Effect of high intensity interval training versus continuous moderate in the peripheral reflex mechanisms of control of the sympathetic activity in patients with heart failure

• 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 researcher: 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)

Scientific publications

(5)

(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)

KLUSER SALES, ALLAN ROBSON; NEGRAO, MARCELO VAILATI; TESTA, LAURA; FERREIRA-SANTOS, LARISSA; RAMALHO GROEHS, RAPHAELA VILLAR; CARVALHO, BRUNA; TOSCHI-DIAS, EDGAR; ROCHA, NATALIA GALITO; MARTINS LAURINDO, FRANCISCO RAFAEL; DEBBAS, VICTOR; et al. Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer. AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, v. 317, n. 1, p. H1-H12, JUL 2019. (14/11671-6, 15/22814-5)

SALES, ALLAN R. K.; AZEVEDO, LUCIENE F.; SILVA, THIAGO O. C.; RODRIGUES, AMANDA G.; OLIVEIRA, PATRICIA A.; JORDAO, CAMILA P.; ANDRADE, ANA C. M.; URIAS, URSULA; GUIMARAES, GUILHERME V.; BOCCHI, EDIMAR A.; et al. High-Intensity Interval Training Decreases Muscle Sympathetic Nerve Activity and Improves Peripheral Vascular Function in Patients With Heart Failure With Reduced Ejection Fraction. Circulation-Heart Failure, v. 13, n. 8, AUG 2020. (15/22814-5, 17/25613-6, 10/08990-1, 14/11671-6)

PARK, LAUREN K.; PARKS, ELIZABETH J.; PETTIT-MEE, RYAN J.; WOODFORD, MAKENZIE L.; GHIARONE, THAYSA; SMITH, JAMES A.; SALES, ALLAN R. K.; MARTINEZ-LEMUS, LUIS A.; MANRIQUE-ACEVEDO, CAMILA; PADILLA, JAUME. Skeletal muscle microvascular insulin resistance in type 2 diabetes is not improved by eight weeks of regular walking. Journal of Applied Physiology, v. 129, n. 2, p. 283-296, AUG 2020. (17/25613-6, 14/11671-6)

SILVA, THIAGO O. C.; SALES, ALLAN R. K.; ARAUJO, GUSTAVO S. M.; FONSECA, GUILHERME W. P.; BRAGA, PEDRO G. S.; FARIA, DIEGO; ROCHA, HELENA N. M.; ROCHA, NATALIA G.; LIMA, MARTA F.; MADY, CHARLES; et al. Disturbed Blood Flow Acutely Increases Endothelial Microparticles and Decreases Flow Mediated Dilation in Patients With Heart Failure With Reduced Ejection Fraction. FRONTIERS IN PHYSIOLOGY, v. 12, MAR 11 2021. (15/22814-5, 14/11671-6, 17/25613-6)

PECANHA, TIAGO; MEIRELES, KAMILA; PINTO, ANA JESSICA; NUNES REZENDE, DIEGO AUGUSTO; IRAHA, AMANDA YURI; MAZZOLANI, BRUNA CARUSO; SMAIRA, FABIANA INFANTE; KLUSER SALES, ALLAN ROBSON; BONFIGLIOLI, KARINA; DE SA-PINTO, ANA LUCIA; et al. Increased sympathetic and haemodynamic responses to exercise and muscle metaboreflex activation in post-menopausal women with rheumatoid arthritis. JOURNAL OF PHYSIOLOGY-LONDON, v. 599, n. 3, NOV 2020. (15/26937-4, 19/07150-4, 17/13552-2, 19/14819-8, 14/11671-6)