Análise da variabilidade da freqüência cardíaca em pacientes hipertensos, antes e depois do tratamento com inibidores da enzima conversora da angiotensina II

Abstract

169The autonomic nervous system (ANS) plays a fundamental role in the control of arterial blood pressure and heart rate, and, therefore, may be considered an important pathophysiologic factor in the development of arterial hypertension 1 . Currently, the status of autonomic action of the heart may be known through the study of heart rate variability. Heart rate varies per beat as a consequence of the constant adaptations promoted by the ANS to maintain cardiovascular system balance. These alterations may be assessed through the variations in R-R intervals, therefore, constituting the heart rate variability 2 . The integration between the sympathetic and parasympathetic modulations determines heart rate variability 3 . As a research tool, assessment of heart rate variability has provided a better understanding of the participation of the ANS in different physiological and pathological situations of the cardiovascular system. The assessment of heart rate variability has stimulated a large number of observations, indicating the potential value of that approach in the diffusion of knowledge about the alterations in the mechanisms of blood pressure control involved in hypertension 4-6 .The existence of sympathetic hyperactivity has been frequently associated with arterial hypertension 7,8 . Evidence exists indicating that the sensitivity of baroreceptor control, impaired in some hypertensive individuals 9-11 , involves mainly parasympathetic mechanisms 12-14 .Although several studies indicate that sympathetic and parasympathetic alterations are simultaneously involved in the pathogenesis and development of arterial hypertension, the results obtained using heart rate variability are controversial. Populationbased studies have reported reduced heart rate variability in patients with long-term arterial hypertension, despite treatment with antihypertensive drugs 15 . However, one does not know whether abnormal autonomic cardiovascular regulation is a primary characteristic preceding the onset of hypertension, or whether it may be reversed with antihypertensive therapy. In addition, it is not known whether the improvement in autonomic regulation is related to a reduction in blood pressure or whether it is an immediate effect of the drug 16 . The present study aimed at analyzing and comparing heart rate variability in normotensive and hypertensive individuals and at observing the behavior of the ANS after administration of ACE inhibitors to these hypertensive patients. Original Article Analysis of Heart Rate Variability in Hypertensive Patients Before and After Treatment with Angiotensin II-Converting Enzyme Inhibitors ResultsThe SDNN and PNN50 parameters (TD), and the LF spectrum (FD)

Elastase-2, a Tissue Alternative Pathway for Angiotensin II Generation, Plays a Role in Circulatory Sympathovagal Balance in Mice

“…However, the LF power of the pulse interval spectrum and LF/HF ratio were reduced, whereas the HF was increased in ELA-2KO mice, indicating a sympathovagal balance with a shift toward parasympathetic modulation of the heart. Clinical and experimental studies that evaluated heart rate variability after inhibition of ACE in cardiovascular disease also led to an increase in HF oscillations and decrease in both LF oscillations and the LF/HF ratio (Menezes et al, 2004; Albarwani et al, 2013; Chompoosan et al, 2014). These data indicate that the prevailing sympathetic drive observed in cardiovascular diseases can be blunted by ACE inhibition and its consequent reduction of Ang II availability.…”

Efeitos da aplicação da terapia combinada pulsada associada à corrente excitomotora de média frequência sob a redução de gordura localizada abdominal em mulheres

“…Research, Society and Development, v. 9, n. 11, e36691110086, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i11.10086 A corrente russa, é classificada de média frequência que pode ser modulada em "rajadas" ou "burst" com fins excitomotores. O protocolo de aplicação da corrente foi baseado em Borges (2010) No domínio do tempo foram analisados os índices RMSSD (à raiz quadrada da média do quadrado das diferenças entre os intervalos RR normais adjacentes em um intervalo de tempo expresso em milissegundos [ms]) e SDNN (desvio padrão de todos os intervalos RR normais gravados em um intervalo de tempo, expresso em ms) (Vanderlei, et al, 2009;Menezes et al, 2004;Teixeira, et al, 2011).…”

“…Além disso, a VFC é um método não invasivo, de fácil execução e alta reprodutibilidade. (Vanderlei, et al, 2009;Menezes, et al, 2004) Portanto o objetivo deste estudo é verificar se a aplicação da terapia combinada Research, Society and Development, v. 9, n. 11, e36691110086, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i11.10086 4 associada à estimulação elétrica neuromuscular pode reduzir a gordura acumulada na abdominal, devido aos seus efeitos fisiológicos promovidos no tecido adiposo, e assim alcançar influências no sistema cardiovascular e na resposta autonômica, quando aplicado de maneira aguda e/ou crônica.…”

Efeito da música na modulação autonômica da frequência cardíaca em cardiopatas

“…A variabilidade da frequência cardíaca (VFC) é definida como as oscilações dos intervalos entre batimentos cardíacos consecutivos (intervalos RR), sendo principalmente dependente da regulação extrínseca da FC. Bem como, a VFC retrata a capacidade do coração de se moldar à certas eventualidades, reagindo de forma ativa aos inesperados estímulos (Acharya et al, 2006. A manifestação de eventos cardíacos, retratam um significativo motivo de diminuição na VFC, em indivíduos teoricamente saudáveis (Rebelo et al, 2013;Neves et al, 2006;Ribeiro et al, 2001), cardiopatas (Kunzat al., 2012;Novais et al, 2004;Kleiger et al, 1987) bem como obesos (Paschoal, Trevizan & Scodeler, 2009), pessoas com diabetes tipo 2 (Menezes, Moreira & Daher, 2004) e hipertensão arterial sistêmica (HAS) (Schmid, Neumann & Brugnara, 2003); sendo essa atenuação relativa a uma diminuição da atividade vagal ou aumento da simpática (Menezes, Moreira & Daher, 2004;Task, 1996).…”