Cardiovascular and autonomic responses to maximal exercise in men and women with intermittent claudication.

Author(s)

Roberto Sanches Miyasato

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Escola de Educação Física e Esportes (EEFE/BT)
• Defense date: 2019-11-06

Examining board members

Cláudia Lúcia de Moraes Forjaz; Kátia de Angelis Lobo D'Avila; Aluisio Henrique Rodrigues de Andrade Lima; Maria Urbana Pinto Brandão Rondon

• Advisor: Cláudia Lúcia de Moraes Forjaz

Abstract

Peripheral artery disease (PAD) is characterized by the presence of obstructions in the lower limb arteries, which reduce blood flow to the muscles, causing pain during exercise (i.e. intermittent claudication - IC). Walking is recommended to the treatment of this disease, but its execution causes cardiovascular responses different from those observed in healthy individuals. These responses have been investigated in men with PAD and IC, but although the disease is equally prevalent between the sexes and its functional consequences are greater in women, the acute responses to walking have not been investigated in females. Thus, the aim of this study was to evaluate and compare functional, cardiovascular and autonomic responses to a walking session until maximal pain in men and women with PAD and IC. For this, 40 subjects with PAD and IC (20 men and 20 women) underwent, in a random order, two experimental sessions: control (resting on a treadmill) and exercise (maximal treadmill cardiopulmonary test following Gardners protocol). During the exercise, different indices of functional capacity and the cardiovascular responses (heart rateHR and blood pressure-BP) at submaximal (1st stage) and maximal (peak) workloads were assessed. In addition, pre and post-exercise, cardiovascular (BP, HR, cardiac output, peripheral vascular resistance and stroke volume-SV) and autonomic (HR and BP variabilities as well as baroreflex sensitivity-BRS) variables were measured. After the sessions, ambulatory BP monitoring was performed for 24h. Data between sexes were compared by Student\'s t-tests and 2 and 3-way ANOVAs, considering P <0.05 as significant. There was no difference in functional capacity assessed by initial and maximal claudication distances as well as by VO2peak and VO2at the first stage of the test. There were no differences in systolic BP and HR measured at submaximal and maximal workloads .Post-exercise cardiovascular and autonomic responses were also similar between the sexes with previous exercise decreasing clinic systolic BP, but this effect was not sustained during the post-exercise ambulatory period. BP decrease was accompanied by a decrease in SV and an increase in HR, while autonomic function variables did not change except for total variance of HR that did not change in exercise the session but increased in control session. In conclusion, men and women with PAD and IC present similar functional capacity as well as cardiovascular and autonomic responses during and after a walking (AU)

• FAPESP's process: 17/12973-4 - Cardiovascular and autonomic responses to maximal exercise in men and women with intermittent claudication
• Grantee: Roberto Sanches Miyasato
• Support Opportunities: Scholarships in Brazil - Master