Effects of Exercise Training on Heart Rate Variability in Chagas Heart Disease

Nascimento, Bruno Ramos; Lima, Márcia Maria Oliveira; Nunes, Maria do Carmo Pereira; Alencar, Maria Clara; Costa, Henrique Silveira; Filho, Marcelo; Cota, Vitor Emanuel Serafim; Rocha, Manoel Otávio da Costa; Ribeiro, Antônio Luiz Pinho

doi:10.5935/abc.20140108

Cited by 12 publications

(12 citation statements)

References 45 publications

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“…Ortiz & Mendoza (2008) reportaron valores para SDRR en un rango entre 30,9-66,8ms, lo que ubica los datos de este estudio, dentro de ese rango. Ramos et al (2014) estudiaron el efecto del ejercicio en la VFC de pacientes chagásicos, en comparación con pacientes chagásicos no ejercitados, analizando la variable SDRR y no encontraron diferencias significativas entre los dos grupos, lo cual, se esperaba por el efecto que sobre la VFC tiene el mayor tono vagal. El resultado lo atribuyen a la disfunción del sistema nervioso autónomo y presencia de anticuerpos antimuscarinicos en estos pacientes.…”

Section: Resultados Y Discusiónunclassified

Variabilidad de la frecuencia cardiaca en pacientes con cardiopatía chagásica

Corredor-Matus

Riveros-Sanabria

Corredor-Mesa

2020

Rev. U.D.C.A Act. & Div. Cient.

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Se estima la prevalencia por Trypanosoma cruzi de 436.000 habitantes en Colombia, con casos anuales de 5.250, en población expuesta de 4.792.000 habitantes. La variabilidad de la frecuencia cardiaca (VFC) es la variabilidad en el tiempo, de un latido cardiaco, medido en un análisis de periodo temporal determinado. Su análisis permite determinar el equilibrio simpático-vagal de manera indirecta. Este estudio analizó las variables temporales y No lineales, en 19 pacientes Chagásicos y 19 controles, utilizándose un polígrafo de alta resolución y el software Kubios. La variable Desviación Estandar del Intervalo RR (SDRR) en la población control arrojó un promedio de 56,23±29,6ms vs 40,62±30,1ms, en los seropositivos; La Raíz Cuadrada del Promedio de la Suma de las Diferencias al Cuadrado de todos los intervalos Adyacentes (RMSSD) fue de 34,31±21,01ms y 31,94±37,33ms, para controles y Chagas, respectivamente. El número de los intervalos RR consecutivos, que difieren en más de 50ms entre sí (NN50), en controles 76,47±78,3 latidos vs 13,47±36,8 para seropositivos, que correspondió con el porcentaje de NN50 (pNN50) 12,3±13,3% y 2,64±6,0%, respectivamente, para el mismo orden de los grupos. Valores de Entropía Aproximada (ApEn) fueron 1,249±0,134, para controles y 0,959±0,325, para seropositivos y para la Entropía Muestral (SampEn) fue de 1,358±0,264 y 1,102±0,385, para controles y chagásicos, respectivamente. Se encontró mayor irregularidad de HRV en controles, que es reflejo de un mejor estado de salud.

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Section: Resultados Y Discusiónunclassified

Variabilidad de la frecuencia cardiaca en pacientes con cardiopatía chagásica

Corredor-Matus

Riveros-Sanabria

Corredor-Mesa

2020

Rev. U.D.C.A Act. & Div. Cient.

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“…Since an exacerbated inflammatory response is an important mechanism involved in the development of CHD [ 46 ] and because several studies have been demonstrating an important anti-inflammatory property of exercise training [ 47 ], a decrease in the serum levels of pro-inflammatory cytokines and an increase in the serum levels of anti-inflammatory cytokines in patients with CHD in the exercise group is expected. Although enhancements in autonomic function as results of exercise training are present in studies with other cardiomyopathies [ 48 ], a recent article did not confirm this finding in patients with CHD [ 30 ]. We also hypothesize that cardiac function will improve by an increase in LVEF and an improvement in diastolic function, as seen in coronary artery disease [ 49 ], and that exercise will improve body composition, respiratory strength, microvascular reactivity, and oxidative stress agents based on results from studies evaluating exercise in non-CHD patients [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…Only tracings of at least 18 h will be studied. Standard time-domain HRV indices (SDNN: standard deviation of normal-to-normal RR intervals; SDANN: standard deviation of the averages of normal-to-normal RR intervals in all 5-min segments of a 24-h recording; SDNNIDX: mean of the standard deviations of normal-to-normal RR intervals in all 5-min segments of a 24-h recording; rMSSD: root mean square of successive differences; and PNN >50: percentage of differences between adjacent normal-to-normal RR intervals that are greater than 50 ms) and frequency domain (TP: total power; VLFP: very low-frequency power; LFP: low-frequency power; HFP: high-frequency power) will be calculated [ 30 – 32 ].…”

Section: Methodsmentioning

confidence: 99%

Effect of physical exercise training in patients with Chagas heart disease: study protocol for a randomized controlled trial (PEACH study)

Mendes

Sousa

Souza

et al. 2016

Trials

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Background: The effects of exercise training on Chagas heart disease are still unclear. This study aimed to evaluate the effect of exercise training over functional capacity, cardiac function, quality of life, and biomarkers in Chagas heart disease. Methods: The PEACH study is a superiority randomized clinical trial which will include subjects who meet the following criteria: Chagas heart disease with a left ventricular ejection fraction below 45 % with or without heart failure symptoms; clinical stability in the last 3 months; adherence to clinical treatment; and age above 18 years. The exclusion criteria are: pregnancy; neuromuscular limitations; smoking; evidence of non-chagasic heart disease; systemic conditions that limit exercise practice or cardiopulmonary exercise test; unavailability to attend the center three times a week during the intervention period; and practitioners of regular exercise. The intervention group will perform an exercise training intervention three times per week during 6 months and will be compared to the control group without exercise. Both groups will undergo the same monthly pharmaceutical and nutritional counseling as well as standard medical treatment according to the Brazilian consensus on Chagas disease. The primary outcome is functional capacity based on peak exercise oxygen consumption during cardiopulmonary exercise testing. Secondary outcomes are: cardiac function; body composition; muscle respiratory strength; microvascular reactivity; cardiac rhythm abnormalities; autonomic function; biochemical; oxidative stress and inflammatory biomarkers; and quality of life. Subjects will be evaluated at baseline, and at 3 and 6 months after randomization. Thirty patients will be randomly assigned into exercise or control groups at a ratio of 1:1.

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“…All of these findings stress the importance of the present study and identify the need for further studies to determine the reduction in exercise capacity in the early stages of Chagas disease and evaluate the role of exercise training in its treatment. As the authors observed, small studies have demonstrated the benefit of physical rehabilitation in the general well-being, functional capacity, autonomic heart control, respiratory muscle strength, and quality of life of CHD patients [17][18][19][20] . Larger studies on the implementation and cost-effectiveness of this muchvalued therapeutic approach are welcome and can contribute to the general goal of improving quality of life in patients with this highly neglected tropical disease.…”

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confidence: 91%