IntroductionChronic obstructive pulmonary disease (COPD) is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities, including respiratory muscle weakness and cardiovascular and cardiac autonomic regulation disorders. We investigated whether alterations in respiratory muscle strength (RMS) would affect cardiac autonomic modulation in COPD patients.MethodsThis study was a cross-sectional study done in ten COPD patients affected by moderate to very severe disease. The heart rate variability (HRV) signal was recorded using a Polar cardiofrequencimeter at rest in the sitting position (10 minutes) and during a respiratory sinus arrhythmia maneuver (RSA-M; 4 minutes). Linear analysis in the time and frequency domains and nonlinear analysis were performed on the recorded signals. RMS was assessed using a digital manometer, which provided the maximum inspiratory pressure (PImax) and the maximum expiratory pressure (PEmax).ResultsDuring the RSA-M, patients presented an HRV power increase in the low-frequency band (LFnu) (46.9±23.7 vs 75.8±27.2; P=0.01) and a decrease in the high-frequency band (HFnu) (52.8±23.5 vs 24.0±27.0; P=0.01) when compared to the resting condition. Significant associations were found between RMS and HRV spectral indices: PImax and LFnu (r=−0.74; P=0.01); PImax and HFnu (r=0.74; P=0.01); PEmax and LFnu (r=−0.66; P=0.01); PEmax and HFnu (r=0.66; P=0.03); between PEmax and sample entropy (r=0.83; P<0.01) and between PEmax and approximate entropy (r=0.74; P=0.01). Using a linear regression model, we found that PImax explained 44% of LFnu behavior during the RSA-M.ConclusionCOPD patients with impaired RMS presented altered cardiac autonomic control, characterized by marked sympathetic modulation and a reduced parasympathetic response; reduced HRV complexity was observed during the RSA-M.

BackgroundWe investigated a potential link between genetic polymorphisms in genes XRCC1 (Arg399Gln), OGG1 (Ser326Cys), XRCC3 (Thr241Met), and XRCC4 (Ile401Thr) with the level of DNA damage and repair, accessed by comet and micronucleus test, in 51 COPD patients and 51 controls.MethodsPeripheral blood was used to perform the alkaline and neutral comet assay; and genetic polymorphisms by PCR/RFLP. To assess the susceptibility to exogenous DNA damage, the cells were treated with methyl methanesulphonate for 1-h or 3-h. After 3-h treatment the % residual damage was calculated assuming the value of 1-h treatment as 100%. The cytogenetic damage was evaluated by buccal micronucleus cytome assay (BMCyt).ResultsCOPD patients with the risk allele XRCC1 (Arg399Gln) and XRCC3 (Thr241Met) showed higher DNA damage by comet assay. The residual damage was higher for COPD with risk allele in the four genes. In COPD patients was showed negative correlation between BMCyt (binucleated, nuclear bud, condensed chromatin and karyorrhexic cells) with pulmonary function and some variant genotypes.ConclusionOur results suggest a possible association between variant genotypes in XRCC1 (Arg399Gln), OGG1 (Ser326Cys), XRCC3 (Thr241Met), and XRCC4 (Ile401Thr), DNA damage and progression of COPD.

Objectives: To investigate the effect of repeated binge drinking and moderate alcohol consumption in young adults on arterial stiffness and sympathetic activity in young adults Methods: We enrolled 49 healthy young adults, free of cardiovascular diseases (25 males; age: 23.5±0.4 years; body mass index: 23.4±0.4 kg/m2; mean±S.E). Subjects included were those with a history of repeated binge drinking (BDs, > 2 years duration; n=20), drank at moderate levels (MODs, > 5 years duration; n=16), and abstained from alcohol (ABs, last 2-3 years; n=13). Arterial stiffness was assessed using carotid to femoral pulse wave velocity (cfPWV) and sympathetic activity was assessed using 24-hour urinary norepinephrine (NE) levels. Also measured was aortic systolic blood pressure and augmentation index (AIx), a measure of wave reflection.Results: BDs and MODs had higher cfPWV compared with ABs (0.6 and 0.5 m/sec, respectively; P≤0.04). In addition, BDs had higher urinary NE levels compared with MODs and ABs (P<0.05). Higher cfPWV were correlated with higher NE levels (r=0.35. P=0.02). Aortic systolic blood pressure (P=0.2) and AIx (P=0.96) were similar among BDs, MODs, and ABs. Conclusions:Our findings suggest that repeated exposure to alcohol, regardless of drinking pattern, may increase aortic arterial stiffness in healthy young adults. In addition, sympathetic activation, reflected by increased 24-hour urinary NE levels may contribute to alcohol-induced arterial stiffening in young adults.

BackgroundTuberculosis (TB), Lung Cancer (LC) and Chronic Obstructive Pulmonary Diseases (COPD) affect millions of individuals worldwide. Monitoring of DNA damage in pathological situations has been investigated because it can add a new dimension to clinical expression and may represent a potential target for therapeutic intervention. The aim of this study was to evaluate DNA damage and the frequency of cellular abnormalities in TB, LC and COPD patients by comparing them to healthy subjects.MethodsThe detection of DNA damage by a buccal micronucleus cytome assay was investigated in patients with COPD (n = 28), LC (n = 18) and TB (n = 22) and compared to control individuals (n = 17).ResultsThe COPD group had a higher frequency of apoptotic cells compared to TB and LC group. The TB group showed a higher frequency of DNA damage, defect in cytokinesis, apoptotic and necrotic cells. Patients with LC had low frequency of chromosomal aberrations than TB and COPD patients.ConclusionCOPD patients showed cellular abnormalities that corresponded to cell death by apoptosis and necrosis, while patients with TB presented defects in cytokinesis and dysfunctions in DNA repair that resulted in the formation of micronucleus (MN) besides apoptotic and necrotic cells. Patients with COPD, TB and LC had a low frequency of permanent DNA damage.

our aim was to identify optimal cardiopulmonary exercise testing (cpet) threshold values that distinguish disease severity progression in patients with co-existing systolic heart failure (Hf) and chronic obstructive pulmonary disease (COPD), and to evaluate the impact of the cut-off determined on the prognosis of hospitalizations. We evaluated 40 patients (30 men and 10 woman) with HF and copD through pulmonary function testing, doppler echocardiography and maximal incremental cpet on a cycle ergometer. Several significant CPET threshold values were identified in detecting a forced expiratory volume in 1 second (FEV 1 ) < 1.6 L: 1) oxygen uptake efficiency slope (OUES) < 1.3; and 2) circulatory power (cp) < 2383 mmHg.mlO 2 .kg −1 . CPET significant threshold values in identifying a left ventricular ejection fraction (LVef) < 39% were: 1) OUES: < 1.3; 2) CP < 2116 mmHg.mlO 2 .kg −1 . min −1 and minute ventilation/carbon dioxide production (V̇e/Vċo 2 ) slope>38. The 15 (38%) patients hospitalized during follow-up (8 ± 2 months). In the hospitalizations analysis, LVEF < 39% and FEV 1 < 1.6, OUES < 1.3, CP < 2116 mmHg.mlO 2 .kg −1 .min −1 and V̇e/Vċo 2 > 38 were a strong risk predictor for hospitalization (p ≤ 0.050). The CPET response effectively identified worsening disease severity in patients with a Hf-copD phenotype. LVef, feV 1, CP, OUES, and the V̇e/Vċo 2 slope may be particularly useful in the clinical assessment and strong risk predictor for hospitalization.

Fisioter Mov. 2011 abr/jun;24(2):211-9 Ribeiro A, Wayhs JHA, Machado MM, Fleig TCM, da Silva ALG. 212 ciclo de marcha. Resultados: Os dados cinemáticos encontraram-se variados; cada indivíduo apresentou peculiaridades sobrepostas aos padrões básicos. Observou-se forte correlação negativa entre cadência e PImax (p = 0,002 e r = -0,96), entre comprimento de passo e PEmax (p = 0,007 e r = -0,93). Para a qualidade de vida (SGQR), associações diretas, qualidade de vida total (QVT) e percentual da fase de apoio (p = 0,086 e r = 0,75); qualidade de vida impacto (QVI) e percentual da fase de apoio (p = 0,09 e r = 0,74). Conclusão: Avaliar a marcha do portador de DPOC possibilitou inferir objetivamente, delineando intervenções terapêuticas. Os benefícios esperados da pesquisa, tanto para o indivíduo quanto para a sociedade, é uma nova maneira de avaliar e incrementar a marcha, elemento fundamental para manutenção da independência funcional e qualidade de vida. [#] [P] Palavras-chave: DPOC. Marcha. Autonomia. Qualidade de vida. AbstractIntroduction: Knowledge about gait functional in COPD patients and the identification of the associated variables in these characteristics can support the development of specific approaches in rehabilitation with the objective to maintain the autonomy. Objective: To evaluate the gait pattern adopted by COPD patients using a bidimensional analysis. Method: Transversal delineation, study of cases, carried through with six patients of COPD, the masculine sex, 64,00 ± 8,07 years of age, index of corporal mass (IMC) 22,28 ± 2,46 kg/m2, forced expiratory volume in the first second (VEF1) 35.17 ± 25.79% predicted, vital capacity forced (CVF) 64.83 ± 17.84% predicted. For kinematic data, we used bidimensional videography Simi Motion, connected was used the camera of digital video. The registers in 60 frames for second and time of acquisition of march cycle. Results: The kinematic data had met varied, since each individual presented overlapping peculiarities the basic standards. One strong negative correlation between cadence and PImax (p = 0,002 and r = -0,96), between length of step and PEmax was observed (p = 0,007 and r = -0,93). For the quality of life (SGQR), direct associations had been found, quality of total life (QVT) and percentage of the support phase (p = 0,086 and r = 0,75), and also quality of life impact (QVI) and percentage of the support phase (p = 0,09 and r = 0,74). Conclusion: To evaluate the standard of march the DPOC carrier, made possible in them to infer objective on this, possible to delineate therapeutically interventions. The benefits waited with such research, as much for the individual as for the society, it was in a new way to evaluate and to develop the march, basic element for maintenance of functional independence and quality of life. [#] [K]

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Introduction: In the Chronic Obstructive Pulmonary Disease (COPD) both pulmonary and systemic condition increase dyspnea, intolerance to exercise and inactivity. Objective: To evaluate possible association between Hand Grip Strength (HGS) and the distance covered in the Six-Minute Walk Test (6MWT) in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: A cross-sectional study that evaluated 34 patients with COPD from moderate to very severe stages. The HGS test was performed with a manual hydraulic dynamometer (Jamar®, California, USA) with three bilateral measures, allowing