Predictors of exercise training response in heart failure patients
| Grant number: | 14/11671-6 |
| Support type: | Scholarships in Brazil - Post-Doctorate |
| Effective date (Start): | October 01, 2014 |
| Effective date (End): | September 30, 2019 |
| Field of knowledge: | Health Sciences - Medicine |
| Cooperation agreement: | Coordination of Improvement of Higher Education Personnel (CAPES) |
| Principal Investigator: | Carlos Eduardo Negrão |
| Grantee: | Allan Robson Kluser Sales |
| 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 |
| Associated scholarship(s): | 17/25613-6 - Habitual aerobic exercise decreases endothelin-1 and restores insulin-induced vasodilation in patients with type 2 diabetes: role shear stress, BE.EP.PD |
Abstract The continuous moderate aerobic training (CMT) has been successfully used in reducing the sympathetic nervous activity in patients with heart failure and autonomic changes that seem to be explained, at least in part, by improvement in sensitivity of arterial baroreceptors, peripheral chemoreceptors and (mechano/metaboreceptors) muscle ergoreceptors. The high intensity interval training (HIIT), stimuli that alternate high and moderate intensities, has been shown safe and seems to overcome the effects of CMT in improved endothelial function and increased functional capacity in patients with heart failure. What is not known is whether the HIIT also causes improvement in controls peripheral reflexes that regulate sympathetic nerve activity. And how these effects HIIT if compare to the CMT. To answer this two questions, patients with heart failure, aged 35 to 60 years, ejection fraction <40%, II-III NYHA functional class will be consecutively and randomly divided into three groups: 1) HIIT Group, n=15; 2) CMT Group, n=15 e; 3) Control, no training (NT Group = 15). Muscle sympathetic nerve activity will be evaluated directly by Microneurography technique, muscle blood flow by both venous occlusion plethysmography and Ultrasound, blood pressure continuously heartbeat by Finometer and heart rate (HR) by ECG. Arterial baroreflex sensitivity will be evaluated by spontaneous method (auto-regressive), the peripheral chemoreflex sensitivity by isocapnic hypoxia induced by inhalation of a gas mixture (10% O2 and 90% N2) and controls muscle mechano/metaboreflex by passive exercise and occlusion circulatory after exercise, respectively. Biopsy samples from the vastus lateralis of the thigh will be used for analysis of the intracellular mechanisms that modulate muscle ergoreflex control. Both models of training will be conducted on a cycle ergometer for lower limbs for a period of 12 weeks, with a frequency of 3 times per week. HIIT is performed in cycles of 2 minutes at a stimulus equal to 5% above of HR of the respiratory compensation point and a 2 min corresponding to the HR of anaerobic threshold. The MCT will be performed in the HR corresponding average interval between the anaerobic threshold and respiratory compensation point. The duration of the session in each type of training is equivalent to an energy expenditure of 200 kilocalories. The patients in the NT group will receive good practice guidance and self-monitoring of heart failure. (AU) | |