% do consumo maximo de oxigenio) tres vezes semanalmente durante 12 semanas. O grupo intervencao recebeu testosterona na primeira e sexta semanas. Antes e apos o periodo de estudo foram obtidas medidas da capacidade funcional e escores do Minnesota Living with Heart Failure Questionnaire.RESULTADOS: No intragrupo controle e intervencao, respectivamente, houve aumento do pico de consumo de oxigenio (12% vs. 15%; p CONCLUSAO: Exercicio de alta intensidade melhora a capacidade funcional e escores da QV apos 12 semanas de tratamento.^lpt^aINTRODUCTION: Heart failure is a syndrome related to neuroendocrine alterations and limitations on daily activities associated with poor quality of life. Little is known about the effects of high-intensity exercise and testosterone supplementation therapy (TST) on heart failure patients with hypotestosteronemia.OBJECTIVE: To evaluate the effects of high-intensity exercise and testosterone supplementation on quality of life and aerobic power in these patients.METHODS: Nineteen heart failure patients (age=58 ± 10 years; ejection fraction= 34 ± 8%) were randomized to either a high-intensity exercise group (control; n=9) or high-intensity exercise group with hormonal supplementation (intervention; n=10). Patients exercised (40 minutes, 90% peak oxygen consumption) for 12 weeks, three times weekly and intervention group received testosterone in the first and sixth weeks. Functional capacity measurements and Minnesota Living With Heart Failure Questionnaire (MLWHFQ) scores were obtained before and after the study period.RESULTS: Within control and intervention group respectively there was an increase in peak oxygen uptake (12% vs. 15%; pCONCLUSION: High-intensity exercise improves functional capacity and quality of life scores after 12 weeks of treatment.^len^aINTRODUCCION: La insuficiencia cardiaca (IC) es un sindrome con alteraciones neuroendocrinas, limitaciones funcionales asociadas a la baja calidad de vida. Hay poco conocimiento de los efectos del ejercicio fisico de alta intensidad y terapia de suplementacion de testosterona (TST) en portadores de IC e hipotestosteronemia.OBJETIVO: Evaluar los efectos del ejercicio de alta intensidad asociado a TST en la calidad de vida y potencia aerobica de estos pacientes.METODOS:Diecinueve pacientes portadores de IC (promedio de edad= 58 ± 10 anos; fraccion de eyeccion= 34 ± 8%) fueron randomizados para el grupo ejercicio de alta intensidad (control; n=9) y ejercicio de alta intensidad con suplementacion hormonal (intervencion; n=10). Los pacientes se ejercitaron (40 minutos, 90% del consumo maximo de oxigeno) tres veces semanalmente por 12 semanas, el grupo intervencion recibio testosterona en la primera y sexta semanas. Antes y despues del periodo de estudio fueron obtenidas medidas de la capacidad funcional y escores del Minnesota Living with Heart Failure Questionnaire.RESULTADOS: Intragrupo control e intervencion respectivamente hubo aumento del pico de consumo de oxigeno (12% vs. 15%; pCONCLUSIONES: El ejercicio de alta intensidad mejora la capacidad funcional y escores de la CV despues de 12 semanas de tratamiento.^les