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Effects of Aerobic Exercise Training Associated with Inspiratory Muscle Training on Skeletal Myopathy in Patients with Heart Failure

Grant number: 13/15651-7
Support type:Scholarships in Brazil - Post-Doctorate
Effective date (Start): October 01, 2013
Effective date (End): September 30, 2017
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Carlos Eduardo Negrão
Grantee:Lígia de Moraes Antunes Corrêa
Home Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
Associated research grant:15/22814-5 - Cancer and heart: new paradigms of diagnosis and treatment, AP.TEM

Abstract

The most typical symptoms of heart failure (HF) are dyspnea and exercise intolerance. Sympathetic hyperactivation, the hallmark of HF, contributes significantly to peripheral vasoconstriction. The muscle blood flow (MBF) reduction increases oxidative stress, pro-inflammatory cytokines and contributes to changes in the phenotype of skeletal muscle. Together, these alterations lead to skeletal myopathy and reduced functional capacity in HF patients. Accumulated evidence has shown that exercise training (ET) is a safe and effective non-pharmacological therapy to the treatment of HF patients. ET improves functional capacity and quality of life in these patients. In addition, ET decreases sympathetic nerve activity and increases MBF. These responses substantially contribute to the improvement in skeletal myopathy. Recently, inspiratory muscle training (IMT) has emerged as an alternative to the treatment of HF patients. The IMT improves functional capacity and quality of life and, in addition, reduces sympathetic nerve activity and increases MBF. Thus, it is possible to hypothesize that the combination of these two non-pharmacological therapies will potentate the benefits in the treatment of HF patients. The present study aims to investigate whether the increase in the MBF after the aerobic ET plus IMT is associated with neurovascular control and angiogenic factors in HF patients. In addition, we will investigate the consequences of the increase in MBF on pro-inflammatory cytokines, oxidative stress and muscle protein balance. Finally, we will investigate the clinical implications of the changes in skeletal myopathy on exercise tolerance and quality of life of these patients.

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Scientific publications (8)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
GROEHS, RAPHAELA V.; TOSCHI-DIAS, EDGAR; ANTUNES-CORREA, LIGIA M.; TREVIZAN, PATRICIA F.; RONDON, MARIA URBANA P. B.; OLIVEIRA, PATRICIA; ALVES, MARIA J. N. N.; ALMEIDA, DIRCEU R.; MIDDLEKAUFF, HOLLY R.; NEGRAO, CARLOS E.. Exercise training prevents the deterioration in the arterial baroreflex control of sympathetic nerve activity in chronic heart failure patients. AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, v. 308, n. 9, p. H1096-H1102, . (13/07651-7, 10/50048-1, 13/15651-7)
BOUCHARD, CLAUDE; ANTUNES-CORREA, LIGIA M.; ASHLEY, EUAN A.; FRANKLIN, NINA; HWANG, PAUL M.; MATTSSON, C. MIKAEL; NEGRAO, CARLOS E.; PHILLIPS, SHANE A.; SARZYNSKI, MARK A.; WANG, PING-YUAN; et al. Personalized Preventive Medicine: Genetics and the Response to Regular Exercise in Preventive Interventionse. PROGRESS IN CARDIOVASCULAR DISEASES, v. 57, n. 4, p. 337-346, . (13/07607-8, 10/50048-1, 13/15651-7)
NEGRAO, CARLOS E.; MIDDLEKAUFF, HOLLY R.; GOMES-SANTOS, IGOR L.; ANTUNES-CORREA, LIGIA M.. Effects of exercise training on neurovascular control and skeletal myopathy in systolic heart failure. AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, v. 308, n. 8, p. H792-H802, . (10/50048-1, 14/13690-8, 13/15651-7)
ANTUNES-CORREA, LIGIA M.; TREVIZAN, PATRICIA F.; BACURAU, ALINE V. N.; FERREIRA-SANTOS, LARISSA; GOMES, JOAO L. P.; URIAS, URSULA; OLIVEIRA, PATRICIA A.; ALVES, MARIA JANIEIRE N. N.; DE ALMEIDA, DIRCEU R.; BRUM, PATRICIA C.; et al. Effects of aerobic and inspiratory training on skeletal muscle microRNA-1 and downstream-associated pathways in patients with heart failure. JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE, . (15/22814-5, 13/15651-7)
SARMENTO, ADRIANA OLIVEIRA; ANTUNES-CORREA, LIGIA M.; ALVES, MARIA J. N. N.; BACURAU, ALINE V. N.; FONSECA, KEILA C. B.; PESSOA, FERNANDA G.; LOBO, DENISE M. L.; MOREIRA, LEILA D. P.; TROMBETTA, IVANI C.; RONDON, MARIA U. P. B.; et al. Effect of exercise training on cardiovascular autonomic and muscular function in subclinical Chagas cardiomyopathy: a randomized controlled trial. CLINICAL AUTONOMIC RESEARCH, v. 31, n. 2, . (13/15651-7, 11/17533-6, 10/50048-1)
GROEHS, RAPHAELA V.; ANTUNES-CORREA, LIGIA M.; NOBRE, THAIS S.; ALVES, MARIA-JANIEIRE N. N.; RONDON, MARIA URBANA P. B.; PEREIRA BARRETO, ANTONIO CARLOS; NEGRAO, CARLOS E.. Muscle electrical stimulation improves neurovascular control and exercise tolerance in hospitalised advanced heart failure patients. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, v. 23, n. 15, p. 1599-1608, . (10/50048-1, 13/15651-7)
ANTUNES-CORREA, LIGIA M.; UENO-PARDI, LINDA M.; TREVIZAN, PATRICIA F.; SANTOS, MARCELO R.; DA SILVA, CARLOS HENRIQUE P.; FRANCO, FABIO G. M.; ALVES, MARIA JANIEIRE N. N.; RONDON, MARIA URBANA P. B.; NEGRAO, CARLOS E.. The influence of aetiology on the benefits of exercise training in patients with heart failure. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, v. 24, n. 4, p. 365-372, . (10/50048-1, 13/15651-7)
TREVIZAN, PATRICIA F.; ANTUNES-CORREA, LIGIA M.; LOBO, DENISE M. L.; OLIVEIRA, PATRICIA A.; DE ALMEIDA, DIRCEU R.; ABDUCH, MARIA CRISTINA D.; MATHIAS JUNIOR, WILSON; HAJJAR, LUDHMILA ABRAHAO; KALIL FILHO, ROBERTO; NEGRAO, CARLOS EDUARDO. Effects of inspiratory muscle training combined with aerobic exercise training on neurovascular control in chronic heart failure patients. ESC HEART FAILURE, v. 8, n. 5, p. 3845-3854, . (15/22814-5, 13/15651-7)

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